@article {12543, title = {Access to Disease-Modifying Alzheimer{\textquoteright}s Therapies: Addressing Possible Challenges Using Innovative Payment Models.}, journal = {Value in Health}, year = {Forthcoming}, abstract = {

OBJECTIVES: Aduhelm is the first approved disease-modifying therapies (DMT) for Alzheimer disease (AD). Nevertheless, under current payment models, AD DMTs-especially because they treat broader populations-will pose challenges to patient access since costs may accrue sooner than benefits do. New payment approaches may be needed to address this difference in timing.

METHODS: We use the Future Elderly Model that draws on nationally representative data sets such as the Health and Retirement Study to estimate the potential benefits because of hypothetical AD DMTs in 4 stylized treatment scenarios for patients with mild cognitive impairment or mild AD, and develop a payment model to estimate the accrual of net costs and benefits to private and public payers.

RESULTS: The modeled AD DMTs result in clinical benefit of 0.30 to 0.55 quality-adjusted life-years gained per patient in the baseline treatment scenario and 0.13 to 0.24 quality-adjusted life-years gained per patient in the least optimistic scenario. Private payers may observe a net loss in patients at the age of 61 to 65 years under the status quo (payment upon treatment). Constant and deferred installment payment models resolve this issue.

CONCLUSIONS: Innovative payment solutions, such as installment payments, may be required to address misaligned incentives that AD DMTs may create among patients younger than the age of 65 years and may help address concerns about the timing and magnitude of costs and benefits accrued to private payers.

}, keywords = {disease-modifying therapies, payment, prescription drugs}, issn = {1524-4733}, doi = {10.1016/j.jval.2022.06.003}, author = {Hl{\'a}vka, Jakub P and Tysinger, Bryan and Yu, Jeffrey C and Lakdawalla, Darius N} } @article {13821, title = {Age Differences Experiences of Pandemic-related Health and Economic Challenges among Adults Aged 55 and Older.}, journal = {The Gerontologist}, year = {Forthcoming}, abstract = {

BACKGROUND AND OBJECTIVES: The oldest adults faced the highest risk of death and hospitalization from COVID-19, but less is known about whether they also were the most likely to experience pandemic-related economic, health care, and mental health challenges. Guided by prior research on vulnerability versus resilience among older adults, the current study investigated age differences in economic hardship, delays in medical care, and mental health outcomes among adults aged 55 and older.

RESEARCH DESIGN AND METHODS: Data were from the COVID-19 module and Leave Behind Questionnaire in the 2020 Health and Retirement Study (HRS). We estimated linear probability models to examine differences in experiences of pandemic-related economic and health challenges by age group (55-64, 65-74, 75+) with and without controls for preexisting sociodemographic, social program, health, and economic characteristics from the 2018 HRS. Models accounting for differential mortality also were estimated.

RESULTS: Adults aged 65-74 and 75+ experienced fewer economic and mental health challenges and those aged 75+ were less likely to delay medical care than adults aged 55-64. Age gradients were consistent across a broad range of measures and were robust to including controls. For all age groups, economic challenges were less common than delays in medical care or experiences of loneliness, stress, or being emotionally overwhelmed.

DISCUSSION AND IMPLICATIONS: Even though the oldest adults were at the greatest risk of death and hospitalization from COVID-19, they experienced fewer secondary pandemic-related challenges. Future research should continue to explore the sources of this resilience for older adults.

}, keywords = {Access to medical care, COVID-19, Economic hardship, Mental Health}, issn = {1758-5341}, doi = {10.1093/geront/gnae023}, author = {Wiemers, Emily E and Lin, I-Fen and Wiersma Strauss, Anna and Chin, Janecca and Hotz, V Joseph and Seltzer, Judith A} } @article {13792, title = {The Association of Allergy-Related and Non-Allergy-Related Olfactory Impairment with Cognitive Function in Older Adults: Two Cross-Sectional Studies.}, journal = {Current Alzheimer Research}, year = {Forthcoming}, abstract = {

BACKGROUND: Evidence on the association of Olfactory Impairment (OI) with age-related cognitive decline is inconclusive, and the potential influence of allergy remains unclear.

OBJECTIVE: We aimed to evaluate the cross-sectional associations of allergy-related and non-allergy- related OI to cognitive function.

METHODS: We included 2,499 participants from the Health and Retirement Study (HRS)-Harmonized Cognitive Assessment Protocol (HCAP) sub-study and 1,086 participants from the English Longitudinal Study of Ageing (ELSA)-HCAP. The Olfactory Function Field Exam (OFFE) using Sniffin{\textquoteright} Stick odor pens was used to objectively assess olfactory function and an olfactory score <6/11 indicated OI. Mini-Mental Status Examination (MMSE) was used to assess global cognitive function and define cognitive impairment (<24/30). A neuropsychologic battery was used to assess five cognitive domains.

RESULTS: Compared to non-OI participants, individuals with OI had lower MMSE z-score [βHRS = -0.33, 95\% Confidence Interval (CI): -0.41 to -0.24; βELSA = -0.31, -0.43 to -0.18] and higher prevalence of cognitive impairment [Prevalence Ratio (PR)HRS = 1.46, 1.06 to 2.01; PRELSA = 1.63, 1.26 to 2.11]. The associations were stronger for non-allergy-related OI (βHRS = -0.36; βELSA = -0.34) than for allergy-related OI (βHRS = -0.26; βELSA = 0.13). Similar associations were observed with domain- specific cognitive function measures.

CONCLUSION: OI, particularly non-allergy-related OI, was related to poorer cognitive function in older adults. Although the current cross-sectional study is subject to several limitations, such as reverse causality and residual confounding, the findings will provide insights into the OI-cognition association and enlighten future attention to non-allergy-related OI for the prevention of potential cognitive impairment.

}, keywords = {allergic status, cognitive domains, cognitive impairment, cross-- sectional studies., Global cognitive function, olfactory impairment}, issn = {1875-5828}, doi = {10.2174/0115672050284179240215052257}, author = {Chen, Hui and Ding, Yihong and Huang, Liyan and Zhong, Wansi and Lin, Xiaojun and Zhang, Baoyue and Zheng, Yan and Xu, Xin and Lou, Min and Yuan, Changzheng} } @article {13530, title = {Associations between psychological resilience and epigenetic clocks in the health and retirement study.}, journal = {GeroScience}, year = {Forthcoming}, abstract = {

The aim of this study was to evaluate the associations between psychological resilience and epigenetic clocks assessed by DNA methylation age predictions. We used data from 4018 participants in the Health and Retirement Study. Multivariable linear regression models were used to estimate the association between psychological resilience and epigenetic clocks adjusted for age, sex, race, body mass index, smoking status, and years of education. Thirteen epigenetic clocks were used in our analysis and were highly correlated with one another. A higher psychological resilience score was associated with slower DNA methylation age acceleration for the majority of epigenetic clocks after multivariable adjustment. These findings imply that people with a higher level of psychological resilience may experience slower DNA methylation age acceleration and biological aging.

}, keywords = {; DNA methylation, Agin, epigenetic clock, Resilience}, issn = {2509-2723}, doi = {10.1007/s11357-023-00940-0}, author = {Zhang, Aijie and Zhang, Yasi and Meng, Yaxian and Ji, Qianqian and Ye, Meijie and Zhou, Liqiong and Liu, Miao and Yi, Chao and Karlsson, Ida K and Fang, Fang and H{\"a}gg, Sara and Zhan, Yiqiang} } @article {13735, title = {Associations between self-perceptions of aging and social functioning in older adults: An analysis based on health and retirement study data.}, journal = {Archives of Gerontology and Geriatrics}, volume = {119}, year = {Forthcoming}, pages = {105307}, abstract = {

OBJECTIVES: Self-perception of aging (SPA) and social functioning are two important variables in the process of healthy aging, but the relationship between them is still unclear. This study aimed to explore the association between SPA and social functioning in older adults.

METHODS: We conducted a longitudinal study utilizing data from the Health and Retirement Study. The sample comprised individuals aged 50 and above. Socio-demographic, psychosocial, and lifestyle information of study participants was systematically collected at baseline (2012 and 2014) and during follow-up four years later (2016 and 2018). SPA was measured using a scale assessing individuals{\textquoteright} attitudes toward their aging process. Social functioning was evaluated through 22 questions, reflecting individuals{\textquoteright} abilities to engage in and perform various roles and tasks in their daily lives. Multilevel modeling was employed to analyze the relationship between SPA and social functioning. Differences in social functioning changes among various SPA groups were assessed through the Generalized Estimating Equations methodology.

RESULTS: The study included 8,454 participants with an average age of 68.3 years (SD~=~9.92). The multilevel model revealed a significant correlation between SPA and social functioning (β~=~0.131; P < 0.001). This relationship persisted after adjusting the model (β~=~0.088; P < 0.001). Generalized Estimating Equations indicated noteworthy differences in social functioning changes among distinct SPA groups (P~=~0.034).

DISCUSSION: Positive SPA is associated with the healthy social functioning of older adults. Healthcare providers could target modifiable aspects of SPA to enhance the social function of older adults and promote successful aging.

}, keywords = {Attitudes toward own aging, healthy aging, Human Activities}, issn = {1872-6976}, doi = {10.1016/j.archger.2023.105307}, author = {Cai, Yingying and Ren, Xiaohe and Wang, Jingyi and Hou, Yue and Zhang, Mengyuan and Chen, Ou} } @article {13882, title = {Associations of vegetable and fruit intake with cognitive function and its decline: Two longitudinal studies.}, journal = {The Journal of Nutrition, Health \& Aging}, volume = {28}, year = {Forthcoming}, pages = {100223}, abstract = {

OBJECTIVES: Previous studies suggested protective associations of vegetables and fruits (VF) intake with cognitive function, but evidence on specific types of VF was insufficient.

METHODS: The current study included 4066 participants from 1997 to 2006 in the China Health and Nutrition Survey (CHNS) and 6170 participants from 2013 to 2020 in the Health and Retirement Study (HRS). Dietary intake (using 3-day 24-h dietary recalls in CHNS and food frequency questionnaire in HRS) and cognitive function (using the Telephone Interview for Cognitive Status-Modified, TICS-m) were measured. Linear mixed-effects models were used to estimate the beta coefficients (β) and the 95\% confidence intervals (CI) to evaluate the association of VF with cognitive function (z-score) and its decline.

RESULTS: Highest intake of total VF was associated with better cognitive function and slower cognitive decline. Differences in cognitive function z-score between the highest and lowest tertiles of VF consumption were 0.039 (95\% CI: 0.002, 0.076) for CHNS and 0.063 (95\% CI: 0.026, 0.100) for HRS. The corresponding differences in annual cognitive decline were 0.011 (95\% CI: 0.002, 0.021) and 0.012 (95\% CI: 0.003, 0.020) units respectively. Vegetables and fruits showed independent associations with cognitive function and its decline. In specific VF subgroups, when comparing the highest to the lowest tertile intake, cruciferous vegetables (β = 0.058, 95\% CI: 0.017, 0.100 in CHNS and β = 0.067, 95\% CI: 0.032, 0.101 in HRS) and green leafy vegetables (β = 0.036, 95\% CI: -0.001, 0.073 in CHNS and β = 0.082, 95\% CI: 0.046, 0.117 in HRS) was associated with better cognitive function in both cohorts. Similarly, higher intake of dark-colored vegetables (β = 0.019, 95\% CI: 0.008, 0.030 for red/yellow vegetables in CHNS and β = 0.004, 95\% CI: 0.001, 0.007 for green leafy vegetables in HRS) were associated with slower cognitive decline in subsequent years. Moreover, rigorous sensitivity analyses confirmed the stability of the results.

CONCLUSIONS: Our findings support the potential beneficial roles of VF, especially cruciferous vegetables, green leafy vegetables, and red/yellow vegetables, in maintaining cognitive function and slowing cognitive decline in middle-aged and older adults.

}, keywords = {Cognitive decline, cognitive function, Cohort study, Fruits, Vegetables}, issn = {1760-4788}, doi = {10.1016/j.jnha.2024.100223}, author = {Huang, Liyan and Zhao, Caifeng and Gao, Mengyan and Tao, Yang and Chen, Xiao and Chen, Hui and Li, Fengping and Zheng, Ying and Lu, Mengxi and Ma, Yuan and Rong, Shuang and Yuan, Changzheng} } @article {10.1093/geroni/igae021, title = {Can Retrospective Reports Provide Accurate Job History Information? A Comparison with Concurrent Reports in a National Prospective Study of Older Adults}, journal = {Innovation in Aging}, year = {Forthcoming}, abstract = {Growing interest in the impact of lifetime occupational exposures on later life health underscores the need to expand and evaluate the quality of data resources. The present study took advantage of a retrospective life history survey fielded within context of the Health and Retirement Study (HRS) to assess the accuracy of retrospectively obtained information on job history. We evaluated hypotheses related to job history and respondent characteristics to understand more about factors associated with recall accuracy.We used data from the Life History Mail Survey (LHMS), a self-administered survey conducted in 2015 and 2017. We compared the match rate of work status collected in the LHMS questionnaire with data collected concurrently during HRS core face-to-face or phone interviews from 1992 through 2016 with respect to jobs held at the time of interview. We also conducted a limit set of comparisons of occupation and industry match.The sample was 61.79\% female, 82.12\% white, and 8.57 percent Hispanic with a mean age of 74.70 years. The overall work status match rate was 83 percent. Jobs held longer ago were recalled with less accuracy. Jobs held for longer durations and that were full-time rather than part-time were recalled with greater accuracy. More complex job histories that involved a larger number of jobs were also associated with a lower match rate. Higher levels of conscientiousness and cognitive functioning were both associated with a higher match between the two sources of work status information. The occupation match rate was 69 percent, and the industry match rate was 77 percent.A self-administered, paper-and-pencil questionnaire attempting to measure decades-long histories of autobiographically important dimensions of life can provide reasonably accurate historical employment information. Several factors are likely to influence the relative accuracy of recalled information.}, keywords = {employment history, Life History Mail Survey, recall accuracy}, issn = {2399-5300}, doi = {10.1093/geroni/igae021}, author = {Sonnega, Amanda and Al-Hinai, Maymona and Chen, Qize and Helppie-McFall, Brooke and Smith, Jacqui} } @article {13850, title = {Can you tell people{\textquoteright}s cognitive ability level from their response patterns in questionnaires?}, journal = {Behavior Research Methods}, year = {Forthcoming}, abstract = {

Questionnaires are ever present in survey research. In this study, we examined whether an indirect indicator of general cognitive ability could be developed based on response patterns in questionnaires. We drew on two established phenomena characterizing connections between cognitive ability and people{\textquoteright}s performance on basic cognitive tasks, and examined whether they apply to questionnaires responses. (1) The worst performance rule (WPR) states that people{\textquoteright}s worst performance on multiple sequential tasks is more indicative of their cognitive ability than their average or best performance. (2) The task complexity hypothesis (TCH) suggests that relationships between cognitive ability and performance increase with task complexity. We conceptualized items of a questionnaire as a series of cognitively demanding tasks. A graded response model was used to estimate respondents{\textquoteright} performance for each item based on the difference between the observed and model-predicted response ("response error" scores). Analyzing data from 102 items (21 questionnaires) collected from a large-scale nationally representative sample of people aged 50+ years, we found robust associations of cognitive ability with a person{\textquoteright}s largest but not with their smallest response error scores (supporting the WPR), and stronger associations of cognitive ability with response errors for more complex than for less complex questions (supporting the TCH). Results replicated across two independent samples and six assessment waves. A latent variable of response errors estimated for the most complex items correlated .50 with a latent cognitive ability factor, suggesting that response patterns can be utilized to extract a rough indicator of general cognitive ability in survey research.

}, keywords = {Cognitive Ability, item response theory, Questionnaire responding, Task complexity, Worst performance rule}, issn = {1554-3528}, doi = {10.3758/s13428-024-02388-2}, author = {Schneider, Stefan and Hernandez, Raymond and Junghaenel, Doerte U and Jin, Haomiao and Lee, Pey-Jiuan and Gao, Hongxin and Maupin, Danny and Orriens, Bart and Meijer, Erik and Stone, Arthur A} } @article {12417, title = {Consequences of forgoing prescription drug subsidies among low-income Medicare beneficiaries with diabetes.}, journal = {Health Services Research}, year = {Forthcoming}, abstract = {

OBJECTIVE: The objective is to estimate the take-up of the Medicare Part D Low-Income Subsidy (LIS) among Medicare beneficiaries with diabetes and examine differences in out-of-pocket costs and prescription drug use between LIS enrollees and LIS-eligible non-enrollees. The LIS reduces out-of-pocket drug costs for low-income beneficiaries; however, not all LIS-eligible individuals are enrolled. Take-up of the LIS, and consequences of forgoing this benefit among beneficiaries with diabetes, remains unknown.

DATA SOURCES: Health and Retirement Study linked to Medicare administrative data from 2008 to 2016.

STUDY DESIGN: We conducted two analyses among beneficiaries with diabetes. First, we estimated LIS take-up stratified by income (<=100\% of the Federal Poverty Level [FPL] and >100\% to <=150\% of FPL). Second, to assess the consequences of forgoing the LIS among near-poor beneficiaries (incomes >100\% to <=150\% of FPL), we conducted propensity score-weighted regression analyses to compare out-of-pocket costs, the prescription drug use, and cost-related medication non-adherence among LIS enrollees and LIS-eligible non-enrollees.

DATA COLLECTION/DATA EXTRACTION: N/A.

PRINCIPAL FINDINGS: Among Medicare beneficiaries with diabetes, 68.1\% of those with incomes >100\% to <=150\% of FPL received the LIS, while 90.3\% with incomes <=100\% of FPL received the LIS. Among near-poor beneficiaries, LIS-eligible non-enrollees incurred higher annual out-of-pocket drug spending ($518; 95 [in USD]\% CI: $370 [in USD], $667 [in USD]; p < 0.001), filled 7.3 fewer prescriptions for diabetes, hypertension, and hyperlipidemia drugs (95\% CI: -11.1, -3.5; p < 0.001), and were 8.9 percentage points more likely to report skipping drugs due to cost (95\% CI: 0.3, 18.0; p~=~0.04), all compared to LIS enrollees.

CONCLUSIONS: Despite providing substantial financial assistance with prescription drug costs, the LIS is under-utilized among beneficiaries with chronic conditions requiring routine medication use. As policy makers discuss Part D reforms to address rising out-of-pocket drug costs, they should consider strategies to increase participation in existing programs that alleviate cost burdens among low-income Medicare beneficiaries.

}, keywords = {Diabetes Mellitus, Drug Costs, Health Expenditures, Medicare Part D, out-of-pocket costs, Poverty}, issn = {1475-6773}, doi = {10.1111/1475-6773.13990}, author = {Glynn, Alexandra and Hernandez, Inmaculada and Roberts, Eric T} } @article {12224, title = {Considering Financial Assets When Promoting Sense of Purpose in Older Adulthood.}, journal = {Journal of Aging \& Social Policy}, year = {Forthcoming}, abstract = {

Sense of purpose, a consistent promoter of successful aging across the lifespan, has been shown in previous research to decline during older adulthood. As such, research is needed to understand how to inform policies around promoting a sense of purpose for older adults, and which adults may need more assistance on this front. One potential mechanism for lower purpose in older adulthood could be due to the more limited financial assets many face following retirement. As such, the current study investigated the cross-sectional associations between different kinds of financial assets and sense of purpose among older adults from the 2006 and 2008 waves of the Health and Retirement Study ( =~9,380). Sense of purpose as well as four financial assets were assessed: physical assets, retirement account assets, investment account assets, and debts. Findings indicated that greater physical assets and retirement account assets predicted a higher sense of purpose, while debt and investment account assets did not. Furthermore, there were no moderating effects of different grouping variables, such as retirement status, race, marital status, subjective health, or wave, on the associations between total net worth and sense of purpose. Findings are discussed regarding why net worth matters for all, and why certain assets may be more important than others when promoting a sense of purpose.

}, keywords = {net worth, retirement assets, Sense of purpose, Successful aging}, issn = {1545-0821}, doi = {10.1080/08959420.2022.2029271}, author = {Pfund, Gabrielle N and Hill, Patrick L} } @article {13610, title = {Couples{\textquoteright} Cognition, Intimacy, and Activity Engagement: An Actor-Partner Interdependence Model Analysis.}, journal = {Clinical gerontologist}, year = {Forthcoming}, pages = {1-13}, abstract = {

OBJECTIVES: This study examines the actor and partner effects of cognition on activity engagement and the potential mediating role of intimate relationship in older couple dyadic context.

METHODS: Data for this study were obtained from heterosexual couples who participated in the 2020 wave of the Health and Retirement Study. Constructing a dyadic model of couples{\textquoteright} cognitions, activity engagement, and intimacy using structural equation modeling to analyze the relationship between variables and mediating effects.

RESULTS: At the actor level, cognition was positively correlated with their activity participation. At the partner level, wives{\textquoteright} cognition and husbands{\textquoteright} activity engagement were positively correlated. Husband{\textquoteright}s cognitive score affect wife{\textquoteright}s subjective feelings about intimacy. The mediation effect of Wife{\textquoteright}s intimacy on the relationship between husband{\textquoteright}s cognition and wife{\textquoteright}s activity engagement was significant.

CONCLUSIONS: In older couples, cognition influences activity engagement at a binary level, and this association is influenced by the level of intimacy. Improving intimacy can help increase activity engagement in older couples, which in turn promotes health. Clinical Implications Maintaining cognition helps older people enjoy good marriage and participation in activities. For women, the closer the partnership, the higher the frequency of participating in various activities.

}, keywords = {Activity engagement, Cognition, dyadic analysis, spouse relationship}, issn = {1545-2301}, doi = {10.1080/07317115.2023.2274524}, author = {Su, Fan and Chao, Jianqian and Zhang, Bowen and Zhang, Na and Luo, Zongyu and Han, Jiaying} } @article {13805, title = {Education, Income, Wealth, and Discrimination in Black-White Allostatic Load Disparities.}, journal = {American Journal of Preventive Medicine}, year = {Forthcoming}, abstract = {

INTRODUCTION: Allostatic load (AL) is a significant marker of aging, associated with disease and mortality. Research has elucidated the impact of education and income on AL. However, the roles of wealth and discrimination in contributing to AL and shaping AL disparities remain underexplored. This study aimed to investigate the association between wealth and AL, while also examining the independent contributions of education, income, wealth, and everyday discrimination in shaping AL disparities.

METHODS: Using 2016 data from the nationally representative Health and Retirement Study (N=3,866), this study employed multilinear regression analysis to quantify the association between education and income, wealth (calculated as assets minus debts), and everyday discrimination with AL. Oaxaca-Blinder decomposition analysis was conducted to determine the proportion of AL disparities between Black and White participants attributed to education and income, wealth, and everyday discrimination. Analyses were performed in 2023.

RESULTS: Having a college degree or more (b = -0.32; 95\% CI: -0.46, -0.17), higher income (b = -0.06; 95\% CI: -0.11, -0.01), and greater wealth (b = -0.11; 95\% CI: -0.16, -0.07) were linked to reduced AL. Conversely, increased experiences of everyday discrimination were associated with heightened AL (b = 0.07; 95\% CI: 0.01, 0.16). Collectively, differences in possessing a college degree or more, wealth, and exposure to discrimination accounted for about 18\% of the observed Black-White AL disparities.

CONCLUSIONS: Education, income, wealth, and experiences of discrimination may independently contribute to AL and partially explain Black-White disparities in AL. There is a need to elucidate the underlying mechanisms governing these relationships, particularly wealth, and extend the research to additional social determinants of racial health disparities.

}, keywords = {Aging, Discrimination, Education, Income, Wealth}, issn = {1873-2607}, doi = {10.1016/j.amepre.2024.02.021}, author = {Cuevas, Adolfo G and McSorley, Anna-Michelle and Lyngdoh, Adiammi and Kaba-Diakit{\'e}, Fatoumata and Harris, Adrian and Rhodes-Bratton, Brennan and Rouhani, Saba} } @article {12238, title = {The Effects of Religiosity on Depression Trajectories After Widowhood.}, journal = {Omega }, year = {Forthcoming}, abstract = {

This longitudinal study analyzed data from the 2006-2016 waves of the nationally representative Health and Retirement Study (HRS). Trajectories of depression among older adults >= 50~years ( = 1254) were examined over time to explore patterns of depression among those entering widowhood and the potential impact of religiosity on depressive symptoms during various stages of widowhood. Ordinary least squares (OLS) regression analysis was used to examine the association between widowhood and depression and the role of religiosity as a moderator of this association. Older adults experienced a statistically significant increase in depressive symptomology after the onset of widowhood, and depressive symptomology decreased post widowhood, but did not return to pre-widowhood levels. Additionally, high religious service attendance and higher intrinsic religiosity were both associated with lower depressive symptomology. High religious service attendance moderated the relationship between widowhood and depression among widowed older adults living alone.

}, keywords = {depression, Depressive symptoms, religiosity, Social Support, Widowhood}, issn = {1541-3764}, doi = {10.1177/00302228211051509}, author = {Hawes, Frances M and Jane Tavares and Corina R Ronneberg and Miller, Edward Alan} } @article {13708, title = {Gender-specific association of the accumulation of chronic conditions and disability in activities of daily living with depressive symptoms.}, journal = {Archives of Gerontology and Geriatrics}, volume = {118}, year = {Forthcoming}, pages = {105287}, abstract = {

BACKGROUND: In the era of rapid aging with a rising prevalence of multimorbidity, complex interactions between physical and psychological conditions have challenged the health care system. However, little is known about the association of the accumulation of chronic conditions and disability in activities of daily living with depressive symptoms, especially in developed countries.

METHODS: This population-based cohort study used data from the Health and Retirement Study. A total of 22,335 middle-aged and older adults participated in the 2014 (T1), 2016 (T2), and 2018 (T3) waves of the cohort were included. The accumulation of chronic conditions and disability were defined as the number of chronic diseases and the five activities of daily living. Depressive symptoms were measured by the Center for Epidemiologic Studies Depression Scale. A longitudinal mediation model with a cross-lagged panel model was run. As robust check, the models were applied with a longer follow-up period (from 2012 to 2018). Additionally, results were estimated in China.

RESULTS: Bidirectional associations have been found among the accumulation of chronic conditions, disability, and depressive symptoms, especially between disability and depression. Disability (T2) mediated 11.11~\% and 16.87~\% of the association between the accumulation of chronic conditions (T1) and depression (T3) for men and women in the United States. The results were consistent in robust analysis.

CONCLUSIONS: This study found that men and women routinely experienced disability and depressive symptoms because of the accumulation of chronic conditions. In terms of depressive symptoms, women were more sensitive to the accumulation of chronic conditions through disability.

}, keywords = {Depressive symptoms, Disability in activities of daily living, Longitudinal mediating effect, The accumulation of chronic conditions}, issn = {1872-6976}, doi = {10.1016/j.archger.2023.105287}, author = {Hu, Mengxiao and Yu, Haiyang and Zhang, Yike and Xiang, Bowen and Wang, Qing} } @article {13773, title = {Health Care Access and Cognitive Function in Older Adults: A Cross-Lagged Panel Longitudinal Analysis.}, journal = {Journal of Applied Gerontology: the official journal of the southern gerontology society}, year = {Forthcoming}, pages = {7334648241230015}, abstract = {

The current longitudinal study examined how (1) cognitive measures, including episodic memory, executive function, and global cognition, predict later healthcare access and how (2) healthcare access predicts later cognition. Drawing a sample ( = 9920) from the Health and Retirement Study dataset, we created a cross-lagged panel model to examine the longitudinal association between cognitive measures and healthcare access from 2012 to 2018. Results revealed that cognitive measures significantly predict later healthcare access, with effects increasing across waves. However, within sub-domains, memory was more predictive of later healthcare access over time compared to executive function. Our study suggested an increased link between cognition and healthcare access during aging. Even outside of the context of AD, there are likely both policy-based and practical implications to ensure those experiencing cognitive decline continue to maintain access to care.

}, keywords = {cognitive function, cross-lagged panel analysis, health care access, health retirement study}, issn = {1552-4523}, doi = {10.1177/07334648241230015}, author = {Du, Chenguang and Katz, Benjamin and Shrestha, Prabisha and Hori, Kazuki and Dave, Gaurav} } @article {13824, title = {Heterogeneous Effects of Volunteering on Frailty in Later Life: A Panel Quantile Regression Approach.}, journal = {The Journals of Gerontology, Series B, Psychological Sciences and Social Sciences}, year = {Forthcoming}, abstract = {

OBJECTIVES: Decades of research indicate that volunteering is associated with better health for the volunteer beyond the selection effects based on health. However, little is known about potential heterogeneity in health outcomes associated with volunteering in the context of good or poor health. This study addresses this gap by focusing on the frailty index (FI) to investigate the volunteering-health nexus across the population frailty distribution ranging from fit to frail.

METHODS: Using nationally representative data from the Health and Retirement Study (person N = 34,986; 198,218 person-wave observations), we estimated unconditional quantile regression models with panel fixed effects to estimate changes in FI associated with changes in the share of volunteers in the population across the frailty distribution observed across the study period (1998-2020).

RESULTS: Our findings demonstrated that the volunteering-FI association was heterogeneous across the frailty distribution. The association was the most potent at the higher end of the frailty distribution, suggesting that efforts to promote volunteering may yield greater benefits for older adults experiencing high levels of frailty.

DISCUSSION: The current study findings provide unique and compelling evidence in support of earlier calls for considering volunteering as a public health intervention. The study findings are discussed in the context of population health outcomes and health disparities.

}, keywords = {Health and Retirement Study; Health disparities; Helping behaviors; Population health}, issn = {1758-5368}, doi = {10.1093/geronb/gbae033}, author = {Han, Sae Hwang and Park, Narae} } @article {13837, title = {Inter- and intrapopulation differences in the association between physical multimorbidity and depressive symptoms.}, journal = {Journal of Affective Disorders}, volume = {354}, year = {Forthcoming}, pages = {434-442}, abstract = {

BACKGROUND: The association between physical multimorbidity and depression differs by populations. However, no direct inter- or intrapopulation comparison of the association has been conducted. Thus, this study aims to estimate the association in China and the United States and reveal inter- and intrapopulation differences in the association.

METHODS: Middle-aged and older adults from the China Health and Retirement Longitudinal Study and the Health and Retirement Study were included. Physical multimorbidity was defined as the simultaneous presence of two or more chronic physical conditions and depressive symptoms was measured by the Center for Epidemiologic Studies Depression Scale. Generalized estimating equation model and stratification multilevel method were the main statistical models.

RESULTS: The presence of physical multimorbidity was associated with a higher risk of depression in both China (RR~=~1.360 [95~\% CI: 1.325-1.395]) and the US (RR~=~1.613 [95~\% CI: 1.529-1.701]). For individuals at a low risk of multimorbidity, multimorbidity was associated with 47.4~\% (95~\% CI: 1.377-1.579) and 71.1~\% (95~\% CI: 1.412-2.074) increases in the likelihood of depression in China and the US. The effect size was smaller for individuals at a moderate or high risk. However, the cross-national differences were greater for those with a high risk of multimorbidity.

LIMITATIONS: The self-report measures, attribution bias.

CONCLUSIONS: Compared to Chinese adults, the presence of physical multimorbidity led to an additional increase in depressive symptoms for American counterparts. The association was stronger for individuals at a low risk of multimorbidity, but cross-national differences were observed mostly among individuals at a high risk.

}, keywords = {China, Depressive symptoms, Interpopulation, Intrapopulation, Physical multimorbidity, The United States}, issn = {1573-2517}, doi = {10.1016/j.jad.2024.03.090}, author = {Yu, Haiyang and Zhang, Yike and Hu, Mengxiao and Xiang, Bowen and Wang, Sijia and Wang, Qing} } @article {12636, title = {Leisure Activity, Leisure Satisfaction, and Hedonic and Eudaimonic Well-Being Among Older Adults With Cancer Experience.}, journal = {Psychological Reports}, year = {Forthcoming}, abstract = {

Older adults with cancer experience are more likely to encounter a notable reduction of participation in physical and social leisure activities, which may threaten their overall well-being. The purpose of this study was to explore how specific types of leisure activities and leisure satisfaction were linked to hedonic and eudaimonic well-being among older adults who had experienced cancer. A nationally representative sample of 2,934 older adults with lifetime cancer experience was retained from the Health and Retirement Study. The results of regression analysis revealed that walking for 20 minutes was reported as the only type of leisure activity related to hedonic well-being for the oldest-old (85+ years old). The current study also found that TV watching was significantly, but negatively associated with eudaimonic well-being for the young-old (50-74 years of age). In contrast, using a computer was positively linked to hedonic and eudaimonic well-being among the young-old and old-old (75-84 years of age). The current study made a significant contribution to build the body of knowledge that the different age groups of older adults who had experienced cancer can enhance eudaimonic and hedonic well-being by participating in different types of leisure activities. Implications for further research are discussed.

}, keywords = {Cancer, eudaimonic and hedonic well-being, Internet use, leisure activity, TV watching}, issn = {1558-691X}, doi = {10.1177/00332941221123236}, author = {Chun, Sanghee and Lee, Sunwoo and Heo, Jinmoo and Ryu, Jungsu and Lee, Kyung Hee} } @article {13557, title = {Loneliness and Depressive Symptoms Are High Among Older Adults With Digestive Disease and Associated With Lower Perceived Health.}, journal = {Clin Gastroenterol Hepatol}, year = {Forthcoming}, abstract = {

BACKGROUND \& AIMS: Current approaches to managing digestive disease in older adults fail to consider the psychosocial factors contributing to a person{\textquoteright}s health. We aimed to compare the frequency of loneliness, depression, and social isolation in older adults with and without a digestive disease and to quantify their association with poor health.

METHODS: We conducted an analysis of Health and Retirement Study data from 2008 to 2016, a nationally representative panel study of participants 50 years and older and their spouses. Bivariate analyses examined differences in loneliness, depression, and social isolation among patients with and without a digestive disease. We also examined the relationship between these factors and health.

RESULTS: We identified 3979 (56.0\%) respondents with and 3131 (44.0\%) without a digestive disease. Overall, 60.4\% and 55.6\% of respondents with and without a digestive disease reported loneliness (P < .001), 12.7\% and 7.5\% reported severe depression (P < .001), and 8.9\% and 8.7\% reported social isolation (P~= NS), respectively. After adjusting for covariates, those with a digestive disease were more likely to report poor or fair health than those without a digestive disease (odds ratio [OR], 1.25; 95\% CI, 1.11-1.41). Among patients with a digestive disease, loneliness (OR, 1.43; 95\% CI, 1.22-1.69) and moderate and severe depression (OR, 2.93; 95\% CI, 2.48-3.47; and OR, 8.96; 95\% CI, 6.91-11.63, respectively) were associated with greater odds of poor or fair health.

CONCLUSIONS: Older adults with a digestive disease were more likely than those without a digestive disease to endorse loneliness and moderate to severe depression and these conditions are associated with poor or fair health. Gastroenterologists should feel empowered to screen patients for depression and loneliness symptoms and establish care pathways for mental health treatment.

}, keywords = {Epidemiology, General Practice, Outcomes Research, Psychiatric Disorders}, issn = {1542-7714}, doi = {10.1016/j.cgh.2023.08.027}, author = {Cohen-Mekelburg, Shirley and Jordan, Ariel and Kenney, Brooke and Burgess, Helen J and Chang, Joy W and Hu, Hsou Mei and Tapper, Elliot and Kenneth M. Langa and Levine, Deborah A and Waljee, Akbar K} } @article {13876, title = {A Longitudinal Investigation of the Association between Stroke and Loneliness.}, journal = {Journal of Applied Gerontology, Series B, Psychological Sciences and social sciences}, year = {Forthcoming}, abstract = {

OBJECTIVE: The present research examined associations between stroke and long-term trajectories of loneliness.

METHODS: We conducted secondary analyses in three large representative panel studies of adults 50 years and older in the U.S., Europe, and Israel: the English Longitudinal Study of Aging (ELSA; analytic N=14,992); the Survey of Health, Aging, and Retirement in Europe (SHARE; analytic N=103,782); and the Health and Retirement Study (HRS; analytic N=22,179) .Within each sample, we used discontinuous growth curve modeling to estimate loneliness trajectories across adulthood, and the impact of stroke on loneliness trajectories.

RESULTS: Across all three samples, participants who experienced stroke reported higher levels of loneliness relative to participants who did not experience stroke. In ELSA and HRS (but not SHARE), loneliness levels were higher after stroke onset relative to before stroke onset.

DISCUSSION: This research adds to a growing body of evidence demonstrating elevated loneliness among stroke survivors and highlights the need for interventions to increase social connectedness after stroke.

}, keywords = {Cerebrovascular disease, Health Event, Recovery, Social connectedness}, issn = {1758-5368}, doi = {10.1093/geronb/gbae048}, author = {Willroth, Emily C and Rule, Payton D and Graham, Eileen K and Nicholas, Marjorie L and Hattori, Robin and Thompson, Tess and Connor, Lisa Tabor} } @article {13797, title = {Longitudinal study of cognitive decline among women with and without urinary incontinence.}, journal = {American Journal of Obstetrics and Gynecology}, year = {Forthcoming}, abstract = {

BACKGROUND: Cross-sectional and short-term cohort studies have demonstrated an association between urinary incontinence and dementia as well as lower performance on cognitive testing. The Health and Retirement Study, a longitudinal study of community-dwelling older adults, offers an opportunity to assess the temporal association between these conditions, as this study included an assessment of incontinence symptoms as well as biennial assessments of cognitive function.

OBJECTIVES: This study aimed to evaluate if urinary incontinence before age 70 had an effect on changes in cognitive function among women participating in the Health and Retirement Study.

STUDY DESIGN: This secondary analysis included data from female respondents in the Health and Retirement Study ages 58 to 67 years with >=2 cognitive assessments. Urinary incontinence was defined as any involuntary loss of any urine in the preceding 12 months. A control group without incontinence was reweighted for better comparability using coarsened exact matching for age and comorbidities. Validated methods, including neuropsychological test data, estimated a Memory score and DP for each participant biennially. Coprimary outcomes were the changes in Memory score and dementia probability. Linear regression models were used to estimate the association of urinary incontinence with change in Memory score and dementia probability, adjusting for baseline demographics and comorbidities. A subgroup analysis was performed to assess the effects of urinary incontinence frequency on these outcomes. The infrequent subgroup reported less than fifteen days of leakage per month and the frequent subgroup reported fifteen or more days of leakage per month.

RESULTS: Among eligible female respondents, 40.6\% reported urinary incontinence between ages 58 to 69 years. Baseline Memory scores and dementia probability were similar between those with urinary incontinence (n=1706) and controls (n=2507). Memory score declined significantly in both cohorts, indicating poorer memory over time -0.222 among those with incontinence (95\% confidence interval (CI) -0.245, -0.199) versus -0.207 in controls (95\% CI: -0.227, -0.188). The decline of Memory score was not statistically different between cases and controls (mean difference -0.015, 95\% CI: -0.045, 0.015). Dementia probability increased significantly in both groups, indicating a greater probability of dementia: 0.018 among those with incontinence (95\% CI: 0.015, 0.020) and by 0.020 among controls (95\% CI: 0.017, 0.022). The change in DEMENTIA PROBABILITY was not significantly different between groups (mean difference -0.002, 95\% CI: -0.006, 0.002). Frequent urinary incontinence was reported in 105/1706 (6\%) with urinary incontinence. Memory score declined and dementia probability increased with time (p<0.001) in frequent and infrequent UI subgroups. There was no dose-response relationship.

CONCLUSIONS: Measures of cognitive performance declined with approximately 10 years of observation; the changes in performance were not associated with the presence of urinary incontinence in their younger years.

}, keywords = {Aging, Cognitive decline, Dementia, Memory, Urinary incontinence}, issn = {1097-6868}, doi = {10.1016/j.ajog.2024.02.305}, author = {High, Rachel A and Alvarez, Miriam and Champion, Brachel and Anger, Jennifer and Handa, Victoria L} } @article {13675, title = {A naturally occurring variant of SHLP2 is a protective factor in Parkinson{\textquoteright}s disease.}, journal = {Molecular Psychiatry}, year = {Forthcoming}, abstract = {

Mitochondrial DNA single nucleotide polymorphisms (mtSNPs) have been associated with a reduced risk of developing Parkinson{\textquoteright}s disease (PD), yet the underlying mechanisms remain elusive. In this study, we investigate the functional role of a PD-associated mtSNP that impacts the mitochondrial-derived peptide (MDP) Small Humanin-like Peptide 2 (SHLP2). We identify m.2158 T > C, a mtSNP associated with reduced PD risk, within the small open reading frame encoding SHLP2. This mtSNP results in an alternative form of SHLP2 (lysine 4 replaced with arginine; K4R). Using targeted mass spectrometry, we detect specific tryptic fragments of SHLP2 in neuronal cells and demonstrate its binding to mitochondrial complex 1. Notably, we observe that the K4R variant, associated with reduced PD risk, exhibits increased stability compared to WT SHLP2. Additionally, both WT and K4R SHLP2 show enhanced protection against mitochondrial dysfunction in in vitro experiments and confer protection against a PD-inducing toxin, a mitochondrial complex 1 inhibitor, in a mouse model. This study sheds light on the functional consequences of the m.2158 T > C mtSNP on SHLP2 and provides insights into the potential mechanisms by which this mtSNP may reduce the risk of PD.

}, keywords = {DNA, Parkinson Disease}, issn = {1476-5578}, doi = {10.1038/s41380-023-02344-0}, author = {Kim, Su-Jeong and Miller, Brendan and Hartel, Nicolas G and Ramirez, Ricardo and Braniff, Regina Gonzalez and Leelaprachakul, Naphada and Huang, Amy and Wang, Yuzhu and Arpawong, Thalida Em and Crimmins, Eileen M and Wang, Penglong and Sun, Xianbang and Liu, Chunyu and Levy, Daniel and Yen, Kelvin and Petzinger, Giselle M and Graham, Nicholas A and Jakowec, Michael W and Cohen, Pinchas} } @article {13620, title = {Neighborhood Features and Cognitive Function: Moderating Roles of Individual Socioeconomic Status.}, journal = {American journal of preventive medicine}, year = {Forthcoming}, abstract = {

INTRODUCTION: There is an interest in exploring the associations between neighborhood characteristics and individual cognitive function; however, little is known about whether these relationships can be modified by individual socioeconomic status, such as educational attainment and income.

METHODS: Drawing from the 2010-2018 Health and Retirement Study, this study analyzed 10,621 older respondents (aged 65+) with a total of 33,931 person-waves. These respondents did not have dementia in 2010 and stayed in the same neighborhood throughout the study period. Cognitive function was measured with a 27-point indicator biennially, and neighborhood characteristics (i.e., walkability, concentrated disadvantage, and social isolation) were assessed in 2010. All analyses were performed in 2023.

RESULTS: Cognitive function is positively associated with neighborhood walkability and negatively related to concentrated disadvantage, suggesting that exposures to these neighborhood characteristics have long-lasting impacts on cognitive function. Furthermore, individual socioeconomic status modifies the relationship between neighborhood characteristics and cognitive function. Compared with those graduating from college, respondents without a bachelor{\textquoteright}s degree consistently have lower cognitive function but the educational gap in cognitive function narrows with increases in walkability (b= -0.152, SE=0.092), and widens when neighborhood concentrated disadvantage (b=0.212, SE=0.070) or social isolation (b=0.315, SE=0.125) rises. The income gap in cognitive function shrinks with increases in walkability (b= -0.063, SE=0.027).

CONCLUSIONS: The moderating role of socioeconomic status indicates that low-socioeconomic status older adults who also live in disadvantaged neighborhoods face a higher risk of poor cognitive function. Low-education and low-income aging adults may have the most to gain from investments to improve neighborhood characteristics.

}, keywords = {cognitive function, low-education, low-income, Older Adults, socioeconomic status}, issn = {1873-2607}, doi = {10.1016/j.amepre.2023.10.012}, author = {Yang, Tse-Chuan and Kim, Seulki and Choi, Seung-Won Emily and Halloway, Shannon and Mitchell, Uchechi A and Shaw, Benjamin A} } @article {13640, title = {An outcome-wide analysis of the effects of diagnostic labeling of Alzheimer{\textquoteright}s disease and related dementias on social relationships.}, journal = {Alzheimers \& dementia: the journal of the Alzheimer{\textquoteright}s Association}, year = {Forthcoming}, abstract = {

INTRODUCTION: This study examines how receiving a dementia diagnosis influences social relationships by race and ethnicity.

METHODS: Using data from the Health and Retirement Study (10 waves; 7,159 observations) of adults 70 years and older predicted to have dementia using Gianattasio-Power scores (91\% accuracy), this study assessed changes in social support, engagement, and networks after a dementia diagnosis. We utilized quasi-experimental methods to estimate treatment effects and subgroup analyses by race/ethnicity.

RESULTS: A diagnostic label significantly increased the likelihood of gaining social support but reduced social engagement and one measure of social networks. With some exceptions, the results were similar by race and ethnicity.

DISCUSSION: Results suggest that among older adults with assumed dementia, being diagnosed by a doctor may influence social relationships in both support-seeking and socially withdrawn ways. This suggests that discussing services and supports at the time of diagnosis is important for healthcare professionals.

}, keywords = {diagnostic label of dementia, Health and Retirement Study (HRS), outcome-wide analysis, Propensity score analysis, social engagement, social network, Social Support}, issn = {1552-5279}, doi = {10.1002/alz.13574}, author = {Amano, Takashi and Halvorsen, Cal J and Kim, Seoyoun and Reynolds, Addam and Scher, Clara and Jia, Yuane} } @article {13869, title = {Partner Plan Choices and Medicare Advantage Enrollment Decisions Among Older Adults.}, journal = {JAMA}, year = {Forthcoming}, abstract = {In 2023, 50\% of Medicare beneficiaries were enrolled in Medicare Advantage (MA).1 While enrollment is common, so is disenrollment: between 2011 and 2018, 12\% to 20\% of enrollees left their MA contract within 1 year.2 Beneficiary- and plan-level characteristics, including Medicare-Medicaid dual eligibility, functional limitations, health care needs, and plan star rating, are associated with disenrollment.3-6 For working-age adults, spouses or partners (hereafter, partners) often share insurance coverage under the same plan; whether this pattern occurs in MA is unknown. This study considered dyadic MA enrollment decisions, examining the association of respondent plan changes with partner plan changes and other beneficiary and plan characteristics.}, keywords = {Couples, Insurance Coverage, Medicare, Medicare advantage}, issn = {1538-3598}, doi = {10.1001/jama.2024.1773}, author = {Lei, Lianlian and Levy, Helen and Ankuda, Claire and Hoffman, Geoffrey J and Kim, Hyungjin Myra and Strominger, Julie and Maust, Donovan T} } @article {13883, title = {Perceived discrimination and incident dementia among older adults in the U.S.: The buffering role of social relationships.}, journal = {Journal of Applied Gerontology, Series B, Psychological Sciences and social sciences}, year = {Forthcoming}, abstract = {

OBJECTIVES: Recent studies have found that perceived discrimination as a chronic stressor predicts poorer cognitive health. However, little research has investigated how social relationships as potential intervening mechanisms may mitigate or exacerbate this association. Using a nationally representative sample of U.S. older adults, this study examined how the existence and quality of four types of relationships-with a partner, children, other family members, and friends-may modify the impact of perceived discrimination on incident dementia.

METHODS: We analyzed data from the 2006-2016 Health and Retirement Study (N=12,236) using discrete-time event history models with competing risks. We used perceived discrimination, social relationships, and their interactions at the baseline to predict the risk of incident dementia in the follow-ups.

RESULTS: Perceived discrimination predicted a higher risk of incident dementia in the follow-ups. Although having a partner or not did not modify this association, partnership support attenuated the negative effects of discrimination on incident dementia. Neither the existence nor quality of relationships with children, other family members, or friends modified the association.

DISCUSSION: Our findings imply that intimate partnership plays a critical role in coping with discrimination and, consequently, influencing the cognitive health of older adults. While perceived discrimination is a significant risk factor for the incidence of dementia, better partnership quality may attenuate this association. Policies that eliminate discrimination and interventions that strengthen intimate partnership may facilitate better cognitive health in late life.

}, keywords = {Cognitive health, Relationship strain, Social Support, Stress}, issn = {1758-5368}, doi = {10.1093/geronb/gbae059}, author = {Hsieh, Ning and Liu, Hui and Zhang, Zhenmei} } @article {12406, title = {Racial and Ethnic Differences in Informal and Formal Advance Care Planning Among U.S. Older Adults.}, journal = {Journal of Aging and Health}, year = {Forthcoming}, abstract = {

OBJECTIVE: To examine advance care planning (ACP) trends among an increasingly diverse aging population, we compared informal and formal ACP use by race/ethnicity among U.S. older adults (<=65~years).

METHODS: We used Health and Retirement Study data (2012-2018) to assess relationships between race/ethnicity and ACP type (i.e., no ACP, informal ACP only, formal ACP only, or both ACP types). We reported adjusted risk ratios with 95\% confidence intervals.

RESULTS: Non-Hispanic Black and Hispanic respondents were 1.77 (1.60, 1.96) and 1.76 (1.55, 1.99) times as likely, respectively, to report no ACP compared to non-Hispanic White respondents. Non-Hispanic Black and Hispanic respondents were 0.74 (0.71, 0.78) and 0.74 (0.69, 0.80) times as likely, respectively, to report using both ACP types as non-Hispanic White respondents.

DISCUSSION: Racial/ethnic differences in ACP persist after controlling for a variety of barriers to and facilitators of ACP which may contribute to disparities in end-of-life care.

}, keywords = {Advance care planning, Advance directives, end of life, Healthcare Disparities, race and ethnicity}, issn = {1552-6887}, doi = {10.1177/08982643221104926}, author = {Lenko, Rachel and Voepel-Lewis, Terri and Robinson-Lane, Sheria G and Silveira, Maria J and Hoffman, Geoffrey J} } @article {11922, title = {Racial, ethnic, and urban/rural differences in transitions into diabetes: Evidence from the Health and Retirement Survey biomarker and self-reported data}, year = {Forthcoming}, abstract = {We examine the differences in transitions between stages of type 2 diabetes across racial, ethnic, and urban/rural statuses. The individual-level data from the 2006 to 2012 waves of the Health and Retirement Survey (HRS) and county-level data from the 1990-2000 US Censuses, the Dartmouth Atlas of Health Care, and the Inter-university Consortium for Political and Social Research are used to analyze the transition from the stage of prediabetic to diabetic, and the transition from having no diabetes to being prediabetic and diabetic. The HRS includes both biomarker data and self-reported doctors{\textquoteright} diagnoses of diabetes, which allow us to identify people who are prediabetic and undiagnosed diabetics. Employing logistic models, we find that the likelihood of reporting the transition from prediabetes to diabetes increases with the degree of rurality. We also find that county-level proxies for structural disadvantage and individual-level correlates attenuate race/ethnicity and rurality disparities in the development of diabetes. In addition, racial/ethnic differences in transitions into diabetes are partially explained by differences in individual-level factors and further explained by differences in disadvantaged conditions associated with rural counties.}, keywords = {biomarker data, Diabetes, ethnicity, race, rural, self reported, urban}, url = {https://www.researchgate.net/publication/354982473_Racial_ethnic_and_urbanrural_differences_in_transitions_into_diabetes_Evidence_from_the_Health_and_Retirement_Survey_biomarker_and_self-reported_data}, author = {Hyeran, Chung and Arends-Kuenning, Mary Paula} } @article {12972, title = {Racial inequality in functional trajectories between Black and White U.S. veterans.}, journal = {Journal of the American Geriatrics Society}, year = {Forthcoming}, abstract = {

BACKGROUND: Racial inequality in functional trajectories has been well documented in the U.S. civilian population but has not been explored among Veterans. Our objectives were to: (1) assess how functional trajectories differed for Black and White Veterans aged >=50 and (2) explore how socioeconomic, psychosocial, and health-related factors altered the relationship between race and function.

METHODS: We conducted a prospective, longitudinal analysis using the 2006-2016 Health and Retirement Study. The study cohort included 3700 Veterans who self-identified as Black or White, responded to baseline psychosocial questionnaires, and were community-dwelling on first observation. We used stepwise and stratified linear mixed effects models of biannually assessed functional limitations. The outcome measure was as a count of functional limitations. Race was measured as respondent self-identification as Black or White. Demographic measures included gender and age. Socioeconomic resources included partnership status, education, income, and wealth. Psychosocial stressors included exposure to day-to-day and major discrimination, traumatic life events, stressful life events, and financial strain. Health measures included chronic and mental health diagnoses, smoking, rurality, and use of Veterans Affairs services.

RESULTS: Black Veterans developed functional limitations at earlier ages and experienced faster functional decline than White Veterans between the ages of 50 and 70, with convergence occurring at age 85. Once we accounted for economic resources and psychosocial stressors in multivariable analyses, the association between race and the number of functional limitations was no longer statistically significant. Lower wealth, greater financial strain, and traumatic life events were significantly associated with functional decline.

CONCLUSIONS: Health systems should consider how to track Veterans{\textquoteright} function earlier in the life course to ensure that Black Veterans are able to get timely access to services that may slow premature functional decline. Providers may benefit from training about the role of economic resources and psychosocial stressors in physical health outcomes.

}, keywords = {Functional limitations, psychosocial stressors, racial inequity, Veterans}, issn = {1532-5415}, doi = {10.1111/jgs.18169}, author = {Jacobs, Josephine C and Bowling, Christopher Barrett and Brown, Tyson and Smith, Valerie A and Decosimo, Kasey and Wilson, Sarah M and Hastings, Susan Nicole and Shepherd-Banigan, Megan and Allen, Kelli and Van Houtven, Courtney} } @article {13714, title = {Religious Involvement and the Impact on Living Alone and Depression: An Examination of Gendered Pathways Post-Widowhood.}, journal = {Journal of Applied Gerontology}, year = {Forthcoming}, pages = {7334648231225355}, abstract = {

This study analyzed data from the nationally representative Health and Retirement Study (HRS) to examine the association between widowhood and depression. The results revealed that both men and women experienced increased depression after widowhood, with women exhibiting a better recovery pattern over time. Religiosity, especially attending religious services, was found to be a beneficial coping mechanism for both genders, although men were less religious than women. Living alone was a significant factor associated with depression in widowhood for both men and women. High religious service attendance moderated the association between living alone and depression for women, while both high and moderate religious service attendance moderated this association for men. These findings emphasize the importance of considering gender differences and the potential benefits of religious involvement in addressing depression during widowhood, highlighting the need for tailored interventions and support services for widows and widowers, particularly those living alone.

}, keywords = {depression, gender, Religion, Social Support, Widows}, issn = {1552-4523}, doi = {10.1177/07334648231225355}, author = {Hawes, Frances M and Tavares, Jane L} } @article {13625, title = {The role of smoking, obesity and physical inactivity in cognitive performance and decline: a multi-cohort study.}, journal = {The Journals of Gerontology, Series A, Biological Sciences and Medical Sciences}, year = {Forthcoming}, abstract = {

BACKGROUND: Unhealthy lifestyles are recognized contributors to cognitive decline, yet limited evidence focuses on their roles in cognitive decline rate. This study examined the role of smoking, obesity and physical inactivity in cognitive performance and rate of cognitive decline by birth cohort on a global scale.

METHODS: Utilizing data from four prospective cohort studies (CHARLS; ELSA; HRS; and SHARE) across 14 countries, a multi-cohort study was performed. Eligible participants were aged 50 years and older. Linear mixed models were employed to detect the role of smoking, obesity, and physical inactivity in cognitive function domains (epidemic memory, working memory, and time orientation).

RESULTS: Higher scores of cognitive functions were found in participants who engaged in more vigorous physical activity, were non-current smokers, and maintained underweight (e.g., for episodic memory scores in females at 60 years, vigorous physical activity: 0.47, 95\%CI: 0.46, 0.49). In addition, a slower rate of cognitive decline was also found in individuals who engaged in moderate or vigorous physical activity, were non-current smokers, and maintained not underweight (e.g., for episodic memory scores changing from 50-70 years old in females, vigorous physical activity: from 0.54 (95\%CI: 0.51, 0.57) to 0.40 (95\%CI: 0.37, 0.44) and in males from 0.33 (95\%CI: 0.30, 0.36) to 0.11 (95\%CI: 0.08, 0.14)).

CONCLUSIONS: We confirmed the beneficial impact of healthy lifestyles in preventing cognitive decline and promoting healthy aging. Urgent measures are needed to identify and encourage healthy lifestyles, such as strengthening tobacco control, developing policy on physical activity promotion, and preventing underweight, to minimize worldwide levels of cognitive decline.

}, keywords = {birth cohort, Cognitive decline, lifestyles.}, issn = {1758-535X}, doi = {10.1093/gerona/glad232}, author = {Hong, Chenlu and Liu, Zhaorui and Liu, Yating and Jin, Yinzi and Luo, Yanan} } @article {13839, title = {The silent epidemic of loneliness: identifying the antecedents of loneliness using a lagged exposure-wide approach.}, journal = {Psychology of Medicine}, year = {Forthcoming}, pages = {1-14}, abstract = {

BACKGROUND: A large and accumulating body of evidence shows that loneliness is detrimental for various health and well-being outcomes. However, less is known about potentially modifiable factors that lead to decreased loneliness.

METHODS: We used data from the Health and Retirement Study to prospectively evaluate a wide array of candidate predictors of subsequent loneliness. Importantly, we examined if changes in 69 physical-, behavioral-, and psychosocial-health factors (from ;2006/2008 to ;2010/2012) were associated with subsequent loneliness 4 years later (;2014/2016).

RESULTS: Adjusting for a large range of covariates, changes in certain health behaviors (e.g. increased physical activity), physical health factors (e.g. fewer functioning limitations), psychological factors (e.g. increased purpose in life, decreased depression), and social factors (e.g. greater number of close friends) were associated with less subsequent loneliness.

CONCLUSIONS: Our findings suggest that subjective ratings of physical and psychological health and perceived social environment (e.g. chronic pain, self-rated health, purpose in life, anxiety, neighborhood cohesion) are more strongly associated with subsequent loneliness. Yet, objective ratings (e.g. specific chronic health conditions, living status) show less evidence of associations with subsequent loneliness. The current study identified potentially modifiable predictors of subsequent loneliness that may be important targets for interventions aimed at reducing loneliness.

}, keywords = {Health behaviors, Loneliness, Older Adults, Physical Health, predictors, Psychosocial factors, Public Health}, issn = {1469-8978}, doi = {10.1017/S0033291723002581}, author = {Hong, Joanna H and Nakamura, Julia S and Sahakari, Sakshi S and Chopik, William J and Shiba, Koichiro and VanderWeele, Tyler J and Kim, Eric S} } @article {13643, title = {Spouses of individuals living with mild cognitive impairment or dementia in the United States: A descriptive, population-based study.}, journal = {Alzheimers \& dementia: the journal of the Alzheimer{\textquoteright}s Association}, year = {Forthcoming}, abstract = {

BACKGROUND: Little is known about the population of individuals who live with a spouse with cognitive impairment (CI) or dementia.

METHODS: Using the US Health and Retirement Study, 2000 to 2018, we estimated the population of adults >= 50 years old co-residing with a spouse with probable CI/dementia. We described their socio-demographic and health characteristics and quantified socio-demographic inequities.

RESULTS: Among community-dwelling adults >= 50 years old, 6\% of women and 4\% of men co-resided with a spouse with probable CI/dementia. Among those who were married/partnered, the prevalence of spousal dementia was greater for Black and Hispanic adults compared to their White counterparts, and for those with lower versus higher educational attainment. Among spouses, activities of daily living disability, depression, and past 2-year hospitalization was common.

DISCUSSION: Millions of older adults, disproportionately Black and Hispanic people and people with lower levels of educational attainment, live with a spouse with CI while also facing their own major health challenges.

}, keywords = {Dementia, Epidemiology, Family, health equity, mild cognitive impairment, Spouses}, issn = {1552-5279}, doi = {10.1002/alz.13555}, author = {Torres, Jacqueline M and Flores Romero, Karla Renata and Kotwal, Ashwin A and Chen, Ruijia and Hill-Jarrett, Tanisha and Mitchell, Uchechi A and Glymour, Medellena Maria} } @article {12934, title = {Telehealth uptake among middle-aged and older Americans during COVID-19: chronic conditions, social media communication, and race/ethnicity.}, journal = {Aging \& Mental Health}, year = {Forthcoming}, abstract = {

OBJECTIVES: This study investigated whether and to what extent constructs of the protection motivation theory of health (PMT)-threat appraisal (perceived vulnerability/severity) and coping appraisal (response efficacy and self-efficacy)-are related to telehealth engagement during the COVID-19 pandemic, and how these associations differ by race/ethnicity among middle-aged and older Americans.

METHODS: Data were from the 2020 Health and Retirement Study. Multivariable ordinary least-squares regression analyses were computed adjusting for health and sociodemographic factors.

RESULTS: Some PMT constructs are useful in understanding telehealth uptake. Perceived vulnerability/severity, particularly comorbidity ( = 0.13, 95\% confidence interval (CI) [0.11, 0.15], < 0.001), and response efficacy, particularly participation in communication via social media ( = 0.24, 95\% CI [0.21, 0.27], < 0.001), were significantly and positively associated with higher telehealth uptake during the COVID-19 pandemic among middle-aged and older Americans. Non-Hispanic Black adults were more likely to engage in telehealth during the pandemic than their non-Hispanic White counterparts ( = 0.20, 95\% CI [0.12, 0.28], < 0.001). Multiple moderation analyses revealed the significant association between comorbidity and telehealth uptake was similar across racial/ethnic groups, whereas the significant association between social media communication and telehealth uptake varied by race/ethnicity. Specifically, the association was significantly less pronounced for Hispanic adults ( = -0.11, 95\% CI [-0.19, -0.04], < 0.01) and non-Hispanic Asian/other races adults ( = -0.13, 95\% CI [-0.26, -0.01], < 0.05) than it was for their non-Hispanic White counterparts.

CONCLUSION: Results suggest the potential of using social media and telehealth to narrow health disparities, particularly serving as a bridge for members of underserved communities to telehealth uptake.

}, keywords = {Comorbidity, COVID-19, midlife, Race/ethnicity, social media communication, telehealth}, issn = {1364-6915}, doi = {10.1080/13607863.2022.2149696}, author = {Choi, Shinae L and Hites, Lisle and Bolland, Anneliese C and Lee, Jiyoung and Payne-Foster, Pamela and Bissell, Kimberly} } @article {13875, title = {Terminal Trajectory of HbA1c for 10 Years Supports HbA1c Paradox: Longitudinal Study Using Health and Retirement Study}, journal = {Endocrinology of Aging}, volume = {15}, year = {Forthcoming}, keywords = {Glycated hemoglobin (HbA1c), Mortality, Terminal decline, time-varying, trajectory}, doi = {10.3389/fendo.2024.1383516}, author = {Heng, Cao and Zeyi, Zhang and Longshan, Yang} } @article {11154, title = {Using Medicare claims in identifying Alzheimer{\textquoteright}s disease and related dementias.}, journal = {Alzheimer{\textquoteright}s \& Dementia}, year = {Forthcoming}, abstract = {

INTRODUCTION: This study develops a measure of Alzheimer{\textquoteright}s disease and related dementias (ADRD) using Medicare claims.

METHODS: Validation resembles the approach of the American Psychological Association, including (1) content validity, (2) construct validity, and (3) predictive validity.

RESULTS: We found that four items-a Medicare claim recording ADRD 1 year ago, 2 years ago, 3 years ago, and a total stay of 6 months in a nursing home-exhibit a pattern of association consistent with a single underlying ADRD construct, and presence of any two of these four items predict a direct measure of cognitive function and also future claims for ADRD.

DISCUSSION: Our four items are internally consistent with the measurement of a single quantity. The presence of any two items do a better job than a single claim when predicting both a direct measure of cognitive function and future ADRD claims.

}, keywords = {administrative data, Alzheimer{\textquoteright}s disease, cognitive impairment, Dementia, Medicare}, issn = {1552-5279}, doi = {10.1002/alz.12199}, author = {Jain, Siddharth and Rosenbaum, Paul R and Reiter, Joseph G and Geoffrey J Hoffman and Small, Dylan S and Ha, Jinkyung and Hill, Alexander S and Wolk, David A and Timothy G. Gaulton and Mark D Neuman and Roderic G Eckenhoff and Fleisher, Lee A and Jeffrey H Silber} } @article {13744, title = {Wealth Redistribution to Extend Longevity in the US.}, journal = {JAMA Internal Medicine}, year = {Forthcoming}, abstract = {

IMPORTANCE: The US is unique among wealthy countries in its degree of wealth inequality and its poor health outcomes. Wealth is known to be positively associated with longevity, but little is known about whether wealth redistribution might extend longevity.

OBJECTIVE: To examine the association between wealth and longevity and estimate the changes in longevity that could occur with simulated wealth distributions that were perfectly equal, similar to that observed in Japan (among the most equitable of Organisation for Economic Co-operation and Development [OECD] countries), generated by minimum inheritance proposals, and produced by baby bonds proposals.

DESIGN, SETTING, AND PARTICIPANTS: This longitudinal cohort study analyzed the association between wealth and survival among participants in the Health and Retirement Study (1992-2018), a nationally representative panel study of middle-aged and older (>=50 years) community-dwelling, noninstitutionalized US adults. The data analysis was performed between November 15, 2022, and September 24, 2023.

EXPOSURE: Household wealth on study entry, calculated as the sum of all assets minus the value of debts and classified into deciles.

MAIN OUTCOMES AND MEASURES: Weibull survival models were used to estimate the association between per-person wealth decile and survival, adjusting for age, sex, marital status, household size, and race and ethnicity. Changes in longevity that might occur under alternative wealth distributions were then estimated.

RESULTS: The sample included 35 164 participants (mean [SE] age at study entry, 59.1 [0.1] years; 50.1\% female and 49.9\% male [weighted]). The hazard of death generally decreased with increasing wealth, wherein participants in the highest wealth decile had a hazard ratio of 0.59 for death (95\% CI, 0.53-0.66) compared with those in the lowest decile, corresponding to a 13.5-year difference in survival. A simulated wealth distribution of perfect equality would increase populationwide median longevity by 2.2 years (95\% CI, 2.2-2.3 years), fully closing the mortality gap between the US and the OECD average. A simulated minimum inheritance proposal would increase populationwide median longevity by 1.7 years; a simulated wealth distribution similar to Japan{\textquoteright}s would increase populationwide median longevity by 1.2 years; and a simulated baby bonds proposal would increase populationwide median longevity by 1.0 year.

CONCLUSIONS AND RELEVANCE: These findings suggest that wealth inequality in the US is associated with significant inequities in survival. Wealth redistribution policies may substantially reduce those inequities and increase population longevity.

}, keywords = {health outcomes, Longevity, reduce inequalities, Wealth Inequality}, issn = {2168-6114}, doi = {10.1001/jamainternmed.2023.7975}, author = {Himmelstein, Kathryn E W and Tsai, Alexander C and Venkataramani, Atheendar S} } @article {MACCONNACHIE2024116698, title = {The association between incarceration and housing insecurity and advanced immune age during late life}, journal = {Social Science \& Medicine}, year = {2024}, pages = {116698}, abstract = {Emerging evidence suggests that psychosocial stress ages the immune system. Accordingly, immune aging may be an important potential mechanism linking psychosocial stress to aging-related decline and disease. Incarceration and housing insecurity represent severe and complex experiences of a multitude of psychosocial stressors, including discrimination, violence, and poverty. In this study, we investigated the association between incarceration and/or housing insecurity and advanced immune age in adults aged 55 and older. Our sample was derived from the Health and Retirement Survey (HRS), with n~=~7003 individuals with valid housing insecurity data and n~=~7523 with valid incarceration data. From 2016 Venous Blood Study data, we assessed immune aging using a comprehensive set of immune markers including inflammatory markers (IL-6, CRP, s-TNFR1), markers of viral control (CMV IgG antibodies), and ratios of T cell phenotypes (CD8+:CD4+, CD~+~Memory: Na{\"\i}ve, CD4+ Memory: Na{\"\i}ve, CD8+ Memory: Na{\"\i}ve ratios). We found that both incarceration and housing insecurity were strongly associated with more advanced immune aging as indicated by increased inflammation, reduced viral control, and reduction in na{\"\i}ve T cells relative to memory T cells. Given that those who experienced incarceration, housing insecurity, and/or are racialized minorities were less likely to be included in this study, our results likely underestimated these associations. Despite these limitations, our study provided strong evidence that experiencing incarceration and/or housing insecurity may accelerate the aging of the immune system.}, keywords = {Aging, Homelessness, Housing insecurity, HRS, immune aging, Immunosenescence, incarceration, Inequity, psychosocial stressors}, issn = {0277-9536}, doi = {https://doi.org/10.1016/j.socscimed.2024.116698}, author = {Lauren MacConnachie and Yuan S. Zhang and Mateo Farina and Carmen Gutierrez and Andrew Hoover and Yuelin He and Allison E. Aiello and Grace A. Noppert} } @article {13815, title = {Associations of Everyday and Lifetime Experiences of Discrimination With Willingness to Undergo Alzheimer Disease Predictive Testing.}, journal = {Neurology}, volume = {102}, year = {2024}, pages = {e208005}, abstract = {

BACKGROUND AND OBJECTIVES: Rapid developments in Alzheimer disease (AD) biomarker research suggest that predictive testing may become widely available. To ensure equal access to AD predictive testing, it is important to understand factors that affect testing interest. Discrimination may influence attitudes toward AD testing, particularly among racially and ethnically minoritized populations, because of structural racism in health care systems. This study examined whether everyday or lifetime discrimination experiences shape interest in AD predictive testing.

METHODS: In the 2010 and 2012 biennial Health and Retirement Study waves, respondents were randomly selected to complete questions on interest in receiving free testing that could determine whether they would develop AD in the future. The exposures were everyday discrimination (6 items) and lifetime discrimination (7 items); both were transformed into a binary variable. Logistic regression models predicting interest in AD testing were controlled for deciles of propensity scores for each discrimination measure. Odds ratios were re-expressed as risk differences (RDs).

RESULTS: Our analytic sample included 1,499 respondents. The mean age was 67 (SD = 10.2) years, 57.4\% were women, 65.7\% were White, and 80\% endorsed interest in AD predictive testing. Most of the participants (54.7\%) experienced everyday discrimination in at least one domain; 24.1\% experienced major lifetime discrimination in at least one domain. Those interested in predictive testing were younger (66 vs 70 years) and more likely to be Black (20\% vs 15\%) or Latinx (14\% vs 8\%) than participants uninterested in testing. The probability of wanting an AD test was not associated with discrimination for Black (RD everyday discrimination = -0.026; 95\% CI [-0.081 to 0.029]; RD lifetime discrimination = -0.012; 95\% CI [-0.085 to 0.063]) or Latinx (RD everyday discrimination = -0.023, 95\% CI [-0.082 to 0.039]; RD lifetime discrimination = -0.011; 95\% CI [-0.087 to 0.064]) participants.

DISCUSSION: Despite historical and contemporary experiences of discrimination, Black and Latinx individuals express interest in AD testing. However, Black and Latinx individuals remain underrepresented in AD research, including research on AD testing. Interest in personalized information about dementia risk may be a pathway to enhance their inclusion in research and clinical trials.

}, keywords = {Alzheimer disease, Logistic Models, Odds Ratio, Propensity Score, Retirement}, issn = {1526-632X}, doi = {10.1212/WNL.0000000000208005}, author = {Hill-Jarrett, Tanisha G and Choi, Minhyuk and Buto, Peter T and Miramontes, Silvia and Thomas, Marilyn D and Yang, Yulin and Kim, Min Hee and Sims, Kendra D and Glymour, M Maria} } @article {10.1093/geroni/igae033, title = {Cognitive Decline after Divorce and Widowhood: Is Marital Loss Always a Loss?}, journal = {Innovation in Aging}, year = {2024}, month = {03}, pages = {igae033}, abstract = {We used longitudinal data to determine whether the type of marital loss is associated with the rate of cognitive change before and after divorce or widowhood. Previous research found that relationship status was associated with older adults{\textquoteright} cognitive performance: married persons performed better on memory assessments and had lower dementia risk than unmarried-cohabitating, never-married, divorced, and widowed persons. However, the end of a marriage may cause distress or reduce distress because a stressor disappears. Questions thus remain about the mechanisms by which marital change affects cognitive outcomes and, specifically, whether termination of marriage can improve cognitive performance for some.Using data from the 1998{\textendash}2016 waves of the Health and Retirement Study (HRS; N = 23,393), we conducted two analyses. First, we used trajectory analysis to create clusters of participants with similar cognitive trajectories and tested the association between participants{\textquoteright} cluster membership and marital loss type. Second, we used multi-level modeling (MLM) to analyze the relationship between participants{\textquoteright} cognitive scores while married and following divorce or widowhood and linked these to marital features.Participants who divorced showed no difference in trajectory distribution; widowed participants were more likely to be in the lower-performing and more quickly declining groups. Participants had lower rates of decline following divorce (β = 0.136, p \< 0.001), while widowed participants had accelerated decline following spousal death (β = -0.183, p \< 0.001) and an immediate decline following spousal death (β = -0.11}, keywords = {Alzheimer{\textquoteright}s disease, Dementia, Marriage}, issn = {2399-5300}, doi = {10.1093/geroni/igae033}, author = {Hanes, Douglas William and Clouston, Sean A P} } @article {13816, title = {Cognitive Functioning is Higher among Older Adults in Walkable Neighborhoods that Have Low Economic Disadvantage}, year = {2024}, institution = {Syracuse University}, address = {Syracuse}, keywords = {cognitive, economic disadvantage, Older Adults, walkable neighborhoods}, url = {https://surface.syr.edu/cgi/viewcontent.cgi?article=1244\&context=lerner}, author = {Tse-Chuan Yang and Seulki Kim and Seung-won Emily Choi and Shannon Halloway and Uchechi A. Mitchell and Benjamin A. Shaw} } @article {13817, title = {Cognitive Functioning is Higher among Older Adults in Walkable Neighborhoods that Have Low Economic Disadvantage}, year = {2024}, institution = {Syracuse University}, address = {Syracuse}, keywords = {cognitive, economic disadvantage, Older Adults, walkable neighborhoods}, url = {https://surface.syr.edu/cgi/viewcontent.cgi?article=1244\&context=lerner}, author = {Tse-Chuan Yang and Seulki Kim and Seung-won Emily Choi and Shannon Halloway and Uchechi A. Mitchell and Benjamin A. Shaw} } @article {13748, title = {Cost of care for Alzheimer{\textquoteright}s disease and related dementias in the United States: 2016 to 2060.}, journal = {NPJ Aging}, volume = {10}, year = {2024}, pages = {13}, abstract = {

Medical and long-term care for Alzheimer{\textquoteright}s disease and related dementias (ADRDs) can impose a large economic burden on individuals and societies. We estimated the per capita cost of ADRDs care in the in the United States in 2016 and projected future aggregate care costs during 2020-2060. Based on a previously published methodology, we used U.S. Health and Retirement Survey (2010-2016) longitudinal data to estimate formal and informal care costs. In 2016, the estimated per patient cost of formal care was $28,078 (95\% confidence interval [CI]: $25,893-$30,433), and informal care cost valued in terms of replacement cost and forgone wages was $36,667 ($34,025-$39,473) and $15,792 ($12,980-$18,713), respectively. Aggregate formal care cost and formal plus informal care cost using replacement cost and forgone wage methods were $196 billion (95\% uncertainty range [UR]: $179-$213 billion), $450 billion ($424-$478 billion), and $305 billion ($278-$333 billion), respectively, in 2020. These were projected to increase to $1.4 trillion ($837 billion-$2.2 trillion), $3.3 trillion ($1.9-$5.1 trillion), and $2.2 trillion ($1.3-$3.5 trillion), respectively, in 2060.

}, keywords = {Alzheimer, cost, Dementia, Health Care, health policy}, issn = {2731-6068}, doi = {10.1038/s41514-024-00136-6}, author = {Nandi, Arindam and Counts, Nathaniel and Br{\"o}ker, Janina and Malik, Sabrina and Chen, Simiao and Han, Rachael and Klusty, Jessica and Seligman, Benjamin and Tortorice, Daniel and Vigo, Daniel and Bloom, David E} } @article {13831, title = {Dyadic profiles of couples{\textquoteright} self-perceptions of aging: Implications for mental health.}, journal = {Psychology and Aging}, volume = {39}, year = {2024}, pages = {153-165}, abstract = {

The way older adults perceive their own aging processes influences their mental health, but we know little about how this occurs in a dyadic context, where spouses{\textquoteright} perceptions and health are often intertwined. The present study sought to identify dyadic profiles of self-perceptions of aging (SPAs) in couples and examine how certain profiles are associated with each partner{\textquoteright}s mental health over time. A pooled sample of 3,850 heterosexual couples aged 50+ in the Health and Retirement Study (2012/2014) rated positive and negative SPAs and provided data on demographic characteristics, couple relationships, and health. We tracked these couples{\textquoteright} depressive symptoms over 2 years (2014/2016). Latent profile analysis revealed five profiles of couples{\textquoteright} SPAs: similarly positive (20\%), similarly negative (6\%), similarly average (38\%), husband negative (20\%), and wife negative (17\%). Physical health and marital quality consistently differentiated couples in profile membership. Couples with similarly positive and similarly average SPAs reported the smallest increases in depressive symptoms over time, and couples with similarly negative SPAs fared worst in mental health. We observed interesting gender differences across profiles; husbands in the husband negative profile reported significantly greater increases in depressive symptoms than those in the wife negative profile. Yet, wives in these two profiles did not differ in their depressive symptoms over time, and they reported worse mental health than wives in the similarly positive and similarly average profiles. This study adds to the emerging literature that advocates for an interpersonal approach to SPAs and reveals risk and resilience in couples as they age together. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

}, keywords = {Aged, Aging, Humans, Mental Health, Resilience, Psychological, Retirement, Self Concept}, issn = {1939-1498}, doi = {10.1037/pag0000801}, author = {Huo, Meng and Kim, Kyungmin} } @article {13769, title = {The Effect of Public Health Insurance on Individual Consumption: Evidence from Medicaid Expansion}, year = {2024}, abstract = {This paper examines the impact of the Affordable Care Act Medicaid expansion on individual consumption by leveraging nationally representative panel data of near-elderly adults in the United States. I take advantage of the panel structure to control for unobservable differences across individuals and to identify individuals who are more likely to be impacted by the expansion ex-ante. Using a difference-in-difference approach, I find that the ACA Medicaid expansion increases total monthly consumption by $144.13, which is equivalent to a 14.4 percent increase from the pre-expansion mean. This growth in total consumption is driven primarily by a rise in non-durable spending and housing consumption. Additionally, I observe that individuals in expansion states are 3.9 percentage points more likely to be homeowners than those in non-expansion states. These effects are driven by a reduction in out-of-pocket medical spending and an improvement in financial well-being.}, keywords = {Affordable Care Act, consumption, Medicaid expansion}, doi = {http://dx.doi.org/10.2139/ssrn.4722128}, author = {Allen Hardiman} } @article {13799, title = {First-generation college graduates have similar depressive symptoms in midlife as multi-generational college graduates.}, journal = {SSM Population Health}, volume = {25}, year = {2024}, pages = {101633}, abstract = {

PURPOSE: Higher education may protect an individual against depressive symptoms, yet, disadvantaged socioeconomic status (SES) during childhood, often measured by lower parental education, may put them at higher risk for depressive symptoms later in life. This study evaluates if midlife depression is similar for first-generation and multi-generation college graduates.

METHODS: For US Health and Retirement Study (HRS) participants ages 55-63 (N~=~16,752), we defined a 4-category exposure from parents{\textquoteright} (highest of mother or father{\textquoteright}s) and participant{\textquoteright}s own years of education, with 16 years indicating college completion: multi-gen (both 16 years: reference); first-gen (parents <16; own 16); only parent(s) (parents 16; own <16); and neither (both <16) college graduates across three birth cohorts. We used linear regressions to evaluate relationships between college completion and depressive symptoms measured by an 8-item Center for Epidemiologic Studies - Depression (CES-D) scale. Models pooled over time evaluated differences by sex, race/ethnicity, and birthplace.

RESULTS: First-gen and multi-gen college graduates averaged similar depressive symptoms in midlife (: 0.01; 95\% CI: 0.15, 0.13). Results were similar by sex and race/ethnicity.

CONCLUSION: Consistent with resource substitution theory, college completion may offset the deleterious effects of lower parental education on midlife depressive symptoms for first-generation graduates.

}, keywords = {First-generation, Intergenerational education, Midlife depressive symptoms}, issn = {2352-8273}, doi = {10.1016/j.ssmph.2024.101633}, author = {Meza, Erika and Hebert, Jillian and Garcia, Maria E and Torres, Jacqueline M and Glymour, M Maria and Vable, Anusha M} } @article {13813, title = {Grey divorce: Losing touch with adult children aggravates depression}, year = {2024}, publisher = {PsyPost}, keywords = {Adult children, depression, Divorce}, url = {https://www.psypost.org/grey-divorce-losing-touch-with-adult-children-aggravates-depression/}, author = {Hedrih, Vladimir} } @article {13718, title = {Health and Retirement Study 2020 Tracker}, year = {2024}, pages = {1-38}, institution = {Survey Research Center, Institute for Social Research, University of Michigan}, address = {Ann Arbor}, keywords = {data description, Tracker}, author = {HRS Staff} } @article {13884, title = {The importance of education for understanding variability of dementia onset in the United States}, journal = {Demographic Research}, volume = {50}, year = {2024}, abstract = {Background: Greater levels of education are associated with lower risk of dementia, but less is known about how education is also associated with the compression of dementia incidence. Objective: We extend the literature on morbidity compression by evaluating whether increased levels of education are associated with greater dementia compression. We evaluate these patterns across race and gender groups. Methods: We use the Health and Retirement Study (2000{\textendash}2016), a nationally representative longitudinal study of older adults in the United States. To evaluate the onset and compression of dementia across education groups, we examine the age-specific distribution of dementia events, identifying the modal age of onset and the standard deviation above the mode (a measure of compression). Results: While the modal age of onset is around 85 years among adults with a college degree, the modal age for adults with less than a high school education occurs before age 65 {\textendash} at least a 20-year difference. The standard deviation of dementia onset is about three times greater for adults with less than a high school education compared to adults with a college degree. Patterns were consistent across race and gender groups. Conclusions: This research highlights the variability of dementia experiences in the older population by documenting differences in longevity without dementia and compression of dementia onset among more educated adults and less educated adults. Contribution: We incorporate conceptual insights from the life span variability and compression literature to better understand education{\textendash}dementia disparities in both the postponement and uncertainty of dementia onset in the US population. }, keywords = {Dementia, Education, lifespan variability, modal age, morbidity compression}, doi = {10.4054/DemRes.2024.50.26}, author = {Hyungmin Cha and Mateo P. Farina and Chi-Tsun Chiu and Mark D. Hayward} } @article {13849, title = {Inflation and Economic Security of the Older Population}, year = {2024}, institution = {University of Michigan Retirement and Disability Research Center }, address = {Ann Arbor}, keywords = {economic security, economic vulnerability, Income, inflation, older population}, url = {https://mrdrc.isr.umich.edu/publications/papers/pdf/wp480.pdf}, author = {Michael D. Hurd and Susann Rohwedder} } @booklet {unknown, title = {Long Term Care Risk For Couples and Singles}, year = {2024}, abstract = {This paper compares the impact of long term care (LTC) risk on single and married households and studies the roles played by informal care (IC), consumption sharing within households, and Medicaid in insuring this risk. We develop a life-cycle model where individuals face survival and health risk, including the possibility of becoming highly disabled and needing LTC. Households are heterogeneous in various important dimensions including education, productivity, and the age difference between spouses. Health evolves stochasti-cally. Agents make consumption-savings decisions in a framework featuring an LTC state-dependent utility function. We find that household expenditures increase significantly when LTC becomes necessary, but married individuals are well insured against LTC risk due to IC. However, they still hold considerable assets due to the concern for the spouse who might become a widow/widower and can expect much higher LTC costs. IC significantly reduces precautionary savings for middle and high income groups, but interestingly, it encourages asset accumulation among low income groups because it reduces the probability of means-tested Medicaid LTC.}, keywords = {Household Risk, InformalCare, long term care, Medicaid, Precautionary Savings}, doi = {10.13140/RG.2.2.34349.87521}, author = {Capatina, Elena and Hansen, Gary and Hsu, Minchung} } @article {13701, title = {Older couples in stepfamilies report less positive and more negative relationships with their children}, year = {2024}, publisher = {PsyPost}, url = {https://www.psypost.org/2024/01/older-couples-in-stepfamilies-report-less-positive-and-more-negative-relationships-with-their-children-220817}, author = {Hedrih, Vladimir} } @article {13677, title = {Physical Activity Participation Decreases the Risk of Depression in Older Adults: The ATHLOS Population-Based Cohort Study.}, journal = {Sports Medicine Open}, volume = {10}, year = {2024}, pages = {1}, abstract = {

BACKGROUND: To which extent physical activity is associated with depression independent of older adults{\textquoteright} physical and cognitive functioning is largely unknown. This cohort study using harmonised data by the EU Ageing Trajectories of Health: Longitudinal Opportunities and Synergies consortium, including over 20 countries, to evaluate the longitudinal association of physical activity (light-to-moderate or vigorous intensity) with depression in older adults (aged >= 50~years).

RESULTS: We evaluated 56,818 participants (light-to-moderate models; 52.7\% females, age 50-102~years) and 62,656 participants (vigorous models; 52.7\% females, age 50-105~years). Compared to never, light-to-moderate or vigorous physical activity was associated with a lower incidence rate ratio (IRR) of depression (light-to-moderate model: once/week: 0.632, 95\% CI 0.602-0.663; twice or more/week: 0.488, 95\% CI 0.468-0.510; vigorous model: once/week: 0.652, 95\% CI 0.623-0.683; twice or more/week: 0.591, 95\% CI 0.566-0.616). Physical activity remained associated with depression after adjustment for the healthy ageing scale, which is a scale that incorporated 41 items of physical and cognitive functioning (light-to-moderate model: once/week: 0.787, 95\% CI 0.752-0.824; twice or more/week: 0.711, 95\% CI 0.682-0.742; vigorous model: once/week: 0.828, 95\% CI 0.792-0.866; twice or more/week: 0.820, 95\% CI 0.786-0.856).

CONCLUSIONS: Physical activity, of any intensity and weekly frequency, was a strong protective factor against depression, independent of physical and mental functioning. Health policies could stimulate the incorporation of lower physical activity intensity to protect against depression, which might be more feasible at the population level.

}, keywords = {Data harmonization, depression, Health metric, KLoSA, lifestyle behaviors, Physical activity, SHARE}, issn = {2199-1170}, doi = {10.1186/s40798-023-00664-7}, author = {Lima, Rodrigo A and Condominas, Elena and Sanchez-Niubo, Albert and Olaya, Beatriz and Koyanagi, Ai and de Miquel, Carlota and Haro, Josep Maria} } @article {13782, title = {The Potential of Informal Care for Self-Perceptions of Aging Among Older Community-Dwelling Adults: Longitudinal Findings From the Health and Retirement Study.}, journal = {Journal of Applied Gerontology, Series B, Psychological Sciences and social sciences}, volume = {79}, year = {2024}, abstract = {

OBJECTIVES: This is the first study to analyze, whether receipt of (informal) care with (instrumental) activities of daily living (IADL/ADL) is associated with (positive and negative) self-perceptions of aging among community-dwelling older adults; and whether chronological age moderates these associations, using a longitudinal design.

METHODS: Longitudinal data of the Health and Retirement Study in the United States was used. The sample was composed of up to 9,198 observations of community-dwelling adults aged >=50 years pooled over 6 waves (2008-2018). Receiving care at all and the amount of care received with (I)ADL were analyzed in association with positive and negative attitudes towards own aging (ATOA; 8-item modified Philadelphia Geriatric Center Morale Scale, positive and negative subscore). Adjusted fixed effects regression analyses with robust standard errors were calculated.

RESULTS: Transitioning into receipt of care with any (I)ADL was associated with lower positive ATOA but not with any change in negative ATOA. Chronological age moderated the association between receipt of informal care, primarily with IADL, and negative ATOA. More negative ATOA was found among care recipients between 50 and 64 years but less among care recipients aged >=80 years.

DISCUSSION: Receiving any form of informal care was associated with an increase in internalized ageism, in particular among adults aged 50 to 64 years, but a decrease among those aged >=80 years. Psycho-educative measures are recommended for adults with care needs to prevent a loss of positive self-perceptions of aging, and reduce the danger to their healthy aging, with the receipt of care.

}, keywords = {Activities of Daily Living, Aged, Humans, Independent Living, Longitudinal Studies, Patient Care, Retirement, Self Concept, United States}, issn = {1758-5368}, doi = {10.1093/geronb/gbad189}, author = {Zwar, Larissa and K{\"o}nig, Hans-Helmut and Hajek, Andr{\'e}} } @article {13730, title = {Purposeful and purposeless aging: Structural issues for sense of purpose and their implications for predicting life outcomes.}, journal = {Developmental Psychology}, volume = {60}, year = {2024}, pages = {75-93}, abstract = {

Despite the value of sense of purpose during older adulthood, this construct often declines with age. With some older adults reconsidering the relevance of purpose later in life, the measurement of purpose may suffer from variance issues with age. The current study investigated whether sense of purpose functions similarly across ages and evaluated if the predictive power of purpose on mental, physical, cognitive, and financial outcomes changes when accounting for a less age-affected measurement structure. Utilizing data from two nationwide panel studies (Health and Retirement Study: = 14,481; Midlife in the United States: = 4,030), the current study conducted local structural equation modeling and found two factors for the positively and negatively valenced purpose items in the Purpose in Life subscale (Ryff, 1989), deemed the purposeful and purposeless factor. These factors become less associated with each other at higher ages. When reproducing past findings with this two-factor structure, the current study found that the purposeful and purposeless factors predicted these outcomes in the same direction as would be suggested by past research, but the magnitude of these effects differed for some outcomes. The discussion focuses on the implications of what this means for our understanding of sense of purpose across the lifespan. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

}, keywords = {Aged, Aging, Humans, Longevity, Retirement, United States}, issn = {1939-0599}, doi = {10.1037/dev0001633}, author = {Pfund, Gabrielle N and Olaru, Gabriel and Allemand, Mathias and Hill, Patrick L} } @article {Chowdhury2024, title = {Regressive class models for machine learning algorithms to predict trajectories of repeated multinomial outcomes: an application to the activity of daily living of elderly data}, journal = {Communications in Statistics: Simulation and Computation}, year = {2024}, abstract = {Due to the advancement of electronic data capturing, the amount of repeated categorical data being collected and stored has increased. This massive amount of data is complex and poses significant statistical challenges in methodology and computation. To analyze such big data, the divide and recombine method is commonly used. First, a large data set is partitioned into subsets, and each subset is analyzed separately. Then, the results are recombined in a manner that produces statistically valid output. However, available literature can only accommodate cross-sectional data. We propose a new simpler approach to analyze large, repeated categorical data using a joint modeling framework. In the proposed method, follow-up time is a natural conditioning variable that allows big data to be divided into subsets. Then, using the relationship between joint, marginal, and conditional probabilities, we can recombine the results in a statistically valid way. Several machine learning algorithms for cross-sectional data are extended for repeated outcomes to predict trajectories using the proposed framework. As an illustration, the proposed methodology is used to analyze repeatedly measured activity of daily living (ADL) data from the Health and Retirement Study (HRS), USA. We also check model performances under multiple machine learning algorithms using bootstrap simulations. }, keywords = {Categorical outcomes, Large complex data, Machine learning, Markov chain, repeated measures}, doi = {10.1080/03610918.2024.2311774}, author = {Chowdhury, R.I. and Hasan, M.T. and Huda, S. and Sneddon, G.} } @article {13754, title = {Research Spotlight: Modeling Study Shows that Policies to Reduce Wealth Inequality Could Improve Health and Life Expectancy of Americans}, year = {2024}, publisher = {Massachusetts General Hospital}, keywords = {health, Life Expectancy, Wealth Inequality}, url = {https://www.massgeneral.org/news/research-spotlight/study-shows-policies-to-reduce-wealth-inequality-could-improve-life-expectancy}, author = {Himmelstein, Kathryn} } @article {13808, title = {Simultaneous variable selection and estimation in semiparametric regression of mixed panel count data.}, journal = {Biometrics}, volume = {80}, year = {2024}, pages = {ujad041}, abstract = {

Mixed panel count data represent a common complex data structure in longitudinal survey studies. A major challenge in analyzing such data is variable selection and estimation while efficiently incorporating both the panel count and panel binary data components. Analyses in the medical literature have often ignored the panel binary component and treated it as missing with the unknown panel counts, while obviously such a simplification does not effectively utilize the original data information. In this research, we put forward a penalized likelihood variable selection and estimation procedure under the proportional mean model. A computationally efficient EM algorithm is developed that ensures sparse estimation for variable selection, and the resulting estimator is shown to have the desirable oracle property. Simulation studies assessed and confirmed the good finite-sample properties of the proposed method, and the method is applied to analyze a motivating dataset from the Health and Retirement Study.

}, keywords = {Algorithms, Computer Simulation, Likelihood Functions}, issn = {1541-0420}, doi = {10.1093/biomtc/ujad041}, author = {Ge, Lei and Hu, Tao and Li, Yang} } @article {13775, title = {Structural Racism and Health Stratification: Connecting Theory to Measurement.}, journal = {Journal of Health and Social Behavior}, volume = {65}, year = {2024}, pages = {141-160}, abstract = {

Less than 1\% of studies on racialized health inequities have empirically examined their root cause: structural racism. Moreover, there has been a disconnect between the conceptualization and measurement of structural racism. This study advances the field by (1) distilling central tenets of theories of structural racism to inform measurement approaches, (2) conceptualizing U.S. states as racializing institutional actors shaping health, (3) developing a novel latent measure of structural racism in states, (4) using multilevel models to quantify the association between structural racism and five individual-level health outcomes among respondents from the Health and Retirement Study (N = 9,020) and the Behavioral Risk Factor Surveillance System (N = 308,029), and (5) making our measure of structural racism publicly available to catalyze research. Results show that structural racism is consistently associated with worse health for Black people but not White people. We conclude by highlighting this study{\textquoteright}s contributions (theoretical, methodological, and substantive) and important avenues for future research on the topic.

}, keywords = {Black or African American, Health Status Disparities, Humans, systemic racism, White}, issn = {2150-6000}, doi = {10.1177/00221465231222924}, author = {Brown, Tyson H and Homan, Patricia} } @article {13736, title = {Trajectory of multimorbidity before dementia: A 24-year follow-up study.}, journal = {Alzheimers \& dementia (Amsterdam, Netherlands)}, volume = {16}, year = {2024}, pages = {e12523}, abstract = {

INTRODUCTION: Although the multimorbidity-dementia association has been widely addressed, little is known on the long-term trajectory of multimorbidity (TOM) in preclinical dementia.

METHODS: Based on the Health and Retirement Study, burden of multimorbidity was quantified with the total number of eight long-term conditions (LTC). Patterns of TOM before dementia diagnosis were investigated with mixed-effects models.

RESULTS: In 1752 dementia cases and 5256 matched controls, cases showed higher and faster increasing predicted number of LTC than controls, with a significant case-control difference from 20 years prior to dementia diagnosis. Larger increases in number of LTC during preclinical phase of dementia were found in White participants, females, those whose age at dementia onset was younger, and those who were less educated.

DISCUSSION: Our findings emphasize the faster accumulation of multimorbidity in prodromal dementia than in natural aging, as well as effect modifications by age and sex.

HIGHLIGHTS: TOM increased faster in prodromal dementia than in natural ageing.Patterns of TOM by dementia status diverged at 20 years before dementia diagnosis.Patterns of TOM were modified by age and sex.

}, keywords = {Dementia, Epidemiology, multimorbidity, trajectory}, issn = {2352-8729}, doi = {10.1002/dad2.12523}, author = {Guo, Jing and Gao, Bin and Huang, Yun and Song, Suhang} } @article {12996, title = {Age and Cohort Trends in Formal Volunteering and Informal Helping in Later Life: Evidence From the Health and Retirement Study.}, journal = {Demography}, volume = {60}, year = {2023}, pages = {99-122}, abstract = {

Formal volunteering holds great importance for the recipients of volunteer services, individuals who volunteer, and the wider society. However, how much recent birth cohorts volunteer in middle and late adulthood compared with earlier birth cohorts is not well understood. Even less well-known are the age and cohort trends in informal helping provided to friends and neighbors in later adulthood. Using longitudinal data from the Health and Retirement Study, we estimated age and cohort trends in formal volunteering and informal helping from 1998 to 2018 for a wide range of birth cohorts born between 1909 and 1958. We used multivariate, multilevel models based on Bayesian generalized modeling methods to estimate the probabilities of volunteering and informal helping simultaneously in a single model. Despite having advantages in human and health capital, recent birth cohorts showed volunteering levels in late adulthood that are similar to those of their predecessors. Moreover, more recent birth cohorts were consistently less engaged in informal helping than earlier birth cohorts throughout the observation period. More research is needed to illuminate the sociocultural drivers of changes in helping behaviors and overall prosocial and civic engagement.

}, keywords = {Bayes Theorem, Retirement, Volunteers}, issn = {1533-7790}, doi = {10.1215/00703370-10395916}, author = {Han, Sae Hwang and Shih, Yao-Chi and Burr, Jeffrey A and Peng, Changmin} } @article {13240, title = {Age-Related Trajectories of General Fluid Cognition and Functional Decline in the Health and Retirement Study: A Bivariate Latent Growth Analysis.}, journal = {J Intell}, volume = {11}, year = {2023}, abstract = {

There have been few studies on associations between age-related declines in fluid cognition and functional ability in population-representative samples of middle-aged and older adults. We used a two-stage process (longitudinal factor analysis followed by structural growth modeling) to estimate bivariate trajectories of age-related changes in general fluid cognition (numeracy, category fluency, executive functioning, and recall memory) and functional limitation (difficulties in daily activities, instrumental activities, and mobility). Data came from the Health and Retirement Study (Waves 2010-2016; N = 14,489; ages 50-85 years). Cognitive ability declined on average by -0.05 SD between ages 50-70 years, then -0.28 SD from 70-85 years. Functional limitation increased on average by +0.22 SD between ages 50-70 years, then +0.68 SD from 70-85 years. Significant individual variation in cognitive and functional changes was observed across age windows. Importantly, cognitive decline in middle age (pre-age 70 years) was strongly correlated with increasing functional limitation ( = -.49, < .001). After middle age, cognition declined independently of change in functional limitation. To our knowledge, this is the first study to estimate age-related changes in fluid cognitive measures introduced in the HRS between 2010-2016.

}, issn = {2079-3200}, doi = {10.3390/jintelligence11040065}, author = {Handing, Elizabeth P and Jiao, Yuqin and Aichele, Stephen} } @article {13561, title = {Air pollution linked to dementia cases}, year = {2023}, publisher = {National Institutes of Health}, keywords = {Air Pollution, Dementia}, url = {https://www.nih.gov/news-events/nih-research-matters/air-pollution-linked-dementia-cases}, author = {National Institutes of Health} } @article {13410, title = {[Analysis of healthy life expectancy and related socioeconomic influencing factors among the middle-aged and elderly in China, the United States, and the European Union].}, journal = {Zhonghua Liu Xing Bing Xue Za Zhi}, volume = {44}, year = {2023}, month = {2023 Jun 10}, pages = {1006-1012}, abstract = {

To calculate and compare the healthy life expectancy (HLE) of the middle-aged and elderly in China, the United States, and developing and developed countries in the European Union(EU) and analyze the impact of socioeconomic factors on HLE in different countries or regions. Four surveys from 2010 to 2019 were brought into the research. The data were collected from the China Health and Retirement Longitudinal Study, Health and Retirement Study, and the Survey of Health, Ageing and Retirement in Europe. Developed and developing countries in the EU were divided into two groups for calculation. Education level, total family wealth, and work retirement status were selected to measure socioeconomic status, and activities of daily living were used as health status indicators. We used the multi-state life cycle table method to calculate the transition probability between different health states and estimate life expectancy and HLE. A total of 69 544 samples were included in the study. In terms of age, the middle-aged and elderly in the United States and developed countries of the EU have higher HLE in all age groups. In terms of gender, only Chinese women have lower HLE than men. Regarding socioeconomic factors, the middle-aged and elderly with higher education levels and total family wealth level have higher HLE. In China, working seniors have higher HLE, while for USA women and developed countries of the EU, retired or unemployed seniors have higher HLE. Demographic and socioeconomic factors impact HLE in different countries or regions. China should pay more attention to the health of women and the middle-aged and elderly retired with lower education and less total family wealth.

}, keywords = {Activities of Daily Living, Aged, China, European Union, Female, Healthy life expectancy, Humans, Longitudinal Studies, Male, Middle Aged, Socioeconomic factors, United States}, issn = {0254-6450}, doi = {10.3760/cma.j.cn112338-20221031-00924}, author = {Hou, X D and Luo, Y N and Jin, Y Z and Zheng, Z J} } @article {13350, title = {Apolipoprotein E (APOE) genotype, dementia, and memory performance among Caribbean Hispanic versus US populations.}, journal = {Alzheimers Dement}, volume = {19}, year = {2023}, pages = {602-610}, abstract = {

INTRODUCTION: Apolipoprotein E (APOE) is considered the major susceptibility gene for developing Alzheimer{\textquoteright}s disease. However, the strength of this risk factor is not well established across diverse Hispanic populations.

METHODS: We investigated the associations among APOE genotype, dementia prevalence, and memory performance (immediate and delayed recall scores) in Caribbean Hispanics (CH), African Americans (AA), Hispanic Americans (HA) and non-Hispanic White Americans (NHW). Multivariable logistic regressions and negative binomial regressions were used to examine these associations by subsample.

RESULTS: Our final dataset included 13,516 participants (5198 men, 8318 women) across all subsamples, with a mean age of 74.8 years. Prevalence of APOE ε4 allele was similar in CHs, HAs, and NHWs (21.8\%-25.4\%), but was substantially higher in AAs (33.6\%; P~<~0.001). APOE ε4 carriers had higher dementia prevalence across all groups.

DISCUSSION: APOE ε4 was similarly associated with increased relative risk of dementia and lower memory performance in all subsamples.

}, keywords = {Aged, Alleles, Alzheimer disease, Apolipoprotein E4, Apolipoproteins E, Caribbean Region, Female, Genotype, Hispanic or Latino, Humans, Male}, issn = {1552-5279}, doi = {10.1002/alz.12699}, author = {Llibre-Guerra, Jorge J and Li, Jing and Qian, Yuting and Llibre-Rodriguez, Juan de Jes{\'u}s and Jim{\'e}nez-Vel{\'a}zquez, Ivonne Z and Acosta, Daisy and Salas, Aquiles and Llibre-Guerra, Juan Carlos and Valvuerdi, Adolfo and Harrati, Amal and Weiss, Jordan and Liu, Mao-Mei and Dow, William H} } @article {13324, title = {Are Changes in Somatic Health Reflected Differently in Updated Self-Ratings by Big-Five Personality Traits?}, journal = {J Aging Health}, year = {2023}, pages = {8982643231180934}, abstract = {

OBJECTIVES: This longitudinal study tests whether the Big-Five personality traits influence the changes individuals make in self-rated health (SRH) as they adjust their initial level to account for information on concurrent changes in disease burden, activities of daily living (ADLs), and pain.

METHODS: A bi-variate Latent Growth Curve model was fitted to data to estimate longitudinal associations between SRH and each health measure across up-to-five repeated observations, collected from the year 2006 to 2018 from 13,096 participants in the Health and Retirement Study.

RESULTS: Negative longitudinal associations between SRH and all three health reports were significantly stronger for those who are more conscientious. No significant moderation was found for the other four personality traits.

DISCUSSION: Compared to the less conscientious, highly conscientious people may assign greater importance to specific health reports when rating and revising their assessments of SRH. This moderating effect was previously tested but not supported.

}, issn = {1552-6887}, doi = {10.1177/08982643231180934}, author = {Oi, Katsuya and Hardy, Melissa} } @article {13415, title = {Are loneliness and social isolation equal threats to health and well-being? An outcome-wide longitudinal approach.}, journal = {SSM Popul Health}, volume = {23}, year = {2023}, pages = {101459}, abstract = {

The detrimental effects of loneliness and social isolation on health and well-being outcomes are well documented. In response, governments, corporations, and community-based organizations have begun leveraging tools to create interventions and policies aimed at reducing loneliness and social isolation at scale. However, these efforts are frequently hampered by a key knowledge gap: when attempting to improve specific health and well-being outcomes, decision-makers are often unsure whether to target loneliness, social isolation, or both. Filling this knowledge gap will inform the development and refinement of effective interventions. Using data from the Health and Retirement Study (13,752 participants (59\% women and 41\% men, mean [SD] age~=~67 [10] years)), we examined how changes in loneliness and social isolation over a 4-year follow-up period (from t0:2008/2010 to t1:2012/2014) were associated with 32 indicators of physical-, behavioral-, and psychosocial-health outcomes 4-years later (t2:2016/2018). We used multiple logistic-, linear-, and generalized-linear regression models, and adjusted for sociodemographic, personality traits, pre-baseline levels of both exposures (loneliness and social isolation), and all outcomes (t0:2008/2010). We incorporated data from all participants into the overall estimate, regardless of whether their levels of loneliness and social isolation changed from the pre-baseline to baseline waves. After adjusting for a wide range of covariates, we observed that both loneliness and social isolation were associated with several physical health outcomes and health behaviors. However, social isolation was more predictive of mortality risk and loneliness was a stronger predictor of psychological outcomes. Loneliness and social isolation have independent effects on various health and well-being outcomes and thus constitute distinct targets for interventions aimed at improving population health and well-being.

}, keywords = {health, Loneliness, social isolation, Well-being}, issn = {2352-8273}, doi = {10.1016/j.ssmph.2023.101459}, author = {Hong, Joanna H and Nakamura, Julia S and Berkman, Lisa F and Chen, Frances S and Shiba, Koichiro and Chen, Ying and Kim, Eric S and VanderWeele, Tyler J} } @article {13339, title = {Assessing out-of-pocket expenses and indirect costs for the Alzheimer disease continuum in the United States.}, journal = {J Manag Care Spec Pharm}, year = {2023}, pages = {1-13}, abstract = {

The societal costs of Alzheimer disease (AD) are considerable. Cost data stratified by cost category (direct and indirect) and AD severity in the United States are limited. To describe out-of-pocket (OOP) expenses and indirect costs from unpaid caregiving and work impairment among patients with AD by severity and among patients with mild cognitive impairment (MCI) in a representative sample of the US population. Data from the Health and Retirement Study (HRS) were used. HRS respondents were included if they reported an AD diagnosis or were considered as having MCI based on their cognitive performance. MCI and AD severity staging was performed using a crosswalk from results of the modified Telephone Interview of Cognitive Status to the Mini-Mental State Examination. OOP expenses were assessed along with indirect costs (costs to caregivers from providing unpaid help and costs to employers). Sensitivity analyses were performed by varying assumptions of caregiver employment, missed workdays, and early retirement. Patients with AD were stratified by nursing home status, type of insurance, and income level. All cost calculations applied sampling weights. A total of 18,786 patients were analyzed. Patients with MCI (n = 17,885) and AD (n = 901) were aged 67.8 {\textpm} 10.7 and 80.9 {\textpm} 9.3 years, were 55.7\% and 63.3\% female, and were 28.3\% and 0.9\% employed, respectively. OOP expenses per patient per month increased with AD severity, ranging from $420 in mild to $903 in severe AD but were higher in MCI ($554) than in mild AD. Indirect costs to employers were similar across the AD continuum ($197-$242). Costs from unpaid caregiving generally increased by disease severity, from $72 (MCI) to $1,298 (severe AD). Total OOP and indirect costs increased by disease severity, from $869 (MCI) to $2,398 (severe AD). Sensitivity analysis assuming nonworking caregivers and zero costs to employers decreased the total OOP and indirect costs by 32\%-53\%. OOP expenses were higher for patients with AD who had private insurance ( < 0.01), had higher incomes ( < 0.01), or were in nursing homes ( < 0.01). Indirect costs to caregivers were lower for patients with AD in nursing homes ($600 vs $1,372, < 0.01). Total indirect costs were higher for patients with AD with lower incomes ($1,498 vs $1,136, < 0.01) and for those not in nursing homes ($1,571 vs $799, < 0.01). This study shows that OOP expenses and indirect costs increase with AD severity, OOP expenses increase with higher income, subscription of private insurance, and nursing home residency, and total indirect costs decrease with higher income and nursing home residency in the United States. This study was financially sponsored by Eisai. Drs Zhang and Tahami are employees of Eisai. Drs Chandak, Khachatryan, and Hummel are employees of Certara; Certara is a paid consultant to Eisai. The views expressed here are those of the authors and are not to be attributed to their respective affiliations. Laura De Benedetti, BSc, provided medical writing support to the manuscript; she is an employee of Certara.

}, issn = {2376-1032}, doi = {10.18553/jmcp.2023.23013}, author = {Monfared, Amir Abbas Tahami and Hummel, Noemi and Chandak, Aastha and Khachatryan, Artak and Zhang, Quanwu} } @article {13683, title = {Association between BMI trajectories in late-middle age and subsequent dementia risk in older age: a 26-year population-based cohort study.}, journal = {BMC Geriatrics}, volume = {23}, year = {2023}, pages = {773}, abstract = {

BACKGROUND: The association between body mass index (BMI) and dementia risk differs depending on follow-up time and age at BMI measurement. The relationship between BMI trajectories in late-middle age (50-65~years old) and the risk of dementia in older age (> 65~years old) has not been revealed.

METHODS: In the present study, participants from the Health and Retirement Study were included. BMI trajectories were constructed by combining BMI trend and variation information. The association between BMI trajectories at the age of 50-65~years and dementia risk after the age of 65~years was investigated. Participants with European ancestry and information on polygenic scores for cognitive performance were pooled to examine whether genetic predisposition could modify the association.

RESULTS: A total of 10,847 participants were included in the main analyses. A declining BMI trend and high variation in late-middle age were associated with the highest subsequent dementia risk in older age compared with an ascending BMI trend and low variation (RR = 1.76, 95\% CI = 1.45-2.13). Specifically, in stratified analyses on BMI trajectories and dementia risk based on each individual{\textquoteright}s mean BMI, the strongest association between a declining BMI trend with high variation and elevated dementia risk was observed in normal BMI group (RR = 2.66, 95\% CI = 1.72-4.1). Similar associations were found when participants were stratified by their genetic performance for cognition function without interaction.

CONCLUSIONS: A declining BMI trend and high variation in late-middle age were associated with a higher risk of dementia. Early monitoring of these individuals is needed to prevent dementia in older individuals.

}, keywords = {Aged, Body Mass Index, Cognition, Cohort Studies, Dementia, Humans, Risk Factors}, issn = {1471-2318}, doi = {10.1186/s12877-023-04483-z}, author = {Qin, Zijian and Liu, Zheran and Li, Ruidan and Luo, Yaxin and Wei, Zhigong and He, Ling and Pei, Yiyan and Su, Yonglin and Hu, Xiaolin and Peng, Xingchen} } @article {12945, title = {Association Between Loneliness and Postoperative Mortality Among Medicare Beneficiaries.}, journal = {JAMA Surgery}, volume = {158}, year = {2023}, pages = {212-214}, keywords = {Loneliness, Medicare}, issn = {2168-6262}, doi = {10.1001/jamasurg.2022.4784}, author = {Shen, Mary R and Suwanabol, Pasithorn A and Howard, Ryan A and Hu, Hsou Mei and Levine, Deborah A and Kenneth M. Langa and Waljee, Jennifer F} } @article {13320, title = {Association Between Serum Cystatin C and Cognitive Decline Independently from Creatinine: Evidence from Two Nationally Representative Aging Cohorts.}, journal = {J Alzheimers Dis}, volume = {93}, year = {2023}, pages = {459-469}, abstract = {

BACKGROUND: Studies on the association between cystatin C based estimated glomerular filtration rate (eGFRcys) and cognitive outcomes yielded inconsistent results.

OBJECTIVE: The present study aimed to examine the potential association of eGFRcys with subsequent cognitive decline rate.

METHODS: A total of 11,503 community-based participants were involved in our analyses, including 5,837 (aged 72.9{\textpm}6.3; 58.6\% women) in the Health and Retirement Study (HRS) from the US and 5,666 (aged 58.1{\textpm}9.2; 49.0\% women) in the China Health and Retirement Longitudinal Study (CHARLS). The association of eGFRcys with subsequent cognitive decline rate was evaluated by linear mixed models.

RESULTS: During 85,266 person-years of follow-up, both baseline elevated serum cystatin C (-0.048 standard deviation [SD]/year per mg/L; 95\% confidence interval [CI], -0.060 to -0.036; p < 0.001) and decreased eGFRcys (0.026 SD/year per 30 mL/min/1.73m2; 95\% CI, 0.020 to 0.032; p < 0.001) were associated with faster cognitive decline rate after full adjustment. Compared with those had eGFRcys >=90 mL/min/1.73m2, participants with eGFRcys between 60 to 90 mL/min/1.73m2 (-0.012 SD/year; 95\% CI, -0.020 to -0.004; p = 0.004) and those with eGFRcys <60 mL/min/1.73m2 (-0.048 SD/year; 95\% CI, -0.058 to -0.039; p < 0.001) experienced statistically significantly faster cognitive decline after adjustment. The associations were independent from serum creatinine/eGFRcre (eGFR that was calculated from serum creatinine).

CONCLUSION: Decreased eGFRcys are significantly associated with faster cognitive decline after full adjustment, independently from serum creatinine/eGFRcre. Serum cystatin C might be a risk factor or a prodromal biomarker of cognitive decline.

}, keywords = {Aging, Cognitive Dysfunction, Creatinine, Cystatin C, Female, Glomerular Filtration Rate, Humans, kidney, Longitudinal Studies, Male}, issn = {1875-8908}, doi = {10.3233/JAD-221162}, author = {Ma, Yanjun and Li, Chenglong and Hua, Rong and Yang, Chao and Xie, Wuxiang and Zhang, Luxia} } @article {12812, title = {Association Between Supplemental Nutrition Assistance Program Use and Memory Decline: Findings From the Health and Retirement Study.}, journal = {Neurology}, year = {2023}, abstract = {

BACKGROUND AND OBJECTIVES: Studies on the effect of the Supplemental Nutrition Assistance Program (SNAP) on the cognitive health of older adults are scarce. We sought to examine the associations between SNAP use and memory decline among SNAP-eligible US older adults.

METHODS: Participants aged 50+ and SNAP-eligible in 1996 from the Health and Retirement Study were included. Participants{\textquoteright} SNAP eligibility was constructed using federal criteria. Participants also self-reported whether they used SNAP. Memory function was assessed biennially from 1996 through 2016 using a composite score. To account for pre-existing differences in characteristics between SNAP users and non-users, we modeled the probability of SNAP use using demographic and health covariates. Using linear mixed-effect models, we then modeled trajectories of memory function for SNAP users and non-users using inverse probability (IP) weighting and propensity score (PS) matching techniques. In all models, we accounted for study attrition.

RESULTS: Of the 3,555 SNAP-eligible participants, a total of 15.7\% were SNAP users. At baseline, SNAP users had lower socioeconomic status and a greater number of chronic conditions than non-users, and were more likely to be lost to follow-up. Our multivariable IP-weighted models (N=3,555) suggested SNAP users had worse memory scores at baseline but slower rates of memory decline compared with non-users (annual decline rate is -0.038 standardized units [95\%CI=-0.044, -0.032] for users and -0.046 [95\%CI=-0.049, -0.043] for non-users). Results were slightly stronger from the PS-matched sample (N=1,014) (annual decline rate was -0.046 units [95\%CI=-0.050; -0.042] for users and -0.060 units [95\%CI=-0.064, -0.056] for non-users). Put in other words, our findings suggested that SNAP users had about 2 fewer years of cognitive aging over a 10-year period compared with non-users.

DISCUSSION: After accounting for pre-existing differences between SNAP users and non-users as well as differential attrition, we find SNAP use to be associated with slower memory function decline.

}, keywords = {cognitive aging, government food benefits, health policy, SNAP}, issn = {1526-632X}, doi = {10.1212/WNL.0000000000201499}, author = {Lu, Peiyi and Kezios, Katrina and Lee, Jongseong and Calonico, Sebastian and Wimer, Christopher and Al Hazzouri, Adina Zeki} } @article {13214, title = {Association of Arts Event Attendance With Cognitive Function Among Older Adults Enrolled in the Health and Retirement Study.}, journal = {Innov Aging}, volume = {7}, year = {2023}, pages = {igad015}, abstract = {

BACKGROUND AND OBJECTIVES: Among the cognitively impaired, arts engagement is associated with improved neurocognitive symptoms. Less is known about arts engagement as a potentially modifiable lifestyle factor to prevent or slow cognitive decline. Our aim was to evaluate the association between arts event attendance and cognition.

RESEARCH DESIGN AND METHODS: We used data from the 2014 and 2016 waves of the Health and Retirement Study to evaluate the association between arts event attendance and cognition using multivariable linear regressions. Arts event attendance in 2014 was our exposure of interest and included visiting an art museum or art gallery; attending an arts or crafts fair; attending a live performance (concert, play, or reading); and/or going to a movie theater. Cognitive function in 2016 measured on a 27-point scale by the Telephone Interview for Cognitive Status was our main outcome of interest.

RESULTS: Of the 1,149 participants included in the final analysis, 70.7\% attended an arts event. The mean baseline cognitive score was higher among those who attended art events (16.8 [standard deviation {}, {\textpm}3.8] vs 13.8 [, {\textpm}5.0]; < .001). In our multivariable regressions, those who attended arts events in 2014 exhibited higher cognitive scores in 2016 after controlling for demographic, socioeconomic, health, and baseline cognitive covariates (β, 1.07 [95\% confidence interval {CI}, 0.50-1.64]; < .001). This association was primarily observed in those with lower baseline cognitive function (β, 1.19 [95\% CI, 0.33-2.06]; = .008).

DISCUSSION AND IMPLICATIONS: Arts event attendance may be associated with better cognitive function. Given concerns for residual confounding and reverse causality, this association warrants further study.

}, keywords = {Arts engagement; Cognition; Community activity; Geriatrics; Humanities}, issn = {2399-5300}, doi = {10.1093/geroni/igad015}, author = {Ike, John David and Choi, Hwa Jung and Cho, Tsai-Chin and Howell, Joel D and Kenneth M. Langa} } @article {BRITT2023e670, title = {The Association of Private Prayer with Neuropsychiatric Symptoms, Cognition, and Sleep Disturbances in Persons with Dementia (Sci255)}, journal = {Journal of Pain and Symptom Management}, volume = {65}, year = {2023}, pages = {e670}, abstract = {Outcomes 1. Verbalize the association of private prayer with symptoms of dementia progression with cultural consideration of populations who may find religion and spirituality important to inform person-centered care. 2. Demonstrate the need for additional studies to be conducted examining association of private prayer over time with symptoms of dementia progression to evaluate potential for improving quality of life. Protective factors that slow progression and improve quality of life in persons with dementia (PWD) are needed. Neuropsychiatric symptoms (NPS), cognitive decline, and sleep disturbances are common, increase caregiver stress, and indicate dementia progression. Accruing research suggests religious practice is associated with improved mental and physical health, yet few studies have been conducted in dementia. We analyzed data from the Health and Retirement study in 2000, 2006, and 2008 and sub study, Aging, Demographics, and Memory Study in 2001{\textendash}2003, 2006{\textendash}2007, and 2008{\textendash}2009 to examine the association of private prayer with NPS, cognitive function, and sleep disturbances among PWD age 70 years and older in the United States (N=40). A cross-sectional analysis using bootstrapped Spearman{\textquoteright}s Rho correlation was utilized. Mean age was 84.67 years (sd 5.16), 73.9\% were non-Hispanic White, and 74.9\% were female. Ninety-one percent reported praying at least once per week with higher rates identified among non-Hispanic Black (100\%) and Hispanic participants (100\%). Cognitive function was 1.169 (sd .516), indicating mild cognitive impairment, mean score of NPS 5.22 (sd 7.41) was identified as clinically significant, and mean sleep disturbances .79 (sd 1.078) were mild on 0{\textendash}9 score. Private prayer was significantly associated with neuropsychiatric symptoms (rs (97) = - .358, 95\% CI [-.363, -.353], p<.01), cognitive function (rs (97) = - .383, 95\% CI [-.388, -.378], p<.01), and sleep disturbances (rs (97) = -,147 95\% CI [-.153, -.141], p<.01). Increased frequency of private prayer was associated with lower NPS, better cognitive function, and lower sleep disturbances. This could be due to the use of cognitive processes used in prayer to seek guidance for making decisions, request aid when distressed, and reduce loneliness through communication with the divine. Longitudinal studies are needed, including minority populations and examining age moderation especially as minorities and older adults find religion and spirituality important.}, issn = {0885-3924}, doi = {https://doi.org/10.1016/j.jpainsymman.2023.02.305}, url = {https://www.sciencedirect.com/science/article/pii/S0885392423003846}, author = {Katherine C. Britt and Kathy C. Richards and Shelli Kesler and Gayle Acton and Jill Hamilton and Kavita Radhakrishnan} } @article {13036, title = {Association of Religious Service Attendance and Neuropsychiatric Symptoms, Cognitive Function, and Sleep Disturbances in All-Cause Dementia.}, journal = {International Journal of Environmental Research and Public Health}, volume = {20}, year = {2023}, pages = {4300}, abstract = {

Commonly reported in dementia, neuropsychiatric symptoms (NPS), cognitive decline, and sleep disturbances indicate dementia progression. With the growing dementia burden, identifying protective factors that may slow dementia progression is increasingly essential. Religion and spirituality are associated with better mental and physical health, yet few studies have been reported in older adults with dementia. This study examines associations between religious service attendance and symptoms of dementia progression. Using data from the Health and Retirement Study in 2000, 2006, and 2008 and the sub-study, Aging, Demographics, and Memory Study in 2001-2003, 2006-2007, and 2008-2009, we examined the association of religious attendance with neuropsychiatric symptoms, cognitive function, and sleep disturbances among U.S. older adults aged 70 years and older with all-cause dementia ( = 72) using Spearman{\textquoteright}s partial Rho correlation controlling for social interaction. Significant associations were identified for religious attendance and NPS (r (97) = -0.124, 95\% CI [-0.129, -0.119], < 0.0005); cognitive function, r (97) = -0.018, 95\% CI [-0.023, -0.013], < 0.001); and sleep disturbances, r (97) = -0.275, 95\% CI [-0.280, -0.271], < 0.0005). Beyond adjusting for social interaction, increased religious attendance was associated with lower NPS, better cognitive function, and fewer sleep disturbances. Clinical trials and longitudinal studies with a larger sample size examining religion and spirituality factors with dementia progression are warranted.

}, keywords = {Cognition, Dementia, Religion, Sleep, Sleep Wake Disorders, Spirituality}, issn = {1660-4601}, doi = {10.3390/ijerph20054300}, author = {Britt, Katherine Carroll and Richards, Kathy C and Acton, Gayle and Hamilton, Jill and Radhakrishnan, Kavita} } @article {13068, title = {Association of the Mediterranean Dietary Approaches to Stop Hypertension Intervention for Neurodegenerative Delay (MIND) Diet With the Risk of Dementia.}, journal = {JAMA Psychiatry}, year = {2023}, abstract = {

IMPORTANCE: Dementia threatens the well-being of older adults, making efforts toward prevention of great importance.

OBJECTIVE: To evaluate the association of the Mediterranean-Dietary Approaches to Stop Hypertension (DASH) Intervention for Neurodegenerative Delay (MIND) diet with the risk of dementia in 3 prospective studies and a meta-analysis.

DESIGN, SETTING, AND PARTICIPANTS: Cohort analyses included the Whitehall II study (WII), the Health and Retirement Study (HRS), and the Framingham Heart Study Offspring cohort (FOS), and the meta-analysis included 11 cohort studies. Participants were middle-aged and older women and men from WII in 2002 to 2004, HRS in 2013, and FOS in 1998 to 2001 without dementia at the study baseline. Data were analyzed from May 25 to September 1, 2022.

EXPOSURES: MIND diet score was measured using food frequency questionnaires, and scores ranged from 0 to 15, with a higher score indicating higher adherence to the MIND diet.

MAIN OUTCOME AND MEASURES: Incident all-cause dementia, with cohort-specific definitions.

RESULTS: Included in this study were 8358 participants (mean [SD] age, 62.2 [6.0] years; 5777 male [69.1\%]) from WII, 6758 participants (mean [SD] age, 66.5 [10.4] years; 3965 female [58.7\%]) from HRS, and 3020 participants (mean [SD] age, 64.2 [9.1] years; 1648 female [54.6\%]) from FOS. The mean (SD) baseline MIND diet score was 8.3 (1.4) in WII, 7.1 (1.9) in HRS, and 8.1 (1.6) in FOS. Over 166 516 person-years, a total of 775 participants (220 in WII, 338 in HRS, and 217 in FOS) developed incident dementia. In the multivariable-adjusted Cox proportional hazard model, higher MIND diet score was associated with lower risk of dementia (pooled hazard ratio [HR] for every 3-point increment, 0.83; 95\% CI, 0.72-0.95; P for trend = .01; I2 = 0\%). The associations were consistently observed in subgroups defined by sex, age, smoking status, and body mass index. In the meta-analysis of 11 cohort studies with 224 049 participants (5279 incident dementia cases), the highest tertile of MIND diet score was associated with lower risk of dementia compared with the lowest tertile (pooled HR, 0.83; 95\% CI, 0.76-0.90; I2 = 35\%).

CONCLUSIONS AND RELEVANCE: Results suggest that adherence to the MIND diet was associated with lower risk of incident dementia in middle-aged and older adults. Further studies are warranted to develop and refine the specific MIND diet for different populations.

}, keywords = {Dementia, Hypertension, Mediterranean diet}, issn = {2168-6238}, doi = {10.1001/jamapsychiatry.2023.0800}, author = {Chen, Hui and Dhana, Klodian and Huang, Yuhui and Huang, Liyan and Tao, Yang and Liu, Xiaoran and Melo van Lent, Debora and Zheng, Yan and Ascherio, Alberto and Willett, Walter and Yuan, Changzheng} } @article {12741, title = {Associations of cumulative depressive symptoms with subsequent cognitive decline and adverse health events: Two prospective cohort studies.}, journal = {Journal of Affective Disorders}, volume = {320}, year = {2023}, pages = {91-97}, abstract = {

BACKGROUND: The course of depression is variable; however, few studies examined the relationship between long-term cumulative depressive symptoms and adverse health outcomes in the elderly.

METHODS: In this cohort study, we used data from the Health and Retirement Study (HRS) over 24 years and the English Longitudinal Study of Ageing (ELSA) over 16 years. Cumulative depressive symptoms were estimated by calculating the areas under the curve based on the Center for Epidemiological Research Depression scale assessed at four examinations. Outcomes include cognitive decline, incident dementia, cardiovascular disease (CVD), cancer, and all-cause mortality.

RESULTS: A total of 8284 American (mean age: 60.1 years; male: 35.4 \%) and 4314 British (60.1 years; 42.4 \%) were included in the analysis. The median follow-up was 16.1 years in the HRS and 9.9 years in the ELSA. Similar results were observed in two cohorts. Comparing with the first tertile of cumulative depressive symptoms, the third tertile experienced faster cognitive decline (p = 0.013 in the ELSA and p < 0.001 in the HRS), increased risk of dementia (both p < 0.001), CVD (both p < 0.001) and all-cause mortality (p = 0.002 in the HRS). Strong dose-response relationships were observed. We did not found clearly association between cumulative depressive symptoms and incident cancer.

CONCLUSIONS: This study suggests that long-term cumulative depressive symptoms were associated with subsequent faster cognitive decline and greater risks for dementia, CVD and all-cause mortality, but not cancer. These findings provide insights on potential effective strategy that may improve health in the elderly, future clinical trials are needed to determine causality.

}, keywords = {Adverse health events, Cumulative exposure, Depressive symptoms, ELSA}, issn = {1573-2517}, doi = {10.1016/j.jad.2022.09.128}, author = {Zhu, Yidan and Li, Chenglong and Wu, Tao and Wang, Yongqian and Hua, Rong and Ma, Yanjun and Xie, Wuxiang} } @article {13416, title = {Associations of Food Insecurity and Memory Function Among Middle to Older-Aged Adults in the Health and Retirement Study.}, journal = {JAMA Netw Open}, volume = {6}, year = {2023}, pages = {e2321474}, abstract = {

IMPORTANCE: Food insecurity is a leading public health issue in the US. Research on food insecurity and cognitive aging is scarce, and is mostly cross-sectional. Food insecurity status and cognition both can change over the life course, but their longitudinal relationship remains unexplored.

OBJECTIVE: To examine the longitudinal association between food insecurity and changes in memory function during a period of 18 years among middle to older-aged adults in the US.

DESIGN, SETTING, AND PARTICIPANTS: The Health and Retirement Study is an ongoing population-based cohort study of individuals aged 50 years or older. Participants with nonmissing information on their food insecurity in 1998 who contributed information on memory function at least once over the study period (1998-2016) were included. To account for time-varying confounding and censoring, marginal structural models were created, using inverse probability weighting. Data analyses were conducted between May 9 and November 30, 2022.

MAIN OUTCOMES AND MEASURES: In each biennial interview, food insecurity status (yes/no) was assessed by asking respondents whether they had enough money to buy food or ate less than they felt they should. Memory function was a composite score based on self-completed immediate and delayed word recall task of a 10-word list and proxy-assessed validated instruments.

RESULTS: The analytic sample included 12 609 respondents (mean [SD] age, 67.7 [11.0] years, 8146 [64.60\%] women, 10 277 [81.51\%] non-Hispanic White), including 11 951 food-secure and 658 food-insecure individuals in 1998. Over time, the memory function of the food-secure respondents decreased by 0.045 SD units annually (β for time, -0.045; 95\% CI, -0.046 to -0.045 SD units). The memory decline rate was faster among food-insecure respondents than food-secure respondents, although the magnitude of the coefficient was small (β for food insecurity {\texttimes} time, -0.0030; 95\% CI, -0.0062 to -0.00018 SD units), which translates to an estimated 0.67 additional (ie, excess) years of memory aging over a 10-year period for food-insecure respondents compared with food-secure respondents.

CONCLUSIONS AND RELEVANCE: In this cohort study of middle to older-aged individuals, food insecurity was associated with slightly faster memory decline, suggesting possible long-term negative cognitive function outcomes associated with exposure to food insecurity in older age.

}, keywords = {Adult, Aged, Cohort Studies, Cross-Sectional Studies, Female, Food insecurity, Food Supply, Humans, Male, Memory Disorders, Middle Aged, Retirement}, issn = {2574-3805}, doi = {10.1001/jamanetworkopen.2023.21474}, author = {Lu, Peiyi and Kezios, Katrina and Jawadekar, Neal and Swift, Samuel and Vable, Anusha and Zeki Al Hazzouri, Adina} } @article {12946, title = {Associations of local area level new deal employment in childhood with late life cognition: evidence from the census-linked health and retirement study.}, journal = {Journal of Epidemiology \& Community Health}, volume = {77}, year = {2023}, month = {2023 Fe}, pages = {81-88}, abstract = {

BACKGROUND: Emergency employment programmes during the 1930s and 1940s invested income, infrastructure and social services into communities affected by the Great Depression. We estimate the long-term associations of growing up in an area exposed to New Deal emergency employment in 1940 with cognitive functioning in later life.

METHODS: Members of the Health and Retirement Study cohort (N=5095; mean age 66.3 at baseline) who were age 0-17 in 1940 were linked to their census record from that year, providing prospective information about childhood contextual and family circumstances. We estimated the association between subcounty-level emergency employment participation in 1940 and baseline cognition and rate of cognitive decline between 1998 and 2016.

RESULTS: Compared with those living in the lowest emergency employment quintile in 1940, those who were exposed to moderate levels of emergency employment (third quintile) had better cognitive functioning in 1998 (b=0.092 SD, 95\% CI 0.011 to 0.173), conditional on sociodemographic factors. This effect was modestly attenuated after adjusting for respondents{\textquoteright} adult education, finances and health factors. There were no significant effects of area-level emergency employment on rate of cognitive decline.

CONCLUSIONS: Exposure to New Deal employment policies during childhood is associated with long-term cognitive health benefits. This is partially explained by increases in educational attainment among those with greater levels of emergency employment activity in the place where they were raised. Future research should investigate which types of New Deal investments may most be related to long-term cognitive health, or if the associations we observe are due to co-occurring programmes.

