REtiring Well: defining an Index of Risk and modelling of an Effective integrated cognitive-physical intervention (REWIRE)

PRIN 2022 Tessari

Abstract

In Europe, retirement occurs on average around 62–63 years of age, while the subsequent life expectancy can exceed twenty years. Retirement is therefore not a concluding event, but the beginning of a long phase in which preserving mental health, cognitive functioning, autonomy and the quality of relationships becomes essential. The literature shows that retirement can be experienced as an opportunity for freedom and reorganization of time, but also as a stressful event, associated with loss of role, reduction of social networks, difficulties in adaptation, anxiety, depression and possible cognitive decline. REWIRE was created to study this transition through a multidimensional approach. REWIRE studies the transition to retirement as a critical phase for psychological, cognitive and social well-being. The objective is to identify risk and protective factors — loneliness, depression, anxiety, stress, cognitive reserve, physical activity, personality, occupational conditions, social networks and lifestyles — in order to build a Retirement Risk Index, a predictive tool useful for identifying vulnerable individuals and guiding preventive interventions. The project, carried out by the University of Bologna and the University of Pavia, is structured in two phases: a longitudinal assessment phase before and after retirement and a phase devoted to the development of an integrated physical-cognitive intervention.

Results achieved

Scientific activities were organized into three areas: literature review, REWIRE Phase 1 and REWIRE Phase 2. The systematic review built the theoretical framework by analyzing studies on retirement, psychological well-being, cognitive functions, health, individual differences and lifestyles, with particular attention to physical health, economic conditions, social participation, cognitive resources and family relationships. A specific in-depth analysis concerned integrated physical-cognitive interventions and executive functions, which are fundamental for autonomy and particularly sensitive to ageing. Phase 1 aimed to identify psychological, cognitive, social and behavioral predictors of early adaptation to retirement. The longitudinal design included four assessment points: before retirement (3 months before leaving work), and then at 3, 6 and 12 months after retirement. This structure makes it possible to observe the evolution of individual profiles and distinguish factors preceding and following the transition. The instruments adopted cover eight domains: psychological and emotional well-being, psychological resources and coping, personality, health and lifestyles, social and relational functioning, occupational factors, attitudes toward retirement and cognitive performance. The measures include scales assessing loneliness, depression, anxiety, stress, self-efficacy, cognitive reserve, psychological well-being, personality and somatic symptoms, as well as information on health, diet, sleep, social networks, occupational category, economic satisfaction and expectations regarding retirement. Cognitive assessment includes online tasks measuring memory and executive functions: word recognition, digit span backward, Go/No-Go and letter-digit task. Recruitment was based on a broad network of territorial and institutional collaborations. Welfare organizations, trade unions, associations, healthcare bodies, companies, sports organizations and communication agencies were involved. Partners and stakeholders included CISL, CGIL, INAPA, INAC, EPACA, EPASA-ITACO, PREVINDAI, ASST Lombardia, AUSL Bologna, HERA, Bonsay and UISP, as well as local institutions and recreational associations. Outreach activities included informational materials, videos, newsletters, dedicated meetings and a website. This strategy proved crucial in reaching individuals approaching retirement and ensuring a heterogeneous sample. Preliminary analyses of Phase 1 focused on T0–T1 data (before retirement and 3 months after retirement). At the time of reporting, 719 participants had completed the initial assessment. Analyses were conducted on subsets of the sample in order to validate statistical models in a timely manner. The results support the central hypothesis of the project: adaptation to retirement does not depend on a single element, but on the interaction of multiple factors. Perceived loneliness emerged as a particularly relevant variable, associated with worsening depressive symptoms and reductions in working memory. Gender and occupational category also appear to influence cognitive trajectories. These findings confirm the importance of social relationships and individual resources in protecting psychological well-being and cognitive functioning. Phase 2 developed an integrated physical-cognitive intervention aimed at modulating cognitive performance and psychological well-being among newly retired individuals. The literature suggests that physical activity may support brain plasticity, memory, executive functions and