}, keywords = {Adolescent, Censuses, Child, Cognition, Employment, Infant, Newborn, Preschool, Prospective Studies, Retirement}, issn = {1470-2738}, doi = {10.1136/jech-2022-219259}, author = {Lee, Mark and Harrati, Amal and Rehkopf, David H and Modrek, Sepideh} } @article {doi:10.1200/JCO.2023.41.16_suppl.6531, title = {Associations of loneliness and mortality risk among cancer survivors in the United States.}, journal = {Journal of Clinical Oncology}, volume = {41}, year = {2023}, pages = {6531-6531}, abstract = {6531Background: Loneliness (i.e., the subjective feeling of being isolated from others), has been linked to multiple adverse health outcomes, including chronic conditions such as heart disease, mental health disorders, and higher risk for early mortality. However, associations between loneliness and worse health outcomes have not been thoroughly examined in cancer survivors. This study examined associations between loneliness and mortality risk among cancer survivors in the U.S. Methods: Cancer survivors were identified from the 2008-2018 Health and Retirement Study, a nationally representative longitudinal survey conducted biannually among individuals aged >=50 years, with follow-up was through December 31, 2020. Loneliness was measured at every 4 years using an abbreviated 11-item version of the UCLA Loneliness Scale Version 3. Example items include feelings of lacking companionship and isolation from others. Items were summed to create total loneliness scores, which were categorized into four levels: 11-12 (low/no loneliness), 13-15 (mild loneliness), 16-19 (moderate loneliness), and 20-33 (high loneliness). Time-varying Cox proportional hazard models were used to examine the association of loneliness and mortality risk among cancer survivors, while accounting for measurements at multiple time points. Sex, marital status, educational attainment, number of health conditions other than cancer, and year since cancer diagnosis were included in multivariable models. Results: Among 5808 person-years, there were 724 deaths during the study period. Compared to the low/no loneliness group, survivors reporting greater loneliness had higher hazard ratios (HR), indicating higher mortality risks; the highest HR observed was among the high loneliness group (HR:1.90, 95\%CI:1.58-2.29), following a dose-response association (Table). HRs were attenuated after adjusting for sociodemographic characteristics, but findings were largely unchanged, and HRs remained highest for the high loneliness group (HR:1.71, 95\%CI:1.39-2.12). Conclusions: Any elevated loneliness was associated with higher mortality risks among cancer survivors. Programs to screen for loneliness among cancer survivors and to provide social support to those in need are warranted. Association of loneliness and mortality risk among cancer survivors. Loneliness ScoreUnadjusted HR (95\%CI)Adjusted HR (95\%CI)11-121113-151.28 (1.00-1.63)1.21 (0.92-1.58)16-191.62 (1.33-1.98)1.47 (1.19-1.82)20-331.90 (1.58-2.29)1.71 (1.39-2.12)}, doi = {10.1200/JCO.2023.41.16_suppl.6531}, author = {Zhao, Jingxuan and Reese, Jennifer B. and Han, Xuesong and Yabroff, Robin} } @article {Hickman, title = {Associations of self-rated mental and physical work demands with cognition are dependent in a cross-sectional sample of the Health and Retirement Study}, journal = {Alzheimer{\textquoteright}s \& dementia}, volume = {19}, year = {2023}, abstract = {Background The number of older adults remaining in the workforce is growing, but little is known about how physical and mental work demands jointly affect cognitive health. This study assessed whether self-rated physical and mental work demands were associated with cognition among older working adults and whether their associations were dependent. Methods Our cross-sectional sample consisted of 6,376 working older adults in the 2004 wave of the Health and Retirement Study. Self-rated work demands were summarized from four questions about frequency of mental or physical demands in the respondent{\textquoteright}s current job. Cognition was assessed using a subset of the Telephone Interview for Cognitive Status. We used multivariable linear regression to test for associations and additive interaction between physical and mental work demands and cognition, adjusted for age, sex, race, education, and practice effect. Result Independently, higher physical work demands were associated (P<0.001) with poorer cognition and higher mental work demands were associated (P<0.001) with better cognition. In an interaction analysis, the effect of one work demand measure became more negative as level of the other increased (B for interaction = -0.22, 95\% CI: -0.42, -0.02). A one-point increase in mental work demands was associated with 0.69 (95\% CI: 0.40, 0.99) points higher cognition score when physical work demands were lowest. At the highest level of physical work demands, mental work demands were not associated with cognition (0.11, 95\% CI: -0.28, 0.49). A one-point increase in physical work demands was not associated with cognition (0.09, 95\% CI: -0.30, 0.48) when mental work demands were lowest. At the highest level of mental work demands, physical work demands were associated with -0.53 (95\% CI: -0.78, -0.29) points lower cognition score. The highest predicted cognition score was for the highest mental and lowest physical work demands. Results were robust to additional adjustment for health and behavior covariates. Conclusion The associations of self-rated mental and physical work demand with cognition were dependent. Beneficial cognitive effects of mental work demands may not apply to workers with physically demanding jobs. Future studies should strongly consider examining interactions to capture the range of work demand effects.}, keywords = {Cognition, mental work demands, physical work demands}, issn = {1552-5260}, doi = {10.1002/alz.066265}, author = {Hickman, Ruby and Bakulski, Kelly M and Brandt, Daniel and Jessica Faul and Ware, Erin B} } @article {13466, title = {Black-White Differences in Offspring Educational Attainment and Older Parents{\textquoteright} Dementia.}, journal = {J Health Soc Behav}, year = {2023}, pages = {221465231168910}, abstract = {

Emerging research documents the health benefits of having highly educated adult offspring. Yet less is known about whether those advantages vary across racial groups. This study examines how offspring education is tied to parents{\textquoteright} dementia risk for Black and White parents in the United States. Using data from the Health and Retirement Study, findings suggest that children{\textquoteright}s education does not account for the Black-White gap in dementia risk. However, results confirm that parental race moderates the relationship between children{\textquoteright}s education and dementia risk and that the association between children{\textquoteright}s education and parents{\textquoteright} dementia risk is strongest among less-educated parents. Among less-educated parents, higher levels of children{\textquoteright}s attainment prevent the risk of dementia onset for Black parents, but low levels of offspring schooling increase dementia risk among White parents. The study highlights how offspring education shapes the cognitive health of social groups differently and points to new avenues for future research.

}, keywords = {cognitive health; health disparities; intergenerational relationships; life course.}, issn = {2150-6000}, doi = {10.1177/00221465231168910}, author = {Yahirun, Jenjira J and Vasireddy, Sindhu and Hayward, Mark D} } @article {13183, title = {Black/white differences in the relationship between debt and risk of heart attack across cohorts.}, journal = {SSM Popul Health}, volume = {22}, year = {2023}, month = {2023 Jun}, pages = {101373}, abstract = {

BACKGROUND: Numerous studies show that increasing levels of education, income, assets, and occupational status are linked to greater improvements in White adults{\textquoteright} health than Black adults{\textquoteright}. Research has yet to determine, however, whether there are racial differences in the relationship between health and debt and whether this relationship varies across cohorts.

METHODS: Using data from the 1992-2018 Health and Retirement Study, we use survival analyses to examine the link between debt and heart attack risk among the Prewar Cohort, born 1931-1941, and Baby Boomers, born 1948-1959.

RESULTS: Higher unsecured debt is associated with increased heart attack risk for Black adults, especially among Baby Boomers and during economic recessions. Higher mortgage debt is associated with lower risk of heart attack for White but not Black Baby Boomers. The relationship between debt and heart attack risk remains after controlling for health behaviors, depressive symptoms, and other economic resources that are concentrated among respondents with high levels of debt.

CONCLUSION: Debt is predictive of heart attack risk, but the direction and strength of the relationship varies by type of debt, debtors{\textquoteright} racial identity, and economic context.

}, issn = {2352-8273}, doi = {10.1016/j.ssmph.2023.101373}, author = {Hamil-Luker, Jenifer and O{\textquoteright}Rand, Angela M} } @article {13244, title = {BMI trajectories in late middle age, genetic risk, and the incident diabetes in older adults: evidence from a 26-year longitudinal study.}, journal = {Am J Epidemiol}, year = {2023}, abstract = {

This study investigated the association between BMI trajectories in late middle age and incident diabetes in later years. A total of 11,441 participants aged 50-60 years from the Health and Retirement Study with at least two self-reported BMI records were included. Individual BMI trajectories representing average BMI changes per year were generated using multilevel modeling. Adjusted risk ratios (ARRs) and 95\% confidence intervals (95\% CIs) were calculated. Associations between BMI trajectories and diabetes risk in participants with different genetic risks were estimated for 5720 participants of European ancestry. BMI trajectories were significantly associated with diabetes risk in older age (slowly increasing vs. stable: ARR 1.31, 95\% CI 1.12-1.54; rapidly increasing vs. stable: ARR 1.5, 95\% CI 1.25-1.79). This association was strongest for normal-initial-BMI participants (slowly increasing: ARR 1.34, 95\% CI 0.96-1.88; rapidly increasing: ARR 2.06, 95\% CI 1.37-3.11). Participants with a higher genetic liability to diabetes and a rapidly increasing BMI trajectory had the highest risk for diabetes (ARR 2.15, 95\% CI 1.67-2.76). These findings confirmed that BMI is the leading risk factor for diabetes and that although the normal BMI group has the lowest incidence rate for diabetes, people with normal BMI are most sensitive to changes in BMI.

}, issn = {1476-6256}, doi = {10.1093/aje/kwad080}, author = {Luo, Yaxin and Liu, Zheran and Luo, Jiawei and Li, Ruidan and Wei, Zhigong and Yang, Lianlian and Li, Juejin and He, Ling and Su, Yonglin and Peng, Xingchen and Hu, Xiaolin} } @article {13173, title = {The burden of pre-admission pain, depression, and caregiving on palliative care needs for seriously ill trauma patients.}, journal = {J Am Geriatr Soc}, year = {2023}, month = {2023 Feb 21}, abstract = {

INTRODUCTION: Increasing numbers of individuals admitted to hospitals for trauma are older adults, many of whom also have underlying serious illnesses. Older adults with serious illness benefit from palliative care, but the palliative care needs of seriously ill older adults with trauma have not been elucidated. We hypothesize that older adults with serious illness have a high prevalence of pain, depression, and unpaid caregiving hours before trauma admission.

METHODS: Using Health and Retirement Study data (2008-2018) linked to Medicare claims, we identified patients 66 years or older who met an established definition of serious illness in surgery and were admitted with trauma. Descriptive analyses were performed for baseline patient characteristics, pre-admission pain (dichotomized as none/mild vs. moderate/severe), depression (dichotomized as no, Center for Epidemiologic Studies Depression scale [CES-D] < 3 vs. yes, CES-D >= 3), and unpaid caregiving hours (dichotomized as low (<30 h/month), high (>=30 h/month)).

RESULTS: We identified 1741 patients, 67.4\% were female and 86.8\% White. Mean age was 83 (SD 7.5), and 60.3\% had >=4 comorbidities. The majority (62.9\%) were admitted due to falls, 33.5\% had isolated hip fracture. The prevalence of baseline moderate/severe pain and depression were 38.1\% and 42.6\%, respectively. Among the cohort, 42.2\% had unpaid caregiving, of those 27.7\% had >=30 h/week of unpaid caregiving hours.

CONCLUSIONS: Prior to trauma admission, older adults with serious illness have a high prevalence of pain, depression, and unpaid caregiving hours. These findings may inform targeted palliative care interventions to reduce symptom burden and post-discharge healthcare utilization.

}, issn = {1532-5415}, doi = {10.1111/jgs.18289}, author = {Abbas, Muhammad and Reich, Amanda Jane and Wang, Yihan and Hu, Frances Y and Bollens-Lund, Evan and Kelley, Amy S and Cooper, Zara} } @article {13075, title = {Cardiometabolic multimorbidity, lifestyle behaviours, and cognitive function: a multicohort study.}, journal = {The Lancet. Healthy Longevity}, volume = {4}, year = {2023}, pages = {e265-e273}, abstract = {

BACKGROUND: Little is known about the effect of lifestyle factors on cognitive decline related to cardiometabolic multimorbidity. We aimed to examine the association between cardiometabolic multimorbidity and cognitive decline, and the role of lifestyle factors in this association.

METHODS: We did a pooled multi-cohort study using pooled data from four cohort studies (the Health and Retirement Study; the English Longitudinal Study of Ageing; the Survey of Health, Ageing and Retirement in Europe; and the China Health and Retirement Longitudinal Study) across 14 countries. Eligible participants were age 50 years and older, and those who were missing information on exposure and outcomes, or who had been diagnosed with dementia or Parkinson{\textquoteright}s disease, were excluded. Cardiometabolic multimorbidity was defined as the co-occurrence of two or three cardiometabolic diseases, including diabetes, heart disease, and stroke. The primary outcome of cognitive function was measured in three domains, on the basis of the mean and SD of the corresponding tests: memory, numeracy, and orientation, in all participants with available data. A global cognitive score was created by summing the individual scores.

FINDINGS: The final sample consisted of 160 147 individuals across all four studies (73 846 [46{\textperiodcentered}1\%] men and 86 301 [53{\textperiodcentered}9\%] women) and participants had a mean age of 67{\textperiodcentered}49 years (SD 10{\textperiodcentered}43). An increasing number of cardiometabolic diseases was dose-dependently associated with the decline in cognitive function score (one disease, β=-0{\textperiodcentered}15 [95\% CI -0{\textperiodcentered}17 to -0{\textperiodcentered}13]; two diseases, β=-0{\textperiodcentered}37 [-0{\textperiodcentered}40 to -0{\textperiodcentered}34]; three diseases, β=-0{\textperiodcentered}57 [-0{\textperiodcentered}64 to -0{\textperiodcentered}50]), with comorbid diabetes and stroke (β=-0{\textperiodcentered}23 [-0{\textperiodcentered}29 to -0{\textperiodcentered}17]) contributing most strongly to cardiometabolic disease-associated cognitive decline. Cognitive decline associated with cardiometabolic disease was accelerated with physical inactivity (one cardiometablic disease, p=0{\textperiodcentered}020; two cardiometablic diseases, p=0{\textperiodcentered}42; and three cardiometablic diseases, p=0{\textperiodcentered}24), excessive alcohol use (one cardiometablic disease, p=0{\textperiodcentered}016; two cardiometablic diseases, p=0{\textperiodcentered}65; and three cardiometablic diseases, p=0{\textperiodcentered}50), and the higher number of unhealthy lifestyle factors (one cardiometablic disease, p=0{\textperiodcentered}79; two cardiometablic diseases, p=0{\textperiodcentered}0050; and three cardiometablic diseases, p=0{\textperiodcentered}888).

INTERPRETATION: These findings indicated a targeted approach for simultaneously developing preventative interventions on lifestyles and integrated treatment for cardiometabolic comorbidities to delay cognitive decline in older people.

FUNDING: Major Project of the National Social Science Fund of China, National Natural Science Foundation of China, China Medical Board, and Young Elite Scientists Sponsorship Program by CAST.

}, keywords = {cardiometabolic multimorbidity, CHARLS, Cognition, ELSA, SHARE}, issn = {2666-7568}, doi = {10.1016/S2666-7568(23)00054-5}, author = {Jin, Yinzi and Liang, Jersey and Hong, Chenlu and Liang, Richard and Luo, Yanan} } @article {13217, title = {Cardiovascular disease and type 2 diabetes in older adults: a combined protocol for an individual participant data analysis for risk prediction and a network meta-analysis of novel anti-diabetic drugs.}, journal = {medRxiv}, year = {2023}, abstract = {

INTRODUCTION: Older and multimorbid adults with type 2 diabetes (T2D) are at high risk of cardiovascular disease (CVD) and chronic kidney disease (CKD). Estimating risk and preventing CVD is a challenge in this population notably because it is underrepresented in clinical trials. Our study aims to (1) assess if T2D and haemoglobin A1c (HbA1c) are associated with the risk of CVD events and mortality in older adults, (2) develop a risk score for CVD events and mortality for older adults with T2D, (3) evaluate the comparative efficacy and safety of novel antidiabetics.

METHODS AND ANALYSIS: For Aim 1, we will analyse individual participant data on individuals aged >=65 years from five cohort studies: the Optimising Therapy to Prevent Avoidable Hospital Admissions in Multimorbid Older People study; the Cohorte Lausannoise study; the Health, Aging and Body Composition study; the Health and Retirement Study; and the Survey of Health, Ageing and Retirement in Europe. We will fit flexible parametric survival models (FPSM) to assess the association of T2D and HbA1c with CVD events and mortality. For Aim 2, we will use data on individuals aged >=65 years with T2D from the same cohorts to develop risk prediction models for CVD events and mortality using FPSM. We will assess model performance, perform internal-external cross validation, and derive a point-based risk score. For Aim 3, we will systematically search randomized controlled trials of novel antidiabetics. Network meta-analysis will be used to determine comparative efficacy in terms of CVD, CKD, and retinopathy outcomes, and safety of these drugs. Confidence in results will be judged using the CINeMA tool.

ETHICS AND DISSEMINATION: Aims 1 and 2 were approved by the local ethics committee (Kantonale Ethikkommission Bern); no approval is required for Aim 3. Results will be published in peer-reviewed journals and presented in scientific conferences.

STRENGTHS AND LIMITATIONS: We will analyse individual participant data from multiple cohort studies of older adults who are often not well represented in large clinical trials.By using flexible survival parametric models, we will be able to capture the potentially complex shapes of the baseline hazard functions of cardiovascular disease (CVD) and mortality.Our network meta-analysis will include recently published randomised controlled trials on novel anti-diabetic drugs that have not been included in previous network meta-analysis and results will be stratified by age and baseline HbA1cAlthough we plan to use several international cohorts, the external validity of our findings and particularly of our prediction model will need to be assessed in independent studiesOur study will help guide CVD risk estimation and prevention among older adults with type 2 diabetes.

}, keywords = {anti-diabetic drugs, Cardiovascular disease, Diabetes, risk prediction}, doi = {10.1101/2023.03.13.23287105}, author = {Aponte Ribero, Valerie and Alwan, Heba and Efthimiou, Orestis and Abolhassani, Nazanin and Bauer, Douglas C and Henrard, S{\'e}verine and Christiaens, Antoine and Waeber, G{\'e}rard and Rodondi, Nicolas and Gencer, Baris and Del Giovane, Cinzia} } @article {13137, title = {Centrally Acting ACE Inhibitor Use and Physical Performance in Older Adults.}, journal = {J Frailty Aging}, volume = {12}, year = {2023}, month = {2023}, pages = {103-108}, abstract = {

BACKGROUND: There is conflicting evidence regarding the role of angiotensin-converting enzyme inhibitors and physical function. While some studies show improvements in muscle strength and physical function, others show no significant difference or decreased performance. This ambiguity could be due to differential effects of angiotensin-converting enzyme inhibitor subtypes which can be categorized as centrally or peripherally-acting based upon their ability to cross the blood-brain barrier.

OBJECTIVE: The objective of this study is to compare physical performance measures among angiotensin-converting enzyme inhibitor subtype users.

METHODS: Design: Cross-sectional Setting: Ambulatory Participants: Performed in 364 participants in the Health and Retirement Study cohort who were >= 65 years (median age (IQR) 74.00 (69-80) years.

MEASUREMENTS: Average difference in hand grip (kg), gait speed(m/s) and peak expiratory flow (L/min).

RESULTS: Compared to participants on a peripherally-acting angiotensin-converting enzyme inhibitor (113 (31\%)), those on a centrally-acting agent (251(69\%)) had stronger grip strength 28.9 {\textpm}1.0 vs 26.3{\textpm}1.0, p=.011 and higher peak expiratory flow rates 316.8{\textpm}130.4 vs. 280.0{\textpm}118.5, p= .011 in unadjusted analysis. After multiple adjustments the difference in PEF remained statistically significant (Estimate(CI) 26.5, 95\% CI 2.24, 50.5, p = 0.032).

CONCLUSION: Our results suggest that in older adults the use of centrally-acting angiotensin-converting enzyme inhibitors compared to a peripherally acting angiotensin-converting enzyme inhibitors was associated with better lung function in older individuals.

}, keywords = {Aged, Angiotensin-Converting Enzyme Inhibitors, Cross-Sectional Studies, Hand Strength, Humans, Muscle Strength, Physical Functional Performance}, issn = {2260-1341}, doi = {10.14283/jfa.2023.10}, author = {George, C J and Hall, C B and Weiss, E F and Verghese, J and Neptune, E and Abadir, P} } @article {13354, title = {Changes in childhood caregiving impressions among middle-aged and older adults}, year = {2023}, abstract = {Childhood experiences and impressions are important for individuals{\textquoteright} health and well-being{\textemdash}they often set the stage for how people approach relationships across the lifespan and how they make sense of their relational worlds. However, impressions of these experiences are likely not static and can change over time, even years after these experiences happened. The current study examined how impressions of parental relationships in childhood changed over time, and predictors of these changes, among middle-aged and older adults followed over a 4-year period (N = 2692; Mage = 66.67, SD = 9.15; 64.1\% women). Childhood impressions of parental care were mostly stable over time, with 53.5\%{\textendash}65.0\% of participants reporting consistent impressions. Becoming divorced/separated as an adult was associated with more negative impressions about relationships with fathers in the past. Having a mother pass away was associated with more positive impressions of mothers{\textquoteright} caregiving when participants were children. Higher depressive symptoms at follow-up were associated with darker perceptions of the past{\textemdash} more negative impressions of mothers and fathers as caregivers. The current study is one of the most comprehensive studies of late-life changes in childhood impressions to date, suggesting future directions for studying the organization of relational experiences and recollection over time.}, keywords = {caregiving impressions, divorce/separation, Health and Retirement Study, life span development, reminiscence bump}, doi = { 10.1111/pere.12499}, author = {William J. Chopik and Jeewon Oh and Sneha R. Challa and Hannah L. Hua and Julia M. Maahs and Jacqui Smith} } @article {13086, title = {Changes in Self-Perceptions of Aging Among Black and White Older Adults: The Role of Volunteering.}, journal = {J Gerontol B Psychol Sci Soc Sci}, volume = {78}, year = {2023}, month = {2023 May 11}, pages = {830-840}, abstract = {

OBJECTIVES: Given the health consequences of self-perceptions of aging (SPA), understanding how SPA change among Black and White older adults may shed light on racial disparities in late-life health. The current study is the first to assess whether Black older adults exhibit less favorable patterns of change in SPA than White older adults. We also tested whether the salubrious effect of volunteering on SPA would be particularly salient among Black older adults.

METHODS: A pooled sample of adults aged 50+ (N~=~10,183; Black: n~=~1,672, White: n~=~8,511) from the Health and Retirement Study rated positive and negative SPA once every 4~years across 3 waves (2008/2010, 2012/2014, and 2016/2018). We assessed participants{\textquoteright} reports on volunteering status in each wave.

RESULTS: Growth curve models revealed that positive SPA decreased over time whereas negative SPA increased. Black older adults reported more positive and less negative SPA at baseline and flatter time-related changes than their White counterparts. We found that volunteering was significantly associated with more positive and less negative SPA across waves, but this effect was only evident in White older adults.

DISCUSSION: Findings revealed vulnerabilities in White older adults as they experience and perceive age-related changes but also identified volunteering as a way to uniquely protect them. More research is needed to refine our understanding of racial disparities in the United States and help tailor interventions intended to maximize benefits to older adults from diverse backgrounds.

}, keywords = {Aged, Aging, Black People, Humans, Racial Groups, Self Concept, United States, White}, issn = {1758-5368}, doi = {10.1093/geronb/gbad007}, author = {Huo, Meng and Kim, Kyungmin and Haghighat, Misha D} } @article {https://doi.org/10.1002/aepp.13272, title = {Changing patterns of SNAP take-up and participation and the role of out-of-pocket medical expenses among older adults}, journal = {Applied Economic Perspectives and Policy}, volume = {45}, year = {2023}, pages = {336-349}, abstract = {We use longitudinal data from the nationally representative Health and Retirement Study from 2002 to 2016 to document how Supplemental Nutrition Assistance Program (SNAP) participation and estimated take-up changed over time for older adults and the role that out-of-pocket medical expenses has played in these changing patterns. We rely upon the state adoption of Medicaid expansion of the Affordable Care Act as a source of identifying variation and do not find evidence that Medicaid expansion changed estimated SNAP take-up or participation. These findings suggest that out-of-pocket medical expenses are unlikely to be a major driver of SNAP take-up decisions for the nondisabled population under age 65.}, keywords = {Elderly, Medicaid expansion, Medical Expenses, SNAP}, doi = {https://doi.org/10.1002/aepp.13272}, author = {Heflin, Colleen and Li, Jun and Zuo, Dongmei} } @article {13503, title = {CogDrisk, ANU-ADRI, CAIDE, and LIBRA Risk Scores for Estimating Dementia Risk.}, journal = {JAMA Netw Open}, volume = {6}, year = {2023}, month = {2023 Aug 01}, pages = {e2331460}, abstract = {

IMPORTANCE: While the Australian National University-Alzheimer Disease Risk Index (ANU-ADRI), Cardiovascular Risk Factors, Aging, and Dementia (CAIDE), and Lifestyle for Brain Health (LIBRA) dementia risk tools have been widely used, a large body of new evidence has emerged since their publication. Recently, Cognitive Health and Dementia Risk Index (CogDrisk) and CogDrisk for Alzheimer disease (CogDrisk-AD) risk tools have been developed for the assessment of dementia and AD risk, respectively, using contemporary evidence; comparison of the relative performance of these risk tools is limited.

OBJECTIVE: To evaluate the performance of CogDrisk, ANU-ADRI, CAIDE, LIBRA, and modified LIBRA (LIBRA with age and sex estimates from ANU-ADRI) in estimating dementia and AD risks (with CogDrisk-AD and ANU-ADRI).

DESIGN, SETTING, AND PARTICIPANTS: This population-based cohort study obtained data from the Rush Memory and Aging Project (MAP), the Cardiovascular Health Study Cognition Study (CHS-CS), and the Health and Retirement Study-Aging, Demographics and Memory Study (HRS-ADAMS). Participants who were free of dementia at baseline were included. The factors were component variables in the risk tools that included self-reported baseline demographics, medical risk factors, and lifestyle habits. The study was conducted between November 2021 and March 2023, and statistical analysis was performed from January to June 2023.

MAIN OUTCOMES AND MEASURES: Risk scores were calculated based on available factors in each of these cohorts. Area under the receiver operating characteristic curve (AUC) was calculated to measure the performance of each risk score. Multiple imputation was used to assess whether missing data may have affected estimates for dementia risk.

RESULTS: Among the 6107 participants in 3 validation cohorts included for this study, 2184 participants without dementia at baseline were available from MAP (mean [SD] age, 80.0 [7.6] years; 1606 [73.5\%] female), 548 participants without dementia at baseline were available from HRS-ADAMS (mean [SD] age, 79.5 [6.3] years; 288 [52.5\%] female), and 3375 participants without dementia at baseline were available from CHS-CS (mean [SD] age, 74.8 [4.9] years; 1994 [59.1\%] female). In all 3 cohorts, a similar AUC for dementia was obtained using CogDrisk, ANU-ADRI, and modified LIBRA (MAP cohort: CogDrisk AUC, 0.65 [95\% CI, 0.61-0.69]; ANU-ADRI AUC, 0.65 [95\% CI, 0.61-0.69]; modified LIBRA AUC, 0.65 [95\% CI, 0.61-0.69]; HRS-ADAMS cohort: CogDrisk AUC, 0.75 [95\% CI, 0.71-0.79]; ANU-ADRI AUC, 0.74 [95\% CI, 0.70-0.78]; modified LIBRA AUC, 0.75 [95\% CI, 0.71-0.79]; CHS-CS cohort: CogDrisk AUC, 0.70 [95\% CI, 0.67-0.72]; ANU-ADRI AUC, 0.69 [95\% CI, 0.66-0.72]; modified LIBRA AUC, 0.70 [95\% CI, 0.68-0.73]). The CAIDE and LIBRA also provided similar but lower AUCs than the 3 aforementioned tools (eg, MAP cohort: CAIDE AUC, 0.50 [95\% CI, 0.46-0.54]; LIBRA AUC, 0.53 [95\% CI, 0.48-0.57]). The performance of CogDrisk-AD and ANU-ADRI in estimating AD risks was also similar.

CONCLUSIONS AND RELEVANCE: CogDrisk and CogDrisk-AD performed similarly to ANU-ADRI in estimating dementia and AD risks. These results suggest that CogDrisk and CogDrisk-AD, with a greater range of modifiable risk factors compared with other risk tools in this study, may be more informative for risk reduction.

}, keywords = {Aged, Aged, 80 and over, Alzheimer disease, Australia, Cohort Studies, Female, Heart Disease Risk Factors, Humans, Male, Risk Factors}, issn = {2574-3805}, doi = {10.1001/jamanetworkopen.2023.31460}, author = {Huque, Md Hamidul and Kootar, Scherazad and Eramudugolla, Ranmalee and Han, S Duke and Carlson, Michelle C and Lopez, Oscar L and Bennett, David A and Peters, Ruth and Anstey, Kaarin J} } @article {12962, title = {Cognitive Aging in Same- and Different-Sex Relationships: Comparing Age of Diagnosis and Rate of Cognitive Decline in the Health and Retirement Study.}, journal = {Gerontology}, volume = {69}, year = {2023}, pages = {356-369}, abstract = {

INTRODUCTION: The ongoing marginalization of lesbian, gay, and bisexual people has been hypothesized to produce poorer late-in-life cognitive outcomes, according to mechanisms posited by minority stress and allostatic load theories. Yet the existence of those outcomes remains understudied, and results of existing studies have been contradictory. Using a population-based longitudinal aging study, this paper will compare age at diagnosis of Alzheimer{\textquoteright}s disease (AD) or a related dementia and rates of cognitive decline between participants in same-sex relationships (SSRs) and different-sex relationships (DSRs).

METHODS: The study used longitudinal cognitive-health data from the Health and Retirement Study (HRS; 1998-2018; N = 26,344) to analyze the onset of cognitive impairment and AD/dementia and the rates of cognitive change between participants in SSRs and those in DSRs. We hypothesized that SSR participants would have worse overall cognitive functioning in old age and would experience earlier onset of cognitive impairment. Using multiple regression, we compared the ages at which participants in SSRs and DSRs first reported AD or dementia diagnoses and the ages at which they first scored below cutoffs for cognitive impairment, not dementia (CIND) and possible dementia as determined using the cognitive assessment. The study then compared rates of cognitive decline over time across the SSR and DSR groups, including stratified analyses by education, race/ethnicity, wealth, and sex/gender.

RESULTS: Participants in SSRs reported dementia diagnoses (β = -12.346; p = 0.001), crossed the threshold into CIND (β = -8.815; p < 0.001) and possible dementia (β = -13.388; p < 0.001) at a younger age than participants in DSRs. When adjusted for covariates, participants in SSRs also had lower cognition at baseline (β = 0.745; p = 0.003), though having slower rates of cognitive decline when SSR was interacted with time (β = 0.066; p = 0.003). In separate analyses, cognitive differences for SSR participants were only found in participants without undergraduate degrees, with below-median household incomes, and women.

CONCLUSION: Our findings support theories suggesting that marginalization and stigma cause premature cognitive impairment. Findings also suggest that higher education might mitigate the adverse effects of sexuality-minority status on cognitive aging. Results do not support these theories{\textquoteright} claims of more rapid cognitive decline; the lower slopes of cognitive decline with time are compatible with the possibility of slower rates of decline for aging individuals in SSRs.

}, keywords = {Alzheimer disease, bisexual, Cognition, cognitive aging, Cognitive Dysfunction, Gay, Lesbian, Retirement, same-sex relationship, sexual orientation}, issn = {1423-0003}, doi = {10.1159/000526922}, author = {Hanes, Douglas William and Clouston, Sean A P} } @article {13019, title = {Cognitive Decline Before and During COVID-19 Pandemic Among Older People With Multimorbidity: A Longitudinal Study.}, journal = {Journal of the American Medical Directors Association }, volume = {24}, year = {2023}, pages = {419-425.e10}, abstract = {

OBJECTIVE: To investigate whether older people living with multimorbidity would suffer an accelerated decline in cognition during the COVID-19 pandemic, compared with prepandemic data.

DESIGN: A 5-year cohort conducting surveys from year 2016 to 2021, with 2016 to 2019 as the control period and 2019 to 2021 the pandemic period.

SETTING AND PARTICIPANTS: In total, 9304 cognitively healthy older participants age >=50~years were included from the Health and Retirement Study (HRS).

METHODS: Multimorbidity was defined as the concurrent presence of 2 or more chronic diseases. A global cognition z score was calculated using memory (immediate and delayed word recall tests) and executive function (counting backwards and the serial sevens tests). Incident dementia was defined using either the reported physician diagnosis or an alternative approach based on cognition summary score. Linear mixed models were used to assess longitudinal changes, while modified Poisson regression models were used to analyze the risk of incident dementia.

RESULTS: Of the 9304 participants included, 3649 (39.2\%) were men, with a mean age of 65.8 {\textpm} 10.8~years. Participants with multimorbidity (n~= 4375) suffered accelerated declines of 0.08 standard deviation (95\% confidence interval 0.03, 0.13, P~= .003) in global cognition and an elevated dementia risk (risk ratio 1.66, 95\% confidence 1.05 to 2.61, P~= .029), compared with individuals without morbidity (n~= 1818) during the pandemic period. After further adjusting sociodemographic characteristics and prepandemic cognitive measurements, these differences remained evident. In contrast, no significant differences in cognitive declines were observed during the control period.

CONCLUSIONS AND IMPLICATIONS: During the COVID-19 pandemic, older people with multimorbidity suffered an accelerated decline in cognition and elevated incident dementia risk, while no evident differences in cognitive decline rates were observed before the pandemic. Measures targeting vulnerable older people with multimorbidity could be significant for assisting these individuals to tackle neurocognitive challenges during the pandemic.

}, keywords = {Cognition, Cognitive Dysfunction, COVID-19, Dementia, multimorbidity, Pandemics}, issn = {1538-9375}, doi = {10.1016/j.jamda.2023.01.001}, author = {Li, Chenglong and Hua, Rong and Gao, Darui and Zheng, Fanfan and Xie, Wuxiang} } @article {13174, title = {Cognitive impairment and partnership status in the United States, 1998-2016, by sex, race/ethnicity, and education.}, journal = {Popul Stud (Camb)}, year = {2023}, month = {2023 Feb 22}, pages = {1-11}, abstract = {

Cognitively impaired adults without a partner are highly disadvantaged, as partners constitute an important source of caregiving and emotional support. With the application of innovative multistate models to the Health and Retirement Study, this paper is the first to estimate joint expectancies of cognitive and partnership status at age 50 by sex, race/ethnicity, and education in the United States. We find that women live a decade longer unpartnered than men. Women are also disadvantaged as they experience three more years as both cognitively impaired and unpartnered than men. Black women live over twice as long as cognitively impaired and unpartnered compared with White women. Lower-educated men and women live around three and five years longer, respectively, as cognitively impaired and unpartnered than more highly educated men and women. This study addresses a novel facet of partnership and cognitive status dynamics and examines their variations by key socio-demographic factors.

}, issn = {1477-4747}, doi = {10.1080/00324728.2023.2174267}, author = {Sharma, Shubhankar and Hale, Jo Mhairi and Myrskyl{\"a}, Mikko and Kulu, Hill} } @article {12614, title = {Cognitive Impairment and Supplemental Nutrition Assistance Program Take-up Among the Eligible Older Americans.}, journal = {The Journals of Gerontology, Series B }, year = {2023}, abstract = {

OBJECTIVES: Participation in the Supplemental Nutrition Assistance Program (SNAP) among eligible adults 60 and older is much lower than among the younger population, and rates continue to decline throughout the life course while at the same time the risk of cognitive impairment increases. Due to the high administrative burden associated with SNAP eligibility processes, cognitive impairment may be associated with low uptake of SNAP among the low-income older adult population, particularly among more socially disadvantaged groups (females, Blacks, and those living alone). We provide new evidence that changes in cognitive functioning are associated with reductions in the probability of SNAP take-up among eligible older adults.

METHODS: Using panel data from the Health and Retirement Study, we estimate linear probability fixed-effects models to assess the effect of cognitive decline on the likelihood of SNAP participation among eligible adults aged 60 and above, controlling for observed characteristics that change over time as well as individual, time, and state fixed effects.

RESULTS: Reduced levels of cognitive functioning that rise to the classification of dementia were strongly associated with reductions in the probability of SNAP take-up among eligible older adults. Results were particularly salient for females and those living alone.

DISCUSSION: One barrier to SNAP take-up among older adults may be cognitive impairment with the size of effect differing by gender and living arrangement. Policymakers may want to consider initiatives to increase SNAP participation among older adults, including a focus on further simplification of eligibility and recertification processes that reduce administrative burden.

}, keywords = {Cognition, Dementia, The Supplemental Nutrition Assistance Program (SNAP)}, issn = {1758-5368}, doi = {10.1093/geronb/gbac111}, author = {Zuo, Dongmei and Heflin, Colleen M} } @article {13299, title = {Communication Modalities, Personality Traits, and Change in Perceived Control Over Social Life Following Onset of the COVID-19 Pandemic Among Older Americans.}, journal = {Res Aging}, year = {2023}, pages = {1640275231178809}, abstract = {

We examined associations between change in social contact communication modalities and change in perceived control over social life (PCOSL) following onset of the COVID-19 pandemic among older Americans and evaluated the extent to which associations were moderated by personality. Data were from the 2016 and 2020 waves of the Health and Retirement Study. Multivariate ordinary least squares regression analyses were computed adjusting for baseline PCOSL, sociodemographic, health, and psychosocial factors. Multiple moderation analyses revealed that extraversion moderated the association between change in social media communication and change in PCOSL before to during COVID-19. As levels of engagement in social media communication increased, those with high extraversion experienced increases in PCOSL, whereas those with low extraversion experienced decreases in PCOSL. Findings suggest that social interventions targeting perceived control and communication modality may be useful for older adults during global health events and that personality characteristics can help to inform intervention choices.

}, issn = {1552-7573}, doi = {10.1177/01640275231178809}, author = {Choi, Shinae L and Hill, Kyrsten C and Parmelee, Patricia A} } @article {13360, title = {Comparison of Imputation Strategies for Incomplete Longitudinal Data in Lifecourse Epidemiology.}, journal = {Am J Epidemiol}, year = {2023}, abstract = {

Incomplete longitudinal data are common in lifecourse epidemiology and may induce bias leading to incorrect inference. Multiple imputation (MI) is increasingly preferred for handling missing data, but few studies explore MI method performance and feasibility in real data settings. We compared three MI methods using real data under nine missing data scenarios, representing combinations of 10\%, 20\%, and 30\% missingness and missing completely at random, at random, and not at random. Using data from Health and Retirement Study (HRS) participants, we introduced record-level missingness to a sample of participants with complete data on depressive symptoms (1998-2008), mortality (2008-2018), and relevant covariates. We then imputed missing data using three MI methods (normal linear regression, predictive mean matching, variable-tailored specification), and fit Cox proportional hazards models to estimate effects of four operationalizations of longitudinal depressive symptoms on mortality. We compared bias in hazard ratios, root mean square error (RMSE), and computation time for each method. Bias was similar across MI methods and results were consistent across operationalizations of the longitudinal exposure variable. However, our results suggest predictive mean matching may be an appealing strategy for imputing lifecourse exposure data given consistently low RMSE, competitive computation times, and few implementation challenges.

}, issn = {1476-6256}, doi = {10.1093/aje/kwad139}, author = {Shaw, Crystal and Wu, Yingyan and Zimmerman, Scott C and Hayes-Larson, Eleanor and Belin, Thomas R and Power, Melinda C and Glymour, M Maria and Mayeda, Elizabeth Rose} } @article {13452, title = {Comparison of Particulate Air Pollution From Different Emission Sources and Incident Dementia in the US.}, journal = {JAMA Intern Med}, year = {2023}, abstract = {

IMPORTANCE: Emerging evidence indicates that exposure to fine particulate matter (PM2.5) air pollution may increase dementia risk in older adults. Although this evidence suggests opportunities for intervention, little is known about the relative importance of PM2.5 from different emission sources.

OBJECTIVE: To examine associations of long-term exposure of total and source-specific PM2.5 with incident dementia in older adults.

DESIGN, SETTING, AND PARTICIPANTS: The Environmental Predictors of Cognitive Health and Aging study used biennial survey data from January 1, 1998, to December 31, 2016, for participants in the Health and Retirement Study, which is a nationally representative, population-based cohort study in the US. The present cohort study included all participants older than 50 years who were without dementia at baseline and had available exposure, outcome, and demographic data between 1998 and 2016 (N = 27 857). Analyses were performed from January 31 to May 1, 2022.

EXPOSURES: The 10-year mean total PM2.5 and PM2.5 from 9 emission sources at participant residences for each month during follow-up using spatiotemporal and chemical transport models.

MAIN OUTCOMES AND MEASURES: The main outcome was incident dementia as classified by a validated algorithm incorporating respondent-based cognitive testing and proxy respondent reports. Adjusted hazard ratios (HRs) were estimated for incident dementia per IQR of residential PM2.5 concentrations using time-varying, weighted Cox proportional hazards regression models with adjustment for the individual- and area-level risk factors.

RESULTS: Among 27 857 participants (mean [SD] age, 61 [10] years; 15 747 [56.5\%] female), 4105 (15\%) developed dementia during a mean (SD) follow-up of 10.2 [5.6] years. Higher concentrations of total PM2.5 were associated with greater rates of incident dementia (HR, 1.08 per IQR; 95\% CI, 1.01-1.17). In single pollutant models, PM2.5 from all sources, except dust, were associated with increased rates of dementia, with the strongest associations for agriculture, traffic, coal combustion, and wildfires. After control for PM2.5 from all other sources and copollutants, only PM2.5 from agriculture (HR, 1.13; 95\% CI, 1.01-1.27) and wildfires (HR, 1.05; 95\% CI, 1.02-1.08) were robustly associated with greater rates of dementia.

CONCLUSION AND RELEVANCE: In this cohort study, higher residential PM2.5 levels, especially from agriculture and wildfires, were associated with higher rates of incident dementia, providing further evidence supporting PM2.5 reduction as a population-based approach to promote healthy cognitive aging. These findings also indicate that intervening on key emission sources might have value, although more research is needed to confirm these findings.

}, issn = {2168-6114}, doi = {10.1001/jamainternmed.2023.3300}, author = {Zhang, Boya and Weuve, Jennifer and Kenneth M. Langa and D{\textquoteright}Souza, Jennifer and Szpiro, Adam and Jessica Faul and Mendes de Leon, Carlos and Gao, Jiaqi and Kaufman, Joel D and Sheppard, Lianne and Lee, Jinkook and Lindsay C Kobayashi and Hirth, Richard and Adar, Sara D} } @article {12977, title = {A Connection Between Diabetes, Oral Health and Dementia Highlights the Importance of Dental Care}, year = {2023}, publisher = {Oral Health Group}, keywords = {Dementia, Diabetes, Oral Health}, url = {https://www.oralhealthgroup.com/news/a-connection-between-diabetes-oral-health-and-dementia-highlights-the-importance-of-dental-care-1003972396/}, author = {Oral Heatlh} } @article {13513, title = {Cross-National and Cross-Generational Evidence That Educational Attainment May Slow the Pace of Aging in European-Descent Individuals.}, journal = {The Journal of Gerontology, Series B }, volume = {78}, year = {2023}, pages = {1375-1385}, abstract = {

OBJECTIVES: Individuals with more education are at lower risk of developing multiple, different age-related diseases than their less-educated peers. A reason for this might be that individuals with more education age slower. There are 2 complications in testing this hypothesis. First, there exists no definitive measure of biological aging. Second, shared genetic factors contribute toward both lower educational attainment and the development of age-related diseases. Here, we tested whether the protective effect of educational attainment was associated with the pace of aging after accounting for genetic factors.

METHODS: We examined data from 5 studies together totaling almost 17,000 individuals with European ancestry born in different countries during different historical periods, ranging in age from 16 to 98 years old. To assess the pace of aging, we used DunedinPACE, a DNA methylation algorithm that reflects an individual{\textquoteright}s rate of aging and predicts age-related decline and Alzheimer{\textquoteright}s disease and related disorders. To assess genetic factors related to education, we created a polygenic score based on the results of a genome-wide association study of educational attainment.

RESULTS: Across the 5 studies, and across the life span, higher educational attainment was associated with a slower pace of aging even after accounting for genetic factors (meta-analysis effect size = -0.20; 95\% confidence interval [CI]: -0.30 to -0.10; p = .006). Further, this effect persisted after taking into account tobacco smoking (meta-analysis effect size = -0.13; 95\% CI: -0.21 to -0.05; p = .01).

DISCUSSION: These results indicate that higher levels of education have positive effects on the pace of aging, and that the benefits can be realized irrespective of individuals{\textquoteright} genetics.

}, keywords = {Academic Success, Educational Status, Genome-Wide Association Study}, issn = {1758-5368}, doi = {10.1093/geronb/gbad056}, author = {Sugden, Karen and Moffitt, Terrie E and Arpawong, Thalida Em and Arseneault, Louise and Belsky, Daniel W and Corcoran, David L and Crimmins, Eileen M and Hannon, Eilis and Houts, Renate and Mill, Jonathan S and Poulton, Richie and Ramrakha, Sandhya and Wertz, Jasmin and Williams, Benjamin S and Caspi, Avshalom} } @article {13588, title = {Decision Making for Patients With Severe Dementia Versus Normal Cognition Near the End of Life.}, journal = {Innovation in Aging}, volume = {7}, year = {2023}, pages = {igad081}, abstract = {

BACKGROUND AND OBJECTIVES: The clinical progression of severe dementia frequently leads to situations where surrogate decision makers must quickly make choices about potentially burdensome treatments that offer limited clinical benefit. We examined whether the number of decision makers and their access to advance directives were related to treatment choice for patients with severe dementia in comparison to those with normal cognition.

RESEARCH DESIGN AND METHODS: We retrospectively linked survey responses about end-of-life treatment decisions to Medicare claims for Health and Retirement Study respondents dying between 2002 and 2015 whose next-of-kin reported a need for surrogate decision making. We estimated multivariable logistic regression models to study measures of aggressive care in the last 6 months of life; in-hospital death, burdensome transfers, and burdensome treatments.

RESULTS: Compared to patients who were cognitively normal near the end of life ( = 1 198), patients with severe dementia ( = 722) were less likely to experience burdensome treatments (18\% [95\% confidence interval {CI} 14-21] vs 32\% [95\% CI 29-35]), burdensome transfers (20\% [95\% CI 17-24] vs 30\% [95\% CI 27-33]), and in-hospital death (24\% [95\% CI 20-28] vs 30\% [95\% CI 26-33]) when surrogates were involved. Rates of burdensome treatments, transfers, or in-hospital death for decedents with severe dementia did not vary with single versus multiple decision makers or when decision makers were informed by advance directives. However, among decedents with normal cognition, a single decision maker informed by an advance directive was associated with the lowest rates of burdensome treatments and in-hospital death.

DISCUSSION AND IMPLICATIONS: Surrogate decision makers made similar choices around end-of-life care for patients with severe dementia regardless of the number of decision makers and availability of advance directives. However, both advance directives and single decision makers were associated with less aggressive care for cognitively normal decedents.

}, keywords = {Advance care planning, cognitive impairment, family caregivers}, issn = {2399-5300}, doi = {10.1093/geroni/igad081}, author = {Nicholas, Lauren Hersch and Halpern, Scott D and David R Weir and Baum, Micah Y and Nolan, Marie and Gallo, Joseph and Kenneth M. Langa} } @article {13310, title = {Decomposing interaction and mediating effects of race/ethnicity and circulating blood levels of cystatin C on cognitive status in the United States health and retirement study}, year = {2023}, abstract = {Background and objectives: Elevated circulating cystatin C is associated with cognitive impairment in non-Hispanic Whites, but its role in racial disparities in dementia is understudied. In a nationally representative sample of older non-Hispanic White, non-Hispanic Black, and Hispanic adults in the United States, we use mediation-interaction analysis to understand how racial disparities in the cystatin C physiological pathway may contribute to racial disparities in prevalent dementia. Results: Overall, elevated cystatin C was associated with dementia (prevalence ratio [PR] = 1.4; 95\%CI: 1.2, 1.8). Among non-Hispanic Black relative to non-Hispanic White participants, the relative excess risk due to interaction was 1.7 (95\% CI: -0.2, 3.7), the attributable proportion was 0.2 (95\%CI: 0.0, 0.5), and the synergy index was 1.4 (95\% CI: 1.0, 2.0) in a fully-adjusted model. Elevated cystatin C was estimated to account for 2\% (95\% CI: -0\%, 4\%) for the racial disparity in prevalent dementia, and the interaction accounted for 9\% (95\% CI: -4\%, 23\%). Analyses for Hispanic relative to non-White participants suggested moderation by race/ethnicity, but not mediation. Discussion: Elevated cystatin C was associated with dementia prevalence. Our mediation-interaction decomposition analysis suggested that the effect of elevated cystatin C on the racial disparity might be moderated by race/ethnicity, which indicates that the racialization process affects not only the distribution of circulating cystatin C across minoritized racial groups, but also the strength of association between the biomarker and dementia prevalence. These results provide evidence that cystatin C is associated with adverse brain health and this effect is larger than expected for individuals racialized as minorities had they been racialized and treated as non-Hispanic White.}, doi = {10.3389/fnhum.2023.1052435}, author = {Higgins Tejera, C{\'e}sar and Ware, Erin B and Lindsay C Kobayashi and Fu, Mingzhou and Hicken, Margaret} } @article {13684, title = {Dementia Attributable Healthcare Utilizations in the Caribbean versus United States.}, journal = {Journal of Alzheimers Disease: JAD}, volume = {96}, year = {2023}, pages = {801-811}, abstract = {

BACKGROUND: Despite the high burden of Alzheimer{\textquoteright}s disease and other dementias among the Hispanic population worldwide, little is known about how dementia affects healthcare utilizations among this population outside of the US, in particular among those in the Caribbean region.

OBJECTIVE: This study examines healthcare utilization associated with Alzheimer{\textquoteright}s disease and other dementias among older adults in the Caribbean as compared to the US.

METHODS: We conducted harmonized analyses of two population-based surveys, the 10/66 Dementia Group Research data collected in Dominican Republic, Cuba, and Puerto Rico, and the US-based Health and Retirement Study. We examined changes in hospital nights and physician visits in response to incident and ongoing dementias.

RESULTS: Incident dementia significantly increased the risk of hospitalization and number of hospital nights in both populations. Ongoing dementia increased the risk of hospitalization and hospital nights in the US, with imprecise estimates for the Caribbean. The number of physician visits was elevated in the US but not in the Caribbean.

CONCLUSIONS: The concentration of increased healthcare utilization on hospital care and among patients with incident dementia suggests an opportunity for improved outpatient management of new and existing dementia patients in the Caribbean.

}, keywords = {Aged, Alzheimer disease, Delivery of Health Care, ethnicity, Humans, Patient Acceptance of Health Care, Puerto Rico, United States}, issn = {1875-8908}, doi = {10.3233/JAD-230505}, author = {Li, Jing and Weiss, Jordan and Rajadhyaksha, Ashish and Acosta, Daisy and Harrati, Amal and Jim{\'e}nez Vel{\'a}zquez, Ivonne Z and Liu, Mao-Mei and Guerra, Jorge J Llibre and Rodriguez, Juan de Jes{\'u}s Llibre and Dow, William H} } @article {13231, title = {Depression trajectories, genetic risk, and cognitive performance in older adults: multilevel model with a 10-year longitudinal cohort.}, journal = {Gerontology}, year = {2023}, abstract = {

BACKGROUND: Cognitive performance in older ages is strongly affected by individuals{\textquoteright} genetic predispositions. We investigated whether depression trajectories were associated with subsequent cognitive performance independent of participants{\textquoteright} genetic predispositions.

METHODS: Participants from the Health and Retirement Study with European ancestry and aged over 50 were included in the analysis. Depressive symptoms were evaluated using the Center for Epidemiologic Studies Depression Scale, and the 6-year trajectories were fitted using latent class linear mixed models. Linear multilevel regression was applied to model the associations between depression trajectory and subsequent cognitive performance. Stratified analyses were performed to investigate these associations in participants with different genetic predispositions of cognitive performance and APOE ε4 allelic status.

RESULTS: A total of 5942 eligible participants were included in the study. Four depression trajectories were identified. Compared with the non-depression trajectory, all other depression trajectories were associated with worse cognitive performance (β [95\% CI]: mild-depression trajectory: -0.20 [-0.56, -0.06], p = 0.007; worsening-depression trajectory: -0.29 [-0.47, -0.12], p = 0.001; persistent-depression trajectory: -0.32 [-0.53, -0.13], p = 0.001). Although these associations were independent of participants{\textquoteright} inherent genetic risk, the participants with a low polygenetic score for cognitive performance were more likely to have an enhanced association between depression trajectories and cognitive decline. Similar relationships were also found in APOE ε4 noncarriers.

CONCLUSION: Among older participants with European ancestry, even a mild-depression trajectory was associated with worse cognitive performance. Early intervention in participants with any degree of depression might benefit regarding preventing cognitive performance decline.

}, keywords = {depression, genetic risk, Older Adults}, issn = {1423-0003}, doi = {10.1159/000530200}, author = {Liu, Zheran and Su, Yonglin and Huang, Rendong and Li, Ruidan and Wei, Zhigong and He, Ling and Pei, Yiyan and Min, Yu and Hu, Xiaolin and Peng, Xingchen} } @article {13163, title = {Dietary Intake Levels of Iron, Copper, Zinc, and Manganese in Relation to Cognitive Function: A Cross-Sectional Study.}, journal = {Nutrients}, volume = {15}, year = {2023}, month = {2023 Jan 30}, abstract = {

: Previous studies have related circulating levels of trace metal elements, of which dietary intake is the major source, to cognitive outcomes. However, there are still relatively few studies evaluating the associations of dietary intake levels of iron, copper, zinc, and manganese with cognitive function (CF). : We leveraged the data of 6863 participants (mean [standard deviation] age = 66.7 [10.5] years) in the Health and Retirement Study (2013/2014). Dietary intake levels of iron, copper, zinc, and manganese were calculated from a semi-quantitative food frequency questionnaire. CF was assessed using the 27-point modified Telephone Interview for Cognitive Status (TICS). We used linear regression models to calculate the mean differences in global CF scores by quintiles of dietary intake levels of trace metal elements. : Among the study participants, the mean (SD) values of daily dietary intake were 13.3 (6.3) mg for iron, 1.4 (0.7) mg for copper, 10.7 (4.6) mg for zinc, and 3.3 (1.6) mg for manganese. Compared with the lowest quintile of dietary iron intake (<8.1 mg), the highest quintile (>=17.7 mg) was associated with a lower cognitive score (-0.50, -0.94 to -0.06, P-trend = 0.007). Higher dietary copper was significantly associated with poorer CF (P-trend = 0.002), and the mean difference in cognitive score between extreme quintiles (>=1.8 vs. <0.8 mg) was -0.52 (95\% confidence interval: -0.94 to -0.10) points. We did not observe significant associations for dietary intake of zinc (P-trend = 0.785) and manganese (P-trend = 0.368). : In this cross-sectional study, higher dietary intake of iron and copper was related to worse CF, but zinc and manganese intake levels were not significantly associated with CF.

}, keywords = {Aged, Cognition, Copper, Cross-Sectional Studies, Eating, Humans, Iron, Manganese, Trace Elements, Zinc}, issn = {2072-6643}, doi = {10.3390/nu15030704}, author = {Zhao, Dong and Huang, Yilun and Wang, Binghan and Chen, Hui and Pan, Wenfei and Yang, Min and Xia, Zhidan and Zhang, Ronghua and Yuan, Changzheng} } @article {13648, title = {Do Pets Really Help Aging People Stay Mentally Sharp?}, year = {2023}, publisher = {Psychology Today}, keywords = {Cognition, ELSA, Pets}, url = {https://www.psychologytoday.com/us/blog/animals-and-us/202312/do-pets-really-help-aging-people-stay-mentally-sharp}, author = {Herzog, Hal} } @article {13428, title = {Does education moderate gender disparities in later-life memory function? A cross-national comparison of harmonized cognitive assessment protocols in the United States and India.}, journal = {Alzheimers Dement}, year = {2023}, abstract = {

INTRODUCTION: We compared gender disparities in later-life memory, overall and by education, in India and the United States (US).

METHODS: Data (N~=~7443) were from harmonized cognitive assessment protocols (HCAPs) in the Longitudinal Aging Study of India-Diagnostic Assessment of Dementia (LASI-DAD; N~=~4096; 2017-19) and US Health and Retirement Study HCAP (HRS-HCAP; N~=~3347; 2016-17). We derived harmonized memory factors from each study using confirmatory factor analysis. We used multivariable-adjusted linear regression to compare gender disparities in memory function between countries, overall and by education.

RESULTS: In the United States, older women had better memory than older men (0.28 SD-unit difference; 95\% CI: 0.22, 0.35). In India, older women had worse memory than older men (-0.15 SD-unit difference; 95\% CI: -0.20, -0.10), which attenuated with increasing education and literacy.

CONCLUSION: We observed gender disparities in memory in India that were not present in the United States, and which dissipated with education and literacy.

}, keywords = {Education, gender disparities, India, memory function, United States}, issn = {1552-5279}, doi = {10.1002/alz.13404}, author = {Westrick, Ashly C and Avila-Rieger, Justina and Gross, Alden L and Hohman, Timothy and Vonk, Jet M J and Zahodne, Laura B and Lindsay C Kobayashi} } @article {GOLDBERG2023e304, title = {Drainage Percutaneous Endoscopic Gastrostomy for Malignant Bowel Obstruction in Advanced Cancer: Patient Expectations and Decisional Regret (SA314A)}, journal = {Journal of Pain and Symptom Management}, volume = {65}, year = {2023}, pages = {e304}, abstract = {Outcomes: 1. Describe the potential benefits of decompressive percutaneous endoscopic gastrostomy (dPEG) in patients with a malignant bowel obstruction 2. Evaluate the importance of effective communication regarding dEPG in patients with advanced cancer Decompressive percutaneous endoscopic gastrostomy (dPEG) is often recommended for palliation of symptoms in patients with malignant bowel obstruction. While this intervention can help improve comfort, patients may have unrealistic expectations about their ability to resume eating, enhance nutritional status, build strength, and receive further disease-directed treatment. We undertook this study to evaluate patients{\textquoteright} expectations about the impact of dPEG placement. We prospectively enrolled 50 adult patients in our dedicated cancer hospital who were scheduled for dPEG for management of MBO between September 2019 to February 2022. Before the procedure, patients completed the FACT-G7, a closed-ended questionnaire about expected outcomes of the procedure, and a brief, semi-structured qualitative interview exploring their understanding of the procedure and expectations for the future. Two weeks after the procedure, patients were contacted to complete the FACT-G7 for a second time and Decision Regret Scale. Sociodemographic, clinical variables, and patient outcomes were collected. The most common primary tumors in this cohort were ovarian (28\%), pancreatic (24\%), and colon (14\%), and the median time to death after dPEG was 30 days (range 5{\textendash}780). Before the procedure, almost half of patients had unrealistic expectations about the potential benefits of dPEG on their ability to eat and to prolong their life and cited these expected benefits as important in their decision to undergo the procedure. At follow-up, one-third of patients expressed regret about the decision. However, patients reported improvement in symptom burden after the procedure compared to before. Our findings suggest ongoing needs to improve communication to help align patients{\textquoteright} expectations with their future experience and support them to manage challenges.}, keywords = {Cancer, decisional regret, patient expectations}, issn = {0885-3924}, doi = {https://doi.org/10.1016/j.jpainsymman.2022.12.131}, author = {Jessica Goldberg and Richard S. Sheppard and Afshana Hoque and Rushil V. Patel and Judith Nelson} } @article {13356, title = {An Early and Unequal Decline: Life Course Trajectories of Cognitive Aging in the United States.}, journal = {J Aging Health}, year = {2023}, pages = {8982643231184593}, abstract = {

OBJECTIVES: Cognitive aging is a lifelong process with implications for Alzheimer{\textquoteright}s disease and dementia. This study aims to fill major gaps in research on the natural history of and social disparities in aging-related cognitive decline over the life span.

METHODS: We conducted integrative data analysis of four large U.S. population-based longitudinal studies of individuals aged 12 to 105 followed over two decades and modeled age trajectories of cognitive function in multiple domains.

RESULTS: We found evidence for the onset of cognitive decline in the 4 decade of life, varying gender differences with age, and persistent disadvantage among non-Hispanic Blacks, Hispanics, and those without college education. We further found improvement in cognitive function across 20 century birth cohorts but widening social inequalities in more recent cohorts.

DISCUSSION: These findings advance an understanding of early life origins of dementia risk and invite future research on strategies for promoting cognitive health for all Americans.

}, keywords = {Alzheimer{\textquoteright}s disease, cognitive aging, Dementia, social disparities}, issn = {1552-6887}, doi = {10.1177/08982643231184593}, author = {Yang, Yang C and Walsh, Christine E and Shartle, Kaitlin and Stebbins, Rebecca C and Aiello, Allison E and Belsky, Daniel W and Harris, Kathleen Mullan and Chanti-Ketterl, Marianne and Plassman, Brenda L} } @article {13291, title = {Education, incident cancer, and rate of memory decline in a national sample of US adults in mid-to-later-life.}, journal = {J Geriatr Oncol}, volume = {14}, year = {2023}, pages = {101530}, abstract = {

INTRODUCTION: Middle-aged and older adults who develop cancer experience memory loss following diagnosis, but memory decline in the years before and after cancer diagnosis is slower compared to their cancer-free counterparts. Educational attainment strongly predicts memory function during aging, but it is unclear whether education protects against memory loss related to cancer incidence or modifies long-term memory trajectories in middle-aged and older cancer survivors.

MATERIALS AND METHODS: Data were from 14,449 adults (3,248 with incident cancer, excluding non-melanoma skin cancer) aged 50+ in the population-based US Health and Retirement Study from 1998 to 2016. Memory was assessed every two years as a composite of immediate and delayed word recall tests and proxy assessments for impaired individuals. Memory scores all time points were standardized at to the baseline distribution. Using multivariate-adjusted linear mixed-effects models, we estimated rates of memory decline in the years before cancer diagnosis, shortly after diagnosis, and in the years after diagnosis. We compared rates of memory decline between incident cancer cases and age-matched cancer-free adults, overall and according to level of education (<12~years, "low"; 12 to <16~years, "intermediate"; >=16~years, "high").

RESULTS: Incident cancer diagnoses were followed by short-term declines in memory averaging 0.06 standard deviation (SD) units (95\% confidence interval [CI]: -0.084, -0.036). Those with low education experienced the strongest magnitude of short-term decline in memory after diagnosis (-0.10 SD units, 95\% CI: -0.15, -0.05), but this estimate was not statistically significantly different from the short-term decline in memory experienced by those with high education (-0.04 SD units, 95\% CI: -0.08, 0.01; p-value for education as an effect modifier~=~0.15). In the years prior to and following an incident cancer diagnosis, higher educational attainment was associated with better memory, but it did not modify the difference in rate of long-term memory decline between cancer survivors and those who remained cancer-free.

DISCUSSION: Education was associated with better memory function over time among both cancer survivors and cancer-free adults aged 50 and over. Low education may be associated with a stronger short-term decline in memory after a cancer diagnosis.

}, keywords = {Aged, Aging, Cancer Survivors, Educational Status, Humans, Longitudinal Studies, Memory Disorders, Middle Aged, Neoplasms}, issn = {1879-4076}, doi = {10.1016/j.jgo.2023.101530}, author = {Ospina-Romero, Monica and Brenowitz, Willa D and Glymour, M Maria and Westrick, Ashly and Graff, Rebecca E and Hayes-Larson, Eleanor and Mayeda, Elizabeth Rose and Ackley, Sarah F and Lindsay C Kobayashi} } @article {13038, title = {The Epidemiology of Smoking in Older Adults: A National Cohort Study.}, journal = {Journal of General Internal Medicine}, volume = {38}, year = {2023}, pages = {1697-1704}, abstract = {

BACKGROUND: Older smokers account for the greatest tobacco-related morbidity and mortality in the USA, while quitting smoking remains the single most effective preventive health intervention for reducing the risk of smoking-related illness. Yet, knowledge about patterns of smoking and smoking cessation in older adults is lacking.

OBJECTIVE: Assess trends in prevalence of cigarette smoking between 1998 and 2018 and identify patterns and predictors of smoking cessation in US older adults.

DESIGN: Retrospective cohort study PARTICIPANTS: Individuals aged 55+ enrolled in the nationally representative Health and Retirement Study, 1998-2018 MAIN MEASURES: Current smoking was assessed with the question: "Do you smoke cigarettes now?" Quitting smoking was defined as having at least two consecutive waves (between 2 and 4 years) in which participants who were current smokers in 1998 reported they were not currently smoking in subsequent waves.

KEY RESULTS: Age-adjusted smoking prevalence decreased from 15.9\% in 1998 (95\% confidence interval (CI) 15.2, 16.7) to 11.2\% in 2018 (95\% CI 10.4, 12.1). Among 2187 current smokers in 1998 (mean age 64, 56\% female), 56\% of those living to age 90 had a sustained period of smoking cessation. Smoking less than 10 cigarettes/day was strongly associated with an increased likelihood of quitting smoking (subdistribution hazard ratio 2.3; 95\% CI 1.9, 2.8), compared to those who smoked more than 20 cigarettes/day.

CONCLUSIONS: Smoking prevalence among older persons has declined and substantial numbers of older smokers succeed in quitting smoking for a sustained period. These findings highlight the need for continued aggressive efforts at tobacco cessation among older persons.

}, keywords = {Epidemiology, Geriatrics, Public Health, Smoking}, issn = {1525-1497}, doi = {10.1007/s11606-022-07980-w}, author = {Hunt, Lauren J and Covinsky, Kenneth E and Cenzer, Irena and Espejo, Edie and Boscardin, W John and Leutwyler, Heather and Lee, Alexandra K and Cataldo, Janine} } @article {13066, title = {Estimated Annual Spending on Lecanemab and Its Ancillary Costs in the US Medicare Program.}, journal = {JAMA Internal Medicine}, volume = {183}, year = {2023}, pages = {885-889}, abstract = {Lecanemab, an antidementia medication with modest clinical benefit, received accelerated US Food and Drug Administration (FDA) approval. Traditional FDA approval of lecanemab could occur in 2023, prompting Medicare to reconsider coverage restrictions and potentially enabling widespread use. Lecanemab{\textquoteright}s $26 500 proposed annual acquisition cost and ancillary spending (eg, imaging) could increase Medicare spending, possibly leading to beneficiary premium increases. To estimate annual Medicare spending on lecanemab, we performed a cost analysis using nationally representative survey data from the 2018 Health and Retirement Study (HRS).}, keywords = {Health Care Costs, lecanemab, Medicare spending}, issn = {2168-6114}, doi = {10.1001/jamainternmed.2023.1749}, author = {Arbanas, Julia Cave and Damberg, Cheryl L and Leng, Mei and Harawa, Nina and Sarkisian, Catherine A and Landon, Bruce E and Mafi, John N} } @article {13308, title = {Estimating Transition Probabilities Across the Alzheimer{\textquoteright}s Disease Continuum Using a Nationally Representative Real-World Database in the United States.}, journal = {Neurol Ther}, year = {2023}, abstract = {

INTRODUCTION: Clinical Alzheimer{\textquoteright}s disease (AD) begins with mild cognitive impairment (MCI) and progresses to mild, moderate, or severe dementia, constituting a disease continuum that eventually leads to death. This study aimed to estimate the probabilities of transitions across those disease states.

METHODS: We developed a mixed-effects multi-state Markov model to estimate the transition probabilities, adjusted for 5 baseline covariates, using the Health and Retirement Study (HRS) database. HRS surveys older adults in the United States bi-annually. Alzheimer states were defined using the modified Telephone Interview of Cognitive Status (TICS-m).

RESULTS: A total of 11,292 AD patients were analyzed. Patients were 70.8~{\textpm}~9.0~years old, 54.9\% female, and with 12.0~{\textpm}~3.3~years of education. Within 1~year from the initial state, the model estimated a higher probability of transition to the next AD state in earlier disease: 12.8\% from MCI to mild AD and 5.0\% from mild to moderate AD, but~<~1\% from moderate to severe AD. After 10~years, the probability of transition to the next state was markedly higher for all states, but still higher in earlier disease: 29.8\% from MCI to mild AD, 23.5\% from mild to moderate AD, and 5.7\% from moderate to severe AD. Across all AD states, the probability of transition to death was~<~5\% after 1~year and~>~15\% after 10~years. Older age, fewer years of education, unemployment, and nursing home stay were associated with a higher risk of disease progression (p~<~0.01).

CONCLUSIONS: This analysis shows that the risk of progression is greater in earlier AD states, increases over time, and is higher in patients who are older, with fewer years of education, unemployed, or in a nursing home at baseline. The estimated transition probabilities can provide guidance for future disease management and clinical trial design optimization, and can be used to refine existing cost-effectiveness frameworks.

}, issn = {2193-8253}, doi = {10.1007/s40120-023-00498-1}, author = {Tahami Monfared, Amir Abbas and Fu, Shuai and Hummel, Noemi and Qi, Luyuan and Chandak, Aastha and Zhang, Raymond and Zhang, Quanwu} } @article {13113, title = {Everyday Discrimination, Neighborhood Perceptions, and Incidence of Activity Limitations Among Middle-Aged and Older African Americans.}, journal = {J Gerontol B Psychol Sci Soc Sci}, volume = {78}, year = {2023}, pages = {866-879}, abstract = {

OBJECTIVES: This study aims to examine the relationship between everyday discrimination, neighborhood perceptions, and the incidence of daily activity limitations (i.e., activities of daily living [ADL] and instrumental activities of daily living [IADL]) among middle-aged and older African Americans. This study also examines whether neighborhood perceptions moderate the association between discrimination and the incidence of daily activity limitations.

METHODS: Data were from the 2006 to 2016 waves of the Health and Retirement Study. African Americans aged 50 or older free of ADL limitations (N~=~1,934) and IADL limitations (N~=~2,007) at baseline were selected. Cox proportional hazards regression models were performed to test the study aims. Multiple imputations were applied to handle missing data.

RESULTS: One-unit increase in everyday discrimination was associated with a 25\% (p < .05) higher risk of ADL limitation onset. Perceived neighborhood social cohesion and physical disadvantage moderated the association between discrimination and IADL limitation onset.

DISCUSSION: Everyday discrimination represents a significant stressor that negatively affects older African Americans{\textquoteright} performance of daily activities. Community-level efforts that improve neighborhood perceptions are needed to alleviate the negative effects of discrimination on the incidence of activity limitations.

}, keywords = {Activities of Daily Living, Aged, Black or African American, Humans, Incidence, Middle Aged, Residence Characteristics, Retirement}, issn = {1758-5368}, doi = {10.1093/geronb/gbad001}, author = {Qin, Weidi and Nguyen, Ann W and Wang, Yi and Hamler, Tyrone C and Wang, Fei} } @article {13441, title = {Examining the role of different weakness categories for mobility and future falls in older Americans.}, journal = {Aging Clin Exp Res}, year = {2023}, abstract = {

BACKGROUND: Recently developed absolute and body size normalized handgrip strength (HGS) cut-points could be used individually and collectively to predict mobility problems and falls.

AIMS: We examined the associations of (1) each absolute and normalized weakness cut-point, (2) collective weakness categories, and (3) changes in weakness status on future falls in older Americans.

METHODS: The analytic sample included 11,675 participants from the 2006-2018 waves of the Health and Retirement Study. Falls were self-reported. Men were classified as weak if their HGS was < 35.5-kg (absolute), < 0.45~kg/kg (body mass normalized), or < 1.05~kg/kg/m (body mass index normalized). While, women were considered weak if their HGS was < 20.0-kg, < 0.337~kg/kg, or < 0.79~kg/kg/m. Collective weakness categorized those below 1, 2, or all 3 cut-points. The collective weakness categories were also used to observe changes in weakness status over time.

RESULTS: Older Americans below each absolute and normalized cut-point had greater odds for future falls: 1.23 (95\% confidence interval (CI): 1.15-1.32) for absolute weakness, 1.20 (CI 1.11-1.29) for body mass index normalized weakness, and 1.26 (CI 1.17-1.34) for body mass normalized weakness. Persons below 1, 2, or all 3 weakness cut-points had 1.17 (CI 1.07-1.27), 1.29 (CI 1.18-1.40), and 1.36 (CI 1.24-1.48) greater odds for future falls, respectively. Those in some changing weakness categories had greater odds for future falls: 1.26 (CI 1.08-1.48) for persistent and 1.31 (CI 1.11-1.55) for progressive.

DISCUSSION: Collectively using these weakness cut-points may improve their predictive value.

CONCLUSION: We recommend HGS be evaluated in mobility and fall risk assessments.

}, keywords = {mobility, Older Americans}, issn = {1720-8319}, doi = {10.1007/s40520-023-02516-6}, author = {McGrath, Ryan and Jurivich, Donald A and Christensen, Bryan K and Choi, Bong-Jin and Langford, Matthew and Rhee, Yeong and Tomkinson, Grant R and Hackney, Kyle J} } @article { WOS:000967740400009, title = {Exposure to Family Member Deaths Across the Life Course for His panic Individuals}, journal = {DEMOGRAPHY}, volume = {60}, year = {2023}, pages = {539-562}, keywords = {deaths, family members, panic}, issn = {0070-3370}, doi = {10.1215/00703370-10604036}, author = {Donnelly, Rachel and Garcia, Michael A. and Cha, Hyungmin and Hummer, Robert A. and Umberson, Debra} } @article {13246, title = {Exposure to Family Member Deaths Across the Life Course for Hispanic Individuals.}, journal = {Demography}, volume = {60}, year = {2023}, pages = {539-562}, abstract = {

The present study documents differences in exposure to family member deaths among foreign-born and U.S.-born Hispanic individuals compared with non-Hispanic Black and non-Hispanic White individuals. We use data from the Health and Retirement Study (HRS; 1992-2016, ages 51+; N = 23,228) and the National Longitudinal Study of Adolescent to Adult Health (Add Health; Waves I-V, ages 12-43; N = 11,088) to estimate the risk of exposure to the death of a mother, father, spouse, sibling, and child across the life course. HRS results show more inequities in exposure to family deaths compared with Add Health results, suggesting differences by age or birth cohort. Compared with non-Hispanic Whites, U.S.-born Hispanic individuals in the HRS have a higher risk of experiencing a child{\textquoteright}s death throughout adulthood and a sibling{\textquoteright}s death in later life; the latter is explained by larger sibship size, indicating a greater lifetime risk of bereavement experiences. The higher risk of parental death during childhood for U.S.-born and foreign-born Hispanic individuals is explained by covariates (e.g., lower levels of educational attainment). Hispanic individuals generally have a lower risk of family deaths than non-Hispanic Black individuals, but at times a higher risk of exposure relative to non-Hispanic White individuals.

}, keywords = {Adolescent, Adult, Child, Death, Family, Hispanic or Latino, Humans, Life Change Events, Longitudinal Studies, Middle Aged, United States, White, Young Adult}, issn = {1533-7790}, doi = {10.1215/00703370-10604036}, author = {Donnelly, Rachel and Garcia, Michael A and Cha, Hyungmin and Hummer, Robert A and Umberson, Debra} } @article {13559, title = {Feeling a sense of purpose drops after dementia, new study shows}, year = {2023}, publisher = {CNN}, keywords = {cognitive impairment, Dementia, Sense of purpose}, url = {https://www.cnn.com/2023/09/13/health/dementia-life-purpose-wellness/index.html}, author = {Holcombe, Madeline} } @article {13662, title = {Food Insecurity, Memory, and Dementia Among US Adults Aged 50 Years and Older.}, journal = {JAMA Network Open}, volume = {6}, year = {2023}, pages = {e2344186}, abstract = {

IMPORTANCE: Despite existing federal programs to increase access to food, food insecurity is common among US older adults. Food insecurity may affect Alzheimer disease and Alzheimer disease-related dementias via multiple mechanisms, yet there is almost no quantitative research evaluating this association.

OBJECTIVE: To examine whether food insecurity in older adults is associated with later-life cognitive outcomes.

DESIGN, SETTING, AND PARTICIPANTS: This cohort study of US residents aged 50 years and older from the US Health and Retirement Study was restricted to respondents with food insecurity data in 2013 and cognitive outcome data between calendar years 2014 and 2018. Analyses were conducted from June 1 to September 22, 2023.

EXPOSURE: Food insecurity status in 2013 was assessed using the validated US Department of Agriculture 6-item Household Food Security Module. Respondents were classified as being food secure, low food secure, and very low food secure.

MAIN OUTCOMES AND MEASURES: Outcomes were dementia probability and memory score (standardized to 1998 units), estimated biennially between 2014 and 2018 using a previously validated algorithm. Generalized estimation equations were fit for dementia risk and linear mixed-effects models for memory score, taking selective attrition into account through inverse probability of censoring weights.

RESULTS: The sample consisted of 7012 participants (18 356 person-waves); mean (SD) age was 67.7 (10.0) years, 4131 (58.9\%) were women, 1136 (16.2\%) were non-Hispanic Black, 4849 (69.2\%) were non-Hispanic White, and mean (SD) duration of schooling was 13.0 (3.0) years. Compared with food-secure older adults, experiencing low food security was associated with higher odds of dementia (odds ratio, 1.38; 95\% CI, 1.15-1.67) as was experiencing very low food security (odds ratio, 1.37; 95\% CI, 1.11-1.59). Low and very low food security was also associated with lower memory levels and faster age-related memory decline.

CONCLUSIONS AND RELEVANCE: In this cohort study of older US residents, food insecurity was associated with increased dementia risk, poorer memory function, and faster memory decline. Future studies are needed to examine whether addressing food insecurity may benefit brain health.

}, keywords = {agriculture, Algorithms, Alzheimer disease, Food insecurity, Memory Disorders}, issn = {2574-3805}, doi = {10.1001/jamanetworkopen.2023.44186}, author = {Qian, Haobing and Khadka, Aayush and Martinez, Suzanna M and Singh, Sonali and Brenowitz, Willa D and Zeki Al Hazzouri, Adina and Hill-Jarrett, Tanisha G and Glymour, M Maria and Vable, Anusha M} } @article {13325, title = {Frailty trajectory predicts subsequent cognitive decline: A 26-year population-based longitudinal cohort study.}, journal = {MedComm (2020)}, volume = {4}, year = {2023}, pages = {e296}, abstract = {

Frailty refers to a decline in the physiological functioning of one or more organ systems. It remained unclear whether variations in the trajectory of frailty over time were associated with subsequent cognitive change. The aim of the current study was to investigate the association between frailty trajectories and subsequent cognitive decline based on the Health and Retirement Study (HRS). A total of 15,454 participants were included. The frailty trajectory was assessed using the Paulson-Lichtenberg Frailty Index, while the cognitive function was evaluated using the Langa-Weir Classification. Results showed that severe frailty was significantly associated with the subsequent decline in cognitive function ( [95\% CI]~=~-0.21 [-0.40, -0.03], ~=~0.03). In the five identified frailty trajectories, participants with mild frailty (inverted U-shaped, [95\% CI]~=~-0.22 [-0.43, -0.02], ~=~0.04), mild frailty (U-shaped, [95\% CI]~=~-0.22 [-0.39, -0.06], ~=~0.01), and frailty (β [95\% CI]~=~-0.34 [-0.62, -0.07], ~=~0.01) were all significantly associated with the subsequent cognition decline in the elderly. The current study suggested that monitoring and addressing frailty trajectories in older adults may be a critical approach in preventing or mitigating cognitive decline, which had significant implications for healthcare.

}, issn = {2688-2663}, doi = {10.1002/mco2.296}, author = {Li, Ruidan and Liu, Zheran and Huang, Rendong and Chen, Ye and Wei, Zhigong and Wang, Jingjing and He, Ling and Pei, Yiyan and Su, Yonglin and Hu, Xiaolin and Peng, Xingchen} } @article {13188, title = {Gender of study partners and research participants associated with differences in study partner ratings of cognition and activity level.}, journal = {J Gerontol B Psychol Sci Soc Sci}, year = {2023}, month = {2023 Feb 15}, abstract = {

OBJECTIVE: Studies of Alzheimer{\textquoteright}s disease (AD) typically include "study partners" (SPs) who report on participants{\textquoteright} cognition and function. Prior studies show SP reports differ depending on the relationship between the SP and participant, that is, spouse or adult child. Adult children SPs are typically female. Could differing reports be due to gender? Knowing this may help explain variability in measurement.

METHODS: The Aging, Demographics and Memory Study (ADAMS) enrolled a subset of participants from the Health and Retirement Study (HRS). Each participant had a SP. Bivariate and multivariable regression models compared 718 SP-participant dyads.

RESULTS: In analyses of four groups defined by SP and participant gender, dyads composed of two women were less likely to identify as White (75.8\%, 95\%CI 70.4 to 80.5) than dyads composed of two men (93.3\%, 95\%CI 81.2 to 97.8). In analyses adjusted for severity of cognitive and functional impairment, women SPs rated women participants as more active than they rated men, mean 2.15 (95\%CI, 2.07 to 2.22) versus mean 2.30 (95\%CI, 2.24 to 2.37), respectively, on a 4-point scale. Similarly, men SPs rated women participants as more active than they rated men, mean 2.1 (95\%CI, 2.0 to 2.2) and mean 2.4 (95\%CI, 2.3 to 2.5), respectively. In an analysis of cognitively unimpaired participants, women SPs rated participants{\textquoteright} memory worse than men SPs did (p<0.05).

DISCUSSION: SP and participant gender influence SPs{\textquoteright} reports of another person{\textquoteright}s cognition and activity level. Our findings expand what is understood about how non-disease factors influence measures of disease severity.

}, keywords = {activity level, Cognition, gender}, issn = {1758-5368}, doi = {10.1093/geronb/gbad026}, author = {Stites, Shana D and Gurian, Anna and Coykendall, Cameron and Largent, Emily A and Harkins, Kristin and Karlawish, Jason and Coe, Norma B} } @article {13414, title = {Genetic associations with parental investment from conception to wealth inheritance in six cohorts.}, journal = {Nat Hum Behav}, year = {2023}, abstract = {

Genetic inheritance is not the only way parents{\textquoteright} genes may affect children. It is also possible that parents{\textquoteright} genes are associated with investments into children{\textquoteright}s development. We examined evidence for links between parental genetics and parental investments, from the prenatal period through to adulthood, using data from six population-based cohorts in the UK, US and New Zealand, together totalling 36,566 parents. Our findings revealed associations between parental genetics-summarized in a genome-wide polygenic score-and parental behaviour across development, from smoking in pregnancy, breastfeeding in infancy, parenting in childhood and adolescence, to leaving a wealth inheritance to adult children. Effect sizes tended to be small at any given time point, ranging from RR = 1.12 (95\% confidence interval (95\%CI) 1.09, 1.15) to RR = 0.76 (95\%CI 0.72, 0.80) during the prenatal period and infancy; β = 0.07 (95\%CI 0.04, 0.11) to β = 0.29 (95\%CI 0.27, 0.32) in childhood and adolescence, and RR = 1.04 (95\%CI 1.01, 1.06) to RR = 1.11 (95\%CI 1.07, 1.15) in adulthood. There was evidence for accumulating effects across development, ranging from β = 0.15 (95\%CI 0.11, 0.18) to β = 0.23 (95\%CI 0.16, 0.29) depending on cohort. Our findings are consistent with the interpretation that parents pass on advantages to offspring not only via direct genetic transmission or purely environmental paths, but also via genetic associations with parental investment from conception to wealth inheritance.

}, keywords = {genetic associations, parental investment, wealth inheritance}, issn = {2397-3374}, doi = {10.1038/s41562-023-01618-5}, author = {Wertz, Jasmin and Moffitt, Terrie E and Arseneault, Louise and Barnes, J C and Boivin, Michel and Corcoran, David L and Danese, Andrea and Hancox, Robert J and Harrington, HonaLee and Houts, Renate M and Langevin, Stephanie and Liu, Hexuan and Poulton, Richie and Sugden, Karen and Tanksley, Peter T and Williams, Benjamin S and Caspi, Avshalom} } @article {13500, title = {Getting under the skin? Influences of work-family experiences on personality trait adaptation and reciprocal relationships.}, journal = {J Pers Soc Psychol}, year = {2023}, abstract = {

The literature on personality trait development has mainly focused on influences of life experiences in one single life domain (e.g., work or family) separate from one another and has primarily examined personality development in early life stages. Thus, less attention has been devoted to influences from interplays across different life domains and personality development in middle and late adulthood. Synthesizing the literature on personality science and organizational research, we built a theoretical model and investigated what, how, and why the interplay between two central life domains-work and family-may be related to personality trait development of people at their middle and late life stages, and more important, change-related reciprocal relationships between personality traits and work-family experiences. Generally, convergent findings with data from two longitudinal studies (National Survey of Midlife in the United States, maximum = 3,192, three waves; and Health and Retirement Study, maximum = 1,133, three waves except anxiety) revealed that work-to-family conflict, family-to-work conflict, work-to-family facilitation, and family-to-work facilitation mostly had lagged effects on changes of Conscientiousness, Extraversion, and Neuroticism, and the influences were generally channeled through changes of anxiety. Personality traits also had lagged influences on changes of work-family experiences, with some influences deteriorating over time. Change-related reciprocal relationships were recorded mainly between Neuroticism and Extraversion with work-family experiences. Some selection effects were larger than socialization effects. Our research contributes to the personality and the work-family literature and represents a useful example of cross-fertilization of research in different areas of psychology to advance personality research. (PsycInfo Database Record (c) 2023 APA, all rights reserved).

}, issn = {1939-1315}, doi = {10.1037/pspp0000476}, author = {Li, Wen-Dong and Wang, Jiexin and Allen, Tammy and Zhang, Xin and Yu, Kaili and Zhang, Hong and Huang, Jason L and Liu, Mengqiao and Li, Andrew} } @article {13408, title = {Harmonization of cognitive screening tools for dementia across diverse samples: A simulation study.}, journal = {Alzheimers Dement (Amst)}, volume = {15}, year = {2023}, pages = {e12438}, abstract = {

INTRODUCTION: Research focusing on cognitive aging and dementia is a global endeavor. However, cross-national differences in cognition are embedded in other sociocultural differences, precluding direct comparisons of test scores. Such comparisons can be facilitated by co-calibration using item response theory (IRT). The goal of this study was to explore, using simulation, the necessary conditions for accurate harmonization of cognitive data.

METHOD: Neuropsychological test scores from the US Health and Retirement Study (HRS) and the Mexican Health and Aging Study (MHAS) were subjected to IRT analysis to estimate item parameters and sample means and standard deviations. These estimates were used to generate simulated item response patterns under 10 scenarios that adjusted the quality and quantity of linking items used in harmonization. IRT-derived factor scores were compared to the known population values to assess bias, efficiency, accuracy, and reliability of the harmonized data.

RESULTS: The current configuration of HRS and MHAS data was not suitable for harmonization, as poor linking item quality led to large bias in both cohorts. Scenarios with more numerous and higher quality linking items led to less biased and more accurate harmonization.

DISCUSSION: Linking items must possess low measurement error across the range of latent ability for co-calibration to be successful.

HIGHLIGHTS: We developed a statistical simulation platform to evaluate the degree to which cross-sample harmonization accuracy varies as a function of the quality and quantity of linking items.Two large studies of aging-one in Mexico and one in the United States-use three common items to measure cognition.These three common items have weak correspondence with the ability being measured and are all low in difficulty.Harmonized scores derived from the three common linking items will provide biased and inaccurate estimates of cognitive ability.Harmonization accuracy is greatest when linking items vary in difficulty and are strongly related to the ability being measured.

}, keywords = {cognitive screening, Dementia, Simulation}, issn = {2352-8729}, doi = {10.1002/dad2.12438}, author = {Gavett, Brandon E and Ilango, Sindana D and Koscik, Rebecca and Ma, Yue and Helfand, Benjamin and Eng, Chloe W and Gross, Alden and Trittschuh, Emily H and Richard N Jones and Mungas, Dan} } @article {12908, title = {History of Low Hourly Wage and All-Cause Mortality Among Middle-aged Workers.}, journal = {JAMA}, volume = {329}, year = {2023}, pages = {561-573}, abstract = {

IMPORTANCE: Earning a low wage is an increasingly recognized public health concern, yet little research exists on the long-term health consequences of sustained low-wage earning.

OBJECTIVE: To examine the association of sustained low-wage earning and mortality in a sample of workers with hourly wage reported biennially during peak midlife earning years.

DESIGN, SETTING, AND PARTICIPANTS: This longitudinal study included 4002 US participants, aged 50 years or older, from 2 subcohorts of the Health and Retirement Study (1992-2018) who worked for pay and reported earning hourly wages at 3 or more time points during a 12-year period during their midlife (1992-2004 or 1998-2010). Outcome follow-up occurred from the end of the respective exposure periods until 2018.

EXPOSURES: Low-wage-less than the hourly wage for full-time, full-year work at the federal poverty line-earning history was categorized as never earning a low wage, intermittently earning a low wage, and sustained earning a low wage.

MAIN OUTCOMES AND MEASURES: Cox proportional hazards and additive hazards regression models sequentially adjusted for sociodemographics, and economic and health covariates were used to estimate associations between low-wage history and all-cause mortality. We examined interaction with sex or employment stability on multiplicative and additive scales.

RESULTS: Of the 4002 workers (aged 50-57 years at the beginning of exposure period and 61-69 years at the end), 1854 (46.3\%) were female; 718 (17.9\%) experienced employment instability; 366 (9.1\%) had a history of sustained low-wage earning; 1288 (32.2\%) had intermittent low-wage earning periods; and 2348 (58.7\%) had never earned a low wage. In unadjusted analyses, those who had never earned low wages experienced 199 deaths per 10 000 person-years, those with intermittent low wages, 208 deaths per 10 000 person-years, and those with sustained low wages, 275 deaths per 10 000 person-years. In models adjusted for key sociodemographic variables, sustained low-wage earning was associated with mortality (hazard ratio [HR], 1.35; 95\% CI, 1.07-1.71) and excess deaths (66; 95\% CI, 6.6-125); these findings were attenuated with additional adjustments for economic and health covariates. Significant excess death and elevated mortality risk were observed for workers with sustained low-wage exposure and employment fluctuations (eg, for sustained low-wage {\texttimes} employment fluctuated, HR, 2.18; 95\% CI, 1.35-3.53; for sustained low-wage {\texttimes} stable employment, HR, 1.17; 95\% CI, 0.89,-1.54; P for interaction = .003).

CONCLUSIONS AND RELEVANCE: Sustained low-wage earning may be associated with elevated mortality risk and excess deaths, especially when experienced alongside unstable employment. If causal, our findings suggest that social and economic policies that improve the financial standing of low-wage workers (eg, minimum wage laws) could improve mortality outcomes.

}, keywords = {Employment, Income, Poverty, Salaries and Fringe Benefits}, issn = {1538-3598}, doi = {10.1001/jama.2023.0367}, author = {Kezios, Katrina L and Lu, Peiyi and Calonico, Sebastian and Al Hazzouri, Adina Zeki} } @article {12560, title = {How Do Marital Transitions Affect Self-Perceptions of Aging?}, journal = {Research on Aging}, year = {2023}, abstract = {

OBJECTIVES: We analyzed whether marital status and experiences of marital loss or gain were associated with self-perceptions of aging (SPA), a major psychosocial mechanism of healthy aging.

METHOD: We used data from 7028 participants of the Health and Retirement Study. Participants reported their marital status and their positive and negative SPA on two occasions 4~years apart. We ran general linear models to analyze differences in SPA between men and women who remained married, became divorced or widowed, or remarried following divorce or widowhood.

RESULTS: Participants who experienced marital loss had lower positive SPA than participants who remained marred. Participants who experienced marital gain had lower negative SPA than participants who remained married. None of the associations differed between men and women.

DISCUSSION: Results suggest that it may not be marital status itself, but rather the transition into or out of marriage, that impacts how people appraise their own aging.

}, keywords = {Divorce, Marriage, self-perceptions of aging, Widowhood}, issn = {1552-7573}, doi = {10.1177/01640275221113219}, author = {Turner, Shelbie G and Witzel, Dakota D and Stawski, Robert S and Hooker, Karen} } @article {13210, title = {"How Social Connection and Engagement Relate to Functional Limitations and Depressive Symptoms Outcomes After Stroke".}, journal = {medRxiv}, year = {2023}, abstract = {

BACKGROUND: Stroke commonly leads to disability and depression. Social connection and engagement can be protective against functional decline and depression in the general population. We investigated the effects of social connection and engagement on trajectories of function and depressive symptoms in stroke.

METHODS: Participants were 898 individuals with incident stroke from the Health and Retirement Study between 1998-2012. Multilevel modeling was used to examine associations of social connection and engagement with changes in functional limitations in instrumental activities of daily living (IADLs) and depressive symptoms over time. Models controlled for age, gender, education, and race/ethnicity. Moderation analyses examined whether high social connection and engagement reduced depressive symptoms for survivors with high IADL impairment.

RESULTS: Social connection and engagement were generally associated with fewer IADL limitations and depressive symptoms at the time of stroke and after stroke. For example, participants who felt lonely and did not provide help to others before stroke had more IADL limitations. Pre-stroke volunteering was associated with less increase in IADL limitations with stroke and increase in having friends and providing help to others compared to one{\textquoteright}s pre-stroke status were associated with fewer IADL limitations after stroke. For depressive symptoms, participants who felt lonely and did not have a friend or partner before stroke had more depressive symptoms, and participants who had children residing nearby before stroke showed less increase in depressive symptoms. Moderation effects were not found for social connection and engagement on high IADL impairment and depressive symptoms.

CONCLUSIONS: Findings suggest that social connection and engagement may reduce the negative physical and psychological outcomes of stroke, both at baseline and after stroke. Efforts to enhance social engagement and diminish loneliness may both enhance population well-being and enhance resilience and recovery from stroke and other illnesses.

}, doi = {10.1101/2023.03.07.23286965}, author = {Elayoubi, Joanne and Haley, William E and Nelson, Monica E and Hueluer, Gizem} } @article {Theou2023, title = {How to construct a frailty index from an existing dataset in 10 steps}, journal = {Age and Ageing}, volume = {52}, year = {2023}, abstract = {Background: The frailty index is commonly used in research and clinical practice to quantify health. Using a health deficit accumulation model, a frailty index can be calculated retrospectively from data collected via survey, interview, performance test, laboratory report, clinical or administrative medical record, or any combination of these. Here, we offer a detailed 10-step approach to frailty index creation, with a worked example. Methods: We identified 10 steps to guide the creation of a valid and reliable frailty index. We then used data from waves 5 to 12 of the Health and Retirement Study (HRS) to illustrate the steps. Results: The 10 steps are as follows: (1) select every variable that measures a health problem; (2) exclude variables with more than 5\% missing values; (3) recode the responses to 0 (no deficit) through 1 (deficit); (4) exclude variables when coded deficits are too rare (< 1\%) or too common (> 80\%); (5) screen the variables for association with age; (6) screen the variables for correlation with each other; (7) count the variables retained; (8) calculate the frailty index scores; (9) test the characteristics of the frailty index; (10) use the frailty index in analyses. In our worked example, we created a 61-item frailty index following these 10 steps. Conclusions: This 10-step procedure can be used as a template to create one continuous health variable. The resulting high-information variable is suitable for use as an exposure, predictor or control variable, or an outcome measure of overall health and ageing. {\textcopyright} 2023 The Author(s). Published by Oxford University Press on behalf of the British Geriatrics Society. All rights reserved.}, keywords = {frail, Frailty, Health and Retirement Study, health measurement, Morbidity, Older people}, doi = {10.1093/ageing/afad221}, author = {Theou, Olga and Haviva, Clove and Wallace, Lindsay and Searle, Samuel D and Rockwood, Kenneth} } @article {13788, title = {How to construct a frailty index from an existing dataset in 10 steps.}, journal = {Age and Ageing}, volume = {52}, year = {2023}, abstract = {

BACKGROUND: The frailty index is commonly used in research and clinical practice to quantify health. Using a health deficit accumulation model, a frailty index can be calculated retrospectively from data collected via survey, interview, performance test, laboratory report, clinical or administrative medical record, or any combination of these. Here, we offer a detailed 10-step approach to frailty index creation, with a worked example.

METHODS: We identified 10 steps to guide the creation of a valid and reliable frailty index. We then used data from waves 5 to 12 of the Health and Retirement Study (HRS) to illustrate the steps.

RESULTS: The 10 steps are as follows: (1) select every variable that measures a health problem; (2) exclude variables with more than 5\% missing values; (3) recode the responses to 0 (no deficit) through 1 (deficit); (4) exclude variables when coded deficits are too rare (< 1\%) or too common (> 80\%); (5) screen the variables for association with age; (6) screen the variables for correlation with each other; (7) count the variables retained; (8) calculate the frailty index scores; (9) test the characteristics of the frailty index; (10) use the frailty index in analyses. In our worked example, we created a 61-item frailty index following these 10 steps.

CONCLUSIONS: This 10-step procedure can be used as a template to create one continuous health variable. The resulting high-information variable is suitable for use as an exposure, predictor or control variable, or an outcome measure of overall health and ageing.

}, keywords = {Aged, Aging, Frail Elderly, Frailty, Geriatric Assessment, Humans, Retrospective Studies}, issn = {1468-2834}, doi = {10.1093/ageing/afad221}, author = {Theou, Olga and Haviva, Clove and Wallace, Lindsay and Searle, Samuel D and Rockwood, Kenneth} } @article {13546, title = {Hypertension and Stroke as Mediators of Air Pollution Exposure and Incident Dementia.}, journal = {JAMA Network Open}, volume = {6}, year = {2023}, pages = {e2333470}, abstract = {

IMPORTANCE: Fine particulate matter air pollution (PM2.5) has been consistently associated with cardiovascular disease, which, in turn, is associated with an increased risk of dementia. As such, vascular dysfunction might be a mechanism by which PM2.5 mediates dementia risk, yet few prior epidemiological studies have examined this potential mechanism.

OBJECTIVE: To investigate whether hypertension and stroke serve as mediators and modifiers of the association of PM2.5 with incident dementia.

DESIGN, SETTING, AND PARTICIPANTS: As part of the Environmental Predictors of Cognitive Health and Aging (EPOCH) Project, this cohort study used biennial survey data collected between 1998 and 2016 from respondents of the Health and Retirement Study (HRS), a nationally representative, population-based, cohort in the US. Eligible participants were those over 50 years of age who were free of dementia at baseline and had complete exposure, mediator, outcome, and demographic data from the HRS. Data analysis was conducted from August to November 2022.

EXPOSURES: Exposure to PM2.5, calculated for the 10 years preceding each person{\textquoteright}s baseline examination according to residential histories and spatiotemporal models.

MAIN OUTCOMES AND MEASURES: Incident dementia was identified using a validated algorithm based on cognitive testing and informant reports. The 4-way decomposition causal mediation analysis method was used to quantify the degree to which hypertension and stroke mediated or modified the association of PM2.5 with incident dementia after adjustment for individual-level and area-level covariates.

RESULTS: Among 27 857 participants (mean [SD] age at baseline, 61 [10] years; 15 747 female participants [56.5\%]; 19 249 non-Hispanic White participants [69.1\%]), 4105 (14.7\%) developed dementia during the follow-up period (mean [SD], 10.2 [5.6] years). Among participants with dementia, 2204 (53.7\%) had a history of hypertension at baseline and 386 (9.4\%) received a diagnosis of hypertension during the follow up. A total of 378 participants (9.2\%) had a history of stroke at baseline and 673 (16.4\%) developed stroke over the follow-up period. The IQR of baseline PM2.5 concentrations was 10.9 to 14.9 μg/m3. In fully adjusted models, higher levels of PM2.5 (per IQR) were not associated with increased risk of incident dementia (HR, 1.04; 95\% CI, 0.98 to 1.11). Although there were positive associations of prevalent stroke (HR, 1.67; 95\% CI, 1.48 to 1.88) and hypertension (HR, 1.15; 95\% CI, 1.08 to 1.23) with incident dementia compared with those free of stroke and hypertension during follow-up, there was no statistically significant association of PM2.5 with stroke (odds ratio per IQR increment in PM2.5, 1.08; 95\%CI, 0.91 to 1.29) and no evidence of an association of PM2.5 with hypertension (odds ratio per IQR increment in PM2.5, 0.99; 95\%CI, 0.92 to 1.07). Concordantly, there was no evidence that hypertension or stroke acted as mediators or modifiers of the association of PM2.5 with incident dementia. Although the nonmediated interaction between PM2.5 and hypertension accounted for 39.2\% of the total excess association (95\% CI, -138.5\% to 216.9\%), the findings were not statistically significant.

CONCLUSIONS AND RELEVANCE: These findings suggest that although hypertension may enhance the susceptibility of individuals to air pollution, hypertension and stroke do not significantly mediate or modify the association of PM2.5 with dementia, indicating the need to investigate other pathways and potential mediators of risk.

}, keywords = {Air Pollution, Dementia, Hypertension, Particulate Matter, Stroke}, issn = {2574-3805}, doi = {10.1001/jamanetworkopen.2023.33470}, author = {Zhang, Boya and Kenneth M. Langa and Weuve, Jennifer and D{\textquoteright}Souza, Jennifer and Szpiro, Adam and Jessica Faul and Mendes de Leon, Carlos and Kaufman, Joel D and Lisabeth, Lynda and Hirth, Richard A and Adar, Sara D} } @article {13621, title = {Identifying the Relationships between Types of Leisure Activities and Cognitive Functions in Older Adults}, journal = {American Journal of Health Behavior}, volume = {47}, year = {2023}, pages = {650 {\textendash} 659}, abstract = {Objectives: We investigated the relationship between types of leisure-time physical activity (LTPA) activities, intellectually stimulating activities, and community-based activities and the cognitive functions of older adults. Methods: We extracted 3,767 samples from the 2020 Health and Retirement Study (N=15,723). We defined cognitive functions as: (1) memory as assessed by both immediate and delayed recall tests, (2) working memory measured by a subtraction-by-7 test, and (3) attention and processing speed assessment through the use of the counting backward test. We used hierarchical regression analysis to assess the relationships between types of leisure and cognitive functions. Results: LTPA, intellectual leisure, and community-based leisure were significantly associated with improved memory function. Intellectual activity was significantly associated with improved working memory, and improved attention and processing speed. Conclusion: These findings provide data-based implications for the design and implementation of various types of leisure activities for older adults by healthcare providers and therapists. {\textcopyright} 2023 PNG Publications. All rights reserved.}, keywords = {cognitive functions, healthy aging, Leisure activities, Older Adults, Successful aging}, doi = {10.5993/AJHB.47.4.2}, author = {Kim, Junhyoung and Lee, Jungjoo and Rodriguez, Miriam and Han, Areum and Ju, Hyo-Jin} } @article {13456, title = {The Impact of Caregiving History on Later-life Self-Perceptions of Aging.}, journal = {J Gerontol B Psychol Sci Soc Sci}, year = {2023}, abstract = {

OBJECTIVES: Theories suggest that self-perceptions of aging (SPA) reflect structural and cultural ageism together with an individual{\textquoteright}s personal life experiences. We examine the impact of an individual{\textquoteright}s history of informal caregiving on their SPA.

METHODS: Using data from the Health and Retirement Study (HRS, N = 8,372, age range 50 - 102 years), we investigated caregiving history as a determinant of later-life SPA. HRS participants provided reports of up to five episodes of caregiving, the life course timing of each episode (start / end year), and their relationship with the care recipients. SPA was measured by the HRS Attitudes toward Own Aging Scale. We conducted linear regressions to examine associations between specific caregiving histories and later-life SPA. Models included controls for current sociodemographic and health status.

RESULTS: Individuals who were ever a caregiver reported more negative SPA than non-caregivers. Variations in the impact of histories of caregiving were also revealed. Specifically, compared to people who had cared for adult(s) only, HRS participants who cared for both a child with special needs and an adult reported more negative SPA later in life.

DISCUSSION: The study provides insight into potential life course precursors of SPA and highlights the importance of conceptualizing caregiving history as a complex life experience that might impact an individual{\textquoteright}s SPA later in life.

}, keywords = {Informal caregiving; Self-perceptions of aging; life course history; the Health and Retirement Study}, issn = {1758-5368}, doi = {10.1093/geronb/gbad103}, author = {Hu, Rita Xiaochen and Larkina, Marina and Jacqui Smith} } @article {13439, title = {In sickness and in health: Loneliness, depression, and the role of marital quality among spouses of persons with dementia.}, journal = {J Am Geriatr Soc}, year = {2023}, abstract = {

BACKGROUND: Older adults married to persons living with dementia (PLwD) may be at risk for loneliness and depression. We assessed the prevalence of loneliness and depressive symptoms among spouses of PLwD or cognitive impairment not dementia (CIND), and the role of marital quality in mediating these outcomes.

METHODS: We used a US population-based sample of 4071 couples enrolled in the Health and Retirement Study (2014 and 2016). We included older adults married to PLwD (N = 227), married to persons with CIND (N = 885), or married to persons with no cognitive impairment (NCI) (N = 2959). We determined the prevalence of loneliness (UCLA 3-item scale), depressive symptoms (CESD-8 scale), and both, using multivariable logistic regression adjusting for sociodemographic and health-related characteristics. We then tested for interaction terms between marital quality (4-item scale) and degree of spousal cognitive impairment for each outcome of loneliness and depressive symptoms.

RESULTS: The sample was 55\% women and on average 67-years-old (range: 50-97). After adjustment, spouses of persons with cognitive impairment were more likely to be lonely (NCI: 20\%, CIND: 23\%, PLwD: 29\%; p = 0.04), depressed (NCI: 8\%, CIND: 15\%, PLwD: 14\%; p < 0.01), and both (NCI: 4\%, CIND: 9\%, PLwD: 7\%; p < 0.01). The association between cognition and loneliness, but not depression, differed by marital quality (interaction p-value = 0.03). Among couples with high marital quality, spousal cognitive impairment was associated with higher likelihood of loneliness (p < 0.05). In contrast, no association existed between spousal cognition and loneliness among couples with lower marital quality (p = 0.37).

CONCLUSIONS: One in six spouses of persons with CIND or more advanced disease (PLwD) experienced depressive symptoms, and loneliness among spouses of PLwD was experienced at a twofold rate. By identifying and managing both, and facilitating interventions that promote high-quality social connection, clinical teams might improve the lives of older couples facing dementia.

}, keywords = {Dementia, depression, health, Loneliness, Marital quality, sickness, Spouses}, issn = {1532-5415}, doi = {10.1111/jgs.18520}, author = {Hsu, Kristie Y and Cenzer, Irena and Harrison, Krista L and Ritchie, Christine S and Waite, Linda and Kotwal, Ashwin} } @article {HERNANDEZ2023101453, title = {In the wake of a crisis: Caught between housing and healthcare}, journal = {SSM - Population Health}, year = {2023}, pages = {101453}, abstract = {Objective To measure the association between housing insecurity and foregone medication due to cost among Medicare beneficiaries aged 65+ during the Recession. Methods Data came from Medicare beneficiaries aged 65+ years from the 2006{\textendash}2012 waves of the Health and Retirement Study (HRS). Two-wave housing insecurity changes are evaluated as follows: (i) No insecurity, (ii) Persistent insecurity, (iii) Onset insecurity, and (iv) Onset security. We implemented a series of four weighted longitudinal General Estimating Equation (GEE) models, two minimally adjusted and two fully adjusted models, to estimate the probability of foregone medications due to cost between 2008-2012. Results Our study sample was restricted to non-proxy interviews of non-institutionalized Medicare beneficiaries aged 65+ in the 2006 wave (n = 9936) and their follow up visits (n = 8753; in 2008; n = 7464 in 2010; and n = 6594 in 2012). Results from our fully adjusted model indicated that the odds of foregone medication was 64\% higher among individuals experiencing Onset insecurity versus No insecurity in 2008, and also generally larger for individuals experiencing Onset Insecurity versus Persistent Insecurity. Odds of foregone medication was also larger among females, minority versus non-Hispanic white adults, those reporting a chronic condition, those with higher medical expenditures, and those living in the South versus Northeast. Conclusion This study drew from nationally representative data to elucidate the disparate health and financial impacts of a crisis on Medicare beneficiaries who, despite health insurance coverage, displayed variability in foregone medication patterns. Our findings suggest that the onset of housing insecurity is most closely linked with unexpected acute economic shocks leading households with little time to adapt and forcing trade-offs in their prescription and other needs purchases. Both housing and healthcare policy implications exist from these findings including expansion of low-income housing units and rent relief post-recession as well as wider prescription drug coverage for Medicare adults.}, keywords = {Foregone medication due to cost, Great Recession, Health Disparities, Housing insecurity, Medicare Beneficiaries}, issn = {2352-8273}, doi = {https://doi.org/10.1016/j.ssmph.2023.101453}, author = {Monica Hernandez and Rebeca Wong and Xiaoying Yu and Neil Mehta} } @article {11464, title = {The Influence of Cognitive Impairment on Post-Operative Outcomes.}, journal = {Annals of Surgery}, volume = {277}, year = {2023}, pages = {e212-e217}, abstract = {

OBJECTIVE: To examine differences in rates of elective surgery, postoperative mortality, and readmission by pre-existing cognitive status among Medicare beneficiaries undergoing surgery.

BACKGROUND: Mild cognitive impairment (MCI) is common among older adults, but the impact of MCI on surgical outcomes is understudied.

METHODS: We conducted a retrospective cohort study of individuals >=65 who underwent surgery between 2001 and 2015 using data from the nationally-representative Health and Retirement Study linked with Medicare claims. Cognitive status was assessed by the modified Telephone Interview for Cognitive Status score and categorized as normal cognition (score: 12-27), MCI (7-11), and dementia (<7). Outcomes were 30- and 90-day postoperative mortality and readmissions. We used Cox proportional hazard models to estimate the risk of each outcome by cognition, adjusting for patient characteristics.

RESULTS: In 6,590 patients, 69.9\% had normal cognition, 20.1\% had MCI, and 9.9\% had dementia. Patients with MCI (79.9\%) and dementia (73.6\%) were less likely to undergo elective surgery than patients with normal cognition (85.9\%). Patients with MCI had similar postoperative mortality and readmissions rates as patients with normal cognition. However, patients with dementia had significantly higher postoperative 90-day mortality (5.2\% vs. 8.4\%, p=0.002) and readmission rates (13.9\% vs. 17.3\%, p=0.038).

CONCLUSION: Patients with self-reported MCI are less likely to undergo elective surgery but have similar postoperative outcomes compared with patients with normal cognition. Despite the variability of defining MCI, our findings suggest that MCI may not confer additional risk for older individuals undergoing surgery, and should not be a barrier for surgical care.

}, keywords = {cognition impairment, Postoperative Period}, issn = {1528-1140}, doi = {10.1097/SLA.0000000000004799}, author = {Blair, Emilie M and Deborah A Levine and Hu, Hsou Mei and Kenneth M. Langa and Mohammed U Kabeto and Waljee, Jennifer} } @article {doi:10.1177/0192513X221150988, title = {Interpersonal Discrimination and Relationship Quality among Married Mid-Life and Older Black Adults}, journal = {Journal of Family Issues}, year = {2023}, pages = {0192513X221150988}, abstract = {Theories of minority stress contagion suggest that the consequences of racial discrimination may extend beyond the individual to impact close others. We empirically test direct and spillover associations between racialized stress and marital support and strain among mid-life and older Black spouses. We use actor-partner interdependence models to analyze dyadic data from 280 different-sex, married Black couples from the 2014 and 2016 Health and Retirement Study who completed the psychosocial leave-behind module. We find significant actor effects for husbands{\textquoteright} racial discrimination on their own marital support and strain, while wives{\textquoteright} racial discrimination is positively associated with their own marital strain. We find no evidence of partner effects nor significant gender differences in the association between racial discrimination and marital quality. The findings highlight pathways by which racial discrimination affects the marriage quality of Black men and women in mid- to late-life.}, keywords = {Black adults, Interpersonal discrimination, Older Adults, relationship quality}, doi = {10.1177/0192513X221150988}, author = {Andrea K. Henderson and Jaclyn S. Wong and Adrianne Dues and Katrina M. Walsemann} } @article {12471, title = {Job Quality in the Late Career in Sweden, Japan and the United States.}, journal = {Research on Aging}, year = {2023}, abstract = {

Increasing numbers of older workers continue to work after being eligible to claim a state pension, yet little is known about the quality of these jobs. We examine how psychosocial and physical job quality as well as job satisfaction vary over the late career in three contrasting national settings: Sweden, Japan and the United States. Analyses using random effects modelling drew on data from the Swedish Longitudinal Occupational Survey of Health ( = 13,936-15,520), Japanese Study of Ageing and Retirement ( = 3704) and the Health and Retirement Study ( = 6239 and 8002). Age was modelled with spline functions in which two knots were placed at ages indicating eligibility for pensions claiming or mandatory retirement. In each country, post-pensionable-age jobs were generally less stressful, freer and more satisfying than jobs held by younger workers, results that held irrespective of gender or education level.

}, keywords = {international comparative study, post-retirement work, Working conditions, working retirees}, issn = {1552-7573}, doi = {10.1177/01640275221075985}, author = {Platts, Loretta G and Sacco, Lawrence B and Hiyoshi, Ayako and Westerlund, Hugo and Cahill, Kevin E and K{\"o}nig, Stefanie} } @article {13540, title = {A lack of financial planning predicts increased mortality risk: Evidence from cohort studies in the United Kingdom and United States.}, journal = {PLoS One}, volume = {18}, year = {2023}, pages = {e0290506}, abstract = {

We investigate whether a lack of planning and future-orientation in financial behavior is associated with a higher mortality risk. Our evidence is based on two nationally representative cohorts of older people living in the United States (n = 11,478) and England (n = 11,298), where we compared individuals{\textquoteright} self-reported planning horizons on spending and saving with government mortality records. Controlling for demographics, participants with a 1 SD shorter planning horizon had a 9\% greater hazard of dying in the English sample (evaluated over 10 years), and a 7\% greater hazard in the US sample (over 22 years). These differences in mortality risk could not be explained by variation in respondent{\textquoteright}s life expectancy, their financial circumstances or a range of other observable covariates. Similar results are found for self-reported health, with the positive association between longer planning horizons and health strongest for those with fewest financial resources.

}, keywords = {ELSA, Financial planning, mortality risk}, issn = {1932-6203}, doi = {10.1371/journal.pone.0290506}, author = {Gladstone, Joe J and Hundtofte, C Sean} } @article { WOS:001008140400001, title = {Lapses in long-term care insurance}, journal = {JOURNAL OF RISK AND INSURANCE}, year = {2023}, abstract = {About a quarter of long-term care insurance (LTCI) policy holders aged 65 let their policies lapse before death, forfeiting all benefits. We find that lapse rates are substantially higher among the cognitively impaired in the Health and Retirement Study. This generates a pernicious form of dynamic advantageous selection, as the cognitively impaired are more likely to use care. Simulations show that an inappropriately optimistic asset drawdown path further increases the individual welfare cost of unanticipated lapses. Meanwhile, we find evidence of a significant but very small role for either strategic or financial motives for lapsing.}, keywords = {cognitively impaired, Long-term Care}, issn = {0022-4367}, doi = {10.1111/jori.12425}, author = {Friedberg, Leora and Hou, Wenliang and Sun, Wei and Webb, Anthony} } @article {13396, title = {Lonely individuals tend to develop sleep problems, study finds}, year = {2023}, publisher = {PsyPost}, keywords = {Loneliness, sleep disorders}, url = {https://www.psypost.org/2023/07/lonely-individuals-tend-to-develop-sleep-problems-study-finds-167013}, author = {Hedrih, Vladimir} } @article {13181, title = {Longitudinal body weight dynamics in relation to cognitive decline over two decades: A prospective cohort study.}, journal = {Obesity (Silver Spring)}, volume = {31}, year = {2023}, month = {2023 Mar}, pages = {852-860}, abstract = {

OBJECTIVE: The aim of this study was to investigate the associations of body weight change (BWC) and body weight variability (BWV) with changes in cognitive function.

METHODS: In 10,340 Health and Retirement Study participants (mean age: 68.0 years), body weight was reported biennially from 1993/1994 to 2016, and cognitive function was measured biennially from 1998 to 2016. We calculated BWC and BWV as the slope and root-mean-square error by regressing body weight on time for each individual. BWC was categorized by quintiles (Q): stable weight (Q2 to Q4), weight loss (Q1), and weight gain (Q5). BWV was categorized by tertiles. We used linear mixed regression models to assess associations with cognitive change.

RESULTS: Compared with stable weight (median: 0~kg/y), weight loss (median: -1.3~kg/y) predicted faster cognitive decline as demonstrated by mean difference of -0.023 (95\% CI: -0.027 to -0.019) in cognitive change z score per year, whereas weight gain (median: 1~kg/y) was related to slower cognitive decline (β~=~0.006; 95\% CI: 0.003 to 0.009). Larger BWV was also associated with faster cognitive decline (β comparing the top with bottom tertile~=~-0.003; 95\% CI: -0.006 to -0.0002). Similar associations were observed for episodic and working memory.

CONCLUSIONS: Weight loss and large BWV over a long time independently predicted faster cognitive decline in middle-aged and older adults, underscoring the importance of long-term dynamic body weight monitoring.

}, keywords = {Aged, Body Weight, Cognitive Dysfunction, Humans, Longitudinal Studies, Middle Aged, Prospective Studies, Weight Gain, Weight Loss}, issn = {1930-739X}, doi = {10.1002/oby.23671}, author = {Zhou, Tianjing and Chen, Hui and Huang, Yuhui and Wang, Binghan and Zheng, Yan and Wang, Liang and Rong, Shuang and Ma, Yuan and Yuan, Changzheng} } @article {12261, title = {Longitudinal Examination of an Ethnic Paradox of Stress and Mental Health in Older Black and Latinx Adults.}, journal = {Clinical Gerontologist}, volume = {46}, year = {2023}, pages = {27-46}, abstract = {

OBJECTIVES: To explain the ethnic paradox of mental health in aging, we evaluated whether Black and Latinx older adults experience (1) fewer depressive symptoms (DepSx), but more physical problems, and (2) greater psychological resilience as a result of life stressors than White older adults.

METHODS: DepSx, physical health, and recent stress were obtained biennially from 25,893 older adults (77\% White, 15\% Black, 9\% Latinx) in the U.S. Health and Retirement Study, across 16~years. Psychological resilience, lifetime stress, and discrimination experiences were available for 13,655 individuals. We conducted mixed-effects and linear regression analyses.

RESULTS: For Blacks and Latinxs, experiencing more-than-usual stress events was associated with less increase in DepSx compared to Whites, although on average Blacks and Latinxs experience more DepSx. Black adults showed worse physical health than White adults and weaker effects of stress on psychological resilience despite experiencing more stress of all types. Findings were mixed for Latinxs.

CONCLUSIONS: Studying effects of time-varying stress on changes in health and multiple stressors on psychological resilience by race/ethnicity elucidates mechanisms for later-age health disparities.

CLINICAL IMPLICATIONS: Cross-sectional evaluations of stress and psychological health in a clinical setting may provide incomplete appraisals of health risks for Black and Latinx older Americans.

}, keywords = {Depressive symptoms, Health Disparities, physical functioning, psychological resilience, Race/ethnicity, Stressful Life Events}, issn = {1545-2301}, doi = {10.1080/07317115.2022.2056102}, author = {Thalida E. Arpawong and Sakuma, Kari-Lyn K and Espinoza, Lilia and Huh, Jimi} } @article {12493, title = {Long-term psychological consequences of parental bereavement prior to midlife: volunteering helps.}, journal = {Aging \& Mental Health}, year = {2023}, abstract = {

OBJECTIVES: Losing a child prior to midlife may be a uniquely traumatic event that continues to compromise parents{\textquoteright} well-being in later life. This study compared psychological well-being between bereaved and non-bereaved parents, and examined whether volunteering protects bereaved parents. Because most families have more than one child, we further explored whether the number of living children parents had differentiated bereaved parents in their well-being.

METHODS: We analyzed a pooled sample of parents aged 50+ ( = 12,023) from the (2010/2012-2012/2014), including parents who lost a child prior to 50 and those who never lost a child. Two-level linear regression models were estimated to test the associations between child loss, volunteering, and psychological well-being, and examine the moderating effect of number of living children.

RESULTS: Bereaved parents reported more depressive symptoms and lower life satisfaction than their non-bereaved counterparts, which was more evident among parents with fewer children alive. Among bereaved parents, volunteering, particularly volunteering 100+ hours/year, was associated with better psychological well-being at baseline; yet, volunteering 1-99 hours/year led to a larger increase in life satisfaction over time. The benefits of volunteering held true regardless of the number of living children.

CONCLUSION: This study adds to our understanding of the lasting effect of parental bereavement and suggests volunteering as a potential intervention aimed at helping bereaved older parents. Findings identify parents with fewer children as a particularly vulnerable population in the face of child loss and calls for more resources allocated to help them.

}, keywords = {bereaved parents, child loss, depression, volunteer}, issn = {1364-6915}, doi = {10.1080/13607863.2022.2087209}, author = {Huo, Meng and Kim, Kyungmin and Wang, Dahua} } @article {13190, title = {Measurement differences in the assessment of functional limitations for cognitive impairment classification across geographic locations.}, journal = {Alzheimers Dement}, volume = {19}, year = {2023}, month = {2023 May}, pages = {2218-2225}, abstract = {

INTRODUCTION: The measurement of dementia in cross-national contexts relies on the assessment of functional limitations. We aimed to evaluate the performance of survey items on functional limitations across culturally diverse geographic settings.

METHODS: We used data from the Harmonized Cognitive Assessment Protocol Surveys (HCAP) in five countries (total N~=~11,250) to quantify associations between items on functional limitations and cognitive impairment.

RESULTS: Many items performed better in the United States and England compared to South Africa, India, and Mexico. Items on the Community Screening Instrument for Dementia (CSID) had the least variability across countries (SD~=~0.73~vs. 0.92 [Blessed] and 0.98 [Jorm IQCODE]), but also the weakest associations with cognitive impairment (median odds ratio [OR]~=~2.23~vs. 3.01 [Blessed] and 2.75 [Jorm IQCODE]).

DISCUSSION: Differences in cultural norms for reporting functional limitations likely influences performance of items on functional limitations and may affect the interpretation of results from substantive studies.

HIGHLIGHTS: There was substantial cross-country variation in item performance. Items from the Community Screening Instrument for Dementia (CSID) had less cross-country variability but lower performance. There was more variability in performance of instrumental activities of daily living (IADL) compared to activities of daily living (ADL) items. Variability in cultural expectations of older adults should be taken into account. Results highlight the need for novel approaches to assessing functional limitations.

}, keywords = {Activities of Daily Living, Aged, Cognitive Dysfunction, Dementia, England, Humans, Surveys and Questionnaires, United States}, issn = {1552-5279}, doi = {10.1002/alz.12994}, author = {Nichols, Emma and Ng, Derek K and Hayat, Shabina and Kenneth M. Langa and Lee, Jinkook and Steptoe, Andrew and Deal, Jennifer A and Gross, Alden L} } @article {12918, title = {Multimorbidity burden and developmental trajectory in relation to later-life dementia: A prospective study.}, journal = {Alzheimer{\textquoteright}s \& Dementia}, year = {2023}, abstract = {

INTRODUCTION: This study assessed the associations of multimorbidity burden and its developmental trajectory with later-life dementia.

METHODS: Among 5923 Health and Retirement Study participants, major chronic conditions including hypertension, diabetes mellitus, cancer, lung diseases, heart disease, stroke, psychological disorders, and arthritis were self- or~proxy-reported in 1994-2008. Dementia diagnosis was self- or proxy-reported in 2008-2018. We used Cox regression to assess the associations of multimorbidity with incident dementia.

RESULTS: During follow-up (median = 8 years), 701 participants developed dementia. Each additional chronic condition in 2008 was related to 15\% (confidence interval: 9\% to 22\%) higher hazard of dementia. Multimorbidity trajectories in 1994-2008 were classified as "rapid growth", "steady growth", "slow growth", and "no new condition" by the group-based trajectory modelling methods. Compared to "no new condition", the "rapid growth" trajectory was related to 32\% (3\% to 69\%) higher dementia risk.

CONCLUSIONS: Both multimorbidity burden and its developmental trajectory were prospectively associated with risk of dementia.

}, keywords = {Dementia, healthy aging, multimorbidity}, issn = {1552-5279}, doi = {10.1002/alz.12840}, author = {Chen, Hui and Zhou, Yaguan and Huang, Liyan and Xu, Xiaolin and Yuan, Changzheng} } @article {13576, title = {Neighborhood Characteristics and Elevated Blood Pressure in Older Adults.}, journal = {JAMA Network Open}, year = {2023}, month = {2023 Sep 05}, pages = {e2335534}, abstract = {

IMPORTANCE: The local environment remains an understudied contributor to elevated blood pressure among older adults. Untargeted approaches can identify neighborhood conditions interrelated with racial segregation that drive hypertension disparities.

OBJECTIVE: To evaluate independent associations of sociodemographic, economic, and housing neighborhood factors with elevated blood pressure.

DESIGN, SETTING, AND PARTICIPANTS: In this cohort study, the sample included Health and Retirement Study participants who had between 1 and 3 sets of biennial sphygmomanometer readings from 2006 to 2014 or 2008 to 2016. Statistical analyses were conducted from February 5 to November 30, 2021.

EXPOSURES: Fifty-one standardized American Community Survey census tract variables (2005-2009).

MAIN OUTCOMES AND MEASURES: Elevated sphygmomanometer readings over the study period (6-year period prevalence): a value of at least 140 mm Hg for systolic blood pressure and/or at least 90 mm Hg for diastolic blood pressure. Participants were divided 50:50 into training and test data sets. Generalized estimating equations were used to summarize multivariable associations between each neighborhood variable and the period prevalence of elevated blood pressure, adjusting for individual-level covariates. Any neighborhood factor associated (Simes-adjusted for multiple comparisons P <= .05) with elevated blood pressure in the training data set was rerun in the test data set to gauge model performance. Lastly, in the full cohort, race- and ethnicity-stratified associations were evaluated for each identified neighborhood factor on the likelihood of elevated blood pressure.

RESULTS: Of 12 946 participants, 4565 (35\%) had elevated sphygmomanometer readings (median [IQR] age, 68 [63-73] years; 2283 [50\%] male; 228 [5\%] Hispanic or Latino, 502 [11\%] non-Hispanic Black, and 3761 [82\%] non-Hispanic White). Between 2006 and 2016, a lower likelihood of elevated blood pressure was observed (relative risk for highest vs lowest tertile, 0.91; 95\% CI, 0.86-0.96) among participants residing in a neighborhood with recent (post-1999) in-migration of homeowners. This association was precise among participants with non-Hispanic White and other race and ethnicity (relative risk, 0.91; 95\% CI, 0.85-0.97) but not non-Hispanic Black participants (relative risk, 0.97; 95\% CI, 0.85-1.11; P = .48 for interaction) or Hispanic or Latino participants (relative risk, 0.84; 95\% CI, 0.65-1.09; P = .78 for interaction).

CONCLUSIONS AND RELEVANCE: In this cohort study of older adults, recent relocation of homeowners to a neighborhood was robustly associated with reduced likelihood of elevated blood pressure among White participants but not their racially and ethnically marginalized counterparts. Our findings indicate that gentrification may influence later-life blood pressure control.

}, keywords = {Aged, Blood pressure, Cohort Studies, ethnicity, Female, Humans, Hypertension, Male, Neighborhood characteristics}, issn = {2574-3805}, doi = {10.1001/jamanetworkopen.2023.35534}, author = {Sims, Kendra D and Willis, Mary D and Hystad, Perry W and Batty, G David and Bibbins-Domingo, Kirsten and Smit, Ellen and Odden, Michelle C} } @article {13369, title = {Neighborhood Cohesion Across the Life Course and Effects on Cognitive Aging.}, journal = {J Gerontol B Psychol Sci Soc Sci}, year = {2023}, abstract = {

OBJECTIVES: Greater neighborhood cohesion is associated with better cognitive function in adulthood and may serve as a protective factor against cognitive impairment and decline. We build on prior work by examining the effects of perceived neighborhood cohesion across the life course on level and change in cognitive function in adulthood.

METHODS: Utilizing longitudinal data from the Health and Retirement Study (1998-2016) and its Life History Mail Survey, we leveraged data from 3,599 study participants (baseline age: 51-89) who participated in up to 10 waves. Respondents provided retrospective ratings of neighborhood cohesion at childhood (age 10), young adulthood (age at first full-time job), early midlife (age 40), and concurrently at baseline (i.e., late midlife/adulthood); they completed the modified version of the Telephone Interview for Cognitive Status (mTICS). We fit a univariate latent growth curve model of change in cognitive function across waves and tested whether neighborhood cohesion during each recollected life stage predicted level and change in cognitive function.

RESULTS: Greater neighborhood cohesion during childhood and late midlife/adulthood each predicted higher cognitive function at baseline but not rate of cognitive decline. The final model showed that greater neighborhood cohesion in childhood and in late midlife/adulthood remained significantly associated with higher baseline cognitive function, even after accounting for one another.

DISCUSSION: Findings provide insight into life course neighborhood contextual influences on cognitive aging. Our results emphasize the need for more research to understand the life course dynamics between neighborhood environments and cognitive aging.

}, issn = {1758-5368}, doi = {10.1093/geronb/gbad095}, author = {Choi, Jean and Han, Sae Hwang and Ng, Yee To and Mu{\~n}oz, Elizabeth} } @article {13702, title = {Patterns and Life Course Determinants of Black-White Disparities in Biological Age Acceleration: A Decomposition Analysis.}, journal = {Demography}, volume = {60}, year = {2023}, pages = {1815-1841}, abstract = {

Despite the prominence of the weathering hypothesis as a mechanism underlying racialized inequities in morbidity and mortality, the life course social and economic determinants of Black-White disparities in biological aging remain inadequately understood. This study uses data from the Health and Retirement Study (n = 6,782), multivariable regression, and Kitagawa-Blinder-Oaxaca decomposition to assess Black-White disparities across three measures of biological aging: PhenoAge, Klemera-Doubal biological age, and homeostatic dysregulation. It also examines the contributions of racial differences in life course socioeconomic and stress exposures and vulnerability to those exposures to Black-White disparities in biological aging. Across the outcomes, Black individuals exhibited accelerated biological aging relative to White individuals. Decomposition analyses showed that racial differences in life course socioeconomic exposures accounted for roughly 27\% to 55\% of the racial disparities across the biological aging measures, and racial disparities in psychosocial stress exposure explained 7\% to 11\%. We found less evidence that heterogeneity in the associations between social exposures and biological aging by race contributed substantially to Black-White disparities in biological aging. Our findings offer new evidence of the role of life course social exposures in generating disparities in biological aging, with implications for understanding age patterns of morbidity and mortality risks.

}, keywords = {Aging, Black or African American, Health Status Disparities, Humans, Life Change Events, Morbidity, Mortality, White}, issn = {1533-7790}, doi = {10.1215/00703370-11057546}, author = {Boen, Courtney E and Yang, Y Claire and Aiello, Allison E and Dennis, Alexis C and Harris, Kathleen Mullan and Kwon, Dayoon and Belsky, Daniel W} } @article {12870, title = {Physical Activity, Inflammation, and Physical Function in Older Adults: Results From the Health \& Retirement Study.}, journal = {Biological Research for Nursing}, volume = {25}, year = {2023}, pages = {24-32}, abstract = {

UNLABELLED: Physical function declines with aging due to physical and biological changes. The biological process of aging has been associated with increases in systemic inflammation and a greater risk for chronic conditions. In older adults, physical activity aids in maintenance of function. However, the influence of inflammatory biomarkers and adiposity on physical activity and physical function needs to be further explored.

METHODS: A cross-sectional secondary data analysis from Wave 13 of the Health \& Retirement Study (HRS) core biennial data and Venous Blood Study (VBS) was conducted. Structural equation modeling was used to establish the model and test the relationships.

RESULTS: Chronic low-level inflammation was moderately negatively correlated with physical activity (r = -0.326) and function (r = -0.367). Latent regressions showed that higher physical activity is associated with better physical function (unstandardized estimate = 0.600, < .001) while inflammation negatively affects physical function (unstandardized estimate = -0.139, < .001), and adiposity was not a predictor in the model ( = 0.055).

CONCLUSION: For older adults, preserving physical function by participation in physical activity and decreasing chronic inflammation are key preventive health strategies for older adults to maintain independence, with a need to further explore pro and anti-inflammatory biomarkers.

}, keywords = {Adiposity, Aging, Biomarkers, Exercise, Inflammation, Obesity}, issn = {1552-4175}, doi = {10.1177/10998004221111217}, author = {Hlebichuk, Jeanne L and Gretebeck, Randall J and Garnier-Villarreal, Mauricio and Piacentine, Linda B and Singh, Maharaj and Gretebeck, Kimberlee A} } @article {13525, title = {A pilot genome-wide association study meta-analysis of gastroparesis.}, journal = {United European Gastroenterol Journal}, volume = {11}, year = {2023}, pages = {784-796}, abstract = {

BACKGROUND: Gastroparesis (GP) is characterized by delayed gastric emptying in the absence of mechanical obstruction.

OBJECTIVE: Genetic predisposition may play a role; however, investigation at the genome-wide level has not been performed.

METHODS: We carried out a genome-wide association study (GWAS) meta-analysis on (i) 478 GP patients from the National Institute of Diabetes and Digestive and Kidney Diseases Gastroparesis Clinical Research Consortium (GpCRC) compared to 9931 population-based controls from the University of Michigan Health and Retirement Study; and (ii) 402 GP cases compared to 48,340 non-gastroparesis controls from the Michigan Genomics Initiative. Associations for 5,811,784 high-quality SNPs were tested on a total of 880 GP patients and 58,271 controls, using logistic mixed models adjusted for age, sex, and principal components. Gene mapping was obtained based on genomic position and expression quantitative trait loci, and a gene-set network enrichment analysis was performed. Genetic associations with clinical data were tested in GpCRC patients. Protein expression of selected candidate genes was determined in full thickness gastric biopsies from GpCRC patients and controls.

RESULTS: While no SNP associations were detected at strict significance (p~<=~5~{\texttimes}~10 ), nine independent genomic loci were associated at suggestive significance (p~<=~1~{\texttimes}~10 ), with the strongest signal (rs9273363, odds ratio~=~1.4, p~=~1~{\texttimes}~10 ) mapped to the human leukocyte antigen region. Computational annotation of suggestive risk loci identified 14 protein-coding candidate genes. Gene-set network enrichment analysis revealed pathways potentially involved in immune and motor dysregulation (p <= 0.05). The GP risk allele rs6984536A (Peroxidasin-Like; PXDNL) was associated with increased abdominal pain severity scores (Beta~=~0.13, p~=~0.03). Gastric muscularis expression of PXDNL also positively correlated with abdominal pain in GP patients (r~=~0.8, p~=~0.02). Dickkopf WNT Signaling Pathway Inhibitor 1 showed decreased expression in diabetic GP patients (p~=~0.005 vs. controls).

CONCLUSION: We report preliminary GWAS findings for GP, which highlight candidate genes and pathways related to immune and sensory-motor dysregulation. Larger studies are needed to validate and expand these findings in independent datasets.

}, keywords = {abdominal pain, delayed gastric emptying, Diabetes, enteric nervous system, gastroparesis, Genetics, immune dysregulation, Inflammation, motor function., PXDNL}, issn = {2050-6414}, doi = {10.1002/ueg2.12453}, author = {Tavares, Leticia Camargo and Zheng, Tenghao and Kwicklis, Madeline and Mitchell, Emily and Pandit, Anita and Pullapantula, Suraj and Bernard, Cheryl and Teder-Laving, Maris and Marques, Francine Z and Esko, Tonu and Kuo, Braden and Shulman, Robert J and Chumpitazi, Bruno P and Koch, Kenneth L and Sarosiek, Irene and Abell, Thomas L and McCallum, Richard W and Parkman, Henry P and Pasricha, Pankaj J and Hamilton, Frank A and Tonascia, James and Zawistowski, Matthew and Farrugia, Gianrico and Grover, Madhusudan and D{\textquoteright}Amato, Mauro} } @article {12915, title = {Positive social factors prospectively predict younger epigenetic age: Findings from the Health and Retirement Study.}, journal = {Psychoneuroendocrinology}, volume = {148}, year = {2023}, pages = {105988}, abstract = {

OBJECTIVES: Positive social factors may slow biological aging, but this has yet to be rigorously tested. This study investigated whether baseline levels or changes over time in social support and contact frequency prospectively predicted epigenetic age.

METHOD: Health and Retirement Study participants (N~=~1912, 46.3~\% male, aged 42-87 at baseline) reported longitudinal social support and contact frequency data up to 3 times between 2006 and 2016 and provided blood in 2016. Baseline levels (intercepts) and changes over time (slopes) in social support from and contact frequency with spouses, children, friends, and other family were outputted from multilevel models and used to predict epigenetic age, estimated from Horvath, Hannum, GrimAge, PhenoAge, and Dunedin Pace of Aging.

RESULTS: In models adjusted for demographic and health characteristics, higher baseline levels of support from and contact frequency with friends were prospectively associated with a slower Pace of Aging (support: p~=~.002; contact: p~=~0.009) and a lower GrimAge (contact: p~=~.001). In addition, higher contact frequency with children at baseline was prospectively associated with a lower GrimAge (p~<~.001), and higher contact frequency with family at baseline and an increase in family contact over time was associated with a lower Hannum age (baseline: p~=~.005; slope: p~=~.015).

CONCLUSIONS: Perceived support from and contact with close others, particularly friends, may have implications for healthy biological aging. Notably, the effect sizes for friends were comparable to the effect of body mass index on epigenetic age. Positive social factors were generally associated with second- and third-generation clocks, which may be more sensitive to psychosocial factors than first-generation clocks.

}, keywords = {Aging, DNA Methylation, Epigenesis, genetic, Retirement, Social Factors, Spouses}, issn = {1873-3360}, doi = {10.1016/j.psyneuen.2022.105988}, author = {Hillmann, Abby R and Dhingra, Roma and Reed, Rebecca G} } @article {13734, title = {Prevalence and Trends of Basic Activities of Daily Living Limitations in Middle-Aged and Older Adults in the United States.}, journal = {Epidemiologia (Basel, Switzerland)}, volume = {4}, year = {2023}, pages = {483-491}, abstract = {

BACKGROUND: Population-level surveillance of the prevalence and trends of basic self-care limitations will help to identify the magnitude of physical disablement in the rapidly growing older American demographic. We sought to evaluate the prevalence and trends of activities of daily living (ADL) limitations in the United States.

METHODS: The analytic sample included 30,418 Americans aged >=50 years from the 2006-2018 waves of the Health and Retirement Study. ADLs were self-reported. Weighted prevalence estimates were presented, and trends analyses were performed.

RESULTS: Although overall ADL disability prevalence was 16.5\% (95\% confidence interval: 15.8-17.2) in 2018, there were no changes in limitations during the study period ( = 0.52). Older adults had a greater ADL disability prevalence than middle-aged adults ( < 0.001). While older persons experienced a declining trend of ADL limitations ( < 0.001), middle-aged persons had an increasing trend ( < 0.001). Males had a lower ADL limitation prevalence than females ( < 0.001). Hispanic and non-Hispanic Black had a higher ADL disability prevalence than non-Hispanic White ( < 0.001).

CONCLUSIONS: This investigation revealed that while the estimated prevalence of ADL limitations in the United States was substantial, changes in such limitations were not observed. Our findings can help guide ADL screening, target sub-populations with an elevated ADL limitation prevalence, and inform interventions.

}, keywords = {Epidemiology, Geriatrics, Population Surveillance, self-care}, issn = {2673-3986}, doi = {10.3390/epidemiologia4040040}, author = {Heimbuch, Halli and Rhee, Yeong and Douglas, Marty and Juhl, Kirsten and Knoll, Kelly and Stastny, Sherri and McGrath, Ryan} } @article {13342, title = {The Prevalence and Trends of Instrumental Activities of Daily Living Impairments in the United States from 2008-2018.}, journal = {J Alzheimers Dis Rep}, volume = {7}, year = {2023}, pages = {271-278}, abstract = {

BACKGROUND: Instrumental activities of daily living (IADL) are neuropsychological-driven tasks that are linked to cognitive dysfunction. Examining population-based IADL deficits may reveal insights for the presence of these impairments in the United States.

OBJECTIVE: This investigation sought to evaluate the prevalence and trends of IADL impairments in Americans.

METHODS: A secondary analysis of data from the 2006-2018 waves of the Health and Retirement Study was conducted. The overall unweighted analytic sample included 29,764 Americans aged>=50 years. Respondents indicated their ability to perform six IADLs: manage money, manage medications, use a telephone, prepare hot meals, shop for groceries, and use a map. Persons reporting difficulty or an inability to complete an individual IADL were considered as having a task-specific impairment. Similarly, those indicating difficulty or an inability to perform any IADL were classified as having an IADL impairment. Sample weights were utilized to generate nationally-representative estimates.

RESULTS: Having an impairment in using a map (2018 wave: 15.7\% (95\% confidence interval (CI): 15.0-16.4) had the highest prevalence in individual IADLs regardless of wave examined. The overall prevalence of IADL impairments declined during the study period ( < 0.001) to 25.4\% (CI: 24.5-26.2) in the 2018 wave. Older Americans and women had a consistently higher prevalence of IADL impairments compared to middle-aged Americans and men, respectively. The prevalence of IADL impairments was also highest among Hispanics and non-Hispanic Blacks.

CONCLUSION: IADL impairments have declined over time. Continued surveillance of IADLs may help inform cognitive screening, identify subpopulations at risk of impairment, and guide relevant policy.

}, issn = {2542-4823}, doi = {10.3233/ADR-220107}, author = {Knoll, Kelly and Rhee, Yeong and Hamm, Jeremy M and Hammer, Kimberly D P and Heimbuch, Halli and Holloway, Jeremy and Jurivich, Donald and Lahr, Peyton and McGrath, Brenda and Parker, Kelly and Robinson-Lane, Sheria and Stover, Emily and Tomkinson, Grant R and McGrath, Ryan} } @article {13606, title = {Prevalence and Trends of Slow Gait Speed in the United States.}, journal = {Geriatrics (Basel, Switzerland)}, volume = {8}, year = {2023}, abstract = {

Gait speed is a simple, effective indicator of age-related disease and disability. We sought to examine the prevalence and trends of slow gait speed in older Americans. Our unweighted analytic sample included 12,427 adults aged >= 65 years from the 2006-2016 waves of the Health and Retirement Study. Gait speed was measured in participant residences. Persons with gait speed < 0.8 or <0.6 m/s were slow. Sample weights were used to generate nationally representative estimates. The overall estimated prevalence of slow gait speed with the <0.8 m/s cut-point was 48.6\% (95\% confidence interval (CI): 47.4-49.8) in the 2006-2008 waves yet was 45.7\% (CI: 44.3-47.1) in the 2014-2016 waves, but this downward trend was not statistically significant ( = 0.06). The estimated prevalence of slowness with the <0.6 m/s cut-point was 21.3\% (CI: 20.4-22.3) for the 2006-2008 waves, 18.5\% (CI: 17.5-19.4) for the 2010-2012 waves, and 19.2\% (CI: 18.2-20.2) for the 2014-2016 waves, but there were again no significant trends ( = 0.61). Our findings showed that the estimated prevalence of slow gait speed in older Americans is pronounced, and different cut-points largely inform how slowness is categorized. Continued surveillance of slowness over time will help guide screening for disablement and identify sub-populations at greatest risk for targeted interventions.

}, keywords = {Geriatrics, Physical Functional Performance, Population Surveillance, Walking}, issn = {2308-3417}, doi = {10.3390/geriatrics8050095}, author = {Stover, Emily and Andrew, Sarah and Batesole, Joshua and Berntson, Maren and Carling, Chloe and FitzSimmons, Samantha and Hoang, Tyler and Nauer, Joseph and McGrath, Ryan} } @article {13641, title = {Prevalence and Trends of Weakness Among Middle-Aged and Older Adults in the United States.}, journal = {Journal of strength and conditioning research}, volume = {37}, year = {2023}, pages = {2484-2490}, abstract = {

McGrath, R, FitzSimmons, S, Andrew, S, Black, K, Bradley, A, Christensen, BK, Collins, K, Klawitter, L, Kieser, J, Langford, M, Orr, M, and Hackney, KJ. Prevalence and trends of weakness among middle-aged and older adults in the United States. J Strength Cond Res 37(12): 2484-2490, 2023-Muscle weakness, which is often determined with low handgrip strength (HGS), is associated with several adverse health conditions; however, the prevalence and trends of weakness in the United States is not well-understood. We sought to estimate the prevalence and trends of weakness in Americans aged at least 50 years. The total unweighted analytic sample included 22,895 Americans from the 2006-2016 waves of the Health and Retirement Study. Handgrip strength was measured with a handgrip dynamometer. Men with weakness were below at least one of the absolute or normalized (body mass, body mass index) cut points: <35.5 kg, <0.45 kg/kg, <1.05 kg/kg/m 2 . The presence of any weakness in women was also identified as being below one of the absolute or normalized HGS cut points: <20.0 kg, <0.34 kg/kg, or <0.79 kg/kg/m 2 . There was an increasing trend in the prevalence of any weakness over time ( p < 0.001). The prevalence of weakness was 45.1\% (95\% confidence interval [CI]: 44.0-46.0) in the 2006-2008 waves and 52.6\% (CI: 51.5-53.7) in the 2014-2016 waves. Weakness prevalence was higher for older (>=65 years) Americans (64.2\%; CI: 62.8-65.5) compared with middle-aged (50-64 years) Americans (42.2\%; CI: 40.6-43.8) in the 2014-2016 waves. Moreover, the prevalence of weakness in the 2014-2016 waves was generally higher in women (54.5\%; CI: 53.1-55.9) than in men (50.4\%; CI: 48.7-52.0). Differences existed in weakness prevalence across races and ethnicities. The findings from our investigation suggest that the prevalence of weakness is overall pronounced and increasing in Americans. Efforts for mitigating and better operationalizing weakness will elevate in importance as our older American population grows.

}, keywords = {Aged, Body Mass Index, Female, Hand Strength, Humans, Male, Middle Aged, Muscle Weakness, Prevalence, Retirement, United States}, issn = {1533-4287}, doi = {10.1519/JSC.0000000000004560}, author = {McGrath, Ryan and FitzSimmons, Samantha and Andrew, Sarah and Black, Kennedy and Bradley, Adam and Christensen, Bryan K and Collins, Kyle and Klawitter, Lukus and Kieser, Jacob and Langford, Matthew and Orr, Megan and Hackney, Kyle J} } @article {13218, title = {Prevalence of unpaid caregiving, pain, and depression in older seriously ill patients undergoing elective surgery.}, journal = {J Am Geriatr Soc}, year = {2023}, month = {2023 Mar 13}, abstract = {

INTRODUCTION: Serious illness is a life-limiting condition negatively impacting daily function, quality of life, or excessively straining caregivers. Over 1 million older seriously ill adults undergo major surgery annually, and national guidelines recommend that palliative care be available to all seriously ill patients. However, the palliative care needs of elective surgical patients are incompletely described. Understanding baseline caregiving needs and symptom burden among seriously ill older surgical patients could inform interventions to improve outcomes.

METHODS: Using Health and Retirement Study data (2008-2018) linked to Medicare claims, we identified patients >=66 years who met an established serious illness definition from administrative data and underwent major elective surgery using Agency for Healthcare Research and Quality (AHRQ) criteria. Descriptive analyses were performed for preoperative patient characteristics, including: unpaid caregiving (no or yes); pain (none/mild or moderate/severe); and depression (no, CES-D < 3, or yes, CES-D >= 3). Multivariable regression was performed to examine the association between unpaid caregiving, pain, depression, and in-hospital outcomes, including hospital days (days admitted between discharge date and one-year post-discharge), in-hospital complications (no or yes), and discharge destination (home or non-home).

RESULTS: Of the 1343 patients, 55.0\% were female and 81.6\% were non-Hispanic White. Mean age was 78.0 (SD 6.8); 86.9\% had >=2 comorbidities. Before admission, 27.3\% of patients received unpaid caregiving. Pre-admission pain and depression were 42.6\% and 32.8\%, respectively. Baseline depression was significantly associated with non-home discharge (OR 1.6, 95\% CI 1.2-2.1, p~=~0.003), while baseline pain and unpaid caregiving needs were not associated with in-hospital or post-acute outcomes in multivariable analysis.

CONCLUSIONS: Prior to elective surgery, older adults with serious illnesses have high unpaid caregiving needs and a prevalence of pain and depression. Baseline depression alone was associated with discharge destinations. These findings highlight opportunities for targeted palliative care interventions throughout the surgical encounter.

}, keywords = {depression, Surgery, unpaid caregiving}, issn = {1532-5415}, doi = {10.1111/jgs.18316}, author = {Hu, Frances Y and Wang, Yihan and Abbas, Muhammad and Bollens-Lund, Evan and Reich, Amanda J and Lipsitz, Stuart R and Gray, Tamryn F and Kim, Dae and Ritchie, Christine and Kelley, Amy S and Cooper, Zara} } @article {13235, title = {Propensity Scores in Health Disparities Research: The Example of Cognitive Aging and the Hispanic Paradox.}, journal = {Epidemiology}, volume = {34}, year = {2023}, pages = {495-504}, abstract = {

BACKGROUND: Individuals of Mexican ancestry in the United States experience substantial socioeconomic disadvantages compared with non-Hispanic white individuals; however, some studies show these groups have similar dementia risk. Evaluating whether migration selection factors (e.g., education) associated with risk of Alzheimer disease and related dementia (ADRD) explain this paradoxical finding presents statistical challenges. Intercorrelation of risk factors, common with social determinants, could make certain covariate patterns very likely or unlikely to occur for particular groups, which complicates their comparison. Propensity score (PS) methods could be leveraged here to diagnose nonoverlap and help balance exposure groups.

METHODS: We compare conventional and PS-based methods to examine differences in cognitive trajectories between foreign-born Mexican American, US-born Mexican American, and US-born non-Hispanic white individuals in the Health and Retirement Study (1994-2018). We examined cognition using a global measure. We estimated trajectories of cognitive decline from linear mixed models adjusted for migration selection factors also associated with ADRD risk conventionally or with inverse probability weighting. We also employed PS trimming and match weighting.

RESULTS: In the full sample, where PS overlap was poor, unadjusted analyses showed both Mexican ancestry groups had worse baseline cognitive scores but similar or slower rates of decline compared with non-Hispanic white adults; adjusted findings were similar, regardless of method. Focusing analyses on populations where PS overlap was improved (PS trimming and match weighting) did not alter conclusions.

CONCLUSIONS: Attempting to equalize groups on migration selection and ADRD risk factors did not explain paradoxical findings for Mexican ancestry groups in our study.

}, keywords = {Adult, cognitive aging, Hispanic or Latino, Humans, Mexican Americans, Propensity Score, Risk Factors, United States}, issn = {1531-5487}, doi = {10.1097/EDE.0000000000001620}, author = {Kezios, Katrina L and Zimmerman, Scott C and Zhang, Adina and Calonico, Sebastian and Jawadekar, Neal and Glymour, M Maria and Zeki Al Hazzouri, Adina} } @article {13248, title = {Racial and Ethnic Disparities in Health Care Use and Access Associated With Loss of Medicaid Supplemental Insurance Eligibility Above the Federal Poverty Level.}, journal = {JAMA Intern Med}, volume = {183}, year = {2023}, pages = {534-543}, abstract = {

IMPORTANCE: Medicaid supplemental insurance covers most cost sharing in Medicare. Among low-income Medicare beneficiaries, the loss of Medicaid eligibility above this program{\textquoteright}s income eligibility threshold (100\% of federal poverty level [FPL]) may exacerbate racial and ethnic disparities in Medicare beneficiaries{\textquoteright} ability to afford care.

OBJECTIVE: To examine whether exceeding the income threshold for Medicaid, which results in an abrupt loss of Medicaid eligibility, is associated with greater racial and ethnic disparities in access to and use of care.

DESIGN, SETTING, AND PARTICIPANTS: This cross-sectional study used a regression discontinuity design to assess differences in access to and use of care associated with exceeding the income threshold for Medicaid eligibility. We analyzed Medicare beneficiaries with incomes 0\% to 200\% of FPL from the 2008 to 2018 biennial waves of the Health and Retirement Study linked to Medicare administrative data. To identify racial and ethnic disparities associated with the loss of Medicaid eligibility, we compared discontinuities in outcomes among Black and Hispanic beneficiaries (n = 2885) and White beneficiaries (n = 5259). Analyses were conducted between January 1, 2022, and October 1, 2022.

MAIN OUTCOME MEASURES: Patient-reported difficulty accessing care due to cost and outpatient service use, medication fills, and hospitalizations measured from Medicare administrative data.

RESULTS: This cross-sectional study included 8144 participants (38 805 person-years), who when weighted represented 151 282 957 person-years in the community-dwelling population of Medicare beneficiaries aged 50 years and older and incomes less than 200\% FPL. In the weighted sample, the mean (SD) age was 75.4 (9.4) years, 66.1\% of beneficiaries were women, 14.8\% were non-Hispanic Black, 13.6\% were Hispanic, and 71.6\% were White. Findings suggest that exceeding the Medicaid eligibility threshold was associated with a 43.8 percentage point (pp) (95\% CI, 37.8-49.8) lower probability of Medicaid enrollment among Black and Hispanic Medicare beneficiaries and a 31.0 pp (95\% CI, 25.4-36.6) lower probability of Medicaid enrollment among White beneficiaries. Among Black and Hispanic beneficiaries, exceeding the threshold was associated with increased cost-related barriers to care (discontinuity: 5.7 pp; 95\% CI, 2.0-9.4), lower outpatient use (-6.3 services per person-year; 95\% CI, -10.4 to -2.2), and fewer medication fills (-6.9 fills per person-year; 95\% CI, -11.4 to -2.5), but it was not associated with a statistically significant discontinuity in hospitalizations. Discontinuities in these outcomes were smaller or nonsignificant among White beneficiaries. Consequently, exceeding the threshold was associated with widened disparities, including greater reductions in outpatient service use (disparity: -6.2 services per person-year; 95\% CI, -11.7 to -0.6; P = .03) and medication fills (disparity: -7.2 fills per person-year; 95\% CI, -13.4 to -1.0; P = .02) among Black and Hispanic vs White beneficiaries.

CONCLUSIONS AND RELEVANCE: This cross-sectional study found that loss of eligibility for Medicaid supplemental insurance above the federal poverty level, which increases cost sharing in Medicare, was associated with increased racial and ethnic health care disparities among low-income Medicare beneficiaries. Expanding eligibility for Medicaid supplemental insurance may narrow these disparities.

}, keywords = {Aged, Cross-Sectional Studies, Female, Healthcare Disparities, Humans, Male, Medicaid, Medicare, Middle Aged, Poverty, United States}, issn = {2168-6114}, doi = {10.1001/jamainternmed.2023.0512}, author = {Roberts, Eric T and Kwon, Youngmin and Hames, Alexandra G and McWilliams, J Michael and Ayanian, John Z and Tipirneni, Renuka} } @article {13084, title = {Racial Differences in Employment and Poverty Histories and Health in Older Age.}, journal = {Am J Prev Med}, volume = {64}, year = {2023}, pages = {543-551}, abstract = {

INTRODUCTION: Black Americans encounter more barriers in the job market and earn less than White Americans. However, the extent to which racial disparities in employment and poverty histories impact health is not fully understood. This study characterized employment-poverty histories for Black and White middle-aged adults and examined their association with health.

METHODS: Respondents born in 1948-1953 and enrolled in the 2004 Health and Retirement Study (N=555, N=2,209) were included. Sequence analysis grouped respondents with similar employment-poverty trajectories from 2004 to 2016, and confounder-adjusted regression analyses estimated the associations between these trajectories and health in 2018. Analyses were conducted in 2021-2022.

RESULTS: More than 23\% of Black respondents experienced both employment and poverty fluctuations, including bouts of extreme poverty (<50\% of the federal poverty threshold), whereas no trajectory for White respondents included extreme poverty. Adversities in employment-poverty were associated with worse health. For example, among Black respondents, those who experienced both employment and poverty fluctuations had worse cognition than those employed and not poor (β= -0.55 standardized units, 95\% CI= -0.81, -0.30). Similarly, among White respondents, those who experienced employment fluctuations had worse cognition than those employed (β= -0.35, 95\% CI= -0.46, -0.24). Notably, the employed and not poor trajectory was associated with worse survival among Black respondents than among White respondents.

CONCLUSIONS: Employment fluctuations were associated with worse health, especially cognitive function, where the association was stronger among Black Americans who experienced both employment fluctuations and poverty. Findings highlight the importance of enhancing employment stability and of antipoverty programs, especially for Black Americans.

}, keywords = {Aged, Black or African American, Employment, Humans, Middle Aged, Poverty, Race Factors, White}, issn = {1873-2607}, doi = {10.1016/j.amepre.2022.10.018}, author = {Lu, Peiyi and Kezios, Katrina and Milazzo, Floriana and Jawadekar, Neal and Shelley, Mack and Zeki Al Hazzouri, Adina} } @article {13349, title = {Racialized Health Inequities: Quantifying Socioeconomic and Stress Pathways Using Moderated Mediation.}, journal = {Demography}, year = {2023}, abstract = {

Racism drives population health inequities by shaping the unequal distribution of key social determinants of health, such as socioeconomic resources and exposure to stressors. Research on interrelationships among race, socioeconomic resources, stressors, and health has proceeded along two lines that have largely remained separate: one examining differential effects of socioeconomic resources and stressors on health across racialized groups (moderation processes), and the other examining the role of socioeconomic resources and stressors in contributing to racial inequities in health (mediation processes). We conceptually and analytically integrate these areas using race theory and a novel moderated mediation approach to path analysis to formally quantify the extent to which an array of socioeconomic resources and stressors-collectively and individually-mediate racialized health inequities among a sample of older adults from the Health and Retirement Study. Our results yield theoretical contributions by showing how the socioeconomic status-health gradient and stress processes are racialized (24\% of associations examined varied by race), substantive contributions by quantifying the extent of moderated mediation of racial inequities (approximately 70\%) and the relative importance of various social factors, and methodological contributions by showing how commonly used simple mediation approaches that ignore racialized moderation processes overestimate-by between 5\% and 30\%-the collective roles of socioeconomic status and stressors in accounting for racial inequities in health.

}, issn = {1533-7790}, doi = {10.1215/00703370-10740718}, author = {Brown, Tyson H and Hargrove, Taylor W and Homan, Patricia and Adkins, Daniel E} } @article {12881, title = {Reduced epigenetic age in older adults who volunteer.}, journal = {Psychoneuroendocrinology}, volume = {148}, year = {2023}, pages = {106000}, abstract = {

BACKGROUND: Volunteering is associated with improved health and well-being outcomes, including a reduced risk of mortality. However, the biological mechanisms underlying the association between volunteering and healthy aging and longevity have not been well-established. We evaluated if volunteering was associated with reduced epigenetic age acceleration in older adults.

METHODS: We evaluated associations between volunteering and age acceleration, measured by 13 DNA methylation (DNAm) "epigenetic clocks" in 4011 older adults (M=69 years; SD=10 years) who participated in the Health and Retirement Study. We assessed 9 first-generation clocks (Horvath, Hannum, Horvath Skin, Lin, Garagnani, Vidalbralo, Weidner, Yang, and Bocklandt, which predict chronological age) and 4 second-generation clocks (Zhang, PhenoAge, GrimAge, and DunedinPoAm, which predict future disease or longevity). We quantified the total associations between volunteering and DNAm age acceleration as well as the extent to which these associations might be attributable to potential confounding by individual demographics (e.g., race), social demographics (e.g., income), health factors (e.g., diabetes), and health behaviors (e.g., smoking).

RESULTS: Volunteering was associated with reduced epigenetic age acceleration across 6 epigenetic clocks optimized for predicting health and longevity (False Discovery Rate [FDR] q < 0.0001 for epigenetic clocks: PhenoAge, GrimAge, DunedinPoAm, Zhang mortality, Yang mitotic; FDR q < 0.01: Hannum). These associations were mostly independent of demographic and health factors, but substantially attenuated after adjusting for health behaviors.

CONCLUSION: Volunteering was associated with reduced epigenetic age acceleration in 6 of 13 (mostly second-generation) epigenetic clocks. Results provide preliminary evidence that volunteering might provide health benefits through slower biological aging and implicate health behaviors as one potential mechanism of such effects.

}, keywords = {DNA Methylation, Epigenetic age acceleration, Health behaviors, Volunteering}, issn = {1873-3360}, doi = {10.1016/j.psyneuen.2022.106000}, author = {Nakamura, Julia S and Kwok, Cherise and Huang, Andrew and Strecher, Victor J and Kim, Eric S and Cole, Steven W} } @article {13300, title = {Relationships Between Types of Leisure Activities and Mental Health among Older Adults With Diabetes During the COVID-19 Pandemic.}, journal = {Am J Health Behav}, volume = {47}, year = {2023}, pages = {228-236}, abstract = {

Three types of leisure activities such as sedentary, social, and leisure-time physical activity (LTPA) have been identified as essential factors that influence mental health outcomes among older adults with diabetes. In this study, we aimed to investigate what types of leisure activities are associated with mental health outcomes among older adults with diabetes during the COVID-19 pandemic. We used 2020 Health and Retirement Study (HRS) data. We extracted 310 records from 3266 individuals diagnosed with diabetes and conducted a hierarchical regression analysis to investigate the research question. LTPA was the strongest predictor of reduced loneliness and stress and increased happiness and life satisfaction among older adults with diabetes. Our findings highlight the relationship between different types of leisure activities and mental health for older adults with diabetes during the COVID-19 pandemic. Data suggest that LTPA, social leisure, and sedentary leisure reduce loneliness and stress and improve happiness and life satisfaction.

}, keywords = {Aged, COVID-19, Diabetes Mellitus, Humans, Leisure activities, Mental Health, Pandemics}, issn = {1945-7359}, doi = {10.5993/AJHB.47.2.3}, author = {Lee, Jungjoo and Han, Areum and Kim, Junhyoung and Park, Se-Hyuk} } @article {13681, title = {Revisiting the caregiver stress process: Does family caregiving really lead to worse mental health outcomes?}, journal = {Advances in Life Course Research}, volume = {58}, year = {2023}, pages = {100579}, abstract = {

While the act of caregiving is often characterized as a stressful experience detrimental to mental health, recent studies are challenging this view by reporting robust health and well-being benefits linked to family caregiving. The current study attempted to provide an explanation of this apparent paradox by focusing on the role played by family health problems in the association between being a caregiver and mental health. Framed within the life course perspective and focusing on caregiving provided to aging mothers, the current study aimed 1) to demonstrate how the linkage between caregiving and depression reported in earlier studies may be misleading and 2) to further investigate whether caregiving to an aging mother may lead to any mental health benefits. Using longitudinal data drawn from the nationally representative US Health and Retirement Study, I follow adult children 50 and older who had a living mother during the observation period (N~=~4812; 18,442 person-wave observations). A series of within-between random effects models were estimated to explicate how health conditions of aging mothers (i.e., disability and dementia) and caregiving transitions of adult children were associated with changes in depressive symptoms of adult children. Findings demonstrated that caregiving transitions were unrelated to depressive symptoms among adult children once the model controlled for the confounding effects of having their mother experience disability and dementia. Further, caregiving behavior was found to buffer the direct detrimental effect of maternal disability on adult children{\textquoteright}s depressive symptoms. This study adds to the growing body of research that cautions against characterizing caregiving as a chronic stressor detrimental to mental health and further echoes earlier calls for a more balanced portrayal of caregiving in policy reports and research literature.

}, keywords = {Adult children, Caregivers, Dementia, Health Care, Mental Health, Outcome Assessment}, issn = {1879-6974}, doi = {10.1016/j.alcr.2023.100579}, author = {Han, Sae Hwang} } @article {13203, title = {Risk of Large Medical Expenditures at Older Ages and Their Impact on Economic Well-being}, year = {2023}, institution = {University of Michigan Retirement and Disability Research Center}, address = {Ann Arbor, Michigan}, abstract = {We study out-of-pocket (OOP) medical expenditure risk of the U.S. population ages 55 and older using data from the Health and Retirement Study and its supplemental survey on household spending. We document trends in individual-level OOP spending from 1998 to 2018, both at the median and 95th percentile, showing a large increase until 2004, followed by rapid declines, so that 2018 OOP was less than 1998 OOP spending. We show how these changes impacted the budget share of OOP as a fraction of total household spending and analyze how households adjust the composition of their spending as OOP expenses vary. Because the distribution of OOP expenses is skewed, households face a non-negligible risk of incurring a large expense. We examined the extent to which OOP medical expenditures contribute to economic hardship among older households, as measured by food insecurity and skipping medications because of cost. We found a weak relationship with respect to food insecurity, suggesting that government programs, like Medicaid, help protect against OOP risk leading to such as an extreme form of hardship. However, we obtained statistically significant and economically meaningful effects with respect to medication insecurity: An increase from the 10th to the 90th percentile in OOP spending would increase the probability of medication insecurity by about 15 percentage points. When asked about their perceived OOP risk, individuals tend to substantially overestimate the chances of large OOP spending, although less so at advanced ages; prior experience with OOP expenses seems to lead to more accurate expectations.}, keywords = {economic well-being, medical expenditures, Older ages}, url = {https://mrdrc.isr.umich.edu/publications/papers/pdf/wp457.pdf}, author = {Susann Rohwedder and P{\'e}ter Hudomiet and Michael D Hurd} } @article {13709, title = {The Role of Different Weakness Cut-Points for Future Cognitive Impairment in Older Americans.}, journal = {Journal of the American Directors Association}, volume = {24}, year = {2023}, pages = {1936-1941.e2}, abstract = {

OBJECTIVES: New absolute and normalized handgrip strength (HGS) cut-points may not yield similar predictive value for cognitive performance. We sought to determine the associations of (1) each absolute and normalized weakness cut-point, and (2) compounding weakness on future cognitive impairment in older Americans.

DESIGN: Longitudinal panel.

SETTING AND PARTICIPANTS: The analytic sample included 11,116 participants aged >=65 years from the 2006 to 2018 waves of the Health and Retirement Study. Participants from the Health and Retirement Study completed detailed interviews that included physical measures and core interviews.

METHODS: The modified Telephone Interview of Cognitive Status assessed cognitive function and persons scoring <11 were classified as having a cognitive impairment. A handgrip dynamometer measured HGS. Men were considered weak if their HGS was <35.5 kg (absolute), <0.45~kg/kg (body mass normalized), or <1.05~kg (body mass index normalized), whereas women were classified as weak if their HGS was <20.0 kg, <0.337~kg/kg, or <0.79~kg. Compounding weakness included those below 1, 2, or all 3 cut-points. Generalized estimating equations quantified the associations.

RESULTS: Persons considered weak under the absolute cut-point had 1.62 (95\% CI 1.34-1.96) greater odds for future cognitive impairment, but no significant associations were observed for those classified as weak under the body mass [odds ratio (OR) 1.12, CI 0.91-1.36] and body mass index normalized (OR 1.17, CI 0.95-1.43) cut-points. Older Americans below all 3 weakness cut-points had 1.47 (CI 1.15-1.88) greater odds for future cognitive impairment, but no significant associations were found for persons classified as weak under 1 (OR 1.08, CI 0.83-1.42) or 2 (OR 1.19, CI 0.91-1.55) cut-points.

CONCLUSIONS AND IMPLICATIONS: Our findings suggest that each weakness cut-point has differential prognostic value for future cognitive impairment, and aggregating weakness cut-points may improve their predictive utility. Consideration should be given to how weakness categories are uniquely linked to cognitive function.

}, keywords = {Aged, Body Mass Index, Cognition, Cognitive Dysfunction, Female, Geriatric Assessment, Hand Strength, Humans, Male}, issn = {1538-9375}, doi = {10.1016/j.jamda.2023.07.021}, author = {McGrath, Ryan and Tomkinson, Grant R and Hamm, Jeremy M and Juhl, Kirsten and Knoll, Kelly and Parker, Kelly and Smith, Ashleigh E and Rhee, Yeong} } @article {12879, title = {Salivary telomere length and the risks of prediabetes and diabetes among middle-aged and older adults: findings from the Health and Retirement Study.}, journal = {Acta Diabetologica}, volume = {60}, year = {2023}, pages = {273-283}, abstract = {

AIM: To assess the association of telomere length (TL) with prediabetes/diabetes and to explore the potential factors affecting TL among individuals with prediabetes/diabetes by weight status.

METHODS: This study included 3,379 eligible adults (aged 45-85~years, males: 42\%) from the US Health and Retirement Study in 2008. TL was assayed using quantitative PCR of saliva (T/S ratio). Linear and nonlinear associations between TL and prediabetes/diabetes were assessed using the logistic regression and restricted cubic spline model, respectively, adjusting for TL-plate numbers, age, sex, race, body mass index, lifestyles, diabetes medications, and cardiometabolic parameters (blood pressure, C-reactive protein, and total cholesterol). Multiple linear regression was used for testing any factors associated with TL.

RESULTS: Among 3,379 participants, 868 (25.7\%) had prediabetes with a mean TL of 1.34 {\textpm} 0.37 (T/S ratio) and 858 (25.4\%) had diabetes with a mean TL of 1.36 {\textpm} 0.43 (T/S ratio). Neither linear nor nonlinear association of TL with prediabetes/diabetes was significant by weight status. Age was negatively associated with TL in both normal-weight (β = - 0.002, p = 0.025) and overweight/obese (β = - 0.002, p = 0.006) prediabetes, but non-significant in normal-weight and overweight/obese diabetes. BMI and cardiometabolic parameters were not associated with TL in prediabetes/diabetes by weight status.

CONCLUSIONS: Salivary TL was not associated with prediabetes/diabetes among the US middle-aged and older adults. Further longitudinal studies are required to establish the link between TL and diabetes development and to identify potential factors affecting TL shortening, particularly in normal-weight diabetic patients.

}, keywords = {Cardiovascular Diseases, Diabetes Mellitus, Obesity, Overweight, Prediabetic State, Telomere, Telomere Shortening}, issn = {1432-5233}, doi = {10.1007/s00592-022-02004-9}, author = {Yu, Hong-Jie and Ho, Mandy and Chau, Pui Hing and Geng, Leiluo and Fong, Daniel Yee Tak} } @article {13448, title = {Self-perception of aging and perceived medical discrimination.}, journal = {J Am Geriatr Soc}, year = {2023}, abstract = {

BACKGROUND: Individuals who perceive medical discrimination often face adverse consequences. How individuals perceive their own aging experiences may influence perceived medical discrimination due to age by generating expectations that they will receive poor treatment from clinicians, which may be amplified for individuals who also perceive discrimination because of race. This study explored the relationship between self-perceptions of aging (SPA) and perceived medical discrimination due to age, race, and other reasons.

METHODS: We used three waves (2008, 2012, 2016) from the nationally representative Health and Retirement Study (HRS) data. Our sample included 10,188 community-residing individuals aged 51 and over. SPA were measured by two domains: positive SPA and negative SPA. Multinomial logistic regression that adjusted for demographic, health characteristics, and year-fixed effects was conducted to estimate the relationship between SPA and categories of perceived medical discrimination (age, race, age and race, and other).

RESULTS: Approximately 11\% of the population perceived discrimination because of age or race in the medical setting from 2008 to 2016. Older adults who had a positive SPA were 15\% [Adjusted relative risk ratio (ARR): 0.85, 95\% CI: 0.79-0.91], 13\% [ARRR: 0.87, 95\% CI: 0.76-1.00], and 20\% [ARRR: 0.80, 95\% CI: 0.74-0.88] less likely to experience perceived medical discrimination due to age, race, and the intersection of age and race, respectively, than those who did not, holding other factors constant. Those who held a negative SPA were 38\% [ARRR: 1.38, 95\% CI: 1.28-1.48] more likely to report perceived medical discrimination due to age and 12\% [ARRR: 1.12, 95\% CI: 1.03-1.21] more likely to report perceived medical discrimination due to other reasons.

CONCLUSIONS: Holding a positive perception of aging may help reduce perceived medical discrimination because of age and race, which may in turn improve communication and lead to timely and appropriate treatment.

}, keywords = {ageism; intersection; medical environment; perspective of age.}, issn = {1532-5415}, doi = {10.1111/jgs.18517}, author = {Sun, Na and Xu, Ziyao and Hua, Cassandra L and Qiu, Xiao and Pittman, Amelia and Abdou, Basel and Brown, J Scott} } @article {Wang2023, title = {A semiparametric alternative to the Heckman correction: application with left-censored data on parental transfers}, journal = {Empirical Economics}, year = {2023}, abstract = {Using a semiparametric estimator developed by Klein and Vella (J Appl Econom 24(5):735{\textendash}762, 2009b), we study the motives for parental wealth transfers to living children using left-censored data from the Health and Retirement Study. We confirm the presence of heteroskedastic errors in our data and show that the inverse Mills ratio approach employed by the Heckman correction would be biased in such a setting. Using the more flexible semiparametic approach, we find evidence of a nonlinear relationship between amount of inter vivo transfers and recipient children{\textquoteright}s household incomes, suggesting that parents{\textquoteright} motives for transferring wealth may vary depending on their child{\textquoteright}s income level. {\textcopyright} 2023, The Author(s), under exclusive licence to Springer-Verlag GmbH Germany, part of Springer Nature.}, keywords = {Earning income tax credit (EITC), Heteroskedasticity, Inter Vivos Transfers}, doi = {10.1007/s00181-023-02507-6}, author = {Wang, Lu and Jiang, Yixiao and He, Zhaochen} } @article {13271, title = {Sense of purpose in life and allostatic load in two longitudinal cohorts.}, journal = {J Psychosom Res}, volume = {170}, year = {2023}, pages = {111346}, abstract = {

OBJECTIVE: Sense of purpose in life has been linked with better physical health, longevity, and reduced risk for disability and dementia, but the mechanisms linking sense of purpose with diverse health outcomes are unclear. Sense of purpose may promote better physiological regulation in response to stressors and health challenges, leading to lower allostatic load and disease risk over time. The current study examined the association between sense of purpose in life and allostatic load over time in adults over age 50.

METHODS: Data from the nationally representative US Health and Retirement Study (HRS) and English Longitudinal Study of Ageing (ELSA) were used to examine associations between sense of purpose and allostatic load across 8 and 12~years of follow-up, respectively. Blood-based and anthropometric biomarkers were collected at four-year intervals and used to compute allostatic load scores based on clinical cut-off values representing low, moderate, and high risk.

RESULTS: Population-weighted multilevel models revealed that sense of purpose in life was associated with lower overall levels of allostatic load in HRS, but not in ELSA after adjusting for relevant covariates. Sense of purpose in life did not predict rate of change in allostatic load in either sample.

CONCLUSIONS: The present investigation supports sense of purpose predicting preserved differentiation of allostatic regulation, with more purposeful individuals demonstrating consistently lower allostatic load over time. Persistent differences in allostatic burden may account for divergent health trajectories between individuals low and high in sense of purpose.

}, keywords = {Adult, Aging, Allostasis, Biomarkers, Humans, Longitudinal Studies, Middle Aged, Retirement}, issn = {1879-1360}, doi = {10.1016/j.jpsychores.2023.111346}, author = {Lewis, Nathan A and Hill, Patrick L} } @article {13021, title = {Sex differences in changes of depressive symptoms among older adults before and during the COVID-19 pandemic: evidence from two longitudinal cohorts.}, journal = {BMC Geriatrics}, volume = {23}, year = {2023}, pages = {64}, abstract = {

BACKGROUND: Major concerns about the adverse mental health impact of the rapidly spread COVID-19 pandemic have been raised. Previous studies on changes of depressive symptoms during the COVID-19 pandemic have yielded inconsistent results regarding the sex differences. Since women have higher depressive symptoms even without the pandemic, it is essential to consider the pre-existing change of depressive symptoms of a similar period to discern the effect of the pandemic on depression. This study aimed to evaluate sex differences in depressive symptoms before and during the pandemic.

METHODS: Data from the Health and Retirement Study (HRS; waves 13 to 15) and the English Longitudinal Study of Ageing (ELSA; wave 8 to COVID-19 wave 2) were analyzed. Depressive symptoms were assessed by the 8-item Center for Epidemiological Studies Depression (CES-D) scale. According to the time of COVID-19 outbreak in the US and the UK, the intervals from waves 13 to 14 surveys of the HRS and from waves 8 to 9 surveys of the ELSA were employed as pre-pandemic periods to control for the pre-existing depressive symptoms, respectively. Changes of CES-D scores during the pre-pandemic and pandemic periods were assessed by linear mixed models.

RESULTS: Nine thousand, seven hundred thirty-seven participants (mean age: 66.7 {\textpm} 10.7~years) from the HRS and 5,098 participants (mean age: 68.7 {\textpm} 10.0~years) from the ELSA were included. CES-D scores among women were significantly higher than those among men at all waves in both cohorts. During the pre-pandemic period, no significant sex difference on changes of CES-D scores was detected in either the HRS or the ELSA. During the pandemic period, CES-D scores were increased in both men and women and the sex differences in CES-D increments of the two cohorts were both significant. Enlarged sex differences were demonstrated in increments of CES-D scores during the pandemic period.

CONCLUSIONS: Our results suggest women suffered from worse depressive symptoms in response to the pandemic, although the changes of depression were similar between men and women before the pandemic. These findings underscore the necessity to support the vulnerable populations, especially women, to manage the distress brought by the pandemic and maintain optimal mental health status.

}, keywords = {COVID-19, depression, ELSA, Pandemics, Sex Characteristics}, issn = {1471-2318}, doi = {10.1186/s12877-023-03744-1}, author = {Zheng, Fanfan and Li, Chenglong and Hua, Rong and Liang, Jie and Gao, Darui and Xie, Wuxiang} } @article {13083, title = {Sex differences in cognitive aging and the role of socioeconomic status: Evidence from multi-cohort studies.}, journal = {Psychiatry Res}, volume = {321}, year = {2023}, pages = {115049}, abstract = {

BACKGROUND: Sex differences exist in cognitive function, and socioeconomic status (SES) may play a role in changing these discrepancies. This study investigated the role of SES in contributing to sex differences in cognitive function.

METHODS: We conducted a pooled multi-cohort study on the basis of four comparative cohort studies from the UK, the US, Europe and China to assess sex differences and the role of SES in cognitive decline by birth cohort (1930-1938, 1939-1945, 1946-1968). Cognitive function was measured in three domains based on the mean and SD of the corresponding tests: episodic memory, working memory, and time orientation. SES was the summed scores of education and household wealth.

FINDINGS: 61,019 individuals were involved. Cognitive function of women declined faster than those of men as growing old (particularly after 80 years old). As SES increased, cognitive function increased more for women than for men in most cases among later-born cohorts (1930-1938, 1939-1945, 1946-1968) (e.g., episodic memory scores at 60 years old: women exhibited an increase from -0.09 [95\%CI -0.12, -0.07] in low SES to 0.89 [0.86, 0.92] in high SES; men from -0.16 [-0.19, -0.14] to 0.59 [0.56, 0.62]). However, sex-specific cognitive benefits were absent in the oldest birth cohort (1895-1929).

INTERPRETATION: These findings highlight the importance of considering the role of SES in the discrepancy of sex difference in cognitive aging.

}, keywords = {Aged, 80 and over, Aging, cognitive aging, Cohort Studies, Female, Humans, Male, Middle Aged, Sex Characteristics, Social Class, Socioeconomic factors}, issn = {1872-7123}, doi = {10.1016/j.psychres.2023.115049}, author = {Jin, Yinzi and Hong, Chenlu and Luo, Yanan} } @article {Zhang2023, title = {Social relationships in later life: Does marital status matter?}, journal = {Journal of Social and Personal Relationships}, year = {2023}, abstract = {Previous research has suggested that unmarried persons may be disadvantaged in personal networks and social support. However, little is known about whether the quantity and quality of social relationships differ by marital status among older Americans. Using data from the 2006 and 2008 psychosocial questionnaires of the Health and Retirement Study, we examined the quantity and frequency of contact of three types of social relationships (i.e., friends, children, and family members) as well as the quality of these ties across six marital status groups (i.e., first married, remarried, cohabiting, divorced/separated, widowed, and never married). Our analytic sample included 13,087 respondents aged 51 and above. Multiple linear regression was used for the analysis. Our results show significant differences in social relationships by marital status. In terms of relationships with friends, compared to first-married persons, all the unmarried groups (except the cohabitors) had more frequent contact with their friends and reported greater support as well as greater strain from their friends, controlling for demographic covariates. Remarried persons and cohabitors were largely similar to their first-married counterparts except that both had fewer friends they felt close to, and the cohabitors also reported greater strain with their friends. In terms of relationships with children, all the unmarried groups except for widowed persons had fewer children they felt close to. All the unmarried groups were also disadvantaged in contact frequency and perceived social support from their children. Remarried persons were significantly disadvantaged compared to first-married persons in contact frequency and relationship quality with their children. These associations were largely robust when health and socioeconomic conditions were controlled for. In terms of relationships with family members, there were only a few significant differences across marital status groups. Our findings show the crucial role of marital status in shaping social relationships in later life. {\textcopyright} The Author(s) 2023.}, keywords = {cohabitation; confidants; gender; intergenerational relations; Marital status; relationship quality; remarriage; social network}, doi = {10.1177/02654075231163112}, author = {Zhang, Zhenmei and Hsieh, Ning and Lai, Wen-hua} } @article {HURD2023100468, title = {Spending trajectories after age 65 variation by initial wealth}, journal = {The Journal of the Economics of Ageing}, volume = {26}, year = {2023}, pages = {100468}, abstract = {There has been extensive research on the importance of saving for retirement and on tools to support the accumulation of retirement wealth. Much less attention has been paid to the decumulation phase, that is, the spending down of wealth following retirement. Understanding the decumulation phase requires information about the spending patterns of older households and how those patterns evolve with age. This study uses comprehensive longitudinal data on total household spending from a survey that is representative of the older U.S. population to estimate the trajectories of spending after age 65. Based on data spanning the period 2005{\textendash}2019, real spending declined for both single and coupled households after age 65 at annual rates of about 1.7 percent and 2.4 percent, respectively. Stratification by wealth holdings observed at or closely following age 65 showed sizeable variation in spending levels by wealth quartile, but little variation in rates of change in spending. The fact that spending declines broadly, including among those in the highest wealth quartile, suggests that the decline may not be related to economic position. This view is supported by an analysis of budget shares which show increases with age in the budget share for gifts and donations which suggests that economic position on average does not deteriorate with age, even as spending declines.}, keywords = {Budget shares, consumption, Financial security of older adults, life-cycle model, Retirement saving}, issn = {2212-828X}, doi = {https://doi.org/10.1016/j.jeoa.2023.100468}, author = {Michael D Hurd and Susann Rohwedder} } @article {HSU2023e304, title = {Spousal Loneliness, Depression, and Closeness Among Older Adults Married to Persons with Dementia: A Nationally Representative Study (SA314B)}, journal = {Journal of Pain and Symptom Management}, volume = {65}, year = {2023}, pages = {e304-e305}, abstract = {Outcomes 1. Analyze the role of marriage in serious illness and dementia 2. Discuss interactive biopsychosocial model underlying marriage and health among older adults with serious illness, and key social measures 3. Describe the prevalence of loneliness, depression, or both among spouses married to persons with dementia 4. Discuss how one{\textquoteright}s partner{\textquoteright}s cognitive decline is associated with higher levels of loneliness and depression Background Older adults married to persons with dementia (PWD) may be at risk for loneliness and depression. However, it is unclear how often each occur and the extent to which they are distinct. Research objectives To determine the prevalence of loneliness and depression among older adults married to PWD or mild cognitive impairment (MCI) and the role of marital closeness in mediating these outcomes Methods We used a nationally representative sample of 3,666 married couples enrolled in the Health and Retirement Study (2014 and 2016). We included older adults married to PWD (N=201), married to persons with MCI (N=778), or married to persons with normal cognition (N=2,687). We determined the prevalence of loneliness using multivariable logistic regression adjusting for socio-demographic characteristics, then tested for interaction between marital closeness and degree of spousal cognitive impairment. We assessed the prevalence of depression, and both loneliness and depression, using the same method. Results The sample was 54\% women and on average 67 years old (Range: 50{\textendash}97). After adjustment, older adults married to PWD were more likely to be lonely (Normal: 20\%, MCI: 21\%, PWD: 30\%; p=0.02), depressed (Normal: 7\%, MCI: 14\%, PWD: 16\%; p< 0.01), and both (Normal: 4\%, MCI: 8\%, PWD: 9\%; p< 0.01). The association between spousal cognition and loneliness differed by marital closeness (interaction p-value=0.01); among {\textquotedblleft}close{\textquotedblright} couples, spousal cognitive impairment was associated with higher likelihood of loneliness (p=0.01). In contrast, no association existed between spousal cognitive impairment and loneliness among {\textquotedblleft}not close{\textquotedblright} couples (p=0.24). Conclusion Nearly 1 in 3 spouses of PWD experienced loneliness and 1 in 6 experienced depression. The association between spousal cognition and loneliness was stronger among those with close marital bonds. Implications Findings highlight substantial opportunity to identify and address loneliness and depression among spouses of PWD with close relational bonds to improve quality of life.}, keywords = {closeness, depression, Loneliness, Older Adults}, issn = {0885-3924}, doi = {https://doi.org/10.1016/j.jpainsymman.2022.12.132}, author = {Kristie Hsu and Irena Cenzer and Krista Harrison and Christine Ritchie and Linda Waite and Linda Waite} } @article {Higgins, title = {Systemic inflammation is associated with dementia status in the health and retirement study}, year = {2023}, abstract = {BackgroundThe prevalence of dementia is expected to increase in the coming decades. The highest burden of this chronic condition will likely be borne by racial/ethnic minorities. Systemic inflammation is associated with dementia. This effect may be modified by race/ethnicity, since racial minorities are more likely to have elevated levels of systemic inflammation due to the accumulation of compounded negative experiences (e.g., discrimination, racism, and marginalization). Our goal was to test baseline systemic inflammation in relation to cognitive function in a racially/ethnically representative cohort of US adults.MethodsIn a cross-sectional analysis of the Health and Retirement Study (2006 and 2008 waves, n=9,983), highly sensitive C-reactive protein (hsCRP) was measured in dried blood spots. Cognitive status (dementia, cognitive impairment non-dementia (CIND), and normal cognition) was measured and categorized using the Langa-Weir classification of a modified telephone interview for cognition scale. We estimated the adjusted associations between hsCRP and cognitive status, using multivariable logistic regression. We stratified models by race/ethnicity to explore race-dependent associations.ResultsOur study prevalence of dementia and CIND is 3.5\% and 15.8\%, respectively. Similarly, 26.7\% of dementia and 30.1\% of CIND cases occurred among participants with circulating hsCRP levels above the 75th quartile. We observed a racial and gender gradient in the levels of hsCRP in our cohort. For example, Black females had the highest average concentration of hsCRP (7.53 mg/L, SD =15.1) and Whites males the lowest (3.95 mg/L, SD = 7.42). Among participants with hsCRP >75th we observed higher odds of CIND (OR = 1.45; 95\%CI: 1.22, 1.72) with respect to those in the . Similarly, elevated hsCRP >75th was associated with dementia (OR= 1.21; 95\%CI: 0.86, 1.69), in comparison to the reference lower quartile. We did not observe a race-dependent relationship between hsCRP and cognitive status.ConclusionsSystemic inflammation, as represented by high levels of hsCRP, was associated with concurrent cognitive status. Despite racial minorities exhibiting higher levels of hsCRP; in our study, the association between inflammation on cognition did not differ by race. Further studies should explore whether the established relationship is causal, seek larger sample sizes in diverse populations, and examine longitudinal relationships Peer Reviewed}, issn = {1552-5260 1552-5279}, doi = {10.1002/alz.053316}, author = {Higgins, Cesar and Ware, Erin B and Hicken, Margaret and Zawistowski, Matthew and Bakulski, Kelly M} } @article {12880, title = {Trends in Obesity Prevalence among US Older Adults in the Last Two Years of Life, 1998-2018.}, journal = {Journal of Pain and Symptom Management}, volume = {65}, year = {2023}, pages = {81-86}, abstract = {

CONTEXT: The prevalence of obesity has grown in the US over the decades. The temporal trends of body mass index categories in the last two years of life are poorly understood.

OBJECTIVES: To describe the trends in body mass categories in the last two years of life over the past two decades controlling for other demographic changes.

METHODS: We performed a cross-sectional study of prospectively collected survey data from the nationally representative Health and Retirement Study (HRS) among decedents who died between 1998 and 2018. We categorized BMI into five categories and calculated the proportion of decedents with each BMI category during each four epochs (1998-2003, 2004-2008, 2009-2013, 2014-2018). We examined trends in regression models with survey wave groupings modeled as an orthogonal polynomial and adjusted for factors commonly associated with BMI: sex, age, race, ethnicity, education, and tobacco use.

RESULTS: The analytic cohort included 14,797 decedents. From 1998-2003 to 2014-2018 time periods, those categorized as having mild-to-moderate obesity in the last two years of life increased from 12.4\% to 14.8\% (linear trend P < 0.001), a 19\% increase. Severe obesity increased from 1.9\% to 4.3\%, a 126\% increase (linear trend P < 0.001). Underweight decreased from 9.9\% to 5.9\%, a 40\% decrease (linear trend P < 0.001), adjusted for demographic factors. Adjusted quadratic temporal trends for BMI category were nonsignificant, except for in mild-to-moderate obesity.

CONCLUSION: Severe obesity has increased greatly while underweight has decreased. As obesity increases in the final years of life, it is critical to assess how the existing and future palliative services and end of life care system address body size and weight.

}, keywords = {Body Mass Index, Morbid, Obesity, Prevalence, Thinness}, issn = {1873-6513}, doi = {10.1016/j.jpainsymman.2022.11.004}, author = {Harris, John A and Kavalieratos, Dio and Thoonkuzhy, Matthew and Shieu, Bianca and Schenker, Yael} } @article {13032, title = {Utility of SCORE2 risk algorithm for predicting life course accelerated frailty and physical function decline.}, journal = {Journal of Cachexia Sarcopenia and Muscle}, volume = {14}, year = {2023}, pages = {596-605}, abstract = {

BACKGROUND: Frailty is a dynamic process that increases with ageing, while it remains unclear whether cardiovascular disease (CVD) risk algorithm could predict life course dynamic frailty trajectories, for example, the longitudinal patterns of how frailty evolves with time. We intended to examine the predictive utility of the Systemic Coronary Risk Estimation 2 (SCORE2) algorithm for life course accelerated frailty and physical function decline, in comparison with the precedent SCORE algorithm.

METHODS: Longitudinal data regarding accumulation of deficits frailty index (FI) and physical function (grip strength, gait speed, peak expiratory flow and timed chair rises) were drawn from the English Longitudinal Study of Ageing (ELSA) and Health and Retirement Study (HRS), two nationally representative cohorts with community-dwelling adults aged >=50~years. SCORE and SCORE2 were calculated at baselines following European Society of Cardiology guidelines. A group-based trajectory modelling approach was used for identifying potential life course frailty trajectories, based on 14- and 12-year FI data in the ELSA and HRS. Modified Poisson regression and linear mixed model were applied for analysing associations between SCORE2 with accelerated frailty trajectory and physical function decline, respectively. Receiver operating characteristic curve (ROC) analysis was conducted to evaluate predictive utility for accelerated frailty increase trajectory of SCORE and SCORE2, with the area under the curve (AUC) compared using the paired DeLong{\textquoteright}s test.

RESULTS: A total of 4834 participants from the ELSA and 7815 participants from the HRS were included (mean age: 64.0~{\textpm}~9.2 and 65.4~{\textpm}~9.9~years; men: 44.3\% and 41.4\%, respectively). Three frailty trajectories were consistently identified in both cohorts: (1) stable frailty increase (n~=~3026 in ELSA and 4004 in HRS); (2) moderate frailty increase (n~=~1325 in ELSA and 2955 in HRS); (3) accelerated frailty increase (n~=~483 in ELSA and 856 in HRS). Each 10\% increment in SCORE2 risk was associated with the higher risk of accelerated frailty increase (risk ratio [RR]: 3.58, 95\% confidence interval [CI] [3.22, 3.98], P~<~0.001 in ELSA; RR: 1.61, 95\% CI [1.56, 1.67], P~<~0.001 in HRS) and faster declines in all physical function measurements. SCORE2 algorithm showed good accuracy for predicting accelerated frailty increase (area under the curve [AUC] in ELSA: 0.759; HRS: 0.744), with better performance than the SCORE (AUC in ELSA: 0.729; HRS: 0.700) in both cohorts (P~<~0.001 for comparison).

CONCLUSIONS: SCORE2 algorithm could serve good utility for predicting life course accelerated frailty increase and physical function decline among community-dwelling non-frail adults aged >=50~years.

}, keywords = {ELSA, Frail Elderly, Frailty, Life Change Events}, issn = {2190-6009}, doi = {10.1002/jcsm.13165}, author = {Li, Chenglong and Ma, Yanjun and Hua, Rong and Zheng, Fanfan and Xie, Wuxiang} } @article {10.1093/geroni/igad048, title = {Volunteering and Changes in Cardiovascular Biomarkers: Longitudinal Evidence from the Health and Retirement Study}, journal = {Innovation in Aging}, year = {2023}, abstract = {Growing body of research shows that volunteering is beneficial for those served, the volunteers, and the larger communities. However, major challenges remain that hinder the practical implications for volunteer activity as a public health intervention, including potential selection effects, lack of longitudinal studies that adjust for baseline characteristics, and a paucity of studies that consider multiple physical health outcomes in a single model.Data from 2006-2016 waves of the Health and Retirement Study (2006-2016) was used (N=18,847). Outcome-wide analyses were utilized to evaluate if changes in volunteering between 2006/2008 (t0) and 2010/2012 (t1) were associated with seven cardiovascular disease biomarkers four years later (2014/2016, t2). These models were adjusted for demographic factors, socioeconomic status, health behaviors, chronic conditions, and baseline biomarkers and volunteering. Additionally, selection into volunteering and attrition were taken into account.Compared to non-volunteers, volunteering more than 200 hours a year was associated with a lower risk for clinically high diastolic blood pressure. In addition, increased volunteering effort (change from 1-99 hours at t0 to \>100 hours at t1) was associated with a lower likelihood of clinically high systolic and diastolic blood pressure levels. Sustained high volunteering (\>100 hours at both t0 and t1) was associated with lower diastolic blood pressure.The current study adds to the evidence on health benefits of volunteering for adults 50 and older by inferring a potential causal link between high-intensity volunteering and reduced blood pressure.}, issn = {2399-5300}, doi = {10.1093/geroni/igad048}, author = {Kim, Seoyoun and Halvorsen, Cal and Han, Sae Hwang} } @article {10.1093/arclin/acac060.002, title = {A-2 Modifiable Physical Fitness Is Associated with Executive Function in Black Older Adults}, journal = {Archives of Clinical Neuropsychology}, volume = {37}, year = {2022}, pages = {1237}, abstract = {Objective: Research examining the role of modifiable fitness variables in cognitive aging have been implemented in predominately White study samples. The present study aims to enhance the diversity of the literature by examining the relationship between modifiable physical fitness and cognition in Black older adults. Method: Metrics of modifiable fitness and cognition were assessed in 75 healthy Black older adults from the Health and Retirement Study (HRS; ages 65{\textendash}93 years, X- = 73.4, SD = 6.8). Hierarchical linear regressions were implemented to examine the relationship between a composite measure of modifiable physical fitness (gait speed, grip strength, maximum forced expiratory flow) and composite measures of executive function, episodic memory, and processing speed. Results: Modifiable physical fitness explained a significant amount of additional variance in executive function (p < 0.05) after controlling for age, sex, and education. Modifiable physical fitness was not associated with episodic memory or processing speed after controlling for demographic variables. Conclusions: Results suggest that these course metrics of physical fitness are associated specifically with executive function in Black older adults. These findings extend the current literature by exploring the relationship between modifiable physical fitness variables and cognition in Black older adults. }, keywords = {Black adults, Executive function, Physical Fitness}, issn = {1873-5843}, doi = {10.1093/arclin/acac060.002}, author = {Hayes, Scott M and Stark, Jessica and Hiersche, Kelly and Hayes, Jasmeet} } @article {12810, title = {Academic Study Finds Reparations to Black Americans Would Narrow Racial Health Gap, Increase Life Expectancy}, year = {2022}, publisher = {Newswires}, keywords = {Black Americans, health gap, Life Expectancy, race, reparations}, url = {https://www.einnews.com/pr_news/599990877/academic-study-finds-reparations-to-black-americans-would-narrow-racial-health-gap-increase-life-expectancy}, author = {Himmelstein, Kathryn} } @article {12245, title = {Age Profiles of Cognitive Decline and Dementia in Late Life in the Aging, Demographics and Memory Study (ADAMS).}, journal = {The Journals of Gerontology, Series B }, volume = {77}, year = {2022}, pages = {1880-1891}, abstract = {

OBJECTIVES: To better understand the temporal dynamics of progression from cognitive decline to onset of dementia in the dementia-free older population in the U.S.

METHODS: We used longitudinal data from a diverse national population-based sample of older adults (N=531) in the Aging, Demographics and Memory Study (ADAMS) from the Health and Retirement Study (HRS) with repeated measures of cognitive function and dementia diagnosis during 12 years of follow-up from 1996 to 2009. We employed joint latent class mixed models to estimate the association between cognitive change and competing risks of dementia and non-dementia death and identify heterogeneity in the age profiles of such association adjusting for baseline characteristics.

RESULTS: Our analyses found three latent classes with distinct age profiles of cognitive decline and associated risk of dementia and mortality: "Rapid Cognitive Decline" (19.6\%), "Moderate Progression" (44.6\%), and "Optimal Cognitive Aging" (35.8\%). When simultaneously accounting for cognitive trajectories and time-to-dementia/death, we also found associations of baseline covariates with slope of cognitive decline (e.g., steeper decline among non-Hispanic Blacks and more educated) and risk of dementia (e.g., greater risk for females and apolipoprotein E [APOE-4] carriers, but no difference by education level) that differ substantially from those in separate longitudinal mixed models or survival models.

DISCUSSION: The differential age patterns of cognitive decline predicting dementia incidences identified in this study suggest variation in the course of cognitive aging in older adults that may inform future etiological and intervention studies.

}, keywords = {ADAMS, Cognition, joint models, latent class, longitudinal trajectories, Mortality}, issn = {1758-5368}, doi = {10.1093/geronb/gbac038}, author = {Walsh, Christine E and Yang, Yang C and Oi, Katsuya and Allison E Aiello and Daniel W. Belsky and Mullan Harris, Kathleen and Brenda L Plassman} } @inbook {12775, title = {Appendix A Quantifying the Potential Health and Economic Impacts of Increased Trial Diversity}, booktitle = { Improving Representation in Clinical Trials and Research: Building Research Equity for Women and Underrepresented Groups.}, year = {2022}, publisher = {National Academies Press (US)}, organization = {National Academies Press (US)}, address = {Washington, D.C. }, abstract = {Chronic illness decreases quantity of life, quality of life, and years spent in the labor force. Less appreciated is the potential for differential impact of disease for different race/ethnicity-gender groups. In other words, while chronic illness affects outcomes for all groups, some groups might experience a larger impact. The goal in this analysis is to quantify the differential impact of chronic illness for groups that have historically been underrepresented in clinical trials, as clinical trials are a potential way to identify approaches to reduce these disparities. We examine three key outcomes: quantity of life (measured by life expectancy), quality of life (measured by disability-free life), and working life (measured by years in the labor force). The thought experiment considers a hypothetical world where the differential impact is eliminated, that is, that all groups share the same impact of chronic illness.}, keywords = {Chronic illness, Future Elderly Model, gender, labor force, Quality of Life, Race/ethnicity}, url = {https://www.ncbi.nlm.nih.gov/books/NBK584406/}, author = {Tysinger, Bryan and Bibbins-Domingo, K. and Helman, A.} } @article {12145, title = {Association Between Baseline Buccal Telomere Length and Progression of Kidney Function: The Health and Retirement Study.}, journal = {The Journals of Gerontology, Series A}, volume = {77}, year = {2022}, pages = {471-476}, abstract = {

We aimed to evaluate associations of baseline telomere length with overall and annual change in estimated glomerular filtration rate (eGFR) and trajectory of kidney function during an 8-year follow-up. A total of 3,964 participants of the Health and Retirement Study (HRS) were included. We identified three trajectory groups of kidney function: consistently normal (n=1,163 or 29.3\%), normal to impaired (n=2,306 or 58.2\%), and consistently impaired groups (n=495 or 12.5\%). After controlling for age, sex, race, education, smoking, drinking, diabetes, heart disease, blood pressure, body mass index, total cholesterol, and hemoglobin A1c, participants with longer telomere length were 20\% less likely (odds ratio [OR]=0.80, 95\% confidence interval [CI]: 0.69-0.93, P=0.003) to have a normal to impaired kidney function trajectory than a consistently normal function trajectory. Telomere length was not associated with changing rate of eGFR over 8 years (P=0.45). Participants with longer telomere length were more likely to have consistently normal kidney function.

}, keywords = {Kidney disease, Kidney function, Telomere}, issn = {1758-535X}, doi = {10.1093/gerona/glac004}, author = {Westbrook, Adrianna and Zhang, Ruiyuan and Shi, Mengyao and Razavi, Alexander C and Huang, Zhijie and Chen, Jing and He, Jiang and Tanika N Kelly and Shen, Ye and Li, Changwei} } @article {12871, title = {Association Between Racial Wealth Inequities and Racial Disparities in Longevity Among US Adults and Role of Reparations Payments, 1992 to 2018.}, journal = {JAMA Network Open}, volume = {5}, year = {2022}, pages = {e2240519}, abstract = {

IMPORTANCE: In the US, Black individuals die younger than White individuals and have less household wealth, a legacy of slavery, ongoing discrimination, and discriminatory public policies. The role of wealth inequality in mediating racial health inequities is unclear.

OBJECTIVE: To assess the contribution of wealth inequities to the longevity gap that exists between Black and White individuals in the US and to model the potential effects of reparations payments on this gap.

DESIGN, SETTING, AND PARTICIPANTS: This cohort study analyzed the association between wealth and survival among participants in the Health and Retirement Study, a nationally representative panel study of community-dwelling noninstitutionalized US adults 50 years or older that assessed data collected from April 1992 to July 2019. Participants included 7339 non-Hispanic Black (hereinafter Black) and 26 162 non-Hispanic White (hereinafter White) respondents. Data were analyzed from January 1 to September 17, 2022.

EXPOSURES: Household wealth, the sum of all assets (including real estate, vehicles, and investments), minus the value of debts.

MAIN OUTCOMES AND MEASURES: The primary outcome was all-cause mortality by the end of survey follow-up in 2018. Using parametric survival models, the associations among household wealth, race, and survival were evaluated, adjusting for age, sex, number of household members, and marital status. Additional models controlled for educational level and income. The survival effects of eliminating the current mean wealth gap with reparations payments ($828 055 per household) were simulated.

RESULTS: Of the 33 501 individuals in the sample, a weighted 50.1\% were women, and weighted mean (SD) age at study entry was 59.3 (11.1) years. Black participants{\textquoteright} median life expectancy was 77.5 (95\% CI, 77.0-78.2) years, 4 years shorter than the median life expectancy for White participants (81.5 [95\% CI, 81.2-81.8] years). Adjusting for demographic variables, Black participants had a hazard ratio for death of 1.26 (95\% CI, 1.18-1.34) compared with White participants. After adjusting for differences in wealth, survival did not differ significantly by race (hazard ratio, 1.00 [95\% CI, 0.92-1.08]). In simulations, reparations to close the mean racial wealth gap were associated with reductions in the longevity gap by 65.0\% to 102.5\%.

CONCLUSIONS AND RELEVANCE: The findings of this cohort study suggest that differences in wealth are associated with the longevity gap that exists between Black and White individuals in the US. Reparations payments to eliminate the racial wealth gap might substantially narrow racial inequities in mortality.

}, keywords = {Black People, ethnicity, Income, Socioeconomic factors}, issn = {2574-3805}, doi = {10.1001/jamanetworkopen.2022.40519}, author = {Himmelstein, Kathryn E W and Lawrence, Jourdyn A and Jahn, Jaquelyn L and Ceasar, Joniqua N and Morse, Michelle and Bassett, Mary T and Wispelwey, Bram P and Darity, William A and Venkataramani, Atheendar S} } @article {12293, title = {Association of Cumulative Blood Pressure With Cognitive Decline, Dementia, and Mortality.}, journal = {Journal of the American College of Cardiology}, volume = {79}, year = {2022}, pages = {1321-1335}, abstract = {

BACKGROUND: Elevated blood pressure (BP) has been linked to impaired cognition and dementia in older adults. However, few studies have accounted for long-term cumulative BP exposure.

OBJECTIVES: The aim of this study was to test whether long-term cumulative BP was independently associated with subsequent cognitive decline, incident dementia, and all-cause mortality among cognitively healthy adults.

METHODS: This study used data from the HRS (Health and Retirement Study) and ELSA (English Longitudinal Study of Ageing). Cumulative BP was calculated as the area under the curve using measurements from wave 0 (1998-1999) to wave 4 (2008-2009) in ELSA and wave 8 (2006-2007) to wave 10 (2010-2011) in the HRS. Outcomes included cognitive decline, incident dementia, and all-cause mortality.

RESULTS: A total of 7,566 and 9,294 participants from ELSA and the HRS were included (44.8\% and 40.2\% men and median age 62.0 years [IQR: 55.0-70.0 years] and 65.0 years [IQR: 58.0-72.0 years], respectively). The median follow-up duration was 8.0 years (IQR: 4.0-8.0 years) and 8.0 years (IQR: 6.0-8.0 years), respectively. Elevated cumulative systolic BP and pulse pressure were independently associated with accelerated cognitive decline (P~< 0.001 for both), elevated dementia risk (P~< 0.001 for both), and all-cause mortality (P~< 0.001 for both), while a significant inverse association was observed for diastolic BP. Strong dose-response relationships were identified, with similar results for the 2 cohorts.

CONCLUSIONS: Long-term cumulative BP was associated with subsequent cognitive decline, dementia risk, and all-cause mortality in cognitively healthy adults aged >=50 years. Efforts are required to control long-term systolic BP and pulse pressure and to maintain adequate diastolic BP.

}, keywords = {Aged, Blood pressure, Cognition, Cognitive Dysfunction, Dementia, Female, Male}, issn = {1558-3597}, doi = {10.1016/j.jacc.2022.01.045}, author = {Li, Chenglong and Zhu, Yidan and Ma, Yanjun and Hua, Rong and Zhong, Baoliang and Xie, Wuxiang} } @article {12743, title = {Association of Cystatin C Kidney Function Measures With Long-term Deficit-Accumulation Frailty Trajectories and Physical Function Decline.}, journal = {JAMA Network Open}, volume = {5}, year = {2022}, pages = {e2234208}, abstract = {

Importance: It remains unclear whether cystatin C and cystatin C-based kidney function measures are associated with frailty trajectories and physical function decline.

Objective: To examine the associations of cystatin C level, cystatin C estimated glomerular filtration rate (eGFRcys), and the difference between eGFRs (eGFRdiff) using cystatin C and creatinine levels with long-term deficit-accumulation frailty trajectories and physical function decline.

Design, Setting, and Participants: This prospective cohort study used data from 15 949 participants in the China Health and Retirement Longitudinal Study (CHARLS) and the US Health and Retirement Study (HRS), 2 ongoing nationally representative cohort studies enrolling community-dwelling older people. Biennial surveys, known as waves, are conducted in both the CHARLS and the HRS. Seven-year data from wave 1 (May 2011 to March 2012) to wave 4 (July to September 2018) in the CHARLS and 12-year data from wave 8 (March 2006 to February 2007) to wave 14 (April 2018 to June 2019) in the HRS were assessed, with wave 1 in the CHARLS and wave 8 in the HRS serving as baseline waves. Data were analyzed from February 12 to May 20, 2022.

Exposures: Baseline serum cystatin C and creatinine levels. Cystatin C eGFR and creatinine estimated GFR (eGFRcr) were calculated using the 2021 race-free equations developed by the Chronic Kidney Disease Epidemiology Collaboration. The difference between eGFRcys and eGFRcr was calculated by subtracting eGFRcr from eGFRcys.

Main Outcomes and Measures: Based on 12-year follow-up data from the HRS and 7-year follow-up data from the CHARLS, a 29-item deficit-accumulation frailty index (FI) was constructed to assess frailty trajectories at each visit. Physical function decline was evaluated using repeated objective physical function measurements (grip strength and gait speed). Linear mixed models were used to examine longitudinal associations.

Results: Among 15 949 older adults included in the analysis, 9114 participants were from the HRS (mean [SD] age, 66.2 [10.1] years; 5244 women [57.5\%]), and 6835 were from the CHARLS (mean [SD] age, 58.4 [9.8] years; 3477 women [50.9\%]). With regard to race and ethnicity, the HRS cohort included 7755 White individuals (85.1\%) and 1359 individuals (14.9\%) of other races and/or ethnicities (including American Indian or Alaska Native, Asian, Black or African American, Native Hawaiian or Pacific Islander, and other); all participants in the CHARLS cohort were of Chinese ethnicity. Each SD increment in serum cystatin C was associated with a faster increase in FI in both the HRS cohort (β = 0.050 SD/y; 95\% CI, 0.045-0.055 SD/y; P = .001) and the CHARLS cohort (β = 0.051 SD/y; 95\% CI, 0.042-0.060 SD/y; P = .001). An inverse association was observed for eGFRCys (HRS cohort: β = -0.058 SD/y; 95\% CI, -0.062 to -0.053 SD/y; P = .001; CHARLS cohort: β = -0.056 SD/y; 95\% CI, -0.064 to -0.047 SD/y; P = .001). These associations remained after controlling for serum creatinine (β = 0.051 SD/y; 95\% CI, 0.042-0.060 SD/y; P = .001) and eGFRcr (β = -0.056 SD/y; 95\% CI, -0.064 to -0.047 SD/y; P = .001) in the CHARLS cohort. Similar to the results observed for eGFRcys, each SD increment in the eGFRdiff was associated with a slower increase in FI (β = -0.027 SD/y; 95\% CI, -0.035 to -0.018 SD/y; P = .001) in the CHARLS cohort. Similar findings were observed for physical function decline. For example, each SD increment in serum cystatin C was associated with faster decreases in both grip strength (β = -0.006 SD/y; 95\% CI, -0.008 to -0.003 SD/y; P = .001) and gait speed (β = -0.007 SD/y; 95\% CI, -0.011 to -0.003 SD/y; P = .001) in the HRS cohort and faster decreases in gait speed (β = -0.017 SD/y; 95\% CI, -0.027 to -0.006 SD/y; P = .002) in the CHARLS cohort.

Conclusions and Relevance: In this cohort study, cystatin C, eGFRcys, and eGFRdiff were associated with long-term frailty trajectories and physical function decline among community-dwelling older people without frailty. Monitoring kidney function using cystatin C could have clinical utility in identifying the risk of accelerated frailty progression.

}, keywords = {Cystatin C, Kidney function, physical function decline}, issn = {2574-3805}, doi = {10.1001/jamanetworkopen.2022.34208}, author = {Li, Chenglong and Ma, Yanjun and Yang, Chao and Hua, Rong and Xie, Wuxiang and Zhang, Luxia} } @article {12788, title = {Association of Long-Term Body Weight Variability With Dementia: A Prospective Study.}, journal = {The Journals of Gerontology, Series A }, volume = {77}, year = {2022}, pages = {2116-2122}, abstract = {

BACKGROUND: Body weight variability (BWV) refers to intraindividual weight loss and gain over a period. The association of long-term BWV with dementia remains unclear and whether this association is beyond body weight change is undetermined.

METHODS: In the Health and Retirement Study, a total of 5 547 dementia-free participants (56.7\% women; mean [SD] age, 71.1 [3.2] years) at baseline (2008) were followed up to 8 years (mean = 6.8 years) to detect incident dementia. Body weight was self-reported biennially from 1992 to 2008. BWV was measured as the coefficient of variation utilizing the body weight reported 9 times across 16 years before baseline. Cox-proportional hazard model was used to estimate the hazard ratio (HR) and 95\% confidence interval (CI).

RESULTS: Among the 5 547 participants, a total of 427 incident dementia cases were identified during follow-up. Greater long-term BWV was significantly associated with a higher risk of dementia (HR comparing extreme quartiles: 2.01, 95\% CI: 1.48-2.72; HR of each SD increment: 1.21, 95\% CI: 1.10-1.32; p-trend < .001) independent of mean body weight and body weight change. This significant association was even observed for BWV estimated approximately 15 years preceding dementia diagnosis (HR of each SD increment: 1.13, 95\% CI: 1.03-1.23) and was more pronounced for that closer to diagnosis.

CONCLUSION: Our prospective study suggested that greater BWV may be a novel risk factor for dementia.

}, keywords = {Body Weight, Proportional Hazards Models, Prospective Studies, Risk Factors, Weight Loss}, issn = {1758-535X}, doi = {10.1093/gerona/glab372}, author = {Chen, Hui and Zhou, Tianjing and Guo, Jie and Ji, John S and Huang, Liyan and Xu, Weili and Zuo, Guangmin and Lv, Xiaozhen and Zheng, Yan and Hofman, Albert and Ma, Yuan and Yuan, Changzheng} } @article {12865, title = {Association of Low Hourly Wages in Middle Age With Faster Memory Decline in Older Age: Evidence From the Health and Retirement Study.}, journal = {American Journal of Epidemiology}, volume = {191}, year = {2022}, pages = {2051-2062}, abstract = {

Little research has investigated the long-term relationship between low wages and memory decline, despite the growing share of low-wage workers in the US labor market. Here, we examined whether cumulative exposure to low wages over 12 years in midlife is associated with memory decline in later life. Using 1992-2016 data from the Health and Retirement Study, we analyzed data from 2,879 individuals born in 1936-1941 using confounder-adjusted linear mixed-effects models. Low-wage work was defined as an hourly wage lower than two-thirds of the federal median wage for the corresponding year and was categorized into "never," "intermittent," and "sustained" based on wages earned from 1992 to 2004. Memory function was measured at each study visit from 2004 to 2016 via a memory composite score. The confounder-adjusted annual rate of memory decline among "never" low-wage earners was -0.12 standard units (95\% confidence interval: -0.13, -0.10). Compared with this, memory decline among workers with sustained earning of low midlife wages was significantly faster (βtime{\texttimes}sustained = -0.014, 95\% confidence interval: -0.02, -0.01), corresponding to an annual rate of -0.13 standard units for this group. Sustained low-wage earning in midlife was significantly associated with a downward trajectory of memory performance in older age. Enhancing social policies to protect low-wage workers may be especially beneficial for their cognitive health.

}, keywords = {Employment, low-wage workers, Memory, occupational groups, salaries, wages}, issn = {1476-6256}, doi = {10.1093/aje/kwac166}, author = {Kezios, Katrina L and Zhang, Adina and Kim, Soohyun and Lu, Peiyi and Glymour, M Maria and Elfassy, Tali and Al Hazzouri, Adina Zeki} } @article {12354, title = {Association of Playing College American Football With Long-term Health Outcomes and Mortality.}, journal = {JAMA Network Open}, volume = {5}, year = {2022}, pages = {e228775}, abstract = {

Importance: Exposure to repetitive head impacts from playing American football (including impacts resulting in symptomatic concussions and subconcussive trauma) is associated with increased risk for later-life health problems, including cognitive and neuropsychiatric decline and neurodegenerative disease. Most research on long-term health consequences of playing football has focused on former professional athletes, with limited studies of former college players.

Objectives: To estimate the prevalence of self-reported health conditions among former college football players compared with a sample of men in the general population as well as standardized mortality ratios (SMRs) among former college football players.

Design, Setting, and Participants: This cohort study included data from 447 former University of Notre Dame (ND) football players aged 59 to 75 years who were seniors on the rosters from 1964 to 1980. A health outcomes survey was distributed to living players and next of kin of deceased players for whom contact information was available. The survey was completed from December 2018 to May 2019.

Exposure: Participation in football at ND.

Main Outcomes and Measures: Prevalence of health outcomes was compared between living former players who completed the survey and propensity score-matched participants in the Health and Retirement Study (HRS). Standardized mortality ratios of all causes and specific causes of death among all former players were compared with those among men in the general US population.

Results: A total of 216 living players completed the health survey (median age, 67 years; IQR, 63-70 years) and were compared with 638 participants in the HRS (median age, 66 years; IQR, 63-70 years). Former players reported a higher prevalence of cognitive impairment (10 [5\%] vs 8 [1\%]; P = .02), headaches (22 [10\%] vs 22 [4\%]; P = .001), cardiovascular disease (70 [33\%] vs 128 [20\%]; P = .001), hypercholesterolemia (111 [52\%] vs 182 [29\%]; P = .001), and alcohol use (185 [86\%] vs 489 [77\%]; P = .02) and a lower prevalence of diabetes (24 [11\%] vs 146 [23\%]; P = .001). All-cause mortality (SMR, 0.54; 95\% CI, 0.42-0.67) and mortality from heart (SMR, 0.64; 95\% CI, 0.39-0.99), circulatory (SMR, 0.23; 95\% CI, 0.03-0.83), respiratory (SMR, 0.13; 95\% CI, 0.00-0.70), and digestive system (SMR, 0.13; 95\% CI, 0.00-0.74) disorders; lung cancer (SMR, 0.26; 95\% CI, 0.05-0.77); and violence (SMR, 0.10; 95\% CI, 0.00-0.58) were significantly lower in the ND cohort than in the general population. Mortality from brain and other nervous system cancers was significantly higher in the ND cohort (SMR, 3.82; 95\% CI, 1.04-9.77). Whereas point estimates were greater for all neurodegenerative causes (SMR, 1.42; 95\% CI, 0.29-4.18), amyotrophic lateral sclerosis (SMR, 2.93; 95\% CI, 0.36-10.59), and Parkinson disease (SMR, 2.07; 95\% CI, 0.05-11.55), the difference did not reach statistical significance.

Conclusions and Relevance: In this cohort study of former college football players, both positive and negative health outcomes were observed. With more than 800 000 former college players living in the US, additional research appears to be needed to provide stakeholders with guidance to maximize factors that improve health outcomes and minimize factors that may increase risk for later-life morbidity and mortality.

}, keywords = {Aged, Brain Concussion, Cohort Studies, Female, Football, Health Care, Humans, Male, Neurodegenerative Diseases, Outcome Assessment}, issn = {2574-3805}, doi = {10.1001/jamanetworkopen.2022.8775}, author = {Phelps, Alyssa and Alosco, Michael L and Baucom, Zachary and Hartlage, Kaitlin and Palmisano, Joseph N and Weuve, Jennifer and Mez, Jesse and Tripodis, Yorghos and Stern, Robert A} } @article {10.1093/geroni/igac059.2946, title = {ASSOCIATION OF RELIGIOUS ATTENDANCE WITH NEUROPSYCHIATRIC SYMPTOMS, COGNITION, AND SLEEP IN COGNITIVE IMPAIRMENT}, journal = {Innovation in Aging}, volume = {6}, year = {2022}, month = {12}, pages = {819-819}, abstract = {Neuropsychiatric symptoms (NPS), cognitive decline, and sleep disturbances are common among older adults with cognitive impairment. Religious practices may protect mental and physical health, yet few studies have been reported in older adults with cognitive impairment. Utilizing the Health and Retirement Study in 2006 and 2008 and sub study, Aging, Demographics, and Memory study in 2006{\textendash}2007 and 2008{\textendash}2009, we examined the association of religious attendance with NPS, cognition, and sleep disturbances controlling for social interaction in older adults with cognitive impairment (N = 63). Bootstrapped Spearman{\textquoteright}s partial Rho correlation was conducted separately for time points one (T1) and two (T2); Wilcoxon signed-rank tests were used to examine significant change over time. Mean age was 81.89(5.26) years, 65.9\% were non-Hispanic White, 50.1\% were female, and mean cognition (Clinical Dementia Rating) was .94(.228). Significant changes over 1.5 years were found for sleep disturbances but not for NPS and cognition. Significant associations were found for religious attendance and NPS (T1: rs (97)= - .103, 95\% CI [-.108, -.098], p \< .0005 and T2: -.243, 95\% CI [-.246,-.239], p \< .0005), cognition, (T1: rs (97) = - .119, 95\% CI [-.122, -.115], p \< .0005, and T2: rs (97) = -.104, 95\% CI [-.107,-.102], p \< .0005), and sleep disturbances, (T1: rs (97) = .028, 95\% CI [.023, .033], p \< .001, and T2: rs (97) = -.051, 95\% CI [-.056,-.047], p \< .001). Increased religious attendance was associated with lower NPS and cognition at both time points and greater sleep disturbances at T1 but lower at T2. Longitudinal studies are needed to examine associations further.}, keywords = {Cognition, cognitive impairment, Religious attendance}, issn = {2399-5300}, doi = {10.1093/geroni/igac059.2946}, author = {Britt, Katherine and Richards, Kathy and Kesler, Shelli and Acton, Gayle and Hamilton, Jill and Radhakrishnan, Kavita} } @article {12165, title = {Associations Between Satisfaction With Aging and Health and Well-being Outcomes Among Older US Adults.}, journal = {JAMA Network Open}, volume = {5}, year = {2022}, pages = {e2147797}, abstract = {

Importance: Researchers and policy makers are expanding the focus from risk factors of disease to seek potentially modifiable health factors that enhance people{\textquoteright}s health and well-being. Understanding if and to what degree aging satisfaction (one{\textquoteright}s beliefs about their own aging) is associated with a range of health and well-being outcomes aligns with the interests of older adults, researchers, health systems, and politicians.

Objectives: To evaluate associations between changes in aging satisfaction and 35 subsequent health and well-being outcomes.

Design, Setting, and Participants: This cohort study used data from the Health and Retirement Study, a national, diverse, and longitudinal sample of 13 752 US adults older than 50 years, to evaluate if changes in aging satisfaction (between combined cohorts from 2008 and 2010 and 4 years later, in 2012 and 2014) were subsequently associated with 35 indicators of physical, behavioral, and psychosocial health and well-being in 2016 and 2018. Statistical analysis was conducted from July 24, 2020, to November 6, 2021.

Exposure: Aging satisfaction.

Main Outcomes and Measures: A total of 35 physical (eg, stroke), behavioral (eg, sleep problems), and psychosocial (eg, depression) outcomes were evaluated using multiple linear and generalized linear regression models. Data from all participants, irrespective of how their levels of aging satisfaction changed from the prebaseline to baseline waves, were incorporated into the overall estimate, which was conditional on prior satisfaction.

Results: During the 4-year follow-up period, participants (N = 13 752; 8120 women [59\%]; mean [SD] age, 65 [10] years; median age, 64 years [IQR, 56-72 years]; 7507 of 11 824 married [64\%]) in the highest (vs lowest) quartile of aging satisfaction had improved physical health (eg, 43\% reduced risk of mortality [risk ratio, 0.57; 95\% CI, 0.46-0.71]), better health behaviors (eg, 23\% increased likelihood of frequent physical activity [risk ratio, 1.23; 95\% CI, 1.12-1.34]), and improved psychosocial well-being (eg, higher positive affect [β = 0.51; 95\% CI, 0.44-0.58] and lower loneliness [β = -0.41; 95\% CI, -0.48 to -0.33]), conditional on prebaseline aging satisfaction.

Conclusions and Relevance: This study suggests that higher aging satisfaction is associated with improved subsequent health and well-being. These findings highlight potential outcomes if scalable aging satisfaction interventions were developed and deployed at scale; they also inform the efforts of policy makers and interventionists who aim to enhance specific health and well-being outcomes. Aging satisfaction may be an important target for future interventions aiming to improve later-life health and well-being.

}, keywords = {Aged, Aging, Female, Health Behavior, Humans, Male, Middle Aged, Personal Satisfaction, United States}, issn = {2574-3805}, doi = {10.1001/jamanetworkopen.2021.47797}, author = {Julia S Nakamura and Hong, Joanna H and Jacqui Smith and William J. Chopik and Chen, Ying and Tyler J VanderWeele and Eric S Kim} } @article {12715, title = {Associations of Age at Diagnosis and Duration of Diabetes With Morbidity and Mortality Among Older Adults.}, journal = {JAMA Network Open}, volume = {5}, year = {2022}, pages = {e2232766}, abstract = {

Importance: Older adults vary widely in age at diagnosis and duration of type 2 diabetes, but treatment often ignores this heterogeneity.

Objectives: To investigate the associations of diabetes vs no diabetes, age at diagnosis, and diabetes duration with negative health outcomes in people 50 years and older.

Design, Setting, and Participants: This cohort study included participants in the 1995 through 2018 waves of the Health and Retirement Study (HRS), a population-based, biennial longitudinal health interview survey of older adults in the US. The study sample included adults 50 years or older (n = 36 060) without diabetes at entry. Data were analyzed from June 1, 2021, to July 31, 2022.

Exposures: The presence of diabetes, specifically the age at diabetes diagnosis, was the main exposure of the study. Age at diagnosis was defined as the age when the respondent first reported diabetes. Adults who developed diabetes were classified into 3 age-at-diagnosis groups: 50 to 59 years, 60 to 69 years, and 70 years and older.

Main Outcomes and Measures: For each diabetes age-at-diagnosis group, a propensity score-matched control group of respondents who never developed diabetes was constructed. The association of diabetes with the incidence of key outcomes-including heart disease, stroke, disability, cognitive impairment, and all-cause mortality-was estimated and the association of diabetes vs no diabetes among the age-at-diagnosis case and matched control groups was compared.

Results: A total of 7739 HRS respondents developed diabetes and were included in the analysis (4267 women [55.1\%]; mean [SD] age at diagnosis, 67.4 [9.9] years). The age-at-diagnosis groups included 1866 respondents at 50 to 59 years, 2834 at 60 to 69 years, and 3039 at 70 years or older; 28 321 HRS respondents never developed diabetes. Age at diagnosis of 50 to 59 years was significantly associated with incident heart disease (hazard ratio [HR], 1.66 [95\% CI, 1.40-1.96]), stroke (HR, 1.64 [95\% CI, 1.30-2.07]), disability (HR, 2.08 [95\% CI, 1.59-2.72]), cognitive impairment (HR, 1.30 [95\% CI, 1.05-1.61]), and mortality (HR, 1.49 [95\% CI, 1.29-1.71]) compared with matched controls, even when accounting for diabetes duration. These associations significantly decreased with advancing age at diagnosis. Respondents with diabetes diagnosed at 70 years or older only showed a significant association with the outcome of elevated mortality (HR, 1.08 [95\% CI, 1.01-1.17]).

Conclusions and Relevance: The findings of this cohort study suggest that age at diabetes diagnosis was differentially associated with outcomes and that younger age groups were at elevated risk of heart disease, stroke, disability, cognitive impairment, and all-cause mortality. These findings reinforce the clinical heterogeneity of diabetes and highlight the importance of improving diabetes management in adults with earlier diagnosis.

}, keywords = {Diabetes, Diagnosis, Mortality}, issn = {2574-3805}, doi = {10.1001/jamanetworkopen.2022.32766}, author = {Cigolle, Christine T and Blaum, Caroline S and Lyu, Chen and Ha, Jinkyung and Kabeto, Mohammed and Zhong, Judy} } @article {12364, title = {Bad company: Loneliness longitudinally predicts the symptom cluster of pain, fatigue, and depression in older adults.}, journal = {Journal of the American Geriatrics Society}, volume = {70}, year = {2022}, pages = {2225-2234}, abstract = {

BACKGROUND: Pain, fatigue, and depression frequently co-occur as a symptom cluster. While commonly occurring in those with cancer and autoimmune disease, the cluster is also found in the absence of systemic illness or inflammation. Loneliness is a common psychosocial stressor associated with the cluster cross-sectionally. We investigated whether loneliness predicted the development of pain, fatigue, depression, and the symptom cluster over time.

METHODS: Data from the Health and Retirement Study were used. We included self-respondents >=50 year-old who had at least two measurements of loneliness and the symptom cluster from 2006-2016 (n~=~5974). Time-varying loneliness was used to predict pain, fatigue, depression, and the symptom cluster in the subsequent wave(s) using generalized estimating equations (GEE) and adjusting for sociodemographic covariates, living arrangement, and the presence of the symptom(s) at baseline.

RESULTS: Loneliness increased the odds of subsequently reporting pain (aOR 1.22, 95\% CI 1.08, 1.37), fatigue (aOR 1.47, 95\% CI 1.32, 1.65), depression (aOR 2.33, 95\% CI 2.02, 2.68), as well as the symptom cluster (aOR 2.15, 95\% CI 1.74, 2.67). The median time between the baseline and final follow-up measurement was 7.6 years (IQR 4.1, 8.2).

CONCLUSIONS: Loneliness strongly predicts the development of pain, fatigue, and depression as well as the cluster of all three symptoms several years later in a large, nonclinical sample of older American adults. Future studies should examine the multiple pathways through which loneliness may produce this cluster, as well as examine whether other psychosocial stressors also increase risk. It is possible that interventions which address loneliness in older adults may prevent or mitigate the cluster of pain, fatigue, and depression.

}, keywords = {complex pain, Psychosocial stress, Quality of Life, Social Support}, issn = {1532-5415}, doi = {10.1111/jgs.17796}, author = {Powell, Victoria D and Kumar, Navasuja and Galecki, Andrzej T and Kabeto, Mohammed and Clauw, Daniel J and Williams, David A and Hassett, Afton and Silveira, Maria J} } @article {11714, title = {Beyond Hours Worked and Dollars Earned: Multidimensional EQ, Retirement Trajectories and Health in Later Life}, journal = {Work Aging and Retirement}, volume = {8}, year = {2022}, pages = {51-73}, abstract = {The working lives of Americans have become less stable over the past several decades and older adults may be particularly vulnerable to these changes in employment quality (EQ). We aimed to develop a multidimensional indicator of EQ among older adults and identify EQ and retirement trajectories in the United States. Using longitudinal data on employment stability, material rewards, workers{\textquoteright} rights, working-time arrangements, unionization, and interpersonal power relations from the Health and Retirement Study (HRS), we used principal component analysis to construct an EQ score. Then, we used sequence analysis to identify late-career EQ trajectories (age 50{\textendash}70 years; N = 11,958 respondents), overall and by sociodemographics (race, gender, educational attainment, marital status). We subsequently examined the sociodemographic, employment, and health profiles of these trajectories. We identified 10 EQ trajectories; the most prevalent trajectories were Minimally Attached and Wealthy (13.9\%) and Good EQ to Well-off Retirement (13.7\%), however, 42\% of respondents were classified into suboptimal trajectories. Those in suboptimal trajectories were disproportionately women, people of color, and less-educated. Individuals in the Poor EQ to Delayed and Poor Retirement and Unattached and Poor clusters self-reported the greatest prevalence of poor health and depression, while individuals in the Wealthy Business Owners and Great EQ to Well-off Retirement clusters self-reported the lowest prevalence of poor health and depression at baseline. Trajectories were substantially constrained for women of color. Although our study demonstrates EQ is inequitably distributed in later life, labor organizing and policy change may afford opportunities to improve EQ and retirement among marginalized populations.}, keywords = {employment quality, health, Retirement}, isbn = {2054-4650}, doi = {10.1093/workar/waab012}, author = {Sarah B. Andrea and Eisenberg-Guyot, Jerzy and Vanessa M Oddo and Peckham, Trevor and Jacoby, Daniel and Hajat, Anjum} } @article {WALSEMANN2022101184, title = {Black-White variation in the relationship between early educational experiences and trajectories of cognitive function among US-born older adults}, journal = {SSM - Population Health}, volume = {19}, year = {2022}, pages = {101184}, abstract = {Black adults face a substantially higher risk for dementia in later life compared to their White peers. Given the critical role of educational attainment and cognitive function in later life dementia risk, this paper aims to determine if early educational experiences and educational attainment are differentially related to trajectories of cognitive status across race and if this further varies by education cohort. We use data from the Life History Mail Survey (LHMS) and prospective data on cognition from the Health and Retirement Study (HRS). We restrict our sample to Black and White US-born adults who provided at least one measure of cognitive status from 1995/6{\textendash}2016. We find evidence of Black-White differences in the association between educational experiences and level of cognitive function, episodic memory, and working memory, but little evidence of Black-White differences in these associations with decline. Having a learning problem was associated with lower levels of cognitive function, episodic memory, and working memory for White and Black older adults, but was more strongly related to these outcomes among Black older adults. Further, the Black-White difference in this association was generally found in older cohorts that completed schooling after enactment of federal policies that improved educational resources for children with learning disabilities. Attending racially discordant schools was positively associated with level of these cognitive outcomes for Black older adults but not for White older adults. We also find that the educational gradient in level of cognitive function was larger for Black compared to White older adults in older cohorts not benefiting from the Brown v Board of Education decision but was similar for Black and White older adults attending school in the post-Brown era.}, keywords = {cognitive impairment, Dementia, Early Life, Memory, school segregation}, issn = {2352-8273}, doi = {10.1016/j.ssmph.2022.101184}, author = {Katrina M. Walsemann and Eleanor M. Kerr and Jennifer A Ailshire and Pamela Herd} } @article {12750, title = {Certain Kidney Function Measures May Determine Long-Term Physical Function Decline}, year = {2022}, publisher = {Pharmacy Times}, keywords = {Cystatin C, Kidney function, long-term decline}, url = {https://www.pharmacytimes.com/view/certain-kidney-function-measures-may-determine-long-term-physical-function-decline}, author = {Hunter, Erin} } @article {12077, title = {Change in Episodic Memory with Spousal Loss: The Role of Social Relationships.}, journal = {The Journals of Gerontology, Series B }, volume = {77}, year = {2022}, pages = {683-694}, abstract = {

OBJECTIVES: The spousal relationship is one of the most important social contexts in old age and the loss of a spouse/partner is associated with stress and cognitive decline. In the present study, we examined whether social relationships can buffer potential negative effects of spousal loss on cognition. We examined the role of social network, social activities, and perceived deficiencies in social relationships (loneliness).

METHOD: We used longitudinal data between 1998-2012 from 2,077 participants of the Health and Retirement Study, who had experienced spousal loss during the study period. Multilevel modeling was used to examine how time-varying indicators of social network, social activities, and loneliness were related to age-related trajectories of episodic memory prior to and after spousal loss. Analyses controlled for gender, race/ethnicity, education, time-varying functional health and being re-partnered/re-married.

RESULTS: Having children living within 10 miles and providing help to others buffered negative effects of widowhood on episodic memory. In addition, within-person increase in providing help to others buffered against decline in episodic memory after spousal loss. Having friends in the neighborhood, more frequent social visits, providing help to others, volunteering, and lack of loneliness were related to higher episodic memory, while having relatives in the neighborhood was related to lower episodic memory.

DISCUSSION: Our findings suggest that social networks, social activities, and loneliness are related to levels of cognitive function at the time of spousal loss and that social relationships can buffer negative effects of spousal loss on cognitive function. Implications for future research are discussed.

}, keywords = {Episodic Memory, longitudinal, Social Relationships, Spousal loss, Widowhood}, issn = {1758-5368}, doi = {10.1093/geronb/gbab231}, author = {H{\"u}l{\"u}r, Gizem and Elayoubi, Joanne and Nelson, Monica E and William E. Haley} } @article {13022, title = {Cognitive decline among older adults with heart diseases before and during the COVID-19 pandemic: A longitudinal cohort study.}, journal = {Frontiers in Cardiovascular Medicine}, volume = {9}, year = {2022}, pages = {1077800}, abstract = {

BACKGROUND: Little is known about the impact induced by the COVID-19 pandemic on the cognitive function of older adults with heart diseases. This study aimed to examine whether older adults with heart diseases suffered larger cognitive deterioration during the COVID-19 pandemic.

METHODS: This study leveraged longitudinal data from the Health and Retirement Study (HRS), a nationally representative U.S. aging cohort with objective cognitive assessments measured before and during the pandemic. The interval from HRS waves 13 to 14 (April 2016 to June 2019) was defined as the pre-pandemic period to control the pre-existed cognitive difference between participants with and without heart diseases, and the interval from waves 14 to 15 (June 2019 to June 2021) was defined as the pandemic period. The HRS wave 14 survey was considered the baseline. The heart disease status was defined by a self-reported diagnosis. Linear mixed models were performed to evaluate and compare the cognitive differences during different periods.

RESULTS: A total of 9,304 participants (women: 5,655, 60.8\%; mean age: 65.8 {\textpm} 10.8 years) were included, and 2,119 (22.8\%) had heart diseases. During the pre-pandemic period, there was no significant difference (-0.03, 95\% CI: -0.22 to 0.15, = 0.716) in the changes in global cognitive scores between participants with and without heart disease. During the pandemic period, a larger decreased change in the global cognitive score was observed in the heart disease group compared with the non-heart disease group (-0.37, 95\% CI: -0.55 to -0.19, < 0.001). An enlarged difference in global cognitive score was observed during the pandemic period (-0.33, 95\% CI: -0.65 to -0.02, = 0.036).

CONCLUSION: The findings demonstrated that the population with heart diseases suffered more cognitive decline related to the pandemic, underscoring the necessity to provide immediate cognitive monitoring and interventions for the population with heart diseases.

}, keywords = {Cognitive decline, COVID-19 pandemic, Dementia, Heart Diseases}, issn = {2297-055X}, doi = {10.3389/fcvm.2022.1077800}, author = {Hua, Rong and Li, Chenglong and Gao, Darui and Zheng, Fanfan and Xie, Wuxiang} } @article {12444, title = {Cohort Trends in the Burden of Multiple Chronic Conditions Among Aging U.S. Adults.}, journal = {The Journals of Gerontology, Series B }, volume = {77}, year = {2022}, pages = {1867-1879}, abstract = {

OBJECTIVES: Multimorbidity, also referred to as multiple chronic conditions (MCCs), is the concurrent presence of 2 or more chronic health conditions. Increasing multimorbidity represents a substantial threat to the health of aging populations. Recent trends suggest greater risk of poor health and mortality among later-born cohorts, yet we are unaware of work examining cohort differences in multimorbidity among aging U.S. adults.

METHODS: We examine intercohort variation in MCC burden in adults aged 51 years and older using 20 years (n = 33,598; 1998-2018) of repeated assessment drawn from the Health and Retirement Study. The index of MCCs included 9 chronic conditions (heart disease, hypertension, stroke, diabetes, arthritis, lung disease, cancer excluding skin cancer, high depressive symptoms, and cognitive impairment). We used linear mixed models with various approaches to estimate age/period/cohort effects to model intercohort patterns in MCC burden. We also explored variation in the specific conditions driving cohort differences in multimorbidity.

RESULTS: More recent cohorts had greater MCC burden and developed multimorbidity at earlier ages than those born to prior generations. The burden of chronic conditions was patterned by life-course sociodemographic factors and childhood health for all cohorts. Among adults with multimorbidity, arthritis and hypertension were the most prevalent conditions for all cohorts, and there was evidence that high depressive symptoms and diabetes contributed to the observed cohort differences in multimorbidity risk.

DISCUSSION: Our results suggest increasing multimorbidity burden among more recently born cohorts of aging U.S. adults and should inform policy to address diminishing health in aging populations.

}, keywords = {Baby Boom cohort, life course, multimorbidity, population aging}, issn = {1758-5368}, doi = {10.1093/geronb/gbac070}, author = {Bishop, Nicholas J and Haas, Steven A and Qui{\~n}ones, Ana R} } @article {12601, title = {A computational solution for bolstering reliability of epigenetic clocks: implications for clinical trials and longitudinal tracking}, journal = {Nature Aging}, volume = {2}, year = {2022}, pages = {644{\textendash}661}, abstract = {Epigenetic clocks are widely used aging biomarkers calculated from DNA methylation data, but this data can be surprisingly unreliable. Here we show that technical noise produces deviations up to 9 years between replicates for six prominent epigenetic clocks, limiting their utility. We present a computational solution to bolster reliability, calculating principal components (PCs) from CpG-level data as input for biological age prediction. Our retrained PC versions of six clocks show agreement between most replicates within 1.5 years, improved detection of clock associations and intervention effects, and reliable longitudinal trajectories in vivo and in vitro. This method entails only one additional step compared to traditional clocks, requires no replicates or previous knowledge of CpG reliabilities for training, and can be applied to any existing or future epigenetic biomarker. The high reliability of PC-based clocks is critical for applications to personalized medicine, longitudinal tracking, in vitro studies and clinical trials of aging interventions.}, keywords = {Aging, Bioinformatics, computational models, DNA Methylation, predictive markers}, doi = {10.1038/s43587-022-00248-2}, author = {Higgins-Chen, Albert T. and Thrush, Kyra L. and Wang, Yunzhang and Minteer, Christopher J. and Kuo, Pei-Lun and Wang, Meng and Niimi, Peter and Sturm, Gabriel and Lin, Jue and Ann Zenobia Moore and Bandinelli, Stefania and Vinkers, Christiaan H. and Vermetten, Eric and Rutten, Bart P. F. and Geuze, Elbert and Okhuijsen-Pfeifer, Cynthia and van der Horst, Marte and Schreiter, Stefanie and Gutwinski, Stefan and Luykx, Jurjen J. and Picard, Martin and Ferrucci, Luigi and Eileen M. Crimmins and Boks, Marco P. and H{\"a}gg, Sara and Hu-Seliger, Tina T. and Morgan E. Levine} } @article {HUDOMIET2022102005, title = {Computerization, obsolescence and the length of working life}, journal = {Labour Economics}, volume = {77}, year = {2022}, note = {European Association of Labour Economists, World Conference EALE/SOLE/AASLE, Berlin, Germany, 25 {\textendash} 27 June 2020}, pages = {102005}, abstract = {This paper analyzes how computerization affected the labor market outcomes of older workers between 1984 and 2017. Using the computerization supplements of the Current Population Survey (CPS) we show that different occupations were computerized at different times, older workers tended to start using computers with a delay compared to younger workers, but computer use within occupations converged to the same levels across age groups eventually. That is, there was a temporary knowledge gap between younger and older workers in most occupations. Using this variation, we estimate how this knowledge gap affected older workers{\textquoteright} labor market outcomes using millions of observations from the CPS, and additional data from the Health and Retirement Study. Our models control for occupation and time fixed effects and in some models, we also control for full occupation-time interactions and use middle aged (age 40-49) workers as the control group. We find strong and robust negative effects of the knowledge gap on wages, and a large, temporary increase in transitions from work to non-participation. These results are consistent with a model of creative destruction in which the computerization of jobs made older workers{\textquoteright} skills obsolete in birth cohorts that experienced computerization relatively late in their careers. We find larger effects on females and on middle-skilled workers.}, keywords = {Occupation, Retirement, skills, Technology}, issn = {0927-5371}, doi = {https://doi.org/10.1016/j.labeco.2021.102005}, author = {P{\'e}ter Hudomiet and Robert J. Willis} } @article {12428, title = {COVID-19 pandemic impact on trajectories in cardiometabolic health, physical activity and functioning among adults from the 2006-2020 Health and Retirement Study.}, journal = {The Journal of Gerontology, Series A }, volume = {77}, year = {2022}, pages = {1371-1379}, abstract = {

BACKGROUND: The aim of this study was to evaluate the impact of the COVID-19 pandemic on trajectories in cardiometabolic health, physical activity and functioning among U.S. older adults, overall and according to selected baseline socio-demographic characteristics.

METHODS: We performed secondary analyses using longitudinal data on 1,372 participants from the 2006-2020 Health and Retirement Study. Pre-post COVID-19 pandemic onset was examined in relation to body mass index (BMI), number of cardiometabolic risk factors and/or chronic conditions, physical activity, Activities of Daily Living (ADL) and Instrumental Activities of Daily Living (IADL) using mixed-effects regression models and group-based trajectory models.

RESULTS: The COVID-19 pandemic was associated with significantly increased BMI (β=1.39, 95\% CI: 0.74, 2.03). Furthermore, the odds of having at least one cardiometabolic risk factor and/or chronic disease increased pre-post COVID-19 onset (OR 1.16, 95\% CI: 1.00, 1.36), whereas physical functioning worsened pre-post COVID-19 onset (ADL: β=1.11, 95\% CI: 0.94, 1.28; IADL: β=0.59, 95\% CI: 0.46, 0.73). The pre-post COVID-19 period (2018-2020) showed a stable group of trajectories, with low, medium and high levels of the selected health indicators. Health disparities according to sex, race/ethnicity, educational level, work status and total wealth are highlighted.

CONCLUSIONS: The COVID-19 pandemic onset appears to worsen cardiometabolic health and physical functioning among U.S. older adults, with clusters of individuals defined by selected socio-demographic characteristics experiencing distinct trajectories pre-post COVID-19 pandemic onset.

}, keywords = {Activities of Daily Living, COVID-19, lifestyle, Obesity, Statistical models}, issn = {1758-535X}, doi = {10.1093/gerona/glac028}, author = {Beydoun, Hind A and Beydoun, May A and Gautam, Rana S and Alemu, Brook T and Weiss, Jordan and Hossain, Sharmin and Zonderman, Alan B} } @article {12516, title = {Creating a Public Resource: O*NET Job Characteristics Data Set for Use with the Health and Retirement Study and Other Surveys}, number = {UM22-Q1}, year = {2022}, institution = {Michigan Retirement and Disability Research Center, University of Michigan}, address = {Ann Arbor, MI}, abstract = {Creating a public resource of historical occupational information from the O*NET database linked with survey data in the HRS will allow researchers to better inform policy makers about the impact of long-term exposure to different types of tasks or work environments on the ability and willingness of older adults to work longer. This is relevant to informing potential behavioral responses and other effects of potential SSA policy changes such as increasing the age of eligibility for OASI. With a growing need to understand how individuals within the same work environments experience different outcomes, particularly among those from under-represented groups (e.g., racial and ethnic minorities), pairing O*NET data with HRS data has important implications for scientific advances that can promote more equitable work environments. This project will complete the documentation report of the data set linking 2019 O*NET measures to the 2010 Census occupation code frame; link 2019 O*NET-Census 2010 data set to HRS occupations from 2010 forward; write documentation report of the data set linking 2019 O*NET measures to the HRS occupation data from 2010 forward for the HRS website; and conduct validation and quality control analyses.}, keywords = {O*NET, occupational information, Older workers, Social Security Administration, work environments}, url = {https://mrdrc.isr.umich.edu/projects/creating-a-public-resource-onet-job-characteristics-data-set-for-use-with-the-health-and-retirement-study-and-other-surveys/}, author = {Helppie-McFall, Brooke and Carr, Dawn C and Amanda Sonnega} } @article {12222, title = {Crosswalk between the Mini-Mental State Examination and the Telephone Interview for Cognitive Status (TICS-27/30/40).}, journal = {Alzheimer{\textquoteright}s \& Dementia}, year = {2022}, abstract = {

BACKGROUND: We develop a crosswalk between the Mini-Mental State Examination (MMSE) and Telephone Interview for Cognitive Status (TICS)-27, TICS-30, and TICS-40 for adults 65 years and older.

METHODS: We examined the scores of 1809 participants, with and without cognitive impairment, who completed the MMSE and the TICS assessment in the 2016 Health and Retirement Study and the 2016 Harmonized Cognitive Assessment Protocol study. Crosswalks between MMSE and TICS-27/30/40 were developed via equipercentile equating.

RESULTS: We present crosswalks for MMSE and TICS-27/30/40 for the 65+ population representative of the US elderly. While monotonic, the pattern of the TICS-30 to MMSE crosswalk differs from the other two crosswalks (MMSE to TICS-27/40).

CONCLUSION: Our analysis offers an empirical crosswalk between two commonly used cognitive measures-the MMSE and TICS. Our findings suggest the need for validated and robust measures that allow for the comparison of scores on different cognitive scales.

}, keywords = {Alzheimer, crosswalk, Dementia, HCAP, Mini-Mental State Examination, Telephone Interview for Cognitive Status}, issn = {1552-5279}, doi = {10.1002/alz.12569}, author = {Hl{\'a}vka, Jakub P and Yu, Jeffrey C and Darius Lakdawalla} } @article {13120, title = {Dementia and Care Transitions: Do Transition Care Management Codes Make a Difference?}, volume = {5}, year = {2022}, abstract = {Background: For older adults living with dementia, care transitions from acute or subacute care back to their community can have adverse outcomes such as hospital readmissions, medication errors, or even permanent nursing home placement. To address these adverse outcomes, Transition Care Management (TCM) codes were introduced by the Centers for Medicare and Medicaid Services (CMS) in October 2012. The efficacy of TCM codes has not been examined in the population of persons living with dementia. Thus, this study examines the effect of TCM codes on hospital readmission rates and hypothesizes that TCM codes are effective in decreasing readmission rates after care transitions for persons living with dementia. Methods: After an extensive literature review, we identified the Bynum Standard method for identifying persons living with dementia. We used a linked dataset from the Health and Retirement Study (HRS) and CMS claims to identify persons living with dementia with a hospital discharge between 2015 and 2018. Results: Our initial search has identified a cohort of 4,282 persons living with dementia. 1,584 (37\%) are male and 2,698 (63\%) are female. 3,433 are White, 656 are Black, 126 are Hispanic, 14 are Native American, 4 are Asian, and 49 are either of another race or did not report their race. Conclusion and Potential Impact: Thus far, we have identified a cohort of persons living with dementia from HRS-CMS linked data but have yet to identify who have had the TCM codes used by their provider. In the future, we will examine the effect that TCM codes have on hospital readmission rates within the studied population. Not only will this study determine if these billing codes provide effective care, but it can also tell us if it aids historically underserved groups.}, keywords = {care transitions, Dementia}, doi = {https://doi.org/10.18060/26804}, author = {Micah Hoeksema and Jennifer L. Carnahan} } @article {12442, title = {Dementia diagnosis can also make a big difference in health care costs}, year = {2022}, publisher = {News Medical Net }, keywords = {dementia diagnosis, Health Care Costs, Medicare}, url = {https://www.news-medical.net/news/20220531/Dementia-diagnosis-can-also-make-a-big-difference-in-health-care-costs.aspx}, author = {Henderson, Emily} } @article {12654, title = {Depressive Symptoms and Caregiving Intensity Before and After Onset of Dementia in Partners: A Retrospective, Observational Study.}, journal = {Medical Care}, volume = {60}, year = {2022}, pages = {844-851}, abstract = {

BACKGROUND: Caring for a partner with dementia poses significant emotional burden and high care demands, but changes in impacts before and after dementia onset is unclear.

OBJECTIVE: Examine changes in depressive symptoms and hours of care provided by caregivers through the course of their partners{\textquoteright} cognitive decline.

METHODS: Retrospective, observational study using household survey data from 2000-2016 Health and Retirement Study and count models to evaluate older individuals{\textquoteright} (ages >=51~y) depressive symptoms (measured using the shortened Center for Epidemiologic Studies Depression Scale) and weekly caregiving in the 10 years before and after their partners{\textquoteright} dementia onset (identified using Telephone Interview Cognitive Status screening). Relationships were examined overall and by sex and race.

RESULTS: We identified 8298 observations for 1836 older caregivers whose partners developed dementia. From before to after partners{\textquoteright} dementia onset, caregivers{\textquoteright} mean (SD) depressive symptoms increased from 1.4 (1.9) to 1.9 (2.1) (P<0.001) and weekly caregiving increased from 4.4 (19.7) to 20.8 (44.1) (P<0.001) hours. Depressive symptoms and caregiving hours were higher for women compared with men. Depressive symptoms were higher for Blacks compared with Whites, while caregiving hours were higher for Whites. The expected count of caregivers{\textquoteright} depressive symptoms and caregiving hours increased by 3\% (P<0.001) and 9\% (P=0.001) before partners{\textquoteright} dementia onset and decreased by 2\% (P<0.001) and 1\% (P=0.63) following partners{\textquoteright} dementia onset. No differences observed by sex or race.

DISCUSSION: Depressive symptoms and instrumental burdens for caregivers increase substantially before the onset of dementia in partners. Early referral to specialty services is critical.

}, keywords = {Caregiving, Dementia, Depressive symptoms}, issn = {1537-1948}, doi = {10.1097/MLR.0000000000001771}, author = {Harris, Melissa L and Errickson, Josh and Ha, Jinkyung and Hoffman, Geoffrey J} } @article {RePEc:gam:jijerp:v:19:y:2022:i:19:p:12059-:d:923426, title = {Determinants of COVID-19 Outcome as Predictors of Delayed Healthcare Services among Adults >=50 Years during the Pandemic: 2006{\textendash}2020 Health and Retirement Study}, journal = {IJERPH}, volume = {19}, year = {2022}, pages = {1-24}, abstract = {Background: The coronavirus disease 19 (COVID-19) was declared a global pandemic on 11 March 2020. To date, a limited number of studies have examined the impact of this pandemic on healthcare-seeking behaviors of older populations. This longitudinal study examined personal characteristics linked to COVID-19 outcomes as predictors of self-reported delayed healthcare services attributed to this pandemic, among U.S. adults, >=50 years of age. Methods: Secondary analyses were performed using cross-sectional data (1413 participants) and longitudinal data (2881 participants) from Health and Retirement Study (HRS) (2006{\textendash}2018) linked to the 2020 HRS COVID-19 Project (57\% female, mean age: 68 years). Demographic, socioeconomic, lifestyle and health characteristics were evaluated in relation to delayed overall, surgical and non-surgical healthcare services ({\textquotedblleft}Since March 2020, was there any time when you needed medical or dental care, but delayed getting it, or did not get it at all?{\textquotedblright} and {\textquotedblleft}What type of care did you delay{\textquotedblright}) using logistic regression and Ensemble machine learning for cross-sectional data as well as mixed-effects logistic modeling for longitudinal data. Results: Nearly 32.7\% delayed healthcare services, 5.8\% delayed surgical services and 31.4\% delayed non-surgical services. Being female, having a college degree or higher and 1-unit increase in depression score were key predictors of delayed healthcare services. In fully adjusted logistic models, a history of 1 or 2 cardiovascular and/or metabolic conditions (vs. none) was associated with 60{\textendash}70\% greater odds of delays in non-surgical services, with distinct findings for histories of hypertension, cardiovascular disease, diabetes and stroke. Ensemble machine learning predicted surgical better than overall and non-surgical healthcare delays. Conclusion: Among older adults, sex, education and depressive symptoms are key predictors of delayed healthcare services attributed to the COVID-19 pandemic. Delays in surgical and non-surgical healthcare services may have distinct predictors, with non-surgical delays more frequently observed among individuals with a history of 1 or 2 cardiovascular and/or metabolic conditions.}, keywords = {cardiometabolic, COVID-19, healthcare services, lifestyle, Machine learning, socio-demographic}, url = {https://EconPapers.repec.org/RePEc:gam:jijerp:v:19:y:2022:i:19:p:12059-:d:923426}, author = {Beydoun, Hind A. and Beydoun, May A. and Alemu, Brook T. and Weiss, Jordan and Hossain, Sharmin and Gautam, Rana S. and Zonderman, Alan B.} } @article {12331, title = {Determinants of COVID-19 testing among late middle-aged and older adults: Applying the health belief model.}, journal = {Aging and Health Research}, volume = {2}, year = {2022}, pages = {100066}, abstract = {

Objectives: The purpose of this study was to examine correlates of taking a COVID-19 test among late middle-aged and older adults using nationally representative data.

Methods: Data were obtained from the 2020 Health and Retirement Study midway release COVID-19 module. Our sample was representative of community residing adults aged 51 and over in the United States (~=~2,870).

Measurements: We regressed taking a COVID-19 test on demographic characteristics, medical comorbidities, and measures related to the health belief model (i.e., perceived severity, perceived susceptibility, cues to action, and perceived barriers) using logistic regression, stratifying the model by 10-year age categories.

Results: Concern about the pandemic was associated with an increase in the likelihood of taking a test among late middle-aged adults. Knowing someone who was diagnosed with COVID-19 was associated with taking a test in most age categories. Financial barriers and knowing someone who died of COVID-19 were not associated with taking a test.

Conclusions: How late middle-aged and older adults perceive the COVID-19 pandemic may significantly influence their likelihood of taking a COVID-19 test.

}, keywords = {COVID-19, Health belief model, Perceived barriers}, issn = {2667-0321}, doi = {10.1016/j.ahr.2022.100066}, author = {Sun, Na and Hua, Cassandra L and Qiu, Xiao and Brown, J Scott} } @article {11687, title = {Development of a physical function outcome measure to harmonize comparisons between three Asian adult populations.}, journal = {Quality of Life Research}, volume = {31}, year = {2022}, pages = {281-291}, abstract = {

PURPOSE: The purpose of this study was to use modern measurement techniques and create a precise functional status metric for Asian adults.

METHODS: The study subjects included Asian American adults from the 2012 Health and Retirement Study (n = 211), Chinese adults in the China Health and Retirement Longitudinal Study (n = 13,649), and Korean adults in the Korean Longitudinal Study of Aging (n = 7,486). The Rasch common-item equating method with nine self-care and mobility items from the three databases were used to create a physical function measure across the three Asian adult populations.

RESULTS: The created physical function measure included 23 self-care and mobility tasks and demonstrated acceptable psychometric properties (unidimensional, local independence, no misfit, no differential item functioning). A significant group difference in the estimated physical function across the three Asian adult populations ([Formula: see text] = 445.21, p < 0.0001) was identified. The American Asian adults (5.16 logits) had better physical function compared to the Chinese (4.15 logits) and Korean adults (3.32 logits).

CONCLUSION: Since the outcome measure was calibrated with the population-representative Asian samples, this derived physical function measure can be used for cross-national comparisons between the three countries. Using this precise functional status metric can help to identify factors that influence health outcomes in other Asian countries (China and Korea). This has the potential to generate numerous benefits, such as international disability monitoring and health-related policy development, improved shared decision making, and international syntheses of research findings.

}, keywords = {CHARLS, Cross-national comparison, KLoSA, Outcome measure development, Rasch model}, issn = {1573-2649}, doi = {10.1007/s11136-021-02909-y}, author = {Hong, Ickpyo and Hreha, Kimberly P and Hilton, Claudia L and Lee, Mi Jung} } @article {12392, title = {Different Levels of Leisure-time Physical Activity, Coping, and Mental Health among Older Adults with Diabetes during the COVID-19 Pandemic.}, journal = {American Journal of Health Behavior}, volume = {46}, year = {2022}, pages = {177-185}, abstract = {

The COVID-19 has led public health researchers to try to improve mental health among older adults with diabetes. Leisure-time physical activity (LTPA) has emerged as a means of coping with mental health difficulties in the pandemic. We extracted 301 respondents from the Health and Retirement Study (HRS) based on the following criteria: over 50 years old and the onset of diabetes. We used multiple questionnaire items to assess mental health (ie, loneliness, happiness, and positive and negative affect) for older adults with diabetes. We used multivariate analysis of variance to investigate the relationships between the fixed variable (ie, LTPA) and outcome variables (ie, mental health). We categorized LTPA participation into 3 groups (ie, low, mid, and high) and examined mental health following various levels of LTPA participation. LTPA participation showed a significant group mean differences for loneliness, happiness, and positive affect, but not for negative affect. High-LTPA respondents presented lower loneliness and higher happiness than low-LTPA respondents. High-LTPA and mid-LTPA respondents indicated higher positive affect than low-LTPA respondents. This study provides evidence of the benefits of LTPA on mental health for older adults with diabetes and suggests that high-LPTA involvement can be effective in promoting mental health among older adults with diabetes in the COVID-19 era.

}, keywords = {Adaptation, COVID-19, Cross-Sectional Studies, Diabetes Mellitus, Exercise, Leisure activities, Mental Health, Pandemics, Psychological}, issn = {1945-7359}, doi = {10.5993/AJHB.46.2.7}, author = {Kim, Junhyoung and Han, Sua} } @article {12489, title = {Discrimination, Mediating Psychosocial or Economic Factors, and Antihypertensive Treatment: A 4-Way Decomposition Analysis in the Health and Retirement Study.}, journal = {American Journal of Epidemiology}, volume = {191}, year = {2022}, pages = {1710-1721}, abstract = {

Untested psychosocial or economic factors mediate associations between perceived discrimination and suboptimal antihypertensive therapy. This study included two waves of data from the Health and Retirement Study participants with self-reported hypertension (N=8557, 73\% Non-Hispanic White, 17\% Non-Hispanic Black, and 10\% Hispanic/Latino) over four years (2008-2014). Our primary exposures were frequency of experiencing discrimination in everyday life or across seven lifetime circumstances. Candidate mediators were self-reported depressive symptoms, subjective social standing, and household wealth. We evaluated with causal mediation methods the interactive and mediating associations between each discrimination measure and reported antihypertensive use at the subsequent wave. In unmediated analyses, everyday (OR; 95\% CI: 0.86; 0.78, 0.95) as well as lifetime discrimination (OR; 95\% CI: 0.91; 0.85, 0.98) were associated with a lower likelihood of antihypertensive use. Discrimination was associated with lower wealth, greater depressive symptoms, and decreased subjective social standing. Estimates for associations due to neither interaction nor mediation resembled unmediated associations for most discrimination-mediator combinations. Lifetime discrimination was indirectly associated with reduced antihypertensive use via depressive symptomology (OR; 95\% CI: 0.99; 0.98, 1.00). In conclusion, the impact of lifetime discrimination on the underuse of antihypertensive therapy appears partially mediated by depressive symptoms.

}, keywords = {antihypertensive, causal mediation, Perceived Discrimination, Psychosocial, Wealth}, issn = {1476-6256}, doi = {10.1093/aje/kwac102}, author = {Sims, Kendra D and Batty, G David and Smit, Ellen and Hystad, Perry W and McGregor, Jessina C and Odden, Michelle C} } @article {11618, title = {Do Disability Policies Shape How People Perceive Work Limitation? An International Perspective}, journal = {Journal of Disability Policy Studies}, volume = {33}, year = {2022}, pages = {35-45}, abstract = {This study explored the role that cross-country disability policy differences play in shaping individuals? work limitation reporting styles. We used anchoring vignettes available in comparable U.S. and European survey data to test and adjust for reporting differences in self-reported work limitation measures. We found that disability policy generosity scores showed statistically significant predictive power for respondents? work limitation classification scales, with the association stronger and more statistically significant at the lower end and the middle of the scale. That is, respondents under more generous disability regimes tended to apply a more inclusive (i.e., lenient) scale in classifying a mild, moderate, or severe work limitation. Because there is no natural interpretation of the magnitude of the correlation, we conducted counterfactual policy simulations to illustrate the strength of the association; for example, if the United States were to adopt more generous disability policies such as those in Sweden, there might be an associated increase of more than 36 percentage points in the proportion of Americans aged 50 years and above reporting work limitation (of any severity). This research contributes to a better understanding of the role of disability policy in reporting heterogeneity in comparative disability research, an area that has been seldom studied.}, keywords = {disability policy, work limitations}, isbn = {1044-2073}, doi = {10.1177/10442073211010135}, author = {Yin, Na and Frank Heiland} } @article {12971, title = {Does the Chronic Stress of Everyday Discrimination or Race Itself Better Predict AD Onset Risk?}, journal = {Gerontology \& Geriatric Medicine}, volume = {8}, year = {2022}, pages = {23337214221142944}, abstract = {

Using evidence from the Health and Retirement Study, we explore racial disparities in Alzheimer{\textquoteright}s Disease (AD) onset risk. From a stress process perspective, there is substantial evidence in the literature that everyday discrimination is a chronic strain for Black individuals that acts as a social determinant of illness. However, few studies have examined specific relationships between this social stressor, race, and AD onset risk. Using Cox Proportional Hazard Models, we examined racial differences in exposure and vulnerability to everyday discrimination. Findings suggest that everyday discrimination predicts AD onset risk, and Black individuals experience more frequent exposure to everyday discrimination as a chronic strain. However, contrary to the stress process model, Black respondents were not more vulnerable to the effect of everyday discrimination on AD onset risk. Racial bias from medical professionals during the diagnostic process and mortality selection bias may explain this effect. Overall, the results of this study provide further evidence that discrimination is a key factor in predicting AD while also considering that many racial minorities with high rates of this type of social stress may not receive an unbiased diagnosis and/or survive to late life to develop AD.

}, keywords = {AD/ADRD, Discrimination, medical sociology, Racial Disparities, the stress process}, issn = {2333-7214}, doi = {10.1177/23337214221142944}, author = {Gary, Katharine M and Hoque, Masudul and Yashkin, Arseniy P and Yashin, Anatoliy I and Akushevich, Igor} } @article {12536, title = {Epigenetic clocks and their association with trajectories in perceived discrimination and depressive symptoms among US middle-aged and older adults.}, journal = {Aging }, volume = {14}, year = {2022}, pages = {5311{\textemdash}5344}, abstract = {

BACKGROUND: Perceived discrimination may be associated with accelerated aging later in life, with depressive symptoms acting as potential mediator.

METHODS: A nationally representative sample of older adults was used [Health and Retirement Study 2010-2016, Age: 50-100 y in 2016, = 2,806, 55.6\% female, 82.3\% Non-Hispanic White (NHW)] to evaluate associations of perceived discrimination measures [Experience of discrimination or EOD; and Reasons for Perceived discrimination or RPD) and depressive symptoms (DEP)] with 13 DNAm-based measures of epigenetic aging. Group-based trajectory and four-way mediation analyses were used.

RESULTS: Overall, and mostly among female and NHW participants, greater RPD in 2010-2012 had a significant adverse total effect on epigenetic aging [2016: DNAm GrimAge, DunedinPoAm38 (MPOA), Levine (PhenoAge) and Horvath 2], with 20-50\% of this effect being explained by a pure indirect effect through DEP in 2014-2016. Among females, sustained elevated DEP (2010-2016) was associated with greater LIN DNAm age (β {\textpm} SE: +1.506 {\textpm} 0.559, = 0.009, reduced model), patterns observed for elevated DEP (high vs. low) for GrimAge and MPOA DNAm markers. Overall and in White adults, the relationship of the Levine clock with perceived discrimination in general (both EOD and RPD) was mediated through elevated DEP.

CONCLUSIONS: Sustained elevations in DEP and RPD were associated with select biological aging measures, consistently among women and White adults, with DEP acting as mediator in several RPD-EPICLOCK associations.

}, keywords = {Biological age, Depressive symptoms, DNA Methylation, epigenetic clocks, Perceived Discrimination}, issn = {1945-4589}, doi = {10.18632/aging.204150}, author = {Beydoun, May A and Beydoun, Hind A and Noren Hooten, Nicole and Maldonado, Ana I and Weiss, Jordan and Evans, Michele K and Zonderman, Alan B} } @article {11855, title = {The estimated prevalence of no reported dementia-related diagnosis in older Americans living with possible dementia by healthcare utilization.}, journal = {Aging Clinical and Experimental Research}, volume = {34}, year = {2022}, pages = {359-365}, abstract = {

BACKGROUND: Screening for dementia in relevant healthcare settings may help in identifying low cognitive functioning for comprehensive cognitive assessments and subsequent dementia treatment after diagnosis.

AIMS: This study sought to estimate the prevalence of no reported dementia-related diagnosis in a nationally-representative sample of older Americans with a cognitive impairment consistent with dementia (CICD) by healthcare utilization.

METHODS: The unweighted analytical sample included 1514 Americans aged >= 65~years that were identified as having a CICD without history of stroke, cancers, neurological conditions, or brain damage who participated in at least one-wave of the 2010-2016 waves of the Health and Retirement Study. An adapted Telephone Interview of Cognitive Status assessed cognitive functioning. Those with scores <= 6 had a CICD. Dementia-related diagnosis was self-reported. Respondents indicated if they visited a physician, received home healthcare, or experienced an overnight nursing home stay in the previous two years.