mental health, but interventions specifically targeting the early retirement phase remain limited. REWIRE therefore proposes a protocol integrating movement, cognitive stimulation and socialization. An initial analysis of physical activity data from Phase 1 examined total activity, walking, moderate activity and vigorous activity. The results did not indicate uniform effects on anxiety, stress and depression; however, walking was associated with lower depressive symptoms, with a relationship that tended to strengthen over time. This suggests that accessible, low-intensity activities may play a protective role. To define the protocol, the research team conducted a preliminary study involving healthy older adults, comparing open-skill activities, closed-skill activities and a sedentary control condition. Open-skill activities require environmental monitoring, continuous adaptation, cognitive flexibility and dynamic planning, whereas closed-skill activities are more repetitive. Results showed immediate benefits of physical activity on memory, with a specific advantage of open-skill activities on audiovisual perceptual sensitivity. This guided the project toward exercises capable of combining motor and cognitive demands. The final Phase 2 protocol consists of 45-minute sessions twice per week for six months. Activities train three executive functions: working memory, cognitive flexibility and inhibitory control. Working memory is stimulated through word memorization games during cardiovascular activation; cognitive flexibility through transitions between motor patterns and choreographies in response to external signals; inhibitory control through numerical tasks performed during resistance exercises. Difficulty increases progressively, and activities are conducted in groups, promoting social participation, motivation and continuity. Phase 2 of REWIRE is currently still ongoing within several organizations across the Metropolitan City of Bologna, having received considerable interest from professionals in the field. The main challenges concern recruitment complexity and technological hesitancy among the target population. The online format is sustainable and consistent with the DNSH principles, but it may represent a barrier for some individuals approaching retirement. To mitigate this issue, the team expanded the network of partners, strengthened communication activities, provided supervised support for questionnaires and tests, introduced systematic reminders and increased qualified personnel. Data cleaning procedures also allowed the exclusion of cases with implausible cognitive performances, thereby preserving the reliability of the analyses. REWIRE complies with the principles of DNSH, Open Access, gender equality, generational equity and equal opportunities. Digital activities reduce the use of paper, materials, travel and emissions. Data are managed through university platforms and will be made available at the end of the project according to FAIR principles. Publications currently in preparation will be oriented toward open access and will use institutional repositories such as AMS Acta and IRIS, as well as the project website (https://site.unibo.it/rewire/it). Dissemination activities are already active at multiple levels. The project has been presented at the XXXIV Alzheimer Europe Conference, the European Researchers’ Night and the XII Social Affairs Committee of the Italian Chamber of Deputies. It has also received visibility through newspapers (e.g., Corriere della Sera) and digital channels. Planned publications concern predictors of successful retirement, the relationship between lifestyles and cognitive performance, validation of assessment tools, online assessment methodology for older adults and the results of the physical-cognitive intervention. The REWIRE website will also host a future risk calculator and informational materials accessible to the public. In conclusion, REWIRE demonstrates strong scientific, social and practical potential. Initial evidence indicates that loneliness is a crucial risk factor for psychological well-being and cognitive functioning, while accessible physical activities such as walking may contribute to the protection of well-being. The future Retirement Risk Index could become a useful tool for the early identification of vulnerable individuals and for guiding personalized interventions. In the long term, the model could be transferred to healthcare services, municipalities, welfare organizations, associations and organizations involved in active-ageing policies, contributing to more effective prevention of psychological and cognitive decline during the transition to retirement.

Dettagli del progetto

Responsabile scientifico: Alessia Tessari

Strutture Unibo coinvolte:
Dipartimento di Psicologia "Renzo Canestrari"

Coordinatore:
ALMA MATER STUDIORUM - Università di Bologna(Italy)

Contributo totale di progetto: Euro (EUR) 202.368,00
Contributo totale Unibo: Euro (EUR) 123.623,00
Durata del progetto in mesi: 24
Data di inizio 18/10/2023
Data di fine: 28/02/2026

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