RESULTS: The prevalence of no reported dementia-related diagnosis in persons with a CICD who visited a physician was 89.9\% (95\% confidence interval (CI): 85.4\%-93.1\%). Likewise, the prevalence of no reported diagnosis in those with a CICD who received home healthcare was 84.3\% (CI: 75.1-90.5\%). For persons with a CICD that had an overnight nursing home stay, the prevalence of no reported dementia-related diagnosis was 83.0\% (CI: 69.1-91.4\%).

DISCUSSION: Although the prevalence of no reported dementia-related diagnosis in individuals with a CICD differed across healthcare settings, the prevalence was generally high nonetheless.

CONCLUSIONS: We recommend increased awareness and efforts be given to dementia screenings in various clinical settings.

}, keywords = {Alzheimer disease, Geriatric Assessment, Geriatrics, Mental Status and Dementia Tests}, issn = {1720-8319}, doi = {10.1007/s40520-021-01980-2}, author = {Parker, Kelly and Brenda Vincent and Rhee, Yeong and Choi, Bong-Jin and Sheria G Robinson-Lane and Hamm, Jeremy M and Klawitter, Lukus and Donald A Jurivich and Ryan P McGrath} } @article {10.1093/geroni/igac056, title = {Estimated Pulse Wave Velocity and All-Cause Mortality: Findings from the Health and Retirement Study}, journal = {Innovation in Aging}, year = {2022}, month = {08}, abstract = {The gold standard method for the assessment of vascular aging is carotid-femoral pulse wave velocity (cfPWV). cfPWV can be estimated from two commonly assessed clinical variables{\textemdash}age and blood pressure. This analysis uses data from the Health and Retirement Study to examine the relationship between estimated pulse wave velocity (ePWV) and mortality among 9,293 middle-age and older adults.Cox proportional hazard models were used to predict mortality occurring over a 10 to12-year period. Controls were included for sociodemographic characteristics (age, gender, race, ethnicity, wealth, income, education), health status (history of cardiovascular disease, diabetes, and stroke and related medication use), health behaviors (smoking, physical activity, body mass index), and cardiovascular disease (CVD)-related biomarkers (systolic and diastolic blood pressure, C-reactive protein, cystatin-C, hemoglobin A1c, total cholesterol, high-density lipoprotein (HDL) cholesterol).By 2018, 26.19\% of the weighted analytic sample were reported as deceased. In the fully specified models that control for age, age-squared, systolic and diastolic blood pressure, sociodemographic variables, health status and behaviors, and biomarkers, ePWV was associated with a greater likelihood of mortality.An estimate of PWV derived from age and blood pressure is independently associated with increased likelihood of death in a representative sample of middle-age and older adults in the U.S.}, keywords = {Cardiovascular disease, Estimated pulse wave velocity, Mortality, Vascular aging, Vascular stiffness}, issn = {2399-5300}, doi = {10.1093/geroni/igac056}, author = {Heffernan, Kevin S and Wilmoth, Janet M and London, Andrew S} } @article {10.1001/jamaneurol.2022.3543, title = {Estimating the Prevalence of Dementia and Mild Cognitive Impairment in the US: The 2016 Health and Retirement Study Harmonized Cognitive Assessment Protocol Project}, journal = {JAMA Neurology}, volume = {79}, year = {2022}, pages = {1242-1249}, abstract = {Nationally representative data are critical for understanding the causes, costs, and outcomes associated with dementia and mild cognitive impairment (MCI) in the US and can inform policies aimed at reducing the impact of these conditions on patients, families, and public programs. The nationally representative Health and Retirement Study (HRS) is an essential resource for such data, but the HRS substudy providing dementia diagnostic information was fielded more than 20 years ago and more recent data are needed.The Harmonized Cognitive Assessment Protocol (HCAP) was developed to update national estimates of the prevalence of MCI and dementia in the US and examine differences by age, race, ethnicity, and sex.HRS is an ongoing longitudinal nationally representative study of people 51 years and older with staggered entry dates from 1992 to 2022 and follow-up ranging from 4 to 30 years. HCAP is a cross-sectional random sample of individuals in HRS who were 65 years or older in 2016. Of 9972 age-eligible HRS participants, 4425 were randomly selected for HCAP, and 3496 completed a comprehensive neuropsychological test battery and informant interview, none of whom were excluded. Dementia and MCI were classified using an algorithm based on standard diagnostic criteria and comparing test performance to a robust normative sample.Groups were stratified by age, sex, education, race, and ethnicity.National prevalence estimates using population weights.The mean (SD) age of the study population sample (N = 3496) was 76.4 (7.6) years, and 2095 participants (60\%) were female. There were 551 participants who self-identified as Black and not Hispanic (16\%), 382 who self-identified as Hispanic regardless of race (16\%), 2483 who self-identified as White and not Hispanic (71\%), and 80 who self-identified as another race (2\%), including American Indian or Alaska Native, Asian, Native Hawaiian or Pacific Islander, or another self-described race. A total of 393 individuals (10\%; 95\% CI, 9-11) were classified as having dementia and 804 (22\%; 95\% CI, 20-24) as having MCI. Every 5-year increase in age was associated with higher risk of dementia (weighted odds ratio [OR], 1.95 per 5-year age difference; 95\%, CI, 1.77-2.14) and MCI (OR, 1.17 per 5-year age difference, 95\% CI, 1.09-1.26). Each additional year of education was associated with a decrease in risk of dementia (OR, 0.93 per year of school, 95\% CI, 0.89-0.97) and MCI (OR, 0.94, 95\% CI, 0.91-0.97). Dementia was more common among non-Hispanic Black individuals (OR, 1.81; 95\% CI, 1.20-2.75) and MCI in Hispanic individuals (OR, 1.42; 95\% CI, 1.03-1.96) compared with non-Hispanic White individuals. Other group comparisons by race and ethnicity were not possible owing to small numbers. No differences in prevalence were found between female individuals and male individuals.Using a comprehensive neuropsychological test battery and large sample, the national prevalence of dementia and MCI in 2016 found in this cross-sectional study was similar to that of other US-based studies, indicating a disproportionate burden of dementia and MCI among older Black and Hispanic adults and those with lower education.}, keywords = {Dementia, HCAP, mild cognitive impairment}, issn = {2168-6149}, doi = {10.1001/jamaneurol.2022.3543}, author = {Jennifer J Manly and Richard N Jones and Kenneth M. Langa and Ryan, Lindsay H. and Levine, Deborah A. and McCammon, Ryan and Heeringa, Steven G. and David R Weir} } @article {13496, title = {Exome Array Analysis of 9721 Ischemic Stroke Cases from the SiGN Consortium.}, journal = {Genes }, volume = {14}, year = {2022}, pages = {61}, abstract = {

Recent genome wide association studies have identified 89 common genetic variants robustly associated with ischemic stroke and primarily located in non-coding regions. To evaluate the contribution of coding variants, which are mostly rare, we performed an exome array analysis on 106,101 SNPs for 9721 ischemic stroke cases from the SiGN Consortium, and 12,345 subjects with no history of stroke from the Health Retirement Study and SiGN consortium. We identified 15 coding variants significantly associated with all ischemic stroke at array-wide threshold (i.e., < 4.7 {\texttimes} 10), including two common SNPs in that have previously been associated with stroke. Twelve of the remaining 13 variants were extremely rare in European Caucasians (MAF < 0.1\%) and the associations were driven by African American samples. There was no evidence for replication of these associations in either TOPMed Stroke samples ( = 5613 cases) or UK Biobank ( = 5874 stroke cases), although power to replicate was very low given the low allele frequencies of the associated variants and a shortage of samples from diverse ancestries. Our study highlights the need for acquiring large, well-powered diverse cohorts to study rare variants, and the technical challenges using array-based genotyping technologies for rare variant genotyping.

}, keywords = {Exome, Gene Frequency, Genome-Wide Association Study, Ischemic stroke, Stroke}, issn = {2073-4425}, doi = {10.3390/genes14010061}, author = {Xu, Huichun and Nguyen, Kevin and Gaynor, Brady J and Ling, Hua and Zhao, Wei and McArdle, Patrick F and O{\textquoteright}Connor, Timothy D and Stine, O Colin and Ryan, Kathleen A and Lynch, Megan and Smith, Jennifer A and Jessica Faul and Hu, Yao and Haessler, Jeffrey W and Fornage, Myriam and Kooperberg, Charles and Perry, James A and Hong, Charles C and Cole, John W and Pugh, Elizabeth and Doheny, Kimberly and Sharon L R Kardia and David R Weir and Kittner, Steven J and Mitchell, Braxton D} } @article {11928, title = {Experiences of Older Adults During the 2020 COVID-19 Pandemic in the United States: An Initial Exploration of Nationally Representative Data at the Intersection of Gender and Race.}, journal = {Journal of Applied Gerontology}, volume = {41}, year = {2022}, chapter = {3}, abstract = {

Little is known about the overall experiences and feelings of diverse older populations during the 2020 COVID-19 pandemic. To provide the baseline information for future research and policy, this study analyzed the 2020 Health and Retirement Study COVID-19 project data ( = 1782). More than 70\% of older adults reported the following activities: watching TV (98\%), reading (90\%), using a computer and the internet (83\%), gardening (82\%), walking (75\%), baking and cooking (73\%), and praying (73\%). Volunteering and attending community groups, which are known to benefit well-being, were unpopular (less than 8\%). During the pandemic, older adults were generally satisfied with their lives, but more than half of them were concerned about their own health, family{\textquoteright}s health, and future prospects. Our study also showed the differences in the experiences and feelings by gender and race as well as the intersection of gender and race in the United States.

}, keywords = {COVID-19, gender, Intersectionality, race}, issn = {1552-4523}, doi = {https://doi.org/10.1177/07334648211048258}, author = {Takashi Yamashita and Punksungka, Wonmai and Van Vleet, Samuel and Helsinger, Abigail and Cummins, Phyllis} } @article {12004, title = {Explaining the variance in cardiovascular disease risk factors: A comparison of demographic, socioeconomic, and genetic predictors.}, journal = {Epidemiology}, volume = {33}, year = {2022}, pages = {25-33}, abstract = {

BACKGROUND: Efforts to explain the burden of cardiovascular disease (CVD) often focus on genetic factors or social determinants of health. There is little evidence on the comparative predictive value of each, which could guide clinical and public health investments in measuring genetic versus social information. We compared the variance in CVD-related outcomes explained by genetic versus socioeconomic predictors.

METHODS: Data were drawn from the Health and Retirement Study (N=8,720). We examined self-reported diabetes, heart disease, depression, smoking, and body mass index, and objectively measured total and high-density lipoprotein cholesterol. For each outcome, we compared the variance explained by demographic characteristics, socioeconomic position (SEP), and genetic characteristics including a polygenic score for each outcome and principal components (PCs) for genetic ancestry. We used R-squared values derived from race-stratified multivariable linear regressions to evaluate the variance explained.

RESULTS: The variance explained by models including all predictors ranged from 3.7\% to 14.3\%. Demographic characteristics explained more than half this variance for most outcomes. SEP explained comparable or greater variance relative to the combination of the polygenic score and PCs for most conditions among both white and Black participants. The combination of SEP, polygenic score, and PCs performed substantially better, suggesting that each set of characteristics may independently contribute to prediction of CVD related outcomes.

CONCLUSIONS: Focusing on genetic inputs into personalized medicine predictive models, without considering measures of social context that have clear predictive value, needlessly ignores relevant information that is more feasible and affordable to collect on patients in clinical settings.

}, keywords = {Cardiovascular disease, Demographics, Genetics, Risk Factors, socioeconomics}, issn = {1531-5487}, doi = {10.1097/EDE.0000000000001425}, author = {Hamad, Rita and M. Maria Glymour and Calmasini, Camilla and Thu T Nguyen and Stefan Walter and David Rehkopf} } @article {12673, title = {EXPLANATIONS FOR THE DECLINE IN SPENDING AT OLDER AGES}, number = {30460}, year = {2022}, institution = {NBER}, address = {Cambridge, MA}, abstract = {We use new data from the 2019 wave of the Consumption and Activities Mail Survey to help interpret the observed decline in spending as individuals age. At one extreme, forward-looking individuals optimally chose the decline; at the other, myopic individuals overspent and were forced to reduce spending because they had run out of wealth. Which interpretation is correct has important implications for the measurement of economic preparation for retirement. According to their own assessments, the fraction of respondents feeling financially constrained is lower at advanced ages, and the fraction satisfied with their economic situation is considerably higher at older ages than at ages near retirement. An important mechanism reconciling the evidence of reduced spending and greater economic satisfaction at older ages may be that individuals{\textquoteright} enjoyment of several activities declines with worsening health, widowing, and increasing age, leading to a lessening desire to spend on them. We find strong support for this hypothesis. Nonetheless, close to 20\% of those older than 80 report not being satisfied with their financial situation, pointing to heterogeneity in economic security.}, keywords = {CAMS, consumer spending, Retirement}, url = {http://www.nber.org/papers/w30460}, author = {Rohwedder, Susann and Michael D Hurd and Hudomiet, P{\'e}ter} } @article {11709, title = {Exploring Lifestyle Activities to Reduce Internalized Ageism: Self-Efficacy as a Mediator Between Exercise, Volunteering, Computer Use, and Self-Perceptions of Aging.}, journal = {International Journal of Aging and Human Development}, volume = {94}, year = {2022}, pages = {255-272}, abstract = {

The objective of this study is to test self-efficacy as a mediator in the relationship between three lifestyle activities (exercise, volunteering, and computer use) and self-perceptions of aging (SPA) among older adults. We hypothesize that increased self-efficacy will mediate the relationship between lifestyle activities and more positive SPA. This is a cross-sectional, secondary data analysis drawn from the 2016 wave of the Health and Retirement Study (HRS; = 4,561). Bootstrapping procedures were applied to test the significance of the indirect effects of self-efficacy in the relationship between lifestyle activities and SPA. Results indicate significant direct effects between exercise, computer use, and self-efficacy. Direct effects were observed between exercise, volunteering, computer use, and SPA. Self-efficacy partially mediated the relationship between exercise, volunteering, computer use, and SPA. Implications for practitioners working with older adults are discussed. Future research should test formal intervention programs aimed at reducing internalized ageism through additional pathways.

}, keywords = {computer, Exercise, Self-efficacy, self-perceptions of aging, Volunteering}, issn = {1541-3535}, doi = {10.1177/00914150211024175}, author = {Steward, Andrew and Hasche, Leslie} } @article {12252, title = {Exploring Rural-Urban Differences in Polygenic Associations for Health among Older Adults in the United States}, journal = {Journal of Rural Social Sciences}, volume = {37}, year = {2022}, pages = {art 4}, abstract = {A complex combination of genes and environment influence health and, as a result, both genes and environment can play a role in shaping health disparities. We consider distinctions in these influences across rural and urban settings, expanding upon work that shows lower genetic associations in rural compared to urban places by studying an older age group and examining more than the typical outcomes of alcohol/substance abuse. Using a sample of 14,994 adults from the 1992 through 2016 waves of the Health and Retirement Study, our results suggest genetic associations for BMI and heart conditions are significantly lower in rural compared to urban settings. We do not find evidence in support of this association for depression and smoking. In sum, the results suggest the gene-environment interaction may play a role in the well-documented disparities across rural and urban places within the United States, further highlighting the importance of the social, economic, and built environments for individual health.}, keywords = {Gene-Environment Interaction, Health Disparities, health outcomes, rural-urban}, url = {https://egrove.olemiss.edu/cgi/viewcontent.cgi?article=1499\&context=jrss}, author = {Davidson, Trent and Boardman, Jason D and Hunter, Lori M.} } @article {12079, title = {Factors influencing participation among adults aging with long-term physical disability.}, journal = {Disability and Health Journal}, volume = {15}, year = {2022}, pages = {101169}, abstract = {

BACKGROUND: People aging with long-term physical disability (AwPD) experience barriers to participation and independent living. There are currently limited evidence-based interventions that address issues regarding participation for people AwPD.

OBJECTIVE: This study examined factors influencing participation in personal and life activities among people AwPD to inform future interventions.

METHODS: A cross-sectional study within an ongoing, community-based cohort study of participation was conducted. A purposive sample of people AwPD aged 45-65, living with a physical disability for at least five years, and who speak English was recruited through disability organizations, aging organizations, and social media. Participants answered open-ended questions about what supports they needed to successfully participate in nine activity categories derived from the Health and Retirement Study participation items (e.g., employment, community leisure). A content analysis was conducted using NVivo to categorize responses, and member checking occurred with four additional people AwPD.

RESULTS: A total of 215 participants completed the survey. Eight categories of factors emerged from the data: physical environment factors, social factors, symptoms, economic factors, policy factors, body structure and functions, mental and emotional state, and temporal factors. Participant responses illuminated a combination of environmental and individual factors. Physical effects of disability and accelerated aging, such as pain and fatigue, paired with environmental factors, such as accessibility of transportation, were reported as influencing participation.

CONCLUSIONS: People AwPD experience a range of factors that substantially impact their ability to remain independent and participate in society. By identifying barriers to participation, new interventions addressing these barriers may be developed, resulting in more effective service provision, enhanced participation in personal and life activities, and improved health and well-being.

}, keywords = {Aging, environment, Participation, Physical disability, Qualitative methods}, issn = {1876-7583}, doi = {10.1016/j.dhjo.2021.101169}, author = {Heeb, Rachel and Putnam, Michelle and Keglovits, Marian and Weber, Courtney and Campbell, Margaret and Stark, Susan and Morgan, Kerri} } @article {12492, title = {Favourable Lifestyle Protects Cognitive Function in Older Adults With High Genetic Risk of Obesity: A Prospective Cohort Study.}, journal = {Frontiers in Molecular Neuroscience}, volume = {15}, year = {2022}, pages = {808209}, abstract = {

The relationship between body mass index (BMI) and cognitive impairment remains controversial, especially in older people. This study aims to confirm the association of phenotypic and genetic obesity with cognitive impairment and the benefits of adhering to a healthy lifestyle. This prospective study included 10,798 participants (aged >= 50 years) with normal cognitive function from the Health and Retirement Study in the United States. Participants were divided into low (lowest quintile), intermediate (quintiles 2-4), and high (highest quintile) groups according to their polygenic risk score (PRS) for BMI. The risk of cognitive impairment was estimated using Cox proportional hazard models. Higher PRS for BMI was associated with an increased risk, whereas phenotypic obesity was related to a decreased risk of cognitive impairment. Never smoking, moderate drinking, and active physical activity were considered favourable and associated with a lower risk of cognitive impairment compared with current smoking, never drinking, and inactive, respectively. A favourable lifestyle was associated with a low risk of cognitive impairment, even in subjects with low BMI and high PRS for BMI. This study suggest that regardless of obesity status, including phenotypic and genetic, adhering to a favourable lifestyle is beneficial to cognitive function.

}, keywords = {cognitive function, genetic risk, lifestyle, Obesity}, issn = {1662-5099}, doi = {10.3389/fnmol.2022.808209}, author = {Liu, Huamin and Wang, Zhenghe and Zou, Lianwu and Gu, Shanyuan and Zhang, Minyi and Hukportie, Daniel Nyarko and Zheng, Jiazhen and Zhou, Rui and Yuan, Zelin and Wu, Keyi and Huang, Zhiwei and Zhong, Qi and Huang, Yining and Wu, Xianbo} } @article {NBERw30696, title = {Financial Regret at Older Ages and Longevity Awareness}, number = {30696}, year = {2022}, institution = {NBER}, abstract = {Older people often express regret about financial decisions made earlier in life that left them susceptible to old-age insecurity. Prior work has explored one outcome, saving regret, or peoples{\textquoteright} expressed wish that they had saved more earlier in life. The present paper extends attention to five additional areas regarding financial decisions, examining whether older Americans also regret not having insured better, claimed benefits and quit working too early, and becoming financially dependent on others. Using a controlled randomized experiment conducted on 1,764 respondents age 50+ in the Health and Retirement Study, we show that providing people objective longevity information does alter their self-reported financial regret. Specifically, giving people information about objective survival probabilities more than doubled regret expressed about not having purchased long term care, and it also boosted their regret by 2.4 times for not having purchased lifetime income. We conclude that information provision can be a potent, as well as cost-effective, method of alerting people to retirement risk.}, keywords = {Financial decisions, financial regret, longevity awareness}, doi = {10.3386/w30696}, author = {Hurwitz, Abigail and Mitchell, Olivia S} } @article {12594, title = {Financial social protection and individual out-of-pocket costs of long-term care in the USA and Europe: An observational study.}, journal = {EClinicalMedicine}, volume = {50}, year = {2022}, pages = {101503}, abstract = {

Background: Empirical evidence informing policies aiming at ensuring affordability of long-term care (LTC) costs is limited. Combining system-level with individual-level data, we quantify the burden of out-of-pocket costs of LTC services on households in 13 European countries and the USA and explore how social protection systems impact affordability of care.

Methods: In this observational study, we use harmonised data from the Health and Retirement Study (HRS), collected between 2012 and 2016, and from the Survey of Health, Ageing and Retirement in Europe, collected between 2013 and 2017. We assess the severity of LTC needs of older adults (65+) on the basis of self-reported limitations in activities of daily living (ADLs) and instrumental activities of daily living (IADLs). We classify countries{\textquoteright} social protection systems in terms of affordability and progressivity using information obtained from country officials. We examine variation in individual-level out-of-pocket LTC costs by social protection systems{\textquoteright} affordability and progressivity.

Findings: Out-of-pocket LTC costs are heterogeneous across countries and increase with individuals{\textquoteright} needs. In countries where LTC is more affordable and social protection systems less progressive, older adults incur significantly lower levels of LTC costs. Within Europe, not only are costs lower where systems are characterized by higher affordability and lower progressivity, but they also represent a lower share of households{\textquoteright} disposable income.

Interpretation: Our findings indicate that the social protection systems significantly affect the level of out-of-pocket costs faced and reported by older adults with LTC needs as well as the share of their income that is devoted to pay for care.

Funding: We received funding from the National Institute on Aging (grant number R01 AG030153). The OECD programme of work on ageing and long-term care is partly funded by the European Union.

}, keywords = {Cross-country analysis, Long term care expenditure, SHARE, Social protection systems}, issn = {2589-5370}, doi = {10.1016/j.eclinm.2022.101503}, author = {Angrisani, Marco and Regalado, Jos{\'e} Carlos Ortega and Hashiguchi, Tiago Cravo Oliveira} } @article {ANGRISANI2022101503, title = {Financial social protection and individual out-of-pocket costs of long-term care in the USA and Europe: An observational study}, journal = {eClinicalMedicine}, volume = {50}, year = {2022}, pages = {101503}, abstract = {Background Empirical evidence informing policies aiming at ensuring affordability of long-term care (LTC) costs is limited. Combining system-level with individual-level data, we quantify the burden of out-of-pocket costs of LTC services on households in 13 European countries and the USA and explore how social protection systems impact affordability of care. Methods In this observational study, we use harmonised data from the Health and Retirement Study (HRS), collected between 2012 and 2016, and from the Survey of Health, Ageing and Retirement in Europe, collected between 2013 and 2017. We assess the severity of LTC needs of older adults (65+) on the basis of self-reported limitations in activities of daily living (ADLs) and instrumental activities of daily living (IADLs). We classify countries{\textquoteright} social protection systems in terms of affordability and progressivity using information obtained from country officials. We examine variation in individual-level out-of-pocket LTC costs by social protection systems{\textquoteright} affordability and progressivity. Findings Out-of-pocket LTC costs are heterogeneous across countries and increase with individuals{\textquoteright} needs. In countries where LTC is more affordable and social protection systems less progressive, older adults incur significantly lower levels of LTC costs. Within Europe, not only are costs lower where systems are characterized by higher affordability and lower progressivity, but they also represent a lower share of households{\textquoteright} disposable income. Interpretation Our findings indicate that the social protection systems significantly affect the level of out-of-pocket costs faced and reported by older adults with LTC needs as well as the share of their income that is devoted to pay for care. Funding We received funding from the National Institute on Aging (grant number R01 AG030153). The OECD programme of work on ageing and long-term care is partly funded by the European Union.}, keywords = {Cross-country analysis, Long term care expenditure, SHARE, Social protection systems}, issn = {2589-5370}, doi = {10.1016/j.eclinm.2022.101503}, author = {Marco Angrisani and Jos{\'e} Carlos Ortega Regalado and Tiago Cravo Oliveira Hashiguchi} } @article {https://doi.org/10.1002/aepp.13219, title = {Food insecurity among older adults in the U.S.: The role of mortgage borrowing}, journal = {Applied Economic Perspectives and Policy}, volume = {44}, year = {2022}, pages = {549-574}, abstract = {Housing wealth is the main source of wealth for many older adults. Using the Health and Retirement Study, we assess the impact of new mortgage borrowing on food insecurity among homeowners aged 65 and older. We find a substantial short-term effect, with each additional \$10,000 borrowed, lowering food insecurity by 2.2 percentage points. In a simulation of the impact of relaxing the debt-to-income borrowing constraint, food insecurity is reduced by 2.1 percentage points for previous nonborrowers and by 1.6 percentage points for borrowers. Results support the importance of access to mortgage borrowing to reduce material hardship in older age.}, keywords = {Food insecurity, Housing wealth, mortgage borrowing}, doi = {https://doi.org/10.1002/aepp.13219}, author = {C{\"a}zilia Loibl and Rhodes, Alec P. and Stephanie Moulton and Donald Haurin and Edmunds, Chrisse} } @inbook {12607, title = {Forecasting Employment of the Older Population }, booktitle = {Overtime: America{\textquoteright}s Aging Workforce and the Future of Working Longer}, year = {2022}, pages = {155-174}, publisher = {Oxford University Press}, organization = {Oxford University Press}, chapter = {7}, keywords = {Employment, Older workers, Retirement}, doi = {10.1093/oso/9780197512067.003.0008}, author = {Michael D Hurd and Rohwedder, Susann}, editor = {Berkman, Lisa F and Truesdale, Beth C.} } @article {12862, title = {Frailty does not cause all frail symptoms: United States Health and Retirement Study.}, journal = {PLoS One}, volume = {17}, year = {2022}, pages = {e0272289}, abstract = {

BACKGROUND: Frailty is associated with major health outcomes. However, the relationships between frailty and frailty symptoms haven{\textquoteright}t been well studied. This study aims to show the associations between frailty and frailty symptoms.

METHODS: The Health and Retirement Study (HRS) is an ongoing longitudinal biannual survey in the United States. Three of the most used frailty diagnoses, defined by the Functional Domains Model, the Burden Model, and the Biologic Syndrome Model, were reproduced according to previous studies. The associations between frailty statuses and input symptoms were assessed using odds ratios and correlation coefficients.

RESULTS: The sample sizes, mean ages, and frailty prevalence matched those reported in previous studies. Frailty statuses were weakly correlated with each other (coefficients = 0.19 to 0.38, p < 0.001 for all). There were 49 input symptoms identified by these three models. Frailty statuses defined by the three models were not significantly correlated with one or two symptoms defined by the same models (p > 0.05 for all). One to six symptoms defined by the other two models were not significantly correlated with each of the three frailty statuses (p > 0.05 for all). Frailty statuses were significantly correlated with their own bias variables (p < 0.05 for all).

CONCLUSION: Frailty diagnoses lack significant correlations with some of their own frailty symptoms and some of the frailty symptoms defined by the other two models. This finding raises questions like whether the frailty symptoms lacking significant correlations with frailty statuses could be included to diagnose frailty and whether frailty exists and causes frailty symptoms.

}, keywords = {Frail Elderly, Frailty, Geriatric Assessment, Retirement}, issn = {1932-6203}, doi = {10.1371/journal.pone.0272289}, author = {Chao, Yi-Sheng and Wu, Chao-Jung and Po, June Y T and Huang, Shih-Yu and Wu, Hsing-Chien and Hsu, Hui-Ting and Cheng, Yen-Po and Lai, Yi-Chun and Chen, Wei-Chih} } @article {12171, title = {Gender Disparities of Heart Disease and the Association with Smoking and Drinking Behavior among Middle-Aged and Older Adults, a Cross-Sectional Study of Data from the US Health and Retirement Study and the China Health and Retirement Longitudinal Study.}, journal = {International Journal of Environmental Research and Public Health}, volume = {19}, year = {2022}, pages = {2188}, abstract = {

Heart disease remains the leading cause of death globally by gender and region. Smoking and alcohol drinking are known modifiable health behaviors of heart disease. Utilizing data from the US Health and Retirement Study and the China Health and Retirement Longitudinal Study, this study examines heart disease disparities and the association with smoking and drinking behavior among men and women in the US and China. Smoking and drinking behavior were combined to neither, smoke-only, drink-only, and both. In the US, the prevalence was higher in men (24.5\%, 95\% CI: 22.5-26.6\%) than in women (20.6\%, 95\% CI: 19.3-22.1\%) and a higher prevalence was found in the smoke-only group for both genders. In contrast, women in China had higher prevalence (22.9\%, 95\% CI: 21.7-24.1\%) than men (16.1\%, 95\% CI: 15.1-17.2\%), and the prevalence for women who smoked or engaged in both behaviors were ~1.5 times (95\% CI: 1.3-1.8, < 0.001) those who did not smoke or drink, but no statistical difference were found in men. The findings might be due to differences in smoking and drinking patterns and cultures by gender in the two countries and gender inequality among older adults in China. Culturally tailored health promotion strategies will help reduce the burden of heart disease.

}, keywords = {Alcohol Drinking, CHARLS, gender, Heart disease, Smoking}, issn = {1660-4601}, doi = {10.3390/ijerph19042188}, author = {Li, Yifei and Lu, Yuanan and Eric L Hurwitz and Wu, Yanyan} } @article {11715, title = {Gender Disparities of Heart Disease and the Association with Smoking and Alcohol Drinking Behavior Among the Middle-Aged and Older Population in the US and China, a Cross-Sectional Study of CHARLS and HRS Data}, journal = {International Journal of Environmental Research and Public Health}, volume = {19}, year = {2022}, pages = {2188}, abstract = {Background Heart disease remains the leading cause of death globally with substantial variabilities in mortalities by gender and region. Smoking and alcohol drinking are known modifiable health behaviors associated with heart disease. This study aims to estimate the prevalence of heart disease and to examine the association with smoking and drinking behavior for men and women in the United States (US) and China. Methods This study utilized the Harmonized data from the US Health and Retirement Study (HRS) and the China Health and Retirement Longitudinal Study (CHARLS), which are sister surveys as part of the Gateway to Global Aging Data (https://g2aging.org/). We performed cross-sectional comparisons using the 2016 wave HRS and 2015 wave CHARLS data. Age was categorized into four groups (50{\textendash}59, 60{\textendash}69, 70{\textendash}79, and 80 years or older) and smoking and drinking behavior were combined to neither, smoking only, drinking only and both behaviors. Weighted analyses were conducted to estimate the prevalence and prevalence ratios (PRs) of heart disease accounting for complex survey design. Results The overall prevalence of heart disease was higher in men (24.5\%) than in women (20.6\%) in the US. In contrast, women had higher prevalence (22.9\%) than men (16.1\%) in China. The prevalence of heart disease increased by age with increasing gender gap in the US, while in China, the highest prevalence was observed in the 70{\textendash}79 age group and gender difference were more apparent before 80 years of age. Adjusting for socio-demographic variables and health conditions, smoking only was associated with a higher prevalence of heart disease in both countries and the associations were stronger among women (US: PR = 1.39, 95\%CI: 1.26 to 1.54; China: PR = 1.49, 95\%CI: 1.30 to 1.72) than among men (US: PR = 1.20, 95\%CI: 1.04 to 1.38; China: PR = 1.37, 95\%CI: 0.94 to 1.98). Conclusions Findings from this study will improve present understanding of heart disease etiology and provide essential insights for future prevention, treatment, and control. Better management of smoking behaviors by gender might be beneficial for reducing the burden of heart disease in both countries and worldwide.}, keywords = {Alcohol Drinking, CHARLS, gender, health survey, Heart disease}, doi = {10.21203/rs.3.rs-626338/v1}, author = {Li, Yifei and Lu, Yuanan and Eric L Hurwitz and Wu, Yanyan} } @article {12986, title = {GENETIC RISK FOR ADHD ON LATER LIFE EMOTIONAL AND COGNITIVE HEALTH: TESTING MECHANISMS OF EFFECT}, journal = {Innovation in Aging}, volume = {6}, year = {2022}, pages = {431}, abstract = {Attention Deficit Hyperactivity Disorder (ADHD) is associated with emotional regulation and cognitive processing challenges throughout life. Not well-understood is how ADHD genetic risk (ADHD-GR) affects depressive symptoms (DepSx) and cognitive functioning in older age. Furthermore, less is known about the mechanisms through which some individuals show better outcomes despite higher ADHD-GR. We evaluated potential mechanisms using the Health and Retirement Study with data from 7,871 European Americans (EAs) and 1,226 African Americans (AAs), ages 50-93, and ADHD-GR calculated from a mixed ancestry genomewide scan. Mediators included closeness of parental relationships during childhood, sense of purpose in life in adulthood, and educational attainment. Outcomes included validated scales for DepSx and cognitive functioning. Structural equation models were stratified by race/ethnicity due to potential differences in genetic effects, adjusted for age, gender, ancestry, and health conditions with DepSx and genetic risk for dementia with cognitive functioning. Among EAs, ADHD-GR significantly predicted lower sense of purpose (p<.05) and worse parental relationships (p<.001), with higher levels of both, in turn, predicting less DepSx (p{\textquoteright}s< 0.01). ADHD-GR also showed significant direct effects on DepSx (p<.01), controlling for mediators. Additionally, ADHD-GR predicted less education (p<.001), but more education predicted better cognitive functioning (p< 0.001). No relationships with ADHD-GR were significant among AAs. Findings imply that among EAs, mediators could be targets to mitigate negative effects on psychological and cognitive health, two hallmark challenges for individuals with ADHD. More work is needed to characterize ADHD-GR on outcomes among older AAs.}, keywords = {ADHA, Cognitive health, Emotional Health, genetic risk}, doi = {10.1093/geroni/igac059.1691}, author = {Arpawong, Thalida Em and Huh, Jimi} } @article {12707, title = {Genome-wide meta-analyses reveal novel loci for verbal short-term memory and learning.}, journal = {Molecular Psychiatry}, year = {2022}, abstract = {

Understanding the genomic basis of memory processes may help in combating neurodegenerative disorders. Hence, we examined the associations of common genetic variants with verbal short-term memory and verbal learning in adults without dementia or stroke (N = 53,637). We identified novel loci in the intronic region of CDH18, and at 13q21 and 3p21.1, as well as an expected signal in the APOE/APOC1/TOMM40 region. These results replicated in an independent sample. Functional and bioinformatic analyses supported many of these loci and further implicated POC1. We showed that polygenic score for verbal learning associated with brain activation in right parieto-occipital region during working memory task. Finally, we showed genetic correlations of these memory traits with several neurocognitive and health outcomes. Our findings suggest a role of several genomic loci in verbal memory processes.

}, keywords = {Genome, health outcomes, Memory, neurocognitive outcomes, polygenic score, Verbal Learning}, issn = {1476-5578}, doi = {10.1038/s41380-022-01710-8}, author = {Lahti, Jari and Tuominen, Samuli and Yang, Qiong and Pergola, Giulio and Ahmad, Shahzad and Amin, Najaf and Armstrong, Nicola J and Beiser, Alexa and Bey, Katharina and Bis, Joshua C and Boerwinkle, Eric and Bressler, Jan and Campbell, Archie and Campbell, Harry and Chen, Qiang and Corley, Janie and Cox, Simon R and Davies, Gail and De Jager, Philip L and Derks, Eske M and Jessica Faul and Fitzpatrick, Annette L and Fohner, Alison E and Ford, Ian and Fornage, Myriam and Gerring, Zachary and Grabe, Hans J and Grodstein, Francine and Gudnason, Vilmundur and Simonsick, Eleanor and Holliday, Elizabeth G and Joshi, Peter K and Kajantie, Eero and Kaprio, Jaakko and Karell, Pauliina and Kleineidam, Luca and Knol, Maria J and Kochan, Nicole A and Kwok, John B and Leber, Markus and Lam, Max and Lee, Teresa and Li, Shuo and Loukola, Anu and Luck, Tobias and Marioni, Riccardo E and Mather, Karen A and Medland, Sarah and Mirza, Saira S and Nalls, Mike A and Nho, Kwangsik and O{\textquoteright}Donnell, Adrienne and Oldmeadow, Christopher and Painter, Jodie and Pattie, Alison and Reppermund, Simone and Risacher, Shannon L and Rose, Richard J and Sadashivaiah, Vijay and Scholz, Markus and Satizabal, Claudia L and Schofield, Peter W and Schraut, Katharina E and Scott, Rodney J and Simino, Jeannette and Smith, Albert V and Smith, Jennifer A and Stott, David J and Surakka, Ida and Teumer, Alexander and Thalamuthu, Anbupalam and Trompet, Stella and Turner, Stephen T and van der Lee, Sven J and Villringer, Arno and V{\"o}lker, Uwe and Wilson, Robert S and Wittfeld, Katharina and Vuoksimaa, Eero and Xia, Rui and Yaffe, Kristine and Yu, Lei and Zare, Habil and Zhao, Wei and Ames, David and Attia, John and Bennett, David A and Brodaty, Henry and Chasman, Daniel I and Goldman, Aaron L and Hayward, Caroline and Ikram, M Arfan and Jukema, J Wouter and Sharon L R Kardia and Lencz, Todd and Loeffler, Markus and Mattay, Venkata S and Palotie, Aarno and Psaty, Bruce M and Ramirez, Alfredo and Ridker, Paul M and Riedel-Heller, Steffi G and Sachdev, Perminder S and Saykin, Andrew J and Scherer, Martin and Schofield, Peter R and Sidney, Stephen and Starr, John M and Trollor, Julian and Ulrich, William and Wagner, Michael and David R Weir and Wilson, James F and Wright, Margaret J and Weinberger, Daniel R and Debette, St{\'e}phanie and Eriksson, Johan G and Mosley, Thomas H and Launer, Lenore J and van Duijn, Cornelia M and Deary, Ian J and Seshadri, Sudha and R{\"a}ikk{\"o}nen, Katri} } @article {12240, title = {Geriatric Conditions Among Middle-aged and Older Adults on Methadone Maintenance Treatment: A Pilot Study.}, journal = {Journal of Addiction Medicine}, volume = {16}, year = {2022}, pages = {110-113}, abstract = {

OBJECTIVES: The number of older adults on methadone maintenance treatment (MMT) for opioid use disorder is increasing, but little is known about the characteristics and healthcare needs of this aging treatment population. This population may experience accelerated aging due to comorbidities and health behaviors. The aim of this study was to compare the prevalence of geriatric conditions among adults age >=50 on MMT to a nationally representative sample of community-dwelling older adults.

METHODS: We performed a geriatric assessment on 47 adults age >=50 currently on MMT enrolled in 2 opioid treatment programs, in New York City and in East Providence, Rhode Island. We collected data on self-reported geriatric conditions, healthcare utilization, chronic medical conditions, physical function, and substance use. The results were compared to 470 age, sex, and race/ethnicity-matched adults in the national Health and Retirement Study.

RESULTS: The mean age of the study sample was 58.8 years and 23.4\% were female. The most common chronic diseases were hypertension (59.6\%) and arthritis (55.3\%) with 66\% reporting >=2 diseases. For geriatric conditions, adults on MMT had a significantly higher prevalence of mobility, hearing, and visual impairments as well as falls, urinary incontinence, chronic pain, and insomnia than the Health and Retirement Study sample.

CONCLUSIONS: Older adults on MMT in 2 large opioid treatment programs have a high prevalence of geriatric conditions. An interdisciplinary, geriatric-based approach to care that focuses on function and addresses geriatric conditions is needed to improve the health of this growing population.

}, keywords = {Aged, Analgesics, Opioid, Female, Humans, Methadone, Middle Aged, Opiate Substitution Treatment, Opioid-Related Disorders, Pilot Projects}, issn = {1935-3227}, doi = {10.1097/ADM.0000000000000808}, author = {Benjamin H Han and Cotton, Brandi Parker and Polydorou, Soteri and Sherman, Scott E and Rosie Ferris and Arcila-Mesa, Mauricio and Qian, Yingzhi and McNeely, Jennifer} } @article {12937, title = {Hallucinations, Antipsychotic Use, and Mortality in Older Adults with Dementia: Retrospective Cohort Study of Two Medicare-Linked National Health Surveys.}, journal = {Drugs \& Aging}, volume = {39}, year = {2022}, pages = {967-974}, abstract = {

BACKGROUND: Hallucinations are associated with earlier death in older adults with dementia, but antipsychotic medications are also associated with mortality, and comparisons of their relative harms are lacking.

OBJECTIVE: To determine the individual and combined association between hallucinations, antipsychotic use, and mortality.

METHODS: We performed a retrospective cohort study using Medicare-linked survey data from two nationally representative studies (the National Health and Aging Trends Study and the Health and Retirement Study) containing validated dementia identification algorithms and a screening question for hallucinations. Using Medicare claims, we identified participants with dementia who had no history of antipsychotic use during the year of or prior to entry. We used extended Cox regression with time-varying covariates to analyze the association between hallucinations, antipsychotic use, and mortality adjusting for confounders.

RESULTS: We identified 1703 eligible subjects who contributed 4,819 person-years of follow-up. 555 (32.6\%) had hallucinations at baseline, 705 (41.4\%) reported hallucinations at least once during follow-up, and 284 (16.7\%) received antipsychotics. Hallucinations were associated with an increased risk of death in unadjusted models (hazard ratio (HR) 1.36; 95\% confidence interval (CI): 1.18-1.5), but antipsychotic use was not (HR 1.03; 95\% CI 0.85-1.2). After adjusting for age, race, gender, dementia severity, and comorbidities, the HR for hallucinations attenuated and was no longer statistically significant (1.15, 95\% CI 0.98-1.34). There was no significant interaction between hallucinations and antipsychotic use.

CONCLUSION: Hallucinations are associated with an increased risk of death that is greater than the risk associated with antipsychotic use, though this is partially confounded by dementia severity~and comorbidities.

}, keywords = {Antipsychotic Agents, Dementia, Medicare, Retrospective Studies}, issn = {1179-1969}, doi = {10.1007/s40266-022-00991-6}, author = {Hamedani, Ali G and Weintraub, Daniel and Willis, Allison W} } @article {12001, title = {Handgrip Strength Asymmetry and Weakness Are Associated With Future Morbidity Accumulation in Americans}, journal = {The Journal of Strength and Conditioning Research}, volume = {36}, year = {2022}, pages = {106-112}, abstract = {Identifying strength asymmetries in physically deconditioned populations may help in screening and treating persons at risk for morbidities linked to muscle dysfunction. Our investigation sought to examine the associations between handgrip strength (HGS) asymmetry and weakness on accumulating morbidities in aging Americans. The analytic sample included 18,506 Americans aged >=50 years from the 2006{\textendash}2016 Health and Retirement Study. Handgrip strength was measured on each hand with a handgrip dynamometer, and persons with an imbalance in strength >10\% between hands had HGS asymmetry. Men with HGS <26 kg and women with HGS <16 kg were considered as weak. Subjects reported the presence of healthcare provider{\textendash}diagnosed morbidities: hypertension, diabetes, cancer, chronic lung disease, cardiovascular disease, stroke, arthritis, and psychiatric problems. Covariate-adjusted ordinal generalized estimating equations analyzed the associations for each HGS asymmetry and weakness group on future accumulating morbidities. Of those included in our study, subjects at baseline were aged 65.0 {\textpm} 10.2 years, 9,570 (51.7\%) had asymmetric HGS, and 996 (5.4\%) were weak. Asymmetry alone and weakness alone were associated with 1.09 (95\% confidence interval [CI]: 1.04{\textendash}1.14) and 1.27 (CI: 1.11{\textendash}1.45) greater odds for future accumulating morbidities, respectively. Having both HGS asymmetry and weakness was associated with 1.46 (CI: 1.29{\textendash}1.65) greater odds for future accumulating morbidities. Handgrip-strength asymmetry, as another potential indicator of impaired muscle function, is associated with future morbidity status during aging. Exercise professionals and related practitioners should consider examining asymmetry and weakness with handgrip dynamometers as a simple and noninvasive screening method for helping to determine muscle dysfunction and future chronic disease risk.}, keywords = {Chronic disease, Exercise, Mass Screening, Risk Factors, sarcopenia}, doi = {10.1519/JSC.0000000000004166}, author = {Klawitter, Lukus and Brenda Vincent and Choi, Bong-Jin and Smith, Joseph and Hammer, Kimberly D. and Donald A Jurivich and Lindsey J Dahl and Ryan P McGrath} } @article {11355, title = {Handgrip Strength Asymmetry Is Associated With Limitations in Individual Basic Self-Care Tasks.}, journal = {Journal of Applied Gerontology}, volume = {41}, year = {2022}, pages = {450-454}, abstract = {

This investigation sought to determine the associations between handgrip strength (HGS) asymmetries and limitations in individual activities of daily living (ADL). The analytic sample included 18,468 participants from the 2006 to 2016 waves of the Health and Retirement Study. Those with HGS >10\% stronger on either hand had any HGS asymmetry. Individuals with HGS >10\% stronger on their dominant or non-dominant hand had dominant or non-dominant HGS asymmetry, respectively. ADL abilities were self-reported. Those with any HGS asymmetry had 1.21 (95\% confidence interval [CI] = [1.01-1.46]) greater odds for a toileting limitation and 1.25 (CI = [1.03-1.52]) greater odds for a transferring limitation. Individuals with dominant HGS asymmetry had 1.24 (CI = [1.01-1.53]) greater odds for a transferring limitation. Those with non-dominant HGS asymmetry had 1.39 (CI = [1.01-1.93]) and 1.44 (CI = [1.05-1.96]) greater odds for a bathing and toileting limitation, respectively. HGS asymmetries could help to identify future limitations in specific ADLs.

}, keywords = {Activities of Daily Living, Disability, Frailty, self-care}, issn = {1552-4523}, doi = {10.1177/0733464820982409}, author = {Mahoney, Sean J and Kyle J Hackney and Donald A Jurivich and Lindsey J Dahl and Johnson, Carol and Ryan P McGrath} } @article {5760, title = {Health and Retirement Study Imputation of Cognitive Functioning Measures: 1992-2018}, year = {2022}, institution = {Survey Research Center, University of Michigan}, address = {Ann Arbor, Michigan}, keywords = {Health Conditions and Status, Methodology}, url = {https://hrsdata.isr.umich.edu/sites/default/files/documentation/data-descriptions/1651088507/COGIMP9218_dd.pdf}, author = {Ryan J McCammon and Gwenith G Fisher and Hassan, Halimah and Jessica Faul and Rogers, Willard and David R Weir} } @article {12447, title = {Health Stress accelerates aging of immune system, study finds}, year = {2022}, publisher = {University of Southern California}, abstract = {Everyday stressors, traumatic events, job strain and discrimination prematurely weaken the body{\textquoteright}s mix of immune cells, potentially increasing a person{\textquoteright}s risk of disease.}, keywords = {Cancer, Cardiovascular disease, Discrimination, immune aging, Stress}, url = {https://news.usc.edu/200213/stress-aging-immune-system/}, author = {Hopper, Leigh} } @article {article, title = {HOUSEHOLD COMPOSITION AND THE RESILIENCE OF OLDER ADULTS AGING IN COMMUNITY DURING COVID-19}, journal = {Innovation in Aging}, volume = {6}, year = {2022}, month = {12}, pages = {280-280}, abstract = {Household composition is associated with older residents{\textquoteright} access to resources. This research uses the pandemic period as a stress-test to detect differences in resilience between older adults who lived alone, with a partner, or with other co-residents. Using the Health and Retirement Study (HRS) from 2010 through 2018, we first developed a profile of pre-pandemic needs and resources for each household composition. Using the 2020 HRS survey wave, we then compared pandemicperiod experiences between the three household types. Older adults living in partner households had more economic resources prior to the pandemic and experienced the fewest disruptions to their finances and personal assistance compared with other types. Older adults living alone entered the pandemic with the least financial resources and personal assistance, particularly in the context of need. These residents also lost more assistance and experienced more loneliness during the pandemic. Co-resident households received the most informal personal care support, which remained relatively stable during the pandemic. They had more economic resources than singleperson households prior to the pandemic but experienced more pandemic-related financial hardships than other types. Household composition was systematically related to resilience during the pandemic, and Social Security policy might increase the capacity of older adults living alone to cope with large-scale disruptions.}, keywords = {Aging, household composition, Older Adults}, doi = {10.1093/geroni/igac059.1112}, author = {Scheckler, Samara and Molinsky, Jennifer and Herbert, Christopher} } @article {12533, title = {How Well Do Retirees Assess the Risks They Face in Retirement?}, number = {IB$\#$22-10}, year = {2022}, institution = {Center for Retirement Research at Boston College}, address = {Chestnut Hill, MA}, abstract = {The brief{\textquoteright}s key findings are: Retirees face many financial risks, such as outliving their money, investment losses, and unexpected health expenses. How important are these risks and how well do retirees perceive them? The analysis finds a big disconnect between how actual and perceived risks are ranked:Actual: 1) longevity; 2) health; and 3) market. Perceived: 1) market; 2) longevity; and 3) health. In short, retirees overestimate market volatility and underestimate how long they will live and their health costs.}, keywords = {Financial risks, health costs, Retirement}, url = {https://crr.bc.edu/briefs/how-well-do-retirees-assess-the-risks-they-face-in-retirement/}, author = {Wenliang Hou} } @article {11941, title = {Impact of Comorbid Dementia on Patterns of Hospice Use.}, journal = {Journal of Palliative Medicine}, volume = {25}, year = {2022}, pages = {396-404}, abstract = {

The evidence base for understanding hospice use among persons with dementia is almost exclusively based on individuals with a primary terminal diagnosis of dementia. Little is known about whether comorbid dementia influences hospice use patterns. To estimate the prevalence of comorbid dementia among hospice enrollees and its association with hospice use patterns. Pooled cross-sectional analysis of the nationally representative Health and Retirement Study (HRS) linked to Medicare claims. Fee-for-service Medicare beneficiaries in the United States who enrolled with hospice and died between 2004 and 2016. Dementia was assessed using a validated survey-based algorithm. Hospice use patterns were enrollment less than or equal to three days, enrollment greater than six months, hospice disenrollment, and hospice disenrollment after six months. Of 3123 decedents, 465 (14.9\%) had a primary hospice diagnosis of dementia and 943 (30.2\%) had comorbid dementia and died of another illness. In fully adjusted models, comorbid dementia was associated with increased odds of hospice enrollment greater than six months (adjusted odds ratio [AOR] = 1.52, 95\% confidence interval [CI]: 1.11-2.09) and hospice disenrollment following six months of hospice (AOR = 2.55, 95\% CI: 1.43-4.553). Having a primary diagnosis of dementia was associated with increased odds of hospice enrollment greater than six months (AOR = 2.62, 95\% CI: 1.86-3.68), hospice disenrollment (AOR = 1.82, 95\% CI: 1.32-2.51), and hospice disenrollment following six months of hospice (AOR = 4.31, 95\% CI: 2.37-7.82). Approximately 45\% of the hospice population has primary or comorbid dementia and are at increased risk for long hospice enrollment periods and hospice disenrollment. Consideration of the high prevalence of comorbid dementia should be inherent in hospice staff training, quality metrics, and Medicare Hospice Benefit policies.

}, keywords = {Comorbidity, Dementia, end of life, Health Services Research, Hospice}, issn = {1557-7740}, doi = {10.1089/jpm.2021.0055}, author = {Aldridge, Melissa D and Hunt, Lauren and Husain, Mohammed and Li, Lihua and Amy Kelley} } @article {12076, title = {The Impact of Marital Quality as Older Couples Adjust to Dementia Onset.}, journal = {The Journals of Gerontology, Series B }, volume = {77}, year = {2022}, pages = {1026-1036}, abstract = {

OBJECTIVES: A burgeoning literature links being married to better cognitive health, but less attention has been paid to how couples view their marital relationships. Couples do not always concur in their assessments, and such discrepancies affect both partners{\textquoteright} health. We present a dyadic study on whether and how overall and discrepant views of marital quality predicted (a) dementia onset and (b) changes in older adults{\textquoteright} depressive symptoms with spousal dementia.

METHOD: A pooled sample of couples aged 50+ (dyad N = 3,936) from the Health and Retirement Study rated positive and negative marital quality at baseline (2006/2008). Each participant reported whether they had been told of having dementia and their depressive symptoms once every other year (2006-2016).

RESULTS: Cox proportional hazards regression revealed that older adults who rated their marriages either more positively or more negatively than their spouses were more likely to develop dementia. We applied multiphase growth curve modeling to older adults whose spouses developed dementia, finding that those in marriages that were more negative overall reported more depressive symptoms but exhibited a smaller increase in these symptoms in response to spousal dementia.

DISCUSSION: This study adds to the literature by showing how discrepant marital assessments shape cognitive aging and offers new insights into identifying older adults with greater dementia risk. Findings also revealed the impact of overall negative marital quality on older adults{\textquoteright} psychological adjustment to spousal dementia, which could inform interventions intended to help couples better cope with early-stage dementia from a relational perspective.

}, keywords = {dementia onset, Mental Health, spousal discrepancy}, issn = {1758-5368}, doi = {10.1093/geronb/gbab235}, author = {Huo, Meng and Kim, Kyungmin and Sae Hwang Han} } @article {12455, title = {The Impact of the COVID-19 Pandemic on Business Ownership Across Racial/Ethnic Groups and Gender.}, journal = {Journal of Economics, Race, and Policy}, volume = {5}, year = {2022}, pages = {307-317}, abstract = {

This study examined the economic impact of the COVID-19 pandemic on US older entrepreneurs{\textquoteright} businesses using the Health and Retirement Study. We estimated logistic regression models to document the odds of experiencing economic impact. The COVID-19 pandemic has affected nearly 76\% of US older entrepreneurs but has disproportionately impacted the businesses of Black, Hispanic, Asian/other races, and women entrepreneurs. Older Black entrepreneurs had significantly higher odds of facing business closure (OR = 2.31, < .01), implementing new procedures (OR = 2.44, < .01), workers quitting (OR = 2.95, < .001), and difficulty paying regular bills (OR = 2.88, < .001) than their White counterparts. Older Hispanic entrepreneurs also had significantly higher odds of instituting new procedures (OR = 2.27, < .05), workers quitting (OR = 2.26, < .01), and difficulty paying regular bills (OR = 2.35, < .01) than their White counterparts. Similarly, older Asian/other races entrepreneurs were significantly more likely to report difficulty paying regular bills since the start of the pandemic than their White counterparts (OR = 3.11, < .01). Women entrepreneurs were significantly more likely to close their businesses than their male counterparts (OR = 2.11, < .001). These significant associations persisted after controlling for confounders. Support for underserved racial/ethnic groups and older women entrepreneurs should focus on accessibility to financial services, capital, and support packages as well as legislative support for ensuring business continuity and success.

}, keywords = {COVID-19, Entrepreneurship, gender, Race/ethnicity}, issn = {2520-842X}, doi = {10.1007/s41996-022-00102-y}, author = {Choi, Shinae L and Harrell, Erin R and Watkins, Kimberly} } @article {12231, title = {Incidence of potentially disruptive medical and social events in older adults with and without dementia.}, journal = {Journal of the American Geriatrics Society}, volume = {70}, year = {2022}, pages = {1461-1470}, abstract = {

BACKGROUND: Potentially disruptive medical, surgical, and social events-such as pneumonia, hip fracture, and widowhood-may accelerate the trajectory of decline and impact caregiving needs in older adults, especially among people with dementia (PWD). Prior research has focused primarily on nursing home residents with dementia. We sought to assess the incidence of potentially disruptive events in community-dwelling people with and without dementia.

METHODS: Retrospective cohort study of participants aged 65+ enrolled in the Health and Retirement Study between 2010 and 2018 (n~=~9346), including a subset who were married-partnered at baseline (n~=~5105). Dementia was defined with a previously validated algorithm. We calculated age-adjusted and gender-stratified incidence per 1000 person-years and incidence rate ratios of: 1) hospitalization for pneumonia, 2) hip fracture, and 3) widowhood in people with and without dementia.

RESULTS: PWD (n~=~596) were older (mean age 84 vs. 75) and a higher proportion were female (67\% vs. 57\%) than people without dementia (PWoD) (n~=~8750). Age-adjusted incidence rates (per 1000 person-years) of pneumonia were higher in PWD (113.1; 95\% CI 94.3, 131.9) compared to PWoD (62.1; 95\% CI 54.7, 69.5), as were hip fractures (12.3; 95\% CI 9.1, 15.6 for PWD compared to 8.1; 95\% CI 6.9, 9.2 in PWoD). Point estimates of widowhood incidence were slightly higher for PWD (25.3; 95\% CI 20.1, 30.5) compared to PWoD (21.9; 95\% CI 20.3, 23.5), but differences were not statistically significant. The association of dementia with hip fracture-but not pneumonia or widowhood-was modified by gender (male incidence rate ratio [IRR] 2.24, 95\% CI 1.34, 3.75 versus female IRR 1.31 95\% CI 0.92,1.86); interaction term p~=~0.02).

CONCLUSIONS: Compared to PWoD, community-dwelling PWD had higher rates of pneumonia and hip fracture, but not widowhood. Knowing how often PWD experience these events can aid in anticipatory guidance and care planning for this growing population.

}, keywords = {Dementia, Hip fracture, Pneumonia, Widowhood}, issn = {1532-5415}, doi = {10.1111/jgs.17682}, author = {Hunt, Lauren J and R Sean Morrison and Gan, Siqi and Espejo, Edie and Katherine A Ornstein and W John Boscardin and Smith, Alexander K} } @article {12570, title = {The inequitable burden of the COVID-19 pandemic among marginalized older workers in the United States: an intersectional approach.}, journal = {The Journals of Gerontology, Series B }, volume = {77}, year = {2022}, pages = {1928-1937}, abstract = {

OBJECTIVES: The COVID-19 pandemic has profoundly affected the lives of people globally, widening longstanding inequities. We examined the COVID-19 pandemic{\textquoteright}s impact on employment conditions by race/ethnicity, gender, and educational attainment and the association between such conditions and well-being in older adults in the United States.

METHODS: Using data from the Health and Retirement Study respondents interviewed between May 2020 and May 2021 when they were >=55 years of age, we examined intersectional patterns in COVID-19-related changes in employment conditions among 4,107 participants working for pay at the start of the pandemic. We also examined the compounding nature of changes in employment conditions and their association with financial hardship, food insecurity, and poor self-rated health.

RESULTS: Relative to non-Hispanic White men with greater than high school education (>HS), Black and Latinx men and women were more likely to experience job loss irrespective of education; among those who did not experience job loss, men with <=HS reporting Black, Latinx, or "other" race were >90\% less likely to transition to remote work. Participants who experienced job loss with decreased income or continued in-person employment with decreased income/shift changes had greater prevalence of financial hardship, food insecurity, and poor/fair self-rated health than others.

DISCUSSION: The impact of COVID-19 on employment conditions is inequitably patterned and is associated with financial hardship, food insecurity, and adverse health in older adults. Policies to improve employment quality and expand social insurance programs among this group are needed to reduce growing inequities in well-being later in life.

}, keywords = {COVID-19, Employment, Inequities, Intersectionality}, issn = {1758-5368}, doi = {10.1093/geronb/gbac095}, author = {Andrea, Sarah B and Eisenberg-Guyot, Jerzy and Blaikie, Kieran J and Owens, Shanise and Oddo, Vanessa M and Peckham, Trevor and Minh, Anita and Hajat, Anjum} } @article {11913, title = {Internet Use and Cognitive Functioning in Later Life: Focus on Asymmetric Effects and Contextual Factors.}, journal = {Gerontologist}, volume = {62}, year = {2022}, pages = {425-435}, abstract = {

BACKGROUND AND OBJECTIVES: Despite emerging literature linking Internet usage and cognitive functioning in later life, research seldom takes changes in older adults{\textquoteright} Internet use into account. How changes in Internet use influence older adults{\textquoteright} cognitive decline over time, particularly in the context of sociodemographic factors that shape Information and Communications Technology (ICT) use, remains an open question.

RESEARCH DESIGN AND METHODS: Using nine waves of panel data from the Health and Retirement Study (2002-2018), we examined within-person asymmetric effects of transitioning into and out of Internet use on cognitive functioning, and whether the associations vary across birth cohorts and by living arrangement.

RESULTS: Transitioning into Internet use (i.e., Internet use onset) was associated with improved cognitive functioning at a given wave and decelerated cognitive decline over time. Transitioning out of the Internet (i.e., Internet use cessation) was associated with worse cognitive functioning at a given wave and accelerated cognitive decline over time. Further, birth cohort and living arrangement moderated these associations. The detrimental effect of transitioning out of Internet use was worse for older adults born in 1941 or before. The cognitive benefits of transitioning into Internet use were greater for those older adults who live alone.

DISCUSSION AND IMPLICATIONS: These findings highlight the interplay between technology, social environment, and cognitive functioning in later life. The salubrious effects of using the Internet, as well as the deleterious effects of ceasing to use such technology, underscores the importance of promoting digital literacy and access to ICT among the older adult population.

}, keywords = {Cognition, Internet use, sociodemographic factors}, issn = {1758-5341}, doi = {10.1093/geront/gnab149}, author = {Kim, Yijung K and Sae Hwang Han} } @article {12248, title = {Intersectional Discrimination and Change in Blood Pressure Control Among Older Adults: The Health and Retirement Study.}, journal = {The Journals of Gerontology: Series A }, volume = {77}, year = {2022}, pages = {375-382}, abstract = {

BACKGROUND: Associations between multiple forms of discrimination and blood pressure control in older populations remain unestablished.

METHODS: Participants were 14 582 noninstitutionalized individuals (59\% women) in the Health and Retirement Study aged at least 51 years (76\% non-Hispanic White, 15\% non-Hispanic Black, 9\% Hispanic/Latino). Primary exposures included the mean frequency of discrimination in everyday life, intersectional discrimination (defined as marginalization ascribed to more than one reason), and the sum of discrimination over the life span. We assessed whether discrimination was associated with a change in measured hypertension status (N = 14 582) and concurrent medication use among reported hypertensives (N = 9 086) over 4 years (2008-2014).

RESULTS: There was no association between the frequency of everyday discrimination and change in measured hypertension. Lifetime discrimination was associated with higher odds of hypertension 4 years later among men (odds ratio [OR]: 1.21, 95\% confidence interval [CI]: 1.08-1.36) but not women (OR: 0.98, 95\% CI: 0.86-1.13). Only among men, everyday discrimination due to at least 2 reasons was associated with a 1.44-fold (95\% CI: 1.03-2.01) odds of hypertension than reporting no everyday discrimination, reporting intersectional discrimination was not associated with developing hypertension among women (OR: 0.91, 95\% CI: 0.70-1.20). All 3 discriminatory measures were inversely related to time-averaged antihypertensive medication use, without apparent gender differences (eg, OR for everyday discrimination-antihypertensive use associations: 0.85, 95\% CI: 0.77-0.94).

CONCLUSIONS: Gender differences in marginalization may more acutely elevate hypertensive risk among older men than similarly aged women. Experiences of discrimination appear to decrease the likelihood of antihypertensive medication use among older adults overall.

}, keywords = {cardiovascular, Health Disparities, Risk Factors, Socioeconomic issues}, issn = {1758-535X}, doi = {10.1093/gerona/glab234}, author = {Kendra D Sims and Smit, Ellen and G David Batty and Hystad, Perry W and Michelle C Odden} } @article {13141, title = {Investigating Racial and Ethnic Disparities in the Provision of Workplace Accommodations in the United States}, year = {2022}, institution = {University of Michigan}, address = {Ann Arbor, Michigan}, abstract = {This study used data from a nationally representative survey that follows people 50 and older over time (the Health and Retirement Study) to test whether the receipt of workplace accommodations by persons with work limitations varies by race/ethnicity. Workplace accommodations can include changes to time (allowing more breaks, allowing different arrival or departure times, or shortening the workday), provision of equipment/assistance (getting someone to help, getting special equipment, arranging special transportation), and changes to work (changing the job, helping to learn new job skills). We found that 85\% of persons with work limitations identified a need for workplace accommodations, but only 32\% actually received accommodations. While our preliminary analyses suggested some differences by race/ethnicity in the likelihood of receiving accommodations, when we also considered other factors (age, gender, education, organizational size, and physical nature of an occupation), these differences by race did not hold. Organizational size was a critical factor, however, as persons working for organizations that employed 100 or more people were significantly more likely to receive accommodations. This finding suggests that smaller employers may benefit from training or other supports to increase the availability of workplace accommodations. Workers with disabilities might also benefit from increased education offered by vocational rehabilitation agencies, workforce development programs, and other similar organizations on how to make requests for and implement reasonable accommodations.}, keywords = {Racial and ethnic disparities, United States, workplace accommodations}, url = {https://mrdrc.isr.umich.edu/publications/papers/pdf/wp442.pdf}, author = {Debra L. Brucker and Megan Henly and Andrew Houtenville} } @article {11465, title = {Leisure and Social Supports in Relation to Positive Affect Among Older Adults.}, journal = {Journal of Applied Gerontology}, volume = {41}, year = {2022}, pages = {551-559}, abstract = {

The current study examined the extent to which leisure activities were related to different forms of social support and its association with positive affect. A secondary data analysis was employed using data drawn from the Health and Retirement Study (HRS) in 2014. The study sample was composed of 4,303 individuals whose ages ranged from 65 to 105 ( = 75.78, = 7.42; 57.8\% females). Employing bootstrapping technique, the hypothesized relationship between leisure, social support, and positive affect was examined. Mediating effect of social support was also determined. Results indicated that leisure activity, social support, and positive affect were significantly associated, but the relationship varied. The study findings expanded our understanding of the divergent leisure paths to positive social support and emotional well-being of the older adults. Promoting diverse recreational settings is necessary in leisure interventions that can facilitate frequent and positive social exchanges in both in-home and out-of-home environments.

}, keywords = {leisure activity, perceived social support, Positive affect}, issn = {1552-4523}, doi = {10.1177/0733464821990485}, author = {Lee, Sunwoo and Ryu, Jungsu and Jinmoo Heo} } @article {12749, title = {LHMS User Guide 2015-2017}, year = {2022}, institution = {Institute for Social Research, University of Michigan }, address = {Ann Arbor, MI}, keywords = {life history, mail survey, User guide}, author = {Jacqui Smith and Ofstedal, Mary Beth and Larkina, Marina and Helppie-McFall, Brooke and Amanda Sonnega and David R Weir} } @article {12864, title = {Limited Cognitive Ability May Reduce SNAP Participation among Older Adults }, number = {$\#$81}, year = {2022}, institution = {Center for Aging and Policy Studies, Syracuse University }, address = {Syracuse, NY}, keywords = {cognitive function, SNAP program}, url = {https://surface.syr.edu/cgi/viewcontent.cgi?article=1196\&context=lerner}, author = {Heflin, Colleen and Zuo, Dongmei and Alphonso, Gabriella} } @article {socsci11010027, title = {Linked Lives: Does Disability and Marital Quality Influence Risk of Marital Dissolution among Older Couples?}, journal = {Social Sciences}, volume = {11}, year = {2022}, pages = {27}, abstract = {Using fourteen waves of data from the Health and Retirement Study (HRS), a longitudinal panel survey with respondents in the United States, this research explores whether marital quality\—as measured by reports of enjoyment of time together\—influences risk of divorce or separation when either spouse acquires basic care disability. Discrete-time event history models with multiple competing events were estimated using multinomial logistic regression. Respondents were followed until they experienced the focal event (i.e., divorce or separation) or right-hand censoring (i.e., a competing event or were still married at the end of observation). Disability among wives was predictive of divorce/separation in the main effects model. Low levels of marital quality (i.e., enjoy time together) were associated with marital dissolution. An interaction between marital quality and disability yielded a significant association among couples where at least one spouse acquired basic care disability. For couples who acquired disability, those who reported low enjoyment were more likely to divorce/separate than those with high enjoyment; however, the group with the highest predicted probability were couples with low enjoyment, but no acquired disability.}, keywords = {Disability, marital dissolution, Marital quality}, issn = {2076-0760}, doi = {10.3390/socsci11010027}, author = {Kenzie Latham-Mintus and Holcomb, Jeanne and Zervos, Andrew P.} } @article {12878, title = {Links between inflammation and immune functioning with cognitive status among older Americans in the Health and Retirement Study.}, journal = {Brain, Behavior, \& Immunity - Health}, volume = {26}, year = {2022}, pages = {100559}, abstract = {

Elevated inflammation and poor immune functioning are tied to worse cognitive health. Both processes are fundamental to aging and are strongly implicated in the development of age-related health outcomes, including cognitive status. However, results from prior studies evaluating links between indicators of inflammation and immune function and cognitive impairment have been inconsistent due to biomarker selection, sample selection, and cognitive outcome. Using the Health and Retirement Study (HRS), a nationally representative study of older adults in the United States, we assessed how indicators of inflammation (neutrophil-lymphocyte ratio (NLR), albumin, CRP, IL6, IL10, IL-1Ra, sTNFR1, and TGFβ1) and immune functioning (CMV, CD4 T/T and CD8 T/T) are associated with cognitive status. First, to examine the association between each biomarker and cognitive status, we tested whether markers of inflammation and immune functioning varied across cognitive status categories. We found that dementia and cognitive impairment without dementia (CIND) were associated with elevated inflammation and poorer immune functioning across biomarkers except for CD4 T/T. Next, we estimated multinomial logistic regression models to assess which biomarkers would continue to be associated with dementia and CIND, net of each other. In these models, albumin, cytokines, CMV, CD4 T/T and CD8 T/T are associated with cognitive status. Because poor immune functioning and increased inflammation are associated with cognitive impairment, improving immune functioning and reducing inflammation may provide a mechanism for reducing ADRD risk in the population.

}, keywords = {Biomarkers, Dementia, immune functioning, Inflammation}, issn = {2666-3546}, doi = {10.1016/j.bbih.2022.100559}, author = {Farina, Mateo P and Jung K Kim and Hayward, Mark D and Eileen M. Crimmins} } @article {12167, title = {Lonely older adults are more likely to delay or avoid medical care during the coronavirus disease 2019 pandemic.}, journal = {International Journal of Geriatric Psychiatry}, volume = {37}, year = {2022}, abstract = {

OBJECTIVES: To examine the relationship between loneliness and self-reported delay or avoidance of medical care among community-dwelling older adults during the coronavirus disease 2019 (COVID-19) pandemic.

METHODS: Analyses of data from a nationally representative survey administered in June of 2020, in COVID-19 module of the Health and Retirement Study. Bivariate and multivariable analyses determined associations of loneliness with the likelihood of, reasons for, and types of care delay or avoidance.

RESULTS: The rate of care delay or avoidance since March of 2020 was 29.1\% among all respondents (n~=~1997), and 10.1\% higher for lonely (n~=~1,150\%, 57.6\%) versus non-lonely respondents (33.5\% vs. 23.4\%; odds ratio~=~1.59, p~=~0.003 after covariate adjustment). The differences were considerably larger among several subgroups such as those with emotional/psychiatric problems. Lonely older adults were more likely to cite "Decided it could wait," "Was afraid to go," and "Couldn{\textquoteright}t afford it" as reasons for delayed or avoided care. Both groups reported dental care and doctor{\textquoteright}s visit as the two most common care delayed or avoided.

CONCLUSIONS: Loneliness is associated with a higher likelihood of delaying or avoiding medical care among older adults during the pandemic.

}, keywords = {Aged, COVID-19, Humans, Independent Living, Loneliness, Pandemics, SARS-CoV-2}, issn = {1099-1166}, doi = {10.1002/gps.5694}, author = {Li, Yue and Cheng, Zijing and Cai, Xueya and Holloway, Melissa and Maeng, Daniel and Simning, Adam} } @article {12226, title = {Longitudinal association between depressive symptoms and cognitive decline among middle-aged and elderly population.}, journal = {Journal of Affective Disorders}, volume = {303}, year = {2022}, pages = {18-23}, abstract = {

BACKGROUND: Depression is considered a risk factor for cognitive decline. The long-term impact of depressive symptoms on cognitive performance has not been established thus far.

OBJECTIVES: This study aimed to determine the longitudinal associations between depressive symptoms and cognitive performance among middle-aged and elderly population.

METHODS: We included 10,387 adults aged >=45 years from the Health and Retirement Study (2004 to 2014) in this study. Depressive symptoms were assessed using the Center for Epidemiologic Studies Depression (CESD) scale. Participant{\textquoteright}s cognitive function was assessed via the telephone interview for cognitive status (TICS); the total cognitive score ranged from 0 to 35. We classified the participants into four clusters according to the quartile of the total cognitive score (TCS). We examined the change of depressive symptoms and cognitive performance by using the unconditional latent growth curve modeling (LGCM) method, and a parallel LGCM method was used to examine the longitudinal associations between depressive symptoms and cognitive performance among middle-aged and elderly adults in each cluster.

RESULTS: Participants with lower levels of cognitive performance were associated with a greater risk of high depressive symptoms. Results from unconditional LGCM showed a sustained decline in cognitive performance and an increasing trend in depressive symptoms per 2 years for each cluster of participants. The parallel LGCM indicated that baseline levels of depression showed a significant negative correlation with the cognitive performance at baseline (β [95\% CI] of intercept predicting intercept were -0.33 [-0.41, -0.26], -0.03[-0.06, -0.00], -0.05 [-0.07, -0.02] and -0.64 [-0.70,-0.58], for clusters of Q1 to Q3 and the entire population, respectively). Further, a significant positive prospective association was observed between baseline levels of depression and changes in cognitive performance (intercept predicting slope were -0.05 [-0.08, -0.02], -0.09[-0.13, -0.05], -0.12 [-0.15, -0.08], -0.11 [-0.15, -0.06] and -0.04 [-0.06,-0.02] for clusters of Q1 to Q4 and the entire population, respectively). Moreover, for participants with the highest quartile of TCS, the rising trend of depressive symptoms accelerated the decline of cognitive performance during the follow-up period (Slope predicting Slope: -0.44 [-0.86, -0.01]).

CONCLUSION: Our results suggest that depressive symptoms were associated with lower cognitive performance and larger subsequent decline during follow-up period. Adults with depression may require more medical attention, and early intervention is required to delay the development of cognitive impairment and dementia.

}, keywords = {Cognitive decline, Depressive symptoms, Latent growth curve modeling, Longitudinal association}, issn = {1573-2517}, doi = {10.1016/j.jad.2022.01.107}, author = {Huang, Wentao and Zhu, Wenjing and Chen, Hongyan and Li, Feng and Huang, Jingxin and Zhou, Ye and Sun, Xibin and Lan, Yutao} } @article {13851, title = {Longitudinal patterns in cohort income inequality, income instability, and income trajectories of a US cohort on the cusp of retirement}, year = {2022}, institution = {Oxford University Press}, address = {Oxford}, abstract = {Previous research has shown that the course of income inequality of a US cohort in retirement depends on the inequality measure used. For example, the variance of logarithmic income, a bottom sensitive measure, displays a decidedly declining trend. This study examines the mechanisms that underlie these income inequality changes as a cohort enters their retirement years using longitudinal data over a 20- year period and a variety of methods. In particular, individual income trajectories and income instability just before and in retirement are investigated. The results show (i) the variance of logarithmic income falls as the cohort ages primarily due to a reduction in income instability; (ii) on average, the rich and poor get poorer as they age into retirement; and (iii) consistent with previous research, a person{\textquoteright}s place in the retirement income distribution is largely determined before retirement.}, keywords = {Income inequality, income instability, Retirement, US}, doi = {10.1093/oep/gpab041}, author = {Thomas L. Hungerford} } @article {12370, title = {Long-term weight change and its temporal relation to later-life dementia in the Health and Retirement Study.}, journal = {The Journal of Clinical Endocrinology \& Metabolism}, volume = {107}, year = {2022}, pages = {e2710-e2716}, abstract = {

BACKGROUND: Weight loss among middle and older adults has been associated with a higher risk of subsequent dementia. However, most of studies have limited follow-up time or suboptimal control for the potential influence of physical frailty (PF).

OBJECTIVES: Our study aimed to investigate the long-term and temporal relation of weight change to risk of dementia among U.S. middle-aged and older adults.

METHODS: A total of 5985 participants aged 50 years and older were included from the Health and Retirement Study (HRS). History of long-term weight change was calculated using nine repeated BMI measurements from 1992-2008. We then followed their dementia status from 2008 to 2018. Multivariable cox proportional hazard models were used.

RESULTS: During the study follow-up (mean = 7.54 years), a total of 682 (11.39\%) dementia cases were documented. After controlling for basic demographic and lifestyle, participants with weight loss (median: -0.23~kg/m 2 per year) were at a significantly higher risk of dementia (HR = 1.60, 95\% CI, 1.33, 1.92), compared with the stable-weight group (median: 0.11~kg/m 2 per year). This association was attenuated but remained strong and significant after further adjustment for PF (HR = 1.57, 95\% CI, 1.30, 1.89). The significant association was observed for weight loss assessed approximately 14-18 years preceding dementia diagnosis (HR = 1.30, 95\% CI, 1.07, 1.58), and was consistent for that closer to diagnosis.

CONCLUSIONS: Both recent and remote weight loss were associated with a higher risk of later-life dementia among middle-aged and older adults independent of the status of physical frailty.

}, keywords = {Dementia, physical frailty, prospective cohort, Weight Change}, issn = {1945-7197}, doi = {10.1210/clinem/dgac229}, author = {Shen, Jie and Chen, Hui and Zhou, Tianjing and Zhang, Simei and Huang, Liyan and Lv, Xiaozhen and Ma, Yuan and Zheng, Yan and Yuan, Changzheng} } @article {12786, title = {Managing the onset of a new disease in older age: Housing wealth, mortgage borrowing, and medication adherence.}, journal = {Social Science \& Medicine}, volume = {314}, year = {2022}, pages = {115437}, abstract = {

The relationship between wealth and health is an important yet complex topic for health research. While prior studies document the importance of wealth for healthy aging, the understanding of the mechanisms through which wealth supports health consumption is limited. We investigate the wealth-to-health link by explicitly modeling the effect of liquidating home equity through borrowing on health expenditures, measured here as cost-related non-adherence to prescription medications (CRN), following the onset of one of six costly diseases on or after age 65. Using individual-level data from the 2002-2018 waves of the U.S. Health and Retirement Study (3,772 respondents; 13,708 observations), we exploit exogenous spatial and intertemporal variation in ZIP-code level house values to instrument for borrowing. Results indicate each additional $10,000 in new mortgage borrowing is associated with a 1.6 percentage point reduction in CRN. In subsample regressions, this relationship is strongest for older adults for whom home equity is their largest source of wealth. In a falsification test, we find no relationship between house value changes and CRN for older renters, and no effect of mortgage borrowing on prescription drug non-adherence for health or memory reasons. Our results contribute to the literature by documenting how housing wealth can be tapped by older adults through borrowing to smooth health-related consumption following disease diagnosis. However, not all older homeowners are willing or able to borrow from home equity. Our findings suggest that it is not simply the stock of housing wealth that leads to better health outcomes, but instead the liquidation of housing wealth. Housing wealth is thus not a uniform social determinate of health for older homeowners as it is moderated by the ability to borrow.

}, keywords = {health shock, Housing wealth, Medications, mortgage borrowing, Retirement}, issn = {1873-5347}, doi = {10.1016/j.socscimed.2022.115437}, author = {Moulton, Stephanie and Rhodes, Alec and Haurin, Donald and Loibl, C{\"a}zilia} } @article {11790, title = {Medicare claims data underestimate hallucinations in older adults with dementia}, journal = {The American Journal of Geriatric Psychiatry}, volume = {30}, year = {2022}, pages = {352-359}, abstract = {Objective Administrative claims data are used to study the incidence and outcomes of dementia-related hallucinations, but the validity of International Classification of Diseases (ICD) codes for identifying dementia-related hallucinations is unknown. Methods We analyzed Medicare-linked survey data from two nationally representative studies of U.S. older adults (the National Health and Aging Trends Study and the Health and Retirement Study) which contain validated cognitive assessments and a screening question for hallucinations. We identified older adults who had dementia or were permanent nursing home residents, and we combined this with questionnaire responses to define dementia-related hallucinations. Using Medicare claims data, we calculated the sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) of ICD codes for dementia-related hallucinations overall and within prespecified strata of age, neurologic comorbidity, and health care utilization. Results We included 2,337 older adults with dementia in our cohort. Among 3,789 person-years of data, 1,249 (33.0\%) had hallucations, and of these 286 had a qualifying ICD code for dementia-related hallucinations or psychosis (sensitivity 22.9\%). Of 2,540 person-years of dementia without hallucinations, 284 had a diagnosis code for hallucinations (specificity 88.8\%). PPV was 50.2\%, and NPV was 70.1\%. Sensitivity was greatest (57.0\%) among those seeing a psychiatrist. Otherwise, there were no significant differences in sensitivity, specificity, PPV, or NPV by age, neurologic diagnosis, or neurologist care. Conclusion Dementia-related hallucinations are poorly captured in administrative claims data, and estimates of their prevalence and outcomes using these data are likely to be biased.}, keywords = {Dementia, Hallucinations, Medicare, sensitivity, specificity, validity}, isbn = {1064-7481}, doi = {10.1016/j.jagp.2021.07.018}, author = {Ali G Hamedani and Weintraub, Daniel and Allison W Willis} } @article {12407, title = {Medicare spending associated with a dementia diagnosis among older adults.}, journal = {Journal of the American Geriatrics Society}, volume = {70}, year = {2022}, pages = {2592-2601}, abstract = {

BACKGROUND: Over 6 million Americans have Alzheimer{\textquoteright}s Disease or Related Dementia (ADRD) but whether spikes in spending surrounding a new diagnosis reflect pre-diagnosis morbidity, diagnostic testing, or treatments for comorbidities is unknown.

METHODS: We used the 1998-2018 Health and Retirement Study and linked Medicare claims from older (>=65) adults to assess incremental quarterly spending changes just before versus just after a clinical diagnosis (diagnosis cohort, n~=~2779) and, for comparative purposes, for a cohort screened as impaired based on the validated Telephone Interview for Cognitive Status (TICS) (impairment cohort, n~=~2318). Models were adjusted for sociodemographic and health characteristics. Spending patterns were examined separately by sex, race, education, dual eligibility, and geography.

RESULTS: Among the diagnosis cohort, mean (SD) overall spending was $4773 ($9774) per quarter - 43\% of which was spending on hospital care ($2048). In adjusted analyses, spending increased by $8400 (p < 0.001), or 156\%, from $5394 in the quarter prior to $13,794 in the quarter including the diagnosis. Among the cohort in which impairment was incidentally detected using the TICS, adjusted spending did not change from just before to after detection of impairment, from $2986 before and $2962 after detection (p~=~0.90). Incremental spending changes did not differ by sex, race, education, dual eligibility, or geography.

CONCLUSION: Large, transient spending increases accompany an ADRD diagnosis that may not be attributed to impairment or changes in functional status due to dementia. Further study may help reveal how treatment for comorbidities is associated with the clinical diagnosis of dementia, with potential implications for Medicare spending.

}, keywords = {Dementia, Diagnosis, impairment, Medicare, utilization}, issn = {1532-5415}, doi = {10.1111/jgs.17835}, author = {Hoffman, Geoffrey J and Donovan T Maust and Harris, Melissa and Ha, Jinkyung and Davis, Matthew A} } @article {11514, title = {Music Engagement and Episodic Memory among Middle-Aged and Older Adults: A National Cross-Sectional Analysis.}, journal = {The Journals of Gerontology: Series B}, volume = {77}, year = {2022}, pages = {558-566}, abstract = {

OBJECTIVES: To determine whether music engagement influences middle-aged and older adults{\textquoteright} performance on episodic memory tasks.

METHODS: Secondary data analysis of a sample (N = 4,592) of cognitively healthy adults from the 2016 Health and Retirement Study were used for this study. Multivariable regression models were used to analyze the cross-sectional differences in performance on tasks of episodic memory between participants who listened to music (n= 3,659) or sang or played an instrument (n= 989).

RESULTS: On average, participants recalled 10.3 words out of a possible 20. Regression analyses showed that both music listening and singing or playing an instrument were independently associated with significantly better episodic memory.

DISCUSSION: The findings provide the first population-based evidence that music engagement is associated with better episodic memory among middle-aged and older adults. Future studies should examine whether the association is causal or has a dose response.

}, keywords = {age norms, healthcare policy, lifestyle, Memory, Music, regression methods}, issn = {1758-5368}, doi = {10.1093/geronb/gbab044}, author = {Rouse, Hillary J and Jin, Ying and Hueluer, Gizem and Huo, Meng and Bugos, Jennifer A and Veal, Britney and Torres, Mia and Peterson, Lindsay and Dobbs, Debra and Meng, Hongdao} } @article {11527, title = {Negative marital interaction, purpose in life, and depressive symptoms among middle-aged and older couples: evidence from the Health and Retirement Study.}, journal = {Aging \& Mental Health}, volume = {26}, year = {2022}, pages = {860-869}, abstract = {

OBJECTIVE: Negative marital interaction and purpose in life have been associated with depressive symptoms. Yet, these associations have not been fully explored in a dyadic context. This study examines the actor (intra-individual) and partner (cross-spousal) effects of negative marital interaction on depressive symptoms in couples and the potential mediating role of purpose in life.

METHODS: Data came from 1186 heterosexual married couples who participated in the 2016 (T1) and 2018 (T2) waves of the Health and Retirement Study and completed the psychosocial questionnaire in 2016. Structural equation modeling was used to estimate the direct and indirect associations among T1 negative marital interaction, T1 purpose in life, and T2 depressive symptoms at the actor and partner levels. Models controlled for age, race, educational level, self-rated health, and length of marriage.

RESULTS: At the actor level, a greater negative marital interaction was associated with significantly lower levels of purpose in life for husbands and wives. Negative marital interaction was also associated with depressive symptoms for wives. Purpose in life mediated the relationship between negative marital interaction and depressive symptoms. At the partner level, wives{\textquoteright} negative marital interaction was negatively associated with husbands{\textquoteright} purpose in life, independent of husbands{\textquoteright} own effects.

CONCLUSION: The findings support the dominant marital discord model of depression and highlight gender differences in the cross-spousal effects of negative marital interaction on purpose in life. Positive psychology interventions can be beneficial to promote purpose in life and subsequently improve mental health outcomes among couples.

}, keywords = {dyadic analysis, Mental Health, psychological well-being, relationship quality}, issn = {1364-6915}, doi = {10.1080/13607863.2021.1904831}, author = {Irani, Elliane and Park, Sumin and Hickman, Ronald L} } @article {11602, title = {Neighborhood Characteristics and Inflammation among Older Black Americans: The Moderating Effects of Hopelessness and Pessimism.}, journal = {The Journals of Gerontology: Series A}, volume = {77}, year = {2022}, pages = {e82-e88}, abstract = {

BACKGROUND: Research documents the adverse health effects of systemic inflammation. Overall, older Black Americans tend to have higher inflammation than older non-Hispanic white adults. Given that inflammation is related to a range of chronic health problems that disproportionately affect Blacks compared to whites, this racial disparity in inflammation may contribute to racial disparities in particular chronic health problems. Thus, a better understanding of its determinants in the older Black population is of critical importance. This analysis examined the association between neighborhood characteristics and inflammation in a national sample of older non-Hispanic Black Americans. An additional aim of this study was to determine whether hopelessness and pessimism moderates the association between neighborhood characteristics and inflammation.

METHODS: A sample of older non-Hispanic Black Americans aged 60+ were drawn from the Health and Retirement Study (N=1,004). Neighborhood characteristics included neighborhood physical disadvantage and neighborhood social cohesion. Inflammation was assessed by C-reactive protein (CRP).

RESULTS: The analyses indicated that neighborhood physical disadvantage and social cohesion were not associated with CRP. Hopelessness and pessimism moderated the association between neighborhood physical disadvantage and CRP.

CONCLUSIONS: Knowledge regarding the role of hopelessness and pessimism as moderator in the neighborhood-inflammation association can inform cognitive-behavioral interventions targeted at changes in cognition patterns.

}, keywords = {C-reactive protein, cognitive disposition, neighborhood physical disadvantage, neighborhood social cohesion}, issn = {1758-535X}, doi = {10.1093/gerona/glab121}, author = {Ann W Nguyen and Harry Owen Taylor and Karen D Lincoln and Qin, Weidi and Tyrone C Hamler and Wang, Fei and Uchechi A Mitchell} } @article {rel13100973, title = {Older Adults with Dementia: Association of Prayer with Neuropsychiatric Symptoms, Cognitive Function, and Sleep Disturbances}, journal = {Religions}, volume = {13}, year = {2022}, pages = {973}, abstract = {Protective factors that slow dementia progression and improve quality of life are needed. Neuropsychiatric symptoms (NPS), cognitive decline, and sleep disturbances are commonly found in dementia, indicate progression, and increase caregiver distress. The purpose of this study was to examine the association of private prayer with NPS, cognitive function, and sleep disturbances in older adults with dementia. We analyzed data from the Health and Retirement Study in 2000, 2006, and 2008 and Aging, Demographics, and Memory Sub study in 2001\–2003, 2006\–2007, and 2008\–2009 among 40 older adults (age 70\–100 years, mean age = 84.67, 29 females and 11 males, 73.9\% non-Hispanic White, and 19.2\% Non-Hispanic Black, and 3\% Hispanic, cognitive function = 1.169 indicating mild cognitive impairment) using correlational analysis. The results indicated that increased frequency of private prayer was significantly associated with lower NPS, better cognitive function, and lower sleep disturbances. In total, 100\% of Non-Hispanic Black and Hispanic participants reported praying at least once per week. Findings could be due to use of cognitive processes used in prayer during supplication, requesting aid, and through communication with the divine, reducing loneliness. Longitudinal studies including historically underrepresented populations are needed to examine these associations over time.}, keywords = {Alzheimer{\textquoteright}s, coping, illness, Religion, Spirituality, supplication}, issn = {2077-1444}, doi = {10.3390/rel13100973}, author = {Britt, Katherine Carroll and Richards, Kathy C. and Acton, Gayle and Hamilton, Jill and Radhakrishnan, Kavita} } @article {12842, title = {Owning a pet is linked to having better cognitive health in advanced age, study finds}, year = {2022}, publisher = {PsyPost}, keywords = {Aging, Cognition, pet ownership}, url = {https://www.psypost.org/2022/12/owning-a-pet-is-linked-to-having-better-cognitive-health-in-advanced-age-study-finds-64604}, author = {Hedrih, Vladimir} } @article {12285, title = {Pain and the Alzheimer{\textquoteright}s Disease and Related Dementia Spectrum in Community-Dwelling Older Americans: A Nationally Representative Study.}, journal = {Journal of Pain and Symptom Management}, volume = {63}, year = {2022}, pages = {654-664}, abstract = {

CONTEXT: Pain is a significant concern among older adults with Alzheimer{\textquoteright}s disease and related dementias (ADRD).

OBJECTIVES: Examine the association between cognitive impairment across the ADRD spectrum and pain assessment and treatment in community-dwelling older Americans.

METHODS: This cross-sectional, population-based study included 16,836 community-dwelling participants >= 50 years in the 2018 Health and Retirement Study. ADRD, assessed by validated cognitive measures, was categorized into "dementia," "cognitive impairment, no dementia (CIND)" and "intact cognition." Pain assessment included pain presence (often being troubled with pain), pain severity (degree of pain most of the time [mild/moderate/severe]), and pain interference (pain making it difficult to do usual activities). Pain treatment included recent use of over-the-counter pain medications and opioids (past 3 months), and regular intake of prescriptions for pain.

RESULTS: Dementia were associated with lower likelihood of reporting pain presence (Odds Ratio [OR]= 0.61, P~=~0.01), pain interference (OR~=~0.46, P < 0.001), reporting lower pain severity (e.g., moderate vs. no: Relative Risk Ratio~=~0.38, P < 0.001), and lower likelihood of receiving pain treatment, that is, recent use of over-the-counter pain medications (OR~=~0.60, P~=~0.02) and opioids (OR~=~0.33, P < 0.001), and regular intake of prescriptions for pain (OR~=~0.461, P~=~0.002). CIND was associated with reporting lower pain severity (e.g., moderate vs. no: Relative Risk Ratio~=~0.75, P~=~0.021), lower likelihood of reporting pain interference (OR~=~0.79, P~=~0.045) and recent over-the-counter pain medication use (OR~=~0.74, P~=~0.026).

CONCLUSION: CIND and dementia increased the risk of under-report and under-treatment of pain. Systematic efforts are needed to improve pain recognition and treatment among older adults with cognitive impairment, regardless of dementia diagnosis.

}, keywords = {Alzheimer, Dementia, pain, Pain Management}, issn = {1873-6513}, doi = {10.1016/j.jpainsymman.2022.01.012}, author = {Wang, Jinjiao and Cheng, Zijing and Kim, Yeunkyung and Yu, Fang and Heffner, Kathi L and Qui{\~n}ones-Cordero, Maria M and Li, Yue} } @article {11568, title = {Parental dementia and subjective memory impairment in the Health and Retirement Study.}, journal = {Aging \& Mental Health}, volume = {26}, year = {2022}, pages = {992-1000}, abstract = {

OBJECTIVES: To examine relationships between subjective memory impairment (SMI) and parental dementia among in older adults while considering the interactive influence of depressive symptoms, ethnicity, and race.

METHOD: The sample was drawn from the Health and Retirement Study, a nationally representative longitudinal study of aging ( = 3,809; = 66.09; = 1.88; 84.20\% White; 12.23\% Black; 7.88\% Hispanic). Biennial assessments included two measures of SMI (current memory problems and perceived memory decline), depressive symptoms, and parental dementia, over periods of up to sixteen years. Multilevel modeling analyses examined longitudinal relationships between parental dementia and SMI and whether depressive symptoms, ethnicity, and race interactively influenced this association.

RESULTS: Results showed that when older adults reported parental dementia, they were more likely to report a decline in memory in the past two years. They also reported poorer current memory problems, especially when they experienced increased depressive symptoms. Associations of parental dementia were consistent across ethnicity and race.

CONCLUSIONS: Results demonstrate the importance of considering parental dementia as a factor that may contribute to SMI in older adults.

}, keywords = {Dementia, depression, race, subjective memory impairment}, issn = {1364-6915}, doi = {10.1080/13607863.2021.1910790}, author = {Tyler Reed Bell and Nikki L Hill and Bhargava, Sakshi and Mogle, Jacqueline} } @article {12301, title = {Perceived dementia risk and advance care planning among older adults.}, journal = {Journal of the American Geriatrics Society}, year = {2022}, abstract = {

BACKGROUND: Although advance care planning (ACP) is beneficial if dementia develops, and virtually all older adults are at risk for this disease, older adults do not consistently engage in ACP. Health behavior models have highlighted the importance of perceived susceptibility to medical conditions in motivating behavior. Following these models, we sought to determine how often older adults believe they are not at risk of developing dementia and to examine the association between perceived dementia risk and ACP participation.

METHODS: We performed a cross-sectional study of community-dwelling adults without cognitive impairment, aged >=65 years, who were interviewed for the Health and Retirement Study in 2016 and asked about their perceived dementia risk (n~=~711). Perceived dementia risk was ascertained with this question: "on a scale of 0 to 100, what is the percent chance that you will develop dementia sometime in the future?" We used multivariable-adjusted logistic regression to evaluate the association between perceived risk (0\% versus >0\%) and completion of a living will, appointment of a durable power of attorney for healthcare decisions, and discussion of treatment preferences.

RESULTS: Among respondents, 10.5\% reported a perceived dementia risk of 0\%. Perceived risk of 0\% was associated with lower odds of completing a living will (OR 0.53; 95\% CI, 0.30-0.93) and discussing treatment preferences (OR 0.51; 95\% CI, 0.28-0.93) but not appointment of a durable power of attorney (OR 0.77; 95\% CI, 0.42-1.39). Many respondents with perceived dementia risk >0\% had not completed ACP activities, including a substantial minority of those with perceived risk >50\%.

CONCLUSIONS: Older adults with no perceived dementia risk are less likely to participate in several forms of ACP, but the fact that many older adults with high levels of perceived risk had not completed ACP activities suggests that efforts beyond raising risk awareness are needed to increase engagement.

}, keywords = {Advance care planning, Dementia, Health Literacy, risk perception}, issn = {1532-5415}, doi = {10.1111/jgs.17721}, author = {Lee, Yu Kyung and Fried, Terri R and Costello, Darc{\'e} M and Hajduk, Alexandra M and O{\textquoteright}Leary, John R and Cohen, Andrew B} } @mastersthesis {12520, title = {Perceived Discrimination and Health Outcomes in Older Adults}, volume = {Ph.D.}, year = {2022}, school = {University of Massachusetts, Boston}, address = {Boston, MA}, keywords = {Aging, Discrimination, health outcomes, Healthcare Disparities}, url = {https://www.proquest.com/dissertations-theses/perceived-discrimination-health-outcomes-older/docview/2681897382/se-2?accountid=14667}, author = {Hendricksen, Meghan} } @article {12942, title = {Perceived discrimination in middle-aged and older adults: Comparison between England and the United States.}, journal = {Frontiers in Public Health}, volume = {10}, year = {2022}, pages = {975776}, abstract = {

OBJECTIVES: This study examined differences in perceived discrimination across multiple characteristics in England and the United States (US), in middle- and older-aged adults.

METHODS: Using data from the English Longitudinal Study of Aging ( = 8,671) and the US-based Health and Retirement Study ( = 7,927), we assessed cross-national differences in perceived discrimination attributed to disability, financial status, sex, race, sexual orientation, and weight. We also compared how perceived discrimination varied with socioeconomic position (SEP) based on wealth.

RESULTS: Perceived discrimination due to financial status was more common in England (6.65\%) than in the US (2.14\%) adjusting for age, sex, and wealth [Odds Ratio (OR) = 1.09, 95\% CI (1.07; 1.10)]. This affected people of low but not high SEP. Sexual orientation discrimination was more common in England [0.72 vs. 0.15\%, OR = 4.61, 95\% CI (2.48; 8.57)]. Sex-based perceived discrimination was more prevalent in the US (12.42\%) than England (9.07\%) adjusting for age and wealth [OR = 0.87, 95\% CI (0.86; 0.89)]. Cross-national differences in sex discrimination did not vary with SEP. Racism was the most common type of perceived discrimination reported in both samples (England: 17.84\%, US: 19.80\%), with no significant cross-national differences after adjustment for sex.

DISCUSSION: Perceived discrimination attributed to financial status and sexual orientation were more prevalent in England, while more women perceived sex discrimination in the US. This study suggests that country-specific and socioeconomic factors affect the prevalence of perceived discrimination. This may be relevant when targeting interventions aimed at reducing perceived discrimination.

}, keywords = {Aging, Disabled Persons, ELSA, Perceived Discrimination, Socioeconomic factors}, issn = {2296-2565}, doi = {10.3389/fpubh.2022.975776}, author = {Amirova, Aliya and Rimes, Katharine A and Hackett, Ruth A} } @article {12507, title = {Persistent Depressive Symptoms and the Changes in Serum Cystatin C Levels in the Elderly: A Longitudinal Cohort Study.}, journal = {Frontiers in Psychiatry}, volume = {13}, year = {2022}, pages = {917082}, abstract = {

Background: The burden of depression in the elderly is increasing worldwide with global aging. However, there is still a lack of research on the relationship between depressive symptoms and the progression of renal function. Our aim is to evaluate the longitudinal association between baseline depressive symptoms and the changes in serum cystatin C levels over 10 years{\textquoteright} follow-up period.

Methods: We used longitudinal data from the Health and Retirement Study (HRS), an existing community based nationally representative aging cohort study which enrolled individuals over age 50 in the USA. Depressive symptoms were determined using an eight-item version of the Center for Epidemiologic Studies Depression Scale (CESD) at wave 7 (2004) and wave 8 (2006). Persistent depressive symptoms were defined as both CESD scores measured at waves 7 and 8 were >=3; episodic depressive symptoms were defined as CESD scores >=3 at wave 7 or wave 8. A linear mixed model was used to evaluate the correlation between baseline depressive symptoms and future changes in cystatin C levels.

Results: The mean age of the 7,642 participants was 63.8 {\textpm} 10.8 years, and 60.9\% were women. Among the participants, 1,240 (16.2\%) had episodic depressive symptoms and 778 (10.2\%) had persistent depressive symptoms. Compared with participants with no depressive symptoms at both waves, a significant increase in serum cystatin C levels was found among those with persistent depressive symptoms.

Conclusions: Our results showed that baseline persistent depressive symptoms were significantly associated with an increased rate of serum cystatin C levels. The level of serum cystatin C should be monitored in the elderly with persistent depressive symptoms.

}, keywords = {persistent depressive symptoms, renal function, serum cystatin C}, issn = {1664-0640}, doi = {10.3389/fpsyt.2022.917082}, author = {Han, Tiandong and Zhang, Li and Jiang, Weixing and Wang, Lei} } @article {12147, title = {Personality and compliance with COVID-19 protective measures among older Americans: Moderating effects of age, gender, and race/ethnicity.}, journal = {Personality and Individual Difference}, volume = {189}, year = {2022}, pages = {111499}, abstract = {

Following the growing evidence that personality is related to various health behaviors, we examined whether personality traits were related to compliance with COVID-19 protective measures and evaluated the extent to which associations were moderated by age, gender, or race/ethnicity among older adults during a summer 2020 surge of COVID-19 cases in the United States. Data were from the 2020 Health and Retirement Study COVID-19 module. Multivariate ordinary least squares regression analyses were computed adjusting for health, psychosocial, and sociodemographic factors. Results indicated the significant associations between personality traits and compliance with COVID-19 measures varied by age, gender, and race/ethnicity. Specifically, the associations of agreeableness with wearing a mask and frequent handwashing were less pronounced among older compared with younger individuals. The association between extraversion and wearing masks was stronger for men than for women. The associations of agreeableness with handwashing and physical distancing were weaker for Hispanic older adults, whereas the associations of extraversion with physical distancing and using sanitizers were stronger for Hispanic older adults than for their non-Hispanic White counterparts. Implications regarding behavioral science underlying the current pandemic and future public health crises are discussed.

}, keywords = {COVID-19, gender, Personality, Prevention, Race/ethnicity}, issn = {0191-8869}, doi = {10.1016/j.paid.2022.111499}, author = {Choi, Shinae L and Peter Martin and Cho, Jinmyoung and Ryou, Yeon Ji and Heinz, Melinda} } @article {12312, title = {Predictors of Covid-19 level of concern among older adults from the health and retirement study.}, journal = {Scientific Reports}, volume = {12}, year = {2022}, pages = {4396}, abstract = {

The purpose of this longitudinal study is to construct a prediction model for Covid-19 level of concern using established Covid-19 socio-demographic, lifestyle and health risk characteristics and to examine specific contributions of obesity-related cardiometabolic health characteristics as predictors of Covid-19 level of concern among a representative sample of U.S. older adults. We performed secondary analyses of existing data on 2872 2006-2020 Health and Retirement Study participants and examined 19 characteristics in relation to the outcome of interest using logistic regression and machine learning algorithms. In mixed-effects ordinal logistic regression models, a history of diabetes, stroke as well as 1-2 cardiometabolic risk factors and/or chronic conditions were associated with greater Covid-19 level of concern, after controlling for confounders. Female sex, birth cohort, minority race, Hispanic ethnicity and total wealth as well as depressive symptoms were associated with higher level of Covid-19 concern, and education was associated with lower level of Covid-19 concern in fully adjusted mixed-effects ordinal logistic regression models. The selected socio-demographic, lifestyle and health characteristics accounted for < 70\% of the variability in Covid-19 level of concern based on machine learning algorithms. Independent risk factors for Covid-19 level of concern among U.S. older adults include socio-demographic characteristics and depressive symptoms. Advanced research is needed to identify relevant predictors and elucidate underlying mechanisms of observed relationships.

}, keywords = {COVID-19, Female, Life Style, Retirement, Risk Factors}, issn = {2045-2322}, doi = {10.1038/s41598-022-08332-8}, author = {Beydoun, Hind A and Beydoun, May A and Weiss, Jordan and Gautam, Rana S and Hossain, Sharmin and Alemu, Brook T and Zonderman, Alan B} } @article {12333, title = {Predictors of who Serves as an Alzheimer{\textquoteright}s Disease Research Participant{\textquoteright}s Study Partner and the Impact of their Relationship on Study Partners{\textquoteright} Reports on Participants.}, journal = {Research on Aging}, volume = {44}, year = {2022}, pages = {734-746}, abstract = {

Alzheimer{\textquoteright}s disease and Alzheimer{\textquoteright}s disease related dementias (AD/ADRD) research typically requires participants to enroll with a "study partner" (SP). Little is known about what predicts who steps into the SP role or whether the SP{\textquoteright}s relationship to the participant affects their reports of disease severity. Health and Retirement Study data (HRS), collected prior to the Aging, Demographics and Memory Study (ADAMS), was used to identify sociocultural factors that predict who serves as a SP in ADAMS. SP-reported outcomes were compared between three types of participant-SP relationships: spousal, adult child, and other. Spouses (35\%) and adult children (39\%) were similarly likely to serve as SPs. Factors predicting who served differed. In multivariable analyses, adult children rated participants less impaired than spouses on measures of memory, judgment, and organizational abilities ( < .05). The participant-SP relationship has independent effects on the SP{\textquoteright}s reports of the severity of cognitive impairments.

}, keywords = {ADAMS, Alzheimer, Dementia, informants, Research, study partners}, issn = {1552-7573}, doi = {10.1177/01640275221075739}, author = {Stites, Shana D and Largent, Emily A and Gill, Jeanine and Gurian, Anna and Harkins, Kristin and Karlawish, Jason} } @article {13544, title = {Prevalence of Dementia Is Declining Among Older Americans; Inequalities Reduced but Still Persist}, year = {2022}, publisher = {RAND Corporation}, address = {Santa Monica, CA}, keywords = {Dementia}, url = {https://www.rand.org/news/press/2022/11/07.html}, author = {Hudomiet, P{\'e}ter} } @article {11452, title = {Psychological and Physical Health in Widowhood: Does Marital Quality Make a Difference?}, journal = {Research on Aging}, volume = {44}, year = {2022}, pages = {54-64}, abstract = {

We investigate how preloss marital quality is associated with changes in psychological distress and physical health among older widow(er)s. Using prospective data with a 2-year follow-up from the Health and Retirement Study, we selected 546 respondents who transitioned into widowhood. Respondents were classified as supportive, ambivalent, aversive, or neutral groups. The supportive and ambivalent group experienced greater increase in depressive symptoms compared to the aversive group, in widowhood. The aversive group showed greater increase in chronic conditions compared to the supportive group. Findings indicated that spousal loss may result in more psychological distress for those with supportive and ambivalent marital relationship. Yet, those with mostly negative accounts of their marriage may experience worsened physical health, albeit no increase in psychological distress. Understanding different benefits and challenges facing older individuals after a positive or negative marriage may help direct support and interventions efforts toward older couples during marriage and in widowhood.

}, keywords = {Chronic conditions, Depressive symptoms, Marital quality, Widowhood}, issn = {1552-7573}, doi = {10.1177/0164027521989083}, author = {Lee, Hyo Jung and Sae Hwang Han and Boerner, Kathrin} } @article {12280, title = {Psychological Resilience and Cognitive Function Among Older Military Veterans.}, journal = {Gerontology and Geriatric Medicine}, volume = {8}, year = {2022}, pages = {23337214221081363}, abstract = {

The purpose of this study was to explore the association between psychological resilience and cognitive function in military veterans. We obtained public-use data from the Health and Retirement Study (HRS) for this cross-sectional study of military veterans aged 52 to 101~years ( = 150). We estimated a multivariable linear regression model in which cognitive function served as the dependent variable and psychological resilience served as the independent variable. After controlling for demographics, health conditions, and health behaviors, veterans who had higher psychological resilience scores had better cognitive function (b = 0.22, = 0.03). Our findings suggest that psychological resilience may be associated with cognitive function among veterans. These findings highlight the importance of assessing psychological resilience in gerontological social work practice.

}, keywords = {neurocognitive disorders, psychological resilience, Veterans Health}, issn = {2333-7214}, doi = {10.1177/23337214221081363}, author = {McDaniel, Justin T and Hascup, Erin R and Hascup, Kevin N and Trivedi, Mehul and Henson, Harvey and Rados, Robert and York, Mary and Albright, David L and Weatherly, Taryn and Frick, Kaitlyn} } @article {12933, title = {Race, polygenic risk and their association with incident dementia among older US adults.}, journal = {Brain Communications}, volume = {4}, year = {2022}, pages = {fcac317}, abstract = {

Dementia incidence increases steadily with age at rates that may vary across racial groups. This racial disparity may be attributable to polygenic risk, as well as lifestyle and behavioural factors. We examined whether Alzheimer{\textquoteright}s disease polygenic score and race predict Alzheimer{\textquoteright}s disease and other related dementia incidence differentially by sex and mediation through polygenic scores for other health and behavioural conditions. We used longitudinal data from the nationally representative Health and Retirement Study. We restricted participants to those with complete data on 31 polygenic scores, including Alzheimer{\textquoteright}s disease polygenic score (2006-2012). Among participants aged 55 years and older in 2008, we excluded those with any memory problems between 2006 and 2008 and included those with complete follow-up on incident Alzheimer{\textquoteright}s disease and all-cause dementia, between 2010 and 2018 ( = 9683), based on self- or proxy-diagnosis every 2 years (2010, 2012, 2014, 2016 and 2018). Cox proportional hazards and 4-way decomposition models were conducted. Analyses were also stratified by sex and by race. There were racial differences in all-cause dementia incidence (age and sex-adjusted model, per standard deviation: hazard ratio, HR = 1.34, 95\% confidence interval, CI: 1.09-1.65, = 0.007), partially driven by educational attainment and income. We also found independent associations of race (age and sex-adjusted model, African American versus White adults: HR = 2.07, 95\% CI: 1.52-2.83, < 0.001) and Alzheimer{\textquoteright}s disease polygenic score (age and sex-adjusted model, per SD: HR = 1.37, 95\% CI: 1.00-1.87, < 0.001) with Alzheimer{\textquoteright}s disease incidence, including sex differences whereby women had a stronger effect of Alzheimer{\textquoteright}s disease polygenic score on Alzheimer{\textquoteright}s disease incidence compared with men ( < 0.05 for sex by Alzheimer{\textquoteright}s disease polygenic score interaction) adjusting for race and other covariates. The total impact of Alzheimer{\textquoteright}s disease polygenic scores on Alzheimer{\textquoteright}s disease incidence was mostly direct, while the effect of race on all-cause dementia incidence was mediated through socio-economic, lifestyle and health-related factors. Finally, among the 30 polygenic scores we examined, the total effects on the pathway Alzheimer{\textquoteright}s disease polygenic score --> Other polygenic score --> Incident Alzheimer{\textquoteright}s or all-cause dementia, were statistically significant for all, driven primarily by the controlled direct effect (P< 0. 001). In conclusion, both race and Alzheimer{\textquoteright}s disease polygenic scores were associated independently with Alzheimer{\textquoteright}s disease and all-cause dementia incidence. Alzheimer{\textquoteright}s disease polygenic score was more strongly linked to incident Alzheimer{\textquoteright}s disease among women, while racial difference in all-cause dementia was explained by other factors including socio-economic status.

}, keywords = {Ageing, Alzheimer{\textquoteright}s disease, Dementia, national surveys, polygenic scores}, issn = {2632-1297}, doi = {10.1093/braincomms/fcac317}, author = {Beydoun, May A and Weiss, Jordan and Banerjee, Sri and Beydoun, Hind A and Noren Hooten, Nicole and Evans, Michele K and Zonderman, Alan B} } @article {12913, title = { Racial Disparities in COVID-19 Experiences among Older Adults with Disabling Conditions}, number = {WP$\#$2022-17}, year = {2022}, institution = {Center for Retirement Research at Boston College}, abstract = {This paper examines the experiences of older adults with disabling conditions during the COVID-19 pandemic using data from the 2020 Health and Retirement Study. It documents the negative health, work, and financial experiences of older adults by disability status, race, and ethnicity. It also explores the intersectionality of race and ethnicity with disability and the role of contextual factors affecting the environments in which people live (e.g., health and economic conditions) using county- and state-level data.}, keywords = {COVID-19, Disabilities, Racial Disparities}, url = {https://crr.bc.edu/working-papers/racial-disparities-in-covid-19-experiences-among-older-adults-with-disabling-conditions/}, author = {Marisa Paige Reed Shenk and Harrati, Amal and Hicks, Bernadette and Qui{\~n}ones, Ana} } @article {JANG2021, title = {Racial/Ethnic Differences in Correspondence between Subjective Cognitive Ratings and Cognitive Impairment}, journal = {The American Journal of Geriatric Psychiatry}, volume = {30}, year = {2022}, pages = {627-635}, abstract = {Objectives : Responding to racial/ethnic disparities in dementia diagnosis and care, we examined the role of race/ethnicity in the correspondence between subjective and objective ratings of cognitive impairment. Our examination focused on the two types of discordance: (1) positive ratings in the presence of cognitive impairment and (2) negative ratings in the absence of cognitive impairment. Design and Participants : A cross-sectional assessment was conducted using the data from the Harmonized Cognitive Assessment Protocol (HCAP) project, a sub-study of the Health and Retirement Study (HRS). Our analytic sample included 3,096 participants: 2,257 non-Hispanic Whites, 498 Blacks, and 341 Hispanics. Measurements : Discordant groups were identified based on self-ratings of cognition (positive vs. negative) and the Langa{\textendash}Weir classification of cognitive impairment (normal vs. impaired). Results : Blacks and Hispanics were more prone to falsely positive perceptions of their cognitive function in the presence of cognitive impairment than non-Hispanic Whites. On the other hand, non-Hispanic Whites were more likely to manifest negative ratings even in the absence of cognitive impairment. Conclusions : Our findings demonstrate the critical role of race/ethnicity in determining discordance between subjective and objective measures of cognition and highlight the importance of a tailored effort to promote dementia diagnosis and care.}, keywords = {cognitive impairment, Dementia, Racial and ethnic minorities, Self-rated cognition}, issn = {1064-7481}, doi = {https://doi.org/10.1016/j.jagp.2021.10.015}, author = {Yuri Jang and William E. Haley and Eun-Young Choi and Yujin Franco} } @article {HAURIN2022100362, title = {The relationship of financial stress with the timing of the initial claim of U.S. Social Security retirement income}, journal = {The Journal of the Economics of Ageing}, volume = {21}, year = {2022}, pages = {100362}, abstract = {A large number of U.S. adults claim Social Security benefits at age 62, substantially earlier than the government specified full retirement age. One implication of an early claim is a reduction in the amount of future monthly benefits. The literature on the timing of Social Security claiming has developed numerous hypotheses to explain this behavior; however, previous empirical work has found few factors are statistically significant explanators of early benefit claims. We propose a new test concerning why some older adults claim Social Security benefits early; specifically, we test whether the level of an individual{\textquoteright}s financial stress prior to the claiming decision is associated with a benefit claim at age 62. Our analysis finds that the greater the level of financial stress prior to claiming, the less likely is claiming, controlling for many aspects of an individual{\textquoteright}s financial, social, and demographic situation. Comparing two individuals, we find that a person with a relatively high level of financial stress is 4 to 7 percentage points more likely to delay claiming Social Security benefits than a person with a low level of financial stress. We also find that earned income moderates the relationship between an individual{\textquoteright}s financial stress and early claiming, where the same increase in financial stress is more likely to result in a delay in claiming for those with higher earnings than those with lower earnings.}, keywords = {Early retirement, financial stress, Social security income}, issn = {2212-828X}, doi = {https://doi.org/10.1016/j.jeoa.2021.100362}, author = {Donald Haurin and Stephanie Moulton and C{\"a}zilia Loibl} } @article {11471, title = {Religious Involvement and Cognitive Functioning at the Intersection of Race/Ethnicity and Gender in Mid-Life and Older Adults.}, journal = {The Journals of Gerontology, Series B }, volume = {77}, year = {2022}, pages = {237-248}, abstract = {

OBJECTIVES: To investigate the association between religious involvement and cognitive functioning at the intersections of race-ethnicity and gender among mid-life and older adults, and to determine if psychosocial factors help explain this relationship.

METHODS: The sample included 14,037 adults aged 50+ from the Health and Retirement Study (HRS). We utilized measures from the HRS 2010 and 2012 Core interviews and Leave Behind questionnaires and estimated our models using linear regression.

RESULTS: Compared to individuals who frequently attended religious services, infrequent religious service attendance was related to poorer cognitive functioning. Religiosity was inversely associated with cognitive functioning at baseline, but the relationship varied by race/gender subgroup. Greater religiosity was associated with better cognitive functioning among Black women, but lower cognitive functioning among White men and women. Psychosocial factors did little to explain the inverse association between religiosity and cognitive functioning.

DISCUSSION: Results suggest the association between religious involvement and cognitive functioning is varied and complex, and largely dependent on important social identities. The findings have important implications for investigating health-protective factors, like religious involvement, using an intersectional perspective.

}, keywords = {cognitive functioning, gender, race, Religion}, issn = {1758-5368}, doi = {10.1093/geronb/gbab034}, author = {Henderson, Andrea K and Katrina M Walsemann and Jennifer A Ailshire} } @article {12274, title = {Responding to Disability Onset in the Late Working Years: What do Older Workers do?}, journal = {Research on Aging}, volume = {44}, year = {2022}, pages = {643-657}, abstract = {

This study uses occupational data from the Health and Retirement Study to document the link between disability onset and occupational transitions among older adults who are working and do not report a disabling condition at age 55. We find that one-quarter of workers go on to experience new disabilities before full-retirement age. Relative to their peers who do not report disabilities, stopping work and significant occupational changes are more common among workers who experience new disabilities. Our results suggest that policies to support labor force attachment might consider the importance of new disability onset and whether employer accommodations might help workers with new disabling conditions remain in the jobs they held when their health began to limit their work.

}, keywords = {Disability, Occupations, Older workers, Transitions, work limitations}, issn = {1552-7573}, doi = {10.1177/01640275221074634}, author = {Jody Schimmel Hyde and Wu, April Yanyuan and Livermore, Gina} } @article {11765, title = {The Role of Social Connection/Engagement in Episodic Memory Change in Stroke.}, journal = {Gerontologist}, volume = {62}, year = {2022}, pages = {364-374}, abstract = {

BACKGROUND AND OBJECTIVES: Positive associations between social connection/engagement and cognitive function are well documented. However, little is known about whether social connection/engagement can buffer the impact of serious brain injury such as stroke on cognitive functioning.

RESEARCH DESIGN AND METHODS: Participants were 898 individuals with incident stroke from the Health and Retirement Study (HRS) between 1998-2012. Multilevel modeling was used to examine how social connection/engagement were associated with episodic memory pre- and post-stroke. Models controlled for age, gender, education, race/ethnicity, number of health conditions, and functional health.

RESULTS: Participants who were lonely pre-stroke recalled significantly fewer words at time of stroke, and participants who had children residing within 10 miles pre-stroke showed significantly less decline in word recall over time. Participants who provided help to others pre-stroke showed less stroke-related decline in word recall. Within-person increase in partnered status, having friends, and helping others were related to better word recall in the post-stroke period.

DISCUSSION AND IMPLICATIONS: Higher pre-stroke levels of social connection/engagement predicted better episodic memory at stroke, smaller decline in episodic memory with stroke, and less decline in episodic memory over time. Increases in social connection/engagement from pre- to post-stroke also predicted better post-stroke episodic memory. Beyond the widely documented benefits of social connection/engagement to well-being, they may also increase cognitive stimulation and cognitive reserve and thus contribute to stroke recovery in the cognitive domain. Social connection/engagement is an important and modifiable risk factor in older adults.

}, keywords = {Cardiovascular accident, Cognition, Cognitive Reserve, Social participation, Word recall}, issn = {1758-5341}, doi = {10.1093/geront/gnab095}, author = {Elayoubi, Joanne and Nelson, Monica E and William E. Haley and Hueluer, Gizem} } @article {12459, title = {A Semiparametric Multiple Imputation Approach to Fully Synthetic Data for Complex Surveys}, journal = {Journal of Survey Statistics and Methodology}, volume = {10}, year = {2022}, pages = {618{\textendash}641}, abstract = {Data synthesis is an effective statistical approach for reducing data disclosure risk. Generating fully synthetic data might minimize such risk, but its modeling and application can be difficult for data from large, complex surveys. This article extended the two-stage imputation to simultaneously impute item missing values and generate fully synthetic data. A new combining rule for making inferences using data generated in this manner was developed. Two semiparametric missing data imputation models were adapted to generate fully synthetic data for skewed continuous variable and sparse binary variable, respectively. The proposed approach was evaluated using simulated data and real longitudinal data from the Health and Retirement Study. The proposed approach was also compared with two existing synthesis approaches: (1) parametric regressions models as implemented in IVEware; and (2) nonparametric Classification and Regression Trees as implemented in synthpop package for R using real data. The results show that high data utility is maintained for a wide variety of descriptive and model-based statistics using the proposed strategy. The proposed strategy also performs better than existing methods for sophisticated analyses such as factor analysis.}, keywords = {parametric regressions model, simulated data, synthetic data}, doi = {https://doi.org/10.1093/jssam/smac016}, author = {Yu, Mandi and He, Yulei and Trivellore E. Raghunathan} } @article {12158, title = {Sick And Tired Of Being Excluded: Structural Racism In Disenfranchisement As A Threat To Population Health Equity.}, journal = {Health Affairs}, volume = {41}, year = {2022}, pages = {219-227}, abstract = {

Theoretical research suggests that racialized felony disenfranchisement-a form of structural racism-is likely to undermine the health of Black people, yet empirical studies on the topic are scant. We used administrative data on disproportionate felony disenfranchisement of Black residents across US states, linked to geocoded individual-level health data from the 2016 Health and Retirement Study, to estimate race-specific regression models describing the relationship between racialized disenfranchisement and health among middle-aged and older adults, adjusting for other individual- and state-level factors. Results show that living in states with higher levels of racialized disenfranchisement is associated with more depressive symptoms, more functional limitations, more difficulty performing instrumental activities of daily living, and more difficulty performing activities of daily living among Black people. However, there are no statistically significant relationships between racialized disenfranchisement and health among White people. These findings suggest that policies aiming to mitigate disproportionate Black felony disenfranchisement not only are essential for political inclusion but also may be valuable tools for improving population health equity.

}, keywords = {administrative data, disenfranchisement, health, race}, issn = {1544-5208}, doi = {10.1377/hlthaff.2021.01414}, author = {Patricia Homan and Brown, Tyson H} } @article {12322, title = {Social Disconnectedness and Loneliness: Do Self-Perceptions of Aging Play a Role?}, journal = {The Journals of Gerontology, Series B }, volume = {77}, year = {2022}, pages = {936-945}, abstract = {

OBJECTIVE: Research suggests that self-perceptions of aging (SPA) have effects on physical, mental, cognitive, and emotional well-being among older adults. Few studies have examined the effects of SPA on social well-being. This study investigates the association of SPA with trajectories of social disconnectedness and loneliness in older Americans and explores mechanisms linking SPA and the two forms of social isolation.

METHOD: We conducted Latent Growth Curve Modeling and path analysis using 3-wave data spanning 8 years (2008/2010 - 2016/2018) from the Health and Retirement Study. The sample included respondents aged 65 and older (N = 3,597) at baseline (2008/2010). SPA was measured by the Attitudes Toward Own Aging Scale. Social disconnectedness was an index including 6 indicators of social networks and social engagement. Loneliness was measured using the 11-item UCLA Loneliness Scale.

RESULTS: Older adults with more negative SPA at baseline were more lonely but had slower rates of increase in loneliness during the 8-year study period. More negative SPA also predicted greater social disconnectedness but was not significantly related to the rate of change in social disconnectedness over time. The effects of SPA on social disconnectedness were primarily indirect through loneliness, whereas SPA had direct effects on loneliness. Overall, SPA had a stronger association with loneliness than with social disconnectedness.

DISCUSSION: The results suggest that older adults with negative SPA are at risk of loneliness which then leads to social disconnectedness. Asking about SPA during individual assessment with older adults may help to discern issues with loneliness.

}, keywords = {Ageism, Loneliness, social isolation, Social networks}, issn = {1758-5368}, doi = {10.1093/geronb/gbac008}, author = {Hu, Rita Xiaochen and Li, Lydia W} } @article {12385, title = {Social Relationships, Wealth, and Cardiometabolic Risk: Evidence from a National Longitudinal Study of U.S. Older Adults.}, journal = {Journal of Aging and Health}, volume = {34}, year = {2022}, pages = {1048-1061}, abstract = {

To investigate multiple dimensions of social relationships related to biomarkers of cardiometabolic health and how their associations vary by wealth in older adults. Growth curve models were used to investigate the longitudinal associations between measures of both positive and negative social relationships and cardiometabolic risk (CMR) over a 10-year period from 2006 to 2016 and the moderation of this association by wealth in the Health and Retirement Study (HRS). Older adults with better social relationships had lower CMR on average. The protective effects of positive social relationships, however, waned at older ages, particularly for low-wealth individuals. Our results suggest that good social relationships promote healthy aging by buffering against harmful cardiometabolic consequences of psychosocial stress, particularly among relatively wealthy individuals. Efforts to improve old age health would be more effective when focusing simultaneously on fostering social connections and boosting financial resources.

}, keywords = {cardiometabolic risk, Social Relationships, Trajectories, Wealth}, issn = {1552-6887}, doi = {10.1177/08982643221087807}, author = {Shartle, Kaitlin and Yang, Yang Claire and Richman, Laura S and Belsky, Daniel W and Aiello, Allison E and Harris, Kathleen Mullan} } @article {12439, title = {Socio-demographic, lifestyle and health characteristics as predictors of self-reported Covid-19 history among older adults: 2006-2020 Health and Retirement Study.}, journal = {American Journal of Infection Control}, volume = {50}, year = {2022}, pages = {482-490}, abstract = {

BACKGROUND: To identify key socio-demographic, lifestyle, and health predictors of self-reported coronavirus disease 2019 (Covid-19) history, examine cardiometabolic health characteristics as predictors of self-reported Covid-19 history and compare groups with and without a history of Covid-19 on trajectories in cardiometabolic health and blood pressure measurements over time, among United States (U.S.) older adults.

METHODS: Nationally representative longitudinal data on U.S. older adults from the 2006-2020 Health and Retirement Study were analyzed using logistic and mixed-effects logistic regression models.

RESULTS: Based on logistic regression, number of household members (OR=1.26, 95\% CI: 1.05, 1.52), depressive symptoms score (OR = 1.21, 95\% CI: 1.04, 1.42) and number of cardiometabolic risk factors or chronic conditions ("1-2" vs "0") (OR = 0.27, 95\% CI: 0.11, 0.67) were significant predictors of self-reported Covid-19 history. Based on mixed-effects logistic regression, several statistically significant predictors of Covid-19 history were identified, including female sex (OR = 3.06, 95\% CI: 1.57, 5.96), other race (OR = 5.85, 95\% CI: 2.37, 14.43), Hispanic ethnicity (OR = 2.66, 95\% CI: 1.15, 6.17), number of household members (OR = 1.25, 95\% CI: 1.10, 1.42), moderate-to-vigorous physical activity (1-4 times per month vs never) (OR = 0.38, 95\% CI: 0.18, 0.78) and number of cardiometabolic risk factors or chronic conditions ("1-2" vs "0") (OR = 0.34, 95\% CI: 0.19, 0.60).

CONCLUSIONS: Number of household members, depressive symptoms and number of cardiometabolic risk factors or chronic conditions may be key predictors for self-reported Covid-19 history among U.S. older adults. In-depth analyses are needed to confirm preliminary findings.

}, keywords = {Cardiovascular Diseases, Chronic disease, COVID-19, ethnicity, Female, Life Style, Retirement, Self Report}, issn = {1527-3296}, doi = {10.1016/j.ajic.2022.02.021}, author = {Beydoun, Hind A and Beydoun, May A and Hossain, Sharmin and Alemu, Brook T and Gautam, Rana S and Weiss, Jordan and Zonderman, Alan B} } @article {12948, title = {Spending Trajectories After Age 65}, number = {RR-A2355-1}, year = {2022}, institution = {RAND Corporation}, address = {Santa Monica, CA}, abstract = {There is a large body of work concerned with the importance of saving for retirement and with developing tools to facilitate and support the accumulation of retirement wealth. Much less attention has been paid to the decumulation phase{\textemdash}that is, the spending down of wealth following retirement. Understanding the decumulation phase requires information about the spending patterns of older households and how those patterns evolve with age. The RAND Corporation has conducted extensive research on spending trajectories of older households. Building on this prior work, the authors provide statistics on household spending and its composition based on longitudinal data from the Health and Retirement Study. They present estimates of the trajectories of spending after age 65 among single and coupled households stratified by wealth holdings observed at or closely following age 65. According to the results, real spending declined for both single and coupled households. The rates of decline varied only modestly across initial wealth quartiles. The fact that spending declines broadly, even among those in the highest wealth quartile, suggests that the decline is not related to economic position. The authors discuss how the estimated trajectories can help with the prediction of households{\textquoteright} spending needs at older ages.}, keywords = {health care cost, Households, Personal finance, Retirement, retirement benefits, socioeconomic status}, doi = {10.7249/RRA2355-1}, author = {Michael D Hurd and Rohwedder, Susann} } @article {RR-A2355-1, title = {Spending Trajectories After Age 65: Variation by Initial Wealth}, number = {RR-A2355-1}, year = {2022}, institution = {RAND Corporation}, address = {Santa Monica, CA}, abstract = {There is a large body of work concerned with the importance of saving for retirement and with developing tools to facilitate and support the accumulation of retirement wealth. Much less attention has been paid to the decumulation phase{\textemdash}that is, the spending down of wealth following retirement. Understanding the decumulation phase requires information about the spending patterns of older households and how those patterns evolve with age. The RAND Corporation has conducted extensive research on spending trajectories of older households. Building on this prior work, the authors provide statistics on household spending and its composition based on longitudinal data from the Health and Retirement Study. They present estimates of the trajectories of spending after age 65 among single and coupled households stratified by wealth holdings observed at or closely following age 65. According to the results, real spending declined for both single and coupled households. The rates of decline varied only modestly across initial wealth quartiles. The fact that spending declines broadly, even among those in the highest wealth quartile, suggests that the decline is not related to economic position. The authors discuss how the estimated trajectories can help with the prediction of households{\textquoteright} spending needs at older ages. }, keywords = {Retirement, Savings, Spending}, doi = {10.7249/RRA2355-1}, author = {Michael D Hurd and Susann Rohwedder} } @article {11677, title = {Structural and Functional Aspects of Social Relationships and Episodic Memory: Between-Person and Within-Person Associations in Middle-Aged and Older Adults.}, journal = {Gerontology}, volume = {68}, year = {2022}, pages = {86-97}, abstract = {

OBJECTIVES: A growing body of research has documented associations between social relationships and cognitive function, while findings are less clear regarding specific aspects of social relationships that are relevant to change in cognitive function. Furthermore, it is unclear whether associations differ at the between-person and within-person levels.

METHOD: The present study used 8-year longitudinal data from the Health and Retirement Study (HRS) to examine the role of structural (partnered/married, number of social network partners, and contact frequency) as well as functional (support, strain, and loneliness) aspects of social relationships for episodic memory at the between-person and within-person levels. Analyses are based on up to 3 waves of data from 19,297 participants (mean age at baseline = 66 years, SD = 10, range = 50-104; 58\% women). Control variables include age at baseline, gender, education, functional health, and depressive symptoms.

RESULTS: Findings showed that at the between-person level, most structural and functional aspects were related to levels of memory performance, with participants with higher numbers of social network members, more frequent contact, and more positive experiences outperforming others. An exception was a higher number of family (child or relative) relationships. At the within-person level, on occasions where participants had a higher number of close family relationships than usual, had more social contact than usual, and felt less lonely than usual, they also showed higher than usual episodic memory performance. Finally, negative effects of social strain and loneliness on episodic memory performance at the between-person level were moderated by social network size, indicating that effects were more negative among individuals with larger social networks.

DISCUSSION: Both structural and functional aspects of social relationships contribute to between-person differences in levels and fluctuations of episodic memory performance. Ups and downs of relationships to relatives, social contact, and feelings of loneliness contribute to ups and downs of episodic memory. Potential mechanisms underlying these associations are discussed.

}, keywords = {Episodic Memory, longitudinal change, Social networks, Social Relationships, Social Support}, issn = {1423-0003}, doi = {10.1159/000514949}, author = {H{\"u}l{\"u}r, Gizem} } @article {12797, title = {Study estimates the burden of dementia among older adults in the U.S.}, year = {2022}, publisher = {News-Medical.Net}, keywords = {cognitive impairment, Dementia, HCAP}, url = {https://www.news-medical.net/news/20221024/Study-estimates-the-burden-of-dementia-among-older-adults-in-the-US.aspx}, author = {Henderson, Emily} } @article {12571, title = {Subjective Age and Falls in Older Age: Evidence from two Longitudinal Cohorts.}, journal = {The Journals of Gerontology, Series B }, volume = {77}, year = {2022}, pages = {1814-1819}, abstract = {

OBJECTIVES: Falls are a common and serious health problem. The present study examined the association between subjective age (i.e., feeling younger or older than one{\textquoteright}s chronological age) and falls in two large national samples.

METHOD: Participants, aged 65 to 105 years old, were drawn from the National Health and Aging Trends Study (NHATS) and the Health and Retirement Study (HRS). Data on falls, subjective age, demographic factors, was available from 2,382 participants in HRS and 3,449 in NHATS. Falls were tracked for up to 8 (HRS) and 7 (NHATS) years.

RESULTS: Cox regression analyses that included demographic covariates indicated that older subjective age increased the risk of falling in HRS (hazard ratio [HR]=1.17, 95\% confidence interval [CI]=1.08-1.27), and in NHATS (HR=1.06, 95\%CI=1.00-1.13). When compared to people who felt younger, people who reported an older subjective age had a higher risk of fall (HRS: HR=1.65, 95\% CI=1.33-2.04; NHATS: HR=1.44, 95\% CI=1.15-1.79). The associations remained significant after accounting for depressive symptoms, handgrip strength, chronic diseases, and cognitive impairment in HRS only.

DISCUSSION: These results confirm the role of subjective age as an important health marker in the aging population. Subjective age assessment can help identify individuals at greater risk of falls.

}, keywords = {falling, Felt age, Survival Analysis}, issn = {1758-5368}, doi = {10.1093/geronb/gbac094}, author = {Fundenberger, Herv{\'e} and Stephan, Yannick and Terracciano, Antonio and Dupr{\'e}, Caroline and Bongue, Bienvenu and Hupin, David and Barth, Nathalie and Canada, Brice} } @article {12751, title = {Time to dementia diagnosis by race: a retrospective cohort study.}, journal = {Journal of the American Geriatrics Society}, year = {2022}, abstract = {

BACKGROUND: Non-Hispanic Black individuals may be less likely to receive a diagnosis of dementia compared to non-Hispanic White individuals. These findings raise important questions regarding which factors may explain this observed association and any differences in the time to which disparities emerge following dementia onset.

METHODS: We conducted a retrospective cohort study using survey data from the 1995 to 2016 Health and Retirement Study linked with Medicare fee-for-service claims. Using the Hurd algorithm (a regression-based approach), we identified dementia onset among older adult respondents (age >=65 years) from the Telephone Interview for Cognitive Status and proxy respondents. We determined date from dementia onset to diagnosis using Medicare data up to 3 years following onset using a list of established diagnosis codes. Cox Proportional Hazards modeling was used to examine the association between an individual{\textquoteright}s reported race and likelihood of diagnosis after accounting for sociodemographic characteristics, income, education, functional status, and healthcare use.

RESULTS: We identified 3435 older adults who experienced a new onset of dementia. Among them, 30.1\% received a diagnosis within 36 months of onset. In unadjusted analyses, the difference in cumulative proportion diagnosed by race continued to increase across time following onset, p-value <0.001. 23.8\% of non-Hispanic Black versus 31.4\% of non-Hispanic White participants were diagnosed within 36 months of dementia onset, Hazard Ratio~=~0.73 (95\% CI: 0.61, 0.88). The association persisted after adjustment for functional status and healthcare use; however, these factors had less of an impact on the strength of the association than income and level of education.

CONCLUSION: Lower diagnosis rates of dementia among non-Hispanic Black individuals persists after adjustment for sociodemographic characteristics, functional status, and healthcare use. Further understanding of barriers to diagnosis that may be related to social determinants of health is needed to improve dementia-related outcomes among non-Hispanic Black Americans.

}, keywords = {Dementia, Diagnosis, Disparities, Medicare, race}, issn = {1532-5415}, doi = {10.1111/jgs.18078}, author = {Davis, Matthew A and Lee, Kathryn A and Harris, Melissa and Ha, Jinkyung and Kenneth M. Langa and Bynum, Julie P W and Hoffman, Geoffrey J} } @article {12487, title = {The trajectories of depressive symptoms and subsequent incident dementia, coronary heart diseases, stroke and all-cause mortality.}, journal = {Journal of Affective Disorders}, volume = {312}, year = {2022}, pages = {9-16}, abstract = {

BACKGROUND: Evidence suggests the occurrence of depressive symptoms in mid- to late-life inflates the risk for ageing-related morbidity compared to people without depressive symptoms. The eventual association between depressive symptoms in mid- to late-life and long-term (over 10-year) risks for incident dementia, coronary heart disease (CHD), stroke, and morbidity is to be established.

METHODS: This longitudinal cohort study utilized Health and Retirement Study (HRS) of U.S residents aged~>=~50~years who were interviewed every 2-year during follow-up (average follow-up: 11.6~{\textpm}~2.85~years). Trajectories of depressive symptoms were assessed by the Center for Epidemiologic Studies Depression (CES-D) scale from 1994 to 2000 at baseline. Incident dementia, CHD, stroke and all-cause mortality were determined from 2000 to 2018.

RESULTS: Among 7810 individuals who were free from dementia, CHD and stroke, five trajectories of depressive symptoms were identified: non-depressed (36.7~\%), mild (48.8~\%), worsening (7.8~\%), improving (4.1~\%) and persistent (2.7~\%). Compared with those in the non-depressed group, participants with mild, worsening and persistent depressive symptoms had significantly greater hazards of incident dementia (multivariable adjusted hazard ratios and 95~\% confidence intervals: 1.32 [1.17-1.48], 1.58 [1.30-1.93], 2.82 [2.17-3.67], respectively), CHD (1.13 [1.03-1.24], 1.47 [1.25-1.73], 1.34 [1.03-1.74], respectively), stroke (1.30 [1.12-1.52], 1.58 [1.23-2.04], 1.71 [1.16-2.53], respectively) and all-cause mortality (1.17 [1.07-1.27], 1.46 [1.27-1.68], 1.66 [1.35-2.06], respectively). The hazards of incident events, except for CHD, were not significantly greater in individuals with improving depressive symptoms.

CONCLUSIONS: The present findings suggest even sub-clinical threshold depressive symptoms were associated with the hazards of ageing related diseases while such associations were not significant with managed depressive symptoms.

}, keywords = {Dementia, depressive disorders, Mental Health, Population Health}, issn = {1573-2517}, doi = {10.1016/j.jad.2022.06.001}, author = {Wu, Tao and Li, Chenglong and Zhu, Yidan and Ma, Yanjun and Hua, Rong and Zhong, Baoliang and Xie, Wuxiang} } @article {12291, title = {Trajectories of Frailty With Aging: Coordinated Analysis of Five Longitudinal Studies.}, journal = {Innovation In Aging}, volume = {6}, year = {2022}, pages = {igab059}, abstract = {

Background and Objectives: There is an urgent need to better understand frailty and its predisposing factors. Although numerous cross-sectional studies have identified various risk and protective factors of frailty, there is a limited understanding of longitudinal frailty progression. Furthermore, discrepancies in the methodologies of these studies hamper comparability of results. Here, we use a coordinated analytical approach in 5 independent cohorts to evaluate longitudinal trajectories of frailty and the effect of 3 previously identified critical risk factors: sex, age, and education.

Research Design and Methods: We derived a frailty index (FI) for 5 cohorts based on the accumulation of deficits approach. Four linear and quadratic growth curve models were fit in each cohort independently. Models were adjusted for sex/gender, age, years of education, and a sex/gender-by-age interaction term.

Results: Models describing linear progression of frailty best fit the data. Annual increases in FI ranged from 0.002 in the Invecchiare in Chianti cohort to 0.009 in the Longitudinal Aging Study Amsterdam (LASA). Women had consistently higher levels of frailty than men in all cohorts, ranging from an increase in the mean FI in women from 0.014 in the Health and Retirement Study cohort to 0.046 in the LASA cohort. However, the associations between sex/gender and rate of frailty progression were mixed. There was significant heterogeneity in within-person trajectories of frailty about the mean curves.

Discussion and Implications: Our findings of linear longitudinal increases in frailty highlight important avenues for future research. Specifically, we encourage further research to identify potential effect modifiers or groups that would benefit from targeted or personalized interventions.

}, keywords = {Age-related changes, Frailty, Latent growth curve}, issn = {2399-5300}, doi = {10.1093/geroni/igab059}, author = {Jenkins, Natalie D and Hoogendijk, Emiel O and Armstrong, Joshua J and Lewis, Nathan A and Ranson, Janice M and Rijnhart, Judith J M and Ahmed, Tamer and Ghachem, Ahmed and Mullin, Donncha S and Ntanasi, Eva and Welstead, Miles and Auais, Mohammad and Bennett, David A and Bandinelli, Stefania and Cesari, Matteo and Ferrucci, Luigi and French, Simon D and Huisman, Martijn and Llewellyn, David J and Scarmeas, Nikolaos and Piccinin, Andrea M and Hofer, Scott M and Muniz-Terrera, Graciela} } @article {11734, title = {Trends in Dementia Prevalence, Incidence, and Mortality in the United States (2000-2016).}, journal = {Journal of Aging and Health}, volume = {34}, year = {2022}, pages = {100-108}, abstract = {

The prevalence of dementia has declined in the United States; how this parallels to changes in incidence and mortality, and how improvements in educational attainment may have influences these trends, is not known. Using the Health and Retirement Study (2000-2016), we estimated logistic regression models to examine trends in dementia prevalence and incidence, and mortality for those with and without dementia. The relative decline was about 2.4\% per year for dementia prevalence and 1.9\% for dementia incidence. Mortality declined similarly for those with and without dementia. Improved educational attainment accounted for decline in incidence, some of the decline in prevalence, and had a negligible role in mortality. The declines in dementia incidence provide evidence that dementia prevalence should continue to decline in the near future. These declines are most likely largely driven by continued improvements in older adult education.

}, keywords = {dementia incidence, educational composition}, issn = {1552-6887}, doi = {10.1177/08982643211029716}, author = {Mateo P Farina and Yuan S Zhang and Jung K Kim and Mark D Hayward and Eileen M. Crimmins} } @article {12328, title = {Trends in Health in Midlife and Late Life.}, journal = {Journal of Human Capital}, volume = {16}, year = {2022}, pages = {133-156}, abstract = {

Gains in life expectancy have recently slowed and mortality inequalities have increased. This paper examines whether trends in health observed at ages 55 to 89 mirror those trends in mortality, which may serve as an early indicator for the future evolution of mortality. We found that many health outcomes have worsened from 1992 to 2016, especially at ages below 70, and that differentials in health between low and high education groups have increased among the more recent cohorts. Overall the findings cast a pessimistic light on the future evolution of mortality rates and mortality inequalities.

}, keywords = {Diabetes, Education, Obesity, pain, Smoking}, issn = {1932-8575}, doi = {10.1086/717542}, author = {Hudomiet, P{\'e}ter and Michael D Hurd and Rohwedder, Susann} } @article {12809, title = {Trends in inequalities in the prevalence of dementia in the United States.}, journal = {PNAS}, volume = {119}, year = {2022}, pages = {e2212205119}, abstract = {

This paper presents estimates of the prevalence of dementia in the United States from 2000 to 2016 by age, sex, race and ethnicity, education, and a measure of lifetime earnings, using data on 21,442 individuals aged 65 y and older and 97,629 person-year observations from a nationally representative survey, the Health and Retirement Study (HRS). The survey includes a range of cognitive tests, and a subsample underwent clinical assessment for dementia. We developed a longitudinal, latent-variable model of cognitive status, which we estimated using the Markov Chain Monte Carlo method. This model provides more accurate estimates of dementia prevalence in population subgroups than do previously used methods on the HRS. The age-adjusted prevalence of dementia decreased from 12.2\% in 2000 (95\% CI, 11.7 to 12.7\%) to 8.5\% in 2016 (7.9 to 9.1\%) in the 65+ population, a statistically significant decline of 3.7 percentage points or 30.1\%. Females are more likely to live with dementia, but the sex difference has narrowed. In the male subsample, we found a reduction in inequalities across education, earnings, and racial and ethnic groups; among females, those inequalities also declined, but less strongly. We observed a substantial increase in the level of education between 2000 and 2016 in the sample. This compositional change can explain, in a statistical sense, about 40\% of the reduction in dementia prevalence among men and 20\% among women, whereas compositional changes in the older population by age, race and ethnicity, and cardiovascular risk factors mattered less.

}, keywords = {Dementia, Educational Status, ethnicity, Prevalence, Retirement}, issn = {1091-6490}, doi = {10.1073/pnas.2212205119}, author = {Hudomiet, P{\'e}ter and Michael D Hurd and Rohwedder, Susann} } @article {12874, title = {Understanding cognitive impairment in the U.S. through the lenses of intersectionality and (un)conditional cumulative (dis)advantage}, number = {WP 2022-029}, year = {2022}, institution = {Max Planck Institute}, abstract = {Grounded in theories of intersectionality and cumulative (dis)advantage, we develop complementary formalizations of (dis)advantage to study disparities in cognitive impairment: Conditional Cumulative (Dis)Advantage that reflects inequalities in outcomes and Unconditional Cumulative (Dis)Advantage that additionally accounts for inequalities in opportunities. We study the properties of these formalizations and show that cumulative disadvantage does not imply cumulative advantage. Using these formalizations and incidence-based multistate models, we analyze the Health and Retirement Study to assess how racial/ethnic, nativity, gender, early-life adversity, and educational (dis)advantages accumulate into three important metrics for characterizing later-life cognitive impairment{\textemdash}lifetime risk, mean age at first impairment, and cognitive health expectancies. We find that the benefits and penalties of one (dis)advantage depend on positionality on the other axes of inequality. Black women and Latinas experience Conditional Cumulative Disadvantage in cognitive impairment: they are penalized more from having lower education than Whites. White men experience Conditional Cumulative Advantage: they benefit more from higher education than Blacks or Latinx. However, when accounting for racial/ethnic inequities in educational opportunities, results ubiquitously show Unconditional Cumulative Disadvantage. Our formalization provides a mathematical grounding for cumulative (dis)advantage, and the empirical results comprehensively document the multi-dimensional, intersecting axes of stratification that perpetuate inequities in cognitive impairment.}, keywords = {cognitive impairment, cumulative (dis)advantage, Dementia, Education, Health Disparities, Intersectionality}, doi = {10.4054/MPIDR-WP-2022-029}, author = {Jo Mhairi Hale and Daniel C Schneider and Neil K Mehta and Mikko Myrskyl{\"a}} } @article {12736, title = {Undiagnosed Dementia Is Associated with Poor Physical Function in Older Adults.}, journal = {Journal of Alzheimers Disease}, volume = {89}, year = {2022}, month = {2022}, pages = {473-482}, abstract = {

BACKGROUND: Older adults with a cognitive impairment, including those not yet diagnosed, may have deficits in their physical function.

OBJECTIVE: We sought to determine the associations of cognitive impairment consistent with dementia (CICD) diagnosis status on handgrip strength, gait speed, and functional disability in older adults.

METHODS: The analytical sample included 8,383 adults aged >=65-years without history of stroke, cancers, neurological conditions, or brain damage who participated in at least one-wave of the 2010-2016 waves of the Health and Retirement Study. A handgrip dynamometer measured handgrip strength. Men with handgrip strength <26 kg and women <16 kg were weak. Gait speed was timed across a 2.5-m course and those with slowness had gait speed <0.8 m/s. Participants with difficulty or an inability in completing any basic activities of daily living had a functional disability. The adapted Telephone Interview of Cognitive Status evaluated cognitive function. Persons with scores <7 had a CICD. Healthcare provider dementia-related diagnosis was self-reported. Undiagnosed CICD was defined as no reported dementia-related diagnosis but had CICD, while diagnosed CICD was classified as reporting a dementia-related diagnosis. Covariate-adjusted logistic models were used for the analyses.

RESULTS: Persons with undiagnosed CICD had 1.37 (95\% confidence interval (CI): 1.04-1.80) greater odds for weakness and 2.02 (CI: 1.39-2.94) greater odds for slow gait speed. Older adults with diagnosed CICD had 2.29 (CI: 1.32-3.97) greater odds for slowness and 1.85 (CI: 1.19-2.90) greater odds for functional disability.

CONCLUSION: Screening for CICD could be recommended when defects in physical function are observed in older adults.

}, keywords = {Activities of Daily Living, Cognitive Dysfunction, Dementia, Hand Strength, walking speed}, issn = {1875-8908}, doi = {10.3233/JAD-220257}, author = {McGrath, Ryan and Robinson-Lane, Sheria G and Klawitter, Lukus and Rhee, Yeong and Hamm, Jeremy M and McCourt, Mark E and Parker, Kelly and Hackney, Kyle J} } @article {11249, title = {Urban and Rural Differences in Trajectories of Depressive Symptoms in Later Life in the United States.}, journal = {Journal of Applied Gerontology}, volume = {41}, year = {2022}, pages = {148-157}, abstract = {

OBJECTIVE: This research has two primary goals: to examine the relationship between urban residence and trajectories of depressive symptoms and to investigate whether this relationship differs by social isolation and loneliness.

METHOD: Data are from 2006, 2008, 2010, 2012, 2014, and 2016 waves of the Health and Retirement Study (HRS), a nationally representative sample of U.S. adults aged 51+ ( = 3,346 females and 2,441 males). We conduct latent growth curve analysis to predict both baseline and trajectories of depression based on urban or rural residency.

RESULTS: Residing in urban or rural areas is neither significantly associated with baseline nor the development of late-life depressive symptoms. For females, the relationship between urban residence and baseline depressive symptoms is explained by socioeconomic factors.

DISCUSSION: Findings of this study serve to better understand how social and geographic contexts shape long-term well-being of older adults.

}, keywords = {age-based growth curve, Depressive symptoms, geographic differences, later life, rurality}, issn = {1552-4523}, doi = {10.1177/0733464820972527}, author = {Sun, Na and Cassandra L. Hua and Qiu, Xiao and J Scott Brown} } @article {12705, title = {Using dynamic microsimulation to project cognitive function in the elderly population.}, journal = {PLoS One}, volume = {17}, year = {2022}, pages = {e0274417}, abstract = {

BACKGROUND: A long-term projection model based on nationally representative data and tracking disease progression across Alzheimer{\textquoteright}s disease continuum is important for economics evaluation of Alzheimer{\textquoteright}s disease and other dementias (ADOD) therapy.

METHODS: The Health and Retirement Study (HRS) includes an adapted version of the Telephone Interview for Cognitive Status (TICS27) to evaluate respondents{\textquoteright} cognitive function. We developed an ordered probit transition model to predict future TICS27 score. This transition model is utilized in the Future Elderly Model (FEM), a dynamic microsimulation model of health and health-related economic outcomes for the US population. We validated the FEM TICS27 model using a five-fold cross validation approach, by comparing 10-year (2006-2016) simulated outcomes against observed HRS data.

RESULTS: In aggregate, the distribution of TICS27 scores after ten years of FEM simulation matches the HRS. FEM{\textquoteright}s assignment of cognitive/mortality status also matches those observed in HRS on the population level. At the individual level, the area under the receiver operating characteristic (AUROC) curve is 0.904 for prediction of dementia or dead with dementia in 10 years, the AUROC for predicting significant cognitive decline in two years for mild cognitive impairment patients is 0.722.

CONCLUSIONS: The FEM TICS27 model demonstrates its predictive accuracy for both two- and ten-year cognitive outcomes. Our cognition projection model is unique in its validation with an unbiased approach, resulting in a high-quality platform for assessing the burden of cognitive decline and translating the benefit of innovative therapies into long-term value to society.

}, keywords = {Alzheimer disease, Cognition, Cognitive Dysfunction, Neuropsychological tests, ROC Curve}, issn = {1932-6203}, doi = {10.1371/journal.pone.0274417}, author = {Wei, Yifan and Heun-Johnson, Hanke and Tysinger, Bryan} } @article {11682, title = {Volunteering Dynamics and Life Satisfaction: Self-Perceptions of Aging as a Buffer.}, journal = {The Journals of Gerontology: Series B }, volume = {72}, year = {2022}, pages = {321-331}, abstract = {

OBJECTIVES: Research has extensively documented the concurrent benefits of being a volunteer (versus a non-volunteer), but little is known about older adults who once served as a volunteer but then stopped at some point in their lives (i.e., former volunteers). The current study tracked changes in older adults{\textquoteright} overall life satisfaction and compared these changes among former volunteers, continuous volunteers, and continuous non-volunteers. We also examined whether self-perceptions of aging may serve as a long-term psychological buffer and protect former volunteers{\textquoteright} life satisfaction after they quit volunteering.

METHOD: Data were from the Health and Retirement Study (2006-2016). A pooled sample of participants age 50+ (N = 10,441) indicated volunteer behaviors every other year, and we identified volunteering dynamics based on their volunteering history across 4 waves (8 years). Participants reported on self-perceptions of aging and life satisfaction in the Leave Behind Questionnaire once every 4 years.

RESULTS: Continuous volunteers reported greater subsequent life satisfaction than former volunteers and continuous non-volunteers 4 years later, when we adjusted for their baseline life satisfaction. Yet, the difference between continuous volunteers and former volunteers was absent among participants with more positive self-perceptions of aging.

DISCUSSION: This study reveals a potential discontinuity in the benefits of volunteering as older adults transition out of their volunteer activities. Findings, however, also reveal individual differences by self-perceptions of aging, offering suggestive evidence that may refine interventions to prolong the benefits of volunteering.

}, keywords = {age stereotype, cessation, Subjective well-being, volunteer}, issn = {1758-5368}, doi = {10.1093/geronb/gbab104}, author = {Huo, Meng and Kim, Kyungmin} } @article {11612, title = {Within-Person Associations of Self-Reports of Memory Impairment and Depressive Symptoms in Older Adults: Moderation of Relationships Over Time by Personality.}, journal = {The Journals of Gerontology: Series B }, volume = {77}, year = {2022}, pages = {300-311}, abstract = {

OBJECTIVES: The current study examined within-person associations of self-reports of impaired current memory functioning and perceived decline with depressive symptoms in older adults without cognitive impairment, and whether these associations were moderated by individuals{\textquoteright} levels of neuroticism, conscientiousness, and extraversion.

METHODS: Samples were drawn from the Einstein Aging Study (EAS), Rush Memory and Aging Project (MAP), Minority Aging Research Study (MARS), Health and Retirement Study (HRS), and National Health and Aging Trends Study (NHATS), with over 8,000 participants (65+ years) included across datasets. In a series of coordinated analyses, multilevel linear models tested within-person relationships over periods of up to 22 years.

RESULTS: Across HRS and NHATS samples, self-reports of impaired current memory functioning covaried with depressive symptoms over time. This association was moderated by neuroticism, such that the association was stronger for individuals with higher levels of neuroticism. Across all samples, perceived memory decline covaried with depressive symptoms over time. This association was moderated by neuroticism in MAP/MARS, HRS, and NHATS, such that the association was stronger for individuals with higher levels of neuroticism.

DISCUSSION: Self-reports of impaired current memory functioning and perceived memory decline are important determinants of older adults{\textquoteright} psychological well-being. In our results, at times when older adults perceive poorer memory functioning or decline, they also tend to report more depressive symptoms. Further, results from two larger datasets suggest that individuals{\textquoteright} level of neuroticism may determine the extent to which self-reports of memory impairment and depressive symptoms covary over time.

}, keywords = {coordinated analyses, multilevel linear modeling, within-person associations}, issn = {1758-5368}, doi = {10.1093/geronb/gbab080}, author = {Mogle, Jacqueline and Nikki L Hill and Bratlee-Whitaker, Emily and Bhargava, Sakshi} } @article {12204, title = {The 2020 report of The Lancet Countdown on health and climate change: responding to converging crises.}, journal = {Lancet}, volume = {397}, year = {2021}, pages = {129-170}, keywords = {Climate Change, Conservation of Natural Resources, COVID-19, Extreme Weather, Global Health, health policy, Humans, International Cooperation, Pandemics, SARS-CoV-2}, issn = {1474-547X}, doi = {10.1016/S0140-6736(20)32290-X}, author = {Watts, Nick and Amann, Markus and Arnell, Nigel and Ayeb-Karlsson, Sonja and Beagley, Jessica and Belesova, Kristine and Boykoff, Maxwell and Byass, Peter and Cai, Wenjia and Campbell-Lendrum, Diarmid and Capstick, Stuart and Chambers, Jonathan and Coleman, Samantha and Dalin, Carole and Daly, Meaghan and Dasandi, Niheer and Dasgupta, Shouro and Davies, Michael and Di Napoli, Claudia and Dominguez-Salas, Paula and Drummond, Paul and Dubrow, Robert and Ebi, Kristie L and Eckelman, Matthew and Ekins, Paul and Escobar, Luis E and Georgeson, Lucien and Golder, Su and Grace, Delia and Graham, Hilary and Haggar, Paul and Hamilton, Ian and Hartinger, Stella and Hess, Jeremy and Hsu, Shih-Che and Hughes, Nick and Jankin Mikhaylov, Slava and Marcia P Jimenez and Kelman, Ilan and Kennard, Harry and Kiesewetter, Gregor and Kinney, Patrick L and Kjellstrom, Tord and Kniveton, Dominic and Lampard, Pete and Lemke, Bruno and Liu, Yang and Liu, Zhao and Lott, Melissa and Lowe, Rachel and Martinez-Urtaza, Jaime and Maslin, Mark and McAllister, Lucy and McGushin, Alice and McMichael, Celia and Milner, James and Moradi-Lakeh, Maziar and Morrissey, Karyn and Munzert, Simon and Murray, Kris A and Neville, Tara and Nilsson, Maria and Sewe, Maquins Odhiambo and Oreszczyn, Tadj and Otto, Matthias and Owfi, Fereidoon and Pearman, Olivia and Pencheon, David and Quinn, Ruth and Rabbaniha, Mahnaz and Robinson, Elizabeth and Rockl{\"o}v, Joacim and Romanello, Marina and Semenza, Jan C and Sherman, Jodi and Shi, Liuhua and Springmann, Marco and Tabatabaei, Meisam and Taylor, Jonathon and Tri{\~n}anes, Joaquin and Shumake-Guillemot, Joy and Vu, Bryan and Wilkinson, Paul and Winning, Matthew and Gong, Peng and Montgomery, Hugh and Costello, Anthony} } @article {11532, title = {Acceleration of health deficit accumulation in late-life: Evidence of terminal decline in frailty index three years before death in the US Health and Retirement Study}, journal = {Annals of Epidemiology}, volume = {58}, year = {2021}, pages = {156-161}, abstract = {BackgroundLittle is known about within-person frailty index (FI) changes during the last years of life. In this study, we assess whether there is a phase of accelerated health deficit accumulation (terminal health decline) in late-life.Material and methods23,393 observations from up to the last 21 years of life of 5,713 deceased participants of the AHEAD cohort in the Health and Retirement Study were assessed. A FI with 32 health deficits was calculated for up to 10 successive biannual, self- and proxy-reported assessments (1995-2014), and FI changes according to time-to-death were analyzed with a piecewise linear mixed model with random change points.ResultsThe average normal (pre-terminal) health deficit accumulation rate was 0.01 per year, which increased to 0.05 per year at approximately 3 years before death. Terminal decline began earlier in women and was steeper among men. The accelerated (terminal) rate of health deficit accumulation began at a FI-value of 0.29 in the total sample, 0.27 for men, and 0.30 for women.ConclusionWe found evidence for an observable terminal health decline in the FI following declining physiological reserves and failing repair mechanisms. Our results suggest a conceptually meaningful cut-off value for the continuous FI around 0.30.}, keywords = {Aged, aged 80 and over, Death, Frailty, Geriatrics, repeated rounds of survey}, isbn = {1047-2797}, doi = {10.1016/j.annepidem.2021.03.008}, author = {Stolz, Erwin and Mayerl, Hannes and Emiel O Hoogendijk and Armstrong, Joshua J. and Roller-Wirnsberger, Regina and Wolfgang Freidl} } @article {11372, title = {Acknowledging Systemic Discrimination in the Context of a Pandemic: Advancing an Anti-Racist and Anti-Ageist Movement.}, journal = {Journal of Gerontological Social Work}, volume = {64}, year = {2021}, pages = {223-237}, abstract = {

This commentary draws together the confluence of current events - COVID-19 pandemic and racial injustice. Vulnerability to COVID-19 cannot be understood by age alone but within the context of inequity. We first review how COVID-19 has disproportionately affected Black and Latinx populations across the life span with the latest data from New~York City Department of Health. We then discuss critical race theory and analyze longstanding inequities in health, economic, and social conditions that heighten the risk for vulnerability. We conclude with a discussion for the social work profession on the issues of defunding the police to undoing stereotypes.

}, keywords = {COVID-19, Health Disparities, systemic racism}, issn = {1540-4048}, doi = {10.1080/01634372.2020.1870604}, author = {Gonzales, Ernest and Gordon, Stacey and Whetung, Cliff and Connaught, Gerri and Collazo, Jasmin and Hinton, Jill} } @article {11653, title = {Activity Limitations and Depressive Symptoms Among Older Couples: The Moderating Role of Spousal Care.}, journal = {The Journals of Gerontology: Series B }, volume = {76}, year = {2021}, pages = {360-369}, abstract = {

OBJECTIVES: Limitations in performing basic daily activities, as well as spousal caregiving that arises from activity limitations, are important factors that have ramifications for mental health among couples. The objective of this study was to investigate the interplay of these factors by focusing on whether the associations between activity limitations and depressive symptoms among coupled-individuals were moderated by receipt and provision of spousal care.

METHODS: Longitudinal household data from the Health and Retirement Study (2004-2014; dyad N = 6,614) were analyzed to estimate within-person associations between one{\textquoteright}s own and spousal activity limitations, receipt and provision of spousal care, and depressive symptoms.

RESULTS: Findings showed a consistent link between one{\textquoteright}s own activity limitations and depressive symptoms for both spouses, whereas spousal activity limitations were associated with depressive symptoms for wives only. We also found moderating effects of spousal care in the link between one{\textquoteright}s own and spousal activity limitations and depressive symptoms.

DISCUSSION: Receipt and provision of activities of daily living-related assistance may contextualize the association between activity limitations and depressive symptoms among older coupled-individuals in a direction that could alleviate or aggravate the risk of depression.

}, keywords = {Activities of Daily Living, Caregiving, Disability, instrumental support}, issn = {1758-5368}, doi = {10.1093/geronb/gbz161}, author = {Sae Hwang Han and Kim, Kyungmin and Jeffrey A Burr} } @article {11792, title = {The age profile of life satisfaction after age 65 in the U.S.}, journal = {Journal of Economic Behavior \& Organization}, volume = {189}, year = {2021}, pages = {431-442}, abstract = {Although income and wealth are frequently used as indicators of well-being, they are increasingly augmented with subjective measures such as life satisfaction to capture broader dimensions of the well-being of individuals. Based on large surveys of individuals, life satisfaction in cross-section often is found to increase with age beyond retirement into advanced old age. It may seem puzzling that average life satisfaction does not decline at older ages because older individuals are more likely to experience chronic or acute health conditions, or the loss of a spouse. Accordingly, this empirical pattern has been called the {\textquotedblleft}paradox of well-being.{\textquotedblright} We examine the age profile of life satisfaction of the U.S. population age 65 or older in the Health and Retirement Study (HRS), and find that in cross-section it increases between age 65 and 71 and is flat thereafter; but based on the longitudinal dimension of the HRS, life satisfaction significantly declines with age and the rate of decline accelerates with age. We reconcile the cross-section and longitudinal measurements by showing that both differential mortality and differential non-response bias the cross-sectional age profile upward: individuals with higher life satisfaction and in better health tend to live longer, and, among survivors, individuals with higher life satisfaction are more likely to remain in the survey, masking the decline in life satisfaction experienced by individuals as they age. We conclude that the optimistic view about increasing life satisfaction at older ages based on cross-sectional data is not warranted.}, keywords = {Differential mortality, Differential non-response, health, Subjective well-being, Widowing}, isbn = {0167-2681}, doi = {10.1016/j.jebo.2021.07.002}, author = {P{\'e}ter Hudomiet and Michael D Hurd and Susann Rohwedder} } @article {12049, title = {THE ALIGNMENT BETWEEN SELF-REPORTED AND ADMINISTRATIVE MEASURES OF APPLICATION TO AND RECEIPT OF FEDERAL DISABILITY BENEFITS IN THE HEALTH AND RETIREMENT STUDY}, number = {WP$\#$2021-26}, year = {2021}, institution = {Center for Retirement Research at Boston College}, address = {Chestnut Hill, MA}, abstract = {This paper examines the alignment between self-reported and administrative records of applications to and receipt of federal disability benefits. It uses data from the Health and Retirement Study (HRS), specifically the cross-wave consistent version developed by the RAND Corporation. The HRS has surveyed adults over the age of 50 every other year since 1992 to be nationally representative of the non-institutionalized older adult population, replenishing the sample with a new cohort every six years. The HRS asks respondents periodically if they are willing to have their survey information linked to earnings and benefits information maintained by the U.S. Social Security Administration (SSA). Most respondents agree to the linkage, which provides another source of information about application and receipt patterns for Social Security Disability Insurance (SSDI) and Supplemental Security Income (SSI) than the data that is collected from respondents in the survey. This information may be valuable in understanding disability program participation among older workers and the extent to which survey respondents accurately report their benefit receipt. Using information in the HRS linked to SSA{\textquoteright}s Form 831 records about disability benefit applications and its Disability Analysis File about benefit receipt, the paper compares survey and administrative reports of having ever applied to SSDI and SSI as well as the receipt of those benefits in each HRS survey wave from 1996 through 2016. It presents statistics on the characteristics of HRS respondents based on whether they consented to have their records linked to administrative files as well as whether those who consented to the linkage accurately reported their benefits status. The analyses make comparisons by calendar year and HRS sampling cohort, as well as by each age from 51 through full retirement age. An appendix to the paper offers a primer for other researchers considering using the HRS-SSA linked data.}, keywords = {administrative data, self-reported, Social Security Disability Insurance, Supplemental Security Income}, url = {https://crr.bc.edu/working-papers/the-alignment-between-self-reported-and-administrative-measures-of-application-to-and-receipt-of-federal-disability-benefits-in-the-health-and-retirement-study/}, author = {Jody Schimmel Hyde and Harrati, Amal} } @article {https://doi.org/10.1002/alz.050784, title = {Analysis of pleiotropic genetic effects on cognitive decline and systemic inflammation in the Women{\textquoteright}s Health Initiative Memory Study}, journal = {Alzheimer{\textquoteright}s \& Dementia}, volume = {17}, year = {2021}, pages = {e050784}, abstract = {Background SNPs associated with C-reactive protein (CRP) and plasma lipids have been investigated for polygenic overlap with Alzheimer{\textquoteright}s disease (AD) risk SNPs. Previously, we reported pleiotropic effects between SNPs associated with cognitive impairment (CI) and SNPs associated with systemic inflammation as measured by CRP and plasma lipids in the Health and Retirement Study (HRS). We sought to replicate our results in the Women{\textquoteright}s Health Initiative Memory Study (WHIMS). Method Analysis of SNP pleiotropic effects was completed using data from 6,078 non-Hispanic White women (aged 71.4 [SD 7.4] at baseline) for whom genetic, cognitive, and/or biomarker data were available. We identified CI using WHIMS adjudicated case status (normal vs. mild cognitive impairment or probable dementia). Secondary phenotypes included baseline CRP and plasma lipid levels (HDL, LDL, and total cholesterol [TC]). Genome-wide association analyses were conducted for all phenotypes. A conditional false discovery rate framework defined genetic pleiotropy. Genetic pleiotropy was identified if SNPs were associated with CI conditional on association with secondary phenotypes (CRP, HDL, LDL, TC) at an FDR < 0.05. Functional genomic bioinformatics analysis and comparison with prior findings were conducted. Result Genetic pleiotropy was observed for CI conditional on association with the secondary phenotypes of plasma CRP, HDL, LDL, and TC. These results replicate associations for SNPs in the APOE, APOC1, PVRL2/NECTIN2 loci reported in the prior HRS study for CRP, LDL, TC. The odds ratios for the association of these SNPs with CI ranged from 0.5 to 4.0, consistent with moderate effect sizes for the APOE ε2 or ε4 alleles. For WHIMS, FDR significant results were observed in both directions for several of the traits (CRP, lipids), further supporting evidence of genetic pleiotropy. Moreover, we observed associations for SNPs in the APOE, APOC1, PVRL2/NECTIN2 loci for CI conditional on HDL. Conclusion We identified polygenic overlap between CI and CRP, LDL, HDL, and TC phenotypes in WHIMS, largely replicating prior results in the HRS. The variants and associated genes identified are involved in pathological processes including metabolic, cardiovascular, and immune response and are potentially important for AD risk prediction and development of therapeutic approaches based on anti-inflammatory mechanisms.}, keywords = {Cognitive decline, health, systemic inflammation, women}, doi = {10.1002/alz.050784}, author = {Michael W Lutz and Brown, Mark M. and Kucgibhatla, Maragatha and Brenda L Plassman and Saldana, Santiago and Snively, Beverly M and Chen, Jiu-Chiuan and Henderson, Victor and JoAnn E Manson and Pal, Lubna and Shadyab, Aladdin H. and Rapp, Stephen R. and Kathleen M Hayden} } @article {12059, title = {Are Loneliness and Social Isolation Equal Threats to Health and Well-being? An Outcome Wide Longitudinal Approach}, journal = {Innovation in Aging}, volume = {5}, year = {2021}, pages = {935{\textendash}936}, abstract = {The detrimental effects of loneliness and social isolation on health and well-being outcomes are well documented. In response, governments, corporations, and community-based organizations have begun leveraging emerging tools to create interventions and policies aimed at reducing loneliness and social isolation at-scale. However, these efforts are frequently hampered by a key knowledge gap: when attempting to alleviate specific health and well-being outcomes, decision-makers are unsure whether to target loneliness, social isolation, or both. Participants (N=13,752) were from the Health and Retirement Study- a diverse nationally representative, and longitudinal sample of U.S. adults aged > 50 years. We examined how changes in loneliness and social isolation over a 4-year follow-up period (from t0:2008/2010 to t1:2012/2014) were associated with 32 indicators of physical-, behavioral-, and psychosocial-health outcomes 4-years later (t2:2016/2018). We used, multiple logistic-, linear-, and generalized-linear regression models, and adjusted for sociodemographics, personality traits, pre-baseline levels of both exposures (loneliness and social isolation), and all outcomes (t0:2008/2010). After adjusting for a wide range of covariates, we observed that both loneliness and social isolation have similar effects on physical health outcomes and health behaviors, whereas loneliness is a stronger predictor of psychological outcomes. In particular, behavioral dimensions of the social isolation measure (i.e., participation in social/religious activities, social interaction frequency) were most strongly associated with the largest number of health and well-being outcomes, including all-cause mortality. Loneliness and social isolation have independent effects on various health and well-being outcomes, thus, should be distinct targets for interventions aimed at improving the health and well-being.}, keywords = {health, Loneliness, social isolation, Well-being}, doi = {https://doi.org/10.1093/geroni/igab046.3354}, author = {Henriksson, Tatiana and Julia S Nakamura and Kim, Eric} } @article {11016, title = {Ask Again: Including Gender Identity in Longitudinal Studies of Aging}, journal = {The Gerontologist}, volume = {61}, year = {2021}, pages = {640-649}, abstract = {Information on transgender people{\textquoteright}s health, and especially their experiences of aging, is lacking, including from major longitudinal studies of aging like the Health and Retirement Study and its sister studies in the Gateway to Global Aging Data project. This paper surveys the state of gender-data collection among major longitudinal studies and finds that all but one fail to collect adequate information on participants{\textquoteright} gender to determine participants{\textquoteright} gender identities. It identifies the unique challenges that population-wide longitudinal data-collection poses to current best practices for identifying transgender survey participants and proposes a modified {\textquotedblleft}two-question model{\textquotedblright}: one question for sex assigned at birth, and a second for gender identity, both of which offer three responses.}, keywords = {cisgender, nonbinary, sex, Transgender}, isbn = {0016-9013}, doi = {10.1093/geront/gnaa107}, author = {Douglas William Hanes and Sean A. P. Clouston} } @article {11668, title = {Association Between Receipt of Cancer Screening and All-Cause Mortality in Older Adults.}, journal = {JAMA Network Open}, volume = {4}, year = {2021}, pages = {e2112062}, abstract = {

Importance: Guidelines recommend against routine breast and prostate cancer screenings in older adults with less than 10 years{\textquoteright} life expectancy. One study using a claims-based prognostic index showed that receipt of cancer screening itself was associated with lower mortality, suggesting that the index may misclassify individuals when used to inform cancer screening, but this finding was attributed to residual confounding because the index did not account for functional status.

Objective: To examine whether cancer screening remains significantly associated with all-cause mortality in older adults after accounting for both comorbidities and functional status.

Design, Setting, and Participants: This cohort study included individuals older than 65 years who were eligible for breast or prostate cancer screening and who participated in the 2004 Health and Retirement Study. Data were linked to Medicare claims from 2001 to 2015. Data analysis was conducted from January to November 2020.

Main Outcomes and Measures: A Cox model was used to estimate the association between all-cause mortality over 10 years and receipt of screening mammogram or prostate-specific antigen (PSA) test, adjusting for variables in a prognostic index that included age, sex, comorbidities, and functional status. Potential confounders (ie, education, income, marital status, geographic region, cognition, self-reported health, self-care, and self-perceived mortality risk) of the association between cancer screening and mortality were also tested.

Results: The breast cancer screening cohort included 3257 women (mean [SD] age, 77.8 [7.5] years); the prostate cancer screening cohort included 2085 men (mean [SD] age, 76.1 [6.8] years). Receipt of screening mammogram was associated with lower hazard of all-cause mortality after accounting for all index variables (adjusted hazard ratio [aHR], 0.67; 95\% CI, 0.60-0.74). A weaker, but still statistically significant, association was found for screening PSA (aHR 0.88; 95\% CI, 0.78-0.99). None of the potential confounders attenuated the association between screening and mortality except for cognition, which attenuated the aHR for mammogram from 0.67 (95\% CI, 0.60-0.74) to 0.73 (95\% CI, 0.64-0.82) and the aHR for PSA from 0.88 (95\% CI, 0.78-0.99) to 0.92 (95\% CI, 0.80-1.05), making PSA screening no longer statistically significant.

Conclusions and Relevance: In this study, cognition attenuated the observed association between cancer screening and mortality among older adults. These findings suggest that existing mortality prediction algorithms may be missing important variables that are associated with receipt of cancer screening and long-term mortality. Relying solely on algorithms to determine cancer screening may misclassify individuals as having limited life expectancy and stop screening prematurely. Screening decisions need to be individualized and not solely dependent on life expectancy prediction.

}, keywords = {all-cause mortality, cancer screening, Medicare}, issn = {2574-3805}, doi = {10.1001/jamanetworkopen.2021.12062}, author = {Schoenborn, Nancy L and Sheehan, Orla C and David L. Roth and Cidav, Tansu and Huang, Jin and Chung, Shang-En and Zhang, Talan and Lee, Sei and Xue, Qian-Li and Cynthia Boyd} } @article {11368, title = {Association between vision impairment and cognitive decline in older adults with stroke: Health and Retirement Study.}, journal = {Aging Clinical and Experimental Research}, volume = {33}, year = {2021}, pages = {2605-2610}, abstract = {

Stroke survivors may experience multiple residual symptoms post-stroke, including vision impairment (VI) and cognitive decline. Prior studies have shown that VI is associated with cognitive decline, but have not evaluated the contribution of VI to post-stroke cognitive changes. We used data from four waves (2010-2016) of the Health and Retirement Study to investigate the cognitive trajectories of stroke survivors with and without VI. Vision (excellent-very good[ref], good, fair-poor) and stroke diagnosis were self-reported. Cognition was defined using the Telephone Interview for Cognitive Status. Regression was used to model the association between vision and change in cognitive function, adjusting for confounders. The final sample included 1,439 stroke survivors and the average follow-up time was 4.1~years. Fair-poor overall (B = -1.30, p < 0.01), near (B = -1.53, p < 0.001), and distance (B = -1.27, p < 0.001) vision were associated with significantly lower baseline cognitive function. VI was not associated with the rate of cognitive decline. Future research should determine whether specific types of VI potentiate the risk of cognitive impairment and dementia in stroke survivors.

}, keywords = {Aging, cognitive impairment, Stroke, vision impairment}, issn = {1720-8319}, doi = {10.1007/s40520-020-01776-w}, author = {Hreha, Kimberly P and Brian Downer and Joshua R Ehrlich and Bret Howrey and Taglialatela, Guilio} } @article {11582, title = {Association of social deprivation with cognitive status and decline in older adults.}, journal = {International Journal of Geriatric Psychiatry}, volume = {36}, year = {2021}, pages = {1085-1094}, abstract = {

OBJECTIVES: Social deprivation, i.e. the relative deprivation in socioeconomic domains, is known to exacerbate disease risk. Less is known about its role in cognitive functioning and decline in older adults. This study aimed to investigate the association between social deprivation and cognitive status as well as rate of decline.

METHODS: We analysed data from the nationally representative Health and Retirement study (HRS) of individuals aged 50 and older. The analysis sample contained 11,101 respondents (mean age at baseline: 69.4, SD: 8.6, 55\% female) with at least two cognitive assessments (mean follow up: 11.2, SD: 5.4). To quantify social deprivation we constructed a social deprivation index (SDI) with structural equation modelling. Multiple growth curve modelling was used to model cognitive status and decline as predicted by SDI.

RESULTS: After adjusting for covariates, greater social deprivation was associated with poorer cognitive status (β= -0.910, p <.001; 95\% CI: -0.998-0.823) and faster cognitive decline (β= -0.005, p=.002; 95\% CI:-0.009-0.002). Of the covariates, depressive symptoms, chronic disease burden, belonging to a racial or ethnical minority, and male gender were also associated with poorer cognitive status. Marriage statuses other than being married or partnered had a positive association with cognitive status.

CONCLUSIONS: Our findings indicate that greater social deprivation was associated with significantly poorer cognitive status implying that preventing social deprivation can contribute to raising cognitive functioning in the older population and help reduce the incidence of dementia. Policy that facilitates early intervention in social deprivation will be key. This article is protected by copyright. All rights reserved.

}, keywords = {Cognition, Cognitive decline, Dementia, social deprivation, socioeconomic}, issn = {1099-1166}, doi = {10.1002/gps.5555}, author = {Hofbauer, Lena M and Rodriguez, Francisca S} } @article {11024, title = {Associations Between Alzheimer{\textquoteright}s Disease and Related Dementias and Depressive Symptoms of Partner Caregivers}, journal = {Journal of Applied Gerontology}, volume = {40}, year = {2021}, pages = {772-780}, abstract = {Family members - mainly spouses and partners - are the primary caregivers for individuals with Alzheimer{\textquoteright}s disease and related dementias (ADRDs), chronic progressive illnesses requiring increasing levels of care. We performed a retrospective observational analysis comparing depressive symptoms of 16,650 older individuals with partners without ADRDs, and those recently (within 2 years) or less recently diagnosed (>=2 years prior), controlling for lagged sociodemographic and health characteristics. The mean number of reported depressive symptoms was 1.2 (SD = 1.8). Compared with respondents with partners with no ADRD, having a partner with any ADRD was associated with a 0.35 increase (95\% confidence interval [CI] = [0.30, 0.41]), or 30\% increase, in depressive symptoms. A less recent partner diagnosis was associated with a 33\% increase, while a recent diagnosis was associated with a 27\% increase. Clinically meaningful and longitudinally worsening depressive symptoms amplify the need to prioritize partner health and family-centered care following an ADRD diagnosis.}, keywords = {Alzheimer{\textquoteright}s disease, Caregiving, Dementia, depression, quantitative methods}, isbn = {0733-4648}, doi = {10.1177/0733464820952252}, author = {Harris, Melissa L. and Marita G. Titler and Geoffrey J Hoffman} } @article {11843, title = {Associations between education and dementia in the Caribbean and the United States: An international comparison.}, journal = {Alzheimer{\textquoteright}s \& Dementia}, volume = {7}, year = {2021}, pages = {e12204}, abstract = {

Introduction: Despite high dementia prevalence in Hispanic populations globally, especially Caribbean Hispanics, no study has comparatively examined the association between education and dementia among Hispanics living in the Caribbean Islands and older adults in the United States.

Methods: We used data on 6107 respondents aged 65 and older in the baseline wave of the population-based and harmonized 10/66 survey from Cuba, the Dominican Republic, and Puerto Rico, collected between 2003 and 2008, and 11,032 respondents aged 65 and older from the U.S.-based Health and Retirement Study data in 2014, a total of 17,139 individuals. We estimated multivariable logistic regression models examining the association between education and dementia, adjusted for age, income, assets, and occupation. The models were estimated separately for the Caribbean population (pooled and by setting) and the U.S. population by race/ethnicity (Hispanic, Black, and White), followed by pooled models across all populations.

Results: In the Caribbean population, the relative risk of dementia among low versus high educated adults was 1.45 for women (95\% confidence interval [CI] 1.17, 1.74) and 1.92 (95\% CI 1.35, 2.49) for men, smaller compared to those in the United States, especially among non-Hispanic Whites (women: 2.78, 95\% CI 1.94, 3.61; men: 5.98, 95\% CI 4.02, 7.95).

Discussion: The differential associations between education and dementia across the Caribbean and US settings may be explained by greater disparities in social conditions in the United States compared to the Caribbean, such as access to health care, healthy behaviors, and social stressors, which serve as potentially important mediators.

}, keywords = {Caribbean, Dementia, Education, Hispanics, Sister studies}, issn = {2352-8737}, doi = {10.1002/trc2.12204}, author = {Li, Jing and Llibre-Guerra, Jorge J and Harrati, Amal and Weiss, Jordan and Jim{\'e}nez-Vel{\'a}zquez, Ivonne Z and Acosta, Daisy and Llibre-Rodriguez, Juan de Jes{\'u}s and Liu, Mao-Mei and William H Dow} } @article {Crowe2020.07.10.20147488, title = {Associations of Loneliness and Social Isolation with Health Span and Life Span in the US Health and Retirement Study}, journal = {The Journals of Gerontology: Series A }, volume = {76}, year = {2021}, pages = {1997-2006}, abstract = {Background Loneliness and social isolation are emerging public health challenges for aging populations.Methods We followed N=11,302 US Health and Retirement Study (HRS) participants aged 50-95 from 2006-2014 to measure persistence of experiences of loneliness and exposure to social isolation. We tested associations of longitudinal loneliness and social isolation phenotypes with disability, morbidity, mortality, and biological aging through 2018.Results During follow-up, 18\% of older adults met criteria for loneliness, with 6\% meeting criteria at two or more follow-up assessments. For social isolation, these fractions were 21\% and 8\%. HRS participants who experienced loneliness and were exposed to social isolation were at increased risk for disease, disability, and mortality. Those experiencing persistent loneliness were at a 57\% increased hazard of mortality compared to those who never experienced loneliness. For social isolation, the increase was 28\%. Effect-sizes were somewhat larger for counts of prevalent activity limitations and somewhat smaller for counts of prevalent chronic diseases. Covariate adjustment for socioeconomic and psychological risks attenuated but did not fully explain associations. Older adults who experienced loneliness and were exposed to social isolation also exhibited physiological indications of advanced biological aging (Cohen{\textquoteright}s-d for persistent loneliness and social isolation=0.26 and 0.21, respectively). For loneliness, but not social isolation, persistence was associated with increased risk.Conclusion Deficits in social connectedness prevalent in a national sample of US older adults were associated with morbidity, disability, and mortality and with more advanced biological aging. Bolstering social connectedness to interrupt experiences of loneliness may promote healthy aging.Competing Interest StatementThe authors have declared no competing interest.Funding StatementThis research was supported by the Robert N Butler Columbia Aging Center, Russel Sage Foundation (grant 1810-08987), and the Jacobs Foundation. CLC is supported by a fellowship from the National Institute of Mental Health (5T32MH013043).Author DeclarationsI confirm all relevant ethical guidelines have been followed, and any necessary IRB and/or ethics committee approvals have been obtained.YesThe details of the IRB/oversight body that provided approval or exemption for the research described are given below:The Columbia University Irving Medical Center IRB approved this research.All necessary patient/participant consent has been obtained and the appropriate institutional forms have been archived.YesI understand that all clinical trials and any other prospective interventional studies must be registered with an ICMJE-approved registry, such as ClinicalTrials.gov. I confirm that any such study reported in the manuscript has been registered and the trial registration ID is provided (note: if posting a prospective study registered retrospectively, please provide a statement in the trial ID field explaining why the study was not registered in advance).YesI have followed all appropriate research reporting guidelines and uploaded the relevant EQUATOR Network research reporting checklist(s) and other pertinent material as supplementary files, if applicable.YesAll data are publicly available on the Health and Retirement Study (HRS) website.}, keywords = {Healthspan, Loneliness, social isolation}, doi = {10.1093/gerona/glab128}, author = {Crowe, CL and Benjamin W Domingue and Hu, G and Keyes, KM and Kwon, Dy and Daniel W. Belsky} } @conference {11822, title = {Associations of Long-term Air Pollution Exposure and Incident Late-Life Disability in Older U.S. Adults: The Health Retirement Study}, booktitle = {ISEE Conference Abstracts}, volume = {2021}, year = {2021}, abstract = {Late-life disability is of critical concern to older adults and can reflect the cumulative burden of chronic disease over the lifespan. Although air pollution has been associated with many common chronic conditions, associations with disability are understudied. We aimed to quantify associations between long-term exposures to air pollution and late-life disability. METHODS: We used biennial data between 2000 and 2016 on self-reported Activities of Daily Living (ADL) from participants 65 years from the nationally representative Health and Retirement Study. Using a spatiotemporal prediction model, we estimated 10-year PM2.5, PM10-2.5, NO2, and O3 concentrations at participant residences. We then estimated the risk of incident ADL disability as a function of time-varying air pollution, adjusting for individual and area-level confounders and sampling weights in a Cox model. We fitted single- and two-pollutant models. RESULTS:Our study population of 16,927 adults (70+6.4 years) was predominantly non-Hispanic White (76\%), Non-Hispanic Black (14\%), and Hispanic White (8\%) and 32\% reported a new disability during follow-up. Overall, we found some evidence that air pollution was associated with an increased risk of ADL disability. After adjustment for place and PM2.5, we found that interquartile increases in PM10-2.5 and NO2 were associated with 8\% (HR: 1.08 per 5 {\textmu}g/m3, 95\% CI: 1.01, 1.17) and 9\% (HR: 1.09 per 6 ppb, 95\% CI: 1.00, 1.19) greater hazards of ADL, respectively, with similar findings in the single pollutant models. PM2.5 and O3 were not associated with higher hazards of ADL in single or multipollutant models after detailed adjustment for place. CONCLUSIONS:This prospective study in a nationally representative sample of older adults found some evidence that higher levels of some but not all long-term air pollutants assessed are associated with increased risk of late-life disability.}, keywords = {Activities of Daily Living, Air Pollution, Long-Term Exposure}, url = {https://ehp.niehs.nih.gov/action/doSearch?AllField=Associations+of+Long-term+Air+Pollution+Exposure+and+Incident+Late-Life+Disability+in+Older+U.S.+Adults\%3A+The+Health+Retirement+Study}, author = {Gao, Jiaqi and Carlos F. Mendes de Leon and D{\textquoteright}Souza, Jennifer and Zhang, Boya and Szpiro, Adam and Young, Michael and Weuve, Jennifer and Kenneth M. Langa and Jessica Faul and Kaufman, Joel and Richard A Hirth and Sara Dubowsky Adar} } @article {11528, title = {Associations of vision impairment and eye diseases with memory decline over four years in China and the United States.}, journal = {American Journal of Ophthalmology}, volume = {228}, year = {2021}, pages = {16-26}, abstract = {

PURPOSE: To examine whether vision impairment and eye diseases are independently associated with memory decline in older adults.

DESIGN: Cohort study.

METHODS: We included 8315 participants aged 50-94 years in China Health and Retirement Longitudinal Study (CHARLS) from China and 8939 participants aged 50-95 years in Health and Retirement Study (HRS) from the United States in our analysis.

RESULTS: During 4.0 years{\textquoteright} follow-up, the composite memory decreased by 0.16 points in CHARLS. During 3.9 years{\textquoteright} follow-up, the composite memory decreased by 0.51 in HRS. Distance vision impairment was inversely associated with an annual change in composite memory (β (95\% CI): -0.07 (-0.12, -0.01)) and immediate memory (-0.04 (-0.07, -0.02)) in CHARLS, and the corresponding values in HRS were -0.19 (-0.34, -0.05) and -0.07 (-0.13, -0.00), respectively. Near vision impairment was inversely associated with an annual change in delayed memory in CHARLS and composite memory, immediate memory, and delayed memory in HRS. In HRS, the association between distance vision impairment and memory decline was observed in individuals aged <65 years (β (95\% CI): -0.54 (-0.78, -0.30) but not in those aged >=65 years (-0.01 (-0.20, 0.18)). Cataract surgery or glaucoma was not significantly associated with memory decline in either CHARLS or HRS.

CONCLUSION: Distance vision impairment was independently associated with an accelerated rate of memory decline in both China and the United States. Near vision impairment was predictive of the decline in delayed memory in China and the decline in composite, immediate, and delayed memory in the United States.

}, keywords = {cataract surgery, CHARLS, Distance vision impairment, Glaucoma, moderation analysis, near vision impairment}, issn = {1879-1891}, doi = {10.1016/j.ajo.2021.03.021}, author = {Shang, Xianwen and Zhu, Zhuoting and Wang, Wei and He, Mingguang} } @article {12023, title = {The best reason of all to postpone retirement}, journal = {Retirement Weekly}, year = {2021}, publisher = {MarketWatch}, abstract = {Working longer can postpone cognitive decline }, keywords = {Cognitive decline, Retirement}, url = {https://www.marketwatch.com/story/the-best-reason-of-all-to-postpone-retirement-11638548181?rss=1\&siteid=rss}, author = {Hulbert, Mark} } @article {12065, title = {Birth Cohort Differences in Multimorbidity Burden Among Aging U.S. Adults }, journal = {Innovation in Aging}, volume = {5}, year = {2021}, pages = {257}, abstract = {Multimorbidity is the co-occurrence of two or more chronic health conditions and affects more than half of the US population aged 65 and older. Recent trends suggest increased risk of poor self-reported health, physical disability, cognitive impairment, and mortality among later born birth cohorts, yet we are unaware of work examining cohort trends in multimorbidity among aging US adults. Observations were drawn from the Health and Retirement Study (2000{\textendash}2018) and included adults aged 51 and older across 7 birth cohorts (1923 and earlier, 1924{\textendash}1930, 1931{\textendash}1941, 1942{\textendash}1947, 1948{\textendash}1953, 1954{\textendash}1959, and 1960{\textendash}1965). Multimorbidity was measured as a count of 9 chronic conditions including heart disease, hypertension, stroke, diabetes, arthritis, lung disease, cancer (excluding skin cancer), depression, and cognitive impairment. General linear models adjusting for repeated measures and covariates including age, sex, race/ethnicity, and education were used to identify whether trends in multimorbidity varied across birth cohort. 31,923 adults contributed 153,940 total observations, grand mean age was 68.0 (SD=10.09), and mean multimorbidity was 2.19 (SD=1.49). In analyses adjusted for age and other covariates, adults born 1948{\textendash}1953 reported .34 more chronic conditions (SE=.03, p<.001), adults born 1954{\textendash}1959 reported .42 more chronic conditions (SE=.03, p<.001), and adults born 1960{\textendash}1965 reported .55 more chronic conditions (SE=.03, p<.001), than those born 1931{\textendash}1941, respectively. Our preliminary results confirm increasing multimorbidity among later birth cohorts of older Americans and should help guide policy to manage impending health declines among older Americans.}, keywords = {birth cohort, multimorbidity}, doi = {https://doi.org/10.1093/geroni/igab046.987}, author = {Nicholas J Bishop and Steven A Haas and Ana R Qui{\~n}ones} } @article {11473, title = {Comparing the educational gradients in three cardiovascular disease-specific health measures}, journal = {Longitudinal and Life Course Studies}, volume = {12}, year = {2021}, pages = {591-607(17)}, abstract = {Less-educated persons have worse cardiovascular health. We compare the educational gradients in three disease-specific health measures (biomarkers, self-reported doctors{\textquoteright} diagnoses and cause-specific mortality) in order to compare their relevance in different stages of the disease process. We study 14,102 people aged 50{\textendash}89 from the US Health Retirement Study (HRS) in the period 2006{\textendash}17. We use six CVD biomarkers (systolic/ diastolic blood pressure, ratio total/HDL cholesterol, C-reactive protein, body mass index, HbA1c) and two self-reported doctors{\textquoteright} diagnoses (stroke, heart attack). We estimate the gradient in biomarkers using log-binomial regression and the hazard of diagnoses and CVD mortality with Cox survival models. Among those without pre-diagnosed CVD conditions, the educational gradient in mortality is highest (RR 1.97), the gradient for those who receive a CVD diagnosis is in the middle (RR 1.46), and the gradient in biomarkers is lowest (RR 1.32). Among those with recent/ older diagnoses, the biomarker gradient is comparable to levels among the non-diagnosed, while the mortality gradient is much lower (RR 1.35). The gradients in diagnoses and mortality are only slightly explained by differences in biomarkers. The comparison of the three gradients and the mediation analysis suggest that in each of the steps to diagnosis and death there are social factors involved that increase the gradient and go beyond what biomarkers can predict. Having a CVD diagnosis leads to smaller mortality gradients, presumably because of the convergence of educational differences in behaviour and during treatment and monitoring. Our findings support prevention as a strategy against social inequalities in CVD.}, keywords = {biomarker, Cardiovascular Diseases, Health Inequality, Mortality}, doi = {https://doi.org/10.1332/175795921X16115949972000}, author = {Rasmus Hoffmann and Kr{\"o}ger, Hannes} } @article {11867, title = {Comparisons of disease cluster patterns, prevalence and health factors in the USA, Canada, England and Ireland.}, journal = {BMC Public Health}, volume = {21}, year = {2021}, pages = {1674}, abstract = {

BACKGROUND: Identification of those who are most at risk of developing specific patterns of disease across different populations is required for directing public health policy. Here, we contrast prevalence and patterns of cross-national disease incidence, co-occurrence and related risk factors across population samples from the U.S., Canada, England and Ireland.

METHODS: Participants (n = 62,111) were drawn from the US Health and Retirement Study (n = 10,858); the Canadian Longitudinal Study on Ageing (n = 36,647); the English Longitudinal Study of Ageing (n = 7938) and The Irish Longitudinal Study on Ageing (n = 6668). Self-reported lifetime prevalence of 10 medical conditions, predominant clusters of multimorbidity and their specific risk factors were compared across countries using latent class analysis.

RESULTS: The U.S. had significantly higher prevalence of multimorbid disease patterns and nearly all diseases when compared to the three other countries, even after adjusting for age, sex, BMI, income, employment status, education, alcohol consumption and smoking history. For the U.S. the most at-risk group were younger on average compared to Canada, England and Ireland. Socioeconomic gradients for specific disease combinations were more pronounced for the U.S., Canada and England than they were for Ireland. The rates of obesity trends over the last 50 years align with the prevalence of eight of the 10 diseases examined. While patterns of disease clusters and the risk factors related to each of the disease clusters were similar, the probabilities of the diseases within each cluster differed across countries.

CONCLUSIONS: This information can be used to better understand the complex nature of multimorbidity and identify appropriate prevention and management strategies for treating multimorbidity across countries.

}, keywords = {disease clusters, ELSA, Latent Class Analysis, multimorbidity, Sister studies, TILDA}, issn = {1471-2458}, doi = {10.1186/s12889-021-11706-8}, author = {Hernandez, Belinda and Voll, Stacey and Nathan A Lewis and McCrory, Cathal and White, Arthur and Stirland, Lucy and Kenny, Rose Anne and Reilly, Richard and Hutton, Craig P and Griffith, Lauren E and Kirkland, Susan A and Graciela Mu{\~n}iz Terrera and Scott M Hofer} } @article {11700, title = {COVID-19, Inter-household Contact and Mental Well-being among Older Adults in the US and the UK}, journal = {Frontiers in Sociology}, volume = {6}, year = {2021}, pages = {714626}, abstract = {Interacting with family members and friends from other households is a key part of everyday life and is crucial to people{\textquoteright}s mental well-being. The COVID-19 pandemic severely curtailed face-to-face contact between households, particularly for older adults (aged 60 and above), due to their high risk of developing severe illness if infected by COVID-19. In-person contact, where possible, was largely replaced by virtual interaction during the pandemic. This article examines how inter-household contact in face-to-face and virtual forms, as well as combinations of the two forms of contact, related to older adults{\textquoteright} mental well-being during the pandemic. Data from two national longitudinal surveys, collected from the same respondents before (2018{\textendash}2019) and during (June 2020) the pandemic, were comparatively analysed: the Health and Retirement Study in the US and Understanding Society in the UK. The findings showed a notable increase in loneliness in the US and a decline in general mental well-being in the UK following the outbreak of COVID-19. In both countries, more frequent inter-household face-to-face contact during the pandemic was associated with better general mental well-being, but inter-household virtual contact, via means such as telephone and digital media, was not associated with general mental well-being in either the US or the UK. In the US, older adults who engaged more frequently in virtual contact were more likely to feel lonely during the pandemic, particularly if their face-to-face contact was limited. In both countries, the increase in loneliness following the outbreak of the pandemic was greater for older adults who reported more virtual contact. The findings suggest that household-centred crisis management during the COVID-19 pandemic had unintended mental health implications in both the US and the UK, despite contextual differences between the two countries. Although face-to-face contact between households helped to sustain older adults{\textquoteright} mental well-being, virtual contact was not a qualitatively equivalent alternative. The findings also provide an important evidence base for informing policy developments and for supporting the mental health of older people during the COVID-19 pandemic and in the longer term.}, keywords = {COVID-19, Inter-household contact, Mental Health, Virtual interaction}, doi = {10.3389/fsoc.2021.714626}, author = {Hu, Yang and Qian, Yue} } @article {11472, title = {Cumulative Disparities in the Dynamics of Working Poverty for Later Career U.S. Workers (2002{\textendash}2012)}, journal = {Socius}, volume = {7}, year = {2021}, abstract = {Many more Americans experience working poverty than unemployed poverty, a situation that was only exacerbated by the Great Recession. The consequences of working poverty for later career workers, who should be at their highest earning ages, are particularly dire. The authors expect that later career workers are especially vulnerable in terms of the risk and duration of working poverty and that those who have accumulated disadvantages over their life courses, in terms of the intersecting dimensions of race/ethnicity, gender, early-life disadvantage, and educational attainment, will suffer disproportionately. The authors use incidence-based Markov-chain multistate models to analyze the U.S. Health and Retirement Study, which is representative of the U.S. population aged 50 years and older. The results reveal that Black women and men, Latinx, those who experienced more early-life disadvantages, and people with lower education have higher risk and longer durations in working poverty over the period from 2002 to 2012. The findings also suggest that when confronted with economic hardship (the Great Recession) later career workers who originate in lower socioeconomic statuses, especially Blacks and Latinx, are in more precarious economic positions. Important from a policy perspective, educational attainment only partially mediates the association between race/ethnicity and working poverty; disparities persist.}, keywords = {Aging, cumulative disadvantage, Great Recession, life course, Poverty, Work}, isbn = {2378-0231}, doi = {10.1177/2378023120987332}, author = {Jo Mhairi Hale and Christian Dudel and Angelo Lorenti} } @article {11490, title = {Cumulative Genetic Risk and APOE ε4 Are Independently Associated With Dementia Status in a Multiethnic, Population-Based Cohort}, journal = {Neurology Genetics}, volume = {7}, year = {2021}, pages = {e576}, abstract = {

Objective: Alzheimer disease (AD) is a common and costly neurodegenerative disorder. A large proportion of AD risk is heritable, and many genetic risk factors have been identified. The objective of this study was to test the hypothesis that cumulative genetic risk of known AD markers contributed to odds of dementia in a population-based sample.

Methods: In the US population-based Health and Retirement Study (waves 1995-2014), we evaluated the role of cumulative genetic risk of AD, with and without the alleles, on dementia status (dementia, cognitive impairment without dementia, borderline cognitive impairment without dementia, and cognitively normal). We used logistic regression, accounting for demographic covariates and genetic principal components, and analyses were stratified by European and African genetic ancestry.

Results: In the European ancestry sample (n = 8,399), both AD polygenic score excluding the genetic region (odds ratio [OR] = 1.10; 95\% confidence interval [CI]: 1.00-1.20) and the presence of any alleles (OR = 2.42; 95\% CI: 1.99-2.95) were associated with the odds of dementia relative to normal cognition in a mutually adjusted model. In the African ancestry sample (n = 1,605), the presence of any alleles was associated with 1.77 (95\% CI: 1.20-2.61) times higher odds of dementia, whereas the AD polygenic score excluding the genetic region was not significantly associated with the odds of dementia relative to normal cognition 1.06 (95\% CI: 0.97-1.30).

Conclusions: Cumulative genetic risk of AD and are both independent predictors of dementia in European ancestry. This study provides important insight into the polygenic nature of dementia and demonstrates the utility of polygenic scores in dementia research.

}, keywords = {Aging, Alzheimer disease, Cognition, genetic risk}, issn = {2376-7839}, doi = {10.1212/NXG.0000000000000576}, author = {Kelly M Bakulski and Vadari, Harita S and Jessica Faul and Steven G Heeringa and Sharon L R Kardia and Kenneth M. Langa and Jennifer A. Smith and Jennifer J Manly and Colter Mitchell and Benke, Kelly S and Erin B Ware} } @article {11350, title = {Depressive Symptoms and Multimorbidity: Is There an Association for Older Black Americans?}, journal = {Journal of Aging and Health}, volume = {33}, year = {2021}, pages = {310-316}, abstract = {

Many existing studies have reported a higher prevalence of depressive symptoms among older Black Americans. They also experience a disproportionate burden of multimorbidity, the presence of multiple chronic conditions. Therefore, this study was to identify the association between depressive symptomatology and multimorbidity among older Black Americans. This study analyzed the 2014 Health and Retirement Study ( = 1206). A negative binomial regression was applied to assess the association between multimorbidity and depressive symptomatology. Higher levels of chronic health problems were associated with higher levels of depressive symptomatology among older Black Americans ( = 1.093; = .002). Lower self-reported health, lower income, and lower educational attainment were also related to higher depressive symptoms. Older Black Americans experience vulnerability on multiple levels, and shouldering additional psychosocial and financial burdens adds to already established physical health disparities. This requires critical attention from both practice and policy.

}, keywords = {Chronic Diseases, Depressive symptoms, mental health disparities}, issn = {1552-6887}, doi = {10.1177/0898264320981244}, author = {Cho, Seungjong and Tyrone C Hamler} } @article {12565, title = {Development of a common scale for measuring healthy ageing across the world: results from the ATHLOS consortium.}, journal = {International Journal of Epidemiology}, volume = {50}, year = {2021}, pages = {880-892}, abstract = {

BACKGROUND: Research efforts to measure the concept of healthy ageing have been diverse and limited to specific populations. This diversity limits the potential to compare healthy ageing across countries and/or populations. In this study, we developed a novel measurement scale of healthy ageing using worldwide cohorts.

METHODS: In the Ageing Trajectories of Health-Longitudinal Opportunities and Synergies (ATHLOS) project, data from 16 international cohorts were harmonized. Using ATHLOS data, an item response theory (IRT) model was used to develop a scale with 41 items related to health and functioning. Measurement heterogeneity due to intra-dataset specificities was detected, applying differential item functioning via a logistic regression framework. The model accounted for specificities in model parameters by introducing cohort-specific parameters that rescaled scores to the main scale, using an equating procedure. Final scores were estimated for all individuals and converted to T-scores with a mean of 50 and a standard deviation of 10.

RESULTS: A common scale was created for 343~915 individuals above 18 years of age from 16 studies. The scale showed solid evidence of concurrent validity regarding various sociodemographic, life and health factors, and convergent validity with healthy life expectancy (r = 0.81) and gross domestic product (r = 0.58). Survival curves showed that the scale could also be predictive of mortality.

CONCLUSIONS: The ATHLOS scale, due to its reliability and global representativeness, has the potential to contribute to worldwide research on healthy ageing.

}, keywords = {Aging, Cohort Studies, Health Status, healthy aging, Humans, Reproducibility of Results}, issn = {1464-3685}, doi = {10.1093/ije/dyaa236}, author = {Sanchez-Niubo, Albert and Forero, Carlos G and Wu, Yu-Tzu and Gin{\'e}-V{\'a}zquez, Iago and Prina, Matthew and de la Fuente, Javier and Daskalopoulou, Christina and Critselis, Elena and De La Torre-Luque, Alejandro and Panagiotakos, Demosthenes and Arndt, Holger and Ayuso-Mateos, Jos{\'e} Luis and Bayes-Marin, Ivet and Bickenbach, Jerome and Bobak, Martin and Caballero, Francisco F{\'e}lix and Chatterji, Somnath and Egea-Cort{\'e}s, Laia and Garc{\'\i}a-Esquinas, Esther and Leonardi, Matilde and Koskinen, Seppo and Koupil, Ilona and Mellor-Mars{\'a}, Blanca and Olaya, Beatriz and Paj{\k a}k, Andrzej and Prince, Martin and Raggi, Alberto and Rodr{\'\i}guez-Artalejo, Fernando and Sanderson, Warren and Scherbov, Sergei and Tamosiunas, Abdonas and Tobias-Adamczyk, Beata and Tyrovolas, Stefanos and Haro, Josep Maria} } @article {11962, title = {Different hypertension thresholds and cognitive decline: a pooled analysis of three ageing cohorts.}, journal = {BMC Medicine}, volume = {19}, year = {2021}, pages = {287}, abstract = {

BACKGROUND: The 2017 American College of Cardiology (ACC)/American Heart Association (AHA) guidelines for high blood pressure (BP) in adults came up with a new definition of hypertension with a threshold BP level of 130/80 mmHg. But the 2018 European Society of Cardiology (ESC)/European Society of Hypertension (ESH) guidelines adhered to a conventional hypertension definition as BP >= 140/90 mmHg. We aimed to compare the trajectories of cognitive decline between participants with BP < 130/80 mmHg in all BP measurement waves and others with all BP < 140/90 mmHg.

METHODS: This pooled analysis involved middle-aged and older participants from three nationally representative ageing cohorts, including the Health and Retirement Study (HRS), the English Longitudinal Study of Ageing (ELSA), and the China Health Retirement Longitudinal Study (CHARLS). Participants were divided into the Normal (BP < 130/80 mmHg on all occasions throughout the study), the Borderline (BP < 140/90 mmHg on all occasions throughout the study but not in the Normal group), and the High (the rest of participants) BP groups. Global cognitive Z score was calculated from tests on memory, executive function, and orientation.

RESULTS: A total of 17,590 participants (HRS 6964, median follow-ups 12 years; ELSA 5334, median follow-ups 16 years; CHARLS 5292, median follow-ups 7 years) were included. No significant difference in global cognitive decline rate was detected between the Normal and the borderline groups (men, pooled β = - 0.006 standard deviation [SD]/year; 95\% confidence interval [CI], - 0.020 to 0.008; P = 0.377; women, pooled β = 0.006 SD/year; 95\% CI - 0.005 to 0.018; P = 0.269). Participants in the High group had a significantly faster cognitive decline (men, pooled β = - 0.011 SD/year; 95\% CI - 0.020 to - 0.002; P = 0.013; women, pooled β = - 0.017 SD/year; 95\% CI - 0.026 to - 0.008; P < 0.001) than that in the Borderline group.

CONCLUSIONS: Individuals in the Borderline group did not experience significantly faster cognitive decline compared with those in the Normal group. It might not be necessary for individuals with borderline BP (between 130/80 and 140/90 mmHg) to initiate antihypertension therapy in consideration of cognitive decline.

}, keywords = {Blood pressure, CHARLS, Cognitive Dysfunction, ELSA, Hypertension}, issn = {1741-7015}, doi = {10.1186/s12916-021-02165-4}, author = {Ma, Yanjun and Hua, Rong and Yang, Zhenchun and Zhong, Baoliang and Yan, Li and Xie, Wuxiang} } @article {11608, title = {Disability in Childhood, Special Education Histories, and Lifetime Health Outcomes in the United States}, journal = {Journal of Aging and Health}, volume = {33}, year = {2021}, pages = {919-930}, abstract = {Objectives: We evaluated special education as an indicator of childhood disability and used that indicator to estimate lifetime dependency and life expectancy. Methods: Data: Panel Study of Income Dynamics and Health and Retirement Study (n = 20,563). Dependency: Nursing home care or equivalent. Analysis: We first analyzed special education as an indicator of childhood disability; multinomial logistic Markov models and microsimulation then compared populations with and without childhood disability. Results: Special education history was a valid indicator of childhood disability. For example, with parents who did not complete high school, 3.8\% with no special education history were dependent at least 5 years of adult life; that result with special education was 15.2\%. Life expectancy from age 20 was 58.3 years without special education, 46.0 years with special education (both p < .05). Discussion: Special education history can indicate childhood disability. People with that history had significantly a more dependency than others and significantly shorter lives.}, keywords = {dependency, developmental delay, developmental disability, Life Expectancy, Mortality}, isbn = {0898-2643}, doi = {10.1177/08982643211018918}, author = {Laditka, Sarah B. and Laditka, James N. and Hoyle, Jessica N.} } @article {11221, title = {Disability Incidence Rates for Men and Women in 23 Countries: Evidence on Health Effects of Gender Inequality.}, journal = {The Journals of Gerontology, Series A }, volume = {76}, year = {2021}, pages = {328-338}, abstract = {

BACKGROUND: Inequality in gender varies across social contexts, which may influence the health of both men and women. Based on theories of gender as a social system, we examine whether systematic gender inequality at the macro level influences health of men and women.

METHODS: Using harmonized panel data from the Gateway to Global Aging Data in 23 high and middle income countries (N=168,873), we estimate disability prevalence and incidence for men and women ages 55 to 89 (2000-2016). Within each country or geographic region, we also investigate gender differences in age gradients of the probability of disability onset. We, then, pool data from all countries and test the hypothesis that gender inequality increases the probability of disability onset.

RESULTS: We found substantial cross-country variation in disability incidence rates, and this variation is greater for women than for men. Among ages 65-69, disability incidence rates ranged from 0.4 to 5.0 for men and from 0.5 to 9.4 for women. Our within-country analysis showed significant gender differences in age gradients of the probability of disability onset in the U.S., Korea, Southern Europe, Mexico, and China, but not in Northern, Central, and Eastern Europe, England and Israel. Testing hypothesized effects of gender inequality, we find that gender inequality is significantly associated with the probability of disability onset for women, but not for men.

CONCLUSIONS: Macro-level societal gender inequality is significantly associated with the probability of disability onset for women. Reducing and eliminating gender inequality is crucial to achieving good health for women.

}, keywords = {Activities of Daily Living, CHARLS, Cross-Country, ELSA, health disparity, KLoSA, Longitudinal analysis, MHAS, SHARE}, issn = {1758-535X}, doi = {10.1093/gerona/glaa288}, author = {Jinkook Lee and Erik Meijer and Drystan F. Phillips and Hu, Peifeng} } @article {12121, title = {Discovery and fine-mapping of height loci via high-density imputation of GWASs in individuals of African ancestry.}, journal = {The American Journal of Human Genetics}, volume = {108}, year = {2021}, pages = {564-582}, abstract = {

Although many loci have been associated with height in European ancestry populations, very few have been identified in African ancestry individuals. Furthermore, many of the known loci have yet to be generalized to and fine-mapped within a large-scale African ancestry sample. We performed sex-combined and sex-stratified meta-analyses in up to 52,764 individuals with height and genome-wide genotyping data from the African Ancestry Anthropometry Genetics Consortium (AAAGC). We additionally combined our African ancestry meta-analysis results with published European genome-wide association study (GWAS) data. In the African ancestry analyses, we identified three novel loci (SLC4A3, NCOA2, ECD/FAM149B1) in sex-combined results and two loci (CRB1, KLF6) in women only. In the African plus European sex-combined GWAS, we identified an additional three novel loci (RCCD1, G6PC3, CEP95) which were equally driven by AAAGC and European results. Among 39 genome-wide significant signals at known loci, conditioning index SNPs from European studies identified 20 secondary signals. Two of the 20 new secondary signals and none of the 8 novel loci had minor allele frequencies (MAF) < 5\%. Of 802 known European height signals, 643 displayed directionally consistent associations with height, of which 205 were nominally significant (p < 0.05) in the African ancestry sex-combined sample. Furthermore, 148 of 241 loci contained <=20 variants in the credible sets that jointly account for 99\% of the posterior probability of driving the associations. In summary, trans-ethnic meta-analyses revealed novel signals and further improved fine-mapping of putative causal variants in loci shared between African and European ancestry populations.

}, keywords = {Africa, African Americans, Blacks, Body Height, Europe, Female, Genome-Wide Association Study, Humans, Male, Polymorphism, Single Nucleotide}, issn = {1537-6605}, doi = {10.1016/j.ajhg.2021.02.011}, author = {Graff, Mariaelisa and Justice, Anne E and Young, Kristin L and Marouli, Eirini and Zhang, Xinruo and Fine, Rebecca S and Lim, Elise and Buchanan, Victoria and Rand, Kristin and Feitosa, Mary F and Wojczynski, Mary K and Yanek, Lisa R and Shao, Yaming and Rohde, Rebecca and Adeyemo, Adebowale A and Aldrich, Melinda C and Matthew A. Allison and Ambrosone, Christine B and Ambs, Stefan and Amos, Christopher and Donna K Arnett and Atwood, Larry and Bandera, Elisa V and Traci M Bartz and Becker, Diane M and Berndt, Sonja I and Bernstein, Leslie and Bielak, Lawrence F and Blot, William J and Erwin P Bottinger and Bowden, Donald W and Bradfield, Jonathan P and Brody, Jennifer A and Broeckel, Ulrich and Burke, Gregory and Brian E Cade and Cai, Qiuyin and Caporaso, Neil and Carlson, Chris and John Carpten and Casey, Graham and Chanock, Stephen J and Chen, Guanjie and Chen, Minhui and Chen, Yii-Der I and Chen, Wei-Min and Chesi, Alessandra and Chiang, Charleston W K and Chu, Lisa and Coetzee, Gerry A and Conti, David V and Cooper, Richard S and Cushman, Mary and Ellen W Demerath and Deming, Sandra L and Dimitrov, Latchezar and Ding, Jingzhong and Diver, W Ryan and Duan, Qing and Michele K Evans and Falusi, Adeyinka G and Jessica Faul and Myriam Fornage and Caroline S Fox and Freedman, Barry I and Garcia, Melissa and Gillanders, Elizabeth M and Phyllis J Goodman and Gottesman, Omri and Grant, Struan F A and Guo, Xiuqing and Hakonarson, Hakon and Haritunians, Talin and Tamara B Harris and Harris, Curtis C and Henderson, Brian E and Hennis, Anselm and Dena G Hernandez and Hirschhorn, Joel N and McNeill, Lorna Haughton and Howard, Timothy D and Howard, Barbara and Hsing, Ann W and Hsu, Yu-Han H and Hu, Jennifer J and Huff, Chad D and Huo, Dezheng and Ingles, Sue A and Irvin, Marguerite R and John, Esther M and Johnson, Karen C and Jordan, Joanne M and Kabagambe, Edmond K and Kang, Sun J and Sharon L R Kardia and Keating, Brendan J and Rick A Kittles and Eric A Klein and Kolb, Suzanne and Kolonel, Laurence N and Charles Kooperberg and Kuller, Lewis and Kutlar, Abdullah and Leslie A Lange and Langefeld, Carl D and Loic Le Marchand and Leonard, Hampton and Lettre, Guillaume and Levin, Albert M and Li, Yun and Li, Jin and Liu, Yongmei and Liu, Youfang and Liu, Simin and Kurt Lohman and Lotay, Vaneet and Lu, Yingchang and Maixner, William and JoAnn E Manson and McKnight, Barbara and Meng, Yan and Monda, Keri L and Monroe, Kris and Moore, Jason H and Thomas H Mosley and Mudgal, Poorva and Murphy, Adam B and Nadukuru, Rajiv and Michael A Nalls and Nathanson, Katherine L and Nayak, Uma and N{\textquoteright}Diaye, Amidou and Nemesure, Barbara and Neslund-Dudas, Christine and Neuhouser, Marian L and Nyante, Sarah and Ochs-Balcom, Heather and Ogundiran, Temidayo O and Ogunniyi, Adesola and Ojengbede, Oladosu and Okut, Hayrettin and Olopade, Olufunmilayo I and Olshan, Andrew and Padhukasahasram, Badri and Palmer, Julie and Palmer, Cameron D and Palmer, Nicholette D and George J Papanicolaou and Patel, Sanjay R and Pettaway, Curtis A and Peyser, Patricia A and Press, Michael F and Rao, D C and Rasmussen-Torvik, Laura J and Redline, Susan and Reiner, Alex P and Rhie, Suhn K and Rodriguez-Gil, Jorge L and Charles N Rotimi and Rotter, Jerome I and Ruiz-Narvaez, Edward A and Rybicki, Benjamin A and Babatunde Salako and Sale, Michele M and Sanderson, Maureen and Eric E Schadt and Schreiner, Pamela J and Schurmann, Claudia and Schwartz, Ann G and Daniel Shriner and Signorello, Lisa B and Andrew B Singleton and David S Siscovick and Smith, Jennifer A and Smith, Shad and Elizabeth K Speliotes and Spitz, Margaret and Stanford, Janet L and Stevens, Victoria L and Stram, Alex and Strom, Sara S and Sucheston, Lara and Yan V Sun and Tajuddin, Salman M and Taylor, Herman and Taylor, Kira and Bamidele O Tayo and Michael J Thun and Tucker, Margaret A and Vaidya, Dhananjay and Van Den Berg, David J and Vedantam, Sailaja and Vitolins, Mara and Wang, Zhaoming and Erin B Ware and Wassertheil-Smoller, Sylvia and David R Weir and Wiencke, John K and Williams, Scott M and L Keoki Williams and Wilson, James G and Witte, John S and Wrensch, Margaret and Wu, Xifeng and Yao, Jie and Zakai, Neil and Zanetti, Krista and Zemel, Babette S and Zhao, Wei and Jing Hua Zhao and Zheng, Wei and Zhi, Degui and Zhou, Jie and Zhu, Xiaofeng and Ziegler, Regina G and Zmuda, Joe and Alan B Zonderman and Psaty, Bruce M and Ingrid B Borecki and Cupples, L Adrienne and Liu, Ching-Ti and Christopher A Haiman and Ruth J F Loos and Ng, Maggie C Y and Kari E North} } @article {11776, title = {Does it Matter Who Decides? Outcomes of Surrogate Decision-Making for Community-Dwelling, Cognitively Impaired Older Adults Near the End of Life.}, journal = {Journal of Pain and Symptom Management}, volume = {62}, year = {2021}, pages = {1126-1134}, abstract = {

CONTEXT: Cognitively impaired older adults frequently need surrogate decision-making near the end-of-life. It is unknown whether differences in the surrogate{\textquoteright}s relationship to the decedent are associated with different end-of-life treatment choices.

OBJECTIVES: To describe differences in end-of-life care for community dwelling, cognitively impaired older adults when children and spouses are involved in decision-making.

METHODS: Retrospective observational study.

RESULTS: Among 742 community-dwelling adults with cognitive impairment (mild cognitive impairment or dementia) prior to death, children participated in end-of-life decisions for 615 patients (83\%) and spouses participated in decisions for 258 patients (35\%), with both children and spouses participating for 131 patients (18\%). When controlling for demographic characteristics, decedents with only a spouse decision-maker were less likely to undergo a life-sustaining treatment than decedents with only children decision-makers (P < 0.05). There was no difference in the probability of in-hospital death or burdensome transfers across facilities across decedent-decision-maker relationships. Differences in rates of life-sustaining treatment were greater when we restricted to decedents with dementia.

CONCLUSION: Decedents with cognitive impairment or dementia were less likely to receive life-sustaining treatments when spouses versus children were involved with end-of-life treatment decisions but were no less likely to experience other measures of potentially burdensome end-of-life care.

}, keywords = {end-of-life decisions, Family, surrogate decision-making}, issn = {1873-6513}, doi = {10.1016/j.jpainsymman.2021.06.009}, author = {Micah Y. Baum and Gallo, Joseph J and Nolan, Marie T and Kenneth M. Langa and Halpern, Scott D and Macis, Mario and Lauren Hersch Nicholas} } @article {11726, title = {Does postponing retirement affect cognitive function? A counterfactual experiment to disentangle life course risk factors}, journal = {SSM - Population Health}, volume = {15}, year = {2021}, pages = {100855}, abstract = {Evidence suggests that contemporaneous labor force participation affects cognitive function; however, it is unclear whether it is employment itself or endogenous factors related to individuals{\textquoteright} likelihood of employment that protects against cognitive decline. We exploit innovations in counterfactual causal inference to disentangle the effect of postponing retirement on later-life cognitive function from the effects of other life-course factors. With the U.S. Health and Retirement Study (1996{\textendash}2014, n = 20,469), we use the parametric g-formula to estimate the effect of postponing retirement to age 67. We also study whether the benefit of postponing retirement is affected by gender, education, and/or occupation, and whether retirement affects cognitive function through depressive symptoms or comorbidities. We find that postponing retirement is protective against cognitive decline, accounting for other life-course factors (population: 0.34, 95\% confidence interval (CI): 0.20,0.47; individual: 0.43, 95\% CI: 0.26,0.60). The extent of the protective effect depends on subgroup, with the highest educated experiencing the greatest mitigation of cognitive decline (individual: 50\%, 95\% CI: 32\%,71\%). By using innovative models that better reflect the empirical reality of interconnected life-course processes, this work makes progress in understanding how retirement affects cognitive function.}, keywords = {Causal inference, cognitive function, Labor force participation, life course, Retirement}, isbn = {2352-8273}, doi = {10.1016/j.ssmph.2021.100855}, author = {Jo Mhairi Hale and Maarten J. Bijlsma and Angelo Lorenti} } @article {10.1093/geroni/igab046.1092, title = {Does Relationship End Precede Cognitive Decline? An Analysis of the Health and Retirement Study}, journal = {Innovation in Aging}, volume = {5}, year = {2021}, pages = {281}, abstract = {Relationship status is thought to be associated with cognitive health in older adults, with married persons performing better on memory assessments than unmarried-cohabitating, single, divorced, and widowed persons. However, questions remain about whether relationship termination causes cognitive decline, is a result of it, or whether they share a cause; and the mechanisms by which such a relationship might operate. To address this gap in the literature, we hypothesized that relationship termination could affect cognition via the following five pathways: (1) post-termination depression; (2) loss of distributed-cognition partner; (3) cognitive depletion from caring for partner in declining and ultimately terminal health; (4) divorce to preserve assets to qualify for Medicaid to cover healthcare for cognitive decline; and (5) post-termination changes in neuropsychiatric symptoms alongside a pre-existing neurodegenerative condition that also causes cognitive decline. Using data from the 2000{\textendash}2016 waves of the Health and Retirement Study (HRS; N = 23,393), we found that relationship termination, whether due to divorce or widowhood, was associated with cognitive decline. Using mixed-effects regression we found that the rate of cognitive decline increased after relationship termination (widowhood: □ = -0.587, p \<0.001; divorce: □ = -0.221, p \<0.001), supporting mechanism (5). Using HRS data for respondents and their spouses{\textquoteright} mental and physical health, health insurance, and activities of daily living, we also find support for mechanisms (1) and (3). Relationship termination is a critical juncture in a person{\textquoteright}s life course that has multiple implications and may, ultimately, worsen patients{\textquoteright} conditions.}, keywords = {Cognitive decline, Divorce, Relationships}, issn = {2399-5300}, doi = {10.1093/geroni/igab046.1092}, author = {Hanes, Douglas and Clouston, Sean} } @article {11736, title = {Dose-Response Relationship Between Long-Term Blood Pressure Variability and Cognitive Decline.}, journal = {Stroke}, volume = {52}, year = {2021}, pages = {3249{\textendash}3257}, abstract = {

BACKGROUND AND PURPOSE: We aimed to test whether higher long-term blood pressure variability was associated with accelerated rate of cognitive decline and evaluate potential dose-response relationship.

METHODS: Original survey data from the Health and Retirement Study and the English Longitudinal Study of Ageing were used. Standardized score of cognitive function was the main outcome measure. Visit-to-visit blood pressure SD, coefficient of variation, and variation independent of mean were used. Linear mixed model and restricted spline were applied to assess association and explore dose-response pattern. Segmented regression was used to analyze dose-response relationship and estimate turning point. Meta-analysis using random-effects model was conducted to pool results, with used to test heterogeneity.

RESULTS: A total of 12 298 dementia-free participants were included (mean age: 64.6{\textpm}8.6 years). Significant association was observed between blood pressure variability and cognitive decline. Each 10\% increment in coefficient of variation of systolic and diastolic blood pressure was associated with accelerated global cognitive decline of 0.026 SD/y (95\% CI, 0.016-0.036, 0.001) and 0.022 SD/y (95\% CI, 0.017-0.027, 0.001), respectively. Nonlinear dose-response relationship was found (0.001 for nonlinearity), with clear turning point observed (0.001 for change in slopes).

CONCLUSIONS: Higher long-term blood pressure variability was associated with accelerated cognitive decline among general adults aged >=50 years, with nonlinear dose-response relationship. Further randomized controlled trials are warranted to evaluate potential benefits of blood pressure variability-lowering strategies from a cognitive health perspective.

}, keywords = {Blood pressure, Cognitive decline, ELSA, Hypertension, Retirement}, issn = {1524-4628}, doi = {10.1161/STROKEAHA.120.033697}, author = {Li, Chenglong and Ma, Yanjun and Hua, Rong and Yang, Zhenchun and Zhong, Baoliang and Wang, Hongyu and Xie, Wuxiang} } @conference {11807, title = {Economic Security in Retirement: Does Borrowing from Home Equity Moderate the Impact of a Health Shock on Health Outcomes?}, booktitle = {Retirement and Disability Research Consortium 23rd Annual Meeting}, year = {2021}, month = {08/2021}, publisher = {Center for Financial Security, University of Wisconsin-Madison}, organization = {Center for Financial Security, University of Wisconsin-Madison}, address = {Virtual Event}, abstract = {Health shocks pose a significant risk to economic security in retirement. About 35 percent of older adults are diagnosed with a major disease by age 65, rising to 65 percent by age 90 (Poterba et al. 2018). These health shocks are costly. While the majority of older adults receive Medicare, nearly 20 percent of health expenditures are paid out of pocket (DeNardi et al. 2016). Older adults often self-insure against these risks by accumulating wealth, including home equity. In this study, we ask: To what extent does home equity mitigate the economic burden created by a health shock, ultimately leading to better health outcomes? In contrast to a life cycle model, older adults tend to only spend down home equity following an expense shock (Davidoff, 2010; Nakajima \& Telyukova, 2019; Poterba \& Venti, 2017a). Several recent studies document a decline in home equity after a health shock (Gilligan et al. 2018; Gupta et al. 2018; Poterba et al. 2018), with home equity being second only to formal health insurance for financing health related consumption after a health shock in older age (Dalton and LaFave 2017). These studies do not identify the extent to which liquidating home equity improves the older household{\textquoteright}s health following a shock. An existing body of literature estimates the causal relationship between housing wealth and health outcomes generally, not limited to individuals with a health shock (Angrisani and Lee 2016; Costa-Font et al. 2019; Fichera \& Gathergood 2016; Hamoudi and Dowd 2013; 2014). Similar to our approach, these studies rely on geographic and intertemporal variations in house prices to isolate the exogenous component of housing wealth, either through reduced form specifications that directly model the relationship between changes in house values or house prices on health outcomes (Angrisani and Lee 2016; Fichera \& Gathergood 2016; Hamoudi and Dowd 2013; 2014) or by using geographic changes in house prices as an instrument for housing wealth (Costa-Font et al. 2019). While these papers tend to find a positive relationship between increases in housing wealth and health outcomes, they do not model the mechanisms through which this occurs{\textemdash}which is critical to inform policy. We expect that it is not simply the stock of home equity held by older adults that leads to better health outcomes, but the liquidation of home equity through borrowing following a health shock that leads to improved health outcomes. }, keywords = {health shock, Home equity, Retirement}, url = {https://cfsrdrc.wisc.edu/files/2021-RDRC-Meeting-Booklet.pdf$\#$page=7}, author = {Stephanie Moulton and Joseph, Joshua and C{\"a}zilia Loibl and Donald Haurin} } @article {11555, title = {Education, wealth, and duration of life expected in various degrees of frailty}, journal = {European Journal of Ageing}, volume = {18}, year = {2021}, pages = {393-404}, abstract = {Multistate life tables are used to estimate life expected in three frailty states: frailty free, mild/moderate frailty, severe frailty. Estimates are provided for the combination of education and wealth by age, stratified by sex. Data consider 17,115 cases from the Health and Retirement Study, 2000{\textendash}2014. Frailty is measured using a 59 item frailty index based on deficit accumulation. Estimates are derived using stochastic population analysis for complex events. Population-based and status-based results are reported. Findings confirm a hypothesis that the combination of higher education and wealth results in longer lives in more favorable degrees of frailty. Also, as hypothesized, wealth generally affords a greater advantage than does education among those with severe frailty at baseline. For instance, high wealth provides a 70-year-old woman with severe frailty at baseline 0.70 more total years and 0.81 more frailty free years then her counterpart with low wealth, compared to gains of 0.39 and 0.54, respectively, for those with high education. Unexpectedly, wealth also has a greater role among those frailty free at baseline. A 70-year-old woman frailty free at baseline with high wealth lives 3.19 more net years and 4.13 more years frailty free than her counterpart with low wealth, while the same comparison for high versus low education indicates advantages of 2.00 total and 1.96 frailty free years. Relative change ratios also indicate more robust results for wealth versus education. In sum, there is evidence that inequality in duration of life in degrees of frailty is socially patterned.}, keywords = {Aging, Frailty, health, Multistate life tables, socioeconomic status, Transition probability}, isbn = {1613-9380}, doi = {10.1007/s10433-020-00587-2}, author = {Zachary Zimmer and Saito, Yasuhiko and Theou, Olga and Haviva, Clove and Rockwood, Kenneth} } @proceedings {11633, title = {Educational Differences in Life Span Variation in Dementia Incidence}, journal = {32nd Reves Meeting}, year = {2021}, publisher = {Reves Network on Health Expectancy}, address = {Virtual}, abstract = {Objective: To examine educational differences in life span variation in dementia in the United States and assess the role of adult income in explaining the variation within educational levels. Method: We use the Health and Retirement Study (2000-2014) and techniques of microsimulation and bootstrap to estimate the age distribution of dementia incidence for major education groups, controlling and not controlling for adult income. Hypotheses: We anticipate that life span variation in dementia incidence will be substantially larger among less educated persons than among highly educated persons. Part of the reason for the larger educational variation among less educated persons may reflect both economic vulnerability in later adulthood (a large frail tail) and economic success (a smaller but visible robust tail). Among well educated people, we expect to see a compression of dementia reflecting a very small frail tail and the postponement of dementia until ages proximate to death}, keywords = {Dementia, Education}, url = {https://www.reves2021.org/sites/reves2021.org/files/2021-05/Schedule_REVES2021_withAbstract.pdf}, author = {Hyungmin Cha and Mateo P Farina and Chi-Tsun Chiu and Mark D Hayward} } @proceedings {12603, title = {The Effect Habitual Exercise on Older Adults Mental Health During the COVID-19 Pandemic.}, journal = {American College of Sports Medicine, Mid-Atlantic Chapter}, volume = {10}, year = {2021}, note = {Issue 9, Volume 10}, publisher = {International Journal of Exercise Science}, abstract = {The COVID-19 pandemic increased existing social isolation challenges in older adults due to quarantine and social distancing policies. Social isolation can be associated with an increase in mental health conditions such as anxiety and depression. Due to social isolation, many older adults had limited access to exercise opportunities. This is important because exercise can also affect mental health. PURPOSE: To consider the impact of exercise habits on older adults{\textquoteright} mental health during the COVID-19 pandemic. METHODS: The data used were from the Health and Retirement Study, a longitudinal study interviewing a representative sample of older adults biennially about physical and mental health, employment, and daily activities. In 2020, additional questions were added relating to COVID-19 and distributed to a subset of participants. Participants completed a physical activity questionnaire, the Beck Anxiety Inventory (n=1920) and the Center for Epidemiological Studies Depression questionnaire (n=2909). We ran logistic regression models. Model one had anxiety as the outcome of interest, and model 2 depressive symptoms. The independent variable was engaging in moderate exercise at least twice a week. All analyses were adjusted for covariates including the number of chronic health conditions, race/ethnicity, financial hardship during the pandemic, education, and alcohol use. RESULTS: Approximately 47\% of this sample reported exercising 1 or less times per week (mean age 70{\textpm}11 years, 49\% female) compared to 53\% reporting that they exercise 2 or more times per week (mean age 67{\textpm}11 years, 51\% female). Compared to older adults who exercised 2 or more times a week, those who exercised 1 or fewer times per week were found to be at increased risk for having elevated anxiety (OR = 1.41, 95\% CI= .695 -2.92) and depressive symptomology (OR =1.98,95\% CI =1.51-2.59). CONCLUSIONS: Exercising one or fewer times a week during the COVID-19 pandemic was associated with higher odds of anxiety and depressive symptoms in older adults. Older individuals who exercise less may be at increased risk for mental health symptoms during times of high psychosocial stress. With the emergence of new variants and uncertainty of the pandemic, it is important that older adults are encouraged to exercise to reduce odds of poor mental health outcomes.}, keywords = {COVID-19, Exercise, Mental Health}, url = {https://digitalcommons.wku.edu/cgi/viewcontent.cgi?article=5500\&context=ijesab}, author = {Resnick, Stephanie and Fridley, Echo and Mutambudzi, Miriam and Heffernan, Kevin} } @article {11656, title = {The effect of household wealth on financial debt after cancer diagnosis.}, journal = {Journal of Clinical Oncology}, volume = {39}, year = {2021}, pages = {e18552-e18552}, abstract = {Background: Cancer is the 2nd most common cause of death in the country, eclipsed only by heart disease. Cancer care is increasingly characterized by financial toxicity related to high-cost treatments, though it is unknown whether other chronic conditions impose similar financial harms. Methods: We conducted a retrospective analysis of the Health and Retirement Study participants interviewed between 2012-2018. This is a national, longitudinal survey conducted every two years of adults 50 and older and their spouses. We used fixed effect regression models to compare changes in financial debt among households with new diagnosis of cancer, other major chronic conditions (diabetes, stroke, or heart disease), and no new health diagnosis (or health shock). Since more affluent households may respond to health shocks differently, we estimated separate comparisons for households above versus below median wealth in 2012, prior to new health conditions. We assessed use of any non-housing financial debt, credit card debt, and home equity lines of credit among the subset of homeowning households. Results: In this study of 14,153 households, average age at interview was 62 years, with 43\% male, 70\% White, 22\% Black, 13\% Hispanic, and 70\% with up to high school education. Of this population, 25\% held credit card debt, 70\% owned a home, 18\% had a home equity line of credit, and 9\% used a home equity line of credit. Among households with below median wealth when they entered the study in 2012 ( < $23,000 in $2016), a new cancer diagnosis was associated with a 4.7 percentage point increase in financial debt (12.5\% effect size, p < 0.05). Participants diagnosed with a chronic condition (heart condition, stroke or diabetes) were 3.6 percentage points more likely to develop financial debt (9.6\%, p < 0.05) compared to households that did not develop a new chronic condition. Such differences were eliminated in participants in a house with above median wealth. There was no difference in credit card debt, availability of home equity line of credit, or use of home equity line of credit for participants with a new diagnosis. Conclusions: New diagnosis of cancer or a chronic condition were associated with increased financial debt for older Americans living in a household that were below median wealth.}, keywords = {cancer diagnosis, Debt, household wealth}, isbn = {0732-183X}, doi = {10.1200/JCO.2021.39.15_suppl.e18552}, author = {Hussaini, Syed and Dana, Mia and Lauren Hersch Nicholas} } @article {https://doi.org/10.1111/1475-6773.13784, title = {Eligible but Not Enrolled: Consequences of Forgoing Prescription Drug Subsidies Among Low-Income Medicare Beneficiaries with Diabetes}, journal = {Health Services Research}, volume = {56}, year = {2021}, pages = {62}, abstract = {Research Objective To estimate take-up of the Part D Low-Income Subsidy (LIS) among Medicare beneficiaries with diabetes, and to examine differences in out-of-pocket costs and prescription drug use between enrollees and LIS-eligible non-enrollees. The LIS lowers prescription drug costs for Medicare beneficiaries with incomes <=150\% of the Federal Poverty Level (FPL), and caps out-of-pocket costs for beneficiaries with incomes <=135\% of FPL. Although a number of recent policy proposals seek to address rising drug costs, the LIS itself remains underutilized. The value of forgoing this benefit among chronically ill beneficiaries has not previously been studied. Study Design We used data from the Health and Retirement Study (HRS) to estimate take-up of the LIS among Medicare beneficiaries with diabetes. Using propensity score-weighted analyses, we compared out-of-pocket costs, prescription drug use, and cost-related drug non-adherence among LIS enrollees and eligible non-enrollees. We stratified the analyses according to whether respondents{\textquoteright} income was <=100\% vs. >100\% to <=150\% of FPL because of differences in the generosity and take-up of Medicaid benefits above vs. below 100\% of FPL, and because individuals with Medicaid automatically receive the LIS. Population Studied Community-dwelling HRS respondents surveyed biennially between 2008{\textendash}2016 who were enrolled in Medicare Part D, had an established diagnosis of diabetes, and were eligible for the LIS (income <=150\% FPL and assets below LIS limit). Principal Findings Among Medicare beneficiaries with diabetes, 56.9\% of those with incomes >100\% to <=150\% of FPL received the LIS, while 90.3\% of those with incomes <=100\% received the LIS, reflecting automatic enrollment from Medicaid. Based on these take-up rates, we estimate that 322,746 LIS-eligible individuals with diabetes do not enroll in the LIS annually. For those with incomes >100\% to <=150\% of FPL, compared to LIS enrollees, eligible non-enrollees incurred higher annual out-of-pocket drug spending (\$518, p < 0.001), had 20\% fewer fills for diabetes, hypertension, and hyperlipidemia prescription drugs (p = 0.003), and were 9 percentage points more likely to report skipping drugs due to cost (p = 0.04). Conclusions A substantial proportion of Medicare beneficiaries with diabetes are eligible for but not enrolled in the LIS. Low take-up was concentrated among beneficiaries with income >100\% to <=150\% of FPL. Forgoing the LIS was associated with higher out-of-pocket costs and cost-related non-adherence, and lower use of medications used to treat chronic conditions. Our findings demonstrate the extent to which out-of-pocket costs may be reduced, and use of chronic disease medications increased, if a higher proportion of LIS-eligible Medicare beneficiaries receive this benefit. Implications for Policy or Practice Proposals to lower out-of-pocket drug costs for Medicare beneficiaries often overlook the fact that existing prescription drug subsidy programs are underutilized. Because the LIS reduces cost sharing for all Part D covered drugs and caps annual out-of-pocket costs for most recipients, increasing LIS take-up would likely provide better financial protection for seniors with chronic conditions than a flat subsidy or price caps limited to certain drugs. Policies to streamline or automate LIS enrollment for low-income Medicare beneficiaries could help to mitigate the impact of rising drug costs in this vulnerable population. Primary Funding Source Agency for Healthcare Research and Quality.}, keywords = {Diabetes, low-income, Medicare Beneficiaries, prescription drugs, subsidies}, doi = {10.1111/1475-6773.13784}, author = {Glynn, Alexandra and Hernandez, Inmaculada and Roberts, Eric} } @article {11749, title = {The epidemiology of social isolation and loneliness among older adults during the last years of life.}, journal = {Journal of the American Geriatrics Society}, volume = {69}, year = {2021}, pages = {3081-3091}, abstract = {

BACKGROUND: Social isolation and loneliness are critical to the health of older adults, but they have not been well-described at the end of life.

OBJECTIVES: To determine the prevalence and correlates of social isolation and loneliness among older adults in the last years of life.

DESIGN: Nationally representative, cross-sectional survey.

SETTING: Health and Retirement Study, 2006-2016 data.

PARTICIPANTS: Adults age > 50 interviewed once in the last 4 years of life (n~=~3613).

MEASUREMENTS: We defined social isolation using a 15-item scale measuring household contacts, social network interaction, and community engagement, and frequent loneliness using the 3-item UCLA Loneliness Scale. We used multivariable logistic regression to determine their adjusted prevalence by time prior-to-death and by subgroups of interest.

RESULTS: Approximately 19\% experienced social isolation, 18\% loneliness, and 5\% both in the last 4 years of life (correlation~=~0.11). The adjusted prevalence of social isolation was higher for individuals nearer to death (4 years: 18\% vs 0-3 months: 27\%, p~=~0.05) and there was no significant change in loneliness (4 years: 19\% vs 0-3 months: 23\%, p~=~0.13). Risk factors for both isolation and loneliness included (p < 0.01): low net-worth (Isolation: 34\% vs 14\%; Loneliness: 29\% vs 13\%), hearing impairment (Isolation: 26\% vs 20\%; Loneliness: 26\% vs 17\%), and difficulty preparing meals (Isolation: 27\% vs 19\%; Loneliness: 29\% vs 15\%). Factors associated with loneliness, but not social isolation, included being female, pain, incontinence, and cognitive impairment.

CONCLUSIONS: Social isolation and loneliness are common at the end of life, affecting 1 in 4 older adults, but few experience both. Rates were higher for older adults who were poor and experienced functional or sensory impairments. Results can inform clinical efforts to identify and address end-of-life psychosocial suffering and health policies which prioritize social needs at the end of life.

}, keywords = {Cognition, end of life, Loneliness, Palliative care, social isolation}, issn = {1532-5415}, doi = {10.1111/jgs.17366}, author = {Ashwin A Kotwal and Irena Cenzer and Linda J. Waite and Kenneth E Covinsky and Perissinotto, Carla M and W John Boscardin and Louise C Hawkley and Dale, William and Smith, Alexander K} } @article {11824, title = {Estimating the effects of Mexico to U.S. migration on elevated depressive symptoms: evidence from pooled cross-national cohorts.}, journal = {Annals of Epidemiology}, volume = {64}, year = {2021}, pages = {53-66}, abstract = {

BACKGROUND: Migrating from Mexico to the U.S. is a major, stressful life event with potentially profound influences on mental health. However, estimating the health effects of migration is challenging because of differential selection into migration and time-varying confounder mediators of migration effects on health.

METHODS: We pooled data from the Mexican Health and Aging Study (N=17,771) and Mexican-born U.S. Health and Retirement Study (N=898) participants to evaluate the effects of migration to the U.S. (at any age and in models for migration in childhood or adulthood) on depressive symptom-count, measured with a modified Centers for Epidemiologic Studies-Depression scale. We modeled probability of migrating in each year of life from birth to either age at initial migration to the U.S. or enrollment and used these models to calculate inverse probability of migration weights. We applied the weights to covariate-adjusted negative binomial GEE models, estimating the ratio of average symptom-count associated with migration.

RESULTS: Mexico to U.S. migration was unrelated to depressive symptoms among men (ratio of average symptom-count= 0.98 [95\% CI: 0.89, 1.08]) and women (ratio of average symptom-count=1.00 [95\% CI: 0.92, 1.09]). Results were similar for migration in childhood, early adulthood, or later adulthood.

CONCLUSIONS: In this sample of older Mexican-born adults, migration to the U.S. was unrelated to depressive symptoms.

}, keywords = {depression, Immigration, Mental Health, MHAS, Selection}, issn = {1873-2585}, doi = {10.1016/j.annepidem.2021.08.014}, author = {Audrey R Murchland and Adina Zeki Al Hazzouri and Zhang, Lanyu and Elfassy, Tali and Grasset, Leslie and Riley, Alicia and Wong, Rebecca and Mary Haan and Richard N Jones and Jacqueline M Torres and M. Maria Glymour} } @article {11631, title = {Evidence for a causal association between milk intake and cardiometabolic disease outcomes using a two-sample Mendelian Randomization analysis in up to 1,904,220 individuals.}, journal = {International Journal of Obesity}, volume = {45}, year = {2021}, pages = {1751-1762}, abstract = {

BACKGROUND: High milk intake has been associated with cardio-metabolic risk. We conducted a Mendelian Randomization (MR) study to obtain evidence for the causal relationship between milk consumption and cardio-metabolic traits using the lactase persistence (LCT-13910 C > T, rs4988235) variant as an instrumental variable.

METHODS: We tested the association of LCT genotype with milk consumption (for validation) and with cardio-metabolic traits (for a possible causal association) in a meta-analysis of the data from three large-scale population-based studies (1958 British Birth Cohort, Health and Retirement study, and UK Biobank) with up to 417,236 participants and using summary statistics from consortia meta-analyses on intermediate traits (N = 123,665-697,307) and extended to cover disease endpoints (N = 86,995-149,821).

RESULTS: In the UK Biobank, carriers of {\textquoteright}T{\textquoteright} allele of LCT variant were more likely to consume milk (P = 7.02 {\texttimes} 10). In meta-analysis including UK Biobank, the 1958BC, the HRS, and consortia-based studies, under an additive model, {\textquoteright}T{\textquoteright} allele was associated with higher body mass index (BMI) (P = 4.68 {\texttimes} 10) and lower total cholesterol (TC) (P = 2.40 {\texttimes} 10), low-density lipoprotein cholesterol (LDL-C) (P = 2.08 {\texttimes} 10) and high-density lipoprotein cholesterol (HDL-C) (P = 9.40 {\texttimes} 10). In consortia meta-analyses, {\textquoteright}T{\textquoteright} allele was associated with a lower risk of coronary artery disease (OR:0.86, 95\% CI:0.75-0.99) but not with type 2 diabetes (OR:1.06, 95\% CI:0.97-1.16). Furthermore, the two-sample MR analysis showed a causal association between genetically instrumented milk intake and higher BMI (P = 3.60 {\texttimes} 10) and body fat (total body fat, leg fat, arm fat and trunk fat; P < 1.37 {\texttimes} 10) and lower LDL-C (P = 3.60 {\texttimes} 10), TC (P = 1.90 {\texttimes} 10) and HDL-C (P = 3.00 {\texttimes} 10).

CONCLUSIONS: Our large-scale MR study provides genetic evidence for the association of milk consumption with higher BMI but lower serum cholesterol levels. These data suggest no need to limit milk intakes with respect to cardiovascular disease risk, with the suggested benefits requiring confirmation in further studies.

}, keywords = {Epidemiology, Nutrition, nutrition disorders}, issn = {1476-5497}, doi = {10.1038/s41366-021-00841-2}, author = {Vimaleswaran, Karani Santhanakrishnan and Zhou, Ang and Cavadino, Alana and Hypp{\"o}nen, Elina} } @mastersthesis {11601, title = {Examining the Relationship of Physical Activity, Inflammation \& Adiposity on Physical Function with Gender Differences}, volume = {Ph.D.}, year = {2021}, school = {Marquette University}, address = {Milwaukee, WI}, abstract = {Older adults are a rapidly growing segment of the population in the United States. The ability to maintain physical function declines with age and is a critical factor that contributes to living independently. Physical activity has been shown to slow declines in physical function and decrease chronic inflammation. Increases in adipose tissue and decreases in muscle mass are associated with aging. The increase in adipose tissue produces inflammatory markers that can negatively impact older adults{\textquoteright} health. Males and females{\textquoteright} biological changes with aging have been hypothesized to differ. The purposes of this study were to :1) examine the relationship between physical activity, inflammation, with physical function 2) determine if adiposity was a predictor and moderator of physical function and 3) determine if there were gender differences in these relationships for community dwelling older adults. This study was a cross-sectional secondary data analysis of the Health and Retirement Study (HRS)Wave 13 (2016) core biennial data and Venous Blood Study (n=4042). The mean age of study participants was 68.38 years old (SD = 9.64) and included 57.7\% females (n=2332) and 42.3\% males (n= 1710). Physical function, the outcome variable, included semi-tandem balance test and 3 self-report items addressing balance, grip strength, and walking endurance. Physical activity was measured using five self-report items assessing frequency of walking, sports or activity and mild, moderate, and vigorous activity. Chronic low-level inflammation was measured with the pro-inflammatory markers interleukin-6 and high sensitive c-reactive protein and anti-inflammatory biomarker interleukin-10. BMI was used to measure of adiposity. Using confirmatory factor analysis, latent factors were created for physical function, physical activity, and inflammation. Factor loadings and acceptable model fit (CFI scaled 0.871, CFI robust 0.879, SRMR 0.050, and gamma hat scaled 0.964) supported the indicators represented the measurement model. Latent regressions were significant (p<.001) and showed physical activity is positively associated with physical function and inflammation negatively impacts physical function. Correlations showed inflammation is negatively correlated with both physical activity and function. Adiposity was not a significant predictor and further moderation testing was not indicated. Model comparison between genders supported using the overall model versus gender specific models.}, keywords = {Adiposity, Gender Differences, Inflammation, Physical activity}, url = {https://epublications.marquette.edu/dissertations_mu/1068/}, author = {Jeanne Hlebichuk} } @article {11842, title = {Family Care Availability And Implications For Informal And Formal Care Used By Adults With Dementia In The US.}, journal = {Health Affairs}, volume = {40}, year = {2021}, pages = {1359-1367}, abstract = {

Despite the important role that family members can play in dementia care, little is known about the association between the availability of family members and the type of care, informal (unpaid) or formal (paid), that is actually delivered to older adults with dementia in the US. Using data about older adults with dementia from the Health and Retirement Study, we found significantly lower spousal availability but greater adult child availability among women versus men, non-Hispanic Blacks versus non-Hispanic Whites, and people with lower versus higher socioeconomic status. Adults with dementia and disability who have greater family availability were significantly more likely to receive informal care and less likely to use formal care. In particular, the predicted probability of a community-dwelling adult moving to a nursing home during the subsequent two years was substantially lower for those who had a co-resident adult child (11~percent) compared with those who did not have a co-resident adult child but had at least one adult child living close (20~percent) and with those who have all children living far (23~percent). Health care policies on dementia should consider potential family availability in predicting the type of care that people with dementia will use and the potential disparities in consequences for them and their families.

}, keywords = {Dementia, family caregivers, formal care, Informal care}, issn = {1544-5208}, doi = {10.1377/hlthaff.2021.00280}, author = {Choi, Hwajung and Michele M Heisler and Edward C Norton and Kenneth M. Langa and Cho, Tsai-Chin and Cathleen M. Connell} } @article {11245, title = {Family Caregiving for Those With and Without Dementia in the Last 10 Years of Life.}, journal = {JAMA Internal Medicine}, volume = {181}, year = {2021}, pages = {278-279}, abstract = {Family caregivers of people with dementia (eg, spouses, children, and other unpaid caregivers) provide high levels of care1 and experience substantial caregiver strain at the end of life,2 yet little is known about the trajectory of care as the end of life approaches and how individual family members contribute to total care. We compared the hours of care that family caregivers provide to those with and without dementia during the last 10 years of life. Methods We sampled all decedents in the nationally representative Health and Retirement Study, including interview waves 2006 to 2016, who were 75 years or older at the time of death (n = 5266) and excluded those with significant missing data (n = 1317). Data analysis was conducted between October 2019 and March 2020. We determined each family caregiver{\textquoteright}s annual care hours using the decedent{\textquoteright}s self-reported hours of help received with self-care and household activities in the preceding month. We estimated caregiving hours between interviews using a weighted average of hours from each interview and assigned annual prorated hours based on the time from interview to death.3 We used a clinically validated algorithm4 to determine dementia status in the interview before death and then stratified results based on marital status. The study was approved by the Mount Sinai School of Medicine institutional review board with a waiver of informed consent due to the retrospective nature of the study. Results Family caregivers of people with dementia provided 3 times as many total hours of care over the last 10 years of life compared with caregivers of those without dementia (Figure). While care hours provided to those with dementia increased steadily in each of the last 10 years (mean annual increase, 17\%; range 18\%-41\%), care hours provided to those without dementia remained low and then nearly tripled in the last year of life (mean [SD] of 8 [23] hours of care per week 1-2 years before death and 22 [35] hours in the last year of life). Adult children of those with dementia provided a larger portion of total care hours (50\%) compared with those without dementia (41\%). In the last year of life, adult children of those with dementia provided a mean (SD) of 17 (34) hours of care per week, while children of those without dementia provided a mean (SD) of 10 (22) hours. Among those married at the interview before death, spousal caregivers provided most of the care hours over all 10 years before death in the dementia and nondementia groups (81\% and 77\% of total care hours, respectively). Discussion Our study highlights the high levels of caregiving provided to those with dementia by their family caregivers in general and by adult children in particular. All married individuals relied primarily on spouses to provide care. However, adult children provided the bulk of care for family members with dementia, who were on average older and more likely to be widowed; substantial caregiving responsibilities for this population often began at least 10 years before death. The survey data did not assess the total time caregivers spent with family members; some time reported as caregiving may have replaced time spent in social engagement before needs arose, and our results may therefore overstate the time spent providing care. However, this limitation is unlikely to explain the many hours spent caregiving for individuals with dementia. Moreover, sustained caregiving responsibilities for individuals with dementia likely have financial implications beyond the time spent providing care. Caregivers may work fewer hours, miss opportunities for advancement, or fail to enter or stay in the workforce5; indirect costs of caregiving affect financial security and retirement savings and may even affect opportunities for the next generation. Because of the higher prevalence of dementia among those with lower socioeconomic status, the intergenerational effect of caregiving is particularly concerning for those already struggling to achieve equity. Existing programs that provide short-term, episodic support for caregivers (eg, the US Family Medical Leave Act and paid family leave) do not match the long-term, progressive care needs of those with dementia.}, keywords = {Caregiving, Dementia}, issn = {2168-6114}, doi = {10.1001/jamainternmed.2020.4012}, author = {Reckrey, Jennifer M and Bollens-Lund, Evan and Husain, Mohammed and Katherine A Ornstein and Amy Kelley} } @conference {11692, title = {On the Fence of a Family: Dynamics of Inter-generational Transfers in Stepfamilies}, booktitle = {Population Association of America Meeting}, year = {2021}, abstract = {The growing prevalence of family complexity in the United States calls into question the notion of family boundaries. Past research has shown weaker stepkin support consistently but has not explored the dynamics of exchanges. This paper studies how stepkin respond to each other{\textquoteright}s past signals of help in providing future interpersonal support, financial transfers, and contacts compared to biological kin to sheds light on stepkin{\textquoteright}s different motivations of support and relationship norms. I propose an {\textquotedblleft}on-the-fence{\textquotedblright} theory and three hypotheses suggesting dynamic stepkin relationships subject to their past interactions. Using data of the Health and Retirement Study (HRS) from 1996 to 2014 and within-family fixed effects models, major hypotheses are confirmed. I find that despite the lower transfers among stepkin when no past signals of help are present (low-bar expectation hypothesis), stepkin respond to the other{\textquoteright}s signals with a larger increase of parents{\textquoteright} monetary transfers, contacts, and adult children{\textquoteright}s interpersonal support compared to biological kin (sensitivity response hypothesis), but not a larger increase in parent{\textquoteright}s expectation or parents{\textquoteright} grandchild care support (differential convergence hypothesis). Results also vary depending on specific step status (child-stepmother or child-stepfather). Overall, the study provides a picture of dynamic stepkin relationship and family boundary.}, keywords = {Adult children, intergenerational relationships, motivations of transfers, stepfamilies}, url = {https://submissions2.mirasmart.com/Verify/PAA2021/Submission/Temp/radwd4acozb.pdf}, author = {He, Jingying} } @article {HUDOMIET2021102540, title = {Forecasting Mortality Inequalities in the U.S. Based on Trends in Midlife Health}, journal = {Journal of Health Economics}, volume = {80}, year = {2021}, pages = {102540}, abstract = {Recent literature has documented a widening gap in mortality between older individuals of high versus low socioeconomic status (SES) in the U.S. This paper investigates whether this trend will continue. We analyze the health status of successive cohorts of 54-60-year-old U.S. individuals born between 1934 and 1959 and use a rich set of health indicators to forecast life expectancies. The detailed health measures come from the longitudinal Health and Retirement Study. We find that many health indicators have worsened recently. For example, rates of obesity, diabetes, and self-reported levels of pain sharply increased between 1992 and 2016. Directly relevant for mortality, recent cohorts report lower subjective survival probabilities. Using Social Security wealth as an SES indicator, we find strong evidence for increasing health inequalities. We predict overall life expectancy to increase further; but the increase will be concentrated among higher SES individuals and mortality inequality will continue to increase.}, keywords = {differential survival, Health Inequality, social security wealth, socioeconomic status}, issn = {0167-6296}, doi = {10.1016/j.jhealeco.2021.102540}, author = {P{\'e}ter Hudomiet and Michael D Hurd and Susann Rohwedder} } @article {10692, title = {The Foreclosure Crisis, Community Change, and the Cognitive Health of Older Adults}, journal = {The Journals of Gerontology: Series B}, volume = {76}, year = {2021}, pages = {956-967}, abstract = {Objectives While home foreclosures are often thought of as a household-level event, the consequences may be far-reaching, and spill over to the broader community. Older adults, in particular, could be affected by the spiral of community changes that result from foreclosures, but we know very little about how the foreclosure crisis is related to older adult health, in particular cognition. Method This paper uses growth curve models and data from the Health and Retirement Study matched to Census and county-level foreclosure data to examine whether community foreclosures are related to older adults{\textquoteright} cognitive health and the mechanisms responsible. Results We find that higher rates of county-level foreclosures are associated with a faster decline in individual cognition at older ages. Although we examined an extensive number of individual and community mechanisms, including individual housing wealth and depressive symptoms, community structural factors, social factors, and perceptions of physical disorder and cohesion, none of the mechanisms examined here explained this relationship. Discussion This study shows that the adverse consequences of home foreclosures spill over to the local community, with implications for the cognitive health of older adults}, keywords = {Cognitive decline, Community physical disorder, Community social cohesion, Foreclosures}, doi = {10.1093/geronb/gbaa047}, author = {Esther M Friedman and Houle, Jason and Kathleen A. Cagney and Mary E Slaughter and Regina A Shih} } @article {11202, title = {Frailty Changes Predict Mortality in 4 Longitudinal Studies of Aging}, journal = {The Journals of Gerontology: Series A }, volume = {76}, year = {2021}, pages = {1619-1626}, abstract = {Baseline frailty index (FI) values have been shown to predict mortality among older adults, but little is known about the effects of changes in FI on mortality.In a coordinated approach, we analyzed data from 4 population-based cohorts: the Health and Retirement Study (HRS), the Survey of Health, Ageing and Retirement in Europe (SHARE), the English Longitudinal Survey of Ageing (ELSA), and the Longitudinal Aging Study Amsterdam (LASA), comprising a total of 24 961 respondents (65+), 95 897 observations, up to 9 repeated FI assessments, and up to 23 years of mortality follow-up. The effect of time-varying FI on mortality was modeled with joint regression models for longitudinal and time-to-event data.Differences (of 0.01) in current FI levels (hazard ratio [HR] = 1.04, 95\% credible interval [CI] = 1.03{\textendash}1.05) and baseline FI levels (HR = 1.03, 95\% CI = 1.03{\textendash}1.05) were consistently associated with mortality across studies. Importantly, individuals with steeper FI growth also had a higher mortality risk: An increase in annual FI growth by 0.01 was associated with an increased mortality risk of HR = 1.56 (95\% CI = 1.49{\textendash}1.63) in HRS, HR = 1.24 (95\% CI = 1.13{\textendash}1.35) in SHARE, HR = 1.40 (95\% CI = 1.25{\textendash}1.52) in ELSA, and HR = 1.71 (95\% CI = 1.46{\textendash}2.01) in LASA.FI changes predicted mortality independently of baseline FI differences. Repeated assessment of frailty and individual{\textquoteright}s frailty trajectory could provide a means to anticipate further health deterioration and mortality and could thus support clinical decision making.}, keywords = {ELSA, Epidemiology, Frailty, Mortality, Public Health, SHARE}, isbn = {1079-5006}, doi = {10.1093/gerona/glaa266}, author = {Stolz, Erwin and Emiel O Hoogendijk and Mayerl, Hannes and Wolfgang Freidl} } @article {11425, title = {Gender Disparities in Life Satisfaction after Retirement: The Role of Leisure, Family, and Finances.}, journal = {The Gerontologist}, volume = {61}, year = {2021}, pages = {1277-1286}, abstract = {

BACKGROUND AND OBJECTIVES: Recent research on life satisfaction in retirement explores gender differences but yields inconsistent patterns and does not consider gendered sources of satisfaction. We use a gender relations framework to examine whether women and men experience different changes in life satisfaction with retirement, and whether observed differences are a consequence of different assessments of the leisure, family, and financial situations that characterize their post-retirement lives.

RESEARCH DESIGN AND METHODS: We use longitudinal data drawn from men and women in the Health and Retirement Study who transitioned into retirement between ages 62-72 for the first time between 2008 and 2016 (N=593). We employ Ordinary Least Squares regression and mediation tests to assess gender differences in overall and domain-specific life satisfaction (i.e., leisure, family, finances).

RESULTS: Men reported increased life satisfaction following retirement, but women did not. No gender differences related to leisure or family life post-retirement emerged. Gender was associated with post-retirement satisfaction with finances (p<0.001), with men reporting higher financial satisfaction. Mediation models confirmed a gender disparity in overall life satisfaction mediated by satisfaction with finances post-retirement (p<0.01), explaining approximately one-third of the disparity.

DISCUSSION AND IMPLICATIONS: This study shows men derive greater improvements in life satisfaction in association with retirement than do women, and some of this disparity relates to women{\textquoteright}s lower satisfaction with their finances. These findings should caution policy-makers from assuming how women{\textquoteright}s increased labor force participation influences financial security in retirement, and encourage scholars to consider how gender influences subjective assessments of later life.

}, keywords = {Diversity in aging, Gender relations, Longitudinal methods}, issn = {1758-5341}, doi = {10.1093/geront/gnab015}, author = {Calasanti, Toni and Dawn C Carr and Patricia Homan and Coan, Victoria} } @article {12127, title = {Gene-educational attainment interactions in a multi-ancestry genome-wide meta-analysis identify novel blood pressure loci.}, journal = {Mol Psychiatry}, volume = {26}, year = {2021}, pages = {2111-2125}, abstract = {

Educational attainment is widely used as a surrogate for socioeconomic status (SES). Low SES is a risk factor for hypertension and high blood pressure (BP). To identify novel BP loci, we performed multi-ancestry meta-analyses accounting for gene-educational attainment interactions using two variables, "Some College" (yes/no) and "Graduated College" (yes/no). Interactions were evaluated using both a 1 degree of freedom (DF) interaction term and a 2DF joint test of genetic and interaction effects. Analyses were performed for systolic BP, diastolic BP, mean arterial pressure, and pulse pressure. We pursued genome-wide interrogation in Stage 1 studies (N = 117 438) and follow-up on promising variants in Stage 2 studies (N = 293 787) in five ancestry groups. Through combined meta-analyses of Stages 1 and 2, we identified 84 known and 18 novel BP loci at genome-wide significance level (P < 5 {\texttimes} 10). Two novel loci were identified based on the 1DF test of interaction with educational attainment, while the remaining 16 loci were identified through the 2DF joint test of genetic and interaction effects. Ten novel loci were identified in individuals of African ancestry. Several novel loci show strong biological plausibility since they involve physiologic systems implicated in BP regulation. They include genes involved in the central nervous system-adrenal signaling axis (ZDHHC17, CADPS, PIK3C2G), vascular structure and function (GNB3, CDON), and renal function (HAS2 and HAS2-AS1, SLIT3). Collectively, these findings suggest a role of educational attainment or SES in further dissection of the genetic architecture of BP.

}, keywords = {Blood pressure, Epistasis, Genetic, Genetic Loci, Genome-Wide Association Study, Humans, Hypertension, Polymorphism, Single Nucleotide}, issn = {1476-5578}, doi = {10.1038/s41380-020-0719-3}, author = {de Las Fuentes, Lisa and Yun Ju Sung and Noordam, Raymond and Thomas W Winkler and Feitosa, Mary F and Schwander, Karen and Bentley, Amy R and Brown, Michael R and Guo, Xiuqing and Alisa Manning and Daniel I Chasman and Aschard, Hugues and Traci M Bartz and Bielak, Lawrence F and Campbell, Archie and Cheng, Ching-Yu and Dorajoo, Rajkumar and Hartwig, Fernando P and Horimoto, A R V R and Li, Changwei and Li-Gao, Ruifang and Liu, Yongmei and Marten, Jonathan and Musani, Solomon K and Ntalla, Ioanna and Rankinen, Tuomo and Melissa Richard and Sim, Xueling and Smith, Albert V and Tajuddin, Salman M and Bamidele O Tayo and Vojinovic, Dina and Warren, Helen R and Xuan, Deng and Alver, Maris and Boissel, Mathilde and Jin-Fang Chai and Chen, Xu and Christensen, Kaare and Divers, Jasmin and Evangelou, Evangelos and Gao, Chuan and Giorgia G Girotto and Sarah E Harris and He, Meian and Hsu, Fang-Chi and K{\"u}hnel, Brigitte and Laguzzi, Federica and Li, Xiaoyin and Lyytik{\"a}inen, Leo-Pekka and Ilja M Nolte and Poveda, Alaitz and Rauramaa, Rainer and Riaz, Muhammad and Rueedi, Rico and Shu, Xiao-Ou and Snieder, Harold and Sofer, Tamar and Takeuchi, Fumihiko and Verweij, Niek and Erin B Ware and Weiss, Stefan and Yanek, Lisa R and Amin, Najaf and Dan E Arking and Donna K Arnett and Bergmann, Sven and Boerwinkle, Eric and Brody, Jennifer A and Broeckel, Ulrich and Brumat, Marco and Burke, Gregory and Cabrera, Claudia P and Canouil, Micka{\"e}l and Chee, Miao Li and Chen, Yii-Der Ida and Cocca, Massimiliano and Connell, John and de Silva, H Janaka and de Vries, Paul S and Eiriksdottir, Gudny and Jessica Faul and Fisher, Virginia and Forrester, Terrence and Fox, Ervin F and Friedlander, Yechiel and Gao, He and Gigante, Bruna and Giulianini, Franco and Gu, Chi Charles and Gu, Dongfeng and Tamara B Harris and He, Jiang and Heikkinen, Sami and Heng, Chew-Kiat and Hunt, Steven and Ikram, M Arfan and Irvin, Marguerite R and K{\"a}h{\"o}nen, Mika and Kavousi, Maryam and Khor, Chiea Chuen and Kilpel{\"a}inen, Tuomas O and Koh, Woon-Puay and Komulainen, Pirjo and Kraja, Aldi T and Krieger, J E and Langefeld, Carl D and Li, Yize and Liang, Jingjing and David C Liewald and Liu, Ching-Ti and Liu, Jianjun and Kurt Lohman and M{\"a}gi, Reedik and McKenzie, Colin A and Meitinger, Thomas and Andres Metspalu and Milaneschi, Yuri and Lili Milani and Dennis O Mook-Kanamori and Michael A Nalls and Nelson, Christopher P and Norris, Jill M and Jeff O{\textquoteright}Connell and Ogunniyi, Adesola and Padmanabhan, Sandosh and Palmer, Nicholette D and Nancy L Pedersen and Thomas T Perls and Peters, Annette and Petersmann, Astrid and Peyser, Patricia A and Polasek, Ozren and David J Porteous and Raffel, Leslie J and Rice, Treva K and Rotter, Jerome I and Rudan, Igor and Rueda-Ochoa, Oscar-Leonel and Sabanayagam, Charumathi and Babatunde Salako and Schreiner, Pamela J and Shikany, James M and Stephen Sidney and Sims, Mario and Sitlani, Colleen M and Smith, Jennifer A and John M Starr and Strauch, Konstantin and Swertz, Morris A and Teumer, Alexander and Tham, Yih Chung and Andr{\'e} G Uitterlinden and Vaidya, Dhananjay and van der Ende, M Yldau and Waldenberger, Melanie and Wang, Lihua and Wang, Ya-Xing and Wei, Wen-Bin and David R Weir and Wen, Wanqing and Yao, Jie and Yu, Bing and Yu, Caizheng and Yuan, Jian-Min and Zhao, Wei and Alan B Zonderman and Becker, Diane M and Bowden, Donald W and Ian J Deary and D{\"o}rr, Marcus and T{\~o}nu Esko and Freedman, Barry I and Froguel, Philippe and Paolo P. Gasparini and Gieger, Christian and Jost Bruno Jonas and Kammerer, Candace M and Kato, Norihiro and Lakka, Timo A and Leander, Karin and Lehtim{\"a}ki, Terho and Patrik K E Magnusson and Marques-Vidal, Pedro and Brenda W J H Penninx and Nilesh J Samani and van der Harst, Pim and Wagenknecht, Lynne E and Wu, Tangchun and Zheng, Wei and Zhu, Xiaofeng and Bouchard, Claude and Cooper, Richard S and Correa, Adolfo and Michele K Evans and Gudnason, Vilmundur and Caroline Hayward and Horta, Bernardo L and Tanika N Kelly and Stephen B Kritchevsky and Levy, Daniel and Walter R Palmas and Pereira, A C and Province, Michael M and Psaty, Bruce M and Ridker, Paul M and Charles N Rotimi and Tai, E Shyong and van Dam, Rob M and Cornelia M van Duijn and Wong, Tien Yin and Kenneth Rice and Gauderman, W James and Alanna C Morrison and Kari E North and Sharon L R Kardia and Caulfield, Mark J and Elliott, Paul and Munroe, Patricia B and Franks, Paul W and Rao, Dabeeru C and Myriam Fornage} } @article {11378, title = {Genes Related to Education Predict Frailty Among Older Adults in the United States.}, journal = {The Journals of Gerontology, Series B }, volume = {76}, year = {2021}, pages = {173-183}, abstract = {

OBJECTIVE: This article expands on research that links education and frailty among older adults by considering the role of genes associated with education.

METHOD: Data come from a sample of 7,064 non-Hispanic, white adults participating in the 2004-2012 waves of the Health and Retirement Study. Frailty was measured with two indices: (a) The Frailty Index which corresponds to a deficit accumulation model; and (b) The Paulson-Lichtenberg Frailty Index which corresponds to the biological syndrome/phenotype model. Genes associated with education were quantified using an additive polygenic score. Associations between the polygenic score and frailty indices were tested using a series of multilevel models, controlling for multiple observations for participants across waves.

RESULTS: Results showed a strong and negative association between genes for education and frailty symptoms in later life. This association exists above and beyond years of completed education and we demonstrate that this association becomes weaker as older adults approach their 80s.

DISCUSSION: The results contribute to the education-health literature by highlighting new and important pathways through which education might be linked to successful aging.

}, keywords = {Education, Functional health status, Genetics, Successful aging}, issn = {1758-5368}, doi = {10.1093/geronb/gbz092}, author = {Huibregtse, Brooke M and Breanne L Newell-Stamper and Benjamin W Domingue and Jason D Boardman} } @article {11538, title = {Genome-wide association study of suicidal behaviour severity in mood disorders.}, journal = {World Journal of Biological Psychiatry}, volume = {22}, year = {2021}, pages = {722-731}, abstract = {

OBJECTIVE: Suicide is a major public health problem and it has a prominent genetic component. We performed a genome-wide association study (GWAS) of suicidal behaviour severity.

METHODS: Suicide behaviour severity was assessed within the Schedules for Clinical Assessment in Neuropsychiatry in our mood disorder sample (N = 3506) for the GWAS. We also performed polygenic risk score analyses to explore genetic sharing between suicidal behaviour severity and a number of phenotypes, including bipolar disorder, major depressive disorder, alcoholism, post-traumatic stress disorder, impulsivity, insomnia, educational attainment, loneliness, maltreatment, and amygdala volume.

RESULTS: We did not detect genome-wide significant findings at the single-marker or gene level. We report a number of suggestive single-marker and gene-based findings. Our polygenic risk score analyses did not yield significant findings with these phenotypes.

CONCLUSIONS: Larger sample sizes are required to detect moderate effects.

}, keywords = {Bipolar Disorder, Genome-Wide Association Study, major depressive disorder, Mood Disorders, Suicidal Ideation, suicidality, suicide attempt}, issn = {1814-1412}, doi = {10.1080/15622975.2021.1907711}, author = {Zai, Clement C and Fabbri, Chiara and Hosang, Georgina M and Zhang, Ruo Su and Koyama, Emiko and de Luca, Vincenzo and Tiwari, Arun K and King, Nicole and Strauss, John and Jones, Ian and Jones, Lisa and Breen, Gerome and Farmer, Anne E and McGuffin, Peter and Vincent, John B and Kennedy, James L and Lewis, Cathryn M} } @article {11116, title = {Grandparenthood and risk of mortality: Findings from the Health and Retirement Study.}, journal = {Social Science \& Medicine}, volume = {268}, year = {2021}, pages = {113371}, abstract = {

Grandparenthood constitutes a significant role for older adults and may have important health implications. Our study examines the grandparenthood-mortality nexus, controlling for an array of potentially confounding variables. Longitudinal survey data from the Health and Retirement Study (HRS) were used, comprising twelve biennial waves from 1992 to 2014 with linked data on vital status derived from the National Death Index. The sample included 27,463 participants aged >=51 years with at least one child. Cox proportional hazard models tested the association between grandparenthood and mortality risk with adjustment for socio-demographic variables, for social variables including characteristics of and contact with children, and for health variables, including measures of general, functional and mental health. Grandparenthood overall was unassociated with mortality risk in both women and men. However, the subpopulation of younger, partnered grandmothers with a larger number of grandchildren tended to exhibit a substantial increase in mortality risk as compared to women without grandchildren.

}, keywords = {Aging, Longitudinal research, Social Relationships, Survival, Well-being}, issn = {1873-5347}, doi = {10.1016/j.socscimed.2020.113371}, author = {Ellwardt, Lea and Hank, Karsten and Carlos F. Mendes de Leon} } @mastersthesis {11673, title = {Grandparenthood, Grandparenting, and Working Longer: Do the Genders of Grandparent and of Grandchild{\textquoteright}s Parent Matter?}, year = {2021}, school = {Harvard University}, address = {Cambridge, MA}, abstract = {With the growing importance of grandparenting and working longer, grandparents might experience tensions between paid and unpaid work similar to younger workers. I examine changes in older workers{\textquoteright} engagement in paid employment following their transitions to grandparenthood. Due to gendered expectations for caretaking, I expect the change in women{\textquoteright}s risk of quitting paid work to be more positive than men{\textquoteright}s when they become grandparents and the change in labor force exit risk to be more positive for older workers of both genders when daughters, compared to sons, become parents. Using the Health and Retirement Study (HRS), I find that becoming a grandparent is indeed associated with a higher exit risk for female workers only when their daughters become parents. Both paternal grandmothers{\textquoteright} and maternal grandfathers{\textquoteright} average exit risks remain unchanged from the pre-grandparenthood levels, while paternal grandfathers{\textquoteright} risk drops. These findings suggest that gendered expectations surrounding caregiving persist across generations.}, keywords = {gender, Grandparents, Working Longer}, url = {https://www.icpsr.umich.edu/files/ICPSR/prize/ICPSR_Master_s_Competition_Hwang.pdf}, author = {In Jeong Hwang} } @article {10700, title = {Handgrip Strength Asymmetry and Weakness Together are Associated with Functional Disability in Aging Americans}, journal = {The Journals of Gerontology: Series A}, volume = {76}, year = {2021}, pages = {291}, abstract = {Evaluating handgrip strength (HGS) asymmetry may help to improve the prognostic value of HGS. This study sought to determine the associations of HGS asymmetry and weakness on future activities of daily living (ADL) disability in a national sample of aging Americans.The analytic sample included 18,468 Americans aged >=50-years from the 2006-2016 waves of the Health and Retirement Study. A handgrip dynamometer measured HGS. Those with HGS \>10\% stronger on either hand were considered as having any HGS asymmetry. Individuals with HGS \>10\% stronger on their dominant hand were considered as having dominant HGS asymmetry, while those with HGS \>10\% stronger on their non-dominant hand were classified as having non-dominant HGS asymmetry. Men with HGS \<26-kilograms and women with HGS \<16-kilograms were considered weak. ADLs were self-reported. Generalized estimating equations were used for analyses.Relative to those with symmetric HGS and no weakness, each HGS asymmetry and weakness group had increased odds for future ADL disability: 1.11 (95\% confidence interval (CI): 1.02-1.20) for any HGS asymmetry alone, 1.42 (CI: 1.16-1.74) for weakness alone, and 1.81 (CI: 1.52-2.16) for both any HGS asymmetry and weakness. Most weakness and HGS asymmetry dominance groups had increased odds for future ADL disability: 1.30 (CI: 1.13-1.50) for non-dominant HGS asymmetry alone, 1.42 (CI: 1.16-1.74) for weakness alone, 1.72 (CI: 1.29-2.29) for both weakness and non-dominant HGS asymmetry, and 1.86 (CI: 1.52-2.28) for both weakness and dominant HGS asymmetry.HGS asymmetry and weakness together may increase the predictive utility of handgrip dynamometers.}, keywords = {Biomarkers, Disablement Process, Epidemiology, Functional Performance}, issn = {1079-5006}, doi = {10.1093/gerona/glaa100}, author = {Ryan P McGrath and Brenda Vincent and Donald A Jurivich and Kyle J Hackney and Grant R Tomkinson and Lindsey J Dahl and Brian C Clark} } @article {11434, title = {Health Consequences of Retirement Due to Non-Health Reasons or Poor Health}, journal = {Social Science \& Medicine}, volume = {273}, year = {2021}, pages = {113767}, abstract = {ObjectivesThis study aimed to contribute to our understanding of the complex linkage between retirement and health by estimating health consequences of retirement transitions that were not driven by health reasons separately from those caused by poor health, while taking into consideration the health differences that exist between individuals who engage in different labor force behaviors.MethodsTen waves of rich data from the U.S. Health and Retirement Study (N=9,351; 52,658 person-wave observations) were used to estimate within-person associations between retirement transitions and subsequent health, assessed with self-rated health and depressive symptoms. To account for the bidirectional relationship between retirement and health, retiree{\textquoteright}s self-reports of the reasons for labor force withdrawal were used to identify and parse out retirement transitions driven by poor health from the retirement transitions that were unrelated to health reasons. Results: Retirement transitions were unrelated to subsequent health if the withdrawal from the labor force was driven by non-health reasons, whereas retirement transitions driven by poor health were associated with worse subsequent health. Retirement transitions that were phased through partial retirement were associated with worse health outcomes compared to transitioning from full-time work to complete retirement.ConclusionsStudy findings suggest that retirement policies designed to prolong working lives may be implemented without adversely influencing health of older individuals, and potentially delay negative health outcomes associated with retirement for some segments of the older population for whom labor force participation is considered more valuable.}, keywords = {Depressive symptoms, Endogeneity, labor force behavior, Self-rated health, Within-between random effects model}, isbn = {0277-9536}, doi = {https://doi.org/10.1016/j.socscimed.2021.113767}, author = {Sae Hwang Han} } @article {11880, title = {Heterogenous Trajectories in Physical, Mental and Cognitive Health among Older Americans: Roles of Genetics and Earlier SES}, number = {2021-76}, year = {2021}, institution = {University of Pennsylvania}, address = {Philadelphia, PA}, abstract = {We investigate the roles of genetic predispositions, childhood SES and adult schooling attainment in shaping trajectories for three important components of the overall health and wellbeing of older adults -- BMI, depressive symptoms and cognition. We use the Health \& Retirement Study (HRS) and group-based trajectory modelling (GBTM) to identify subgroups of people who share the same underlying trajectories over ages 50-94 years. After identifying common underlying trajectories, we use fractional multinomial logit models to estimate associations of (1) polygenic scores for BMI, depression, ever-smoked, education, cognition and subjective wellbeing, (2) childhood SES and (3) schooling attainment on the probabilities of trajectory group membership. While genetic predispositions do play a part in predicting trajectory group membership, our results highlight the long arm of socioeconomic factors. Schooling attainment is the most robust predictor{\textemdash}it predicts increased probabilities of belonging to trajectories with BMI in the normal rage, low depressive symptoms and high initial cognition. Childhood circumstances are manifested in trajectories to a lesser extent, with childhood SES only predicting the likelihood of being on the low depressive symptoms trajectory. We also find suggestive evidence that associations of schooling attainment on the probabilities of being on trajectories with BMI in the normal rage, low depressive symptoms and high initial cognition vary with genetic predispositions.}, keywords = {Aging trajectories, childhood socioeconomic status, polygenic scores, schooling}, url = {https://repository.upenn.edu/psc_publications/76/}, author = {Hoang, Cung Truong and Amin, Vikesh and Behrman, Jere R. and Hans-Peter Kohler and Iliana V. Kohler} } @article {12075, title = {History of drinking problems diminishes the protective effects of within-guideline drinking on 18-year risk of dementia and CIND.}, journal = {BMC Public Health}, volume = {21}, year = {2021}, pages = {2319}, abstract = {

OBJECTIVE: To examine the moderating effect of older adults{\textquoteright} history of drinking problems on the relationship between their baseline alcohol consumption and risk of dementia and cognitive impairment, no dementia (CIND) 18 years later.

METHOD: A longitudinal Health and Retirement Study cohort (n = 4421) was analyzed to demonstrate how older adults{\textquoteright} baseline membership in one of six drinking categories (non-drinker, within-guideline drinker, and outside-guideline drinker groups, divided to reflect absence or presence of a history of drinking problems) predicts dementia and CIND 18 years later.

RESULTS: Among participants with no history of drinking problems, 13\% of non-drinkers, 5\% of within-guideline drinkers, and 9\% of outside-guideline drinkers were classified as having dementia 18-years later. Among those with a history of drinking problems, 14\% of non-drinkers, 9\% of within-guideline drinkers, and 7\% of outside-guideline drinkers were classified with dementia. With Non-Drinker, No HDP as reference category, being a baseline within-guideline drinker with no history of drinking problems reduced the likelihood of dementia 18 years later by 45\%, independent of baseline demographic and health characteristics; being a baseline within-guideline drinker with a history of drinking problems reduced the likelihood by only 13\% (n.s.). Similar patterns obtained for the prediction of CIND.

CONCLUSIONS: For older adults, consuming alcohol at levels within validated guidelines for low-risk drinking may offer moderate long-term protection from dementia and CIND, but this effect is diminished by having a history of drinking problems. Efforts to predict and prevent dementia and CIND should focus on older adults{\textquoteright} history of drinking problems in addition to how much alcohol they consume.

}, keywords = {Alcohol Consumption, CIND, Dementia, Drinking problems}, issn = {1471-2458}, doi = {10.1186/s12889-021-12358-4}, author = {Penny L. Brennan and Holahan, Charles J and Moos, Rudolf H and Kathleen K Schutte} } @mastersthesis {11641, title = {Household Incomes and Medical Outcomes: Evaluation of Cost-related Factors in Older Adults with Diabetes}, year = {2021}, school = {University of Michigan}, address = {Ann Arbor, MI}, abstract = {This paper assessed the relationship of income position among samples of older diabetic adults in the US on relative financial and medical outcomes. Using data from the Health and Retirement Study, unadjusted and adjusted variables indicating medical expenditures and rates of medication underuse were analyzed by relative income position and compared across two age groups (55 {\textendash} 64 and 65 {\textendash} 74). Low-income diabetic populations were found to spend substantially higher portions of total income on medical costs compared to high income diabetics (34.08\% in the bottom 10\% vs. 1.24\% in the top 10\% for ages 55 {\textendash} 64). Rates of medication underuse were found to be differentiated at the median income position for the sample ages 55 {\textendash} 64 and significantly higher across all income groups as compared to the sample ages 65 {\textendash} 74. Results of this study reinforce significant established socioeconomic effects on health disparities and suggest a need for policy addressing this issue. }, keywords = {Diabetes, household income, medical outcomes}, url = {https://lsa.umich.edu/content/dam/econ-assets/Econdocs/HonorsTheses/Household\%20Incomes\%20and\%20Medical\%20Outcomes.pdf}, author = {Hanigan, McKenzie} } @article {11665, title = {Household portfolio allocation, uncertainty, and risk}, journal = {Journal of Empirical Finance}, volume = {63}, year = {2021}, pages = {96-117}, abstract = {Analysing the Panel Study of Income Dynamics and the Health and Retirement Study, we investigate the extent to which US households reduce their financial risk exposure when confronted with background risk. Our novel modelling approach {\textendash} termed a deflated ordered fractional model {\textendash} quantifies how the overall composition of a household portfolio with three asset classes adjusts with background risk, and is unique in recovering for any given risky asset class the shares that are reallocated to each safer asset category. Background risk exerts a significant impact on household portfolios, inducing a {\textquoteleft}flight from risk{\textquoteright} from riskier to safer assets.}, keywords = {Applied econometrics, asset allocation, Background risk, Fractional models}, isbn = {0927-5398}, doi = {10.1016/j.jempfin.2021.05.004}, author = {Brown, Sarah and Gray, Daniel and Harris, Mark N. and Spencer, Christopher} } @article {11058, title = {How Self-Employed Older Adults Differ by Age: Evidence and Implications From the Health and Retirement Study}, journal = {The Gerontologist}, volume = {61}, year = {2021}, month = {2020}, pages = {763-774}, abstract = {There has been increased attention in recent years on self-employment in later life, with about one in five workers past of the age of 50 working for themselves. This study aims to build upon previous documentation of the characteristics of self-employed older adults by estimating how these characteristics vary by age.Using seven waves of the Health and Retirement Study with a sample of more than 12,000 working older adults, this study considers how the association between self-employment and sociodemographic characteristics; indicators of human, social, and financial capital; and risk tolerance differ between adults aged 50 to 61 and 62 years and older. Binary logistic regression and seemingly unrelated estimation are used to estimate and compare the characteristics by age group.Compared to wage-and-salary work and controlling for all other factors in the models, the oldest self-employed group was more likely to identify as Black, report lower health, and receive health insurance from several sources than the younger group. Further, the older group reported lower individual earnings from work yet higher total household income (less individual earnings) and was also less likely to formally volunteer at the highest commitment levels.With some exceptions, these results indicate that the diversity of self-employed older adults within traditional retirement age is greater than among those before this age. Implications regarding how access to key safety net programs, such as Social Security retirement benefits and Medicare, may lead to this finding are discussed.}, keywords = {Employment, Entrepreneurship, Financial capital, Human capital, Social capital}, isbn = {0016-9013}, doi = {https://doi.org/10.1093/geront/gnaa132}, author = {Cal J. Halvorsen} } @article {11216, title = {Identifying cohabiting couples in administrative data: evidence from Medicare address data}, journal = {Health Services and Outcomes Research Methodology}, volume = {21}, year = {2021}, pages = {238-247}, abstract = {Marital status is recognized as an important social determinant of health, income, and social support, but is rarely available in administrative data. We assessed the feasibility of using exact address data and zip code history to identify cohabiting couples using the 2018 Medicare Vital Status file and ZIP codes in the 2011{\textendash}2014 Master Beneficiary Summary Files. Medicare beneficiaries meeting our algorithm displayed characteristics consistent with assortative mating and resembled known married couples in the Health and Retirement Study linked to Medicare claims. Address information represents a promising strategy for identifying cohabiting couples in administrative data including healthcare claims and other data types.}, keywords = {Cohabitation, Couples, Marriage, Medicare}, isbn = {1572-9400}, doi = {10.1007/s10742-020-00229-1}, author = {Matta, Sasmira and Joanne W. Hsu and Theodore J Iwashyna and Micah Y. Baum and Kenneth M. Langa and Lauren Hersch Nicholas} } @article {https://doi.org/10.1111/1475-6773.13783, title = {Impact of Medicare Eligibility on Informal Caregiving for Surgery and Stroke}, journal = {Health Services Research}, volume = {56}, year = {2021}, pages = {61-62}, abstract = {Research Objective Over 40 million older Americans rely on informal care (unpaid assistance for personal care such and instrumental support, including toileting, bathing, and shopping). Prior work illustrates 68{\textendash}230\% greater spending on post-acute care after surgery for Medicare beneficiaries compared to older commercial insurance enrollees. Such enhanced access to post-acute care may reduce the need for family and friend caregiving support for rehabilitation following acute medical events. While use of informal care is substantial among older Americans, little is known about informal support for patients after acute medical events, and how formal post-acute care influences its use. Study Design We used 1998 to 2018 Health and Retirement Study (HRS) data to assess changes in weekly hours of informal care received by individuals experiencing acute events before and after Medicare eligibility. We created two similar cohorts of individuals near the Medicare eligibility age: pre-Medicare, or individuals ages 59{\textendash}66 and not covered by Medicare; and Medicare, or individuals ages 67{\textendash}74. We used a threshold of 67, rather than 65, for the Medicare cohort to account for the two-year lookback period used in HRS survey questions. The cohorts were matched using inverse probability treatment weights. A regression discontinuity design assessed three types of caregiving {\textendash} the proportion of respondents receiving care, intensity of care among care recipients, and care intensity among all respondents {\textendash} before and after Medicare eligibility. We estimated generalized linear models with a log link and gamma distribution that regressed informal care on Medicare status, a centered age variable, and an interaction between Medicare status and centered age. Sensitivity analyses included stratification by surgery type and by sex. Population Studied 4264 Health and Retirement Study participants near the age of Medicare eligibility in one of three self-reported acute medical cohorts: stroke, heart surgery, or joint surgery. Principal Findings Among near-retirement individuals, 2031 (47.6\%) had a stroke, 1038 (24.3\%) underwent heart surgery, and 1038 (28.0\%) underwent joint surgery. Of the 937 (22.3\%) of patients who reported receiving care from an informal caregiver, average care measured 34.0 (SD: 49.2) weekly hours. Mean (SD) weekly informal caregiving hours were 7.5 (27.0) overall, and 12.1 (34.7), 3.8 (18.5), and 2.9 (14.1) for stroke, heart surgery, and joint surgery patients, respectively. In adjusted analyses, the proportion of stroke patients receiving informal care decreased from 39.5\% to 28.6\% (or by 28\%) and the average weekly amount of care decreased from 21.0 to 10.3 hours (or 51\%) after Medicare enrollment. Non-significant decreases were observed for the other medical cohorts. There was a non-significant average decrease of 22.8 hours (or 40\%) in the intensity of care received by men after one of three events. Conclusions Access to Medicare coverage was associated with a 51\% reduction in informal care received by older Medicare stroke patients, potentially by increasing access to post-acute services. Implications for Policy or Practice Post-acute care is increasingly targeted for cost savings under Medicare policies, which may restrict access to post-acute care and rehabilitation, impacting demand for informal care for older adults with stroke.}, keywords = {Eligibility Determination, Informal caregiving, Medicare, Stroke, Surgery}, doi = {10.1111/1475-6773.13783}, author = {DeRoo, Ana and Ha, Jinkyung and Norcott, Alexandra and Regenbogen, Scott and Geoffrey J Hoffman} } @article {11215, title = {The Importance of Engaging in Physical Activity in Older Adulthood for Transitions between Cognitive Status Categories and Death: A Coordinated Analysis of Fourteen Longitudinal Studies.}, journal = {The Journals of Gerontology: Series A }, volume = {76}, year = {2021}, pages = {1661-1667}, abstract = {

BACKGROUND: Given increasing incidence of cognitive impairment and dementia, further understanding of modifiable factors contributing to increased healthspan is crucial. Extensive literature provides evidence that physical activity (PA) delays the onset of cognitive impairment; however, it is unclear whether engaging in PA in older adulthood is sufficient to influence progression through cognitive status categories.

METHODS: Applying a coordinated analysis approach, this project independently analyzed fourteen longitudinal studies (NTotal = 52,039; mean baseline age across studies= 69.9-81.73) from North America and Europe using multi-state survival models to estimate the impact of engaging in PA on cognitive status transitions (non-impaired, mildly impaired, severely impaired) and death. Multinomial regression models were fit to estimate life expectancy (LE) based on American PA recommendations. Meta-analyses provided the pooled effect sizes for the role of PA on each transition and estimated LEs.

RESULTS: Controlling for baseline age, sex, education and chronic conditions, analyses revealed that more PA is significantly associated with decreased risk of transitioning from non-impaired to mildly impaired cognitive functioning and death, as well as substantially longer LE. Results also provided evidence for a protective effect of PA after onset of cognitive impairment (e.g., decreased risk of transitioning from mild to severe cognitive impairment; increased likelihood of transitioning backward from severe to mild cognitive impairment), though between-study heterogeneity suggests a less robust association.

CONCLUSIONS: These results yield evidence for the importance of engaging in PA in older adulthood for cognitive health, and a rationale for motivating older adults to engage consistently in PA.

}, keywords = {cognitive aging, Exercise, Longevity, Successful aging}, issn = {1758-535X}, doi = {10.1093/gerona/glaa268}, author = {Yoneda, Tomiko and Nathan A Lewis and Knight, Jamie E and Rush, Jonathan and Vendittelli, Rebecca and Kleineidam, Luca and Hyun, Jinshil and Andrea M Piccinin and Scott M Hofer and Emiel O Hoogendijk and Derby, Carol A and Scherer, Martin and Steffi G Riedel-Heller and Wagner, Michael and van den Hout, Ardo and Wang, Wenyu and David A Bennett and Muniz-Terrera, Graciela} } @article {11396, title = {The Importance of Improving Educational Attainment for Dementia Prevalence Trends from 2000-2014, among Older non-Hispanic Black and White Americans.}, journal = {The Journals of Gerontology, Series B}, volume = {76}, year = {2021}, pages = {1870-1879}, abstract = {

OBJECTIVES: While a number of studies have documented a notable decline in age-standardized prevalence in dementia in the U.S. population, relatively little is known about how dementia has declined for specific age and race groups, and the importance of changing educational attainment on the downward trend. We assess 1) how the trends in dementia prevalence may have differed across age and race groups and 2) the role of changing educational attainment in understanding these trends.

METHOD: This paper estimates a series of logistic regression models using data from the Health and Retirement Study (2000-2014) to assess the relative annual decline in dementia prevalence and the importance of improving educational attainment for non-Hispanic Whites and non-Hispanic Blacks.

RESULTS: Consistent with other studies, we found significant declines in dementia for non-Hispanic Blacks and non-Hispanic Whites across this period. Nonetheless, these declines were not uniform across age and race groups. Non-Hispanic Blacks aged 65-74 had the steepest decline in this period. We also found that improved educational attainment in the population was fundamentally important in understanding declining dementia prevalence in the United States.

DISCUSSION: This study shows the importance of improvement in educational attainment in the early part of the 20 th century to understand the downward trend in dementia prevalence in the United States from 2000 to 2014.

}, keywords = {Cognitive health, Educational attainment}, issn = {1758-5368}, doi = {10.1093/geronb/gbab015}, author = {Mark D Hayward and Mateo P Farina and Yuan S Zhang and Jung K Kim and Eileen M. Crimmins} } @article {11421, title = {Increasing Education-Based Disparities in Healthy Life Expectancy Among U.S. Non-Hispanic Whites, 2000-2010.}, journal = {The Journals of Gerontology, Series B}, volume = {76}, year = {2021}, pages = {319-329}, abstract = {

OBJECTIVES: To examine changes in Healthy Life Expectancy (HLE) against the backdrop of rising mortality among less-educated white Americans during the first decade of the twenty-first century.

METHODS: This study documented changes in HLE by education among U.S. non-Hispanic whites, using data from the U.S. Multiple Cause of Death public-use files, the Integrated Public Use Microdata Sample (IPUMS) of the 2000 Census and the 2010 American Community Survey, and the Health and Retirement Study (HRS). Changes in HLE were decomposed into contributions from: (i) change in age-specific mortality rates; and (ii) change in disability prevalence, measured via Activities of Daily Living (ADL) and Instrumental Activities of Daily Living (IADL).

RESULTS: Between 2000 and 2010, HLE significantly decreased for white men and women with less than 12 years of schooling. In contrast, HLE increased among college-educated white men and women. Declines or stagnation in HLE among less-educated whites reflected increases in disability prevalence over the study period, whereas improvements among the college educated reflected decreases in both age-specific mortality rates and disability prevalence at older ages.

DISCUSSION: Differences in HLE between education groups increased among non-Hispanic whites from 2000 to 2010. In fact, education-based differences in HLE were larger than differences in total life expectancy. Thus, the lives of less-educated whites were not only shorter, on average, compared with their college-educated counterparts, but they were also more burdened with disability.

}, keywords = {Disability, Education, Healthy life expectancy, Mortality}, issn = {1758-5368}, doi = {10.1093/geronb/gbz145}, author = {Cantu, Phillip A and Connor M Sheehan and Sasson, Isaac and Mark D Hayward} } @article {11412, title = {Insomnia as a predictor of diagnosed memory problems: 2006-2016 Health and Retirement Study}, journal = {Sleep Medicine}, volume = {80}, year = {2021}, pages = {158-166}, abstract = {ObjectiveTo evaluate the longitudinal relationship in insomnia symptoms over time with incident memory problems and dementia diagnoses among U.S. adults aged 65 years and older.MethodsSecondary analyses were performed on 9,518 elderly participants (>=65 years) who completed the 2006 wave of the Health and Retirement Study (HRS) and were followed-up to determine if insomnia symptom scores (2006-2014) were associated with time-to-onset of [1] physician-diagnosed {\textquotedblleft}memory-related disease{\textquotedblright}, {\textquotedblleft}Alzheimer{\textquoteright}s disease{\textquotedblright} and/or {\textquotedblleft}dementia, senility or any other serious memory impairment{\textquotedblright} and [2] diagnosis of dementia based on HRS-specific criteria. Cox proportional hazards models were constructed adjusting for socio-demographic, lifestyle, and health characteristics.ResultsIn fully adjusted models, severe insomnia symptoms were associated with increased risk of physician-diagnosed memory problems. Individuals reporting any change (increase or decrease) in insomnia symptoms during the 2006-2010 period were more likely to be diagnosed with dementia based on HRS criteria. Finally, those who experienced an increase in the severity of insomnia symptoms over time exhibited 41-72\% increased risks of physician-diagnosed memory problems and 45-58\% increased risks of dementia diagnosis based on HRS criteria.ConclusionsWhen severe insomnia symptoms increased over time, physician-diagnosed memory problems and dementia diagnoses also increased among U.S. elderly people over a 10-year follow-up period. More studies are required to confirm these findings using large prospective cohort designs and validated tools.}, keywords = {Aging, Alzheimer{\textquoteright}s disease, Dementia, insomnia, Neurodegenerative, Sleep}, isbn = {1389-9457}, doi = {10.1016/j.sleep.2021.01.038}, author = {Beydoun, Hind A. and Beydoun, May A. and Weiss, Jordan and Hossain, Sharmin and Huang, Shuyan and Alemu, Brook T. and Alan B Zonderman} } @article {11034, title = {Intergenerational Ambivalence and Loneliness in Later Life}, journal = {Journal of Marriage and Family}, volume = {83}, year = {2021}, pages = {75-85}, abstract = {Abstract Objective This brief report examined the relationship between intergenerational ambivalence and loneliness in later life among a group of older adults with at least one child. Background Previous work has explored the links between intergenerational ambivalence and other indicators of well-being but has not examined loneliness. Although studies show an association between positive and negative relationship quality with children and loneliness, there are conflicting findings, and there is also insufficient exploration of the role of gender. Method Utilizing pooled data from the 2012 and 2014 waves of the Health and Retirement Study (HRS) (n = 10,967) ( https://hrs.isr.umich.edu/documentation), structural equation models were used to examine the hypothesized relationships, and multiple group analysis was utilized to assess potential gender differences. Results The results indicated that greater intergenerational ambivalence was associated with increased loneliness in later life. However, there were no significant gender or marital status differences in the relationships. Conclusion This study adds to the existing literature on ambivalence and well-being by showing that ambivalent relationships are related to loneliness. Results underscore the emotional complexity of parent?child relationships and suggest the need for investigating the consequences of holding contradictory feelings.}, keywords = {Aging, ambivalence, gender, intergenerational relationships, Older Adults}, isbn = {0022-2445}, doi = {https://doi.org/10.1111/jomf.12716}, author = {Cassandra L. Hua and J Scott Brown and Jennifer R. Bulanda} } @article {11218, title = {Internet Adoption in Older Adults: Findings from the Health and Retirement Study.}, journal = {Cyberpsychol, Behavior, and Social Networking}, volume = {24}, year = {2021}, pages = {101-107}, abstract = {

Being able to use the Internet is becoming increasingly important in today{\textquoteright}s digitized society. Evidence suggests that older adults are at risk of being left behind by technological developments. We examined Internet adoption in older adults in relation to sociodemographic, health, cognitive, social, and personality factors. We used data from the Health and Retirement Study ( = 5,949; 61 percent women; age: = 72 years, standard deviation [] = 7; range = 50-105). Internet use was examined over an 8-year period. Predictors were assessed at baseline. We used a Cox proportional hazards model to examine how predictors were related to Internet adoption during the study period. Overall, 1,296 out of 5,949 participants (22 percent) reported starting to use the Internet during the study period. Our findings revealed that younger age, higher education, higher income, living with a partner, and better cognitive performance were associated with a higher likelihood of Internet adoption, whereas being Black was associated with a lower likelihood. Openness was associated with a higher likelihood of Internet adoption over the study period. Our findings add to the literature on the role of sociodemographic, cognitive, and health factors in older adults{\textquoteright} Internet use. In addition, we show that personality also predicts older adults{\textquoteright} Internet use.

}, keywords = {cognitive function, Internet use, Personality, Successful aging, Technology}, issn = {2152-2723}, doi = {10.1089/cyber.2019.0736}, author = {Macdonald, Birthe and H{\"u}l{\"u}r, Gizem} } @article {11733, title = {Intersectional trends in employment quality in older adults in the United States}, journal = {SSM - Population Health}, volume = {15}, year = {2021}, pages = {100868}, abstract = {Americans{\textquoteright} working lives have become more precarious over the past several decades. Worsening employment quality has been linked to poorer physical and mental health and may disproportionately impact marginalized working populations. We examined differences in the quality and character of worker-employer relationships among older workers in the United States (US) across intersecting gender-racial/ethnic-educational subgroups. Using longitudinal data on employment stability, material rewards, workers{\textquoteright} rights, working-time arrangements, unionization, and interpersonal power relations from the Health and Retirement Study (1992{\textendash}2016), we used principal components analysis to construct an employment quality (EQ) score. We estimated intersectional differences in EQ, overall and over time, using generalized estimating equations. Overall, EQ was greatest for white men with college degrees and poorest for Latinx women with < high school degrees. Over time, EQ tended to remain unchanged or slightly worsen across intersectional strata; the greatest EQ reduction was for Latinx women with college degrees, while the greatest improvement was for white women with high school degrees. There are enduring and growing inequities in EQ for older marginalized adults in the US, which may contribute to growing health inequities.}, keywords = {employment quality, Inequities, Intersectionality, Precarious employment}, isbn = {2352-8273}, doi = {10.1016/j.ssmph.2021.100868}, author = {Sarah B. Andrea and Eisenberg-Guyot, Jerzy and Peckham, Trevor and Vanessa M Oddo and Hajat, Anjum} } @article {11027, title = {Life Course Socioeconomic Disadvantage and the Aging Immune System: Findings from the Health and Retirement Study}, journal = {The Journals of Gerontology: Series B}, volume = {76}, year = {2021}, pages = {1195-1205}, abstract = {Previous research has documented a consistent association between current socioeconomic status (SES) and cytomegalovirus (CMV). Early life is likely a critical period for CMV exposure and immune development, but less is known about early life socioeconomic factors and CMV, particularly in older age populations. Using data from the Health and Retirement Study, we investigated the association between life course socioeconomic disadvantage and immune response to CMV among older adults.Using ordered logit models, we estimated associations between several measures of socioeconomic disadvantage and the odds of being in a higher CMV Immunoglobulin G (IgG) response category in a sample of 8,168 respondents aged 50+ years.We found a significant association between educational attainment and CMV IgG response. Those with less than a high school education had 2.00 (95\% CI: 1.67, 2.40) times the odds of being in a higher CMV category compared to those with a college degree or greater. In addition, we also observed a significant association with parental education and CMV response. Individuals with parents having 8 years or less of schooling had 2.32 (95\% CI: 2.00, 2.70) times the odds of higher CMV response compared to those whose parents had greater than a high school education.CMV IgG levels in older adults are associated with both early life and adult SES. Life course socioeconomic disadvantage may contribute to disparities in immunological aging.}, keywords = {immune aging, life course studies, persistent infections, socioeconomic disadvantage}, isbn = {1079-5014}, doi = {https://doi.org/10.1093/geronb/gbaa144}, author = {Grace A Noppert and Rebecca C Stebbins and Jennifer B Dowd and Robert A Hummer and Allison E Aiello} } @article {12290, title = {The Lifetime Risk of Spousal Nursing Home Use and its Economic Impact on the Community-Dwelling Spouse}, number = {WP 2021-433}, year = {2021}, institution = {Michigan Retirement and Disability Research Center, University of Michigan}, address = {Ann Arbor, MI}, abstract = {A single person in a nursing home is relatively well-protected financially from nursing home expenses because Medicaid covers these once assets are depleted. Couples, however, are less well protected, because the high cost of nursing homes rapidly depletes household assets, possibly impoverishing the spouse living in the community, despite Medicaid provisions that shield spousal assets up to some threshold. In this paper, we estimate the lifetime risk that one spouse will reside in the community while the other resides in a nursing home, and the distribution of the accumulated number of days spent in a nursing home and costs. We use data from the longitudinal Health and Retirement Study and follow individuals and their spouses from age 70 to death. We also examine how spousal nursing home use affects families{\textquoteright} financial outcomes and to what extent Social Security income protects the community-residing spouse from the adverse effects of spousal nursing home use. We find that a 70- to 74-year-old married person who lives in the community faces a 34.3\% chance that his or her spouse would move to a nursing home before death. When they do, spouses spend about nine months, on average, in nursing homes, and the average out-of-pocket cost is about $19,800 (2019 dollars). We find that spousal nursing home use significantly decreases households{\textquoteright} assets and increases the risk of further impoverishment. While Social Security income has an overall positive impact on families{\textquoteright} financial outcomes, it does not mitigate the financial effects of spousal nursing home use.}, keywords = {Community-dwelling, economic impact, lifetime risk, nursing home, spouse}, url = {https://deepblue.lib.umich.edu/bitstream/handle/2027.42/171803/wp433.pdf?sequence=1}, author = {Susann Rohwedder and P{\'e}ter Hudomiet and Michael D Hurd} } @conference {11821, title = {Long-Term Air Pollution Exposures and Major Depression in Older U.S. Adults: The Health and Retirement Study}, booktitle = {ISEE Conference Abstracts}, volume = {2021}, year = {2021}, abstract = {Major depression is a leading cause of morbidity worldwide, especially during later life. Since heritability is modest (40-50\%), there is interest in understanding risk from environmental factors like air pollution. However, research examining this issue is scarce, and often does not use clinical diagnostic criteria. Here, we aimed to quantify associations of air pollution with prevalent major depression in a cohort that deploys diagnostic assessments. METHODS: We conducted a repeated measure analysis of 2008-2016 interviews from the Health and Retirement Study, a nationally representative cohort of older adults in the United States. Major depression status was determined biennially using the Composite International Diagnostic Interview Short Form, with a cutoff of 5. We estimated 1-year average PM2.5, PM10-2.5, NO2, and O3 concentrations at participant residences using fine-scale spatiotemporal models. To estimate prevalence ratios, we fit generalized linear models that accounted for sample weights and clustering by participant. All models included demographic characteristics, individual and neighborhood socioeconomic status, calendar time, and geographic area. RESULTS:Among 25,305 participants with complete data, there was a mean age of 63 years, 53\% were female, and most were Non-Hispanic White (73\%), with some Black (11\%) and Hispanic participants. Eight percent reported major depression. In fully adjusted models, we observed that higher PM2.5 and NO2 concentrations were associated with a greater prevalence of major depression (PR: 1.13 per 3 {\textmu}g/m{\textthreesuperior} PM2.5, 95\% CI: 1.03, 1.23; PR: 1.23 per 5 ppb NO2, 95\% CI: 1.06, 1.20). Only the association with NO2 was robust to adjustment for other pollutants, however, and no associations were observed with PM10-2.5 or O3. CONCLUSIONS:Overall, we observed a robust association of major depression prevalence with long-term exposure to NO2 but not with other air pollutants. This suggests that traffic may be a modifiable risk factor that could be targeted to reduce socioeconomic disparities in mental health. }, keywords = {Health Disparities, Major depression, Psychiatric epidemiology, Traffic-Related Air Pollution}, url = {https://ehp.niehs.nih.gov/doi/abs/10.1289/isee.2021.O-LT-071}, author = {Rachel S. Bergmans and D{\textquoteright} Souza, Jennifer and Fossa, Alan and Szpiro, Adam and Young, Michael T and Carlos F. Mendes de Leon and Kaufman, Joel and Richard A Hirth and Sara Dubowsky Adar} } @article {11433, title = {Low levels of low-density lipoprotein cholesterol and cognitive decline}, journal = {Science Bulletin}, volume = {66}, year = {2021}, pages = {1684-1690}, abstract = {The relationship between low levels of serum low-density lipoprotein cholesterol (LDL-C) and subsequent cognitive decline remains conflicting and unclear. The present study aimed to evaluate the longitudinal association between low LDL-C levels and cognition decline in the context of the current aggressive guideline-recommended targets (LDL-C levels less than 55 mg/dL for individuals at very high risk of cardiovascular events, and less than 70 mg/dL for high risk individuals). Data from wave 13 (2016) to wave 14 (2018) of the Health and Retirement Study (HRS) were utilized. LDL-C concentrations measured at wave 13 were categorized into 5 levels, reflecting currently recommended values for lipid lowering treatment. Of 7129 included participants (mean age: 69.0 {\textpm} 9.9 years, 60.3\% female), we found that compared to participants with LDL-C levels 70{\textendash}99.9 mg/dL, those with LDL-C levels < 55 mg/dL had significantly slower 2-year decline rates in global cognitive function (0.244 point/year; 95\% confidence interval (CI): 0.065, 0.422, P = 0.008), working memory (0.068 point/year; 95\% CI: 0.004, 0.133, P = 0.038), and borderline significantly in episodic memory (0.155 point/year; 95\% CI: -0.004, 0.315, P = 0.057). Similarly, significantly slower decline rates were observed in those with LDL-C levels 55{\textendash}69.9 mg/dL. The present study demonstrated that compared with LDL-C levels 70{\textendash}99.9 mg/dL, low LDL-C levels (< 70 mg/dL, especially < 55 mg/dL) were associated with significantly slower cognitive decline in population-based setting. Future randomized controlled trials are warranted to ascertain the safety and benefit of current aggressive guideline-recommended targets on cognitive function.}, keywords = {Cognitive decline, Longitudinal cohort study, Low-density lipoprotein cholesterol}, isbn = {2095-9273}, doi = {https://doi.org/10.1016/j.scib.2021.02.018}, author = {Hua, Rong and Ma, Yanjun and Li, Chenglong and Zhong, Baoliang and Xie, Wuxiang} } @article {11360, title = {Maintaining Sense of Purpose Following Health Adversity in Older Adulthood: A Propensity Score Matching Examination.}, journal = {The Journals of Gerontology: Series B }, volume = {76}, year = {2021}, pages = {1574-1579}, abstract = {

OBJECTIVES: Research has demonstrated sense of purpose predicts better health in older adulthood. However, work is limited with respect to understanding how experiencing a health event or illness diagnosis impacts older adults{\textquoteright} sense of purpose.

METHOD: The current study employed a propensity score matching approach to compare older adults who did or did not experience an adverse health event on changes in sense of purpose across three waves of the Health and Retirement Study. Sense of purpose was assessed at each wave, and changes were compared between people who did versus did not experience one of seven diagnoses and health events.

RESULTS: When propensity score matching was employed, no differences in trajectories of change for sense of purpose were found with respect to all seven events. Individual differences in trajectories though were evidenced across groups.

DISCUSSION: The current findings suggest that even when health events impact older adults{\textquoteright} physical functioning or place limitations on their activity, it may hold little ramifications for their sense of purpose. Future research should consider this potential for resilience, focusing on how adults compensate for losses.

}, keywords = {health events, older adulthood, propensity score matching, Sense of purpose}, issn = {1758-5368}, doi = {10.1093/geronb/gbab002}, author = {Patrick L Hill and Beck, Emorie D and Joshua J Jackson} } @inbook {11410, title = {Measuring life course events and life histories}, booktitle = {Handbook of Aging and the Social Sciences (Ninth Edition)Handbooks of Aging}, year = {2021}, pages = {33-47}, publisher = {Academic Press}, organization = {Academic Press}, chapter = {3}, abstract = {Whereas some life events are considered potential sources of stress, others are viewed as markers of interconnected life course transitions and processes. In this chapter, we first review the theoretical roots of measures of life events and discuss longstanding methodological critiques regarding the categorization of life events and factors associated with the reliability and validity of reports. We then review calendar interview methods that employ an Event (or Life) History Calendar approach to collect timeline data. These methods, based on cognitive theories of autobiographical memory, are designed to facilitate retrospective recall of thematic temporal sequences of personal memories. We describe the challenges of collecting retrospective life histories in studies of older adults, strategies used to evaluate the veracity of retrospective life history recall, and summarize recent analytic methods that examine the heterogeneity and dynamics of domain-specific and cross-domain timing and sequencing of transitions and events in the lives of individuals.}, keywords = {calendar interview methods, Life event inventories, methodological issues, report accuracy, retrospective life histories, Sequence analysis}, isbn = {978-0-12-815970-5}, doi = {https://doi.org/10.1016/B978-0-12-815970-5.00003-6}, author = {Jacqui Smith and Hu, Mengyao and Lee, Haena}, editor = {Kenneth F Ferraro and Deborah Carr} } @article {Hou12, title = {Measuring Racial/Ethnic Retirement Wealth Inequality}, journal = {The Journal of Retirement}, volume = {8}, year = {2021}, pages = {12{\textendash}28}, abstract = {As the US population becomes more diverse, it will be increasingly important for policymakers addressing Social Security{\textquoteright}s solvency to understand how reliant various racial and ethnic groups will be on the program versus other sources of retirement wealth. Yet, to date, studies on retirement wealth have tended not to focus on race and ethnicity, have largely ignored the role of Social Security, or have excluded the most recent cohort approaching retirement{\textemdash}the Late Boomers. This project uses data from the Health and Retirement Study (HRS) to document the retirement resources of White, Black, and Hispanic households at various points in the wealth distribution for five HRS cohorts of 51- to 56-year-olds between 1992 and 2016.TOPICS: Retirement, wealth management, social securityKey Findings▪ In 2016, the typical Black household had 46 percent of the retirement wealth of the typical White household; the typical Hispanic household had 49 percent. This inequality would be much higher but for the presence of Social Security.▪ The 1992 to 2010 HRS cohorts showed little change in retirement wealth inequality, although a decline in 51- to 56-year-old White households{\textquoteright} retirement wealth between 2010 and 2016 narrowed the racial and ethnic gaps in retirement wealth slightly.▪ The progressivity of Social Security, combined with lower average incomes for minority households, means that replacement rates are more equal than wealth{\textemdash}in 2016, the replacement rate of Black households was 82 percent of White households and Hispanic households was 95 percent.}, keywords = {Retirement, Social Security, Wealth management}, issn = {2326-6899}, doi = {10.3905/jor.2020.1.079}, author = {Wenliang Hou and Geoffrey T. Sanzenbacher} } @article {11891, title = {Measuring the COVID-19 Mortality Burden in the United States : A Microsimulation Study.}, journal = {Annals of Internal Medicine}, volume = {174}, year = {2021}, pages = {1700-1709}, abstract = {

BACKGROUND: Fully assessing the mortality burden of the COVID-19 pandemic requires measuring years of life lost (YLLs) and accounting for quality-of-life differences.

OBJECTIVE: To measure YLLs and quality-adjusted life-years (QALYs) lost from the COVID-19 pandemic, by age, sex, race/ethnicity, and comorbidity.

DESIGN: State-transition microsimulation model.

DATA SOURCES: Health and Retirement Study, Panel Study of Income Dynamics, data on excess deaths from the Centers for Disease Control and Prevention, and nursing home death counts from the Centers for Medicare \& Medicaid Services.

TARGET POPULATION: U.S. population aged 25 years and older.

TIME HORIZON: Lifetime.

PERSPECTIVE: Individual.

INTERVENTION: COVID-19 pandemic through 13 March 2021.

OUTCOME MEASURES: YLLs and QALYs lost per 10~000 persons in the population. The estimates account for the age, sex, and race/ethnicity of decedents, along with obesity, smoking behavior, lung disease, heart disease, diabetes, cancer, stroke, hypertension, dementia, and nursing home residence.

RESULTS OF BASE-CASE ANALYSIS: The COVID-19 pandemic resulted in 6.62 million QALYs lost (9.08 million YLLs) through 13 March 2021, with 3.6 million (54\%) lost by those aged 25 to 64 years. The greatest toll was on Black and Hispanic communities, especially among men aged 65 years or older, who lost 1138 and 1371 QALYs, respectively, per 10~000 persons. Absent the pandemic, 38\% of decedents would have had average or above-average life expectancies for their subgroup defined by age, sex, and race/ethnicity.

RESULTS OF SENSITIVITY ANALYSIS: Accounting for uncertainty in risk factors for death from COVID-19 yielded similar results.

LIMITATION: Estimates may vary depending on assumptions about mortality and quality-of-life projections.

CONCLUSION: Beyond excess deaths alone, the COVID-19 pandemic imposed a greater life expectancy burden on persons aged 25 to 64 years, including those with average or above-average life expectancies, and a disproportionate burden on Black and Hispanic communities.

PRIMARY FUNDING SOURCE: National Institute on Aging.

}, keywords = {COVID-19, mortality burden}, issn = {1539-3704}, doi = {10.7326/M21-2239}, author = {Julian Reif and Heun-Johnson, Hanke and Tysinger, Bryan and Darius Lakdawalla} } @article {11732, title = {Mendelian Randomization of Dyslipidemia on Cognitive Impairment Among Older Americans}, journal = {Frontiers in Neurology}, volume = {12}, year = {2021}, abstract = {Background: Altered lipid metabolism may be a risk factor for dementia, and blood cholesterol level has a strong genetic component. We tested the hypothesis that dyslipidemia (either low levels of high-density lipoprotein cholesterol (HDL-C) or high total cholesterol) is associated with cognitive status and domains, and assessed causality using genetic predisposition to dyslipidemia as an instrumental variable. Methods: Using data from European and African genetic ancestry participants in the Health and Retirement Study, we selected observations at the first non-missing biomarker assessment (waves 2006-2012). Cognition domains were assessed using episodic memory, mental status, and vocabulary tests. Overall cognitive status was categorized in three levels (normal, cognitive impairment non-dementia, dementia). Based on 2018 clinical guidelines, we compared low HDL-C or high total cholesterol to normal levels. Polygenic scores for dyslipidemia were used as instrumental variables in a Mendelian randomization framework. Multivariable logistic regressions and Wald-type ratio estimators were used to examine associations. Results: Among European ancestry participants (n = 8,781), at risk HDL-C levels were associated with higher odds of cognitive impairment (OR = 1.20, 95\% CI: 1.03, 1.40) and worse episodic memory, specifically. Using cumulative genetic risk for HDL-C levels as a valid instrumental variable, a significant causal estimate was observed between at risk low HDL-C levels and higher odds of dementia (OR = 2.15, 95\% CI: 1.16, 3.99). No significant associations were observed between total cholesterol levels and cognitive status. No significant associations were observed in the African ancestry sample (n = 2,101). Conclusion: Our study demonstrates low blood HDL-C is a potential causal risk factor for impaired cognition during aging in non-Hispanic whites of European ancestry. Dyslipidemia can be modified by changing diets, health behaviors, and therapeutic strategies, which can improve cognitive aging. Studies on low density lipoprotein cholesterol, the timing of cholesterol effects on cognition, and larger studies in non-European ancestries are needed.}, keywords = {blood cholesterol, cognitive domain, Dementia, Mendelian randomization, polygenic score}, doi = {10.3389/fneur.2021.660212}, author = {Fu, Mingzhou and Kelly M Bakulski and Higgins, Cesar and Erin B Ware} } @article {10.1093/geronb/gbz156, title = {Mortality and Obesity among US Older Adults: The Role of Polygenic Risk}, journal = {The Journals of Gerontology, Series B}, volume = {76}, year = {2021}, pages = {343-347}, abstract = {To examine the relationship between obesity and mortality as a function of polygenic risk for obesity among older US adults.Using data from the 1994-2014 Health and Retirement Study in conjunction with genome-wide data, we evaluated the risk of mortality as a function of obesity classification, an individual{\textquoteright}s polygenic risk score (PGS) for obesity, and their interaction, stratified by sex. We conducted our analyses using cox proportional hazard models.Among those with an average PGS for obesity (8,143 [68.8 \%]), obese I (HR = 0.7}, keywords = {Mortality, Obesity, polygenic risk, Polygenic risk score}, issn = {1079-5014}, doi = {10.1093/geronb/gbz156}, author = {Vinneau, Justin M and Huibregtse, Brooke M and Laidley, Thomas M and Joshua A Goode and Jason D Boardman} } @article {12126, title = {Multi-Ancestry Genome-wide Association Study Accounting for Gene-Psychosocial Factor Interactions Identifies Novel Loci for Blood Pressure Traits.}, journal = {Human Genetics and Genomics Advances}, volume = {2}, year = {2021}, pages = {100013}, abstract = {

Psychological and social factors are known to influence blood pressure (BP) and risk of hypertension and associated cardiovascular diseases. To identify novel BP loci, we carried out genome-wide association meta-analyses of systolic, diastolic, pulse, and mean arterial BP taking into account the interaction effects of genetic variants with three psychosocial factors: depressive symptoms, anxiety symptoms, and social support. Analyses were performed using a two-stage design in a sample of up to 128,894 adults from 5 ancestry groups. In the combined meta-analyses of Stages 1 and 2, we identified 59 loci (p value <5e-8), including nine novel BP loci. The novel associations were observed mostly with pulse pressure, with fewer observed with mean arterial pressure. Five novel loci were identified in African ancestry, and all but one showed patterns of interaction with at least one psychosocial factor. Functional annotation of the novel loci supports a major role for genes implicated in the immune response (), synaptic function and neurotransmission (), as well as genes previously implicated in neuropsychiatric or stress-related disorders (). These findings underscore the importance of considering psychological and social factors in gene discovery for BP, especially in non-European populations.

}, keywords = {blood pressure traits}, issn = {2666-2477}, doi = {10.1016/j.xhgg.2020.100013}, author = {Sun, Daokun and Melissa Richard and Musani, Solomon K and Yun Ju Sung and Thomas W Winkler and Schwander, Karen and Jin-Fang Chai and Guo, Xiuqing and Kilpel{\"a}inen, Tuomas O and Vojinovic, Dina and Aschard, Hugues and Traci M Bartz and Bielak, Lawrence F and Brown, Michael R and Chitrala, Kumaraswamy and Hartwig, Fernando P and Horimoto, Andrea R V R and Liu, Yongmei and Alisa Manning and Noordam, Raymond and Smith, Albert V and Sarah E Harris and K{\"u}hnel, Brigitte and Lyytik{\"a}inen, Leo-Pekka and Ilja M Nolte and Rauramaa, Rainer and van der Most, Peter J and Wang, Rujia and Erin B Ware and Weiss, Stefan and Wen, Wanqing and Yanek, Lisa R and Dan E Arking and Donna K Arnett and Barac, Ana and Boerwinkle, Eric and Broeckel, Ulrich and Chakravarti, Aravinda and Chen, Yii-Der Ida and Cupples, L Adrienne and Davigulus, Martha L and de Las Fuentes, Lisa and de Mutsert, Ren{\'e}e and de Vries, Paul S and Delaney, Joseph A C and Ana V Diez Roux and D{\"o}rr, Marcus and Jessica Faul and Fretts, Amanda M and Gallo, Linda C and Hans-J{\"o}rgen Grabe and Gu, C Charles and Tamara B Harris and Hartman, Catharina C A and Heikkinen, Sami and Ikram, M Arfan and Isasi, Carmen and Johnson, W Craig and Jost Bruno Jonas and Kaplan, Robert C and Komulainen, Pirjo and Krieger, Jose E and Levy, Daniel and Liu, Jianjun and Kurt Lohman and Luik, Annemarie I and Martin, Lisa W and Meitinger, Thomas and Milaneschi, Yuri and Jeff O{\textquoteright}Connell and Walter R Palmas and Peters, Annette and Peyser, Patricia A and Pulkki-Raback, Laura and Raffel, Leslie J and Reiner, Alex P and Kenneth Rice and Robinson, Jennifer G and Rosendaal, Frits R and Schmidt, Carsten Oliver and Schreiner, Pamela J and Schwettmann, Lars and Shikany, James M and Shu, Xiao-Ou and Stephen Sidney and Sims, Mario and Smith, Jennifer A and Sotoodehnia, Nona and Strauch, Konstantin and Tai, E Shyong and Taylor, Kent and Andr{\'e} G Uitterlinden and Cornelia M van Duijn and Waldenberger, Melanie and Wee, Hwee-Lin and Wei, Wen-Bin and Wilson, Gregory and Xuan, Deng and Yao, Jie and Zeng, Donglin and Zhao, Wei and Zhu, Xiaofeng and Alan B Zonderman and Becker, Diane M and Ian J Deary and Gieger, Christian and Lakka, Timo A and Lehtim{\"a}ki, Terho and Kari E North and Oldehinkel, Albertine J and Brenda W J H Penninx and Snieder, Harold and Wang, Ya-Xing and David R Weir and Zheng, Wei and Michele K Evans and Gauderman, W James and Gudnason, Vilmundur and Horta, Bernardo L and Liu, Ching-Ti and Dennis O Mook-Kanamori and Alanna C Morrison and Pereira, Alexandre C and Psaty, Bruce M and Amin, Najaf and Fox, Ervin R and Charles Kooperberg and Sim, Xueling and Laura Bierut and Rotter, Jerome I and Sharon L R Kardia and Franceschini, Nora and Rao, Dabeeru C and Myriam Fornage} } @article {11728, title = {Muscle weakness is a prognostic indicator of disability and chronic disease multimorbidity.}, journal = {Experimental Gerontology}, volume = {152}, year = {2021}, pages = {111462}, abstract = {

BACKGROUND: The objective of this study was to use nationally-representative data on Americans greater than 50~years of age to determine the association between grip strength and inflammation as independent predictors of incident disability, chronic multimorbidity and dementia.

METHODS: Middle age and older adults (n~=~12,618) from the 2006-2008 waves of the Health and Retirement Study with 8-years of follow-up were included. Longitudinal modeling was performed to examine the association between baseline grip strength (normalized to body mass: NGS) and high sensitivity C-reactive protein (hs-CRP) (>=3.0~mg/L) with incident physical disabilities (i.e., >=2 limitations to activities of daily living), chronic multimorbidity (>=2 of chronic conditions), and dementia.

RESULTS: The odds of incident disability were 1.25 (95\% CI: 1.20-1.30) and 1.31 (95\% CI: 1.26-1.36) for men and women respectively, for each 0.05-unit lower NGS. The odds of incident chronic multimorbidity were 1.14 (95\% CI: 1.08-1.20) and 1.14 (95\% CI: 1.07-1.21) for men and women respectively for each 0.05-unit lower NGS. The odds of incident dementia were 1.10 for men (95\% CI: 1.02-1.20) for each 0.05-unit lower NGS, but there was no significant association for women. Elevated hs-CRP was only associated with chronic multimorbidity among men (OR~=~1.29; 95\% CI: 1.00-1.73) and women (OR~=~1.60; 95\% CI: 1.26-2.02).

CONCLUSIONS: Our findings indicate a robust inverse association between NGS and disability and chronic, multimorbidity in older men and women, and dementia in men. Elevated hs-CRP was only associated with chronic multimorbidity in men and women. Healthcare providers should implement measures of grip strength in routine health assessments and discuss the potential dangers of weakness as well as interventions to improve strength with their patients.

}, keywords = {Aging, Chronic disease, Dementia, Disability, Grip strength, weakness}, issn = {1873-6815}, doi = {10.1016/j.exger.2021.111462}, author = {Mark D Peterson and Casten, Kimberly and Collins, Stacey and Hassan, Halimah and Garc{\'\i}a-Hermoso, Antonio and Jessica Faul} } @article {12058, title = {Music Engagement and Episodic Memory among Middle-Aged and Older Adults: A National Longitudinal Analysis }, journal = {Innovation in Aging}, volume = {5}, year = {2021}, pages = {707}, abstract = {Recent research suggests that engagement with particular activities, such as music, can influence age-related changes in episodic memory. However, it is unclear whether, and to what, extent music engagement is associated with the trajectory of episodic memory. The objective of this study is to examine how passive (i.e., listening to music) and/or active (i.e., singing or playing an instrument) music engagement influences episodic memory over a period of 12 years. Secondary data analysis of a sample (N=5095) of cognitively healthy adults from the Health and Retirement Study were used for this study. Linear mixed effects models were used to examine the independent effect of different levels of music engagement (i.e., low, medium, and high) on changes in performance on episodic memory tasks, while controlling for confounding factors. Compared to those with low engagement (i.e., neither listening nor singing/ playing an instrument), respondents who reported being engaged at the medium (i.e., either listening or singing/ playing an instrument) or high (i.e., both listening and singing/ playing an instrument) level performed 0.24 (p=0.003) and 0.52 (p<0.001) points better, respectively. We found evidence that music engagement attenuated the decline in episodic memory. The findings suggest that music engagement may be a protective factor against aged-related decline in episodic memory. Therefore, music engagement may offer a promising non-pharmacological intervention for dementia risk mitigation among community-living middle-aged and older adults. Future research should examine whether interventions to increase music engagement can affect the trajectories of aged-related decline in cognition in this large and growing population.}, keywords = {Episodic Memory, Music}, doi = {https://doi.org/10.1093/geroni/igab046.2625}, author = {Rouse, Hillary J and Hueluer, Gizem and Torres, Mia and Du, Yan and Conner, Kyaien O and Meng, Hongdao} } @article {11594, title = {A national profile of kinlessness at the end of life among older adults: Findings from the Health and Retirement Study.}, journal = {Journal of the American Geriatric Society}, volume = {69}, year = {2021}, pages = {2143-2151}, abstract = {

BACKGROUND/OBJECTIVES: The majority of end-of-life (EOL) caregiving is provided by unpaid family members. An increasing number of older adults are kinless (without close family/partnerships) and may have insufficient caregiver support to remain at home at the EOL. We therefore determined what proportion of older adults are kinless at the EOL and assessed the association of kinlessness with EOL care.

DESIGN: Retrospective analysis of Health and Retirement Study decedents, 2002-2015.

SETTING: US population-based sample.

PARTICIPANTS: Decedents age 51+ who died within 1 year of interview (n = 3844) and subset who are community-dwelling at last interview.

MEASUREMENTS: Kinlessness was defined as lacking a spouse/partner and children. Primary outcome measure was location of death. Secondary outcome measures included contextual EOL measures such as symptom burden and caregiver support.

RESULTS: A total of 7.4\% of decedents were kinless at the EOL. Kinless decedents were more likely to be female, nonwhite, enrolled in Medicaid, living alone, or living in a nursing home prior to death. Although community-dwelling kinless decedents received fewer hours of caregiving per week at the EOL (34.7 vs. 56.2, p < 0.05) and were more likely to die in nursing homes (18.1\% vs. 10.3\%, p < 0.05) than those with kin, they did not have higher EOL symptom burden or treatment intensity (e.g., intensive care unit use). In multinomial logistic analysis controlling for demographic and illness characteristics, kinless decedents living in the community before death had a twofold increased risk of dying in the nursing home (odds ratio [OR] = 2.02 [95\% confidence interval (CI) = 1.09-3.72]) and a trend toward increased risk of hospital death (OR = 1.60 [95\% CI = 0.96-2.69]) versus home setting.

CONCLUSIONS: Kinless individuals are more likely to die in nursing homes, even if they are living in the community in their last year of life. Expanded long-term care services and policies are needed to enable all older adults regardless of their family support systems to receive high-quality EOL care.

}, keywords = {Caregiving, end of life, Families, kinlessness, location of death}, issn = {1532-5415}, doi = {10.1111/jgs.17171}, author = {Natalie Plick and Claire K. Ankuda and Christine A Mair and Husain, Mohammed and Katherine A Ornstein} } @article {11589, title = {Phenotypic and genetic markers of psychopathology in a population-based sample of older adults.}, journal = {Translational Psychiatry}, volume = {11}, year = {2021}, pages = {239}, abstract = {

Although psychiatric phenotypes are hypothesized to organize into a two-factor internalizing-externalizing structure, few studies have evaluated the structure of psychopathology in older adults, nor explored whether genome-wide polygenic scores (PGSs) are associated with psychopathology in a domain-specific manner. We used data from 6003 individuals of European ancestry from the Health and Retirement Study, a large population-based sample of older adults in the United States. Confirmatory factor analyses were applied to validated measures of psychopathology and PGSs were derived from well-powered genome-wide association studies (GWAS). Genomic SEM was implemented to construct latent PGSs for internalizing, externalizing, and general psychopathology. Phenotypically, the data were best characterized by a single general factor of psychopathology, a factor structure that was replicated across genders and age groups. Although externalizing PGSs (cannabis use, antisocial behavior, alcohol dependence, attention deficit hyperactivity disorder) were not associated with any phenotypes, PGSs for major depressive disorder, neuroticism, and anxiety disorders were associated with both internalizing and externalizing phenotypes. Moreover, the variance explained in the general factor of psychopathology increased by twofold (from 1\% to 2\%) using the latent internalizing or latent one-factor PGSs, derived using weights from Genomic Structural Equation Modeling (SEM), compared with any of the individual PGSs. Collectively, results suggest that genetic risk factors for and phenotypic markers of psychiatric disorders are transdiagnostic in older adults of European ancestry. Alternative explanations are discussed, including methodological limitations of GWAS and phenotypic measurement of psychiatric outcome in large-scale population-based studies.

}, keywords = {Genetic Markers, Phenotypic markers, psychopathology}, issn = {2158-3188}, doi = {10.1038/s41398-021-01354-2}, author = {Arianna M Gard and Erin B Ware and Hyde, Luke W and Lauren L Schmitz and Jessica Faul and Colter Mitchell} } @article {10678, title = {Physical Activity and Falls Among a National Cohort of Older Veterans}, journal = {Journal of Applied Gerontology}, volume = {40}, year = {2021}, pages = {310-319}, abstract = {The more than 20 million U.S. veterans have a history of physical activity engagement but face increasing disability as they age. Falls are common among older adults, but there is little evidence on veterans{\textquoteright} fall risk. We conducted a retrospective cohort study using 48,643 observations from 14,831 older (>=65 years) Americans from the 2006{\textendash}2014 waves of the Health and Retirement Study. Veterans reported more noninjurious falls (26.6\% vs. 24.0\%, p < .002), but fewer fall-related injuries (8.9\% vs. 12.3\%, p < .001) than nonveterans. In adjusted analyses, for each 5-year increase in age, the odds of a noninjurious fall were greater for veterans (odds ratio [OR] = 1.05, 95\% confidence interval [CI] = [1.01, 1.10]) and, among those with regular physical activity, the odds were lower for veterans compared with nonveterans (OR = 0.89; 95\% CI = [0.81, 0.99]). For veterans, physical activity engagement may prove a particularly effective mechanism for reducing the aging-related risks associated with falls and fall injuries.}, keywords = {Aging, Disability, Falls, Physical activity, Veterans}, doi = {10.1177/0733464820915807}, author = {Dan Marciniak and Neil B. Alexander and Geoffrey J Hoffman} } @article {11620, title = {The positive influence of sense of control on physical, behavioral, and psychosocial health in older adults: An outcome-wide approach.}, journal = {Preventative Medicine}, volume = {149}, year = {2021}, pages = {106612}, abstract = {

Accumulating research indicates robust associations between sense of control and salutary health and well-being outcomes. However, whether change in sense of control is associated with subsequent outcomes has been under-evaluated. Participants (N = 12,998) were from the Health and Retirement Study-a diverse, nationally representative, and longitudinal sample of U.S. adults aged >50 years. We examined how increase in sense of control (from t:2006/2008 to t: 2010/2012) was associated with better outcomes on 35 indicators of: physical-, behavioral-, and psychosocial-health (t:2014/2016). We used multiple logistic-, linear-, and generalized-linear regression models and controlled for sociodemographic characteristics, personality traits, sense of control, and all outcomes in the pre-baseline wave (t:2006/2008). During the 4-year follow-up, people in the highest (vs. lowest) quartile of sense of control, conditional on prior sense of control, had reduced risk of mortality and improved physical-health outcomes (lower risk of: stroke, lung disease, physical limitations, cognitive impairment, chronic pain and higher self-rated health). Sense of control was related to better health-behaviors (increased physical activity, reduced sleep problems), higher psychological well-being (positive affect, life satisfaction, optimism, purpose, personal-, health-, financial-mastery), lower psychological distress (depression, hopelessness, negative affect, perceived constraints), decreased loneliness, and increased contact with friends. Sense of control was unrelated to other physical health indicators (diabetes, hypertension, heart disease, cancer, arthritis, overweight/obesity), health behaviors (binge drinking, smoking), and social factors (living with spouse/partner, frequency of contact with children and other family). These findings underscore the importance of sense of control as a potential intervention target for fostering physical-, behavioral-, and psychosocial-health.

}, keywords = {physical well-being, psychosocial health}, issn = {1096-0260}, doi = {10.1016/j.ypmed.2021.106612}, author = {Hong, Joanna H and Margie E Lachman and Susan T Charles and Chen, Ying and Wilson, Caitlyn L and Tyler J VanderWeele and Julia S Nakamura and Eric S Kim} } @article {11406, title = {Proxy Selection in the Health and Retirement Study}, year = {2021}, institution = {Survey Research Center, Institute for Social Research, University of Michigan}, address = {Ann Arbor, MI}, author = {HRS Staff} } @article {11268, title = {Quantifying Lifecourse Drivers of International Migration: A Cross-national Analysis of Mexico and the United States.}, journal = {Epidemiology}, volume = {32}, year = {2021}, pages = {50-60}, abstract = {

BACKGROUND: Evaluating the long-term health consequences of migration requires longitudinal data on migrants and non-migrants to facilitate adjustment for time-varying confounder-mediators of the effect of migration on health.

METHODS: We merged harmonized data on subjects aged 50+ from the US-based Health and Retirement Study (HRS) and the Mexican Health and Aging Study (MHAS). Our exposed group includes MHAS-return migrants (n = 1555) and HRS Mexican-born migrants (n = 924). Our unexposed group includes MHAS-never migrants (n = 16,954). We constructed a lifecourse data set from birth (age 0) until either age at migration to the United States or age at study entry. To account for confounding via inverse probability of treatment weights (IPTW), we modeled the probability of migration at each year of life using time-varying pre-migration characteristics. We then evaluated the effect of migration on mortality hazard estimated with and without IPTW.

RESULTS: Mexico to the United States migration was predicted by time-varying factors that occurred before migration. Using measured covariates at time of enrollment to account for selective migration, we estimated that, for women, migrating reduces mortality risk by 13\%, although this estimate was imprecise and results were compatible with either large protective or deleterious associations (hazard ratio [HR] =0.87, 95\% confidence interval [CI]: 0.60, 1.27). When instead using IPTWs, the estimated effect on mortality was similarly imprecise (HR = 0.98, 95\% CI: 0.77, 1.25). The relationship among men was similarly uncertain in both models.

CONCLUSIONS: Although time-varying social factors predicted migration, IPTW weighting did not affect our estimates. Larger samples are needed to precisely estimate the health effects of migration.

}, keywords = {long-term health consequences, MHAS, migrants}, issn = {1531-5487}, doi = {10.1097/EDE.0000000000001266}, author = {Adina Zeki Al Hazzouri and Zhang, Lanyu and Audrey R Murchland and Grasset, Leslie and Jacqueline M Torres and Richard N Jones and Rebeca Wong and M. Maria Glymour} } @article {10584, title = {Race, Gender, and Socioeconomic Variations in C-Reactive Protein Using the Health and Retirement Study}, journal = {The Journals of Gerontology: Series B}, volume = {76}, year = {2021}, pages = {583{\textendash}595}, abstract = {To clarify the relationships among race, gender, and socioeconomic status (SES) with C-reactive protein (CRP).The present study analyzed data from 6,521 Black and White respondents aged 51 and older in the Health and Retirement Study, a nationally representative sample of midlife and older adults, to address two aims. We sought to (i) assess the independent associations between race, gender, and SES with CRP concentrations and (ii) test whether race, gender, and SES interacted to produce unequal CRP concentrations cross-sectionally and over a 4-year follow-up.The results demonstrated that race, gender, and SES were each independently associated with baseline CRP, but only SES was associated with CRP at follow-up. Furthermore, race, gender, and education interacted to produce differential CRP levels at baseline. There were incremental benefits for each additional level of education for White men and women, but the relationship between education and CRP was more complicated for Black men and women. Compared with other race/gender groups with less than high school, Black women had the highest and Black men had the lowest levels of CRP. There were no apparent benefits to CRP for Black women with college compared with Black women with high school, while Black men with less than high school and college had similar concentrations of CRP.In clarifying the complexity inherent in CRP disparities, this work contributes to a greater understanding of the biological mechanisms underlying racial disparities in leading causes of morbidity and mortality in the United States.}, keywords = {Health Disparities, race, socioeconomic status}, issn = {1079-5014}, doi = {10.1093/geronb/gbaa027}, author = {Heather R. Farmer and Linda A. Wray and Steven A Haas} } @article {12258, title = {The Relationship Between Adverse Experiences Over the Life Course and Early Retirement Due to Disability}, number = {WP 2021-435}, year = {2021}, institution = {Retirement and Disability Research Center, University of Michigan}, address = {Ann Arbor}, abstract = {A growing body of research implicates life span adversity in later-life outcomes. We use data from the Life History Mail Survey (LHMS) with data from the Health and Retirement Study (HRS) core surveys to examine the relationship between adverse experiences over the life course and retirement due to disability. We employ 31 measures of childhood and adulthood adversities in both the financial and social domains. We create three measures of retirement due to disability based on survey responses to questions about health as a reason for retiring and the extent to which health limits work ability. For each measure of early retirement due to disability, we perform competing risk survival analysis modeling these outcomes relative to continued work or retirement for any other reason. We conduct these analyses in four samples depending on the component of the survey the data from which the data derived, with the sample including LHMS information being the most restricted but including the greatest number of adversities. Cumulative life adversity was associated with all outcomes examined, including the most conservative specification of disability retirement (i.e., retirement in the context of a health problem that completely limits work) and across all samples. We also found that childhood financial adversity and adult social adversity were most consistently associated with an increased hazard of retirement due to disability in our analysis, which balances the greatest number of adversities with a reasonably large sample (Sample 3).}, keywords = {Adversity, Disability, Early retirement}, url = {https://hdl.handle.net/2027.42/171806}, author = {Amanda Sonnega and Helppie-McFall, Brooke} } @article {Walker2020, title = {Relationship Between Multiple Measures of Financial Hardship and Glycemic Control in Older Adults With Diabetes}, journal = {Journal of Applied Gerontology}, volume = {40}, year = {2021}, pages = {162-169}, type = {Journal}, abstract = {Aim: To examine the relationship between multiple measures of financial hardship and glycemic control in older adults with diabetes. Methods: Using data from Health and Retirement Study (HRS), we investigated four measures of financial hardship: difficulty paying bills, ongoing financial strain, decreasing food intake due to money, and taking less medication due to cost. Using linear regression models, we investigated the relationship between each measure, and a cumulative score of hardships per person, on glycemic control (HbA1c). Results: After adjustment, a significant relationship existed with each increasing number of hardships associated with increasing HbA1c (0.09, [95\%CI 0.04, 0.14]). Difficulty paying bills (0.25, [95\%CI 0.14, 0.35]) and decreased medication usage due to cost (0.17, [95\%CI 0.03, 0.31]) remained significantly associated with HbA1c. Conclusion: In older adults, difficulty paying bills and cost-related medication nonadherence is associated with glycemic control, and every additional financial hardship was associated with an increased HbA1c by nearly 0.1\%. {\textcopyright} The Author(s) 2020.}, keywords = {Chronic illness, Diabetes, socioeconomic status}, issn = {07334648}, doi = {10.1177/0733464820911545}, author = {Walker, R.J. and Emma Garacci and Campbell, J.A. and Harris, M. and Mosley-Johnson, E. and Leonard E Egede} } @article {11797, title = {The role of education and income for cognitive functioning in old age: A cross-country comparison.}, journal = {International Journal of Geriatric Psychiatry}, volume = {36}, year = {2021}, pages = {1908-1921}, abstract = {

OBJECTIVES: Previous studies have shown that higher education promotes cognitive health. This effect, however, is embedded in the living conditions of a particular country. Since it is not clear to what extent the country and its specific living standards are necessary preconditions for the observed effect, we investigated whether the impact of education and income on cognitive functioning differs between countries.

METHODS: Analyses were based on harmonized data from the World Health Organization{\textquoteright}s multi-country Study on global AGEing and adult health (WHO SAGE), the Health and Retirement Study (HRS), and the Survey of Health, Ageing and Retirement in Europe (SHARE)) of over 85,000 individuals aged 50 years and older. Analyses were conducted via multivariate regression analyses and structural equation modelling adjusted for age, gender, marital status, health status, and depression.

RESULTS: The effect of education was twice as large as the effect of income on cognitive functioning and indirectly moderated the effect of income on cognitive functioning. The effect sizes varied strongly between countries. The country{\textquoteright}s gross domestic product per capita seems to influence cognitive functioning.

CONCLUSIONS: Our findings indicate that education has a dominant effect on cognitive functioning in people aged 50 years and older, which might even offset the adverse implications of living with low income on cognitive health. Therefore, expanding efforts to achieve universal education are essential to mitigate health disparities due to low income and early life disadvantages, including chances for good cognitive functioning over the life-span. This article is protected by copyright. All rights reserved.

}, keywords = {cognitive functioning, Cognitive Reserve, Cross-country comparison, deprivation, Education, Epidemiology, Income, Life-course, Poverty, SHARE}, issn = {1099-1166}, doi = {10.1002/gps.5613}, author = {Rodriguez, Francisca S and Hofbauer, Lena M and R{\"o}hr, Susanne} } @article {AndreaA153, title = {S-207 Multidimensional employment quality, retirement trajectories and cardiometabolic health in later life in the US}, journal = {Occupational and Environmental Medicine}, volume = {78}, year = {2021}, pages = {A153{\textendash}A154}, abstract = {Introduction The working lives of Americans have become less stable over the past several decades and older adults may be particularly vulnerable to these changes in employment quality (EQ).Objective We examined later-life multidimensional EQ and retirement trajectories of older Americans and the potential consequences worsening EQ may have for cardiometabolic health and health inequities in this population.Methods Using longitudinal data on employment stability, material rewards, workers{\textquoteright} rights, working-time arrangements, unionization, and interpersonal power relations from the Health and Retirement Study, we used principal component analysis to construct an EQ score. Then, we used sequence analysis to identify late-career EQ trajectories (age 50{\textendash}70 years; N=11,958 respondents), overall and by race, gender, educational attainment, marital status. Finally, we estimated the association between trajectory-membership and post-sequence-analysis-period prevalence of poor cardiometabolic health.Results We identified ten EQ trajectories; the most prevalent trajectories were Minimally Attached and Wealthy (13.9\%) and Good EQ to Good Retirement (13.7\%), however, 42\% of respondents were classified into suboptimal trajectories. Those in suboptimal trajectories were disproportionately women, Hispanic and/or Black, Indigenous and People of Color, and those with lower educational attainment. Moreover, those in suboptimal trajectories tended to report the worse cardiometabolic health. For example, the prevalence of hypertension was lowest for those in the Wealthy Business Owners trajectory and highest for Workers with Premature Mortality, followed by workers with Fair EQ and Good but Diminishing Wealth in Retirement.Conclusion EQ is inequitably distributed and may play a role in cardiometabolic health inequities in later life.}, keywords = {cardiometabolic health, employment quality, Retirement}, issn = {1351-0711}, doi = {10.1136/OEM-2021-EPI.420}, author = {Sarah B. Andrea and Eisenberg-Guyot, Jerzy and Peckham, Trevor and Vanessa M Oddo and Hajat, Anjum} } @article {11220, title = {Same-Sex Couples and Cognitive Impairment: Evidence from the Health and Retirement Study.}, journal = {The Journals of Gerontology: Series B }, volume = {76}, year = {2021}, pages = {1388-1399}, abstract = {

OBJECTIVES: We provide the first nationally representative population-based study of cognitive disparities among same-sex and different-sex couples in the United States.

METHOD: We analyzed data from the Health and Retirement Study (2000-2016). The sample included 23,669 respondents (196 same-sex partners and 23,473 different-sex partners) aged 50 and older who contributed to 85,117 person-period records (496 from same-sex partners and 84,621 from different-sex partners). Cognitive impairment was assessed using the modified version of the Telephone Interview for Cognitive Status (TICS). Mixed-effects discrete-time hazard regression models were estimated to predict the odds of cognitive impairment.

RESULTS: The estimated odds of cognitive impairment were 78\% (p < .01) higher for same-sex partners than for different-sex partners. This disparity was mainly explained by differences in marital status and, to a much lesser extent, by differences in physical and mental health. Specifically, a significantly higher proportion of same-sex partners than different-sex partners were cohabiting rather than legally married (72.98\% vs. 5.42\% in the study sample), and cohabitors had a significantly higher risk of cognitive impairment than their married counterparts (OR = 1.53, p < .001).

DISCUSSION: The findings indicate that designing and implementing public policies and programs that work to eliminate societal homophobia, especially among older adults, is a critical step in reducing the elevated risk of cognitive impairment among older same-sex couples.

}, keywords = {cognitive impairment, gender, Marital Status, same-sex couples, sexual minorities}, issn = {1758-5368}, doi = {10.1093/geronb/gbaa202}, author = {Hui Liu and Hsieh, Ning and Zhang, Zhenmei and Zhang, Yan and Kenneth M. Langa} } @article {doi:10.1089/heq.2021.0034, title = {Sexual Identity and Self-Rated Health in Midlife: Evidence from the Health and Retirement Study}, journal = {Health Equity}, volume = {5}, year = {2021}, pages = {587-595}, abstract = {Purpose: This study examined health disparities among U.S. sexual minority people in midlife{\textemdash}a critical life course stage that is largely overlooked in the sexual minority health literature. Methods: Data were drawn from the 2016 Health and Retirement Study. We restricted the analysis to respondents aged 50{\textendash}65. The final sample consisted of 3623 respondents, including 3418 self-identified heterosexual individuals, 99 self-identified gay/lesbian individuals, 38 self-identified bisexual individuals, and 68 respondents who identified as {\textquotedblleft}something else.{\textquotedblright} Ordinal logistic regression models were estimated to predict the odds of reporting better health. Results: Bisexual midlifers reported significantly worse health than their heterosexual counterparts after age, gender, and race-ethnicity are controlled for (OR=0.43, 95\% CI=0.25{\textendash}0.76); this health disparity is mostly explained by marital status, socioeconomic status, and health behaviors (in particular smoking and exercising). We did not find evidence of a self-rated health disadvantage among gay and lesbian midlifers relative to their heterosexual counterparts. Conclusion: These findings highlight the diversity of the sexual minority population in midlife. Public policies and programs should be designed and implemented at the interpersonal and institutional levels to eliminate health and other social disadvantages among sexual minority people, in particular bisexual people, in midlife.}, keywords = {Self-rated health, sexual identity}, doi = {10.1089/heq.2021.0034}, author = {Liu, Hui and Hsieh, Ning and Lai, Wen-hua} } @article {11603, title = {Skilled Nursing Facilities Modify the Relationship Between Depressive Symptoms and Hospital Readmissions but Not Health Outcomes Among Older Adults.}, journal = {Journal of Aging and Health}, volume = {33}, year = {2021}, pages = {817-827}, abstract = {

Despite detrimental effects of depressive symptoms on self-care and health, hospital discharge practices and the benefits of different discharge settings are poorly understood in the context of depression. This retrospective cohort study comprised 23,485 hospitalizations from Medicare claims linked to the Health and Retirement Study (2000-2014). Respondents with depressive symptoms were no more likely to be referred to home health, whereas the probability of discharge to skilled nursing facilities (SNFs) went up a half percentage point with each increasing symptom, even after adjusting for family support and health. Rehabilitation in SNFs, compared to routine discharges home, reduced the positive association between depressive symptoms and 30-day hospital readmissions (OR = 0.95, = 0.029) but did not prevent 30-day falls, 1-year falls, or 1-year mortality associated with depressive symptoms. Depressive symptoms were associated with discharges to SNFs, but SNFs do not appear to address depressive symptoms to enhance functioning and survival.

}, keywords = {depression, Medicare, post-acute care, Readmissions, Rehabilitation}, issn = {1552-6887}, doi = {10.1177/08982643211013127}, author = {Leah R. Abrams and Geoffrey J Hoffman} } @article {11706, title = {Social Engagement and Cognitive Function of Older Adults in Mexico and the United States: How Universal Is the Interdependence in Couples?}, journal = {The Journals of Gerontology: Series B}, volume = {76}, year = {2021}, pages = {S41-S50}, abstract = {

OBJECTIVES: Increased social engagement in older adults has been linked to positive cognitive outcomes; however, it is unclear if the social engagement of husbands and wives influences their own cognition as well as each other{\textquoteright}s cognition. Moreover, it is unknown if any such patterns persist in different country contexts.

METHODS: Data from the 2001 Mexican Health and Aging Study (MHAS) and the 2000 Health and Retirement Study (HRS) were combined, and comparable samples of married couples without cognitive impairment at baseline were drawn. Follow-up cognition data was obtained from the 2012 MHAS and the 2012 HRS. Structural equation models (SEM) were used to test the actor-partner interdependence model with moderating effect of country on the association of social engagement with cognition.

RESULTS: Significant actor effects were observed for wives in both countries. Actor effects for husbands were observed in the United States only. In Mexico, a significant partner effect was observed where wives{\textquoteright} social engagement benefited their own cognition as well as their husbands{\textquoteright}, but not vice versa. Partner effects were not observed in the United States. No moderation effects of country were observed.

DISCUSSION: Our results suggest asymmetric patterns of actor-partner interdependence in Mexico, which may be reflective of the more traditional social role of women, and codependence within the couple. On the other hand, our results for the United States, where each spouse had significant actor effects but no partner effects, may suggest more independence within the couple.

}, keywords = {Cohort Analysis, Cross-country study, Marriage, MHAS}, issn = {1758-5368}, doi = {10.1093/geronb/gbaa025}, author = {Bret Howrey and Jaqueline C Avila and Brian Downer and Rebeca Wong} } @article {CHA2021100921, title = {Socioeconomic status across the life course and dementia-status life expectancy among older Americans}, journal = {SSM - Population Health}, volume = {15}, year = {2021}, pages = {100921}, abstract = {This study examines how socioeconomic status (SES) across the life course is associated with individuals{\textquoteright} lifetime dementia experience {\textendash} the years of life persons can expect to live and without with dementia. Conceptually, dementia-free life expectancy reflects the ability to postpone dementia onset while dementia life expectancy reflects the average lifetime period with the condition. How SES across the life course contributes to dementia-status life expectancy is the focus of this study. We assess whether persons who are advantaged in their lifetime SES live the most years without dementia and the fewest years with dementia compared to less advantaged persons. Using the Health and Retirement Study (2000{\textendash}2016), we examine these questions for U.S. adults aged 65 and older using multistate life tables and a microsimulation approach. The results show that higher SES persons can expect to live significantly more years of life without dementia and that the period of life with dementia is compressed compared to less advantaged persons. The results also underscore that importance of cumulative exposure, showing that adults from disadvantaged childhoods who achieve high education levels often have dementia experiences that are similar to or better than those of adults from advantaged childhoods who achieved low education levels.}, keywords = {Dementia, Life Expectancy, Mortality, socioeconomic status}, issn = {2352-8273}, doi = {10.1016/j.ssmph.2021.100921}, author = {Hyungmin Cha and Mateo P Farina and Mark D Hayward} } @conference {11852, title = {Statistical Significance of Hyperparameter Tuning for Varying Levels of Class Imbalance}, booktitle = {26th ISSAT International Conference on Reliability and Quality in Design, RQD 2021}, year = {2021}, month = {08/2021}, abstract = {Researchers experimenting with classification tasks for Machine Learning have a choice to use optimized or default values for their algorithms{\textquoteright} hyperparameters. Our contribution is to conduct experiments with balanced and imbalanced datasets to show hyperparameter tuning has a significant, positive impact on classification results regardless of class ratio. To the best of our knowledge, this is the first study to investigate whether hyperparameter tuning has a statistically significant impact on the classification of balanced and imbalanced datasets derived from the Health and Retirement Study.We conduct a series of experiments with three classifiers, and five datasets. The classifiers are well-known, widely used classifiers in Machine Learning research. The datasets are based on a survey on cognition in human subjects. Three of the datasets are balanced, and two of them are imbalanced. We perform Analysis of Variance and Tukey{\textquoteright}s Honestly Significant Difference tests to determine the effect of hyperparameter tuning. Our results show that, regardless of class imbalance, using optimized hyperparameter values yields better results in a statistically significant sense.}, keywords = {Class imbalance, Cognition, Logistic Regression, Machine learning, Random forest}, isbn = {978-099105769-6}, author = {Hancock, J. and Khoshgoftaar, T.M. and Landset, S.} } @article {11400, title = {Study shows working in agriculture poses higher risk of developing dementia}, journal = {Press Release}, year = {2021}, publisher = {Great Plains Center for Agricultural Health at the University of Iowa}, address = {Iowa City, IA}, abstract = {This first-of-its-kind study in the U.S. asks: Are agricultural workers at greater risk than non-agricultural workers of developing dementia? The answer, according to University of Iowa researchers is: {\textquotedblleft}Yes.{\textquotedblright}}, keywords = {agriculture, Dementia, worker}, url = {https://gpcah.public-health.uiowa.edu/press-release-study-shows-working-in-agriculture-poses-higher-risk-of-developing-dementia/}, author = {Great Plains Center for Agricultural Health} } @article {11655, title = {Take a Sad Song and Make it Better: Spousal Activity Limitations, Caregiving, and Depressive Symptoms Among Couples}, journal = {Social Science \& Medicine}, volume = {281}, year = {2021}, pages = {114081}, abstract = {ObjectivesFramed around key concepts of the life course perspective, we examined the linkages between spousal activity limitations, caregiving transitions, and depression among married couples. The key study objectives were 1) to demonstrate how the caregiving-depression link widely reported in earlier research may have been over-stated, and 2) to investigate whether caregiving yields mental health benefits by weakening the link between spousal activity limitations and depressive symptoms.MethodsWe used longitudinal data from the Health and Retirement Study (2004{\textendash}2016) to examine a national sample of coupled individuals (6,475 couples; 57,844 person-wave observations). A series of longitudinal actor-partner interdependence models were used to estimate within-person associations between spousal activity limitations, caregiving transitions, and depressive symptoms among coupled individuals.ResultsFindings demonstrated that spousal activity limitations function as a confounder for the association between caregiving transitions and depressive symptoms. Results further provided evidence that transitioning into a caregiving role in the context of spousal activity limitations alleviated symptoms of depression for the caregiver.ConclusionOur findings provide an explanation for the extended longevity benefit reaped by caregivers increasingly reported in recent population studies. Implications for policy, practice, and future research are discussed.}, keywords = {agency, Caregivers, caregiving system model, depression, Disability, linked lives, Transitions}, isbn = {0277-9536}, doi = {10.1016/j.socscimed.2021.114081}, author = {Sae Hwang Han and Kim, Kyungmin and Jeffrey A Burr} } @article {11747, title = {TEMPORAL INSTABILITY OF RISK PREFERENCE AMONG THE POOR: EVIDENCE FROM PAYDAY CYCLES}, number = { 28784}, year = {2021}, institution = {National Bureau of Economic Research}, address = {Cambridge, MA}, abstract = {The poor live paycheck to paycheck and are repeatedly exposed to strong cyclical income fluctuations. We investigate whether such income fluctuations affect risk preference among the poor. If risk preference temporarily changes around payday, optimal decisions made before payday may no longer be optimal afterward, which could reinforce poverty. By exploiting Social Security payday cycles in the US, we find that risk preference among the poor relying heavily on Social Security changes around payday. Rather than cognitive decline before payday, the deterioration of mental health and relative deprivation may play a role. We find similar evidence among the Japanese elderly. }, keywords = {Income, instability, payday cycles, Risk preference}, doi = {10.3386/w28784}, author = {Akesaka, Mika and Eibich, Peter and Hanaoka, Chie and Shigeoka, Hitoshi} } @article {11428, title = {Tracking Progress on Person-Centered Care for Older Adults: How Are We Doing?}, year = {2021}, institution = {Center for Consumer Engagement in Health Innovation}, address = {Boston, MA}, abstract = {Person-centered care is essential to a high-quality system of care, emphasizing a holistic approach oriented around individuals{\textquoteright} goals and preferences. Analyzing the 2014 and 2016 Health and Retirement Study, we measure the extent to which older adults experience person-centered care, differences by race, income and other variables, and how receipt of person-centered care affects overall health care satisfaction and service utilization. Roughly one-third of older adults reported that their preferences were only rarely or sometimes taken into account. Results varied greatly by race. One in four Hispanics reported never having their preferences taken into account compared to roughly one in ten whites and one in six Blacks. When people{\textquoteright}s preferences are ignored, they are more likely to forgo medical care and report lower satisfaction with the health care system. New efforts are needed to strengthen and advance person-centered care, particularly for people of color and low-income populations.}, keywords = {Health Care, Income, person-centered care, race}, url = {https://www.healthinnovation.org/resources/publications/body/Person-Centered-Care-Report_Jan-2021.pdf}, author = {Jane Tavares and Hwang, Ann and Marc A Cohen} } @inbook {11409, title = {Trends in morbidity, healthy life expectancy, and the compression of morbidity}, booktitle = {Handbook of the Biology of Aging (Ninth Edition)Handbooks of Aging}, year = {2021}, pages = {405-414}, publisher = {Academic Press}, organization = {Academic Press}, chapter = {19}, abstract = {This chapter lays out the dimensions of morbidity and the processes linking morbidity and mortality. It provides evidence of recent trends in morbidity of the older American population: decline in some types of disability but not others, disease, and physiological dysregulation among the older American population. In addition, the chapter uses data from two recent cohorts to look at survival without disease and the age at onset of diseases. We have generally seen an increase in the prevalence and time with disease; but disease appears less disabling now than in the past. In addition, the onset of myocardial infarction appears to have been delayed by the recent control of biological risk. Most of the evidence does not support the idea that we have experienced a recent compression of morbidity; it does support some delay and retarding of progression of the morbidity process.}, keywords = {compression of morbidity, health trends, Healthy life expectancy, Morbidity}, isbn = {978-0-12-815962-0}, doi = {https://doi.org/10.1016/B978-0-12-815962-0.00019-6}, author = {Eileen M. Crimmins and Yuan S Zhang and Jung K Kim and Morgan E. Levine}, editor = {Musi, Nicolas and Hornsby, Peter J.} } @article {11744, title = {The unsophisticated {\textquotedblleft}sophisticated{\textquotedblright}: Old age and the accredited investors definition}, journal = {Financial Planning Review}, volume = {4}, year = {2021}, pages = {e1114}, abstract = {Abstract Accredited investors are able to participate in unregistered securities offerings such as private equity, venture capital, and hedge funds if they meet income and wealth thresholds. This definition provides a simple screening mechanism intended to restrict the purchase of complex securities to investors who are sophisticated enough to ?fend for themselves.? We investigate whether older households, who are vulnerable to age-related cognitive decline and are more likely to meet the accredited investor threshold, possess greater financial sophistication than younger nonaccredited investors. We find strong evidence that older households are at risk of meeting the accredited investor definition without having the sophistication needed to avoid high agency costs in a largely unregulated securities market. Accredited households age 80 and older are more than 80\% less likely than unaccredited investors age 60?64 to have high financial sophistication scores. This reduced financial capability in later life appears to mirror the rate of decline in measures of cognition.}, keywords = {accredited investor, cognitive aging, financial sophistication, investor protection}, doi = {10.1002/cfp2.1114}, author = {Michael S. Finke and Guo, Tao and Huston, Sandra} } @article {12056, title = {Using HRS-ONET Linked Data to Study Subjective and Objective Mismatch Between Work Demands and Capacity at Older Ages}, journal = {Innovation in Aging}, volume = {5}, year = {2021}, pages = {231{\textendash}232}, abstract = {Mismatch between demands of work and workers{\textquoteright} ability to meet those demands may play an important role in retirement decisions. This presentation extends earlier work using Health and Retirement Study data linked to O*NET to develop measures of discrepancy between individual{\textquoteright}s own reports of physical and mental abilities and 1) their perceptions of the physical and mental demands of their jobs and 2) O*NET ratings of the physical and mental demands of their jobs. In particular, we utilize newly available linked information using 2010 Census codes and 2019 O*NET ratings that reflect more current jobs. We then examine the impact of each type of mismatch (subjective and objective) on retirement timing. Overall, we find a stronger connection between subjective mismatch relative to objective mismatch. We discuss implications of this finding in terms of the value of the O*NET linkage and potential interventions aimed at extending working lives for positive aging.}, keywords = {O*NET, work demands, worker ability}, doi = {https://doi.org/10.1093/geroni/igab046.888}, author = {Amanda Sonnega and Gwenith G Fisher and Helppie-McFall, Brooke} } @article {11771, title = {Volunteering as an Equalizer: A Quasi-Experimental Study Using Propensity Score Analysis}, journal = {American Journal of Preventive Medicine}, volume = {61}, year = {2021}, pages = {628-635}, abstract = {Formal volunteering in later life is beneficial for both physical and psychological well-being. However, research points to potential selection bias because older adults with key advantages, such as wealth, are more likely to volunteer and reap its benefits. Accordingly, this study addresses this selection bias by considering the characteristics of volunteers and nonvolunteers using the inverse probability of treatment weighting. It also examines whether volunteering has differential impacts between the highest and lowest wealth quintiles using inverse probability of treatment weighting. Methods Data were analyzed from the 2004{\textendash}2016 waves of the Health and Retirement Study (N=90,881). The weights, created using a machine learning method, were incorporated in the analysis to estimate the treatment effects along with relevant covariates. Analyses were conducted in 2020. Results Volunteering enhanced self-reported health and reduced depressive symptoms in the full sample. Furthermore, those in the lowest wealth quintile experienced significantly better self-reported health from volunteering than their wealthy counterparts. Volunteering was associated with fewer depressive symptoms regardless of wealth status. Conclusions The study enhances the understanding of formal volunteering and health while suggesting that volunteers with low wealth may benefit more from volunteering in terms of their health. Hindrances to volunteering among the least wealthy, such as financial distress, discrimination, or lack of organizational support, may attenuate the benefits of voluntary activity. }, keywords = {health, Volunteering, Wealth}, doi = {10.1016/j.amepre.2021.05.004}, author = {Kim, Seoyoun and Cal J. Halvorsen} } @article {11174, title = {Volunteering, Self-Perceptions of Aging, and Mental Health in Later Life.}, journal = {Gerontologist}, volume = {61}, year = {2021}, pages = {1131-1140}, abstract = {

BACKGROUND AND OBJECTIVES: Scholars argue that volunteering enhances social, physical, and cognitive activities that are increasingly valued as people age, which in turn improves older adults{\textquoteright} well-being via a host of psychosocial and neurobiological mechanisms. This study explicitly tested older adults{\textquoteright} self-perceptions of aging as a mechanism underlying the mental health benefits of volunteering.

RESEARCH DESIGN AND METHODS: Using 2-wave data from the Health and Retirement Study (2008/2010 for Wave 1 and 2012/2014 for Wave 2), we analyzed reports from a pooled sample of older adults aged 65+ (N = 9,017). Participants reported on demographic characteristics, volunteer work (did not volunteer, 1-99 hours per year, 100+ hours per year), self-perceptions of aging, and depressive symptoms. We estimated an autoregressive cross-lagged panel model.

RESULTS: Volunteering for 100 hours or more per year was associated with older adults{\textquoteright} more positive and less negative self-perceptions of aging in the subsequent wave (i.e., 4 years later), which in turn predicted fewer depressive symptoms.

DISCUSSION AND IMPLICATIONS: This study suggests the promising role of volunteering in shaping older adults{\textquoteright} self-perceptions of aging on a sustained basis and refines our understanding of the benefits volunteering brings. Findings shed light on future interventions aimed at improving older adults{\textquoteright} adjustment to age-related changes and lessening ageism in society.

}, keywords = {age stereotype, depression, Subjective aging, volunteer}, issn = {1758-5341}, doi = {10.1093/geront/gnaa164}, author = {Huo, Meng and Miller, Lisa M Soederberg and Kim, Kyungmin and Liu, Siwei} } @article {11536, title = {Wealth and the utilization of long-term care services: evidence from the United States.}, journal = {International Journal of Health Economics and Management}, volume = {21}, year = {2021}, pages = {345-366}, abstract = {

Long-term care (LTC) provision and financing has become a major challenge for policymakers in the United States and worldwide. To inform associated policies and more efficiently allocate LTC resources, it is important to understand how demand for different types of LTC services responds to increased wealth. We use data from the United States Health and Retirement Study to examine the use of LTC services following plausibly exogenous positive shocks to wealth. We further account for time-invariant household-level characteristics, including the expectation of a wealth shock at an unknown future time, by employing household fixed effects. We find that large positive wealth shocks lead to a greater probability of purchase of paid home care but not of nursing home care. Our results imply that expanding home and community-based services and insurance coverage of home care for people without sufficient wealth is likely to be efficient and welfare improving and should be considered by policymakers.Please confirm if the author names are presented accurately and in the correct sequence (given name, middle name/initial, family name). Author 4 Given name: [R. Tamara] Last name: [Konetzka]. Also, kindly confirm the details in the metadata are correct.confirmedPlease confirm the city are correct and amend if necessary in Affiliations 1, 2, 3, 4.confirmed.

}, keywords = {home care, Long-term care financing, nursing home, Wealth effect}, issn = {2199-9031}, doi = {10.1007/s10754-021-09299-1}, author = {Dong, Jing and Daifeng He and John A. Nyman and R. Tamara Konetzka} } @article {11208, title = {What role for the {\textquoteleft}long arm of childhood{\textquoteright} in social gradients? An international comparison of high-income contexts}, journal = {Longitudinal and Life Course Studies}, volume = {12}, year = {2021}, pages = {147-171(25)}, abstract = {Social gradients in health have been a focus of research for decades. Two important lines of social gradient research have examined (1) international variation in their magnitude and (2) their life course / developmental antecedents. The present study brings these two strands together to explore the developmental origins of educational gradients in health. We leverage data spanning 14 high-income contexts from the Health and Retirement Study and its sisters in Europe. We find that early-life health and socio-economic status consistently attenuate educational gradients in multimorbidity and functional limitation. However, the relative contribution of early-life factors to gradients varies substantially across contexts. The results suggest that research on social gradients, and population health broadly, would benefit from the unique insights available from a conceptual and empirical approach that integrates comparative and life course perspectives.}, keywords = {ELSA, SHARE, social gradiant, TILDA}, doi = {10.1332/175795920X16025975665508}, author = {Steven A Haas and Zhou, Zhangjun and Oi, Katsuya} } @book {WR-A1009-1, title = {The Age Profile of Life-Satisfaction After Age 65 in the U.S.}, series = {RAND Working Paper}, volume = {WR-A1009-1}, year = {2020}, publisher = {RAND Corporation}, organization = {RAND Corporation}, address = {Santa Monica, CA}, abstract = {Although income and wealth are frequently used as indicators of well-being, they are increasingly augmented with subjective measures such as life satisfaction to capture broader dimensions of individuals{\textquoteright} well-being. Based on data from large surveys of individuals, life satisfaction in cross-section increases with age beyond retirement into advanced old age. It may seem puzzling that average life satisfaction would be higher at older ages because older individuals are more likely to experience chronic or acute health conditions, or the loss of a spouse. Accordingly, this empirical pattern has been called the "paradox of well-being." We examine the age profile of life satisfaction of the U.S. population age 65 and older in the Health and Retirement Study (HRS) and also find increasing life satisfaction at older ages in cross-section. But based on the longitudinal dimension of the HRS life satisfaction significantly declines with age and the rate of decline accelerates with age. Widowing and health shocks play important roles in this decline. We reconcile the cross-section and longitudinal measurements by showing that both differential mortality and differential non-response bias the cross-sectional age profile upward: individuals with higher life satisfaction and in better health tend to live longer and to remain in the survey, causing average values to increase. We conclude that the optimistic view about increasing life satisfaction at older ages based on cross-sectional data is not warranted.}, keywords = {age profile, Life Satisfaction}, doi = {10.7249/WRA1009-1}, author = {P{\'e}ter Hudomiet and Michael D Hurd and Susann Rohwedder} } @mastersthesis {11333, title = {Air pollution neurotoxicity throughout the lifespan: studies on the mechanism of toxicity and interactions with effects of sex and genetic background.}, volume = {Biology of Aging}, year = {2020}, school = {University of Southern California}, abstract = {Air pollution (AirP) is a leading global environmental risk factor of mortality and morbidity in humans and many other organisms. AirP affects the lives of more than 90\% of the humans from all ages and unfortunately has an increasing trend in developing countries. Depends on the life stage, exposure to AirP can increase the risk of neurodevelopmental or neurodegenerative diseases. Alarmingly, lack of understanding of the AirP toxicity mechanisms likely led to a severe underestimation of the global health burden of these complex toxicants. AirP toxicity is shaped by a complex interface of chemical properties of toxicants mixture and the biological features of the exposed individuals (e.g. genetic structure, sex, and life-stage). The current dissertation is comprised of a series of projects to resolve some of these complex interactions. In chapters 2-3, we discussed how the chemical characterization of AirP can alter the neurotoxicity in vivo and in vitro. Moreover, we developed a cell-based assay that can predict the neurotoxicity of the AirP particulate matter (PM) in the brain. Chapters 4-7 approaches the nuances in the molecular toxicity of AirP between different life stages (development vs adult), sexes (males vs females), and some genetic variants (ApoE3 vs ApoE4). We also corroborated our findings in Caenorhabditis elegans, a known nematode model for aging research. In the last chapter, we described the gender differences in vulnerability to life-time cigarette smoke exposure for some aging-associated health outcomes. Throughout the dissertation, we discussed the facing challenges in the AirP toxicology field, and also identified potential molecular mechanisms that underlay each complex research question. We hope that our findings lead to several novel studies and translate into the regulation soon.}, keywords = {Air Pollution, genetic, neurotoxicity, Sex Characteristics, Sex differences}, url = {http://digitallibrary.usc.edu/cdm/ref/collection/p15799coll89/id/275759/}, author = {Haghani, Amin} } @article {10976, title = {Are homeownership patterns stable enough to tap home equity?}, journal = {The Journal of Economics of Ageing}, volume = {17}, year = {2020}, abstract = {As retirees live longer, spend more on medical care, and get less income replaced by Social Security, many may need to consider tapping their home equity to be comfortable in retirement. The most direct way to access home equity is downsizing, but few choose this option because they generally prefer to stay in their house. The alternative is withdrawing equity through a reverse mortgage or a property tax deferral, but few households use these options either. While this low take-up has been well documented, a more fundamental question is the extent to which homeowners exhibit sufficient stability in their housing patterns to make them well-suited to tap their equity. For example, if homeowners do tap their equity and then end up moving, they have to pay back the loan with interest, which could leave them with inadequate resources at a vulnerable time in their life. This paper assesses how likely households are to move as they age to see if borrowing against one{\textquoteright}s home is a reasonable financial strategy. The analysis uses the Health and Retirement Study (HRS) to analyze three cohorts: the HRS cohort (ages 50{\textendash}54 in 1992), the AHEAD cohort (ages 70{\textendash}74 in 1993), and a synthetic cohort covering the whole lifespan from age 50 to death. The analysis identifies typical housing trajectories in retirement and explores how often, and for whom, tapping home equity would be a viable strategy. The paper found that:{\textbullet}Seventy percent of households have very stable homeownership patterns, even over several decades. They either stay in the home they own in their 50 s (53 percent) or purchase a new home around retirement and stay for the rest of their life (17 percent).{\textbullet}The 30 percent of households that do move consist of two distinct subgroups. Frequent movers (14 percent) appear to face labor market challenges. Late movers (16 percent) look like a slightly more affluent version of the households that never move, but then face a health shock that forces them out of the home that they owned into a rental unit or a long-term services and supports facility.{\textbullet}Overall, the findings largely support the narrative from prior research that most people want to age in place and move only in response to a shock. The policy implications of the findings are:{\textbullet}Most homeowners experience enough residential stability to tap home equity through reverse mortgages or property tax deferrals.{\textbullet}Retirees might be more likely to tap their home equity if they felt that they had adequate public or private insurance protection against the risk of needing long-term services and supports.}, keywords = {Home equity, Housing trajectories, Property tax deferrals, retirement security, Reverse mortgage, Sequence analysis}, isbn = {2212-828X}, doi = {https://doi.org/10.1016/j.jeoa.2020.100277}, author = {Alicia H. Munnell and Abigail N. Walters and Belbase, Anek and Wenliang Hou} } @article {10553, title = {Are Homeownership Patterns Stable Enough to Tap Home Equity?}, number = {WP$\#$2020-7}, year = {2020}, institution = {Center for Retirement Research at Boston College}, abstract = {As retirees live longer, spend more on medical care, and get less income replaced by Social Security, many may need to tap their home equity to be comfortable in retirement. The most direct way to access home equity is downsizing, but few choose this option because they generally prefer to stay in their house. The alternative is withdrawing equity through a reverse mortgage or a property tax deferral, but few households use these options either. A potential reason that homeowners are reluctant to borrow against their house is that, if they do decide to move, they have to pay back the loan with interest, which could leave them with inadequate resources at a vulnerable time in their life. This paper assesses how likely households are to move as they age to see if borrowing against one{\textquoteright}s home is a viable financial strategy. The analysis uses the Health and Retirement Study (HRS) to analyze three cohorts: the HRS cohort (ages 50-54 in 1992), the AHEAD cohort (ages 70-74 in 1993), and a synthetic cohort covering the whole lifespan from age 50 to death. The analysis identifies typical housing trajectories in retirement and explores how often, and for whom, tapping home equity would be a viable strategy.}, keywords = {Home ownership}, url = {https://crr.bc.edu/working-papers/are-homeownership-patterns-stable-enough-to-tap-home-equity/}, author = {Alicia H. Munnell and Abigail N. Walters and Belbase, Anek and Wenliang Hou} } @article {11146, title = {Are Improvements Still Needed to the Modified Hospital Readmissions Reduction Program: a Health and Retirement Study (2000-2014)?}, journal = {Journal of General Internal Medicine}, volume = {35}, year = {2020}, pages = {3564-3571}, abstract = {

BACKGROUND: To address concerns that the Hospital Readmissions Reduction Program (HRRP) unfairly penalized safety net hospitals treating patients with high social and functional risks, Medicare recently modified HRRP to compare hospitals with similar proportions of high-risk, dual-eligible patients ("peer group hospitals"). Whether the change fully accounts for patients{\textquoteright} social and functional risks is unknown.

OBJECTIVE: Examine risk-standardized readmission rates (RSRRs) and hospital penalties after adding patient-level social and functional and community-level risk factors.

DESIGN: Using 2000-2014 Medicare hospital discharge, Health and Retirement Study, and community-level data, latent factors for patient social and functional factors and community factors were identified. We estimated RSRRs for peer groups and by safety net status using four hierarchical logistic regression models: "base" (HRRP model); "patient" (base plus patient factors); "community" (base plus community factors); and "full" (all factors). The proportion of hospitals penalized was calculated by safety net status.

PATIENTS: 20,255 fee-for-service Medicare beneficiaries (65+) with eligible index hospitalizations MAIN MEASURES: RSRRs KEY RESULTS: Half of safety net hospitals are in peer group 5. Compared with other hospitals, peer group 5 hospitals (most dual-eligibles) treated sicker, more functionally limited patients from socially disadvantaged groups. RSRRs decreased by 0.7\% for peer groups 2 and 4 and 1.3\% for peer group 5 under the patient and full (versus base) models. Measured performance improved after adjusting for patient risk factors for hospitals in peer group 4 and 5 hospitals, but worsened for those in peer groups 1, 2, and 3. Under the patient (versus base) model, fewer safety net hospitals (48.7\% versus 51.3\%) but more non-safety net hospitals (50.0\% versus 49.1\%) were penalized.

CONCLUSIONS: Patient-level risk adjustment decreased RSRRs for hospitals serving more at-risk patients and proportion of safety net hospitals penalized, while modestly increasing RSRRs and proportion of non-safety net hospitals penalized. Results suggest HRRP modifications may not fully account for hospital variation in patient-level risk.

}, keywords = {Readmissions, safety net hospitals, social risk}, issn = {1525-1497}, doi = {10.1007/s11606-020-06222-1}, author = {Hsuan, Charleen and Thomas M Braun and Ninez Ponce and Geoffrey J Hoffman} } @article {11276, title = {The Association Between Depressive Symptoms and Accumulation of Stress Among Black Men in the Health and Retirement Study.}, journal = {Innovation in Aging}, volume = {4}, year = {2020}, pages = {igaa047}, abstract = {

Background and Objectives: Among the multiple factors posited to drive the health inequities that black men experience, the fundamental role of stress in the production of poor health is a key component. Allostatic load (AL) is considered to be a byproduct of stressors related to cumulative disadvantage. Exposure to chronic stress is associated with poorer mental health including depressive symptoms. Few studies have investigated how AL contributes to depressive symptoms among black men. The purpose of the cross-sectional study was to examine the association between AL and depressive symptoms among middle- to old age black men.

Research Design and Methods: This project used the 2010 and 2012 wave of the Health and Retirement Study enhanced face-to-face interview that included a biomarker assessment and psychosocial questionnaire. Depressive symptoms, assessed by the endorsement of 3 or more symptoms on the Center for Epidemiological Studies-Depression 8-item scale, was the outcome variable. The main independent variable, AL, score was calculated by summing the number values that were in the high range for that particular biomarker value scores ranging from 0 to 7. black men whose AL score was 3 or greater were considered to be in the high AL group. Modified Poisson regression was used to estimate prevalence ratios (PRs) and corresponding 95\% confidence intervals (CIs).

Results: There was a larger proportion of black men in the high AL group who reported depressive symptoms (30.0\% vs. 20.0\%) compared with black men in the low AL group. After adjusting for age, education, income, drinking, and smoking status, the prevalence of reporting 3 or more depressive symptoms was statistically significant among black men in the high AL group (PR = 1.61 [95\% CI: 1.20-2.17]) than black men in the low AL group.

Discussion and Implications: Exposure to chronic stress is related to reporting 3 or more depressive symptoms among black men after controlling for potential confounders. Improving the social and economic conditions for which black men work, play, and pray is key to reducing stress, thereby potentially leading to the reporting of fewer depressive symptoms.

}, keywords = {Allostatic load, Black men, Depressive symptoms, health, Inequities, Men, Stress}, issn = {2399-5300}, doi = {10.1093/geroni/igaa047}, author = {Roland J. Thorpe Jr. and Ryon J. Cobb and King, Keyonna and Bruce, Marino A and Archibald, Paul and Jones, Harlan P and Norris, Keith C and Keith E Whitfield and Hudson, Darrell} } @article {10065, title = {Association of parenthood with incident heart disease in United States{\textquoteright} older men and women: A longitudinal analysis of health and retirement study data.}, journal = {Journal of Aging and Health}, volume = {32}, year = {2020}, pages = {517-529}, type = {Journal}, abstract = {

OBJECTIVE: To examine the association of number of children birthed/fathered with incident heart disease, accounting for socioeconomic and lifestyle characteristics.

METHODS: We analyzed data from 24,923 adults 50 and older (55\% women) in the Health and Retirement Study. Participants self-reported number of children and doctor-diagnosed incident heart disease. Cox proportional hazards models estimated heart disease risk.

RESULTS: Compared to women with one to two children, those with five or more had increased risk of heart disease (hazard ratio [HR] = 1.13, 95\% confidence interval [CI] = [1.03, 1.25]). Compared to men with one to two children, those with five or more had a marginally increased risk of heart disease (HR = 1.11, 95\% CI = [0.99, 1.25]), but this association attenuated in models adjusting for socioeconomic and lifestyle variables. Compared to men with no children, those with five or more retained a borderline significant association in the fully adjusted model (HR = 1.15, 95\% CI = [0.99, 1.35]).

DISCUSSION: Social and lifestyle pathways appear to link parenthood to cardiovascular health.

}, keywords = {Gender Differences, Heart disease, Parents, Risk Factors, Socioeconomic factors}, issn = {1552-6887}, doi = {10.1177/0898264319831512}, author = {Sarah L Hipp and Wu, Yan Yan and Nicole T A Rosendaal and Catherine M. Pirkle} } @article {10706, title = {Association of traumatic brain injury with dementia and memory decline in older adults in the United States}, journal = {Alzheimer{\textquoteright}s \& Dementia}, volume = {16}, year = {2020}, pages = {853-861}, abstract = {Abstract Introduction To examine associations of history of traumatic brain injuries (TBIs) with loss of consciousness (LOC) with dementia incidence and memory decline. Methods We studied 2718 participants from the 1992 enrollment cohort of the Health and Retirement Study (HRS) aged 65 years or older in 2000. History of TBI with LOC was self-reported in 1992. Dementia was assessed using four algorithms established in HRS. Participants were followed from 2000 to 2014 with repeated measures of dementia and memory performance. Cox models and linear mixed-effects models were used. Results In 1992, 11.9\% of the participants reported a history of TBI with LOC. In fully adjusted models for all four algorithms, participants with a history of TBI with LOC had no statistically significant difference in dementia incidence nor in memory decline, compared to participants without TBI history. Discussion Our study did not find evidence of a long-term association between history of TBI with LOC (of unknown frequency and severity) and dementia incidence or memory decline.}, keywords = {Cognitive decline, Dementia, longitudinal, Traumatic Brain Injury}, doi = {10.1002/alz.12080}, author = {Grasset, Leslie and M. Maria Glymour and Kristine Yaffe and Swift, Samuel L. and Kan Z Gianattasio and Melinda C Power and Adina Zeki Al Hazzouri} } @mastersthesis {10922, title = {Barriers of aging: The impact of housing on U.S. older adult health}, volume = {Doctor of Philosophy}, year = {2020}, school = {University of Maryland}, address = {College Park, MD}, abstract = {Today, millions of older adults aged 65 and older, face the challenges of aging. In the past ten years, the number of people aged 65 and older in the U.S. increased from 37.2 million to 49.2 million, and by 2040 an estimated one in five Americans will be age 65 or older (Administration for Community Living \& Administration on Aging, 2018; Urban Institute, 2014). Housing is a significant factor in health outcomes for this population because of their increased time spent in the home, which can put them at an increased risk for home accidents (Newman, 2003). Using the Health and Retirement Study, this study explores the association of assistive features being present in one{\textquoteright}s home on health status and provides evidence to identify the housing needs of the older adult population. }, keywords = {home accidents, Housing}, url = {https://drum.lib.umd.edu/bitstream/handle/1903/26301/Hall_umd_0117N_20853.pdf?sequence=2\&isAllowed=y}, author = {Hall, Quinshay Charniece} } @article {10705, title = {Behavioural risk factors and healthy life expectancy: evidence from two longitudinal studies of ageing in England and the US}, journal = {Scientific Reports}, volume = {10}, year = {2020}, type = {Journal}, abstract = {We examined whether the co-occurrence of four behavioural risk factors (alcohol consumption, smoking, physical inactivity and obesity) is associated with disability-free and chronic disease-free life expectancy similarly in two longitudinal studies of ageing in England and the United States. Data were from 17,351 individuals aged 50+ from the US Health and Retirement Study (HRS) and, 10,388 from the English Longitudinal Study of Ageing (ELSA), from 2002 to 2013. Disability-free life expectancy was estimated using repeat measures of limitations with instrumental activities and activities of daily living and, chronic disease-free life expectancy was based on chronic health conditions. Multistate life table models were used to estimate sex-specific health expectancy at the ages of 50, 60 and 70. In both countries and at all ages, there was a clear gradient towards shorter health expectancy with increasing number of behavioural risk factors. Compared to people with 2+ behavioural risk factors, in both countries, those with no behavioural risk factors could expect to live up to 11 years longer without disability and, up to 12 years longer without chronic conditions. Individual and co-occurring behavioural risk factors were strongly associated with shorter healthy life expectancy in both countries, attesting to the robustness of the contribution of lifestyle factors on health expectancy.}, keywords = {Diseases, Risk Factors}, isbn = {2045-2322}, doi = {10.1038/s41598-020-63843-6}, author = {Zaninotto, Paola and Head, Jenny and Andrew Steptoe} } @article {Voss202059, title = {Boundaries of the Construct of Unemployment in the Preretirement Years: Exploring an Expanded Measurement of Lost-Work Opportunity}, journal = {Work, Aging and Retirement}, volume = {6}, year = {2020}, note = {cited By 0}, pages = {59-63}, abstract = {There is uncertainty related to whether retirement negatively affects health - possibly due to complexity around retirement decisions. Lost-work opportunity through unemployment or forced retirement has been shown to negatively affect health. Lost-work opportunity can be captured in two measurement fields, either a reported experience of being forced into retirement or reported unemployment. However, 17\% of individuals retiring due to the loss of work opportunity identified in qualitative interviewing (i.e., unemployment, temporary lay-offs, company buy-outs, forced relocations, etc.) do not report this unemployment or involuntary retirement in quantitative survey responses. We propose broadening the conceptualization of late-career unemployment to incorporate other lost work opportunity scenarios. Using the Health and Retirement Study (HRS), a lost-work opportunity score (LOS) was computed from items indicating unemployment and forced or unplanned retirement. Correlations were computed between this LOS and all continuous variables in the RAND longitudinal compilation of the HRS to determine its convergent and discriminant validity. The LOS demonstrated a Chronbach{\textquoteright}s alpha of α =. 82 and had convergent validity with constructs of employment (9 variables), finances (36 variables), and health (14 variables), as predicted by the literature on retirement timing. No other continuous variables in the HRS were identified with a moderate or strong correlation to LOS, demonstrating discriminant validity. Further research should explore whether a combination of variables in the HRS can improve the accuracy of measuring lost-work opportunity. Improved precision in measurement, through an expanded conceptualization of lost-work opportunity, may help explicate the retirement-related factors that affect health, to inform policy and support healthy aging decisions at a societal level. }, keywords = {Retirement, Retirement Planning, Work}, issn = {20544650}, doi = {10.1093/workar/waz006}, author = {Voss, M.W. and Al Snih, S. and Li, Wei and Hung, M. and Richards, L.G. and Wang, M.} } @article {2020-12150-00120200217, title = {Building sense of purpose in older adulthood: Examining the role of supportive relationships.}, journal = {The Journal of Positive Psychology}, year = {2020}, abstract = {Having supportive others appears valuable for developing a purpose, at least during adolescence and young adulthood. However, work has yet to consider whether sense of purpose and social support change in tandem or predict one another during older adulthood. Using a subsample (N = 7,452) of older adults from the Health and Retirement Study, we estimate the associations of purpose in life to social support and social strain in four domains (spouses/partners, children, family, friends) using bivariate growth models. Participants provided responses at three assessment occasions, 4 years apart. Analyses controlled for social contact frequency to focus on the unique role of supportive relationships. Initial levels of support correlated positively with levels for sense of purpose, while strain was negatively associated with purpose. Moreover, with the exception of family support, changes in sense of purpose were correlated with changes in support and strain in the same direction across doma}, keywords = {No terms assigned, older adulthood, Sense of purpose, Social Support, Well-being}, issn = {1743-9760}, url = {http://dx.doi.org/10.1080/17439760.2020.1725607 }, author = {Sara J Weston and Nathan A Lewis and Patrick L Hill} } @proceedings {10699, title = {Cardiovascular Disease and Cumulative Incidence of Cognitive Impairment: Longitudinal Findings from The Health and Retirement Study}, journal = {Conference of American-College-of-Cardiology (ACC) / World Congress of Cardiology (WCC)}, volume = {75}, year = {2020}, pages = {726}, publisher = {Journal of the American College of Cardiology}, edition = {11}, address = {Chicago, IL}, url = {https://apps.webofknowledge.com/InboundService.do?product=WOS\&Func=Frame\&DestFail=http\%3A\%2F\%2Fwww.webofknowledge.com\&SrcApp=search\&SrcAuth=Alerting\&SID=7EI254HJQZJyroHmyfS\&customersID=Alerting\&mode=FullRecord\&IsProductCode=Yes\&AlertId=2547ce2d-b446-4503-}, author = {Covello, Allyson and Horwitz, Leora and Singhal, Shreya and Caroline S Blaum and John A. Dodson} } @article {11258, title = {Cardiovascular disease risk prediction for people with type 2 diabetes in a population-based cohort and in electronic health record data}, journal = {Jamia Open}, year = {2020}, abstract = {Electronic health records (EHRs) have become a common data source for clinical risk prediction, offering large sample sizes and frequently sampled metrics. There may be notable differences between hospital-based EHR and traditional cohort samples: EHR data often are not population-representative random samples, even for particular diseases, as they tend to be sicker with higher healthcare utilization, while cohort studies often sample healthier subjects who typically are more likely to participate. We investigate heterogeneities between EHR- and cohort-based inferences including incidence rates, risk factor identifications/quantifications, and absolute risks.This is a retrospective cohort study of older patients with type 2 diabetes using EHR from New York University Langone Health ambulatory care (NYULH-EHR, years 2009{\textendash}2017) and from the Health and Retirement Survey (HRS, 1995{\textendash}2014) to study subsequent cardiovascular disease (CVD) risks. We used the same eligibility criteria, outcome definitions, and demographic covariates/biomarkers in both datasets. We compared subsequent CVD incidence rates, hazard ratios (HRs) of risk factors, and discrimination/calibration performances of CVD risk scores.The estimated subsequent total CVD incidence rate was 37.5 and 90.6 per 1000 person-years since T2DM onset in HRS and NYULH-EHR respectively. HR estimates were comparable between the datasets for most demographic covariates/biomarkers. Common CVD risk scores underestimated observed total CVD risks in NYULH-EHR.EHR-estimated HRs of demographic and major clinical risk factors for CVD were mostly consistent with the estimates from a national cohort, despite high incidences and absolute risks of total CVD outcome in the EHR samples.}, keywords = {Cardiovascular disease, type 2 diabetes}, isbn = {2574-2531}, doi = {https://doi.org/10.1093/jamiaopen/ooaa059}, author = {Szymonifka, Jackie and Conderino, Sarah and Christine T Cigolle and Ha, Jinkyung and Mohammed U Kabeto and Yu, Jaehong and John A. Dodson and Thorpe, Lorna and Caroline S Blaum and Zhong, Judy} } @article {11008, title = {Cognitive Function and Cardiometabolic-Inflammatory Risk Factors Among Older Indians and Americans.}, journal = {Journal of the American Geriatrics Society}, volume = {68 }, year = {2020}, pages = {S36-S44}, abstract = {

OBJECTIVES: To investigate how cardiometabolic-inflammatory risk factors are related to cognition among older adults in India and the United States.

DESIGN: The Longitudinal Aging Study in India-Diagnostic Assessment of Dementia (LASI-DAD) and the Harmonized Cognitive Assessment Protocol of the Health and Retirement Study (HRS-HCAP) in the United States conducted an in-depth assessment of cognition, using protocols designed for international comparison.

SETTING: Cognitive tests were conducted in hospital or household settings in India and in household settings in the United States.

PARTICIPANTS: Respondents aged 60 years and older from LASI-DAD (N = 1,865) and respondents aged 65 years and older from HRS-HCAP (N = 2,111) who provided venous blood specimen.

MEASUREMENTS: We used total composite scores from the common cognitive tests administered. Cardiovascular risk was indicated by systolic and diastolic blood pressure, pulse rate, pro-B-type natriuretic peptide (proBNP), and homocysteine. Metabolic risk was measured by body mass index, glycosylated hemoglobin (HbA1c), high-density lipoprotein cholesterol, and lipoprotein (a) (only in India). Inflammatory risk was indicted by white blood cell count, C-reactive protein, albumin, and uric acid (only in India).

RESULTS: The distribution of both total cognition scores and of cardiometabolic risk factors differed significantly between India and the United States. In both countries, lower cognition was associated with older age, lower education, elevated homocysteine, elevated proBNP, and lower albumin levels. The associations between HbA1c levels and cognitive measures were statistically significant in both countries, but in the opposite direction, with a coefficient of 1.5 (P < .001) in India and -2.4 (P < .001) in the United States for one percentage increase in absolute HbA1c value.

CONCLUSION: Cardiometabolic-inflammatory biomarkers are associated with cognitive functional levels in each country, but the relationships may vary across countries. J Am Geriatr Soc 68:S36-S44, 2020.

}, keywords = {cardiometabolic risk, Cognition, HCAP, LASI-DAD}, issn = {1532-5415}, doi = {10.1111/jgs.16734}, author = {Hu, Peifeng and Jinkook Lee and Beaumaster, Sidney and Jung K Kim and Dey, Sharmistha and David R Weir and Eileen M. Crimmins} } @article {HALE2020100577, title = {Cognitive impairment in the U.S.: Lifetime risk, age at onset, and years impaired}, journal = {SSM - Population Health}, volume = {11}, year = {2020}, pages = {100577}, abstract = {Prior studies have analyzed the burden of cognitive impairment, but often use potentially biased prevalence-based methods or measure only years lived with impairment, without estimating other relevant metrics. We use the Health and Retirement Study (1998{\textendash}2014; n = 29,304) and the preferred incidence-based Markov-chain models to assess three key measures of the burden of cognitive impairment: lifetime risk, mean age at onset, and number of years lived impaired. We analyze both mild and severe cognitive impairment (dementia) and gender, racial/ethnic, and educational variation in impairment. Our results paint a multi-dimensional picture of cognitive health, presenting the first comprehensive analysis of the burden of cognitive impairment for the U.S. population age 50 and older. Approximately two out of three Americans experience some level of cognitive impairment at an average age of approximately 70 years. For dementia, lifetime risk for women (men) is 37\% (24\%) and mean age at onset 83 (79) years. Women can expect to live 4.2 years with mild impairment and 3.2 with dementia, men 3.5 and 1.8 years. A critical finding is that for the most advantaged groups (i.e., White and/or higher educated), cognitive impairment is both delayed and compressed toward the very end of life. In contrast, despite the shorter lives of disadvantaged subgroups (Black and/or lower educated), they experience a younger age of onset, higher lifetime risk, and more years cognitively impaired. For example, men with at least an Associate degree have 21\% lifetime dementia risk, compared to 35\% among men with less than high school education. White women have 6 years of cognitively-impaired life expectancy, compared to 12 and 13 years among Black women and Latinas. These educational and racial/ethnic gradients highlight the very uneven burden of cognitive impairment. Further research is required to identify the mechanisms driving these disparities in cognitive impairment.}, keywords = {cognitive impairment, Dementia, Education, Health Disparities, Race/ethnicity}, issn = {2352-8273}, doi = {10.1016/j.ssmph.2020.100577}, author = {Jo Mhairi Hale and Daniel C Schneider and Neil K Mehta and Mikko Myrskyl{\"a}} } @article {10901, title = {Comparison of Health Outcomes Among High- and Low-Income Adults Aged 55 to 64 Years in the US vs England}, journal = {JAMA Intern Med}, year = {2020}, month = {2020}, abstract = {Socioeconomic differences in life expectancy, health, and disability have been found in European countries as well as in the US. Identifying the extent and pattern of health disparities, both within and across the US and England, may be important for informing public health and public policy aimed at reducing these disparities.To compare the health of US adults aged 55 to 64 years with the health of their peers in England across the high and low ranges of income in each country.Using data from the Health and Retirement Study (HRS) and the English Longitudinal Study of Ageing (ELSA) for 2008-2016, a pooled cross-sectional analysis of comparably measured health outcomes, with adjustment for demographic characteristics and socioeconomic status, was conducted. The analysis sample included community-dwelling adults aged 55 to 64 years from the HRS and ELSA, resulting in 46 887 person-years of observations. Data analysis was conducted from September 17, 2019, to May 12, 2020.Residence in the US or England and yearly income.Sixteen health outcomes were compared, including 5 self-assessed outcomes, 3 directly measured outcomes, and 8 self-reported physician-diagnosed health conditions.This cross-sectional study included 12 879 individuals and 31 928 person-years from HRS (mean [SD] age, 59.2 [2.8] years; 51.9\% women) and 5693 individuals and 14 959 person-years from ELSA (mean [SD] age, 59.3 [2.9] years; 51.0\% women). After adjusting for individual-level demographic characteristics and socioeconomic status, a substantial health gap between lower-income and higher-income adults was found in both countries, but the health gap between the bottom 20\% and the top 20\% of the income distribution was significantly greater in the US than England on 13 of 16 measures. The adjusted US-England difference in the prevalence gap between the bottom 20\% and the top 20\% ranged from 3.6 percentage points (95\% CI, 2.0-5.2 percentage points) in stroke to 9.7 percentage points (95\% CI, 5.4-13.9 percentage points) for functional limitation. Among individuals in the lowest income group in each country, those in the US group vs the England group had significantly worse outcomes on many health measures (10 of 16 outcomes in the bottom income decile); the significant differences in adjusted prevalence of health problems in the US vs England for the bottom income decile ranged from 7.6\% (95\% CI, 6.0\%-9.3\%) vs 3.8\% (95\% CI, 2.6\%-4.9\%) for stroke to 75.7\% (95\% CI, 72.7\%-78.8\%) vs 59.5\% (95\% CI, 56.3\%-62.7\%) for functional limitation. Among individuals in the highest income group, those in the US group vs England group had worse outcomes on fewer health measures (4 of 16 outcomes in the top income decile); the significant differences in adjusted prevalence of health problems in the US vs England for the top income decile ranged from 36.9\% (95\% CI, 33.4\%-40.4\%) vs 30.0\% (95\% CI, 27.2\%-32.7\%) for hypertension to 35.4\% (95\% CI, 32.0\%-38.7\%) vs 22.5\% (95\% CI, 19.9\%-25.1\%) for arthritis.For most health outcomes examined in this cross-sectional study, the health gap between adults with low vs high income appeared to be larger in the US than in England, and the health disadvantages in the US compared with England are apparently more pronounced among individuals with low income. Public policy and public health interventions aimed at improving the health of adults with lower income should be a priority in the US.}, keywords = {Demographics, ELSA, Income, socioeconomic status}, isbn = {2168-6106}, doi = {10.1001/jamainternmed.2020.2802}, author = {Choi, Hwajung and Andrew Steptoe and Michele M Heisler and Philippa J Clarke and Robert F. Schoeni and Jivraj, Stephen and Cho, Tsai-Chin and Kenneth M. Langa} } @article {Chao2020, title = {Composite diagnostic criteria are problematic for linking potentially distinct populations: the case of frailty}, journal = {Scientific Reports}, volume = {10}, year = {2020}, note = {cited By 0}, type = {Article}, abstract = {{Composite diagnostic criteria are common in frailty research. We worry distinct populations may be linked to each other due to complicated criteria. We aim to investigate whether distinct populations might be considered similar based on frailty diagnostic criteria. The Functional Domains Model for frailty diagnosis included four domains: physical, nutritive, cognitive and sensory functioning. Health and Retirement Study participants with two or more deficiencies in the domains were diagnosed frail. The survival distributions were analyzed using discrete-time survival analysis. The distributions of the demographic characteristics and survival across the groups diagnosed with frailty were significantly different (p < 0.05). A deficiency in cognitive functioning was associated with the worst survival pattern compared with a deficiency in the other domains (adjusted p < 0.05). The associations of the domains with mortality were cumulative without interactions. Cognitive functioning had the largest effect size for mortality prediction (Odds ratios}, keywords = {Frail Elderly, Frailty Phenotype, Residence Characteristics}, issn = {20452322}, doi = {10.1038/s41598-020-58782-1}, url = {https://www.scopus.com/inward/record.uri?eid=2-s2.0-85079339704\&doi=10.1038\%2fs41598-020-58782-1\&partnerID=40\&md5=ba7c890ffb416ce5b17f819b2c21936a}, author = {Yi-Sheng Chao and Chao-Jung Wu and Hsing-Chien Wu and Hui-Ting Hsu and Tsao, L.-C. and Cheng, Y.-P. and Lai, Y.-C. and Wei-Chih Chen} } @article {10906, title = {Cumulative disparities in the dynamics of working poverty for later-career U.S. workers (2002-2012)}, year = {2020}, institution = {Cornell University}, address = {Ithaca, NY}, abstract = {Many more Americans experience working poverty than unemployed poverty, a situation which was only exacerbated by the Great Recession. The consequences of working poverty for later-career workers {\textendash} who should be in their highest-earning ages {\textendash} are particularly dire. We expect that later-career workers are especially vulnerable in terms of risk and duration of working poverty and that those who have accumulated disadvantages over their life courses, in terms of the intersecting dimensions of race/ethnicity, gender, early-life socioeconomic status, and educational attainment, will suffer disproportionately. We use incidence-based Markov chain multistate models to analyze the U.S. Health and Retirement Study, which is representative of the U.S. population aged 50 and older. We find that Black women and men, Latinx, those who experienced more earlylife disadvantages, and people with lower education have higher risk and longer durations in working poverty over the period 2002-2012. Our findings also suggest that when confronted with economic hardship {\textendash} the Great Recession {\textendash} later-career workers who originate in lower socioeconomic statuses, especially Blacks and Latinx, are in more precarious economic positions. Important from a policy perspective, educational attainment only partially mediates the association between race/ethnicity and working poverty; disparities persist.}, keywords = {Aging, cumulative disadvantage, Great Recession, life course, Poverty, Race/ethnicity, Work}, doi = {10.31235/osf.io/xka5j}, author = {Jo Mhairi Hale and Christian Dudel and Angelo Lorenti} } @mastersthesis {10789, title = {DETERMINANTS OF LONG-TERM CARE INSURANCE: ARE SPOUSES SUBSTITUTES?}, volume = { University Honors}, year = {2020}, school = {University of Northern Iowa}, type = {Thesis}, address = {Cedar Falls}, abstract = {As the U.S. population continues to age due to medical advancements and the aging of the largest generation in the history of the U.S. (baby boomers), the number of people in long-term care facilities has increased significantly; however, the percentage of people with long-term care insurance is small. Research conducted in the early 2000s focused on factors such as availability of children, risk aversion, health status, age, having Medicaid, and other variables that describe personal attributes to explain why the market is so small. This paper will use recent data from the Health and Retirement Study to determine whether or not having a living spouse is a substitute for having long-term care insurance. In particular I investigated this question for those classified as middle baby-boomers. I found that being married has a positive and statistically significant impact on the whether or not an individual has long-term care insurance.}, keywords = {Long-term Care, Long-term care insurance, Spouses}, url = {https://scholarworks.uni.edu/hpt/426/?utm_source=scholarworks.uni.edu\%2Fhpt\%2F426\&utm_medium=PDF\&utm_campaign=PDFCoverPages}, author = {Jacob Harold-Matthew Haag} } @article {10998, title = {Does being active mean being purposeful in older adulthood? Examining the moderating role of retirement.}, journal = {Psychology and Aging}, year = {2020}, abstract = {

The degree to which individuals engage in leisure activities has been shown to predict well-being in older adults, but it is not known whether such activities may help older adults maintain purposefulness into retirement. The current study sought to address whether activity engagement is associated with purpose in life and whether this association differs based on retirement status. We used data from three waves of the Health and Retirement Study between 2008 and 2016. Multilevel growth models accounted for both within- and between-person effects of leisure activity participation and retirement status on change in sense of purpose in life. Participants reported higher sense of purpose on occasions when they engaged more in leisure activities, and more active participants exhibited less decline in purpose over time. Retired individuals showed steeper declines in sense of purpose, but this effect was mitigated among participants reporting greater activity engagement. Leisure activity participation may help to support sense of purpose in life, particularly among retired individuals. These findings underscore the potential for leisure activity interventions to help older adults compensate for loss of work-related roles and maintain purposefulness into retirement. (PsycInfo Database Record (c) 2020 APA, all rights reserved).

}, keywords = {Activity engagement, life purpose, Retirement}, issn = {1939-1498}, doi = {10.1037/pag0000568}, author = {Nathan A Lewis and Patrick L Hill} } @article {RePEc:dem:wpaper:wp-2020-013, title = {Does postponing retirement affect cognitive function? A counterfactual experiment to disentangle life course risk factors}, number = {2020-013}, year = {2020}, institution = {Max Planck Institute for Demographic Research}, type = {Report}, address = {Rostock, Germany}, abstract = {Life-course sociodemographic and behavioral factors affect later-life cognitive function. Some evidence suggests that contemporaneous labor force participation also affects cognitive function; however, it is unclear whether it is employment itself or endogenous factors related to individuals{\textquoteright} likelihood of employment that protects against cognitive decline. We exploit innovations in counterfactual causal inference to disentangle the effect of postponing retirement on later-life cognitive function from the effects of other life-course factors. With the U.S. Health and Retirement Study (1996-2014, n=20,469), we use the parametric g-formula to estimate the population-averaged effect (PAE) of postponing retirement to age 67, the average treatment on the treated (ATT), the moderating effect of gender, education, and occupation, and the mediating effect via depressive symptoms and comorbidities. We find that postponing retirement is protective against cognitive decline, accounting for other life-course factors (age 67 PAE: 0.34, 95\% confidence interval (CI): 0.20,0.47; ATT: 0.43, 95\% CI: 0.26,0.60). The extent of the protective effect depends on subgroup, with the highest educated experiencing the greatest reduction in cognitive decline (age 67 ATT: 50\%, 95\% CI: 32\%,71\%). By using innovative models that better reflect the empirical reality of interconnected life-course processes, this work makes progress in understanding how retirement affects cognitive function.}, keywords = {Age at retirement, Ageing, Labor, length of working life, Retirement}, doi = {10.4054/MPIDR-WP-2020-013}, url = {https://ideas.repec.org/p/dem/wpaper/wp-2020-013.html}, author = {Jo Mhairi Hale and Maarten J. Bijlsma and Angelo Lorenti} } @article {11044, title = {Don{\textquoteright}t ignore genetic data from minority populations}, journal = {Nature}, volume = {585}, year = {2020}, pages = {184-186}, abstract = {Geneticists have known for more than a decade that their focus on people with European ancestry exacerbates health disparities1. A 2018 analysis of studies looking for genetic variants associated with disease found that under-representation persists: 78\% of study participants were of European ancestry, compared to 10\% of Asian ancestry and 2\% of African ancestry. Other ancestries each represented less than 1\% of the total2. Several projects, such as H3Africa3, are starting to increase participation of under-represented groups, both among participants and among researchers. Large biobanks assembled in Europe and North America, combining biological samples with health-related data, also set sampling targets to increase diversity}, keywords = {ethics, Genomics, Society}, doi = {doi: 10.1038/d41586-020-02547-3}, author = {Ben-Eghan, Chief and Sun, Rosie and Hleap, Jose Sergio and Diaz-Papkovich, Alex and Munter, Hans Markus and Grant, Audrey V and Dupras, Charles and Gravel, Simon} } @article {10160, title = {Edentulism and trajectories of cognitive functioning among older adults: The role of dental care service utilization.}, journal = {Journal of Aging and Health}, volume = {32}, year = {2020}, pages = {744-752}, abstract = {

OBJECTIVE: This study examined the associations between edentulism, dental care service utilization, and cognitive functioning trajectories among older adults.

METHOD: Longitudinal data from the Health and Retirement Study (2006-2014) were employed to examine individuals aged 51 and older who were identified as having normal cognition at baseline ( N = 12,405). Cognitive functioning was measured with a modified version of the Telephone Interview for Cognition Status. Edentulism was self-reported as total tooth loss at baseline. Dental care service utilization was measured by self-report of having visited a dentist at least once during the previous 2 years.

RESULTS: The results indicated that edentulism and dental care service utilization were independently associated with cognitive decline during the observation period. Findings also showed that dental care service utilization moderated the association between edentulism and cognitive decline.

DISCUSSION: The findings suggested that providing access to dental services may promote cognitive health and potentially reduce health care expenditures.

}, keywords = {Cognitive Ability, Dental Care, Health Services Utilization}, issn = {1552-6887}, doi = {10.1177/0898264319851654}, author = {Sae Hwang Han and Bei Wu and Jeffrey A Burr} } @article {article, title = {The Education of Multiple Family Members and the Life-Course Pathways to Cognitive Impairment}, journal = {The journals of gerontology. Series B, Psychological sciences and social sciences}, year = {2020}, type = {Journal}, abstract = {Objectives: This paper asks how the educational attainments of multiple family members, including parents and offspring, are associated with the cognitive health of older adults in the United States. Methods: We use panel data from the U.S. Health and Retirement Study (2000-2012) to examine how the education of an individual, their parent(s), and their offspring are associated with the prevalence of moderate/severe cognitive impairment and the onset of cognitive impairment among older adults using logistic regression and discrete-time event history analysis, respectively. Results: We found that when combined, only the education of the individual is inversely associated with cognitive impairment at baseline. However, both the educational attainments of an individual and their offspring are negatively associated with the risk of becoming cognitively impaired, among individuals who were not already cognitively impaired. Conversely, parental education was not predictive of being cognitively impaired or the onset of impairment. Furthermore, we found that respondent gender did not moderate the relationship between a family member{\textquoteright}s education and respondent cognitive health. Discussion: This study adds to current research by asking how resources from earlier and subsequent generations matter for older adults{\textquoteright} cognitive health. Although we found little evidence that parental education matters at this life stage, results suggest that offspring education has a salient positive effect on later-lifer cognitive health. This finding underscores an overlooked source of health disparities - offspring resources - and highlights how a family perspective remains a powerful tool for understanding health inequalities in later life.}, keywords = {Cognitive health; Health and Retirement Study; Intergenerational relationships}, doi = {10.1093/geronb/gbaa039}, author = {Jenjira J Yahirun and Vasireddy, Sindhu and Mark D Hayward} } @article {11332, title = {Effects of Medicare Drug Subsidies on Adherence for Diabetics: Evidence From a Regression Discontinuity Design}, journal = {Innovation in Aging}, volume = {4}, year = {2020}, pages = {280}, abstract = {Out-of-pocket prescription drug costs are rapidly rising, particularly for insulin, which is a life-saving drug used by 3.1 million diabetics on Medicare. High out-of-pocket costs place an accentuated financial strain on older adults with diabetes, many of whom have low incomes, and may impede medication adherence, leading to poor health outcomes. The Medicare Part D Low-Income Subsidy (LIS) program limits drug co-pays to under $8.50 per prescription and caps out-of-pocket drug costs for lowest-income recipients (<135\% Federal Poverty Level, FPL), resulting in pronounced differences in out-of-pocket costs for those with marginally different incomes. Using detailed income data from the Health and Retirement Study linked to Medicare claims (2008-2016), we employed a regression discontinuity (RD) design to isolate the effects of differences in out-of-pocket costs at eligibility thresholds for the LIS. Diabetic beneficiaries whose income exceeded the LIS eligibility threshold had lower Part D spending (-$945/year, p=0.03, n=2,367) and adherence to oral antidiabetic drugs (-8\%, p=0.02). We conducted secondary analyses at the eligibility threshold for Medicaid, as individuals whose income exceeds the eligibility limit for Medicaid (100\% of FPL in most states) are significantly less likely to receive the LIS. Above the Medicaid eligibility threshold (n=2,295), annual spending on insulin was $395 lower (p=0.002) and proportion of insulin use was 6\% lower (p=0.04). These results suggest low-income Medicare beneficiaries who are not shielded from out-of-pocket costs via the LIS are particularly sensitive to drug costs. Policy proposals to limit out-of-pocket costs could improve medication adherence to high-cost drugs for vulnerable beneficiaries.}, keywords = {diabetics, medicare drug subsidies}, isbn = {2399-5300}, doi = {10.1093/geroni/igaa057.896}, author = {Glynn, Alexandra and Hernandez, Inmaculada and Roberts, Eric} } @article {11187, title = {Examining Health and Wealth Correlates of Perceived Financial Vulnerability: A Normative Study.}, journal = {Innovation in Aging}, volume = {4}, year = {2020}, abstract = {

Background and Objectives: Age-associated financial vulnerability was introduced because it was increasingly recognized that cognitively intact older adults experienced changes that rendered them financially vulnerable. In this study, we attempt to apply the construct of Age-Associated Financial Vulnerability to a measure of Perceived Financial Vulnerability and whether this perceived vulnerability is predicted by risk factors from the 4 categorical domains used to define Age-Associated Financial Vulnerability{\textquoteright}s impact.

Research Design and Methods: This study was part of the Health and Retirement Study (HRS) survey in 2018. The survey contained 7 experimental module items of Perceived Financial Vulnerability. One thousand three hundred fourteen participants completed the Perceived Financial Vulnerability measure. The sample was drawn from Waves 13 and 14 of the HRS (2016 and 2018, respectively). The measurement of Perceived Financial Vulnerability was developed on the basis of 7 questions assessing financial awareness and psychological vulnerability items regarding personal finance that were included in the 2018 HRS data collection. Predictors included measures of cognition, function/health, depression, and wealth. Predictor measures from 2016 were regressed on 2018 Perceived Financial Vulnerability scores.

Results: Six items of Perceived Financial Vulnerability had psychometric properties acceptable for a new measure. Responses revealed variability in Perceived Financial Vulnerability. Overall, 18\% of variance was accounted for and measures from cognition, depression, assets, and functional abilities were all unique and significant predictors.

Discussion and Implications: This study represents both a conceptual and empirical contribution to our understanding of older adult{\textquoteright}s perceptions of financial vulnerability. The high levels of Perceived Financial Vulnerability found in this normative sample underscore the importance of context in understanding people{\textquoteright}s economic behaviors. For instance, more than one half of the sample indicated that they wished they had someone to talk to about their finances. This desire to talk with others is normative and yet often underappreciated.

}, keywords = {Financial strain, Mental Health, Wealth}, issn = {2399-5300}, doi = {10.1093/geroni/igaa039}, author = {Peter A Lichtenberg and Daniel Paulson and Han, S Duke} } @inbook {11011, title = {Extending Research Linking Purpose in Life to Health: The Challenges of Inequality, the Potential of the Arts, and the Imperative of Virtue}, booktitle = {The Ecology of Purposeful Living Across the Lifespan: Developmental, Educational, and Social Perspectives}, year = {2020}, pages = {29 - 58}, publisher = {Springer International Publishing}, organization = {Springer International Publishing}, abstract = {Empirical studies of purpose in life are flourishing. However, in light of a rapidly changing social milieu, there are pressing but understudied issues to address if purpose research is to realize its potential in impacting people{\textquoteright}s lives. We first distill what has been learned from prior research on age variation in purpose in life and briefly review accumulating evidence linking higher levels of purpose to better physical health. Possible biobehavioral mechanisms underlying the purpose-health connection are noted. We then build upon this evidence to examine an array of factors that might undermine or nurture purposeful life engagement. Growing societal inequality may be critical in limiting people{\textquoteright}s capacities to pursue meaningful lives, but more research is needed. Alternatively, growing research now links the arts and humanities to health. We focus on possible influences these realms might have in cultivating purpose. The role of education in nurturing exposure to the arts is examined, along with problems of elitism in higher education (thereby re-invoking themes of inequality). Our final section calls for research that more explicitly links purpose in life to human virtues and values. Theoretical approaches and tractable empirical topics are delineated. Our overall objective is to offer innovative future paths to deepen understanding of how health and well-being at individual and societal levels are tied to purpose in life.}, keywords = {Arts, Inequality, Meaning in Life, Purpose in life, Virtue}, isbn = {978-3-030-52078-6}, doi = {https://doi.org/10.1007/978-3-030-52078-6_3}, author = {Carol D Ryff and Eric S Kim}, editor = {Burrow, Anthony L. and Patrick L Hill} } @article {10830, title = {Female vulnerability to the effects of smoking on health outcomes in older people}, journal = {PloS one}, volume = {15}, year = {2020}, abstract = {Cigarette smoking is among the leading risk factors for mortality and morbidity. While men have a higher smoking prevalence, mechanistic experiments suggest that women are at higher risk for health problems due to smoking. Moreover, the comparison of smoking effects on multiple conditions and mortality for men and women has not yet been done in a population-based group with race/ethnic diversity. We used proportional hazards models and restricted mean survival time to assess differences in smoking effects by sex for multiple health outcomes using data from the U.S. Health and Retirement Study (HRS), a population-representative cohort of individuals aged 50+ (n = 22,708, 1992-2014). Men had experienced more smoking pack-years than women (22.0 vs 15.6 average pack-years). Age of death, onset of lung disorders, heart disease, stroke, and cancer showed dose-dependent effects of smoking for both sexes. Among heavy smokers (>28 pack-years) women had higher risk of earlier age of death (HR = 1.3, 95\%CI:1.03-1.65) and stroke (HR = 1.37, 95\%CI:1.02-1.83). Risk of cancer and heart disease did not differ by sex for smokers. Women had earlier age of onset for lung disorders (HR = 2.83, 95\%CI:1.74-4.6), but men risk due to smoking were higher (Smoking-Sex interaction P<0.02) than women. Passive smoke exposure increased risk of earlier heart disease (HR = 1.33, 95\%CI:1.07-1.65) and stroke (HR:1.54, 95\%CI:1.07-2.22) for non-smokers, mainly in men. Smoking cessation after 15 years partially attenuated the deleterious smoking effects for all health outcomes. In sum, our results suggest that women are more vulnerable to ever smoking for earlier death and risk of stroke, but less vulnerable for lung disorders. From an epidemiological perspective, sex differences in smoking effects are important considerations that could underlie sex differences in health outcomes. These findings also encourage future mechanistic experiments to resolve potential mechanisms of sex-specific cigarette smoke toxicity.}, keywords = {Cardiovascular disease, Smoking, Women{\textquoteright}s Health}, isbn = {1932-6203}, doi = {10.1371/journal.pone.0234015}, url = {https://pubmed.ncbi.nlm.nih.gov/32497122}, author = {Haghani, Amin and Thalida E. Arpawong and Jung K Kim and Lewinger, Juan Pablo and Caleb E Finch and Eileen M. Crimmins} } @article {https://doi.org/10.1002/dad2.12008, title = {Genetic and regulatory architecture of Alzheimer{\textquoteright}s disease in the APOE region}, journal = {Alzheimer{\textquoteright}s \& Dementia: Diagnosis, Assessment \& Disease Monitoring}, volume = {12}, year = {2020}, pages = {e12008}, abstract = {Abstract Introduction Apolipoprotein E (APOE) ε2 and ε4 alleles encoded by rs7412 and rs429358 polymorphisms, respectively, are landmark contra and pro {\textquotedblleft}risk{\textquotedblright} factors for Alzheimer{\textquoteright}s disease (AD). Methods We examined differences in linkage disequilibrium (LD) structures between (1) AD-affected and unaffected subjects and (2) older AD-unaffected and younger subjects in the 19q13.3 region harboring rs7412 and rs429358. Results AD is associated with sex-nonspecific heterogeneous patterns of decreased and increased LD of rs7412 and rs429358, respectively, with other polymorphisms from five genes in this region in AD-affected subjects. The LD patterns in older AD-unaffected subjects resembled those in younger individuals. Polarization of the ε4- and ε2 allele{\textendash}related heterogeneous LD clusters differentiated cell types and implicated specific tissues in AD pathogenesis. Discussion Protection and predisposition to AD is characterized by an interplay of rs7412 and rs429358, with multiple polymorphisms in the 19q13.3 region in a tissue-specific manner, which is not driven by common evolutionary forces.}, keywords = {Alzheimer{\textquoteright}s disease, Apolipoprotein E, Linkage Disequilibrium}, doi = {https://doi.org/10.1002/dad2.12008}, url = {https://alz-journals.onlinelibrary.wiley.com/doi/abs/10.1002/dad2.12008}, author = {Alexander M Kulminski and Shu, Leonardo and Loika, Yury and He, Liang and Nazarian, Alireza and Konstantin G Arbeev and Svetlana Ukraintseva and Anatoliy Yashin and Culminskaya, Irina} } @article {11021, title = {Genetic Fortune: Winning or Losing Education, Income, and Health}, number = {TI 2020-053/V}, year = {2020}, institution = {Tinbergen Institute}, address = {Amsterdam}, abstract = {We study the effects of genetic endowments on inequalities in education, income, and health. Specifically, we conduct the first genome-wide association study (GWAS) of individual income, using data from individuals of European ancestries. We find that ≈10\% of the variance in occupational wages can be attributed to genetic similarities between individuals who are only very distantly related to each other. Our GWAS (N = 282,963) identifies 45 approximately independent genetic loci for occupational wages, each with a tiny effect size (R 2<0.04\%). An aggregated genetic score constructed from these GWAS results accounts for ≈1\% of the variance in self-reported income in two independent samples (N = 29,440) and improves upon the variance captured by a genetic score obtained from previous GWAS results for educational attainment. A one-standard-deviation increase in our genetic score for occupational wages is associated with a 6{\textendash}8\% increase in self-reported hourly wages. We exploit random genetic differences between ~35,000 biological siblings to show that (i) roughly half of the covariance between our genetic score and socioeconomic outcomes is causal, (ii) genetic luck for higher income is linked with better health outcomes in late adulthood, and (iii) having a college degree partly mediates this relationship. We also demonstrate that the returns to schooling remain substantial even after controlling for genetic confounds, with an average of 8{\textendash}11\% higher hourly wages for each additional year of education obtained in a US sample. Thus, the implications of genetic endowments are malleable, for example, via policies targeting education.}, keywords = {Education, Genetics, health, heritability, Income, Inequality, polygenic score}, url = {https://papers.tinbergen.nl/20053.pdf}, author = {Kweon, Hyeokmoon and Burik, Casper and Richard Karlsson Linn{\'e}r and de Vlaming, Ronald and Okbay, Aysu and Martschenko, Daphne and Harden, Kathryn and DiPrete, Thomas and Philipp D Koellinger} } @article {MCGRATH2020, title = {Handgrip Strength Asymmetry and Weakness May Accelerate Time to Mortality in Aging Americans}, journal = {Journal of the American Medical Directors Association}, year = {2020}, abstract = {Objectives Assessing handgrip strength (HGS) asymmetry may provide insights into HGS as a prognostic assessment of strength capacity and vitality. This study sought to determine the associations of HGS asymmetry and weakness on time to mortality in aging Americans. Design Longitudinal panel. Setting Secondary analyses of data from participants aged >=50 years from the 2006-2014 waves of the Health and Retirement Study. Participants The analytic sample included 19,325 Americans who identified hand dominance and had measures of HGS for both hands in a single wave. Measures A handgrip dynamometer was used to measure HGS. Men and women who were considered weak had HGS <26 kg and <16 kg, respectively. The highest HGS values from the dominant and nondominant hands were used to calculate HGS ratio: (nondominant HGS/dominant HGS). Those with HGS ratio <0.90 or >1.10 had any HGS asymmetry. Moreover, participants with HGS ratio <0.90 had dominant HGS asymmetry, whereas those with HGS ratio >1.10 had nondominant HGS asymmetry. The National Death Index and postmortem interviews verified date of death. Covariate-adjusted Cox models were used for analyses. Results Those with any HGS asymmetry had a 1.10 [95\% confidence interval (CI) 1.03-1.17] higher hazard for mortality, while those with weakness had a 1.44 (CI 1.32-1.58) higher hazard for mortality. Likewise, participants with dominant HGS asymmetry had a 1.11 (CI 1.03-1.18) higher hazard for mortality, and those with weakness had a 1.45 (CI 1.32-1.58) higher hazard for mortality; however, the association was not significant for those with nondominant HGS asymmetry (hazard ratio: 1.07; CI 0.96-1.18). Conclusions and Implications HGS asymmetry and weakness are markers of impaired strength capacity that independently accelerate time to mortality, but the magnitude of these associations was more prominent for weakness. Nevertheless, assessments of asymmetric HGS are a simple adjunct analysis that may show promise for increasing the prognostic value of handgrip dynamometers.}, keywords = {Death, Frailty, Geriatric Assessment, Muscle Strength, muscle strength dynamometer}, issn = {1525-8610}, doi = {10.1016/j.jamda.2020.04.030}, author = {Ryan P McGrath and Grant R Tomkinson and Dain P. LaRoche and Brenda Vincent and Colin W. Bond and Kyle J Hackney} } @article {9971, title = {Health effects of late-career unemployment}, journal = {Journal of Aging and Health}, volume = {32}, year = {2020}, pages = {106-116}, type = {Journal}, abstract = {Objective: Job loss has a demonstrated negative impact on physical and mental health. Involuntary retirement has also been linked to poorer physical and mental health outcomes. This study examined whether late-career unemployment is related to involuntary retirement and health declines postretirement. Method: Analysis was conducted using the 2000-2012 U.S. Health and Retirement Study (HRS) survey data with unemployment months regressed with demographic and baseline health measures on physical and mental health. Results: Individuals with late-career unemployment reported more involuntary retirement timing (47.0\%) compared with those reporting no unemployment (27.9\%). Late-career unemployment had no significant effect on self-reported physical health (β =.003, p =.84), but was significantly associated with lower levels of mental health (β =.039; p <.01). Conclusion: Self-reports of late-career unemployment are not associated with physical health in retirement, but unemployment is associated with involuntary retirement timing and mental health declines in retirement. Unemployment late in the working career should be addressed as a public mental health concern.}, keywords = {Job loss, Retirement Planning and Satisfaction, Unemployment}, issn = {0898-2643}, doi = {10.1177/0898264318806792}, url = {https://journals.sagepub.com/doi/10.1177/0898264318806792}, author = {Maren W Voss and Lori Wadsworth and Wendy Church Birmingham and Merryman, M. Beth and Crabtree, Lisa and Subasic, Kathy and Hung, Man} } @article {11023, title = {Is Healthy Neuroticism Associated with Health Behaviors? A Coordinated Integrative Data Analysis}, journal = {Collabra: Psychology}, volume = {6}, year = {2020}, abstract = {Current literature suggests that neuroticism is positively associated with maladaptive life choices, likelihood of disease, and mortality. However, recent research has identified circumstances under which neuroticism is associated with positive outcomes. The current project examined whether {\textquotedblleft}healthy neuroticism{\textquotedblright}, defined as the interaction of neuroticism and conscientiousness, was associated with the following health behaviors: smoking, alcohol consumption, and physical activity. Using a pre-registered multi-study coordinated integrative data analysis (IDA) approach, we investigated whether {\textquotedblleft}healthy neuroticism{\textquotedblright} predicted the odds of engaging in each of the aforementioned activities. Each study estimated identical models, using the same covariates and data transformations, enabling optimal comparability of results. These results were then meta-analyzed in order to estimate an average (N-weighted) effect and to ascertain the extent of heterogeneity in the effects. Overall, these results suggest that neuroticism alone was not related to health behaviors, while individuals higher in conscientiousness were less likely to be smokers or drinkers, and more likely to engage in physical activity. In terms of the healthy neuroticism interaction of neuroticism and conscientiousness, significant interactions for smoking and physical activity suggest that the association between neuroticism and health behaviors was smaller among those high in conscientiousness. These findings lend credence to the idea that healthy neuroticism may be linked to certain health behaviors and that these effects are generalizable across several heterogeneous samples.}, keywords = {Coordinated IDA, Health behaviors, Healthy Neuroticism}, doi = {http://doi.org/10.1525/collabra.266}, author = {Graham, Eileen and Sara J Weston and Nicholas A. Turiano and Damaris Aschwanden and Booth, Tom and Harrison, Fleur and James, Byran and Nathan A Lewis and Makkar, Steven and Mueller, Swantje and Wisniewski, Kristi and Yoneda, Tomiko and Zhaoyang, Ruixue and Avron Spiro III and Willis, Sherry and K. Warner Schaie and Sliwinski, Martin and Lipton, Richard and Katz, Mindy and Ian J Deary and Elizabeth Zelinski and David A Bennett and Sachdev, P S and Brodaty, H and Troller, Julian and Ames, David and Margaret J Wright and Denis Gerstorf and Allemand, Mathias and Drewelies, Johanna and Wagner, Gert G and Muniz-Terrera, Graciela and Andrea M Piccinin and Scott M Hofer and Daniel K. Mroczek} } @article {10961, title = {How Accurate Are Retirees{\textquoteright} Assessments of Their Retirement Risk?}, number = {WP$\#$2020-14}, year = {2020}, institution = {Center for Retirement Research at Boston College}, address = {Boston}, abstract = {Retirees with limited financial resources face numerous risks, including out-living their money (longevity risk), investment losses (market risk), unexpected health expenses (health risk), the unforeseen needs of family members (family risk), and even retirement benefit cuts (policy risk). This study systematically values and ranks the financial impacts of these risks from both the objective and subjective perspectives and then compares them to show the gaps between retirees{\textquoteright} actual risks and their perceptions of the risks in a unified framework. It finds that 1) under the empirical analysis, the greatest risk is longevity risk, followed by health risk; 2) under the subjective analysis, retirees perceive market risk as the highest-ranking risk due to their exaggeration of market volatility; and 3) the longevity risk and health risk are valued less in the subjective ranking than in the objective ranking, because retirees underestimate their life spans and their health costs in late life.}, keywords = {family risk, health risk, longevity risk, market risk, policy risk}, url = {https://crr.bc.edu/working-papers/how-accurate-are-retirees-assessments-of-their-retirement-risk/}, author = {Wenliang Hou} } @article {11373, title = {The Impact of Growing Health and Mortality Inequalities on Lifetime Social Security Payouts}, number = {MRDRC WP 2020-412}, year = {2020}, institution = {Michigan Retirement and Disability Research Center, University of Michigan}, address = {Ann Arbor, MI}, abstract = {The prevalence of obesity, diabetes, and other health problems has increased in recent decades in the United States, and there is a growing gap between the health and longevity of individuals with high socioeconomic status (SES) and low SES. These trends likely have implications for Social Security{\textquoteright}s financial position in the coming decades. Because high-SES individuals tend to receive higher annual benefits and live longer, increases in health and mortality inequalities may result in increases in aggregate Social Security payouts. This paper uses data from the Health and Retirement Study, and a microsimulation model of health, mortality, and Social Security benefits, to forecast lifetime Social Security benefits of the 1934 to 1959 birth cohorts in the U.S. We compare alternative assumptions about the future course of mortality. We find that accounting for health and mortality inequalities is important. In a baseline model that ignores trends in mortality inequalities, we estimate that lifetime Social Security benefits would grow by 26\% in real terms between the 1934 and 1959 birth cohorts due to increasing benefit levels and improvements in average mortality. When we account for mortality inequalities, we find an increase of 28\% to 38\% in average lifetime benefits, depending on the assumptions of the model. We also forecast lifetime benefits using the alternative assumption that improvements in population mortality will slow for younger birth cohorts.}, keywords = {health, mortality inequalities, Social Security}, url = {https://mrdrc.isr.umich.edu/publications/papers/pdf/wp412.pdf}, author = {P{\'e}ter Hudomiet and Michael D Hurd and Susann Rohwedder} } @article {10965, title = {Impact of Social, Contextual, and Behavioral Factors on Health Status Among Asian Populations Across the United States, China, and Korea...2020 AOTA Annual Conference \& Expo}, journal = {American Journal of Occupational Therapy}, volume = {74}, year = {2020}, abstract = {PURPOSE: Although cross-national comparisons for patterns of aging populations are feasible due to the existing national micro-data, few studies have attempted to examine different social, cultural, and policy contexts that influence aging across countries in Asian populations. This study aims to examine the social, contextual, and behavioral factors that influence functional status across the three Asian populations. DESIGN: A secondary data analysis was performed on three national surveys: the 2012 Health and Retirement Study, the 2012 China Health and Retirement Longitudinal Study, and the 2012 Korean Longitudinal Study of Aging. METHOD: We retrieved a representative sample of 211 American Asian adults, 13,649 Chinese adults, and 7,486 Korean adults from the national aging surveys. Survey participants were population-based national samples of individuals over 50 years old and lived in community settings. Hierarchical regression models were utilized to compare health status and examine the influence of social-contextual factors on health status across the American Asian, Chinese, and Korean adults. The self-rated health question (1-very good to 5-very bad) was the dependent variable and was identified in all three surveys as a common metric for health status (Cieza et al., 2015; Hong et al., 2018). Social-contextual factors were used as independent variables, including: age, sex, living arrangement, employment status, self-rated health, body mass index (kg/m2), cognitive status (CESD depression score, orientation, and serial 7{\textquoteright}s test score), chronic conditions (stroke, arthritis, diabetes, hypertension, cancer, heart problem), number of people in house, number of living parents, children, siblings, children living in the same city, weekly contact with children, weekly religious participation, and financial transfer from/to children. The regression coefficients (β) on the study variables in regression model were examined to compare the effects of family and environmental factors on health status across countries. RESULTS: The mean age of the sample was 63.8 years (SD=9.5). The majority of the sample lived with a spouse/partner (81.6\%), female (52.8\%), and employed (53.8\%). The unadjusted self-rated health status scores revealed that American Asian had significantly better health status (Mean=2.5, SD=0.06) than Korean (Mean=3.7, SD=0.01) and Chinese adults (Mean=3.9, SD=0.01). Health status orders did not change even after accounting for the social-contextual factors. Age, depression scores, chronic conditions, and receipt of financial assistance from children were significantly associated with poor health status (p<0.05). Factors significantly associated with good health (p<0.05) are: higher education attainment, current employment, active lifestyle, higher cognitive function, social participation, and giving financial support to their children. CONCLUSION: Study findings that the American Asian adults are healthier than the Korean and Chinese adults. We speculate that the majority of the differences across the three countries may be due to differences in the rate of the aging populations or different cultural aspects for the aging populations. Policy makers and clinicians would need to investigate the negative driving factors on health status in China and Korea or adapt the US health policies to improve healthy aging among the adults in the two countries.}, keywords = {Asians, CHARLS, Congresses and Conferences, Functional status, KLoSA, Social determinants of health}, isbn = {0272-9490}, doi = {https://doi.org/10.5014/ajot.2020.74S1-PO3606}, author = {Ickpyo Hong and Pryor, Loree and Kitchens, Riqiea} } @article {11194, title = {Income Dynamics and Consumption Insurance}, year = {2020}, institution = {University of Pennsylvania}, abstract = {An accurate quantitative analysis using lifecycle incomplete markets models requires that they match both the total amount of insurance available to households in the data and the empirical importance of the sources of insurance such as, e.g., household saving and borrowing or the tax and transfer system. The prominent empirical benchmark estimates of the extent and sources of insurance provided in Blundell, Pistaferri and Preston (American Economic Review, 2008) imply that the currently used models poorly fit these data. We show that this is because the income process used as an input in the incomplete markets models and when constructing the empirical benchmark estimates of insurance abstracts from the irregular nature of income observations at the start and end of family income spells. When ignored, this feature of the income data induces a large bias in the empirical measures of the degree and sources of insurance and results in a misleading assessment of the models{\textquoteright} performance. The empirical measures of insurance accounting for the bias imply a limited role of assets and taxes and transfers in insuring permanent shocks to household budgets.}, keywords = {consumption, Income and wealth, Insurance}, url = {https://www.sas.upenn.edu/~manovski/papers/Inc_Dyn_Cons_Ins.pdf}, author = {Dmytro Hryshko and Iourii Manovskii} } @article {10995, title = {Increases in BMI and Chronic Pain for US Adults in Midlife, 1992 to 2016}, journal = {SSM - Population Health}, year = {2020}, abstract = {Recent unprecedented increases in mortality and morbidity during midlife are often ascribed to rising despair in the US population. An alternative and less often examined explanation is that these trends reflect, at least in part, the lagged effects of the obesity epidemic. Adults in midlife today are more likely to live with obesity and have a greater cumulative exposure to excess adiposity during their lifetime than any previous generation. Prior work has demonstrated a link between obesity and mortality risk at midlife, but the mechanisms remain unclear. Pain may represent one important pathway linking obesity to mortality trends. Pain is a debilitating condition that has increased significantly over recent decades and is associated with both morbidity and mortality, including suicide and opioid-related mortality. Evidence suggests obesity and pain may be linked, but there is little evidence of an association at the population level. In this paper, we examine to what extent increases in overweight and obesity explain the rising trends in chronic pain observed among middle-aged adults in the US from 1992 to 2016. We assess trends in both mild/moderate nonlimiting pain and severe and/or limiting pain. In doing so, we draw attention to one mechanism through which overweight/obesity may have contributed to recent population health trends. Our analysis found that increases in BMI from 1992 to 2016 may account for up to 20\% of the upward trend in mild/moderate nonlimiting pain and 32\% of the trend in severe and/or limiting pain for women, and 10\% and 19\% of the trends respectively for men.}, keywords = {activity limitations, Obesity, pain, Trends}, isbn = {2352-8273}, doi = {https://doi.org/10.1016/j.ssmph.2020.100644}, author = {Andrew C. Stokes and Xie, Wubin and Lundberg, Dielle J. and Hempstead, Katherine and Zajacova, Anna and Zachary Zimmer and Dana A Glei and Meara, Ellen and Samuel H. Preston} } @article {11257, title = {The Interaction of Health, Genetics, and Occupational Demands in SSDI Determinations}, number = {NB20-11}, year = {2020}, institution = {National Bureau of Economic Research, Retirement and Disability Research Center}, address = {Cambridge, MA}, abstract = {Evaluations of Social Security Disability Insurance (SSDI) applications are based not only on poor health, but in many cases, consider the vocational factors of age, education and work experience to determine whether individuals can work. SSDI determinations based on these factors have grown threefold since 1985 (Michaud, Nelson, and Wiczer 2016). Yet little is known about the relationship between SSDI activity and the ability to meet occupational requirements (Rutledge, Zulkarnain, and King 2019). Moreover, there is strong evidence that morbidity and mortality are distributed unequally across occupations (Marmot et al. 1991), perhaps because differential work environments may exacerbate disability but also because individual-level underlying health is unlikely to be randomly distributed across occupations (Mackenbach et al. 2017). Together, these phenomena result in complex relationships of SSDI determinants with both the independent and joint effects of health and occupational demands. Disentangling the contributions of these forces is challenging, because selection into occupations by health is often unobserved and because data on occupational demands for employment histories is limited. We propose to triangulate between these factors by using a rich set of data linkages from the Health and Retirement Study, including linkage to the Social Security Administration (SSA) disability application file (831 file), and the Department of Labor{\textquoteright}s O*Net job classification system.}, keywords = {Genetics, health, Occupation, SSDI}, url = {https://www.nber.org/programs-projects/projects-and-centers/retirement-and-disability-research-center/center-papers/nb20-11}, author = {Harrati, Amal and Lauren L Schmitz} } @article {9581, title = {Investigating predictors of cognitive decline using machine learning.}, journal = {Journals of Gerontology, Series B: Psychological Sciences \& Social Sciences}, year = {2020}, abstract = {

Objectives: Genetic risks for cognitive decline are not modifiable; however their relative importance compared to modifiable factors is unclear. We used machine learning to evaluate modifiable and genetic risk factors for Alzheimer{\textquoteright}s disease(AD), to predict cognitive decline.

Methods: Health and Retirement Study participants, aged 65-90, with DNA and >2 cognitive evaluations, were included (n=7,142). Predictors included age, body mass index, gender, education, APOE ε4, CVD, hypertension, diabetes, stroke, neighborhood socio-economic status(NSES), and AD risk genes. Latent class trajectory analyses of cognitive scores determined the form and number of classes. Random Forests (RF) classification investigated predictors of cognitive trajectories. Performance metrics (accuracy, sensitivity and specificity) were reported.

Results: Three classes were identified. Discriminating highest from lowest classes produced the best RF performance: accuracy=78\%(1.0\%), sensitivity=75\%(1.0\%) and specificity=81\%(1.0\%). Top ranked predictors were education, age, gender, stroke, NSES, and diabetes, APOE ε4 carrier status and BMI. When discriminating high from medium classes, top predictors were education, age, gender, stroke, diabetes, NSES and BMI. When discriminating medium from the low classes, education, NSES, age, diabetes and stroke were top predictors.

Discussion: The combination of latent trajectories and RF classification techniques suggested that non-genetic factors contribute more to cognitive decline than genetic factors. Education was the most relevant predictor for discrimination.

}, keywords = {Alzheimer{\textquoteright}s disease, Cognitive Ability, Machine learning}, issn = {1758-5368}, doi = {10.1093/geronb/gby054}, author = {Casanova, Ramon and Saldana, Santiago and Michael W Lutz and Brenda L Plassman and Kuchibhatla, Maragatha and Kathleen M Hayden} } @article {11142, title = {Landfall After the Perfect Storm: Cohort Differences in the Relationship Between Debt and Risk of Heart Attack.}, journal = {Demography}, year = {2020}, abstract = {

Analyses of the Health and Retirement Study (HRS) between 1992 and 2014 compare the relationship between different levels and forms of debt and heart attack risk trajectories across four cohorts. Although all cohorts experienced growing household debt, including the increase of both secured and unsecured debt, they nevertheless encountered different economic opportunity structures and crises at sensitive times in their life courses, with implications for heart attack risk trajectories. Results from frailty hazards models reveal that unsecured debt is associated with increased risk of heart attack across all cohorts. Higher levels of housing debt, however, predict higher rates of heart attack among only the earlier cohorts. Heart attack risk trajectories for Baby Boomers with high levels of housing debt are lower than those of same-aged peers with no housing debt. Thus, the relationship between debt and heart attack varies by level and form of debt across cohorts but distinguishes Baby Boomer cohorts based on their diverse exposures to volatile housing market conditions over the sensitive household formation period of the life course.

}, keywords = {Cohort, Debt, Frailty hazards, Heart attack, Inequality}, issn = {1533-7790}, doi = {10.1007/s13524-020-00930-3}, author = {Angela M O{\textquoteright}Rand and Jenifer Hamil-Luker} } @article {DUCHOWNY2020100587, title = {Life course trauma and muscle weakness in older adults by gender and race/ethnicity: Results from the U.S. health and Retirement Study}, journal = {SSM - Population Health}, volume = {11}, year = {2020}, pages = {100587}, abstract = {Muscle weakness, as measured by handgrip strength, is a primary determinant of physical functioning and disability. There is a high burden of muscle weakness in the United States with close to 50 percent of older Americans meeting criteria for clinical muscle weakness. While previous racial/ethnic disparities have been documented among older adults, the extent to which lifecourse trauma shapes muscle strength trajectories is unknown. Using U.S. Health and Retirement Study (N = 20,472, Mean Age = 63.8 years) data on grip strength (2006{\textendash}2014, up to 3 assessments) and retrospectively reported traumatic events, we fit gender-stratified growth curve models to investigate whether traumatic events experienced across the lifecourse or at distinct sensitive periods (childhood, early/emerging adulthood or mid-life) predicted later-life trajectories of grip strength. There was no association between cumulative trauma and trajectories of grip strength and the main effects for the life stage models were largely null. However, among White women, our results suggest that traumatic events experienced during childhood (β = -0.012; 95\% CI = -0.024, 0.0004) compared to middle adulthood are associated with faster declines in grip strength in later life. Traumatic events reported during childhood was related to a slower decline in grip strength over time among Hispanic women compared to that for White women (β = 0.086, 95\% CI = 0.044, 0.128). Among Black men, the association between traumatic events during early/emerging adulthood and age-related declines in grip strength was stronger for Black men than for White men (interaction β = -0.070; 95\% CI = -0.138, 0.001). Traumatic events experienced during distinct life stages may influence later life declines in grip strength and exacerbate racial inequalities in later life. This study addresses an important gap by investigating the life course social determinants of later life muscle strength, which is a key driver of physical functioning and mobility.}, keywords = {Grip strength, Muscle Weakness, Trauma}, issn = {2352-8273}, doi = {10.1016/j.ssmph.2020.100587}, author = {Kate A Duchowny and Margaret T Hicken and Peggy M Cawthon and M. Maria Glymour and Philippa J Clarke} } @article {10073, title = {Life partner influence on uptake of preventive services: Evidence from flu vaccine adoption among the aging population.}, journal = {Journal of Aging and Health}, volume = {32}, year = {2020}, pages = {441-452}, abstract = {

OBJECTIVES: This study examines how the patterns of life partner concordance on preventive health service uptake vary by a partner{\textquoteright}s previous behavioral history and between genders.

METHOD: This study uses 2008 and 2012 waves of Health and Retirement Study (HRS), a nationally representative sample of U.S. aging population, to examine one{\textquoteright}s decision to receive a preventive service as a function of the partner{\textquoteright}s decision changes over time ( N = 2,680).

RESULTS: Life partner concordance on preventive service use is different by the partner{\textquoteright}s previous use history and gender. Positive partner preventive engagement showed greater association than negative ones. Women are more responsive to the positive health behaviors (of their partners), and men are more sensitive to the negative partner health behaviors.

CONCLUSION: The asymmetric partner concordance by gender and the partner{\textquoteright}s previous usage experience provide implications to develop efficient and culturally acceptable interventions to increase the uptake of preventive health services.

}, keywords = {Health care utilization, Vaccines}, issn = {08982643}, doi = {10.1177/0898264319829979}, url = {http://www.ncbi.nlm.nih.gov/pubmed/30793640?dopt=Abstract}, author = {Ying Jessica Cao and Noyes, Katia and Gregory G Homish} } @article {doi:10.1177/0164027520917059, title = {Life-Course Religious Attendance and Cognitive Functioning in Later Life}, journal = {Research on Aging}, year = {2020}, note = {PMID: 32266864}, type = {Journal}, abstract = {Although several studies suggest that religious attendance is associated with better cognitive functioning in later life, researchers have generally failed to connect with any established life-course perspectives or theories of cognitive aging. Building on previous work, we examine the effects of life-course religious attendance on a range of cognitive functioning outcomes. We employ data from the religious life histories module of the 2016 Health and Retirement Study, a subsample of 516 adults aged 65 and older. Our key findings demonstrate that older adults who attended religious services for more of their life course tend to exhibit poorer working memory and mental status and better self-rated memory than older adults who attended less often. We contribute to previous research by reconceptualizing religious attendance as a cumulative life-course exposure, exploring the effects of religious attendance net of secular social engagement, and examining a wider range of cognitive functioning outcomes.}, keywords = {Cognitive health, Memory, Mental Status, Religion}, doi = {10.1177/0164027520917059}, author = {Terrence D. Hill and Dawn C Carr and Amy M. Burdette and Benjamin Dowd-Arrow} } @article {11180, title = {Linking 1940 U.S. Census Data to the Health and Retirement Survey: Technical Documentation}, year = {2020}, institution = {Institute for Social Research, The University of Michigan}, address = {Ann Arbor, MI}, abstract = {In this document we describe a project to link records from the 1940 U.S. Census to records for respondents to the Health and Retirement Survey (HRS). The project is part of a larger effort to conduct parallel linkages to the 1940 Census for respondents to the HRS, the Panel Study of Income Dynamics (PSID), the Wisconsin Longitudinal Study (WLS), the National Social Life, Health, and Aging Project (NSHAP), and the National Health and Aging Trends Study (NHATS). In each cohort study, many sample members were alive at the time of the 1940 federal census and were thus enumerated (along with their families and household members). These five ongoing longitudinal studies are central components of America{\textquoteright}s data infrastructure for interdisciplinary research on aging and the life course; physical and mental health, disability, and well-being; later-life work, economic well-being, and retirement; end-of-life issues, and many other topics. Adding information about sample members from the 1940 Census will expand the utility of all five projects and will enable important research on the effects of early life social, economic, environmental, contextual, and other factors on subsequent life outcomes. Broadly, the project described in this document involved (1) preparing and formatting data files containing respondents{\textquoteright} identifying information; (2) deploying machine learning algorithms to mechanically link project records to the 1940 U.S. Census; (3) hand linking records that could not be machine linked and hand-verifying a portion of those that could; and (4) documenting the new measures and making them available as part of the HRS{\textquoteright}s restricted access dissemination systems in a manner consistent with HRS respondents{\textquoteright} privacy rights. In this document we describe the linking procedures, explain the structure of the resulting linked files and how they can be accessed, and provide information about linkage rates and the reliability and validity of the links.}, keywords = {census, documentation, linkage}, url = {https://hrs.isr.umich.edu/sites/default/files/restricted_data_docs/HRS-1940-Census-Data-Documentation-Report.pdf}, author = {Warren, John Robert and Pfeffer, Fabian and Helgertz, Jonas and Xu, Dafeng} } @article {10837, title = {Living Longer, With or Without Disability? A Global and Longitudinal Perspective}, journal = {The Journals of Gerontology: Series A}, volume = {75}, year = {2020}, pages = {162-167}, abstract = {Background Significant gains in life expectancy have been achieved, but living longer does not necessarily mean the years gained are productive and healthy. Different theories predict different patterns of time trends in old-age disability prevalence. Methods Using the Gateway to Global Aging Data, which provides internationally harmonized longitudinal data from the Health and Retirement Study and its sister surveys, we compare time trends (from 2004 to 2014) in disability prevalence across countries. Results Disability prevalence varies greatly across countries, and divergent time trends are observed across countries. For countries such as Belgium, Czechia, and Mexico, we observe an increase of disability prevalence, whereas in countries such as Denmark, England, Greece, Korea, Poland, and Sweden, we observe a substantial decrease in disability prevalence. Looking further into the severity of disability, we often observe differential trends in prevalence, but there is no evidence supporting the dynamic equilibrium hypothesis that predicts increased prevalence of modest disability but a decrease in severe disability prevalence. Conclusions Significant gains in life expectancy have translated into different gains in healthy years of life across different countries. Diverse time trends in disability prevalence across countries reaffirm that the expansion of late-life disability is not inevitable.}, keywords = {Activities of Daily Living, CHARLS, Cross-country comparison, Disability, ELSA, KLoSA, MHAS, SHARE, Trends}, issn = {1079-5006}, doi = {10.1093/gerona/glz007}, url = {https://pubmed.ncbi.nlm.nih.gov/30629214/}, author = {Jinkook Lee and Lau, Samuel and Erik Meijer and Hu, Peifeng} } @article {10804, title = {Long working hours and change in body weight: analysis of individual-participant data from 19 cohort studies}, journal = {International Journal of Obesity}, volume = {44}, year = {2020}, pages = {1368 - 1375}, abstract = {Objective To examine the relation between long working hours and change in body mass index (BMI). Methods We performed random effects meta-analyses using individual-participant data from 19 cohort studies from Europe, US and Australia (n = 122,078), with a mean of 4.4-year follow-up. Working hours were measured at baseline and categorised as part time (<35 h/week), standard weekly hours (35{\textendash}40 h, reference), 41{\textendash}48 h, 49{\textendash}54 h and >=55 h/week (long working hours). There were four outcomes at follow-up: (1) overweight/obesity (BMI >= 25 kg/m2) or (2) overweight (BMI 25{\textendash}29.9 kg/m2) among participants without overweight/obesity at baseline; (3) obesity (BMI >= 30 kg/m2) among participants with overweight at baseline, and (4) weight loss among participants with obesity at baseline. Results Of the 61,143 participants without overweight/obesity at baseline, 20.2\% had overweight/obesity at follow-up. Compared with standard weekly working hours, the age-, sex- and socioeconomic status-adjusted relative risk (RR) of overweight/obesity was 0.95 (95\% CI 0.90{\textendash}1.00) for part-time work, 1.07 (1.02{\textendash}1.12) for 41{\textendash}48 weekly working hours, 1.09 (1.03{\textendash}1.16) for 49{\textendash}54 h and 1.17 (1.08{\textendash}1.27) for long working hours (P for trend <0.0001). The findings were similar after multivariable adjustment and in subgroup analyses. Long working hours were associated with an excess risk of shift from normal weight to overweight rather than from overweight to obesity. Long working hours were not associated with weight loss among participants with obesity. Conclusions This analysis of large individual-participant data suggests a small excess risk of overweight among the healthy-weight people who work long hours.}, keywords = {Preventive medicine, Risk Factors}, isbn = {1476-5497}, doi = {10.1038/s41366-019-0480-3}, author = {Virtanen, Marianna and Markus Jokela and Lallukka, Tea and Magnusson Hanson, Linda and Pentti, Jaana and Solja T. Nyberg and Alfredsson, Lars and G David Batty and Casini, Annalisa and Clays, Els and DeBacquer, Dirk and Ervasti, Jenni and Fransson, Eleonor and Halonen, Jaana I. and Head, Jenny and Kittel, France and Knutsson, Anders and Leineweber, Constanze and Nordin, Maria and Oksanen, Tuula and Pietil{\"a}inen, Olli and Rahkonen, Ossi and Salo, Paula and Archana Singh-Manoux and Stenholm, Sari and Suominen, Sakari B. and Theorell, T{\"o}res and Vahtera, Jussi and Westerholm, Peter and Westerlund, Hugo and Mika Kivim{\"a}ki} } @article {Lappan202018, title = {Longitudinal and Reciprocal Relationships Between Psychological Well-Being and Smoking}, journal = {Nicotine \& tobacco research : official journal of the Society for Research on Nicotine and Tobacco}, volume = {22}, year = {2020}, note = {cited By 1}, pages = {18-23}, abstract = {INTRODUCTION: Smoking cessation treatments currently succeed at a rate of approximately 20\%-30\%, underscoring the importance of exploring factors that might increase intervention effectiveness. Although negative affect has been studied extensively in relation to smoking cessation, psychological well-being (PWB; eg, life satisfaction, optimism, positive affect, purpose in life) has received little attention. This study tested longitudinal and reciprocal relationships between PWB and smoking status in older adults. METHODS: Panel data were obtained from the biennial, longitudinal Health and Retirement Study. Using structural equation modeling, we developed cross-lagged models to examine the relationships of PWB in 2006 with smoking status in 2010 and of smoking status in 2006 with PWB in 2010 while controlling for covariates (Ns = 2939-4230, 55\% women, 89\% white, mean age = 64 years, mean years of education = 13, 25\% smokers in 2006 and 21\% smokers in 2010). Separate cross-lagged models were developed for each of the PWB variables: life satisfaction, optimism, positive affect, and purpose in life. RESULTS: Greater life satisfaction (standardized path coefficient = -0.04), optimism (standardized path coefficient = -0.07), and positive affect (standardized path coefficient = -0.08) in 2006 predicted a reduced likelihood of smoking in 2010. Being a smoker in 2006 predicted lower life satisfaction (standardized path coefficient = -0.25), optimism (standardized path coefficient = -0.10), positive affect (standardized path coefficient = -0.10), and purpose in life (standardized path coefficient = -0.13) in 2010. CONCLUSIONS: Findings warrant further exploration of the relationships between PWB and smoking, and support the incorporation of PWB-boosting components into existing treatments. IMPLICATIONS: Given the relatively low success rate of current smoking cessation treatments, the present results suggest that increasing PWB might promote abstinence and therefore warrant consideration as a focus of future cessation treatment research. Moreover, these results suggest that smoking might inhibit PWB, illuminating a negative consequence of smoking not previously identified. Helping smokers increase their PWB may benefit them beyond promoting cessation and contribute to a flourishing society. These results warrant further investigation of PWB and smoking, and support the continued evaluation of PWB-boosting components in smoking cessation treatments. {\textcopyright} The Author(s) 2018. Published by Oxford University Press on behalf of the Society for Research on Nicotine and Tobacco. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.}, keywords = {Adult, Aged, Article, Education, Female, human, Life Satisfaction, Male, Middle Aged, Optimism, people by smoking status, psychological well-being, Retirement, Smoking cessation, structural equation modeling}, issn = {1469994X}, doi = {10.1093/ntr/nty185}, author = {Lappan, S. and Thorne, C.B. and Long, D. and Hendricks, P.S.} } @article {11033, title = {Making it Work: Transitions From Physically Demanding Employment in Advanced Age}, year = {2020}, institution = {Cornell University}, address = {Ithaca, NY}, abstract = {As workers age, they may find it increasingly difficult to sustain employment, particularly if their work is physically demanding. While some workers transition to less onerous roles in the later stage of their careers, others have few employment alternatives. This analysis explores the interaction between older adults{\textquoteright} education and transitions from physically demanding jobs. Using longitudinal data from the Health and Retirement Study, I track changes in employment status and work conditions for the original cohort of interviewees until retirement. Descriptive social sequence analysis reveals that physical demands are most prevalent in the careers of older men and women without a college education. Transitions to less demanding roles feature most clearly in the career sequences of the most educated workers. Using regression analysis, however, I find that workers in physically demanding jobs are no less likely to be employed than their similarly educated peers in less demanding roles. Further, for workers with similar job demands, employment probabilities are comparable across education levels. Overall, my findings suggest that educational attainment can explain differences in the demands older workers face, but does not affect the probability of continued employment in the pre-retirement years.}, keywords = {Education, employment status, work conditions}, url = {https://ardraw.policyresearchinc.org/wp-content/uploads/2020/08/Hyland_Cohort-3_Final-Paper.pdf}, author = {Hyland, Megan} } @article {10554, title = {Measuring Racial/Ethnic Retirement Wealth Inequality}, number = {WP$\#$2020-2}, year = {2020}, institution = {Center for Retirement Research at Boston College}, abstract = {As the U.S. population becomes more diverse, it will be increasingly important for policymakers addressing Social Security{\textquoteright}s solvency to understand how reliant various racial and ethnic groups will be on the program versus other sources of retirement wealth. Yet, to date, studies on retirement wealth have tended not to focus on race and ethnicity, have largely ignored the role of Social Security, or have excluded the most recent cohort approaching retirement {\textendash} the Late Boomers. This project uses data from the Health and Retirement Study (HRS) to document the retirement resources of white, black, and Hispanic households at various points in the wealth distribution for five HRS cohorts of 51-56 year olds between 1992 and 2016. }, keywords = {race-ethnicity, Wealth Inequality}, url = {https://crr.bc.edu/working-papers/measuring-racial-ethnic-retirement-wealth-inequality/}, author = {Wenliang Hou and Geoffrey T. Sanzenbacher} } @article {10602, title = {Memory complaints and depressive symptoms over time: a construct-level replication analysis}, journal = {BMC Geriatrics}, volume = {20}, year = {2020}, pages = {57}, type = {Journal}, abstract = {Memory complaints and depressive symptoms are frequently associated in older adults and both serve as potential indicators of future cognitive decline. However, the temporal ordering of the development of these two symptoms remains unclear. The goal of the current study was to examine concurrent and temporal relationships between memory complaints and depressive symptoms in older adults.}, keywords = {Cognitive decline, Depressive symptoms, memory complaints, Older Adults, Replication analysis}, isbn = {1471-2318}, doi = {https://doi.org/10.1186/s12877-020-1451-1}, author = {Mogle, Jacqueline and Nikki L Hill and Bhargava, Sakshi and Tyler Reed Bell and Bhang, Iris} } @article {12124, title = {Meta-analysis of up to 622,409 individuals identifies 40 novel smoking behaviour associated genetic loci.}, journal = {Molecular Psychiatry}, volume = {25}, year = {2020}, pages = {2392-2409}, abstract = {

Smoking is a major heritable and modifiable risk factor for many diseases, including cancer, common respiratory disorders and cardiovascular diseases. Fourteen genetic loci have previously been associated with smoking behaviour-related traits. We tested up to 235,116 single nucleotide variants (SNVs) on the exome-array for association with smoking initiation, cigarettes per day, pack-years, and smoking cessation in a fixed effects meta-analysis of up to 61 studies (up to~346,813 participants). In a subset of 112,811 participants, a further one million SNVs were also genotyped and tested for association with the four smoking behaviour traits. SNV-trait associations with P < 5 {\texttimes} 10 in either analysis were taken forward for replication in up to 275,596 independent participants from UK Biobank. Lastly, a meta-analysis of the discovery and replication studies was performed. Sixteen SNVs were associated with at least one of the smoking behaviour traits (P < 5 {\texttimes} 10) in the discovery samples. Ten novel SNVs, including rs12616219 near TMEM182, were followed-up and five of them (rs462779 in REV3L, rs12780116 in CNNM2, rs1190736 in GPR101, rs11539157 in PJA1, and rs12616219 near TMEM182) replicated at a Bonferroni significance threshold (P < 4.5 {\texttimes} 10) with consistent direction of effect. A further 35 SNVs were associated with smoking behaviour traits in the discovery plus replication meta-analysis (up to 622,409 participants) including a rare SNV, rs150493199, in CCDC141 and two low-frequency SNVs in CEP350 and HDGFRP2. Functional follow-up implied that decreased expression of REV3L may lower the probability of smoking initiation. The novel loci will facilitate understanding the genetic aetiology of smoking behaviour and may lead to the identification of potential drug targets for smoking prevention and/or cessation.

}, keywords = {Biological Specimen Banks, Databases, Factual, Europe, Exome, Female, Genetic Loci, Humans, Male, Polymorphism, Single Nucleotide, Smoking, United Kingdom}, issn = {1476-5578}, doi = {10.1038/s41380-018-0313-0}, author = {Erzurumluoglu, A Mesut and Liu, Mengzhen and Jackson, Victoria E and Barnes, Daniel R and Datta, Gargi and Melbourne, Carl A and Young, Robin and Batini, Chiara and Surendran, Praveen and Jiang, Tao and Adnan, Sheikh Daud and Afaq, Saima and Agrawal, Arpana and Altmaier, Elisabeth and Antoniou, Antonis C and Asselbergs, Folkert W and Baumbach, Clemens and Laura Bierut and Bertelsen, Sarah and Boehnke, Michael and Bots, Michiel L and Brazel, David M and Chambers, John C and Chang-Claude, Jenny and Chen, Chu and Corley, Janie and Chou, Yi-Ling and David, Sean P and de Boer, Rudolf A and Christiaan de Leeuw and Joe G Dennis and Dominiczak, Anna F and Dunning, Alison M and Easton, Douglas F and Charles B Eaton and Elliott, Paul and Evangelou, Evangelos and Jessica Faul and Tatiana Foroud and Goate, Alison and Gong, Jian and Hans-J{\"o}rgen Grabe and Jeffrey Haessler and Christopher A Haiman and Hallmans, G{\"o}ran and Anke R Hammerschlag and Sarah E Harris and Andrew T Hattersley and Andrew C Heath and Hsu, Chris and Iacono, William G and Kanoni, Stavroula and Kapoor, Manav and Kaprio, Jaakko and Sharon L R Kardia and Karpe, Fredrik and Kontto, Jukka and Kooner, Jaspal S and Charles Kooperberg and Kuulasmaa, Kari and Laakso, Markku and Lai, Dongbing and Langenberg, Claudia and Le, Nhung and Lettre, Guillaume and Loukola, Anu and Luan, Jian{\textquoteright}an and Pamela A F Madden and Mangino, Massimo and Riccardo E Marioni and Marouli, Eirini and Marten, Jonathan and Nicholas G Martin and McGue, Matt and Michailidou, Kyriaki and Mihailov, Evelin and Moayyeri, Alireza and Moitry, Marie and M{\"u}ller-Nurasyid, Martina and Naheed, Aliya and Nauck, Matthias and Neville, Matthew J and Sune Fallgaard Nielsen and Kari E North and Markus Perola and Pharoah, Paul D P and Pistis, Giorgio and Tinca J Polderman and Posthuma, Danielle and Neil Poulter and Qaiser, Beenish and Rasheed, Asif and Reiner, Alex and Renstrom, Frida and Rice, John and Rohde, Rebecca and Rolandsson, Olov and Nilesh J Samani and Samuel, Maria and Schlessinger, David and H Steven Scholte and Scott, Robert A and Peter Sever and Shao, Yaming and Shrine, Nick and Smith, Jennifer A and John M Starr and Kathleen E Stirrups and Stram, Danielle and Heather M Stringham and Tachmazidou, Ioanna and Tardif, Jean-Claude and Thompson, Deborah J and Hilary A Tindle and Tragante, Vinicius and Trompet, Stella and Turcot, Val{\'e}rie and Tyrrell, Jessica and Vaartjes, Ilonca and Van Der Leij, Andries R and van der Meer, Peter and Varga, Tibor V and Verweij, Niek and V{\"o}lzke, Henry and Wareham, Nicholas J and Warren, Helen R and David R Weir and Weiss, Stefan and Wetherill, Leah and Yaghootkar, Hanieh and Yavas, Ersin and Jiang, Yu and Chen, Fang and Zhan, Xiaowei and Zhang, Weihua and Zhao, Wei and Zhao, Wei and Zhou, Kaixin and Amouyel, Philippe and Blankenberg, Stefan and Caulfield, Mark J and Chowdhury, Rajiv and Francesco Cucca and Ian J Deary and Deloukas, Panos and Di Angelantonio, Emanuele and Marco M Ferrario and Ferri{\`e}res, Jean and Franks, Paul W and Timothy M Frayling and Frossard, Philippe and Hall, Ian P and Caroline Hayward and Jansson, Jan-H{\r a}kan and Jukema, J Wouter and Kee, Frank and M{\"a}nnist{\"o}, Satu and Andres Metspalu and Munroe, Patricia B and B{\o}rge G Nordestgaard and Palmer, Colin N A and Veikko Salomaa and Sattar, Naveed and Timothy Spector and David P Strachan and van der Harst, Pim and Zeggini, Eleftheria and Saleheen, Danish and Adam S Butterworth and Wain, Louise V and Gon{\c c}alo R Abecasis and Danesh, John and Tobin, Martin D and Scott Vrieze and Liu, Dajiang J and Howson, Joanna M M} } @article {10670, title = {Methods and Early Recruitment of a Community-Based Study of Cognitive Impairment Among Mexican Americans and Non-Hispanic Whites: The BASIC-Cognitive Study}, journal = {Journal of Alzheimer{\textquoteright}s Disease}, volume = {73}, year = {2020}, month = {2020}, pages = {185-196}, type = {Journal}, abstract = {Background: As the Mexican American (MA) population grows and ages, there is an urgent need to estimate the prevalence of cognitive impairment or dementia (CID), cognitive trajectories, and identify community resource needs. The Brain Attack Surveillance in Corpus Christi (BASIC)-Cognitive project is a population-based study to address these issues among older MAs and non-Hispanic whites (NHW) and their informal care providers. Objective: Present the methodology and initial recruitment findings for the BASIC-Cognitive project. Method: Random, door-to-door case ascertainment is used in Nueces County, Texas, to recruit community-dwelling and nursing home residents >=65 and informal care providers. Households are identified from a two-stage area probability sample, using Census data to aim for equal balance of MAs and NHWs. Individuals with cognitive screens indicative of possible CID complete neuropsychological assessment (Harmonized Cognitive Assessment Protocol from the Health and Retirement Study). Informal care providers complete comprehensive interview and needs assessment. Study pairs repeat procedures at 2-year follow-up. Asset and concept mapping are performed to identify community resources and study care providers{\textquoteright} perceptions of needs for individuals with CID. Results: 1,030 age-eligible households were identified, or 27\% of households for whom age could be determined. 1,320 individuals were age-eligible, corresponding to 1.3 adults per eligible household. Initial recruitment yielded robust participation in the MA eligible population (60\% of 689 individuals that completed cognitive screening). Conclusion: The BASIC-Cognitive study will provide critical information regarding the prevalence of CID in MAs, the impact of caregiving, and allocation of community resources to meet the needs of this population.}, keywords = {Caregivers, Dementia, Epidemiology, Health Resources, mexican american, mild cognitive impairment}, isbn = {1875-8908}, doi = {10.3233/JAD-190761}, url = {https://content.iospress.com/articles/journal-of-alzheimers-disease/jad190761}, author = {Emily Brice{\~n}o and Mehdipanah, Roshanak and Gonzales, Xavier and Steven G Heeringa and Deborah A Levine and Kenneth M. Langa and Garcia, Nelda and Longoria, Ruth and Lewis B Morgenstern} } @article {11069, title = {Middle-aged Americans report more pain than the elderly}, journal = {Research News}, year = {2020}, publisher = {EurekAlert/AAAS}, address = {Washington, D.C.}, abstract = {As people age, they tend to report more acute or chronic pain -- a common sign of getting older. Yet, in the United States, middle-aged adults are now reporting more pain than the elderly, according to a paper published in the Proceedings of the National Academy of Sciences (PNAS).}, keywords = {Aging, Body Weight, Death \& Dying, Gerontology, Longevity, pain, Public Health}, url = {https://www.eurekalert.org/pub_releases/2020-09/puww-mar091720.php}, author = {Huber, B. Rose} } @article {10904, title = {Negative financial shock increases loneliness in older adults, 2006{\textendash}2016: Reduced effect during the Great Recession (2008{\textendash}2010)}, journal = {Social Science \& Medicine}, volume = {255}, year = {2020}, abstract = {Highlights {\textbullet} In older adults, a large loss of income leads to greater loneliness net of covariates. {\textbullet} Loneliness decreased in those who experienced income shock during the Great Recession. {\textbullet} Changes in health and social experiences did not explain the income shock effect. {\textbullet} Reducing financial difficulties may reduce loneliness in older adults.}, keywords = {financial difficulties, Income shocks, Loneliness}, isbn = {0277-9536}, doi = {doi-org.proxy.lib.umich.edu/10.1016/j.socscimed.2020.113000}, author = {Louise C Hawkley and Zheng, Boyan and Song, Xi} } @inbook {Bao2020, title = {Parenting and Grandparenting}, booktitle = {Encyclopedia of Gerontology and Population Aging}, year = {2020}, pages = {1-13}, publisher = {Springer International Publishing}, organization = {Springer International Publishing}, abstract = {Parenting refers to the activities that parents engage in to raise their children and the skills involved to facilitate child development (Lee et al. 2014). When children are young, parenting behaviors often focus on {\textquotedblleft}nurturing, stimulating and socializing children{\textellipsis}(and) monitoring their activities{\textquotedblright} (Furedi 2002, p. 5). As children enter adulthood, parenting in parents{\textquoteright} mid- and later life usually involves granting children autonomy and helping them to achieve independence in emerging adulthood as well as providing instrumental and emotional support to adult children when needed. Grandparenting concerns the support and care that grandparents, typically grandmothers, provide to their grandchildren (Timonen and Arber 2012). Scholars tend to view grandparenting broadly also to include contact, shared activities, emotional attachment, and overall relationship quality between grandparents and grandchildren.}, keywords = {Grandparenting, Intergenerational Relations, Parenting}, isbn = {978-3-319-69892-2}, doi = {10.1007/978-3-319-69892-2_892-1}, author = {Bao, Luoman and Huang, Ying}, editor = {Gu, Danan and Matthew E Dupre} } @article {11121, title = {Pattern Recognition to Objectively Differentiate the Etiology of Cognitive Decline: Analysis of the Impact of Stroke and Alzheimer{\textquoteright}s Disease.}, journal = {Neuroepidemiology}, year = {2020}, abstract = {

BACKGROUND: Undetected Alzheimer{\textquoteright}s disease (AD) and stroke neuropathology is believed to account for a large proportion of decline in cognitive performance that is attributed to normal aging. This study examined the amount of variance in age-related cognitive change that is accounted for by AD and stroke using a novel pattern recognition protocol.

METHOD: Secondary analyses of data collected for the Health and Retirement Study (N = 17,579) were used to objectively characterize patterns of cognitive decline associated with AD and stroke. The rate of decline in episodic memory and orientation was the outcome of interest, while algorithms indicative of AD and stroke pathology were the predictors of interest.

RESULTS: The average age of the sample was 67.54 {\textpm} 10.45 years at baseline, and they completed, on average, 14.20 {\textpm} 3.56 years of follow-up. After adjusting for demographics, AD and stroke accounted for approximately half of age-associated decline in cognition (51.07-55.6\% for orientation and episodic memory, respectively) and explained variance attributed to random slopes in longitudinal multilevel models.

DISCUSSION: The results of this study suggested that approximately half of the cognitive decline usually attributed to normal aging are more characteristic of AD and stroke.

}, keywords = {Adaptive diagnostics, Cerebrovascular disease, Neuroepidemiology, Pattern recognition}, issn = {1423-0208}, doi = {10.1159/000510133}, author = {Sean A. P. Clouston and Richmond, Lauren L and Scott, Stacey B and Luhmann, Christian C and Natale, Ginny and Douglas William Hanes and Yun Zhang and Dylan M Smith} } @article {11040, title = {Perceived Discrimination Trajectories and Depressive Symptoms Among Middle-Aged And Older Black Adults}, journal = {Innovation in Aging}, volume = {4}, year = {2020}, pages = {igaa041}, abstract = {Perceived discrimination is a risk factor for poor mental health. However, most studies measure discrimination at one time point, which does not account for heterogeneity in the cumulative patterning of exposure to discrimination. To address this gap, we examine the association between discrimination trajectories and depressive symptoms among black middle-aged and older adults.Data were analyzed from a subsample of black Health and Retirement Study respondents (2006 {\textendash} 2018, N = 2,926, 50+). General discrimination and racial discrimination trajectories were constructed based on the Everyday Discrimination Scale using repeated measures latent profile analyses. We examined the extent to which the association between discrimination trajectories are differentially associated with depressive symptoms (8-item Center for Epidemiologic Studies {\textendash} Depression scale) using negative binomial regression models adjusted for potential confounders. Effect modification by age and gender was tested.Individuals in the persistently high (IRR: 1.70; 95\% CI: 1.49, 1.95) and moderate general discrimination trajectories (IRR: 1.19; 95\% CI: 1.06, 1.33), were more likely to have elevated depressive symptoms in comparison to those in the persistently low trajectory. This relationship was strongest among older adults aged 65+. Respondents in the persistently high racial discrimination trajectory (IRR: 1.50; 95\% CI: 1.29, 1.73) had higher risk of elevated depressive symptoms in comparison to respondents in the persistently low trajectory. Sensitivity analyses indicated that there was an independent association between persistently high racial discrimination trajectory class and elevated depressive symptoms, after adjusting for racial discrimination measured at a single time point.Characterizing longitudinal patterns of perceived discrimination may facilitate the stratification of mental health risk and vulnerability among black middle-aged and older adults. Trajectories of racial discrimination may inform risk of worse depressive symptoms more accurately than a single assessment of discrimination.}, keywords = {Cumulative Inequality, Life-course perspective, Mental Health, Minority aging, Race/ethnicity, Racial Discrimination}, isbn = {2399-5300}, doi = {10.1093/geroni/igaa041}, author = {White, Kellee and Bell, Bethany A and Huang, Shuo J and Williams, David R} } @article {10950, title = {Personality And Self-Rated Health Across Eight Cohort Studies}, journal = {Social Science \& Medicine}, year = {2020}, abstract = {Rationale There is substantial evidence for the predictive value of single-item selfrated health measures for a range of health outcomes. Past research has found an association between personality traits and self-rated health. However, there has not been a multi-cohort large-scale study that has examined this link, and few studies have examined the association between personality and change in self-rated health. Objective To examine the concurrent and longitudinal association between personality and self-rated health.MethodParticipants were individuals aged from 16 to 107 years (N> 46,000) drawn from eight large longitudinal samples from the US, Europe, and Japan. Brief measures of the five-factor model of personality, a single item measure of self-rated health, and covariates (age, sex, and education, and race) were assessed at baseline and self-rated health was measured again 3 to 20 years later. Results In cross-sectional analyses, higher neuroticism was related to lower self-rated health whereas higher extraversion, openness, agreeableness and conscientiousness were associated with better self-rated health across most samples. A meta-analysis revealed that a one standard deviation higher neuroticism was related to more than 50\% higher risk of fair to poor health, whereas a one standard deviation higher extraversion, openness, agreeableness and conscientiousness was associated with at least 15\% lower risk of fair or poor health. A similar pattern was found in longitudinal analyses: personality was associated with risk of self-rated excellent/very good/good health at baseline becoming fair/poor at follow-up. In multilevel analyses, however, personality was weakly related to trajectories of self-rated health and in the opposite of the expected direction. Conclusions The present study shows replicable cross-sectional and small longitudinal associations between personality and self-rated health. This study suggests that lower neuroticism, higher extraversion, openness, agreeableness and conscientiousness are related to more favorable self-evaluations of health.}, keywords = {Adulthood, ELSA, longitudinal, Personality, Self-rated health}, isbn = {0277-9536}, doi = {https://doi.org/10.1016/j.socscimed.2020.113245}, author = {Yannick Stephan and Angelina R Sutin and Martina Luchetti and Hognon, Louis and Canada, Brice and Antonio Terracciano} } @article {10781, title = {Perspectives: The Benefit Receipt Patterns and Labor Market Experiences of Older Workers Who Were Denied Social Security Disability Insurance Benefits on the Basis of Work Capacity}, journal = {Social Security Bulletin}, volume = {80}, year = {2020}, abstract = {This article examines the experiences of Social Security Disability Insurance (DI) applicants aged 51 or older who were initially denied benefits because the disability examiner determined that they could perform either their past work or other work. We use Health and Retirement Study survey data linked to administrative data on benefit application and receipt and earnings from the Social Security Administration. We find that few older DI applicants who were denied benefits on this basis resumed work at a substantial level following denial. More commonly, applicants denied at this stage continued to pursue benefits, often successfully. Nearly two-thirds of initial work capacity-related denials were ultimately allowed DI benefits after appealing the initial decision or reapplying, and our estimates suggest that many of the rest claimed Old-Age and Survivors Insurance benefits before they reached full retirement age.}, keywords = {disability insurance, Social Security}, url = {https://www.ssa.gov/policy/docs/ssb/v80n2/v80n2p25.html}, author = {Jody Schimmel Hyde and April Yanyuan Wu and Gill, Lakhpreet} } @article {Puterman201918455, title = {Predicting mortality from 57 economic, behavioral, social, and psychological factors}, journal = {Proceedings of the National Academy of Sciences}, year = {2020}, abstract = {In our prospective study using nationally representative data from 13,611 adults in the US Health and Retirement Study, we used traditional and machine-learning statistical approaches to reveal the most important factors across the behavioral and social sciences that predict mortality in older adults. In the study, we found that top predictors of mortality spanned all investigated domains, opening up opportunities for future hypothesis generation in observational and clinical studies and the identification of potential new targets for screening and policy.Behavioral and social scientists have identified many nonbiological predictors of mortality. An important limitation of much of this research, however, is that risk factors are not studied in comparison with one another or from across different fields of research. It therefore remains unclear which factors should be prioritized for interventions and policy to reduce mortality risk. In the current investigation, we compare 57 factors within a multidisciplinary framework. These include (i) adverse socioeconomic and psychosocial experiences during childhood and (ii) socioeconomic conditions, (iii) health behaviors, (iv) social connections, (v) psychological characteristics, and (vi) adverse experiences during adulthood. The current prospective cohort investigation with 13,611 adults from 52 to 104 y of age (mean age 69.3 y) from the nationally representative Health and Retirement Study used weighted traditional (i.e., multivariate Cox regressions) and machine-learning (i.e., lasso, random forest analysis) statistical approaches to identify the leading predictors of mortality over 6 y of follow-up time. We demonstrate that, in addition to the well-established behavioral risk factors of smoking, alcohol abuse, and lack of physical activity, economic (e.g., recent financial difficulties, unemployment history), social (e.g., childhood adversity, divorce history), and psychological (e.g., negative affectivity) factors were also among the strongest predictors of mortality among older American adults. The strength of these predictors should be used to guide future transdisciplinary investigations and intervention studies across the fields of epidemiology, psychology, sociology, economics, and medicine to understand how changes in these factors alter individual mortality risk.}, keywords = {Behavioral Symptoms, Mortality, social, transdisciplinary}, issn = {0027-8424}, doi = {10.1073/pnas.1918455117}, author = {Puterman, Eli and Weiss, Jordan and Hives, Benjamin A. and Gemmill, Alison and Karasek, Deborah and Mendes, Wendy Berry and David Rehkopf} } @article {11010, title = {Prehospital and Posthospital Fall Injuries in Older US Adults}, journal = {JAMA Network Open}, volume = {3}, year = {2020}, abstract = {To date, measurement and treatment of older adult fall injury has been siloed within specific care settings, such as a hospital or within a nursing home or community. Little is known about changes in fall risk across care settings. Understanding the occurrence of falls across settings has implications for measuring and incentivizing high-value care across care settings.To estimate the risk of older adult fall injury within and across discrete periods during a 12-month care episode anchored by an acute hospitalization.This cohort study is a longitudinal analysis of 12-month periods that include an anchor hospital stay using national data from 2006 to 2014. Participants included older (aged >=65 years) Medicare fee-for-service beneficiaries from the Health and Retirement Study. Weekly fall injury rates were computed for 4 periods compared with the anchor hospitalization: at baseline (1-6 months before hospitalization), just before (\<1 month before hospitalization), just after (\<1 month after hospitalization), and at follow-up (1-6 months after hospitalization). Piecewise logistic regression models estimated weekly marginal risk of fall injury within each period, adjusting for sociodemographic and health characteristics. Fall injury risks for high-risk beneficiaries with a fall injury during the anchor hospitalization were also estimated. Data analysis was performed from November 2019 to April 2020.Fall injuries.In total, 10 106 anchor hospitalizations for 4101 beneficiaries (mean [SD] age, 77.1 [7.6] years; 5912 hospitalizations among women [58.5\%]) were identified. The overall fall injury risk was 0.77\%. In adjusted models, marginal increases in weekly fall injury risk just before hospitalization (0.27 percentage points [95\% CI, 0.22 to 0.33 percentage points], or 30.0\%; P \< .001) were 4 times greater than decreases just after hospitalization (-0.18 percentage points [95\% CI, -0.23 to -0.13 percentage points], or -9.2\%; P \< .001)]. A greater risk differential before and after hospitalization was observed for patients with an inpatient fall injury (1.89 percentage points [95\% CI, 1.37 to 2.40], or 309.8\%; P \< .001; vs -0.39 percentage points [95\% CI, -0.73 to -0.04], or -11.6\%; P = .03).An episode-based assessment of fall injury illustrates substantial variability in period-specific risks over an extended period including an anchor hospitalization. Risk transitions between periods include sizable increases just before hospitalization that do not fully subside after hospital discharge. Financial incentives to coordinate hospital and posthospital care for patients at risk for fall injury are needed. These could include bundled payments for fall injury episodes that incentivize coordination across settings.}, keywords = {Fall injury, Hospitalization, Medicare}, isbn = {2574-3805}, doi = {https://doi.org/10.1001/jamanetworkopen.2020.13243}, author = {Geoffrey J Hoffman and Mary Tinetti and Ha, Jinkyung and Neil B. Alexander and Lillian C. Min} } @article {Donnelly2020, title = {Race, death of a child, and mortality risk among aging parents in the United States}, journal = {Social Science and Medicine}, volume = {249}, year = {2020}, pages = {112853}, abstract = {The death of a child is a stressful and traumatic life event that has been linked to increased mortality risk among parents. Tragically, black parents are significantly more likely than white parents to lose a child in the United States; however, prior research has not addressed this racial disadvantage in relation to parents{\textquoteright} mortality risk. In this study, we focus on the racial context of the United States to suggest that black parents already face higher mortality rates compared to white parents, and the unequal burden of child death adds to their mortality risk. Using discrete-time event history models, we consider whether the death of a child by midlife is associated with increased mortality risk for black parents and for white parents in mid- to later-life using longitudinal data from the Health and Retirement Study (HRS; 1996{\textendash}2016). Descriptive results show that by midlife, black parents, especially black mothers, experience substantially higher child mortality compared with white parents. At the same time, we find that losing a child prior to midlife is associated with heightened mortality risk for aging black mothers and white mothers. Controlling for educational attainment explains the association between child death and parental mortality risk among white mothers, whereas heightened biopsychosocial and behavioral risk factors explain the association for black mothers. Overall, the death of a child is associated with increased mortality risk for black mothers and for white mothers, but the processes linking child death to parental mortality seem to differ for black and white parents. These findings have implications for policies and interventions that address increased mortality risk for parents following the death of a child. {\textcopyright} 2020 Elsevier Ltd}, keywords = {Bereavement, Death of a child, Minority aging, Mortality, race}, doi = {10.1016/j.socscimed.2020.112853}, author = {Rachel Donnelly and Debra Umberson and Robert A Hummer and Michael A Garcia} } @article {10097, title = {Racial and educational disparities in cognitive life expectancies.}, journal = {The Journals of Gerontology, Series B: Psychological Sciences and Social Sciences}, volume = {75}, year = {2020}, pages = {e105-e112}, abstract = {

OBJECTIVES: We estimate life expectancy with and without dementia for Americans 65 years and older by education and race to examine how these stratification systems combine to shape disparities in later-life cognitive health.

METHOD: Based on the Health and Retirement Study (2000-2014), we use a multivariate, incidence-based life table approach to estimate life expectancy by cognitive health status for race-education groups. The models also simulate group differences in the prevalence of dementia implied by these rates.

RESULTS: The life table results document notable race-education differences in dementia and dementia-free life expectancy, as well as stark differences in implied dementia prevalence. At each education level, blacks can expect to live more years with dementia and they have significantly higher rates of dementia prevalence. This distribution of disparities in the older population is anchored by two groups -- blacks without a high school diploma and whites with some college or more.

DISCUSSION: Dementia experience and dementia burden differ dramatically along race-education lines. Race and education combine to exaggerate disparities and they both have enduring effects. Future research should explicitly consider how race and education combine to influence dementia in the older American population.

}, keywords = {Cognition \& Reasoning, Mortality, Racial/ethnic differences}, issn = {1758-5368}, doi = {10.1093/geronb/gbz046}, author = {Mateo P Farina and Mark D Hayward and Eileen M. Crimmins and Jung K Kim} } @article {Hurd2020117, title = {Reducing cross-wave variability in survey measures of household wealth}, journal = {Journal of Economic and Social Measurement}, volume = {44}, year = {2020}, note = {cited By 0}, pages = {117-139}, abstract = {Survey measures of household wealth often incorporate measurement error. The resulting excess variability in the first difference in wealth makes meaningful statistical inference difficult on changes in household-level wealth. We study the effects of two methods intended to reduce this problem: Asset verification confronts respondents with large discrepancies between wealth reports from the current wave and from the previous wave. Cross-wave imputation uses adjacent wave information in the imputation procedures for missing data. In the U.S. Health and Retirement Study, the corrections from asset verification substantially reduced wave-To-wave changes in wealth. The cross-wave imputations also reduced variation, but to a lesser extent. {\textcopyright} 2019-IOS Press and the authors. All rights reserved.}, keywords = {household income, Panel data, social structure, survey design, United States}, issn = {07479662}, doi = {10.3233/JEM-190465}, author = {Michael D Hurd and Erik Meijer and Moldoff, Michael and Susann Rohwedder} } @article {doi:10.1111/jgs.16414, title = {Residential Setting and the Cumulative Financial Burden of Dementia in the 7 Years Before Death}, journal = {Journal of the American Geriatrics Society}, year = {2020}, type = {Journal}, abstract = {OBJECTIVES Care for older adults with dementia during the final years of life is costly, and families shoulder much of this burden. We aimed to assess the financial burden of care for those with and without dementia, and to explore differences across residential settings. DESIGN Using the Health and Retirement Study (HRS) and linked claims, we examined total healthcare spending and proportion by payer{\textemdash}Medicare, Medicaid, out-of-pocket, and calculated costs of informal caregiving{\textemdash}over the last 7 years of life, comparing those with and without dementia and stratifying by residential setting. SETTING The HRS is a nationally representative longitudinal study of older adults in the United States. PARTICIPANTS We sampled HRS decedents from 2004 to 2015. To ensure complete data, we limited the sample to those 72 years or older at death who had continuous fee-for-service Medicare Parts A and B coverage during the 7-year period (n = 2909). MEASUREMENTS We compared decedents with dementia at last HRS assessment with those without dementia across annual and cumulative 7-year spending measures, and personal characteristics. We present annual and cumulative spending by payer, and the changing proportion of spending by payer over time, comparing those with and without dementia and stratifying results by residential setting. RESULTS We found that, consistent with prior studies, people with dementia experience significantly higher costs, with a disproportionate share falling on patients and families. This pattern is most striking among community residents with dementia, whose families shoulder 64\% of total expenditures (including \$176,180 informal caregiving costs and \$55,550 out-of-pocket costs), compared with 43\% for people with dementia residing in nursing homes (\$60,320 informal caregiving costs and \$105,590 out-of-pocket costs). CONCLUSION These findings demonstrate disparities in financial burden shouldered by families of those with dementia, particularly among those residing in the community. They highlight the importance of considering the residential setting in research, programs, and policies.}, keywords = {community-dwelling older adults, Dementia, health-related costs, Medicare and Medicaid, nursing home}, doi = {10.1111/jgs.16414}, url = {https://onlinelibrary.wiley.com/doi/abs/10.1111/jgs.16414}, author = {Amy Kelley and Kathleen McGarry and Bollens-Lund, Evan and Rahman, Omari-Khalid and Husain, Mohammed and Ferreira, Katelyn B. and Jonathan S Skinner} } @article {11209, title = {The role of consumer and mortgage debt for financial stress.}, journal = {Aging \& Mental Health}, year = {2020}, abstract = {

OBJECTIVES: Financial debt held by older adults in the U.S. has grown over the past two decades. This study examines the extent to which credit cards, other consumer debts, and mortgage debt increase financial stress. Outcome measures of financial stress include the material domain ("bill-paying difficulty") and psychological domain ("ongoing financial strain").

METHOD: We analyzed adults age 62 and older in the 2004 to 2016 waves of the Health and Retirement Study using random-effects logit regressions.

RESULTS: Unsecured consumer debt is associated with more financial stress per dollar than mortgage debt. A detailed assessment of mortgage debt finds that greater levels of both first and secondary mortgages are associated with greater bill-paying difficulty and greater ongoing financial strain. An increase in new mortgage debt obtained after age 62 is associated with an increase in bill-paying difficulty, but is not significantly associated with ongoing financial strain. In contrast, a reduction in mortgage debt since age 62 is associated with lower bill-paying difficulty and lower levels of ongoing financial strain.

CONCLUSION: The relationship between consumer debt, mortgages, and financial stress is nuanced, and depends on both the type and timing of the debt.

}, keywords = {financial stress, mortgage borrowing, Quality of Life, Well-being}, issn = {1364-6915}, doi = {10.1080/13607863.2020.1843000}, author = {C{\"a}zilia Loibl and Stephanie Moulton and Donald Haurin and Edmunds, Chrisse} } @article {11323, title = {The Roles of Marital Dissolution and Subsequent Repartnering on Loneliness in Later Life.}, journal = {The Journal of Gerontology, Series B}, volume = {75}, year = {2020}, pages = {1796-1807}, abstract = {

OBJECTIVES: Loneliness in later life is associated with poorer health and higher risk of mortality. Our study assesses whether gray divorced adults report higher levels of loneliness than the widowed and whether social support or repartnership offset loneliness.

METHOD: Using data from the 2010 and 2012 Health and Retirement Study, we estimated ordinary least squares regression models for women (n = 2,362) and men (n = 1,127) to examine differences in loneliness by dissolution pathway (i.e., divorce versus widowhood), accounting for social support and repartnership.

RESULTS: Divorced men were lonelier than their widowed counterparts. Although social support reduced loneliness among men, the difference between the divorced and widowed persisted. Repartnership assuaged men{\textquoteright}s loneliness and reduced the variation between divorced and widowed men. Among women, the results did not reveal differences in loneliness for the divorced and widowed although social support and repartnership linked to less loneliness.

DISCUSSION: Later-life marital dissolutions increasingly occur through divorce rather than spousal death. Some older adults go on to form new partnerships. Our findings demonstrate the importance of gerontological research widening the lens beyond widowhood to consider the ramifications of later-life divorce and repartnership for well-being.

}, keywords = {Cohabitation, Divorce, Remarriage, Well-being, Widowhood}, issn = {1758-5368}, doi = {10.1093/geronb/gbz121}, author = {Matthew R Wright and Anna M Hammersmith and Susan L. Brown and Lin, I-Fen} } @article {11135, title = {Self-perceptions of aging and domain-specific health outcomes among midlife and later-life couples.}, journal = {Journal of Aging and Health}, year = {2020}, abstract = {

This study places the self-perceptions of aging (SPA)-health link in the couple context and examines how changes in one{\textquoteright}s own and spouse{\textquoteright}s SPA influence multiple health domains and how such associations differ by gender. : Fixed-effects regression models were estimated. Data were drawn from the Health and Retirement Survey ( = 5972). For both husbands and wives, almost all health domains declined when their own SPA became more negative. The spouse{\textquoteright}s SPA were associated with one{\textquoteright}s self-rated health, regardless of gender. Gender differences existed in some cross-spousal health effects; while the husband{\textquoteright}s SPA were associated with his wife{\textquoteright}s depressive symptoms, the wife{\textquoteright}s SPA were associated with her husband{\textquoteright}s physical disability, functional limitations, and chronic diseases. The SPA-health association extends beyond the individual in married persons, demonstrating intertwined health trajectories in older couples. The detrimental effects of ageism might be underestimated if the spillover effects were not considered.

}, issn = {1552-6887}, doi = {10.1177/0898264320966263}, author = {Luo, Meng Sha and Lydia W Li and Rita Xiaochen Hu} } @article {10864, title = {Self-Perceptions of Aging: Factorial Structure and Invariance by Gender}, journal = {The Gerontologist}, year = {2020}, month = {2020}, abstract = {Self-perceptions of aging (SPA){\textemdash}the appraisals people place on their own aging processes{\textemdash}predict well-being in later life. Researchers are increasingly hypothesizing that the overarching construct of SPA is comprised of two factors{\textemdash}positive SPA and negative SPA{\textemdash}and that SPA are gendered. The purpose of this study was to empirically test the hypothesized two-factor structure of SPA and to analyze how the two-factor structure varies between men and women.Data come from the 2012 wave of the Health and Retirement Study (N = 7,029; Mage = 68.08), which includes an 8-item SPA scale. We used confirmatory factor analysis (CFA) to assess (i) the positive SPA and negative SPA two-factor solution for the 8-item scale and (ii) whether the two-factor solution had configural, strong, or weak invariance across men and women.CFAs indicated a two-factor latent structure of the 8-item scale, with SPA being comprised of both a positive SPA factor and a negative SPA factor. The latent structure was the same for both men and women.Results suggest that SPA is a broader construct made up of positive and negative latent factors. Researchers should consider separating the SPA by positive and negative factors to analyze how each factor uniquely shapes health. Moreover, the two-factor solution was equivalent across men and women, possibly because of the generalized nature of the 8-item scale. Researchers can use the 8-item scale similarly for men and women and should continue to elucidate possible gender differences in SPA.}, keywords = {Confirmatory factor analyses, Measurement, Views on aging}, isbn = {0016-9013}, doi = {10.1093/geront/gnaa059}, author = {Turner, Shelbie G and Hooker, Karen and G John Geldhof} } @article {10.1093/ageing/afaa043, title = {Self-reported vision and hallucinations in older adults: results from two longitudinal US health surveys}, journal = {Age and Ageing}, year = {2020}, note = {afaa043}, type = {Journal}, abstract = {Vision loss may be a risk factor for hallucinations, but this has not been studied at the population level.To determine the association between self-reported vision loss and hallucinations in a large community-based sample of older adults, we performed a cross-sectional and longitudinal analysis of two large, nationally representative US health surveys: the National Health and Aging Trends Study (NHATS) and the Health and Retirement Study (HRS). Visual impairment and hallucinations were self- or proxy-reported. Multivariate single and mixed effects logistic regression models were built to examine whether visual impairment and history of cataract surgery were associated with hallucinations.In NHATS (n = 1520), hallucinations were more prevalent in those who reported difficulty reading newspaper print (OR 1.77, 95\% confidence interval (CI): 1.32{\textendash}2.39) or recognising someone across the street (OR 2.48, 95\% CI: 1.86{\textendash}3.31) after adjusting for confounders. In HRS (n = 3682), a similar association was observed for overall (OR 1.32, 95\% CI: 1.08{\textendash}1.60), distance (OR 1.61, 95\% CI: 1.32{\textendash}1.96) and near eyesight difficulties (OR 1.52, 95\% CI: 1.25{\textendash}1.85). In neither sample was there a significant association between cataract surgery and hallucinations after adjusting for covariates.Visual dysfunction is associated with increased odds of hallucinations in the older US adult population. This suggests that the prevention and treatment of vision loss may potentially reduce the prevalence of hallucinations in older adults.}, keywords = {blindness, Hallucinations, Health Surveys, Older adult, Proxy, self-report, vision}, issn = {0002-0729}, doi = {10.1093/ageing/afaa043}, url = {https://academic.oup.com/ageing/advance-article-abstract/doi/10.1093/ageing/afaa043/5816673}, author = {Ali G Hamedani and Thibault, Dylan P and Shea, Judy A and Allison W Willis} } @article {11107, title = {Sense of Purpose in Life and Likelihood of Future Illicit Drug Use or Prescription Medication Misuse.}, journal = {Psychosomatic Medicine}, volume = {82}, year = {2020}, month = {2020 09}, pages = {715-721}, abstract = {

OBJECTIVE: In the United States, 28.6 million people used illicit drugs or misused prescription drugs in the last 30 days. Thus, identifying factors linked with lower likelihood of future drug misuse is an important target for research and practice. Sense of purpose in life has been linked with better behavioral and physical health outcomes. Furthermore, a higher sense of purpose may reduce the likelihood of drug misuse because it has been linked with several protective factors including enhanced ability to handle stress, higher pain tolerance, and lower impulsivity. However, the association between sense of purpose and drug misuse has been understudied. Thus, we tested whether people with a higher sense of purpose at baseline had a lower likelihood of future drug misuse 9 to 10 years later.

METHODS: This study included 3535 middle-aged adults from the Midlife in the United States Study who were not misusing drugs at baseline. Using multiple logistic regression models, we assessed whether baseline purpose in life was associated with risk of misusing drugs 9 to 10 years later.

RESULTS: Among respondents not misusing drugs at baseline, people in the highest quartile of purpose (versus lowest quartile) had a substantially lower likelihood of future drug misuse in a model adjusting for demographic variables (odds ratio = 0.50, 95\% confidence interval = 0.31-0.83). Associations remained evident after additionally adjusting for psychological distress, baseline health, and health behaviors.

CONCLUSIONS: A growing knowledge base suggests that a sense of purpose can be increased. Additional research is needed to evaluate sense of purpose as a novel target in the prevention and reduction of drug misuse.

}, keywords = {Drug use, Sense of purpose}, issn = {1534-7796}, doi = {10.1097/PSY.0000000000000842}, author = {Eric S Kim and Carol D Ryff and Hassett, Afton and Brummett, Chad and Yeh, Charlotte and Victor J Strecher} } @article {10649, title = {Is social capital protective against hospital readmissions?}, journal = {BMC Health Services Research}, volume = {20}, year = {2020}, pages = {248}, type = {Journal}, abstract = {To evaluate the association between social capital and 30-day readmission to the hospital among Medicare beneficiaries overall, beneficiaries with dementia and related memory disorders, and beneficiaries with dual eligibility for Medicaid.}, keywords = {Aging, Cohort Analysis, health policy}, isbn = {1472-6963}, doi = {10.1186/s12913-020-05092-x}, author = {Zlotnick, Hanna and Geoffrey J Hoffman and Nuliyalu, Ushapoorna and Engler, Tedi A. and Kenneth M. Langa and Ryan, Andrew M.} } @article {11316, title = {Social Engagement and Cognitive Function of Older Adults in Mexico and the United States}, journal = {Innovation in Aging}, volume = {4}, year = {2020}, pages = {560 - 561}, abstract = {Social engagement is linked to better cognition, but it is unclear if the social engagement of husbands and wives influences their own cognition as well as each other{\textquoteright}s cognition in two very different country contexts. Data on married couples come from the 2001 Mexican Health and Aging Study (MHAS) and the 2000 Health and Retirement Study (HRS), with follow-up cognition measured in 2012. Structural equation models (SEM) were used to test the actor-partner interdependence model on the association of social engagement with cognition. In Mexico wives{\textquoteright} social engagement benefited their own cognition as well as their husbands{\textquoteright}, but husband{\textquoteright}s social engagement was unrelated to cognition. In the U.S. both wives{\textquoteright} and husbands{\textquoteright} social engagement benefited their own cognition, but not each other{\textquoteright}s. Results suggest asymmetric patterns of actor-partner interdependence in Mexico, possibly reflecting more traditional social roles of women and co-dependence within couples, but more independence within U.S. couples.}, keywords = {Cognition, Mexico, MHAS, social engagement}, isbn = {2399-5300}, doi = {https://doi.org/10.1093/geroni/igaa057.1846}, author = {Bret Howrey and Jaqueline C Avila and Brian Downer and Rebeca Wong} } @article {RePEc:crr:issbrf:ib2020-2, title = {Social Security Is a Great Equalizer}, year = {2020}, institution = {Center for Retirement Research}, abstract = {As the U.S. population becomes more diverse, it will be increasingly important for policymakers addressing Social Security{\textquoteright}s solvency to understand the extent to which various racial and ethnic groups rely on Social Security versus other sources of retirement wealth. Yet, to date, studies on retirement wealth have tended not to focus on race and ethnicity and have largely ignored the role of Social Security. This brief, based on a recent paper, uses data from the Health and Retirement Study (HRS) to document the retirement resources of white, black, and Hispanic households at various points in the wealth distribution for five cohorts of 51-56 year olds between 1992 and 2016. The discussion proceeds as follows. The first section explains the calculation of retirement wealth. The second section shows how Social Security reduces retirement wealth inequality by race and ethnicity for typical households in each cohort. The third section looks at the impact of Social Security on retirement wealth inequality across wealth quintiles in a single year. The fourth section shifts from wealth to income to examine replacement rates {\textendash} the ratio of projected retirement income to pre-retirement earnings. The final section concludes that, as policymakers consider changes to bring Social Security into fiscal balance, the distributional impact of any benefit cuts with respect to minority groups may be worth considering.}, keywords = {Social Security}, url = {https://ideas.repec.org/p/crr/issbrf/ib2020-2.html}, author = {Wenliang Hou and Geoffrey T. Sanzenbacher} } @article {10994, title = {Social Support, Everyday Discrimination, and Depressive Symptoms Among Older African Americans: A Longitudinal Study}, journal = {Innovation in Aging}, volume = {4}, year = {2020}, pages = {igaa032}, abstract = {The purpose of the study is to explore the long-term effects of everyday discrimination on depressive symptoms among older African Americans, as well as the moderating role of social support in this association.Mixed-effects negative binomial regression analyses were performed on data selected from six waves of the Health and Retirement Study (2006-2016; baseline N=1144). The number of depressive symptoms was calculated based on an 8-item CES-D measure. Everyday discrimination was measured by using a 6-item scale. Contact with and perceived support from extended family and friends were assessed.Older African Americans who experienced more frequent perceived discrimination had more depressive symptoms over time. Significant interactions between discrimination and perceived support from extended family and friends were found, indicating that among older African Americans who reported higher support from extended family and friends, perceived discrimination was positively associated with depressive symptoms over time. However, perceived discrimination and depressive symptoms were not longitudinally related among those who reported lower levels of perceived support.This is one of the few studies to examine the effects of discrimination on depressive symptoms over time and the first longitudinal study to test the role of social support in coping with discrimination in older African Americans. This study extends cross-sectional works on discrimination and mental health, indicating that experiences of discrimination can result in worse mental health over time. The significant interactions are consistent with the resource mobilization framework, which suggests that individuals who are more negatively affected by discrimination (more depressive symptoms) are more likely to reach out to friends and family to cope with discrimination.Older African Americans who experience more discrimination and depressive symptoms are more likely to seek support from extended family and friends for coping with discrimination over time. The study findings suggest that older African Americans may benefit from interventions based on stress coping resources via support from extended family and friends in coping with discrimination.}, keywords = {Black older adults, family social support networks, friendship social support networks, Mental Health, unfair treatment}, isbn = {2399-5300}, doi = {10.1093/geroni/igaa032}, author = {Qin, Weidi and Ann W Nguyen and Mouzon, Dawne M and Tyrone C Hamler and Wang, Fei} } @article {10.1093/gerona/glz266, title = {Socioeconomic Inequalities in Disability-free Life Expectancy in Older People from England and the United States: A Cross-national Population-Based Study}, journal = {The Journals of Gerontology: Series A}, volume = {75}, year = {2020}, month = {01}, pages = {906-913}, abstract = {We examined socioeconomic inequalities in disability-free life expectancy in older men and women from England and the United States and explored whether people in England can expect to live longer and healthier lives than those in the United States.We used harmonized data from the Gateway to Global Aging Data on 14,803 individuals aged 50+ from the U.S. Health and Retirement Study (HRS) and 10,754 from the English Longitudinal Study of Ageing (ELSA). Disability was measured in terms of impaired activities and instrumental activities of daily living. We used discrete-time multistate life table models to estimate total life expectancy and life expectancy free of disability.Socioeconomic inequalities in disability-free life expectancy were of a similar magnitude (in absolute terms) in England and the United States. The socioeconomic disadvantage in disability-free life expectancy was largest for wealth, in both countries: people in the poorest group could expect to live seven to nine fewer years without disability than those in the richest group at the age of 50.Inequalities in healthy life expectancy exist in both countries and are of similar magnitude. In both countries, efforts in reducing health inequalities should target people from disadvantaged socioeconomic groups.}, keywords = {Cross-National, Disability, Healthy life expectancy, socioeconomic status}, issn = {1079-5006}, doi = {10.1093/gerona/glz266}, author = {Zaninotto, Paola and G David Batty and Stenholm, Sari and Ichiro Kawachi and Hyde, Martin and Goldberg, Marcel and Westerlund, Hugo and Vahtera, Jussi and Head, Jenny} } @article {11311, title = {Spousal Activity Limitations and Depressive Symptoms: Benefits of Spousal Caregiving and Costs of Spousal Pain}, journal = {Innovation in Aging}, volume = {4}, year = {2020}, pages = {354}, abstract = {Experiencing difficulties in performing basic activities of daily living poses significant challenges for older adults living with such limitations and also for their spouses. A growing body of evidence demonstrates cross-spousal linkages between activity limitations and depressive symptoms. However, under what conditions these linkages may be strengthened or weakened has received little attention in the literature. We addressed this gap by examining whether a) providing spousal caregiving and b) spousal pain moderated the link between spousal activity limitations and one{\textquoteright}s own depressive symptoms. We used seven waves of longitudinal household data from the Health and Retirement Study (2004-2016; N=12,369) to estimate within-person associations between spousal activity limitations and depressive symptoms, focusing on the moderating roles of caregiving behavior and spousal pain. In particular, asymmetric fixed effects models were used to estimate the unique effects of transitioning into a spousal caregiver role in the context of spousal activity limitations. Results from multilevel models were gendered. For wives (but not for husbands), transitioning into a caregiver role to provide spousal care alleviated depressive symptoms associated with spousal activity limitations, whereas depressive symptoms were increased when husbands with activity limitations also reported frequent, moderate to severe pain. Our findings indicate that the link between spousal activity limitations and depressive symptoms is not uniform, and that the cross-spousal association may best be understood when relevant contextual factors are considered. The findings are also in line with recent studies showing that caregiving may also lead to enhanced well-being and reduced mortality risk under some circumstances.}, keywords = {activity limitations, Caregiving, Depressive symptoms, pain, Spouses}, isbn = {2399-5300}, doi = {10.1093/geroni/igaa057.1138}, author = {Sae Hwang Han and Kim, Kyungmin and Jeffrey A Burr} } @article {11812, title = {Three fast facts: Self-employment trends among older Americans}, year = {2020}, institution = {Center on Aging \& Work at Boston College}, address = {Newton, MA}, abstract = {How important is self-employment as a form of work among older Americans? There are several ways you can answer this question, and this research brief will cover three general trends in self-employment rates.}, keywords = {self employment}, url = {https://dlib.bc.edu/islandora/object/bc-ir\%3A108936}, author = {Cal J. Halvorsen and Jacquelyn Boone James} } @article {10977, title = {Trends in the Risk of Cognitive Impairment in the United States, 1996{\textendash}2014}, journal = {Epidemiology}, volume = {31}, year = {2020}, pages = {745-754}, abstract = {Background: Accumulating evidence suggests risk of cognitive impairment is declining in high-income countries. Much of this research uses longitudinal surveys in which learning over repeated tests may bias results. We analyze trends in cognitive impairment in the United States, accounting for prior test experience and selective mortality. Methods: We use the Health and Retirement Study, a population-based, nationally representative panel dataset and include individuals ages 50 years and older in 1996{\textendash}2014 (n = 32,784). We measure cognitive impairment and dementia using standard cutpoints of the modified Telephone Interview for Cognitive Status. We estimate logistic regression models for any impairment and dementia over time, adjusting for age, sex, and race/ethnicity, comparing models with and without adjustment for practice effects and education. We examine heterogeneity in trends by age, sex, race/ethnicity, and education. Results: Models not controlling for test experience suggest that risk of cognitive impairment and dementia decreased over the study period. Controlling for test experience reverses the trend. In our primary models, prevalence of any cognitive impairment increased for women from 18.7\% to 21.2\% (annual change 0.7\%, 95\% confidence interval [CI], 0.1\%, 1.3\%) and for men from 17.6\% to 21.0\% (annual change 1.0\%, CI, 0.5\%, 1.4\%). For dementia, women{\textquoteright}s annual increase was 1.7\% (CI, 0.8\%, 2.6\%) and men{\textquoteright}s 2.0\% (CI, 1.0\%, 2.9\%). If not for education, the increase would have been stronger. Increased risk was particularly rapid for Latinas, the least educated, and older ages. Conclusions: Risk of cognitive impairment increased from 1996 to 2014. Uncovering determinants of increasing cognitive impairment risk should become a research priority. See video abstract: http://links.lww.com/EDE/B702.}, keywords = {cognitive impairment, Dementia; Learning, Practice effects, Trends}, isbn = {1044-3983}, doi = {10.1097/EDE.0000000000001219}, author = {Jo Mhairi Hale and Daniel C Schneider and Gampe, Jutta and Neil K Mehta and Mikko Myrskyl{\"a}} } @article {10701, title = {Using syndrome mining with the Health and Retirement Study to identify the deadliest and least deadly frailty syndromes}, journal = {Scientific Reports}, volume = {10}, year = {2020}, type = {Journal}, abstract = {Syndromes are defined with signs or symptoms that occur together and represent conditions. We use a data-driven approach to identify the deadliest and most death-averse frailty syndromes based on frailty symptoms. A list of 72 frailty symptoms was retrieved based on three frailty indices. We used data from the Health and Retirement Study (HRS), a longitudinal study following Americans aged 50 years and over. Principal component (PC)-based syndromes were derived based on a principal component analysis of the symptoms. Equal-weight 4-item syndromes were the sum of any four symptoms. Discrete-time survival analysis was conducted to compare the predictive power of derived syndromes on mortality. Deadly syndromes were those that significantly predicted mortality with positive regression coefficients and death-averse ones with negative coefficients. There were 2,797 of 5,041 PC-based and 964,774 of 971,635 equal-weight 4-item syndromes significantly associated with mortality. The input symptoms with the largest regression coefficients could be summed with three other input variables with small regression coefficients to constitute the leading deadliest and the most death-averse 4-item equal-weight syndromes. In addition to chance alone, input symptoms{\textquoteright} variances and the regression coefficients or p values regarding mortality prediction are associated with the identification of significant syndromes.}, keywords = {Epidemiology, Geriatrics}, isbn = {2045-2322}, doi = {10.1038/s41598-020-60869-8}, author = {Yi-Sheng Chao and Chao-Jung Wu and Hsing-Chien Wu and Hui-Ting Hsu and Tsao, Lien-Cheng and Cheng, Yen-Po and Lai, Yi-Chun and Wei-Chih Chen} } @article {10828, title = {Validation of a hybrid approach to standardize immunophenotyping analysis in large population studies: The Health and Retirement Study}, journal = {Scientific Reports}, volume = {10}, year = {2020}, pages = {8759}, abstract = {Traditional manual gating strategies are often time-intensive, place a high burden on the analyzer, and are susceptible to bias between analyzers. Several automated gating methods have shown to exceed performance of manual gating for a limited number of cell subsets. However, many of the automated algorithms still require significant manual interventions or have yet to demonstrate their utility in large datasets. Therefore, we developed an approach that utilizes a previously published automated algorithm (OpenCyto framework) with a manually created hierarchically cell gating template implemented, along with a custom developed visualization software (FlowAnnotator) to rapidly and efficiently analyze immunophenotyping data in large population studies. This approach allows pre-defining populations that can be analyzed solely by automated analysis and incorporating manual refinement for smaller downstream populations. We validated this method with traditional manual gating strategies for 24 subsets of T cells, B cells, NK cells, monocytes and dendritic cells in 931 participants from the Health and Retirement Study (HRS). Our results show a high degree of correlation (r >= 0.80) for 18 (78\%) of the 24 cell subsets. For the remaining subsets, the correlation was low (<0.80) primarily because of the low numbers of events recorded in these subsets. The mean difference in the absolute counts between the hybrid method and manual gating strategy of these cell subsets showed results that were very similar to the traditional manual gating method. We describe a practical method for standardization of immunophenotyping methods in large scale population studies that provides a rapid, accurate and reproducible alternative to labor intensive manual gating strategies.}, keywords = {Bioinformatics, high-throughput screening}, isbn = {2045-2322}, doi = {10.1038/s41598-020-65016-x}, author = {Hunter-Schlichting, DeVon and Lane, John and Cole, Benjamin and Flaten, Zachary and Barcelo, Helene and Ramasubramanian, Ramya and Cassidy, Erin and Jessica Faul and Eileen M. Crimmins and Pankratz, Nathan and Bharat Thyagarajan} } @article {11299, title = {Vision and Hearing Impairments in Relation to Disability-Free Life Expectancy in People From England and the United States}, journal = {Innovation in Aging}, volume = {4}, year = {2020}, pages = {560}, abstract = {Both hearing and vision impairments are some of the most common deficits experienced by older adults. We examined the impact of self-reported vision and hearing impairments on disability-free life expectancy (DFLE). We used harmonized data from the Gateway to Global Aging Data from the US Health and Retirement Study (HRS) and the English Longitudinal Study of Ageing (ELSA). We used discrete-time multistate life table models to estimate disability-free life expectancy by sex, age and country. In both countries and at all ages either vision or hearing impairment was associated with shorter DFLE compared to those who reported no impairments. Reporting both vision and hearing impairments reduced DFLE. For example, at the age of 50, men and women with both vision and hearing impairments could expect to live up to 12 fewer years free from disability compared with men and women with no impairments, similar results were found in both countries.}, keywords = {disability-free life expectancy, Hearing impairment, vision impairment}, isbn = {2399-5300}, doi = {10.1093/geroni/igaa057.1843}, author = {Zaninotto, Paola and Giorgio Di Gessa and Head, Jenny} } @article {HAN2020112970, title = {Volunteering, polygenic risk for Alzheimer{\textquoteright}s disease, and cognitive functioning among older adults}, journal = {Social Science \& Medicine}, volume = {253}, year = {2020}, type = {Journal}, abstract = {Objective In the context of the public health burden posed by increases in Alzheimer{\textquoteright}s Disease (AD) prevalence around the globe and the related research efforts to identify modifiable risk factors for the disease, we sought to provide an empirical test of earlier claims that volunteering may be considered as a health intervention that could help to prevent or delay the onset of AD. Method Using nine waves of panel data from the U.S. Health and Retirement Study (n=9,697), we examined whether volunteering conferred cognitive health benefits in later life and whether volunteering served a gene-regulatory function to help alleviate cognitive decline associated with polygenic risk for AD. Multilevel models were used to estimate associations between volunteering, polygenic risk for AD, and cognitive functioning over time. Results We found robust within-person associations between volunteering (assessed as volunteer status and time commitment) and cognitive functioning over time, such that volunteering was associated with higher levels of cognitive functioning and slower cognitive decline. The findings also provided evidence that the within-person associations for volunteering and cognitive decline were more pronounced for older adults at higher genetic risk for developing AD. Conclusions Our findings are in line with a growing body of theoretical frameworks and empirical evidence suggesting that prosocial behaviors are directly associated with biological systems and may modify gene regulation to confer health benefits. The analytic approach taken in this study also provided a useful framework for investigating the effectiveness of other modifiable risk factors that vary over time in the context of cognitive decline related to genetic risk for AD.}, keywords = {cognitive aging, Cognitive decline, Dementia, Health intervention, Prosocial Behavior, social engagement, Social integration}, issn = {0277-9536}, doi = {10.1016/j.socscimed.2020.112970}, url = {https://www.ncbi.nlm.nih.gov/pubmed/32278238}, author = {Sae Hwang Han and J Scott Roberts and Jan E Mutchler and Jeffrey A Burr} } @mastersthesis {11231, title = {Whose Good Death? Understanding Inequality and the End of Life}, volume = {Doctor of Philosophy}, year = {2020}, school = {University of Michigan}, address = {Ann Arbor, MI}, abstract = {Traditionally disadvantaged groups are more likely to want life-sustaining treatments and are the beneficiaries of greater spending and intervention at the end of life, yet these outcomes are considered disadvantageous by clinicians and scholars. This dissertation investigates how diverse individuals experience end-of-life health care, and how and when differences become disparities. First, I use Health and Retirement Survey data to demonstrate racial and socioeconomic differences in end-of-life preferences and decisions and demonstrate preferences for more aggressive treatment are correlated with a lower likelihood of congruent decisions. Second, I employ ethnographic and interview methods to examine communication and decision-making about life-sustaining treatments and find that population-level inequities arise through 1) clinical patterns of valuation and standardization in medicine, and 2) differences in institutional resources among hospitals that treat demographically different populations. Collectively, my findings reinforce the need for a nuanced understanding of the mechanisms that produce inequality when designing health care interventions focused on alleviating disparities. Further, this research reveals how cultural tastes influence the clinical valuation of treatments and provides clinicians and policymakers with strategies for improving the health care experiences of disadvantaged groups.}, keywords = {Death \& Dying, Health Care, socioeconomic status}, url = {https://deepblue.lib.umich.edu/handle/2027.42/162835}, author = {Hauschildt, Katrina E.} } @article {hou_munnell_sanzenbacher_li_2020, title = {Why are US men retiring later?}, journal = {Journal of Pension Economics and Finance}, volume = {19}, year = {2020}, pages = {442{\textendash}457}, abstract = { Over the past two decades, the share of individuals claiming Social Security at the Early Eligibility Age has dropped and the average retirement age has increased. At the same time, Social Security rules have changed substantially, employer-sponsored retirement plans have shifted from defined benefit (DB) to defined contribution (DC), health has improved, and mortality has decreased. In theory, all of these changes could lead to a trend toward later claiming. Disentangling the effect of any one change is difficult because they have been occurring simultaneously. This paper uses the Gustman and Steinmeier structural model of retirement timing to investigate which of these changes matter most by simulating their effects on the original cohort (1931{\textendash}1941) of the Health and Retirement Study (HRS). The predicted behavior is then compared with the actual retirements of the Early Boomer cohort (1948{\textendash}1953) to see how much of the later cohort{\textquoteright}s delayed claiming and retirement can be explained by these changes. The Early Boomer cohort was less likely to be fully retired than the HRS cohort at both age 62 (36.7\% vs. 44.0\%) and age 64 (49.5\% vs. 53.9\%). The model suggests that the shift from DB toward DC plans was the biggest contributor to these declines, followed by better health. Social Security rules and improvements in mortality played smaller roles.}, keywords = {Pension plans, Retirement Decision, retirement timing, Social Security, structural model}, doi = {10.1017/S1474747218000331}, author = {Wenliang Hou and Alicia H. Munnell and Geoffrey T. Sanzenbacher and Yinji Li} } @article {RePEc:crr:issbrf:ib2020-4, title = {Why Do Late Boomers Have So Little Retirement Wealth?}, year = {2020}, institution = {Center for Retirement Research at Boston College }, type = {Report}, address = {Boston}, abstract = {Over the last 40 years, the retirement system has shifted from defined benefit plans to defined contribution plans, primarily 401(k)s and Individual Retirement Accounts (IRAs). This shift has been accompanied by a decline in Social Security benefits relative to pre-retirement earnings as the program{\textquoteright}s Full Retirement Age has moved from 65 to 67. Thus, the expected pattern when examining retirement wealth across cohorts is relatively less wealth from defined benefit plans and Social Security and much more from 401(k)s and IRAs. However, the numbers for the most recent cohort in the Health and Retirement Study {\textendash} the Late Boomers {\textendash} show not only the predicted declines in defined benefit plans and Social Security but also an unexpected drop in 401(k)/IRA assets. This drop is alarming given that Late Boomers, who were ages 51-56 in 2016, would have spent the majority of their careers in a defined contribution world. This brief is a first pass at trying to explain why this younger cohort has less in 401(k)/IRA assets than older cohorts had at the same age and what that means for the future of retirement security. The discussion proceeds as follows. The first section identifies the cohorts that are examined and the calculation of retirement wealth. The second section identifies a turn in the fortunes of Late Boomers during the Great Recession, when a significant share stopped working. But lack of employment does not explain the whole problem, so the third section follows working households and finds that after the Great Recession they had lower earnings, less 401(k) participation, and flat 401(k) balances, ending up well below earlier cohorts. A look at more recent cohorts offers a mixed picture for the future. The final section concludes that the Late Boomers{\textquoteright} low 401(k)/IRA wealth can be explained by particularly high levels of unemployment during the Great Recession and more reliance on lower-paid jobs when they re-entered the labor market. Why they were so hard hit, wh}, keywords = {Retirement wealth, Social Security}, url = {https://crr.bc.edu/wp-content/uploads/2020/02/IB_20-4.pdf}, author = {Anqi Chen and Wenliang Hou and Alicia H. Munnell} } @article {RePEc:dem:wpaper:wp-2020-006, title = {Working and disability expectancies at old ages: The role of childhood circumstances and education}, number = {WP-2020-006}, year = {2020}, institution = {Max Planck Institute for Demographic Research}, address = {Rostock, Germany}, abstract = {The ability to work at older ages depends on health and education. Both accumulate starting very early in life. We assess how childhood disadvantages combine with education to affect working and health trajectories. Applying multistate period life tables to data from the Health and Retirement Study (HRS) for the period 2008-2014, we estimate how the residual life expectancy at age 50 is distributed in number of years of work and disability, by number of childhood disadvantages, gender, and race/ethnicity. Our findings indicate that number of childhood disadvantages is negatively associated with work and positively with disability, irrespective of gender and race/ethnicity. Childhood disadvantages intersect with low education resulting in shorter lives, and redistributing life years from work to disability. Among the highly educated, health and work differences between groups of childhood disadvantage are small. Combining multistate models and inverse probability weighting, we show that the return of high education is greater among the most disadvantaged.}, keywords = {Disability, early childhood, Education, length of working life, Markov chains, Race/ethnicity, USA}, doi = {10.4054/MPIDR-WP-2020-006}, author = {Angelo Lorenti and Christian Dudel and Jo Mhairi Hale and Mikko Myrskyl{\"a}} } @article {10148, title = {Analysis of pleiotropic genetic effects on cognitive impairment, systemic inflammation, and plasma lipids in the Health and Retirement Study.}, journal = {Neurobiology of Aging}, volume = {80}, year = {2019}, pages = {173-186}, abstract = {Variants associated with modulation of c-reactive protein (CRP) and plasma lipids have been investigated for polygenic overlap with Alzheimer{\textquoteright}s disease risk variants. We examined pleiotropic genetic effects on cognitive impairment conditioned on genetic variants (SNPs) associated with systemic inflammation as measured by CRP and with plasma lipids using data from the Health and Retirement Study. SNP enrichment was observed for cognitive impairment conditioned on the secondary phenotypes of plasma CRP and lipids. Fold enrichment of 100\%-800\% was observed for increasingly stringent p-value thresholds for SNPs associated with cognitive impairment conditional on plasma CRP, 80\%-800\% for low-density lipoprotein, and 80\%-600\% for total cholesterol. Significant associations (false discovery rate Q <= 0.05) between cognitive impairment, conditional with either CRP, low-density lipoprotein, or total cholesterol, were found for the locus on chromosome 19 that contains the APOE, TOMM40, APOC1, and PVRL2 genes. Relative numbers of significant SNPs in each of the genes differed by the conditional associations with the secondary phenotypes. Biological interpretation of both the genetic pleiotropy results and the individual genome-wide association results showed that the variants and proximal genes identified are involved in multiple pathological processes including cholesterol metabolism, inflammation, and mitochondrial transport. These findings are potentially important for Alzheimer{\textquoteright}s disease risk prediction and development of novel therapeutic approaches.}, keywords = {Cognitive Ability, Genetics, Inflammation}, issn = {1558-1497}, doi = {10.1016/j.neurobiolaging.2018.10.028}, author = {Michael W Lutz and Casanova, Ramon and Saldana, Santiago and Kuchibhatla, Maragatha and Brenda L Plassman and Kathleen M Hayden} } @article {9756, title = {Are Spouses{\textquoteright} Sleep Problems a Mechanism Through Which Health is Compromised? Evidence Regarding Insomnia and Heart Disease.}, journal = {Annals of Behavioral Medicine}, volume = {53}, year = {2019}, pages = {345-357}, abstract = {

Background: Symptoms of insomnia have been widely identified as risk factors for health, including heart disease. Despite the expansive and growing literature on health concordance among coupled individuals, few studies have examined insomnia as a shared risk factor for heart disease among middle-aged and older couples.

Purpose: This study examined the association between insomnia and incident heart disease among couples. A dyadic modeling approach was employed to investigate the relationships between one{\textquoteright}s own insomnia and partners{\textquoteright} insomnia for the risk of incident heart disease for each partner.

Methods: Data from the 2010, 2012, and 2014 Health and Retirement Study were utilized in a prospective research design (N = 3,221 couples). Actor-partner interdependence models were employed to estimate actor and partner effects of insomnia symptoms for incident heart disease over the 4 year observation period.

Results: Insomnia symptoms measured at baseline were related to an increased risk for heart disease for husbands, whereas for wives the association was attenuated after other health measures were controlled. Wives{\textquoteright} insomnia was related to an increased risk of incident heart disease for husbands but husbands{\textquoteright} insomnia was not related to wives{\textquoteright} risk of heart disease.

Conclusions: This study showed how subjective insomnia symptoms among middle-aged and older adults in intimate partnerships are associated with their heart disease risk. Further research is needed to verify the results with objective measures of sleep problems and heart disease.

}, keywords = {Depressive symptoms, Heart disease, Marriage, Sleep}, issn = {1532-4796}, doi = {10.1093/abm/kay048}, author = {Shih, Yao-Chi and Sae Hwang Han and Jeffrey A Burr} } @article {2019-73776-00920191201, title = {Are US older adults getting lonelier? Age, period, and cohort differences.}, journal = {Psychology and Aging}, volume = {34}, year = {2019}, pages = {1144 - 1157}, abstract = {Media portrayals of a loneliness {\textquoteright}epidemic{\textquoteright} are premised on an increase in the proportion of people living alone and decreases in rates of civic engagement and religious affiliation over recent decades. However, loneliness is a subjective perception that does not correspond perfectly with objective social circumstances. In this study, we examined whether perceived loneliness is greater among the Baby Boomers{\textemdash}individuals born 1948{\textendash}1965{\textemdash}relative to those born 1920{\textendash}1947 and whether older adults have become lonelier over the past decade (2005{\textendash}2016). We used data from the National Social Life, Health and Aging Project and from the Health and Retirement Study collected during 2005{\textendash}2016 to estimate differences in loneliness associated with age, birth year, and survey time point. Overall, loneliness decreased with age through the early 70s, after which it increased. We found no evidence that loneliness is substantially higher among the Baby Boomers or that it has increased over the past decad}, keywords = {Age differences, age{\textendash}period{\textendash}cohort effects, Aging, Baby Boom cohorts, civic engagement, Cohort Analysis, Community Involvement, Epidemics, Generational Differences, Living Alone, Loneliness, religious affiliation, Test Construction}, issn = {0882-7974}, doi = {10.1037/pag0000365}, url = {https://www.ncbi.nlm.nih.gov/pubmed/31804118}, author = {Louise C Hawkley and Wroblewski, Kristen and Kaiser, Till and Luhmann, Maike and Schumm, L. Philip} } @article {delaFuente20191906, title = {Are younger cohorts in the USA and England ageing better?}, journal = {International journal of epidemiology}, volume = {48}, year = {2019}, note = {cited By 0}, pages = {1906-1913}, abstract = {BACKGROUND: Whether worldwide increases in life expectancy are accompanied by a better health status is still a debate. People age differently, and there is a need to disentangle whether healthy-ageing pathways can be shaped by cohort effects. This study aims to analyse trends in health status in two large nationally representative samples of older adults from England and the USA. METHODS: The sample comprised 55 684 participants from the first seven waves of the English Longitudinal Study of Ageing (ELSA), and the first 11 waves of the Health and Retirement Study (HRS). A common latent health score based on Bayesian multilevel item response theory was used. Two Bayesian mixed-effects multilevel models were used to assess cohort effects on health in ELSA and HRS separately, controlling for the effect of household wealth and educational attainment. RESULTS: Similar ageing trends were found in ELSA (β = -0.311; p < 0.001) and HRS (β = -0.393; p < 0.001). The level of education moderated the life-course effect on health in both ELSA (β = -0.082; p < 0.05) and HRS (β = -0.084; p < 0.05). A birth-year effect was found for those belonging to the highest quintiles of household wealth in both ELSA (β = 0.125; p < 0.001) and HRS (β = 0.170; p < 0.001). CONCLUSIONS: Health inequalities have increased in recent cohorts, with the wealthiest participants presenting a better health status in both the USA and English populations. Actions to promote health in the ageing population should consider the increasing inequality scenario, not only by applying highly effective interventions, but also by making them accessible to all members of society. {\textcopyright} The Author(s) 2019; all rights reserved. Published by Oxford University Press on behalf of the International Epidemiological Association.}, keywords = {Aged, Aging, Article, Cohort Analysis, cultural factor, Education, England, Englishman, Female, Health Status, Household, human, human experiment, human tissue, longitudinal study, major clinical study, Male, mental capacity, Retirement, theoretical study}, issn = {14643685}, doi = {10.1093/ije/dyz126}, author = {de la Fuente, J. and Francisco F{\'e}lix Caballero and Verdes, E. and Rodr{\'\i}guez-Artalejo, F. and Cabello, M. and de la Torre-Luque, A. and Albert S{\'a}nchez-Niub{\'o} and Mar{\'\i}a Haro, J. and Ayuso-Mateos, J.L. and Chatterji, S.} } @article {10047, title = {The association between neighborhood socioeconomic status, cardiovascular and cerebrovascular risk factors, and cognitive decline in the Health and Retirement Study (HRS).}, journal = {Aging \& Mental Health}, year = {2019}, type = {Journal}, abstract = {

BACKGROUND: A small but growing body of evidence supports a relationship between neighborhood socioeconomic status (NSES) and cognitive decline. Additional work is needed to characterize this relationship controlling for risk factors such as cardiovascular, cerebrovascular, and genetic risk factors.

METHODS: Cognitive decline was assessed in association with NSES, and cardiovascular and cerebrovascular risk factors (heart disease, diabetes, hypertension, and stroke) in 8,198 individuals from the 1992-2010 waves of the Health and Retirement Study (HRS). Latent class trajectory analysis determined the number of cognitive trajectory classes that best fit the data, and a multinomial logistic regression model in the latent class framework assessed the risk for cognitive classes conferred by NSES index score and heart disease, diabetes, hypertension, and stroke across three trajectory classes of cognitive function. The analyses controlled for genetic risk for cognitive decline (including APOE genotype) and demographic variables, including education.

RESULTS: The HRS sample was 57.6\% female and 85.5\% White, with a mean age of 67.5(3.5) years at baseline. The three-quadratic-class model best fit the data, where higher classes represented better cognitive function. Those with better cognitive function were mainly younger white females. Those in the highest quartile of NSES had 57\% higher odds of being in the high cognitive function class. Heart disease, diabetes, hypertension, and stroke each increased the odds having of lower cognitive function.

CONCLUSIONS: In examining the relationship of cognitive status with various variables, neighborhood socioeconomic status, cardiovascular risk, and cerebrovascular risk persisted across the cognitive trajectory classes.

}, keywords = {Cardiovascular health, Cognition \& Reasoning, Risk Factors, Socioeconomic factors}, issn = {1364-6915}, doi = {10.1080/13607863.2019.1594169}, author = {Kuchibhatla, Maragatha and Jaimie C Hunter and Brenda L Plassman and Michael W Lutz and Casanova, Ramon and Saldana, Santiago and Kathleen M Hayden} } @article {12122, title = {Association studies of up to 1.2 million individuals yield new insights into the genetic etiology of tobacco and alcohol use.}, journal = {Nature Genetics}, volume = {51}, year = {2019}, pages = {237-244}, abstract = {

Tobacco and alcohol use are leading causes of mortality that influence risk for many complex diseases and disorders. They are heritable and etiologically related behaviors that have been resistant to gene discovery efforts. In sample sizes up to 1.2 million individuals, we discovered 566 genetic variants in 406 loci associated with multiple stages of tobacco use (initiation, cessation, and heaviness) as well as alcohol use, with 150 loci evidencing pleiotropic association. Smoking phenotypes were positively genetically correlated with many health conditions, whereas alcohol use was negatively correlated with these conditions, such that increased genetic risk for alcohol use is associated with lower disease risk. We report evidence for the involvement of many systems in tobacco and alcohol use, including genes involved in nicotinic, dopaminergic, and glutamatergic neurotransmission. The results provide a solid starting point to evaluate the effects of these loci in model organisms and more precise substance use measures.

}, keywords = {Alcohol Drinking, Female, Genetic Variation, Genome-Wide Association Study, Humans, Male, Middle Aged, Phenotype, Risk, Smoking, Tobacco, Tobacco Use Disorder}, issn = {1546-1718}, doi = {10.1038/s41588-018-0307-5}, author = {Liu, Mengzhen and Jiang, Yu and Wedow, Robbee and Li, Yue and Brazel, David M and Chen, Fang and Datta, Gargi and Davila-Velderrain, Jose and McGuire, Daniel and Tian, Chao and Zhan, Xiaowei and Choquet, H{\'e}l{\`e}ne and Docherty, Anna R and Jessica Faul and Foerster, Johanna R and Fritsche, Lars G and Gabrielsen, Maiken Elvestad and Gordon, Scott D and Jeffrey Haessler and Jouke-Jan Hottenga and Huang, Hongyan and Jang, Seon-Kyeong and Philip R Jansen and Ling, Yueh and M{\"a}gi, Reedik and Matoba, Nana and McMahon, George and Mulas, Antonella and Orr{\`u}, Valeria and Palviainen, Teemu and Anita Pandit and Reginsson, Gunnar W and Skogholt, Anne Heidi and Smith, Jennifer A and Taylor, Amy E and Turman, Constance and Gonneke Willemsen and Young, Hannah and Young, Kendra A and Zajac, Gregory J M and Zhao, Wei and Zhou, Wei and Bjornsdottir, Gyda and Boardman, Jason D and Boehnke, Michael and Dorret I Boomsma and Chen, Chu and Francesco Cucca and Davies, Gareth E and Charles B Eaton and Ehringer, Marissa A and T{\~o}nu Esko and Fiorillo, Edoardo and Gillespie, Nathan A and Gudbjartsson, Daniel F and Haller, Toomas and Kathleen Mullan Harris and Andrew C Heath and Hewitt, John K and Hickie, Ian B and Hokanson, John E and Hopfer, Christian J and Hunter, David J and Iacono, William G and Johnson, Eric O and Kamatani, Yoichiro and Sharon L R Kardia and Matthew C Keller and Kellis, Manolis and Charles Kooperberg and Kraft, Peter and Krauter, Kenneth S and Laakso, Markku and Penelope A Lind and Loukola, Anu and Lutz, Sharon M and Pamela A F Madden and Nicholas G Martin and McGue, Matt and Matthew B McQueen and Sarah E Medland and Andres Metspalu and Mohlke, Karen L and Nielsen, Jonas B and Okada, Yukinori and Peters, Ulrike and Tinca J Polderman and Posthuma, Danielle and Reiner, Alexander P and Rice, John P and Rimm, Eric and Rose, Richard J and Runarsdottir, Valgerdur and Stallings, Michael C and Stan{\v c}{\'a}kov{\'a}, Alena and Stefansson, Hreinn and Thai, Khanh K and Hilary A Tindle and Tyrfingsson, Thorarinn and Wall, Tamara L and David R Weir and Weisner, Constance and Whitfield, John B and Winsvold, Bendik Slagsvold and Yin, Jie and Zuccolo, Luisa and Laura Bierut and Hveem, Kristian and Lee, James J and Munaf{\`o}, Marcus R and Saccone, Nancy L and Willer, Cristen J and Marilyn C Cornelis and David, Sean P and Hinds, David A and Jorgenson, Eric and Kaprio, Jaakko and Stitzel, Jerry A and Stefansson, Kari and Thorgeirsson, Thorgeir E and Gon{\c c}alo R Abecasis and Liu, Dajiang J and Scott Vrieze} } @article {Li2019, title = {Associations of plasma high-sensitivity C-reactive protein concentrations with all-cause and cause-specific mortality among middle-aged and elderly individuals}, journal = {Immunity \& Ageing}, volume = {16}, year = {2019}, month = {Nov 2019}, pages = {28}, abstract = {Background The association of high-sensitivity C-reactive protein (hsCRP) with mortality is controversial. We aimed to investigate the associations of hsCRP concentrations with the risks of all-cause and cause-specific mortality and identify potential modifying factors affecting these associations among middle-aged and elderly individuals. Methods This community-based prospective cohort study included 14,220 participants aged 50+ years (mean age: 64.9 years) from the Health and Retirement Study. Cox proportional hazard models were employed to estimate the associations between the hsCRP concentrations and the risk of all-cause and cause-specific mortality with adjustment for sociodemographic and lifestyle factors, self-reported medical history, and other potential confounders. Results In total, 1730 all-cause deaths were recorded, including 725 cardiovascular- and 417 cancer-related deaths, after an 80,572 person-year follow-up (median: 6.4 years; range: 3.6{\textendash}8.1 years). The comparisons of the groups with the highest (quartile 4) and lowest (quartile 1) hsCRP concentrations revealed that the adjusted hazard ratios and 95\% confidence intervals were 1.50 (1.31{\textendash}1.72) for all-cause mortality, 1.44 (1.13{\textendash}1.82) for cardiovascular mortality, and 1.67 (1.23{\textendash}2.26) for cancer mortality. The associations between high hsCRP concentrations and the risks of all-cause, cardiovascular, and cancer mortality were similar in the men and women (P for interaction > 0.05). Conclusions Among middle-aged and older individuals, elevated hsCRP concentration could increase the risk of all-cause, cardiovascular, and cancer mortality in men and women.}, keywords = {C-reactive protein, Genetics, Mortality}, issn = {1742-4933}, doi = {10.1186/s12979-019-0168-5}, url = {https://doi.org/10.1186/s12979-019-0168-5}, author = {Li, Zhi-Hao and Zhong, Wen-Fang and Lv, Yue-Bin and Virginia Byers Kraus and Gao, Xiang and Chen, Pei-Liang and Huang, Qing-Mei and Ni, Jin-Dong and Shi, Xiao-Ming and Mao, Chen and Wu, Xian-Bo} } @article {9964, title = {The burden of functional disabilities for middle-aged and older adults in the United States}, journal = {The Journal of Nutrition, Health \& Aging}, volume = {23}, year = {2019}, pages = {172-174}, abstract = {Understanding the role of functional capacity on longevity is important as the population in the United States ages. The purpose of this study was to determine the burden of instrumental activities of daily living (IADL) and activities of daily living (ADL) disabilities for a nationally-representative sample of middle-aged and older adults in the United States.}, keywords = {Activities of Daily Living, Disabilities, IADLS}, issn = {1279-7707}, doi = {10.1007/s12603-018-1133-2}, author = {Ryan P McGrath and Soham Al Snih and Kyriakos S Markides and Kyle J Hackney and Bailey, R. and Mark D Peterson} } @article {10433, title = {The burden of health conditions across race and ethnicity for aging Americans: Disability-adjusted life years.}, journal = {Medicine }, volume = {98}, year = {2019}, pages = {e17964}, abstract = {

Despite evidence suggesting race and ethnicity are important factors in responses to environmental exposures, drug therapies, and disease risk, few studies focus on the health needs of racially- and ethnically-diverse aging adults.The objective of this study was to determine the burden of 10 health conditions across race and ethnicity for a nationally-representative sample of aging Americans.Data from the 1998 to 2014 waves of the Health and Retirement Study, an ongoing longitudinal-panel study, were analyzed.Those aged over 50 years who identified as Black, Hispanic, or White were included. There were 5510 Blacks, 3423 Hispanics, and 21,168 Whites in the study.At each wave, participants reported if they had cancer, chronic obstructive pulmonary disease, congestive heart failure, diabetes, back pain, hypertension, a fractured hip, myocardial infarction, rheumatism or arthritis, and a stroke. Disability-adjusted life years (DALYs) were calculated for each health condition by race and ethnicity. Ranked DALYs determined how race and ethnicity was differentially impacted by the burden of each health condition. Sample weights were utilized to make DALY estimates nationally-representative.Weighted DALY estimates (in thousands) ranged from 1405 to 55,631 for Blacks, 931 to 28,442 for Hispanics, and 15,313 to 295,623 for Whites. Although the health conditions affected each race and ethnicity differently, hypertension had the largest number of DALYs, and hip fractures had the fewest across race and ethnicity. In total, there were an estimated 198,621, 101,462, and 1,187,725 DALYs for older Black, Hispanic, and White aging adults.Our findings indicate that race and ethnicity may be influential on health and disease for aging adults in the United States. Monitoring DALYs may help guide the flow of health-related expenditures, improve the impact of health interventions, advance inclusive health care for diverse aging adult populations, and prepare healthcare providers for serving the health needs of aging adults.

}, keywords = {Disability, health conditions, race}, issn = {1536-5964}, doi = {10.1097/MD.0000000000017964}, author = {Ryan P McGrath and Soham Al Snih and Kyriakos S Markides and Jessica Faul and Brenda Vincent and Orman T Hall and Mark D Peterson} } @article {10052, title = {The burden of health conditions for middle-aged and older adults in the United States: Disability-adjusted life years.}, journal = {BMC Geriatrics}, volume = {19}, year = {2019}, pages = {100}, abstract = {

BACKGROUND: Many adults are living longer with health conditions in the United States. Understanding the disability-adjusted life years (DALYs) for such health conditions may help to inform healthcare providers and their patients, guide health interventions, reduce healthcare costs, improve quality of life, and increase longevity for aging Americans. The purpose of this study was to determine the burden of 10 health conditions for a nationally-representative sample of adults aged 50 years and older in the United States.

METHODS: Data from the 1998-2014 waves of the Health and Retirement Study were analyzed. At each wave, participants indicated if they were diagnosed with the following 10 conditions: cancer, chronic obstructive pulmonary disease~(COPD), congestive heart failure, diabetes, back pain, hypertension, a fractured hip, myocardial infarction, rheumatism or arthritis, and a stroke. Years lived with a disability and years of life lost to premature mortality were summed for calculating DALYs. Sample weights were utilized in the analyses to make the DALY estimates nationally-representative. Results for the DALYs were presented in thousands.

RESULTS: There were 30,101 participants included. Sex stratified DALY estimates ranged from 4092 (fractured hip)-to-178,055 (hypertension) for men and 13,621 (fractured hip)-to-200,794 (hypertension) for women. The weighted overall DALYs were: 17,660 for hip fractures, 62,630 for congestive heart failure, 64,710 for myocardial infarction, 90,337 for COPD, 93,996 for stroke, 142,012 for cancer, 117,534 for diabetes, 186,586 for back pain, 333,420 for arthritis, and 378,849 for hypertension. In total, there were an estimated 1,487,734 years of healthy life lost from the 10 health conditions examined~over the study period.

CONCLUSIONS: The burden of these health conditions accounted for over a million years of healthy life lost for middle-aged and older Americans over the 16 year study period. Our results should be used to inform healthcare providers and guide health interventions aiming to improve the health of middle-aged and older adults. Moreover, shifting health policy and resources to match DALY trends may help to improve quality of life during aging and longevity.

}, keywords = {Comorbidity, Disabilities, Longevity}, issn = {1471-2318}, doi = {10.1186/s12877-019-1110-6}, author = {Ryan P McGrath and Soham Al Snih and Kyriakos S Markides and Orman T Hall and Mark D Peterson} } @article {10201, title = {Cardiometabolic Risk and Cognitive Decline: The Role of Socioeconomic Status in Childhood and Adulthood.}, journal = {J Health Soc Behav}, volume = {60}, year = {2019}, month = {2019 Sep}, pages = {326-343}, abstract = {

Socioeconomic conditions in childhood predict cognitive functioning in later life. It is unclear whether poor childhood socioeconomic status (SES) also predicts the acceleration of cognitive decline. One proposed pathway is via cardiometabolic risk, which has been linked to both childhood SES and earlier onset of cognitive impairment. Using data from the Health and Retirement Study, we examine the impact of childhood SES on cognitive trajectories over six years and test whether it operates through increased cardiometabolic risk and adult SES. We find that higher childhood SES leads to slower cognitive decline, partially due to lower levels of cardiometabolic risk. However, these pathways operate entirely through adult socioeconomic attainment. The results have important implications for future trends in cognitive population health within the context of growing social inequality and reduced social mobility.

}, keywords = {cardiometabolic risk, cognitive aging, life course, socioeconomic status}, issn = {2150-6000}, doi = {10.1177/0022146519867924}, url = {https://www.ncbi.nlm.nih.gov/pubmed/31526019}, author = {Oi, Katsuya and Steven A Haas} } @article {9862, title = {Changes in cognitive function among older adults: A latent profile transition analysis}, journal = {Archives of Gerontology and Geriatrics}, volume = {80}, year = {2019}, pages = {12-19}, abstract = {Cognitive decline in late life is a crucial health problem. It is important to understand the consistency and change of older adults{\textquoteright} cognitive function in late life. Data for older adults (78 years and above) from the Health and Retirement Study (N = 1680) were used to explore meaningful subtypes of cognitive function and transitions patterns between those profiles across times. Age, gender, levels of education and nursing home were incorporated as covariates to explore the association between these variables and cognitive function transition pattern. Three cognitive function subgroups (Normal Cognitive Function, Fluid Intelligence Impairment and Cognitive Impairment) were identified. Individuals in Normal Cognitive Function status had a high probability to convert to the Fluid Intelligence Impairment status whereas the Cognitive Impairment status appeared a predominant tendency for stability. Increasing age played a significant role in fluid intelligence impairment and cognitive impairment process. Female and individuals with nursing home might be at higher risk of subsequent fluid intelligence impairment, while higher education did not protect against fluid intelligence impairment. These findings highlighted the usefulness to adopt a person-centered approach rather than a variable-centered approach, suggesting directions for future research and tailored interventions approaches to older adults with particular characteristics.}, keywords = {Cognitive Ability, Gender Differences, Latent Variable Modeling}, issn = {01674943}, doi = {10.1016/j.archger.2018.09.006}, url = {https://linkinghub.elsevier.com/retrieve/pii/S0167494318301821https://api.elsevier.com/content/article/PII:S0167494318301821?httpAccept=text/xmlhttps://api.elsevier.com/content/article/PII:S0167494318301821?httpAccept=text/plain}, author = {Huang, Feifei and Zhang, Minqiang and Wang, Shaojie} } @article {10448, title = {CHANGES IN PERSONAL RESOURCES AND SUBJECTIVE AGE ACROSS 8 YEARS}, journal = {Innovation in Aging}, volume = {3}, year = {2019}, month = {2019/11/08}, pages = {S454 - S454}, abstract = {Subjective age has been extensively researched as a predictor of physical and mental health outcomes in older adulthood. However, the mechanisms behind subjective age have not yet been established and reasons for longitudinal changes are unclear. Selective engagement theory (SET; Hess, 2014) proposes a connection between increases in objective and subjective cognitive costs and motivation to engage future resources. Costs are influenced by personal resources, mainly physical and mental health. These changes in costs may also influence subjective experiences of the aging process. For example, aging attitudes have been shown to partially mediate the associations between resources and both motivation and activity engagement (Hess et al., 2018). Using the Health and Retirement Study (HRS) data, changes in resources (physical and mental health) were hypothesized to predict changes in subjective age across 8 years. More specifically, reductions in resources were predicted to be associated with older subjective ages over time. This relationship was expected to be mediated through aging attitudes. Results indicate an association between changes in resources and changes in subjective age over time in the expected direction. Changes in resources were partially mediated by aging attitudes. However, resources function differently in predicting changes in subjective age based on the resource (physical and mental health) and chronological age of the participant. These findings provide more guidance as to the mechanisms behind subjective age and may offer theoretical guidance for future work looking at understanding changes in subjective age.}, keywords = {resources, Subjective age}, isbn = {2399-5300}, url = {https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6840252/}, author = {Allura Lothary and Hess, Thomas M} } @mastersthesis {10234, title = {Childhood socioeconomic status and weight change in later life}, volume = {Doctor of Philosophy}, year = {2019}, month = {2019}, pages = {122}, school = {Miami University}, address = {Miami, United States}, abstract = {Although previous studies find a relationship between childhood socioeconomic adversities and weight change, few examine mediators or moderators of this relationship using a nationally representative older adult sample. Using a life course framework, this study examines causal pathways and whether these pathways are modifiable. Using data from the 2006-2012 waves of the Health and Retirement Study (n=8193), a nationally representative survey of adults aged 50 and over in the United States, this research utilizes a structural equation modeling approach to examine whether physical activity and allostatic load mediate the relationship between childhood SES adversities and weight change. This research also examines the potential role of neighborhood social cohesion, or the mutual trust and solidarity among neighbors. Utilizing multiple-group analysis, this study also examines sex differences in the hypothesized relationships. The results indicate that childhood SES adversities are not directly related to later life weight change. Childhood SES adversities are related to lower levels of neighborhood social cohesion in later life. Low neighborhood social cohesion is related to lower levels of physical activity; it is also indirectly related to allostatic load through reduced levels of physical activity. There appear to be no sex differences in the hypothesized relationships. These findings indicate that the differential assortment into neighborhoods by socioeconomic status is important to consider when examining the role of neighborhood social cohesion and health }, keywords = {Allostatic load, childhood adversities, neighborhood social cohesion, Physical activity}, url = {http://rave.ohiolink.edu/etdc/view?acc_num=miami1554384334613957}, author = {Cassandra L. Hua} } @article {10513, title = {Closing down the shop: Optimal health and wealth dynamics near the end of life}, journal = {Health Economics (United Kingdom)}, year = {2019}, note = {Export Date: 13 January 2020CODEN: HEECECorrespondence Address: Pelgrin, F.; Department of Data Science, Economics and Finance, EDHEC Business SchoolFrance; email: Florian.PELGRIN@edhec.edu}, month = {2019}, abstract = {Near the end of life, health declines, mortality risk increases, and curative care is replaced by uninsured long-term care, accelerating the fall in wealth. Whereas standard explanations emphasize inevitable aging processes, we propose a complementary closing down the shop justification where agents{\textquoteright} decisions affect their health and the timing of death. Despite preferring to live, individuals optimally deplete their health and wealth towards levels associated with high death risk and gradual indifference between life and death. Reinstating exogenous aging processes reinforces the relevance of closing down. Using Health and Retirement Study{\textendash}Consumption and Activities Mail Survey data for elders, a structural estimation of the closed-form decisions identifies, tests, and confirms the relevance of closing down. {\textcopyright} 2019 John Wiley \& Sons, Ltd.}, keywords = {Aged, Aging, Article, dis-savings, end of life, endogenous mortality risk, human, life cycle, long term care, Medically Uninsured, mortality risk, Retirement}, isbn = {10579230 (ISSN)}, url = {https://onlinelibrary.wiley.com/doi/full/10.1002/hec.3960}, author = {Hugonnier, J. and Pelgrin, F. and St-Amour, P.} } @article {doi:10.1111/jgs.16163, title = {Cognitive Performance Among Older Persons in Japan and the United States}, journal = {Journal of the American Geriatrics Society}, year = {2019}, abstract = {OBJECTIVE To compare cognitive performance among Japanese and American persons, aged 68 years and older, using two nationally representative studies and to examine whether differences can be explained by differences in the distribution of risk factors or in their association with cognitive performance. DESIGN Nationally representative studies with harmonized collection of data on cognitive functioning. SETTING Nihon University Japanese Longitudinal Study of Aging and the US Health and Retirement Study. PARTICIPANTS A total of 1953 Japanese adults and 2959 US adults, aged 68 years or older. MEASUREMENTS Episodic memory and arithmetic working memory are measured using immediate and delayed word recall and serial 7s. RESULTS Americans have higher scores on episodic memory than Japanese people (0.72 points on a 20-point scale); however, when education is controlled, American and Japanese people did not differ. Level of working memory was higher in Japan (0.36 on a 5-point scale) than in the United States, and the effect of education on working memory was stronger among Americans than Japanese people. There are no differences over the age of 85 years. CONCLUSION Even with large differences in educational attainment and a strong effect of education on cognitive functioning, the overall differences in cognitive functioning between the United States and Japan are modest. Differences in health appear to have little effect on national differences in cognition.}, keywords = {cognitive performance, Education, Japan, Nihon University Japanese Longitudinal Study of Aging, United States}, doi = {10.1111/jgs.16163}, url = {https://onlinelibrary.wiley.com/doi/abs/10.1111/jgs.16163}, author = {Saito, Yasuhiko and Jung K Kim and Davarian, Shieva and Hagedorn, Aaron and Eileen M. Crimmins} } @article {12564, title = {Cohort Profile: The Ageing Trajectories of Health - Longitudinal Opportunities and Synergies (ATHLOS) project.}, journal = {International Journal of Epidemiology}, volume = {48}, year = {2019}, pages = {1052-1053i}, keywords = {Female, Global Health, Health Behavior, Health Status, Longitudinal Studies, Male, Mental Health, Physical Functional Performance, Social Environment, Socioeconomic factors}, issn = {1464-3685}, doi = {10.1093/ije/dyz077}, author = {Sanchez-Niubo, Albert and Egea-Cort{\'e}s, Laia and Olaya, Beatriz and Caballero, Francisco F{\'e}lix and Ayuso-Mateos, Jose L and Prina, Matthew and Bobak, Martin and Arndt, Holger and Tobiasz-Adamczyk, Beata and Paj{\k a}k, Andrzej and Leonardi, Matilde and Koupil, Ilona and Panagiotakos, Demosthenes and Tamosiunas, Abdonas and Scherbov, Sergei and Sanderson, Warren and Koskinen, Seppo and Chatterji, Somnath and Haro, Josep Maria} } @article {12140, title = {Combined linkage and association analysis identifies rare and low frequency variants for blood pressure at 1q31.}, journal = {European Journal of Human Genetics}, volume = {27}, year = {2019}, pages = {269-277}, abstract = {

High blood pressure (BP) is a major risk factor for cardiovascular disease (CVD) and is more prevalent in African Americans as compared to other US groups. Although large, population-based genome-wide association studies (GWAS) have identified over 300 common polymorphisms modulating inter-individual BP variation, largely in European ancestry subjects, most of them do not localize to regions previously identified through family-based linkage studies. This discrepancy has remained unexplained despite the statistical power differences between current GWAS and prior linkage studies. To address this issue, we performed genome-wide linkage analysis of BP traits in African-American families from the Family Blood Pressure Program (FBPP) and genotyped on the Illumina Human Exome BeadChip v1.1. We identified a genomic region on chromosome 1q31 with LOD score 3.8 for pulse pressure (PP), a region we previously implicated in DBP studies of European ancestry families. Although no reported GWAS variants map to this region, combined linkage and association analysis of PP identified 81 rare and low frequency exonic variants accounting for the linkage evidence. Replication analysis in eight independent African ancestry cohorts (N = 16,968) supports this specific association with PP (P = 0.0509). Additional association and network analyses identified multiple potential candidate genes in this region expressed in multiple tissues and with a strong biological support for a role in BP. In conclusion, multiple genes and rare variants on 1q31 contribute to PP variation. Beyond producing new insights into PP, we demonstrate how family-based linkage and association studies can implicate specific rare and low frequency variants for complex traits.

}, keywords = {African Americans, Chromosomes, Human, Pair 1, Gene Frequency, Genome-Wide Association Study, Humans, Hypertension, Linkage Disequilibrium, Polymorphism, Single Nucleotide}, issn = {1476-5438}, doi = {10.1038/s41431-018-0277-1}, author = {Wang, Heming and Nandakumar, Priyanka and Tekola-Ayele, Fasil and Bamidele O Tayo and Erin B Ware and Gu, C Charles and Lu, Yingchang and Yao, Jie and Zhao, Wei and Smith, Jennifer A and Hellwege, Jacklyn N and Guo, Xiuqing and Edwards, Todd L and Ruth J F Loos and Donna K Arnett and Myriam Fornage and Charles N Rotimi and Sharon L R Kardia and Cooper, Richard S and Rao, D C and Georg B Ehret and Chakravarti, Aravinda and Zhu, Xiaofeng} } @article {10372, title = {Comparisons of the Association of Family and Social Factors With Functional Limitations Across the United States, Mexico, and South Korea: Findings From the HRS Family of Surveys}, journal = {Journal of Aging and Health}, year = {2019}, note = {doi: 10.1177/0898264319878549}, month = {2019/10/04}, abstract = {Objective: The association of family and social factors with the level of functional limitations was examined across the United States, Mexico, and Korea. Method: Participants included adults from the 2012 Health and Retirement Study (n = 10,017), Mexican Health and Aging Study (n = 6,367), and Korean Longitudinal Study of Aging (n = 4,134). A common functional limitation scale was created based on Rasch analysis with a higher score indicating better physical function. Results: The American older adults (3.65 logits) had better physical function compared with Mexican (2.81 logits) and Korean older adults (1.92 logits). There were different associations of family and social factors with functional limitations across the three countries. Discussion: The American older adults demonstrated less functional limitation compared with Mexican and Korean older adults at the population level. The findings indicate the need to interpret carefully the individual family and social factors associated with functional limitations within the unique context of each country.}, keywords = {Cross-Cultural Comparison, cross-national study, Family, KLoSA, MHAS, multiple studies, socialization}, isbn = {0898-2643}, doi = {https://doi.org/10.1177/0898264319878549}, author = {Ickpyo Hong and Pryor, Loree and Rebeca Wong and Ottenbacher, Kenneth J. and Timothy A Reistetter} } @article {10230, title = {The Course of Income Inequality as a Cohort Ages into Old-Age}, journal = {The Journal of Economic Inequality}, year = {2019}, month = {08/2019}, pages = {1-20}, abstract = {Several researchers have shown that income inequality of a cohort increases as the cohort ages. The various studies examining cohort income inequality use a variety of data, measures, and methods. Is the U.S. experience documented in other studies due (1) to cumulative advantages and disadvantages continuing to work through market income into retirement, (2) to the relative weakness of the U.S. Social Security program, or (3) to potential biases due to data, measures and/or methods? This study examines cohort income inequality using nationally representative longitudinal data and a variety of inequality measures to follow a large sample of individuals from their late pre-retirement years into their retirement years. The findings are: (1) the course of the Gini coefficient is flat as the cohort ages into retirement, (2) but the course of income inequality as this cohort ages into retirement depends on the inequality measure employed, and (3) the trend results suggest that what is going on in the bottom part of the distribution is different from what is going on in the upper part.}, keywords = {Aging, Capital income, Earnings, Income inequality, Retirement income, Social Security}, isbn = {1573-8701}, doi = {https://doi.org/10.1007/s10888-019-09427-5}, url = {https://link.springer.com/article/10.1007/s10888-019-09427-5}, author = {Hungerford, Thomas L.} } @article {10455, title = {DEATH OF A CHILD AND MORTALITY RISK OVER THE LIFE COURSE: RACIAL DISADVANTAGE IN THE U.S.}, journal = {Innovation in Aging}, volume = {3}, year = {2019}, pages = {S436-S436}, abstract = {Numerous studies show that bereavement, including bereavement following the death of a minor child, increases mortality risk in white populations. The death of a child prior to midlife has received much less attention. Moreover, recent research shows that black Americans are substantially more likely to lose a child compared to white Americans, but this racial disadvantage is largely unexplored. Losing a child is a traumatic event that may activate biopsychosocial and behavioral risk factors that add to mortality risk. We analyze longitudinal data from the Health and Retirement Study (1992-2014) to assess the association of child loss prior to midlife with mortality risk in mid to later life, and the possible biopsychosocial and behavioral covariates linking child death to mortality. The analytic sample includes 20,489 non-Hispanic white respondents and 5,328 non-Hispanic black respondents who have ever given birth to or fathered at least one child. Findings suggest that that the death of a child prior to midlife is associated with increased mortality risk, net of sociodemographic controls. Psychological (e.g., depressive symptoms), behavioral (e.g., alcohol use, smoking), and social (e.g., income, marital status) factors explain this heightened mortality risk. Although the heightened mortality risk for child loss is similar for black and white parents, black parents experience a greater disadvantage as they are almost twice as likely as white parents to lose a child prior to midlife. Child loss and the resulting health risks disproportionately burden black families, functioning as a unique source of disadvantage for black Americans.}, keywords = {child death, mortality risk, race, race-ethnicity, Racial Disparities}, isbn = {2399-5300}, doi = {10.1093/geroni/igz038.1630}, author = {Rachel Donnelly and Debra Umberson and Robert A Hummer and Michael A Garcia} } @article {10622, title = {Debt, Religious Beliefs, and Life Satisfaction }, journal = {Journal of Financial Therapy}, volume = {10}, year = {2019}, type = {Journal}, abstract = {The purpose of this study was to explore religious factors as a resource for coping with indebtedness. Using a sample (n = 3,174) extracted from the Health and Retirement Study (HRS), we examined the relationship between household debt and life satisfaction, and tested for stress-buffering (i.e., moderation) from religious identification, religious beliefs, and prayer frequency. Results suggest that some religious factors may play a small role in moderating the relationship between indebtedness and life satisfaction, and that such moderation is itself dependent on one{\textquoteright}s religious identification. Implications for practice (particularly faith-based providers of financial counseling) and recommendations for future research are discussed.}, keywords = {complex data analysis, debt; religiosity, Life Satisfaction}, issn = { 1944-9771}, doi = {10.4148/1944-9771.1195}, url = {https://newprairiepress.org/cgi/viewcontent.cgi?article=1195\&context=jft}, author = {Ammerman, David D. and Stueve, Cherie and Hayward, Stephen} } @article {10530, title = {Debt Stress and Mortgage Borrowing in Older Age: Implications for Economic Security in Retirement}, number = {WI19-06}, year = {2019}, institution = {Retirement and Disability Research Center- University of Wisconsin-Madison}, abstract = {The amount of financial debt held by seniors in the U.S. has grown substantially over the past decade. Prior research links higher levels of debt to increased psychological stress and decreased physical health. For seniors, these effects may be exacerbated by fixed incomes and limited ability to offset higher monthly debt obligations through increased labor supply. This study will quantify stress associated with different forms of debt held by seniors{\textemdash}including reverse mortgages, a type of debt available only to seniors; and will explore the relationships between different types and timing of mortgage debt and older adults{\textquoteright} decisions regarding labor force participation and claiming of Social Security Benefits. To analyze these relationships, we use panel data from six waves of the Health and Retirement Study (HRS), supplemented with our own survey data on more than 1,000 reverse mortgage borrowers. Reverse mortgage borrowers are underrepresented in traditional survey populations and thus have been understudied despite potential growth in the market. This research links directly to the SSA{\textquoteright}s focal area of measuring sources of income and adequacy, and in particular consumer debt as part of a household{\textquoteright}s financial portfolio in retirement that presents an evolving risk to economic security. Debt stress among seniors can also have implications for labor force participation and the timing of draws from OASI. In addition to identifying the relationship between debt stress and retirement decisions, we examine the role of reverse mortgages for alleviating debt stress.}, keywords = {debt. mortgage, Finance, Stress}, url = {https://cfsrdrc.wisc.edu/project/wi19-06}, author = {Stephanie Moulton and Donald Haurin and C{\"a}zilia Loibl} } @article {10145, title = {Decreased handgrip strength is associated with impairments in each autonomous living task for aging adults in the United States.}, journal = {Journal of Frailty and Aging}, volume = {8}, year = {2019}, pages = {141-145}, abstract = {

OBJECTIVES: The primary purpose of this study was to determine the time-varying associations between decreased handgrip strength (HGS) and individual instrumental activities of daily living (IADL) impairments for a nationally-representative sample of aging adults in the United States.

DESIGN: Longitudinal-Panel.

SETTING: Detailed interviews were completed in person and core interviews were typically completed over the telephone.

PARTICIPANTS: A total of 15,336 participants aged at least 50 years who participated in the 2006 wave of the Health and Retirement Study were followed biennially for 8-years.

MEASUREMENTS: A hand-held dynamometer assessed HGS and performance in IADLs were self-reported.

RESULTS: Every 5-kilogram decrease in HGS was associated with an increased odds ratio for the following IADL impairments: 1.11 (95\% confidence interval (CI): 1.09, 1.13) for using a map, 1.10 (CI: 1.07, 1.12) for grocery shopping, 1.09 (CI: 1.05, 1.14) for taking medications, 1.07 (CI: 1.05, 1.09) for preparing hot meals, 1.06 (CI: 1.04, 1.08) for managing money, and 1.05 (CI: 1.02, 1.09) for using a telephone.

CONCLUSIONS: Decreased HGS was associated with each IADL impairment, and slightly different associations were observed in individual IADL tasks for aging adults in the United States. Our findings suggest that decreased HGS, which is reflective of reduced function of the neuromuscular system, is associated with diminished performance in autonomous living tasks during aging. Losses in HGS may lead to the development of an IADL impairment. Therefore, health-care providers working with aging adults should utilize measures of HGS as a screening tool for identifying future deficits in neuromuscular functioning. Interventions designed to preserve IADLs in aging adults should also include measures of HGS for detecting early changes in IADL capacity, and intervening at the onset of HGS declines may help aging adults retain their ability to live autonomously.

}, keywords = {Cognitive Ability, Grip strength, Muscle Weakness, Physical measures}, issn = {2260-1341}, doi = {10.14283/jfa.2018.47}, author = {Ryan P McGrath and Erlandson, Kristine M. and Brenda Vincent and Kyle J Hackney and Stephen D. Herrmann and Brian C Clark} } @article {10054, title = {Depressive symptoms following later-life marital dissolution and subsequent repartnering.}, journal = {Journal of Health and Social Behavior}, year = {2019}, abstract = {The doubling of the divorce rate among individuals over age 50 during the past 20 years underscores the urgency of studying the consequences of gray divorce and subsequent repartnering for adult well-being. We filled this gap by using the 1998-to-2014 Health and Retirement Study to evaluate how the levels of depressive symptoms changed following gray divorce versus widowhood. Individuals who divorced or became widowed already had experienced higher levels of depressive symptoms before dissolution relative to those who remained married. Compared with those who became widowed, those who transitioned to divorce experienced a lower elevation and a shorter time to recovery in depressive symptoms. When repartnering, both groups experienced similar magnitudes of initial reduction and subsequent rates of increase. Both the negative consequences of marital dissolution and the beneficial effects of repartnership for mental health persisted for several years, although ultimately they reverted to their predissolution levels of depressive symptoms.}, keywords = {Depressive symptoms, Divorce, Family Roles/Relationships, Marriage, Widowhood}, issn = {2150-6000}, doi = {10.1177/0022146519839683}, author = {Lin, I-Fen and Susan L. Brown and Matthew R Wright and Anna M Hammersmith} } @article {10141, title = {Differential associations between state-level educational quality and cardiovascular health by race: Early-life exposures and late-life health.}, journal = {SSM Population Health}, volume = {8}, year = {2019}, pages = {100418}, abstract = {Cardiovascular diseases (CVD) are patterned by educational attainment but educational quality is rarely examined. Educational quality differences may help explain racial disparities. Health and Retirement Study respondent data (1992-2014; born 1900-1951) were linked to state- and year-specific educational quality measures when the respondent was 6 years old. State-level educational quality was a composite of state-level school term length, student-to-teacher ratio, and per-pupil expenditure. CVD-related outcomes were self-reported (N = 24,339) obesity, heart disease, stroke, ever-smoking, high blood pressure, diabetes and objectively measured (N = 10,704) uncontrolled blood pressure, uncontrolled blood sugar, total cholesterol, high-density lipoprotein cholesterol (HDL), and C-reactive protein. Race/ethnicity was classified as White, Black, or Latino. Cox models fit for dichotomous time-to-event outcomes and generalized estimating equations for continuous outcomes were adjusted for individual and state-level confounders. Heterogeneities by race were evaluated using state-level educational quality by race interaction terms; race-pooled, race by educational quality interaction, and race-specific estimates were calculated. In race-pooled analyses, higher state-level educational quality was protective for obesity (HR = 0.92; 95\%CI(0.87,0.98)). In race-specific estimates for White Americans, state-level educational quality was protective for high blood pressure (HR = 0.95; 95\%CI(0.91,0.99). Differential relationships among Black compared to White Americans were observed for obesity, heart disease, stroke, smoking, high blood pressure, and HDL cholesterol. In race-specific estimates for Black Americans, higher state-level educational quality was protective for obesity (HR = 0.88; 95\%CI(0.84,0.93)), but predictive of heart disease (HR = 1.07; 95\%CI(1.01,1.12)), stroke (HR = 1.20; 95\%CI(1.08,1.32)), and smoking (HR = 1.05; 95\%CI(1.02,1.08)). Race-specific hazard ratios for Latino and Black Americans were similar for obesity, stroke, and smoking. Better state-level educational quality had differential associations with CVD by race. Among minorities, better state-level educational quality was predominately associated with poorer CVD outcomes. Results evaluate the 1900-1951 birth cohorts; secular changes in the racial integration of schools since the 1950s, means results may not generalize to younger cohorts.}, keywords = {Cardiovascular health, Education, Heart disease, Late-life Health, Racial/ethnic differences}, issn = {2352-8273}, doi = {10.1016/j.ssmph.2019.100418}, author = {Anusha M Vable and Thu T Nguyen and David Rehkopf and M. Maria Glymour and Hamad, Rita} } @article {10103, title = {Do post-menopausal women provide more care to their kin?: Evidence of grandparental caregiving from two large-scale national surveys}, journal = {Evolution and Human Behavior}, volume = {40}, year = {2019}, pages = {355-364}, abstract = {Drawing on the logical principles of life-history theory, it may be hypothesized that{\textemdash}compared to pre-menopausal women{\textemdash}post-menopausal women will spend more time caring for grandchildren and other kin. This hypothesis was tested in two studies, on results obtained from two large datasets documenting altruistic behaviors of pre-menopausal and post-menopausal women in the United States (n = 7161) and Australia (N = 25,066). Results from both studies revealed that (even when controlling statistically for age, health, financial resources, and other pertinent variables), post-menopausal women devoted more time to grandparental caregiving. This effect was specific to kin care: Menopause status was not as strongly related to a measure of non-kin-directed altruistic behavior (time spent volunteering). These results provide the first empirical support for a previously-untested behavioral implication of menopause.}, keywords = {Family Roles/Relationships, Grandparents, Menopause, Women and Minorities}, issn = {10905138}, doi = {10.1016/j.evolhumbehav.2019.04.002}, author = {Hofer, Marlise K. and Collins, Hanne K. and Mishra, Gita D. and Schaller, Mark} } @article {10030, title = {Does home equity affect decisions on long-term care insurance purchases? Evidence from the United States.}, journal = {Research on Aging}, volume = {41}, year = {2019}, month = {07/2019}, abstract = {The low uptake of private long-term care insurance (LTCI) by the elderly in the United States, despite visible risks, has left economists puzzled. Prior studies have hypothesized that home equity can be a substitute for LTCI and hence may partly explain the low uptake. We test this hypothesis empirically. We utilize exogenous variation in house prices at the level of the metropolitan statistical area (MSA) as an instrument for home equity for individuals residing in that MSA and data from the Health and Retirement Study. In the most robust specifications, we find no evidence that the elderly change their decision on LTCI based on variation in their home equity, and even specifications requiring stronger identification assumptions imply only small effect magnitudes. Home equity as a substitute for LTCI does not appear to be a major contributing factor to low LTCI take up.}, keywords = {Decision making, Homeownership, Long-term care insurance}, issn = {1552-7573}, doi = {10.1177/0164027519830078}, author = {Richard A Hirth and Acharya, Yubraj and Helen G Levy and Kenneth M. Langa} } @article {10040, title = {Education and cognitive decline: An integrative analysis of global longitudinal studies of cognitive aging.}, journal = {Journals of Gerontology, Series B: Psychological Sciences \& Social Sciences}, year = {2019}, abstract = {

BACKGROUND: The objective of this study was to examine the association between education and incidence of accelerated cognitive decline.

METHODS: Secondary analyses of data from the Health and Retirement Study (HRS), a nationally representative prospective cohort study of U.S. residents were conducted (N=28,417). Cox proportional hazards survival models were layered on longitudinal mixed-effects modeling to jointly examine healthy cognitive aging and incidence of accelerated cognitive decline consistent with patterns seen in preclinical Alzheimer{\textquoteright}s disease and related dementias (ADRD). Replication analyses were completed on a database including 62,485 additional respondents from HRS sister-studies. Life-expectancy ratios (LER) and 95\% confidence intervals were reported.

RESULTS: This study replicated research showing that education was positively associated with cognition at baseline. Model fit improved using the survival method compared to random-slopes models alone. Analyses of HRS data revealed that higher education was associated with delayed onset of accelerated cognitive decline (LER=1.031 95\% C.I. = [1.013-1.015], P<1E-06). Replication analyses using data from 14 countries identified similar results.

CONCLUSIONS: These results are consistent with cognitive reserve theory, suggesting that education reduces risk of ADRD-pattern cognitive decline. Follow-up work should seek to differentiate specific dementia types involved and consider potential mechanisms.

}, keywords = {Alzheimer{\textquoteright}s disease, Cognition \& Reasoning, Cross-National, Education}, issn = {1758-5368}, doi = {10.1093/geronb/gbz053}, author = {Sean A. P. Clouston and Dylan M Smith and Mukherjee, Soumyadeep and Yun Zhang and Hou, Wei and Bruce G Link and Richards, Marcus} } @article {10144, title = {Educational attainment and cardiovascular disease in the United States: A quasi-experimental instrumental variables analysis.}, journal = {PLoS Medicine}, volume = {16}, year = {2019}, month = {2019 Jun}, pages = {e1002834}, abstract = {

BACKGROUND: There is ongoing debate about whether education or socioeconomic status (SES) should be inputs into cardiovascular disease (CVD) prediction algorithms and clinical risk adjustment models. It is also unclear whether intervening on education will affect CVD, in part because there is controversy regarding whether education is a determinant of CVD or merely correlated due to confounding or reverse causation. We took advantage of a natural experiment to estimate the population-level effects of educational attainment on CVD and related risk factors.

METHODS AND FINDINGS: We took advantage of variation in United States state-level compulsory schooling laws (CSLs), a natural experiment that was associated with geographic and temporal differences in the minimum number of years that children were required to attend school. We linked census data on educational attainment (N = approximately 5.4 million) during childhood with outcomes in adulthood, using cohort data from the 1992-2012 waves of the Health and Retirement Study (HRS; N = 30,853) and serial cross-sectional data from 1971-2012 waves of the National Health and Nutrition Examination Survey (NHANES; N = 44,732). We examined self-reported CVD outcomes and related risk factors, as well as relevant serum biomarkers. Using instrumental variables (IV) analysis, we found that increased educational attainment was associated with reduced smoking (HRS β -0.036, 95\%CI: -0.06, -0.02, p < 0.01; NHANES β -0.032, 95\%CI: -0.05, -0.02, p < 0.01), depression (HRS β -0.049, 95\%CI: -0.07, -0.03, p < 0.01), triglycerides (NHANES β -0.039, 95\%CI: -0.06, -0.01, p < 0.01), and heart disease (HRS β -0.025, 95\%CI: -0.04, -0.002, p = 0.01), and improvements in high-density lipoprotein (HDL) cholesterol (HRS β 1.50, 95\%CI: 0.34, 2.49, p < 0.01; NHANES β 0.86, 95\%CI: 0.32, 1.48, p < 0.01), but increased BMI (HRS β 0.20, 95\%CI: 0.002, 0.40, p = 0.05; NHANES β 0.13, 95\%CI: 0.01, 0.32, p = 0.05) and total cholesterol (HRS β 2.73, 95\%CI: 0.09, 4.97, p = 0.03). While most findings were cross-validated across both data sets, they were not robust to the inclusion of state fixed effects. Limitations included residual confounding, use of self-reported outcomes for some analyses, and possibly limited generalizability to more recent cohorts.

CONCLUSIONS: This study provides rigorous population-level estimates of the association of educational attainment with CVD. These findings may guide future implementation of interventions to address the social determinants of CVD and strengthen the argument for including educational attainment in prediction algorithms and primary prevention guidelines for CVD.

}, keywords = {Cardiovascular health, Education, NHANES}, issn = {1549-1676}, doi = {10.1371/journal.pmed.1002834}, author = {Hamad, Rita and Thu T Nguyen and Bhattacharya, Jay and M. Maria Glymour and David Rehkopf} } @article {9966, title = {Educational differences in the compression of disability incidence in the United States}, journal = {SSM - Population Health}, volume = {7}, year = {2019}, pages = {100347}, abstract = {Objective: To examine educational differences in the compression of disability incidence in the United States. Method: We use the Health and Retirement Study and techniques of microsimulation and bootstrap to estimate the distribution of mortality and disability incidence for major education groups. Results: Higher education is associated with a right shift in the age distributions of both mortality and disability incidence, and more compressed distributions above the modal ages (p<0.05). Our study also points to gender differences in the association between education and compression of mortality and disability incidence (p<0.05). Discussion: To our knowledge, no prior studies have examined educational difference in compression of disability incidence and conducted formal tests for statistical significance. Educational differences in life span variation in mortality correspond closely with life span variation in disability incidence. One long-range implication of this work is growing inequality in life-span variation in disability incidence given trends in educational differences in life-span variation in mortality.}, keywords = {Activities of Daily Living, Disabilities, Education}, issn = {23528273}, doi = {10.1016/j.ssmph.2018.100347}, author = {Chi-Tsun Chiu and Mark D Hayward and Chan, Angelique and Matchar, David B.} } @article {10163, title = {Effects of age discrimination on self-perceptions of aging and cancer risk behaviors.}, journal = {Gerontologist}, volume = {59}, year = {2019}, pages = {S28-S37}, abstract = {

BACKGROUND AND OBJECTIVES: Almost one-third of older adults report experiencing age discrimination. We hypothesized sequential links between older adults{\textquoteright} everyday experiences of age discrimination and future health behaviors related to cancer risk through self-perceptions of aging (SPA).

RESEARCH DESIGN AND METHODS: Participants were community-dwelling respondents (age: 51-96 years) from the 2008, 2012, and 2014 waves of the Health and Retirement Study (N = 4,467). Generalized path models estimated the immediate and enduring effects of age discrimination in 2008 on proximal SPA in 2012 and distal health behaviors in 2014.

RESULTS: Age discrimination was associated with lower positive SPA and higher negative SPA in 2012. The effect of age discrimination on physical activity, smoking, and drinking in 2014 was mediated by positive and negative SPA in 2012. Through subsequent SPA, those who experienced age discrimination in 2008 were less likely to engage in regular moderate physical activity, more likely to smoke, and less likely to drink more than 3 times per week in 2014. Analysis of change in positive and negative SPA showed the effect of age discrimination on physical activity to be mediated by change in positive, but not negative, SPA.

DISCUSSION AND IMPLICATIONS: The enduring effects of age discrimination were found through a reduction in positive SPA. Elevating positive SPA could be as important as reducing negative SPA for future health behaviors related to cancer risk.

}, keywords = {Ageism, Cancer, Discrimination, Racial/ethnic differences}, issn = {1758-5341}, doi = {10.1093/geront/gny183}, author = {Hooker, Karen and Shannon T. Mejia and Sandi Phibbs and Erwin J Tan and Stevens, Jonathan} } @article {9466, title = {Evaluating eight-year trajectories for sense of purpose in the Health and Retirement Study.}, journal = {Aging \& Mental Health}, volume = {23}, year = {2019}, pages = {233-237}, abstract = {

OBJECTIVES: Though cross-sectional research has suggested that sense of purpose declines into older adulthood, it remains unclear whether inter-individual variability occurs in these trajectories, and what factors predict these trajectories. The current study provides one of the first longitudinal investigations into how individuals{\textquoteright} sense of purpose fluctuates in older adulthood.

METHOD: Participants from the Health and Retirement Study (n = 4,234, mean age = 65 years), completed assessments of sense of purpose over three years, along with multiple potential predictors (health, personality, demographics) at the start.

RESULTS: Second-order latent growth models demonstrated both mean-level declines on purpose over time, as well as the capacity for inter-individual variability in change patterns for retired adults. Among this cohort, health status, educational attainment, and marital status were significant predictors of purpose trajectories over time, though broad personality trait dimensions failed to uniquely predict change in sense of purpose. However, measurement invariance tests suggest that the scale did not operate similarly across work status groups.

CONCLUSION: Findings advance the previous literature by demonstrating inter-individual variability in sense of purpose for those participants who had retired. Future research should consider that purpose inventories may operate differently for those in the workplace versus retired adults.

}, keywords = {Health Conditions and Status, Purpose in life, Well-being}, issn = {1364-6915}, doi = {10.1080/13607863.2017.1399344}, author = {Patrick L Hill and Sara J Weston} } @article {10.1093/geroni/igz038.3138, title = {EVALUATING ITEM NONRESPONSE IN A LIFE HISTORY CALENDAR: AN ANALYSIS OF MEMORY EFFECTS}, journal = {Innovation in Aging}, volume = {3}, year = {2019}, month = {11}, pages = {S853-S853}, abstract = {Memory decline contributes to response inaccuracy and can produce item missing data, especially in retrospective surveys with older adults. Event history calendars, or the life grid approaches, are commonly used to obtain retrospective life history data. As indicated in previous literature, this approach can assist respondents{\textquoteright} memory retrieval. Despite its wide use, the important issue of item nonresponse due to memory effects in life grid questions has received little attention. Autobiographical memory (AM) research has shown that there are two interconnected long-term memory systems: episodic memories of event details from specific remote times in an individual{\textquoteright}s life; and semantic memories of the important facts and themes that define an individual{\textquoteright}s life history. Episodic and semantic AM may introduce different levels of difficulty in retrieving memory and thus contribute to different levels of missing data. This study examines the effects of both item-level predictors (e.g., types of memories) and respondent-level predictors (e.g., cognitive status, age, and health status) on the likelihood of item missing data in life grid questions. We analyzed missing data in the 2017 Health and Retirement Study (HRS) Life History Mail Survey (n = 3,844), using multilevel logistic regression. The results revealed higher rates of item missing for episodic memories, and that overall respondents{\textquoteright} cognitive status was significantly associated with their likelihood of providing item missing data. Recent residential information was better recalled than childhood information. These results have implications for life course analysis of exposures linked to residential histories.}, keywords = {Memory}, issn = {2399-5300}, doi = {10.1093/geroni/igz038.3138}, url = {https://doi.org/10.1093/geroni/igz038.3138}, author = {Hu, Mengyao and Melipill{\'a}n, Roberto and Zhang, Xinyu and Jacqui Smith} } @article {12125, title = {Exome Chip Meta-analysis Fine Maps Causal Variants and Elucidates the Genetic Architecture of Rare Coding Variants in Smoking and Alcohol~Use.}, journal = {Biological Psychiatry}, volume = {85}, year = {2019}, pages = {946-955}, abstract = {

BACKGROUND: Smoking and alcohol use have been associated with common genetic variants in multiple loci. Rare variants within these loci hold promise in the identification of biological mechanisms in substance use. Exome arrays and genotype imputation can now efficiently genotype rare nonsynonymous and loss of function variants. Such variants are expected to have deleterious functional consequences and to contribute to disease risk.

METHODS: We analyzed \~{}250,000 rare variants from 16 independent studies genotyped with exome arrays and augmented this dataset with imputed data from the UK Biobank. Associations were tested for five phenotypes: cigarettes per day, pack-years, smoking initiation, age of smoking initiation, and alcoholic drinks per week. We conducted stratified heritability analyses, single-variant tests, and gene-based burden tests of nonsynonymous/loss-of-function coding variants. We performed a novel fine-mapping analysis to winnow the number of putative causal variants within associated loci.

RESULTS: Meta-analytic sample sizes ranged from 152,348 to 433,216, depending on the phenotype. Rare coding variation explained 1.1\% to 2.2\% of phenotypic variance, reflecting 11\% to 18\% of the total single nucleotide polymorphism heritability of these phenotypes. We identified 171 genome-wide associated loci across all phenotypes. Fine mapping identified putative causal variants with double base-pair resolution at 24 of these loci, and between three and 10 variants for 65 loci. Twenty loci contained rare coding variants in the 95\% credible intervals.

CONCLUSIONS: Rare coding variation significantly contributes to the heritability of smoking and alcohol use. Fine-mapping genome-wide association study loci identifies specific variants contributing to the biological etiology of substance use behavior.

}, keywords = {Alcohol Drinking, Databases, Genetic, Exome, Genetic Predisposition to Disease, Genetic Variation, Genome-Wide Association Study, Genotype, Humans, Oligonucleotide Array Sequence Analysis, Phenotype, Polymorphism, Single Nucleotide, Smoking}, issn = {1873-2402}, doi = {10.1016/j.biopsych.2018.11.024}, author = {Brazel, David M and Jiang, Yu and Hughey, Jordan M and Turcot, Val{\'e}rie and Zhan, Xiaowei and Gong, Jian and Batini, Chiara and Weissenkampen, J Dylan and Liu, Mengzhen and Barnes, Daniel R and Bertelsen, Sarah and Chou, Yi-Ling and Erzurumluoglu, A Mesut and Jessica Faul and Jeffrey Haessler and Anke R Hammerschlag and Hsu, Chris and Kapoor, Manav and Lai, Dongbing and Le, Nhung and Christiaan de Leeuw and Loukola, Anu and Mangino, Massimo and Melbourne, Carl A and Pistis, Giorgio and Qaiser, Beenish and Rohde, Rebecca and Shao, Yaming and Heather M Stringham and Wetherill, Leah and Zhao, Wei and Agrawal, Arpana and Laura Bierut and Chen, Chu and Charles B Eaton and Goate, Alison and Christopher A Haiman and Andrew C Heath and Iacono, William G and Nicholas G Martin and Tinca J Polderman and Reiner, Alex and Rice, John and Schlessinger, David and H Steven Scholte and Smith, Jennifer A and Tardif, Jean-Claude and Hilary A Tindle and Van Der Leij, Andries R and Boehnke, Michael and Chang-Claude, Jenny and Francesco Cucca and David, Sean P and Tatiana Foroud and Howson, Joanna M M and Sharon L R Kardia and Charles Kooperberg and Laakso, Markku and Lettre, Guillaume and Pamela A F Madden and McGue, Matt and Kari E North and Posthuma, Danielle and Timothy Spector and Stram, Daniel and Tobin, Martin D and David R Weir and Kaprio, Jaakko and Gon{\c c}alo R Abecasis and Liu, Dajiang J and Scott Vrieze} } @mastersthesis {10345, title = {Exploring Disability Outcomes among Aging Latinos in the United States: A Mixed Methods Approach}, volume = {PhD}, year = {2019}, note = {Copyright - Database copyright ProQuest LLC; ProQuest does not claim copyright in the individual underlying works; Last updated - 2019-09-20}, pages = {153}, school = {The University of Chicago}, type = {phd}, abstract = {The population of older adults in the United States is currently growing at unprecedented rates, as is the proportion of those older adults who are of Latino descent. Despite a diversifying population of older adults, much of the research exploring the social context of health and aging does not consider the ways in which the sociocultural environment may differ by ethnicity. The objective of this dissertation is to explore and document the ways in which the social environment and cultural context are related to health and disability outcomes among aging Latinos. This examination explores how the social world of disabled Latinos differs from their non-Latino counterparts, how those differences may drive differential experiences of care receipt upon the onset of disability, and how older Latinos themselves articulate their desires for {\textquotedblleft}aging well{\textquotedblright} and care receipt in old age. Ultimately, I argue that the relationship between social context and physical and psychological health outcomes varies according to the cultural values and preferences of the community in which an individual is embedded. For Latinos in particular, the cultural values of familismo and respeto can produce social relationships that are protective against adverse health outcomes in old age, but these values can also paradoxically produce their own anxieties and present unique challenges to {\textquotedblleft}aging well{\textquotedblright} among Latinos.}, keywords = {0351:Gerontology, 0573:Public health, 0626:Sociology, 0737:Hispanic American studies, ADL disability, Aging, ethnicity, Gerontology, Hispanic American studies, Public Health, Social context, Social determinants of health, Sociology}, isbn = {9781085558570}, url = {https://knowledge.uchicago.edu/record/1831?ln=en}, author = {Howard,Alexis L.} } @article {10076, title = {Factors that impact family perception of goal-concordant care at the end of life.}, journal = {Journal of Palliative Medicine}, year = {2019}, abstract = {

BACKGROUND: Goal-concordant care (GCC)-care aligned with a patient{\textquoteright}s known goals and values-is a measure of the quality of end-of-life (EOL) care that can be assessed by surveying family members after a patient{\textquoteright}s death. It is unknown whether patient characteristics affect this measure.

OBJECTIVE: The objective of the article was to examine family report of GCC and its associations with patient characteristics.

METHODS: Using the Health and Retirement Study, which is a nationally representative, longitudinal cohort of adults over age 50, we sampled decedents whose family completed the 2014 postdeath interview. Families reported frequency of GCC at the EOL. A multivariable regression model assessed the associations between family report of GCC and decedent characteristics.

RESULTS: Of 1175 respondents, 76\% reported that the decedent "usually" or "always" received GCC. Proxy report of GCC was independently associated with age (adjusted odds ratio [AOR] 1.02, 95\% confidence interval [CI] 1.01-1.03), having three or more chronic medical conditions (AOR 1.34, CI 1.02-1.77), the presence of written or verbal advance care planning (ACP) (AOR 1.38, CI 1.02-1.88), and an interaction term of race and ability to participate in EOL decision making (AOR 3.83, CI 1.02-14.40). African American race was not independently associated with GCC (AOR 0.73, CI 0.5-1.06).

CONCLUSION: Family{\textquoteright}s report of GCC is associated with ACP, age, and multimorbidity. Being African American and perceived as able to participate in EOL decision making was significantly associated with report of GCC. Bringing the patient{\textquoteright}s voice into EOL care discussions through upstream ACP with likely surrogates may be particularly important to improving GCC for African Americans.

}, keywords = {Advance care planning, Racial/ethnic differences}, issn = {1557-7740}, doi = {10.1089/jpm.2018.0508}, author = {Haines, Lindsay and Rahman, Omari-Khalid and Justin J Sanders and Kimberly J. Johnson and Amy Kelley} } @article {11241, title = {Food Insecurity among Older Adults in the US: The Role of Mortgage Borrowing}, year = {2019}, institution = {Joint Center for Housing Studies of Harvard University}, abstract = {As of 2016, close to 10 million older adults faced the threat of hunger in the US, constituting an urgent food policy issue. For older adults, heterogeneity in household wealth is even more important than income in predicting whether or not a household is food insecure. Yet not all wealth is equally accessible for households experiencing food hardship. Housing wealth{\textemdash}an illiquid asset{\textemdash}is the primary source of wealth for many older adults, particularly those with lower incomes. We use data for homeowners aged 62 and older from the Health and Retirement Study to identify the mechanism that links housing wealth to food insecurity. The results document the critical role of home equity as a {\textquotedblleft}protective buffer{\textquotedblright} and point to the importance of access to mortgage borrowing to reduce material hardship late in life.}, keywords = {Food insecurity, mortgage, Mortgages}, url = {https://www.jchs.harvard.edu/research-areas/working-papers/food-insecurity-among-older-adults-us-role-mortgage-borrowing}, author = {Stephanie Moulton and C{\"a}zilia Loibl and Donald Haurin and Edmunds, Chrisse} } @article { ISI:000498070900004, title = {Genes, Gender Inequality, and Educational Attainment}, journal = {AMERICAN SOCIOLOGICAL REVIEW}, volume = {84}, year = {2019}, month = {DEC}, pages = {1069-1098}, type = {Article}, abstract = {Women{\textquoteright}s opportunities have been profoundly altered over the past century by reductions in the social and structural constraints that limit women{\textquoteright}s educational attainment. Do social constraints manifest as a suppressing influence on genetic indicators of potential, and if so, did equalizing opportunity mean equalizing the role of genetics? We address this with three cohort studies: the Wisconsin Longitudinal Study (WLS; birth years 1939 to 1940), the Health and Retirement Study, and the National Longitudinal Study of Adolescent Health (Add Health; birth years 1975 to 1982). These studies include a {\textquoteleft}{\textquoteleft}polygenic score{\textquoteright}{\textquoteright} for educational attainment, providing a novel opportunity to explore this question. We find that within the WLS cohort, the relationship between genetics and educational outcomes is weaker for women than for men. However, as opportunities changed in the 1970s and 1980s, and many middle-aged women went back to school, the relationship between genetic factors and education strengthened for women as they aged. Furthermore, utilizing the HRS and Add Health, we find that as constraints limiting women{\textquoteright}s educational attainment declined, gender differences in the relationship between genetics and educational outcomes weakened. We demonstrate that genetic influence must be understood through the lens of historical change, the life course, and social structures like gender.}, keywords = {biodemography, Education, gender, Genetics}, issn = {0003-1224}, doi = {10.1177/0003122419886550}, author = {Herd, Pamela and Freese, Jeremy and Sicinski, Kamil and Benjamin W Domingue and Kathleen Mullan Harris and Wei, Caiping and Hauser, Robert M.} } @article {10124, title = {Handgrip strength is associated with poorer cognitive functioning in aging Americans.}, journal = {Journal of Alzheimer{\textquoteright}s Disease}, year = {2019}, abstract = {

BACKGROUND: Measures of handgrip strength may show promise for detecting cognitive erosion during aging.

OBJECTIVE: To determine the associations between lower handgrip strength and poorer cognitive functioning for aging Americans.

METHODS: There were 13,828 participants aged at least 50 years from the 2006 wave of the Health and Retirement Study included and followed biennially for 8 years. Handgrip strength was assessed with a hand-held dynamometer and cognitive functioning was assessed with a modified version of the Mini-Mental State Examination. Participants aged <65 years with scores 7- 11 had a mild cognitive impairment, <=6 had a severe cognitive impairment, and <=11 had any cognitive impairment. Respondents aged >=65 years with scores 8- 10 had a mild cognitive impairment, <=7 had a severe cognitive impairment, and <=10 had any cognitive impairment Separate covariate-adjusted multilevel logistic models examined the associations between lower handgrip strength and any or severe cognitive impairment. A multilevel ordered logit model analyzed the association between lower handgrip strength and poorer cognitive functioning.

RESULTS: Every 5-kg lower handgrip strength was associated with 1.10 (95\% confidence interval (CI): 1.04, 1.15) and 1.18 (CI: 1.04, 1.32) greater odds for any and severe cognitive impairment, respectively. Similarly, every 5-kg lower handgrip strength was associated with 1.10 (CI: 1.05, 1.14) greater odds for poorer cognitive functioning.

CONCLUSIONS: Measurement of handgrip strength is a simple, risk-stratifying method for helping healthcare providers determine poorer cognitive functioning. Interventions aiming to prevent or delay cognitive dysfunction should also implement measures of handgrip strength as an assessment tool for determining efficacy.

}, keywords = {Alzheimer{\textquoteright}s disease, Cognitive Ability, Dementia, Physical measures}, issn = {1875-8908}, doi = {10.3233/JAD-190042}, author = {Ryan P McGrath and Sheria G Robinson-Lane and Cook, Summer and Brian C Clark and Stephen D. Herrmann and Melissa L O{\textquoteright}Connor and Kyle J Hackney} } @article {10017, title = {Health and Retirement Study 2016 Tracker}, year = {2019}, month = {01/2019}, pages = {1-44}, institution = {Survey Research Center, Institute for Social Research, University of Michigan}, address = {Ann Arbor}, author = {HRS Staff} } @mastersthesis {10291, title = {Health Consequences of Retirement Among Married Couples}, volume = {PhD}, year = {2019}, note = {Copyright - Database copyright ProQuest LLC; ProQuest does not claim copyright in the individual underlying works; Last updated - 2019-06-28}, pages = {126}, school = {University of Massachusetts Boston}, type = {phd}, abstract = {The aim of this dissertation was to contribute to our understanding of the health consequences of retirement by proposing three major theory-driven research questions, set within a life course perspective. The first and second research questions addressed whether retirement transitions are associated with subsequent health for the retiree, as well as the partner. That is, given the coupled-nature of retirement transition for many married individuals, the question of the health consequences of retirement was examined in the context of married relationships. Importantly, by focusing on married individuals, I also investigated whether there are cross-spousal health consequences of retirement. The third research question addressed whether the linkages between retirement transitions and the health vary depending on a number of contextual factors concerning the experience of retirement.This study was based on nine waves of biennial data (1998{\textendash}2014) from the Health and Retirement Study (HRS). I took advantage of the household panel structure of the HRS data to examine individuals nested within couples over time, employing an actor-partner interdependence model (APIM) framework to estimate the health effects of one{\textquoteright}s own and spouse{\textquoteright}s retirement. To account for potential reverse causality, retirement decisions that are unrelated to health and those that are reported as caused by poor health were specified separately in the analyses. Omitted variable bias was addressed using within-between random effects models.Findings indicated that retirement transitions driven by non-health reasons were unrelated to subsequent self-rated health of both wives and husbands, whereas the transition was associated with an increased number of depressive symptoms for husband, but not wives. In contrast, retirement transitions driven by poor health were consistently associated with worse health outcomes, as assessed with self-rated health and depressive symptoms, for both wives and husbands. As for the partner effects of retirement transitions, the findings indicated that spousal retirement transitions were largely unrelated to changes in subsequent health. I further found that actor effects of retirement transitions were significantly moderated by a number of different contextual factors. The findings provide support for implementing policy measures to facilitate longer working lives of older married individuals, especially those in compromised health conditions.}, keywords = {Endogeneity, Gerontology, Health and Retirement Study, Labor force transitions, Multilevel models, Older couples, Social Sciences}, isbn = {9781392238288}, url = {http://paa2019.populationassociation.org/abstracts/192345}, author = {Sae Hwang Han} } @article {11139, title = {Horizontal or Vertical? The Effects of Visual Orientation of Categorical Response Options on Survey Responses in Web Surveys}, journal = {Social Science Computer ReviewSocial Science Computer Review}, volume = {38}, year = {2019}, month = {2020/12/01}, pages = {779 - 792}, abstract = {Prior research has studied the impact of horizontal versus vertical orientation of rating scales on survey responses, but not the effects of orientation of categorical options. The present study attempts to fill this gap by investigating the orientation effects of categorical options on response burden and response quality and by studying how the effects of orientation of response categories interact with cognition capacity. The data are drawn from an experiment embedded in the 2013 Internet Survey of the Health and Retirement Study (HRS), in which respondents were randomly assigned to a question with either horizontally or vertically aligned response categories. Response burden is measured by response time, and response quality is measured by reliability, primacy effect, and item missing on the question. Horizontal orientation is found to be more burdensome than vertical orientation on the web for HRS respondents, but there is no significant difference between the two orientations on primacy effect and item missing, and the two orientations are equally reliable. The effects of cognition capacity are found to interact with orientation on both response burden and response quality on the web. Compared to vertical orientation, horizontal orientation leads to longer response time but less primacy effect for people with lower cognition capacity versus people with higher cognition capacity. However, the effects of the orientation and cognition capacity do not interact on item missing. Vertical orientation for categorical response options in web surveys is recommended in general, but more caution should be exercised if respondents are elderly and primacy effect is a main concern.}, keywords = {categorical response options, horizontal orientation, vertical orientation, web surveys}, isbn = {0894-4393}, doi = {https://doi.org/10.1177/0894439319834296}, author = {Hu, Jingwei} } @article {10627, title = {How Best to Annuitize Defined Contribution Assets?}, number = {WP$\#$2019-13}, year = {2019}, institution = {Center for Retirement Research at Boston College}, type = {Report}, address = {Newton, MA}, abstract = {Unlike defined benefit pensions that provide participants with steady benefits for as long as they live, 401(k) plans and Individual Retirement Accounts (IRAs) provide little guidance on how to turn accumulated assets into income. As a result, retirees have to decide how much to withdraw each year and face the risk of either spending too quickly and outliving their resources or spending too conservatively and consuming too little. Surveys of individuals{\textquoteright} plans and several recent studies suggest that people will not draw down their accumulations for fear that they will exhaust their money and be unable to cover end-of-life health care costs. They also must consider how to invest their savings after retirement. These are difficult decisions. Better strategies are possible that will ensure a higher level of lifetime income, reduce the likelihood that people will outlive their resources, and alleviate some of the anxiety associated with post-retirement investing. Workers could use a portion of their 401(k) and IRA assets to purchase an immediate annuity that pays a fixed amount throughout their lives, typically starting at age 65. Or they could purchase an advanced life deferred annuity (ALDA) that requires a smaller share of accumulated assets and begins payments at a later age like 85. Alternatively, they could use their assets to delay claiming Social Security {\textendash} essentially purchasing an inflation-indexed annuity. Right now, none of these three options is commonly used. Very few workers choose to purchase immediate or deferred annuities (the first two options). And few retirees appear to be deferring claiming in order to receive the maximum annuity income from Social Security {\textendash} most people simply retire earlier and claim immediately. Increasing annuitization in a meaningful way would require embedding annuities in 401(k) plans, with annuitization as the default. Recent proposed federal legislation, such as the SECURE Act (Setting Every Community Up for Retirement Enhancement), encourages plan sponsors to offer annuities in their plans by establishing a fiduciary safe harbor when specific statutory conditions are followed in selecting an insurance company. This legislation does not address, however, the question of defaults or the possibility of using 401(k) assets to purchase additional Social Security benefits. Moving forward on these fronts would require some consensus about the appropriate share of 401(k) assets to be annuitized and the best method for annuitizing them. To address these issues, this paper compares the level of lifetime utility generated by alternative annuitization approaches {\textendash} immediate annuities, deferred annuities, and additional Social Security through delayed claiming. The analysis also tests different assumptions for the share of initial wealth that participants use to purchase these products.}, keywords = {Annuitization, contribution}, url = {https://crr.bc.edu/working-papers/how-best-to-annuitize-defined-contribution-assets/}, author = {Alicia H. Munnell and Gal Wettstein and Wenliang Hou} } @article {10581, title = {How Reliant are Older Americans on State and Local Government Pensions?}, number = {WP 2019-399}, year = {2019}, type = {Report}, abstract = {State and local government pension plans cover about 19.5 million participants, and many participants are heavily reliant on these pensions for retirement income. Most of these plans, however, are underfunded. Based on data from the Health and Retirement Study, we examined the lifetime work histories of those observed at ages 67 to 72 in 2004, 2008, or 2014. Seventy-seven percent of single persons and 61 percent of couple households had never worked for state or local (S\&L) government. Among those single and couple households who did work for S\&L government, we found that they have on average more years of education and more economic resources. Among currently retired and near-retirement households, we compared economic preparation for retirement according to their lifetime employment in the S\&L sector, and we examined how economic preparation would be affected if pension benefits were cut. Based on stochastic simulations, which account for uncertainty about length of life and out-of-pocket medical expenditures, we found that economic preparation for retirement among those with S\&L government work histories would only be modestly reduced if their pension income were cut. Under a 50 percent cut to all pension income of households with any S\&L sector work, only an additional three to four percent of these households would no longer be prepared for retirement. The change is modest because households with S\&L employment have better preparation than other households; some of the cuts are paid for by reduced taxes; and the affected households will bequeath less.}, url = {https://mrdrc.isr.umich.edu/pubs/how-reliant-are-older-americans-on-state-and-local-government-pensions/}, author = {Philip Armour and Michael D Hurd and Susann Rohwedder} } @proceedings {10174, title = {HRS at the American Sociological Association 2019}, journal = {American Sociological Association}, year = {2019}, publisher = {Health and Retirement Study}, address = {New York City}, author = {HRS Staff} } @proceedings {10022, title = {HRS Presentations at PAA by Date (2019)}, journal = {Population Association of America}, year = {2019}, month = {04/2019}, publisher = {Health and Retirement Study, Survey Research Center, Institute for Social Research, University of Michigan}, address = {Austin, TX}, author = {HRS Staff} } @proceedings {10031, title = {HRS Presentations at the American Geriatrics Society 2019}, journal = {American Geriatrics Society}, year = {2019}, month = {04/2019}, pages = {2}, publisher = {Health and Retirement Study, Survey Research Center, Institute for Social Research, University of Michigan}, address = {Portland, OR}, author = {HRS Staff} } @article {9913, title = {Impairments in Individual Autonomous Living Tasks and Time to Self-Care Disability in Middle-Aged and Older Adults}, journal = {Journal of the American Medical Directors Association}, volume = {20}, year = {2019}, pages = {730-735}, type = {Journal}, abstract = {Objectives: Impairments in specific tasks that are necessary for independent living may identify future self-care limitations, and the use of time-varying covariates can better capture the fluidity in functional capacity trajectories over time. The purpose of this study was to determine the associations between individual instrumental activities of daily living (IADL) impairments and time to activities of daily living (ADL) disability for middle-aged and older adults in the United States. Design: Longitudinal panel. Setting: Detailed interviews that included physical, biological, and psychosocial measures were completed in person. The core interview was typically completed over the telephone. Participants: A nationally representative sample of 15,336 adults aged at least 50 years from the 2006 wave of the Health and Retirement Study was followed for 8 years. Measures: Ability to perform IADL and ADL were self-reported at each wave. Separate covariate-adjusted Cox models were used to examine the time-varying associations between individual IADL impairments and time to ADL disability. Results: The presence of each IADL impairment was associated with a higher hazard ratio for an ADL disability for the following functions: 2.52 [95\% confidence interval (CI) 2.35, 2.70] for grocery shopping, 1.91 (CI 1.77, 2.06) for preparing hot meals, 1.55 (CI 1.37, 1.76) for taking medications, 1.48 (CI 1.36, 1.61) for managing money, 1.41 (CI 1.27, 1.57) for using a telephone, and 1.38 (CI 1.29, 1.48) for using a map. Conclusions/Implications: Our findings provide insights into the disabling process by revealing how impairments in each IADL are differentially associated with time to ADL disability. Interventions aiming to retain function during aging should be informed by fluctuations in IADL performance and how specific IADL impairments may exacerbate functional capacity declines more so than others.}, keywords = {Activities of Daily Living, Caregiving, Cognitive Ability, Disabilities}, issn = {15258610}, doi = {10.1016/j.jamda.2018.10.014}, url = {https://linkinghub.elsevier.com/retrieve/pii/S1525861018305875https://api.elsevier.com/content/article/PII:S1525861018305875?httpAccept=text/xmlhttps://api.elsevier.com/content/article/PII:S1525861018305875?httpAccept=text/plain}, author = {Ryan P McGrath and Brian C Clark and Erlandson, Kristine M. and Stephen D. Herrmann and Brenda Vincent and Orman T Hall and Kyle J Hackney} } @article {11347, title = {Incentives for Home- and Community-Based Care Under the Affordable Care Act: Implications for SSI Receipt}, year = {2019}, institution = {University of Wisconsin-Madison}, abstract = {One in three 65-year-olds will require long term care at some point in their lives. Most nursing home stays cost over $3,500 a month, an expense that eventually exhausts the financial resources of most families. Medicaid currently covers these expenses for 6 out of 10 nursing home residents. Not all those who require care need enough help to justify moving into a nursing home, but in many states Medicaid will not pay for care received at home. In these states, moving into a nursing home is the only way to get help paying for care. The Balancing Incentives Program (BIP), which is part of the Affordable Care Act, encouraged states that spend most of their Medicaid dollars on nursing home care to adopt programs and practices that extend coverage for care while living at homes, living with relatives, or living in assisted living facilities. In participating states, the BIP may have enabled some elderly to return to home and community settings or prevented them from needing to move into nursing homes. When living outside of a nursing home, low income elderly may also be eligible for Supplemental Security Income (SSI) payments. SSI is income assistance available to financially needy elderly, disabled and blind persons living in the community. People living in nursing homes are generally not eligible for SSI. Our project will examine whether and how the BIP changed living arrangements and receipt of SSI. It is a first step towards understanding whether the BIP improved the lives and well-being of economically-disadvantaged elderly adults. If changes in living arrangements are found, future work will examine the impact on the health of those affected and on relatives who may be providing or coordinating their care.}, keywords = {Affordable Care Act, CMS, SSA, SSI}, url = {https://cfsrdrc.wisc.edu/publications/working-paper/wi19-08}, author = {Mary K. Hamman and Helppie-McFall, Brooke and Daniela Hochfellner} } @article {9764, title = {Interdependence in Health and Functioning Among Older Spousal Caregivers and Care Recipients.}, journal = {Western Journal of Nursing Research}, volume = {41}, year = {2019}, pages = {685-703}, abstract = {Older spousal caregiving relationships involve support that may be affected by the health of either the caregiver or care recipient. We conducted a longitudinal analysis using pooled data from 4,632 community-dwelling spousal care recipients and caregivers aged ⩾50 from the 2002 to 2014 waves of the Health and Retirement Study. We specified logistic and negative binomial regression models using lagged predictor variables to assess the role of partner health status on spousal caregiver and care recipient health care utilization and physical functioning outcomes. Care recipients{\textquoteright} odds of hospitalization, odds ratio (OR): 0.83, p<.001, decreased when caregivers had more ADL difficulties. When spouses were in poorer versus better health, care recipients{\textquoteright} bed days decreased (4.69 vs. 2.54) while caregivers{\textquoteright} bed days increased (0.20 vs. 0.96). Providers should consider the dual needs of caregivers caring for care recipients and their own health care needs, in adopting a family-centered approach to management of older adult long-term care needs.}, keywords = {Activities of Daily Living, Caregiving, Marriage, Physical Ability}, issn = {1552-8456}, doi = {10.1177/0193945918781057}, author = {Geoffrey J Hoffman and Sarah A. Burgard and Carolyn A Mendez-Luck and Joseph E Gaugler} } @article {9770, title = {Internet Use and Preventive Health Behaviors Among Couples in Later Life: Evidence from the Health and Retirement Study.}, journal = {Gerontologist}, year = {2019}, abstract = {

Background and Objectives: The aim of this study was to examine the link between internet use and preventive health behaviors. We focused on couples to examine whether there were cross-partner associations between internet use and preventive health behaviors.

Research Design and Methods: The data for this study came from the 2010 and 2012 waves of the Health and Retirement Study and the sample consisted of 5,143 pairs of coupled-individuals. Preventive health behaviors included cancer screenings (mammogram and prostate tests), cholesterol tests, and flu shots. Logistic multilevel actor-partner interdependence models were employed to test the study hypotheses.

Results: Internet use was associated with a higher likelihood of receiving prostate exams and cholesterol tests for husbands, net of demographic and health characteristics, and insurance status. We found that wives{\textquoteright} internet use was associated with a higher likelihood of receiving flu shots and prostate exams for husbands, but husbands{\textquoteright} internet use was not associated with wives{\textquoteright} preventive health behaviors.

Discussion and Implications: Research linking internet use and preventive health behaviors is important because such behaviors are associated not only with health of the older population but also with substantial reductions in health care expenditures. Our findings suggested that internet use of older adults is associated with their own preventive health behaviors, as well as their spouses{\textquoteright} preventive health behaviors. Interventions and programs to facilitate older adults{\textquoteright} preventive health behaviors should consider couple-based approaches.

}, keywords = {Health Behavior, Internet usage, Marriage, Preventative Care}, issn = {1758-5341}, doi = {10.1093/geront/gny044}, author = {Nam, Sangbo and Sae Hwang Han and Megan Gilligan} } @article {10375, title = {Interpreting Subjective and Objective Measures of Job Resources: The Importance of Sociodemographic Context.}, journal = {International Journal of Environmental Research and Public Health}, volume = {16}, year = {2019}, month = {2019 08 23}, abstract = {

Salutary retirement policy depends on a clear understanding of factors in the workplace that contribute to work ability at older ages. Research in occupational health typically uses either self-reported or objective ratings of the work environment to assess workplace determinants of health and work ability. This study assessed whether individual characteristics and work-related demands were differentially associated with (1) self-reported ratings of job resources from older workers in the Health and Retirement Study, and (2) corresponding objective ratings of job resources from the Occupational Information Network (O*NET). Results from regression and relative weights analyses showed that self-reported ratings were associated with self-reported job demands and personal resources, whereas corresponding O*NET ratings were associated with differences in gender, race, or socioeconomic standing. As a result, subjective ratings may not capture important aspects of aging workers{\textquoteright} sociodemographic background that influence work ability, occupational sorting, opportunities for advancement, and ultimately the job resources available to them. Future studies should consider including both subjective and objective measures to capture individual and societal level processes that drive the relationship between work, health, and aging.

}, keywords = {Job resources, sociodemographics}, issn = {1660-4601}, doi = {10.3390/ijerph16173058}, url = {https://www.ncbi.nlm.nih.gov/pubmed/31443601}, author = {Lauren L Schmitz and Courtney L McCluney and Amanda Sonnega and Margaret T Hicken} } @mastersthesis {10377, title = {Life Satisfaction and Healthcare Utilization Among Immigrants to the United States}, volume = {Master}, year = {2019}, pages = {71}, school = {Louisiana State University}, abstract = {Previous research suggests a relationship between life satisfaction and healthcare utilization or HCU (Habibov \& Afandi, 2016; Kim, Park, Sun, Smith, \& Peterson, 2014). However, no study was found that examined this relationship among elderly American immigrants. The purpose of this study was to determine whether life satisfaction is linked to HCU for this population. The researcher of the current study applied binary logistic regression to data taken from the Health and Retirement Survey to determine whether changes in life satisfaction could be linked to variance in HCU across seven domains, including hospitalization, overnight nursing home stays, doctors visits, dentist visits, use of prescription medications, use of home health, and outpatient surgery. Results of this analysis suggested that a significant relationship did exist between life satisfaction and each of these domains, although the relationships varied in direction and effect size.}, keywords = {Healthcare, Immigration, Life Satisfaction}, url = {https://digitalcommons.lsu.edu/gradschool_theses/4999/}, author = {Harrelson, MC} } @article {10177, title = {A life-span approach to examining older vulnerable population{\textquoteright}s subjective well-being: The role of adversity and trauma.}, journal = {Aging and Mental Health}, year = {2019}, type = {Journal}, abstract = {Using the life course guidance, the goal of this study was to examine the degree to which previously experienced adversity and trauma was associated with subjective well-being among older adults. Data from the Health and Retirement Study (1992-2012) was used to examine these trends over time. We used multilevel models to test for specific individual change across time. The study sample included older community dwellers aged 55 and over ( = 5,649). In terms of early childhood adversities, 77\% experienced at least one trauma and 72\% experienced at least one trauma in adulthood. Adverse childhood experiences and adulthood trauma were predictors of depressive symptoms, poorer self-rated health, and worse life satisfaction. Older black, other race, and Hispanic groups have poorer subjective well-being overtime compared to whites. Findings suggested exposure to childhood adversities and adulthood trauma increases depressive symptoms, poor self-rated health, and low satisfaction of life over time. Findings from this study provide insight into how life course exposure of adversity and trauma among older adults showed a negative trend over time.}, keywords = {Childhood adversity, Trauma, Well-being}, issn = {1364-6915}, doi = {10.1080/13607863.2019.1652245}, url = {https://www.tandfonline.com/doi/full/10.1080/13607863.2019.1652245?scroll=top\&needAccess=true}, author = {Mai See Yang and Hedeker, Donald} } @article {10158, title = {Lifetime benefits of early detection and treatment of diabetic kidney disease.}, journal = {PLoS One}, volume = {14}, year = {2019}, pages = {e0217487}, abstract = {

OBJECTIVES: Diabetic kidney disease (DKD) is a frequent complication of diabetes with potentially devastating consequences that may be prevented or delayed. This study aimed to estimate the health and economic benefit of earlier diagnosis and treatment of DKD.

METHODS: Life expectancy and medical spending for people with diabetes were modeled using The Health Economics Medical Innovation Simulation (THEMIS). THEMIS uses data from the Health and Retirement Study to model cohorts of individuals over age 50 to project population-level lifetime health and economic outcomes. DKD status was imputed based on diagnoses and laboratory values in the National Health and Nutrition Examination Survey. We simulated the implementation of a new biomarker identifying people with diabetes at an elevated risk of DKD and DKD patients at risk of rapid progression.

RESULTS: Compared to baseline, the prevalence of DKD declined 5.1\% with a novel prognostic biomarker test, while the prevalence of diabetes with stage 5 chronic kidney disease declined 3.0\%. Consequently, people with diabetes gained 0.2 years in life expectancy, while per-capita annual medical spending fell by 0.3\%. The estimated cost was $12,796 per life-year gained and $25,842 per quality-adjusted life-year.

CONCLUSIONS: A biomarker test that allows earlier treatment reduces DKD prevalence and slows DKD progression, thereby increasing life expectancy among people with diabetes while raising healthcare spending by less than one percent.

}, keywords = {Biomarkers, Diabetes, Kidney disease, THEMIS}, issn = {1932-6203}, doi = {10.1371/journal.pone.0217487}, author = {Thornton Snider, J. and Jeffrey Sullivan and van Eijndhoven, Emma and Michael K. Hansen and Bellosillo, Nobel and Neslusan, Cheryl and O{\textquoteright}Brien, Ellen and Riley, Ralph and Seth Seabury and Bertram L Kasiske} } @article { ISI:000499534300001, title = {Longer-but Harder-Lives?: The Hispanic Health Paradox and the Social Determinants of Racial, Ethnic, and Immigrant-Native Health Disparities from Midlife through Late Life}, journal = {JOURNAL OF HEALTH AND SOCIAL BEHAVIOR}, year = {2019}, pages = {UNSP 0022146519884538}, type = {Article; Early Access}, abstract = {Though Hispanics live long lives, whether a {\textquoteleft}{\textquoteleft}Hispanic paradox{\textquoteright}{\textquoteright} extends to older-age health remains unclear, as do the social processes underlying racial-ethnic and immigrant-native health disparities. Using data from the Health and Retirement Study (2004-2012; N = 6,581), we assess the health of U.S.- and foreign-born Hispanics relative to U.S.-born whites and blacks and examine the socioeconomic, stress, and behavioral pathways contributing to health disparities. Findings indicate higher disability, depressive, metabolic, and inflammatory risk for Hispanics relative to whites and similar health profiles among Hispanics and blacks. We find limited evidence of a healthy immigrant pattern among foreign-born Hispanics. While socioeconomic factors account for Hispanic-white gaps in inflammation, disparities in other outcomes persist after adjustment for socioeconomic status, due in part to group differences in stress exposure. Hispanics may live long lives, but their lives are characterized by more socioeconomic hardship, stress, and health risk than whites and similar health risks as blacks.}, keywords = {Aging, Health Disparities, Hispanic paradox}, issn = {0022-1465}, doi = {10.1177/0022146519884538, Early Access Date = {NOV 2019}, author = {Courtney Boen and Robert A Hummer} } @article {MCGRATH2019, title = {The Longitudinal Associations of Handgrip Strength and Cognitive Function in Aging Americans}, journal = {Journal of the American Medical Directors Association}, year = {2019}, abstract = {Objectives Factors that are responsible for age-related neurologic deterioration of noncognitive and cognitive processes may have a shared cause. We sought to examine the temporal, directional associations of handgrip strength and cognitive function in a national sample of aging Americans. Design Longitudinal panel. Setting Enhanced interviews that included physical, biological, and psychosocial measures were completed in person. Core interviews were often conducted over the telephone. Participants The analytic sample included 14,775 Americans aged at least 50 years who participated in at least 2 waves of the 2006-2016 waves of the Health and Retirement Study. Measures Handgrip strength was measured with a hand-held dynamometer. Participants were considered cognitively intact, mildly impaired, or severely impaired according to the Telephone Interview of Cognitive Status questionnaire. Separate lagged general estimating equations analyzed the directional associations of handgrip strength and cognitive function. Results The overall time to follow-up was 2.1 {\textpm} 0.4 years. Every 5 kg higher handgrip strength was associated with 0.97 [95\% confidence interval (CI) 0.93, 0.99] lower odds for both future cognitive impairment and worse cognitive impairment. Those who were not weak had 0.54 (CI 0.43, 0.69) lower odds for future cognitive impairment and 0.57 (CI 0.46, 0.72) lower odds for future worse cognitive impairment. Conversely, any (β = -1.09; CI {\textendash}1.54, -0.64), mild (β = -0.85; CI {\textendash}1.34, -0.36), and severe cognitive impairment (β = -2.34; CI {\textendash}3.25, -1.42) predicted decreased handgrip strength. Further, the presence of any, mild, and severe cognitive impairment was associated with 1.82 (CI 1.48, 2.24), 1.65 (CI 1.31, 2.08), and 2.53 (CI 1.74, 3.67) greater odds for future weakness, respectively. Conclusions/Implications Strength capacity and cognitive function may parallel each other, whereby losses of functioning in 1 factor may forecast losses of functioning in the other. Handgrip strength could be used for assessing cognitive status in aging Americans and strength capacity should be monitored in those with cognitive impairment.}, keywords = {Alzheimer{\textquoteright}s disease, Dementia, Geriatrics, Muscle Strength, Muscle Weakness, sarcopenia}, issn = {1525-8610}, doi = {https://doi.org/10.1016/j.jamda.2019.08.032}, url = {http://www.sciencedirect.com/science/article/pii/S1525861019306498}, author = {Ryan P McGrath and Brenda Vincent and Kyle J Hackney and Sheria G Robinson-Lane and Brian Downer and Brian C Clark} } @article {10668, title = {Measurement of Fall Injury With Health Care System Data and Assessment of Inclusiveness and Validity of Measurement Models}, journal = {JAMA Network Open}, volume = {2}, year = {2019}, pages = {e199679-e199679}, abstract = {National injury surveillance systems use administrative data to collect information about severe fall-related trauma and mortality. Measuring milder injuries in ambulatory clinics would improve comprehensive outcomes measurement across the care spectrum.To assess a flexible set of administrative data{\textendash}only algorithms for health systems to capture a greater breadth of injuries than traditional fall injury surveillance algorithms and to quantify the algorithm inclusiveness and validity associated with expanding to milder injuries.In this longitudinal diagnostic study of 13 939 older adults (>=65 years) in the nationally representative Health and Retirement Study, a survey was conducted every 2 years and was linked to hospital, emergency department, postacute skilled nursing home, and outpatient Medicare claims (2000-2012). During each 2-year observation period, participants were considered to have sustained a fall-related injury (FRI) based on a composite reference standard of having either an external cause of injury (E-code) or confirmation by the Health and Retirement Study patient interview. A framework involving 3 algorithms with International Classification of Diseases, Ninth Revision codes that extend FRI identification with administrative data beyond the use of fall-related E-codes was developed: an acute care algorithm (head and face or limb, neck, and trunk injury reported at the hospital or emergency department), a balanced algorithm (all acute care algorithm injuries plus severe nonemergency outpatient injuries), and an inclusive algorithm (almost all injuries). Data were collected from January 1, 1998, through December 31, 2012, and statistical analysis was performed from August 1, 2016, to March 1, 2019.Validity, measured as the proportion of potential FRI diagnoses confirmed by the reference standard, and inclusiveness, measured as the proportion of reference-standard FRIs captured by the potential FRI diagnoses.Of 13 939 participants, 1672 (42.4\%) were male, with a mean (SD) age of 77.56 (7.63) years. Among 50 310 observation periods, 9270 potential FRI diagnoses (18.4\%) were identified; these were tested against 8621 reference-standard FRIs (17.1\%). Compared with the commonly used method of E-coded{\textendash}only FRIs (2-year incidence, 8.8\% [95\% CI, 8.6\%-9.1\%]; inclusion of 51.5\% [95\% CI, 50.4\%-52.5\%] of the reference-standard FRIs), FRI inclusion was increased with use of the study framework of algorithms. With the acute care algorithm (2-year incidence, 12.6\% [95\% CI, 12.4\%-12.9\%]), validity was prioritized (88.6\% [95\% CI, 87.4\%-89.8\%]) over inclusiveness (62.1\% [95\% CI, 61.1\%-63.1\%]). The balanced algorithm showed a 2-year incidence of 14.6\% (95\% CI, 14.3\%-14.9\%), inclusion of 65.3\% (95\% CI, 64.3\%-66.3\%), and validity of 83.2\% (95\% CI, 81.9\%-84.6\%). With the inclusive algorithm, the number of potential FRIs increased compared with the E-code{\textendash}only method (2-year incidence, 17.4\% [95\% CI, 17.1\%-17.8\%]; inclusion, 68.4\% [95\% CI, 67.4\%-69.3\%]; validity, 75.2\% [95\% CI, 73.7\%-76.6\%]).The findings suggest that use of algorithms with International Classification of Diseases, Ninth Revision codes may increase inclusion of FRIs by health care systems compared with E-codes and that these algorithms may be used by health systems to evaluate interventions and quality improvement efforts.}, keywords = {Fall injury, Health Care, Inclusiveness}, issn = {2574-3805}, doi = {10.1001/jamanetworkopen.2019.9679}, author = {Lillian C. Min and Mary Tinetti and Kenneth M. Langa and Ha, Jinkyung and Neil B. Alexander and Geoffrey J Hoffman} } @article {9802, title = {Measuring Social Participation in the Health and Retirement Study.}, journal = {Gerontologist}, year = {2019}, abstract = {

Background and Objectives: Large data sets have the potential to reveal useful information regarding social participation; however, most data sets measure social participation via individual items without a global assessment of social participation.

Research Design and Methods: We used data from the Health and Retirement Study (HRS) to assess whether 8 items from questionnaire pertaining to social participation (religious attendance, caring for an adult, activities with grandchildren, volunteering, charity work, education, social clubs, nonreligious organizations) formed a reliable, cohesive scale and to explore the predictive validity of this scale. We included respondents 65 years and older in the HRS who returned the psychosocial questionnaire in 2010 and 2012 with responses to the social participation items (n = 4,317 and n = 3,978). Three scales were explored: SoPart-30 using the original scoring; SoPart-10 using modified scoring; and SoPart-5 using dichotomous scoring.

Results: Five items were retained as a single factor for each scale, and graded response models and Mokken scale analysis confirmed the scale items with the SoPart-10 scale having the highest reliability (alpha = 0.74).

Discussion and Implications: Results suggest that a scale derived from the social participation items in the HRS may be useful in characterizing general social participation levels and identifying modifiable factors that can promote it in older populations.

}, keywords = {Social Factors, Social Support, Survey Methodology}, issn = {1758-5341}, doi = {10.1093/geront/gny094}, author = {Bret Howrey and Carri L. Hand} } @article {10225, title = {A meta-analysis of genome-wide association studies identifies multiple longevity genes.}, journal = {Nature Communications}, volume = {10}, year = {2019}, month = {08/2019}, pages = {3669}, abstract = {

Human longevity is heritable, but genome-wide association (GWA) studies have had limited success. Here, we perform two meta-analyses of GWA studies of a rigorous longevity phenotype definition including 11,262/3484 cases surviving at or beyond the age corresponding to the 90th/99th survival percentile, respectively, and 25,483 controls whose age at death or at last contact was at or below the age corresponding to the 60th survival percentile. Consistent with previous reports, rs429358 (apolipoprotein E (ApoE) ε4) is associated with lower odds of surviving to the 90th and 99th percentile age, while rs7412 (ApoE ε2) shows the opposite. Moreover, rs7676745, located near GPR78, associates with lower odds of surviving to the 90th percentile age. Gene-level association analysis reveals a role for tissue-specific expression of multiple genes in longevity. Finally, genetic correlation of the longevity GWA results with that of several disease-related phenotypes points to a shared genetic architecture between health and longevity.

}, keywords = {genes, Genome-Wide Association Study, GWA, longevity genes, meta-analysis}, issn = {2041-1723}, doi = {10.1038/s41467-019-11558-2}, url = {https://www.ncbi.nlm.nih.gov/pubmed/31413261}, author = {Deelen, Joris and Daniel S Evans and Dan E Arking and Tesi, Niccol{\`o} and Nygaard, Marianne and Liu, Xiaomin and Wojczynski, Mary K and Biggs, Mary L and van der Spek, Ashley and Atzmon, Gil and Erin B Ware and Sarnowski, Chlo{\'e} and Albert Vernon Smith and Sepp{\"a}l{\"a}, Ilkka and Cordell, Heather J and Dose, Janina and Amin, Najaf and Alice M. Arnold and Kristin L. Ayers and Barzilai, Nir and Becker, Elizabeth J and Beekman, Marian and Blanch{\'e}, H{\'e}l{\`e}ne and Christensen, Kaare and Christiansen, Lene and Collerton, Joanna C and Cubaynes, Sarah and Steven R Cummings and Davies, Karen and Debrabant, Birgit and Deleuze, Jean-Fran{\c c}ois and Duncan, Rachel and Jessica Faul and Franceschi, Claudio and Galan, Pilar and Gudnason, Vilmundur and Tamara B Harris and Huisman, Martijn and Hurme, Mikko A and Jagger, Carol and Jansen, Iris and Jylh{\"a}, Marja and K{\"a}h{\"o}nen, Mika and Karasik, David and Sharon L R Kardia and Kingston, Andrew and Kirkwood, Thomas B L and Lenore J Launer and Lehtim{\"a}ki, Terho and Lieb, Wolfgang and Lyytik{\"a}inen, Leo-Pekka and Martin-Ruiz, Carmen and Min, Junxia and Nebel, Almut and Anne B Newman and Nie, Chao and Nohr, Ellen A and Orwoll, Eric S and Thomas T Perls and Province, Michael A and Psaty, Bruce M and Olli T Raitakari and Reinders, Marcel J T and Robine, Jean-Marie and Rotter, Jerome I and Sebastiani, Paola and Jennifer A Smith and S{\o}rensen, Thorkild I A and Kent D Taylor and Andr{\'e} G Uitterlinden and van der Flier, Wiesje and Sven J van der Lee and Cornelia M van Duijn and van Heemst, Diana and James W Vaupel and David R Weir and Ye, Kenny and Zeng, Yi and Zheng, Wanlin and Holstege, Henne and Douglas P Kiel and Kathryn L Lunetta and Eline P Slagboom and Joanne M Murabito} } @article {9990, title = {Moral hazard and long-term care insurance}, journal = {The Geneva Papers on Risk and Insurance - Issues and Practice}, volume = {44}, year = {2019}, pages = {231{\textendash}251}, abstract = {In private long-term care insurance markets, moral hazard is central to pricing and long-run robustness of the market, yet there is remarkably little evidence on the extent to which moral hazard is present in long-term care insurance. We use Health and Retirement Study data from 1996 to 2014 to assess moral hazard in nursing home and home care use in private long-term care insurance, employing a combination of propensity score matching and instrumental variables approaches. We find evidence of significant moral hazard in home care use and a potentially meaningful but noisy effect on nursing home use. Policymakers designing incentives to promote private long-term care insurance should consider the consequences of moral hazard.}, keywords = {Aging in place, Long-term care insurance, Nursing homes}, issn = {1018-5895}, doi = {10.1057/s41288-018-00119-1}, author = {R. Tamara Konetzka and Daifeng He and Dong, Jing and John A. Nyman} } @article {12128, title = {Multi-ancestry study of blood lipid levels identifies four loci interacting with physical activity.}, journal = {Nature Communications}, volume = {10}, year = {2019}, pages = {376}, abstract = {

Many genetic loci affect circulating lipid levels, but it remains unknown whether lifestyle factors, such as physical activity, modify these genetic effects. To identify lipid loci interacting with physical activity, we performed genome-wide analyses of circulating HDL cholesterol, LDL cholesterol, and triglyceride levels in up to 120,979 individuals of European, African, Asian, Hispanic, and Brazilian ancestry, with follow-up of suggestive associations in an additional 131,012 individuals. We find four loci, in/near CLASP1, LHX1, SNTA1, and CNTNAP2, that are associated with circulating lipid levels through interaction with physical activity; higher levels of physical activity enhance the HDL cholesterol-increasing effects of the CLASP1, LHX1, and SNTA1 loci and attenuate the LDL cholesterol-increasing effect of the CNTNAP2 locus. The CLASP1, LHX1, and SNTA1 regions harbor genes linked to muscle function and lipid metabolism. Our results elucidate the role of physical activity interactions in the genetic contribution to blood lipid levels.

}, keywords = {Adolescent, Adult, Aged, Aged, 80 and over, Asians, Blacks, Brazil, Calcium-Binding Proteins, Cholesterol, Cholesterol, HDL, Cholesterol, LDL, Exercise, Female, Genetic Loci, Genome-Wide Association Study, Genotype, Hispanic or Latino, Humans, LIM-Homeodomain Proteins, Lipid Metabolism, Lipids, Male, Membrane Proteins, Microtubule-Associated Proteins, Middle Aged, Muscle Proteins, Nerve Tissue Proteins, Transcription Factors, Triglycerides, Whites, Young Adult}, issn = {2041-1723}, doi = {10.1038/s41467-018-08008-w}, author = {Kilpel{\"a}inen, Tuomas O and Bentley, Amy R and Noordam, Raymond and Yun Ju Sung and Schwander, Karen and Thomas W Winkler and Jakupovi{\'c}, Hermina and Daniel I Chasman and Alisa Manning and Ntalla, Ioanna and Aschard, Hugues and Brown, Michael R and de Las Fuentes, Lisa and Franceschini, Nora and Guo, Xiuqing and Vojinovic, Dina and Aslibekyan, Stella and Feitosa, Mary F and Kho, Minjung and Musani, Solomon K and Melissa Richard and Wang, Heming and Wang, Zhe and Traci M Bartz and Bielak, Lawrence F and Campbell, Archie and Dorajoo, Rajkumar and Fisher, Virginia and Hartwig, Fernando P and Horimoto, Andrea R V R and Li, Changwei and Kurt Lohman and Marten, Jonathan and Sim, Xueling and Smith, Albert V and Tajuddin, Salman M and Alver, Maris and Amini, Marzyeh and Boissel, Mathilde and Jin-Fang Chai and Chen, Xu and Divers, Jasmin and Evangelou, Evangelos and Gao, Chuan and Graff, Mariaelisa and Sarah E Harris and He, Meian and Hsu, Fang-Chi and Jackson, Anne U and Jing Hua Zhao and Kraja, Aldi T and K{\"u}hnel, Brigitte and Laguzzi, Federica and Lyytik{\"a}inen, Leo-Pekka and Ilja M Nolte and Rauramaa, Rainer and Riaz, Muhammad and Robino, Antonietta and Rueedi, Rico and Heather M Stringham and Takeuchi, Fumihiko and van der Most, Peter J and Varga, Tibor V and Verweij, Niek and Erin B Ware and Wen, Wanqing and Li, Xiaoyin and Yanek, Lisa R and Amin, Najaf and Donna K Arnett and Boerwinkle, Eric and Brumat, Marco and Brian E Cade and Canouil, Micka{\"e}l and Chen, Yii-Der Ida and Concas, Maria Pina and Connell, John and de Mutsert, Ren{\'e}e and de Silva, H Janaka and de Vries, Paul S and Demirkan, Ayse and Ding, Jingzhong and Charles B Eaton and Jessica Faul and Friedlander, Yechiel and Gabriel, Kelley P and Ghanbari, Mohsen and Giulianini, Franco and Gu, Chi Charles and Gu, Dongfeng and Tamara B Harris and He, Jiang and Heikkinen, Sami and Heng, Chew-Kiat and Hunt, Steven C and Ikram, M Arfan and Jost Bruno Jonas and Koh, Woon-Puay and Komulainen, Pirjo and Krieger, Jose E and Stephen B Kritchevsky and Kutalik, Zolt{\'a}n and Kuusisto, Johanna and Langefeld, Carl D and Langenberg, Claudia and Lenore J Launer and Leander, Karin and Lemaitre, Rozenn N and Lewis, Cora E and Liang, Jingjing and Liu, Jianjun and M{\"a}gi, Reedik and Manichaikul, Ani and Meitinger, Thomas and Andres Metspalu and Milaneschi, Yuri and Mohlke, Karen L and Thomas H Mosley and Murray, Alison D and Michael A Nalls and Nang, Ei-Ei Khaing and Nelson, Christopher P and Nona, Sotoodehnia and Norris, Jill M and Nwuba, Chiamaka Vivian and Jeff O{\textquoteright}Connell and Palmer, Nicholette D and Papanicolau, George J and Pazoki, Raha and Nancy L Pedersen and Peters, Annette and Peyser, Patricia A and Polasek, Ozren and David J Porteous and Poveda, Alaitz and Olli T Raitakari and Rich, Stephen S and Neil Risch and Robinson, Jennifer G and Rose, Lynda M and Rudan, Igor and Schreiner, Pamela J and Scott, Robert A and Stephen Sidney and Sims, Mario and Smith, Jennifer A and Snieder, Harold and Sofer, Tamar and John M Starr and Sternfeld, Barbara and Strauch, Konstantin and Tang, Hua and Kent D Taylor and Tsai, Michael Y and Tuomilehto, Jaakko and Andr{\'e} G Uitterlinden and van der Ende, M Yldau and van Heemst, Diana and Voortman, Trudy and Waldenberger, Melanie and Wennberg, Patrik and Wilson, Gregory and Xiang, Yong-Bing and Yao, Jie and Yu, Caizheng and Yuan, Jian-Min and Zhao, Wei and Alan B Zonderman and Becker, Diane M and Boehnke, Michael and Bowden, Donald W and de Faire, Ulf and Ian J Deary and Elliott, Paul and T{\~o}nu Esko and Freedman, Barry I and Froguel, Philippe and Paolo P. Gasparini and Gieger, Christian and Kato, Norihiro and Laakso, Markku and Lakka, Timo A and Lehtim{\"a}ki, Terho and Patrik K E Magnusson and Oldehinkel, Albertine J and Brenda W J H Penninx and Nilesh J Samani and Shu, Xiao-Ou and van der Harst, Pim and Jana V. van Vliet-Ostaptchouk and Vollenweider, Peter and Wagenknecht, Lynne E and Wang, Ya X and Wareham, Nicholas J and David R Weir and Wu, Tangchun and Zheng, Wei and Zhu, Xiaofeng and Michele K Evans and Franks, Paul W and Gudnason, Vilmundur and Caroline Hayward and Horta, Bernardo L and Tanika N Kelly and Liu, Yongmei and Kari E North and Pereira, Alexandre C and Ridker, Paul M and Tai, E Shyong and van Dam, Rob M and Fox, Ervin R and Sharon L R Kardia and Liu, Ching-Ti and Dennis O Mook-Kanamori and Province, Michael A and Redline, Susan and Cornelia M van Duijn and Rotter, Jerome I and Charles Kooperberg and Gauderman, W James and Psaty, Bruce M and Kenneth Rice and Munroe, Patricia B and Myriam Fornage and Cupples, L Adrienne and Charles N Rotimi and Alanna C Morrison and Rao, Dabeeru C and Ruth J F Loos} } @article {12123, title = {New alcohol-related genes suggest shared genetic mechanisms with neuropsychiatric disorders.}, journal = {Nature Human Behaviour}, volume = {3}, year = {2019}, pages = {950-961}, abstract = {

Excessive alcohol consumption is one of the main causes of death and disability worldwide. Alcohol consumption is a heritable complex trait. Here we conducted a meta-analysis of genome-wide association studies of alcohol consumption (g d) from the UK Biobank, the Alcohol Genome-Wide Consortium and the Cohorts for Heart and Aging Research in Genomic Epidemiology Plus consortia, collecting data from 480,842 people of European descent to decipher the genetic architecture of alcohol intake. We identified 46 new common loci and investigated their potential functional importance using magnetic resonance imaging data and gene expression studies. We identify genetic pathways associated with alcohol consumption and suggest genetic mechanisms that are shared with neuropsychiatric disorders such as schizophrenia.

}, keywords = {Adult, Aged, Alcohol Drinking, Alcoholism, Brain, Female, genes, Genetic Predisposition to Disease, Genome-Wide Association Study, Humans, Magnetic Resonance Imaging, Male, Mental Disorders, Middle Aged, Neuroimaging, Polymorphism, Single Nucleotide, Quantitative Trait Loci, Schizophrenia, Whites}, issn = {2397-3374}, doi = {10.1038/s41562-019-0653-z}, author = {Evangelou, Evangelos and Gao, He and Chu, Congying and Ntritsos, Georgios and Blakeley, Paul and Butts, Andrew R and Pazoki, Raha and Suzuki, Hideaki and Koskeridis, Fotios and Yiorkas, Andrianos M and Karaman, Ibrahim and Elliott, Joshua and Luo, Qiang and Aeschbacher, Stefanie and Traci M Bartz and Baumeister, Sebastian E and Braund, Peter S and Brown, Michael R and Brody, Jennifer A and Clarke, Toni-Kim and Dimou, Niki and Jessica Faul and Homuth, Georg and Jackson, Anne U and Kentistou, Katherine A and Joshi, Peter K and Lemaitre, Rozenn N and Penelope A Lind and Lyytik{\"a}inen, Leo-Pekka and Mangino, Massimo and Milaneschi, Yuri and Nelson, Christopher P and Ilja M Nolte and Per{\"a}l{\"a}, Mia-Maria and Polasek, Ozren and David J Porteous and Scott M Ratliff and Smith, Jennifer A and Stan{\v c}{\'a}kov{\'a}, Alena and Teumer, Alexander and Tuominen, Samuli and Th{\'e}riault, S{\'e}bastien and Vangipurapu, Jagadish and Whitfield, John B and Wood, Alexis and Yao, Jie and Yu, Bing and Zhao, Wei and Dan E Arking and Auvinen, Juha and Liu, Chunyu and M{\"a}nnikk{\"o}, Minna and Risch, Lorenz and Rotter, Jerome I and Snieder, Harold and Veijola, Juha and Alexandra I Blakemore and Boehnke, Michael and Campbell, Harry and Conen, David and Johan G Eriksson and Hans-J{\"o}rgen Grabe and Guo, Xiuqing and van der Harst, Pim and Catharina A Hartman and Caroline Hayward and Andrew C Heath and J{\"a}rvelin, Marjo-Riitta and K{\"a}h{\"o}nen, Mika and Sharon L R Kardia and K{\"u}hne, Michael and Kuusisto, Johanna and Laakso, Markku and Lahti, Jari and Lehtim{\"a}ki, Terho and McIntosh, Andrew M and Mohlke, Karen L and Alanna C Morrison and Nicholas G Martin and Oldehinkel, Albertine J and Brenda W J H Penninx and Psaty, Bruce M and Olli T Raitakari and Rudan, Igor and Nilesh J Samani and Scott, Laura J and Timothy Spector and Verweij, Niek and David R Weir and James F Wilson and Levy, Daniel and Tzoulaki, Ioanna and Bell, Jimmy D and Matthews, Paul M and Rothenfluh, Adrian and Desrivi{\`e}res, Sylvane and Schumann, Gunter and Elliott, Paul} } @article {RePEc:mpr:mprres:0d12254d6aa542e09156584e8db851ba, title = {New Work-Limiting Health Events and Occupational Transitions Among Older Workers}, year = {2019}, institution = {Mathematica Policy Research}, abstract = {In this study, we use the Health and Retirement Study linked to detailed occupational data to descriptively examine whether the occupational path of older workers who report a new work-limiting health condition in the years before retirement differs from that of workers who remain limitation-free.}, keywords = {Disability, Occupations, Transitions, work limitations}, url = {https://ideas.repec.org/p/mpr/mprres/0d12254d6aa542e09156584e8db851ba.html}, author = {Jody Schimmel Hyde and April Yanyuan Wu} } @article {10463, title = {PATH ANALYSIS OF EDUCATION AND DISEASE BURDEN IN DEMENTIA VULNERABILITY}, journal = {Innovation in Aging}, volume = {3}, year = {2019}, month = {2019/11/08}, pages = {S704 - S704}, abstract = {When considering the various extrinsic variables that may affect disease vulnerability, it is valuable to study temporal ordering of factors to identify areas for disease intervention efforts. This study sought to inform improvement of networks for the purposes of education and health by attempting to better define the causal ordering of ethnicity, age, gender, education, disease burden, and dementia diagnosis with the Aging, Demographics, and Memory Study, a sub-study of the Health and Retirement Study. Participants and/or proxies self-reported total number of chronic conditions, subsequently regarded as disease burden. Assessments occurred over four waves; participants were not reassessed after dementia diagnosis. The current study categorized participants as demented (n=414), identified in any wave, or normal (n=117), identified in the final wave. Cognitively-impaired-not-demented and deceased participants were not considered due to lack of diagnosis. Cross-sectional weighting was used. A path model was developed; ethnicity, age, and gender were antecedent to education, and education was casually ordered before disease burden, which was antecedent to dementia diagnosis. A series of logistic and linear regression analyses were conducted. Results revealed that being non-white (Σβ=0.643, all p{\textquoteright}s<.001), of older age (Σβ=0.250, all p{\textquoteright}s<.001), female (Σβ=0.180, all p{\textquoteright}s<.001), and having increased disease burden (Σβ=0.118, p<.001) all demonstrated a positive total effect on dementia diagnosis. Conversely, more years of education (Σβ=-0.245, p<.001) had a negative total effect on diagnosis. The education to disease burden pathway was non-significant. Ultimately, these results may indicate a need for dementia interventions that target those with low education or high disease burden.}, keywords = {Dementia, dementia vulnerability, Education}, isbn = {2399-5300}, url = {https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6845840/}, author = {Sarah B Hubner and Kim, Hyeon Jung and Boron, Julie Blaskewicz} } @article {10043, title = {Person-environment fit approach to trajectories of cognitive function among older adults who live alone: Intersection of life-course SES disadvantage and senior housing.}, journal = {Journals of Gerontology, Series B: Psychological Sciences \& Social Sciences}, year = {2019}, abstract = {

OBJECTIVES: Drawing from life course and environmental perspectives, we examined the trajectory of cognitive function and how senior housing moderates the effects of life-course socioeconomic status (SES) disadvantage among older people living alone over time.

METHOD: Six waves of the Health and Retirement Study (HRS) were used with multilevel growth modeling to analyze developmental patterns of cognitive function over time and how various forms of life-course SES disadvantage affect cognitive function depending on senior housing residency status.

RESULTS: At baseline, we found a positive role of senior housing in four subgroups: SES disadvantage in childhood only, unstable mobility pattern (disadvantage in childhood and old age only), downward mobility (no disadvantage in childhood, but in later two life stages), and cumulative disadvantage (all three life stages). Over time, the positive role of senior housing for the unstable and the most vulnerable group persisted.

DISCUSSION: Our findings provide a much-needed practical and theoretical underpinning for environmental policy-making efforts regarding vulnerable elders who live alone.

}, keywords = {Cognition \& Reasoning, Housing, Living arrangements, Socioeconomic factors}, issn = {1758-5368}, doi = {10.1093/geronb/gbz025}, author = {So Jung Park and Kwon, Eunsun and BoRin Kim and Han, Yoonsun} } @article {10418, title = {Policy Levers May Improve Older Workers{\textquoteright} Perceptions of Their Psychosocial Work Environment: Research findings show that workplace policies can play a crucial role in the quality of older worker{\textquoteright}s health and job longevity.}, journal = {Generations}, volume = {43}, year = {2019}, pages = {78-85}, abstract = {A supportive psychosocial work environment (PWE) is critical to worker well-being and labor force attachment at older ages. Using data from the Health and Retirement Study, linked to workplace ratings from the Occupational Information Network (0*NET), this article explores factors associated with workers{\textquoteright} perception of their PWE. Deviations in workers{\textquoteright} PWE perceptions relative to corresponding 0*NET ratings are driven not by worker characteristics, but by workplace practices that better policy could amend. Findings support the important role workplace policies play in promoting health and longer working lives.}, keywords = {Policy, Psychosocial, Workers, workplace policies}, author = {Lauren L Schmitz and Courtney L McCluney and Amanda Sonnega and Margaret T Hicken} } @article {2019-52815-00120190903, title = {Predicting current and future anxiety symptoms in cognitively intact older adults with memory complaints.}, journal = {International Journal of Geriatric Psychiatry}, volume = {34}, year = {2019}, pages = {1874-1882}, abstract = {Objectives Memory complaints are a common concern for older adults and may co-occur with anxiety symptoms. Although both memory complaints and anxiety are associated with heightened cognitive decline risk, little is known about how these symptoms develop over time. The purpose of this study was to examine the differential concurrent and longitudinal relationships among anxiety symptoms and two types of memory complaints in cognitively intact older adults. Methods/Design The current study sample was drawn from two longitudinal, nationally representative datasets, the National Health and Aging Trends Study (NHATS) and the Health and Retirement Study (HRS). Cognitively intact older adults aged 65 and over were included, representing six (n = 5069; NHATS) and two (n = 5284; HRS) waves of data, respectively. Using multilevel linear modeling, we tested bidirectional relationships between anxiety and two types of memory complaints: current rating of memory performance and perceived memory de}, keywords = {Anxiety, coordinated analysis, longitudinal, memory complaints, No terms assigned}, issn = {0885-6230}, doi = {10.1002/gps.5204}, author = {Nikki L Hill and Mogle, Jacqueline and Tyler Reed Bell and Bhargava, Sakshi and Wion, Rachel K. and Bhang, Iris} } @mastersthesis {10283, title = {Racial and Ethnic Differences in End-of-Life (EOL) Care and Planning: A Secondary Analysis of the Health and Retirement Study (HRS) 2004-2014}, volume = {PhD}, year = {2019}, note = {Copyright - Database copyright ProQuest LLC; ProQuest does not claim copyright in the individual underlying works; Last updated - 2019-05-09}, month = {2019}, pages = {150}, school = {Fordham University}, type = {phd}, abstract = {Due to population ageing, coupled with advances in medical practices, more older Americans have a greater chance to consider end-of-life (EOL) care options such as hospice use and advance care planning, including the completion of two forms of advance directives, living wills and the Durable Power of Attorney for Health Care (DPAHC). Despite the documented benefits, advance care planning and hospice care are underutilized. A number of studies have been conducted to identify the factors affecting advance care planning and hospice care use, and among those factors, racial and ethnic disparities in EOL care and planning have been well-documented. However, the results of previous studies are not consistent with findings from recent other studies. These conflicting findings are, at least, due to variation in specific covariates in each study. An examination of EOL care and planning with a more comprehensive and theory driven consideration of potential covariates is limited. Therefore, based on two theoretical frameworks, the Andersen{\textquoteright}s Behavioral Model of Health Service Use (BM) and the Critical Race Theory (CRT), and using the Health and Retirement Study (HRS), which is a nationally representative dataset that includes an oversample of African Americans and Hispanics, the present study explored whether or not there are racial and ethnic differences in the completion of advance directives, place of death, and the receipt of hospice care by older non-Hispanic white, non-Hispanic black, and Hispanic adults after controlling for a comprehensive list of covariates. The covariates which have been identified by two theoretical frameworks and documented in the literature included 12 variables divided into three categories; predisposing factors: age, gender, marital status, place of birth, religion, and educational attainment; enabling factor: income; and need factors: limitations in physical functioning, the presence of chronic diseases, depressive symptoms, cognitive function, and geriatric syndromes (incontinence and falls). In addition, the present study examined the potential mediating effect of education and income on racial and ethnic differences in the completion of advance directives, place of death, and the receipt of hospice care as well as the potential moderating effect of gender on racial and ethnic differences in the completion of advance directives, place of death, and the receipt of hospice care. A secondary data analysis of the Health Retirement Survey (HRS), a nationally representative longitudinal panel survey collected by using a multi-stage area probability sampling, was utilized. The study initially included 6,518 HRS participants who have died at the age of 65 or above between 2004 and 2014 and have a completed an exit interview by a proxy, but final sample size was 5,312 decedents after cases with missing values from dependent variables, covariates, mediators, and moderators were excluded. The final sample size for testing the relationship between race and ethnicity and hospice use was 992 decedents since it was only asked at one survey wave due to changes in item wording and response categories for measuring the variable of hospice care use. Hierarchical logistic regression analyses were used to determine the independent influence of race and ethnicity on EOL outcomes. The analyses showed that race and ethnicity significantly predicted completion of ADs, either living wills or DPAHC, even after controlling for covariates. As compared to non-Hispanic whites, non-Hispanic blacks and Hispanics were less likely to have DPAHC or living wills. Race and ethnicity significantly predicted non-hospital death, as well. As compared to non-Hispanic whites, non-Hispanic blacks and Hispanics were less likely to die at non-hospital settings. However, race and ethnicity had no significant effect on hospice use. For the mediation analyses, the method suggested by Karlson, Holm, and Breen (KHB) was used. The KHB test showed that the relationship between race and ethnicity and the completion of living wills and DPAHC was significantly partially mediated by education and income. In particular, the degree of mediation was much larger for education than income. The interaction between race and ethnicity and gender did not have significant effects on the completion of living wills, place of death, and hospice use. However, there were significant interaction effects between race and ethnicity and gender on the completion of DPAHC. In particular, for non-Hispanic whites, the odds of completing DPAHC for female participants were 1.41 times that of non-Hispanic white male participants. From the CRT as an interpretative tool for understanding the complex mechanism of racial and ethnic gaps in EOL care and planning, the findings can be evidence that the source of the gaps may be structural racism, which interacts with gender, socio-economic status such as income and educational attainment, religion, and other social identities to create racialization in health care outcomes. (Abstract shortened by ProQuest.)}, keywords = {0452:Social work, 0631:Ethnic studies, End-of-life (EOL) care and planning, Ethnic studies, Health and Retirement Study (HRS) 2004-2014, Racial and ethnic differences, Social Sciences, Social work}, isbn = {9781392118276}, url = {https://proxy.lib.umich.edu/login?url=https://search.proquest.com/docview/2218669527?accountid=14667}, author = {Han,Junghee} } @article {9944, title = {Racial disparities in eligibility for low-dose computed tomography lung cancer screening among older adults with a history of smoking.}, journal = {Cancer Causes \& Control}, volume = {30}, year = {2019}, pages = {235-240}, abstract = {

PURPOSE: Lung cancer early detection screening has been demonstrated to decrease lung cancer mortality among high-risk smokers. This study aimed to examine whether current screening guidelines may disproportionately exclude African American smokers who are at higher overall risk for lung cancer.

METHODS: Data from the 2014 Health and Retirement Study were analyzed. Older African Americans and Whites with a history of smoking were included in the analyses (n = 7,348). Eligibility criteria established by the U.S. Preventive Services Task Force (USPSTF) for LDCT lung cancer screening were used. Multivariate logistic regression analyses were conducted to examine racial differences in eligibility for LDCT lung cancer screening.

RESULTS: Overall, 21.1\% of current and 10.5\% of former smokers met USPSTF{\textquoteright}s eligibility criteria for LDCT screening. In multivariate logistic regression analyses, African American smokers were less likely to be eligible for LDCT lung cancer screening compared to Whites (odds ratio = 0.5; p < 0.001).

CONCLUSION: African American smokers were less likely to meet established lung cancer screening eligibility criteria compared to Whites. Current lung cancer screening criteria may not adequately capture African Americans at risk and may widen the health disparities in African Americans. Further longitudinal studies are needed to evaluate the efficacy of current lung cancer screening guideline.

}, keywords = {Cancer, Cancer screenings, Racial/ethnic differences, Smoking}, issn = {1573-7225}, doi = {10.1007/s10552-018-1092-2}, author = {Li, Chien-Ching and Alicia K Matthews and Mantle M Rywant and Hallgren, Emily and Raj C Shah} } @article {10215, title = {The Relationship Between Depression and Frailty in Community-Dwelling Older People: A Systematic Review and Meta-Analysis of 84,351 Older Adults.}, journal = {Journal of Nursing Scholarship}, volume = {51}, year = {2019}, month = {2019 Sep}, pages = {547-559}, abstract = {

OBJECTIVES: In this study we investigated the correlation between depression and frailty in older adults. Additionally, correlations among study designs (prospective vs. cross-sectional), regions, depression indices, frailty indices, covariance corrections, and sexes were explored to support the analysis.

METHODS: A systematic literature review and meta-analysis were conducted. A total of 84,351 older adults, all 65 years of age or older, were analyzed. Both authors independently extracted and examined retrieved articles. Searched keywords included "depression" or "depressive"; "frailty" or "frail"; and "older people," "elderly," "geriatric," or "senior." Articles published between January 2000 and December 2016 were searched. A literature quality assessment was conducted in accordance with the guidelines of the Preferred Reporting Items for Systematic REVIEWS AND META-ANALYSES: Systematic literature searches were conducted on the Embase, PubMed, MEDLINE, Cumulative Index to Nursing and Allied Health Literature, and Cochrane Library databases, and collected studies were analyzed using a random effects model.

RESULTS: Fourteen studies on people 65 years of age or older were collected, and a correlation analysis was conducted for depression and frailty. According to the meta-analysis, the risk for frailty due to depression was nonsignificant among the subgroups for study design (p for heterogeneity = .149), region (p = .429), depression criteria (p = .934), covariate adjustment (p = .702), and frailty criteria (p = .661). Notably, the risk for frailty due to depression was significantly higher in men than in women (pooled odds ratios for men and women: 4.76 and 2.25, respectively; Qbetween χ = 9.93, p = .002).

CONCLUSION: Older adults with depression are more prone to frailty than are those without depression. Regardless of study design, region, depression index, frailty index, and covariance corrections, no significant differences were observed in the results of studies on depression and frailty in older adults. The only factor that had a significant influence was sex; older men with depression were at a higher risk for frailty than were older women with depression.

CLINICAL RELEVANCE: Depression and frailty are pertinent health concerns related to geriatric syndromes. Because older adults with depression have a high risk for frailty, nursing personnel should use a depression index as early as possible to screen for depression and further reduce the occurrence of frailty in older adults. Furthermore, based on the aforementioned differences between the sexes, special attention should be paid to older men with depression to reduce their risk for frailty.

}, keywords = {depression, Frailty, meta-analysis, systematic review}, issn = {1547-5069}, doi = {10.1111/jnu.12501}, url = {https://www.ncbi.nlm.nih.gov/pubmed/31328878}, author = {Chu, Wen and Chang, Shu-Fang and Ho, Hsu-Yu and Lin, Hsiang-Chun} } @article {9908, title = {The relationship between lifetime out-of-pocket medical expenditures, dementia, and socioeconomic status in the U.S}, journal = {The Journal of the Economics of Ageing}, volume = {14}, year = {2019}, pages = {100181}, type = {Journal}, abstract = {Dementia is one of the most expensive medical conditions. The costs are borne by families, by private insurance and by society via public programs such as Medicaid in the U.S.. There is extensive research on the relationship between dementia and annual medical spending. This paper, instead, estimates cumulative lifetime medical expenditures that can be attributed to the onset of dementia using a nationally representative longitudinal survey from the U.S., the Health and Retirement Study. The lifetime expenditures are estimated by summing any out-of-pocket medical spending reported in the panel from age 65 to death. Censored cases are imputed using a non-parametric matching algorithm called splicing. For example, survivors to the most recent wave are matched to similar individuals from older cohorts who are observed at the relevant ages all the way through death. We find that those who live with dementia for at least half a year pay, on average, $38,540 more out of pocket from age 65 to death when controlling for length of life, demographics, lifetime earnings and comorbidities. The costs of dementia are almost exclusively due to spending on nursing homes. Spending on drugs, doctor visits or hospitals, is not significantly related to dementia. The lifetime costs of dementia are significantly larger for white and rich individuals, perhaps because they use higher quality nursing homes and because they have more financial resources to spend down before becoming eligible for Medicaid support.}, keywords = {Cognitive Ability, Dementia, Medical Expenses, Out-of-pocket payments, Socioeconomic factors}, issn = {2212828X}, doi = {10.1016/j.jeoa.2018.11.006}, url = {https://www.sciencedirect.com/science/article/pii/S2212828X18300690}, author = {P{\'e}ter Hudomiet and Michael D Hurd and Susann Rohwedder} } @article {9861, title = {Religious Attendance and Biological Risk: A National Longitudinal Study of Older Adults}, journal = {Journal of Religion and Health}, volume = {58}, year = {2019}, pages = {1188{\textendash}1202}, type = {Journal}, abstract = {Although several studies suggest that religious involvement is associated with healthier biological functioning in later life, most of this work is cross-sectional. We extend previous research by employing a longitudinal design. Our analysis of Health and Retirement Study (2006/2010) data suggests that older adults who attended religious services weekly or more in 2006 tend to exhibit fewer high-risk biomarkers in 2010 and greater reductions in allostatic load over the 4-year study period than respondents who attended yearly or not at all. These patterns persisted with adjustments for baseline allostatic load and a range of background variables.}, keywords = {Allostatic load, Biomarkers, Cystatin C, Religion}, issn = {0022-4197}, doi = {10.1007/s10943-018-0721-0}, url = {https://link.springer.com/article/10.1007\%2Fs10943-018-0721-0}, author = {Suh, Hyungjun and Terrence D. Hill and Koenig, Harold G.} } @article {11086, title = {Retirement Security and Financial Decision Making}, number = {WR-1224-CFPB}, year = {2019}, institution = {RAND Corporation}, address = {Santa Monica, CA}, abstract = {Financial planning for retirement in the United States has never been more important. Americans now have greater control on how much to accumulate during their working years, and how much to deaccumulate during their retirement. With greater control also comes great responsibility for the individual. As this individual-level responsibility has increased so has the relevance of making the right claiming decision about Social Security, which for many will be the only source of life-time income protected against inflation. Longer life spans, and especially longer post-retirement life spans, have also raised long-term care costs for households, further requiring careful financial planning for retirement. The Consumer Financial Protection Bureau{\textquoteright}s Office of Older Americans seeks to provide older Americans with resources to help them plan for their retirement. To do so, they also need a greater knowledge of which populations are the most at risk. In this report, we seek to identify leading indicators of financial insecurity in retirement that can assist the Office of Older Americans in 1) identifying key decisions prior to retirement that may be correlated with insecurity in later years, and 2) identifying populations who may benefit most from targeted information. Individuals and households who are financially secure are able to meet their financial goals. In this report, we develop three measures of financial security, related to three common financial goals, among retired Health and Retirement Study (HRS) respondents. These measures cover ability to pay for regular expenses, ability to pay for long-term care costs, and the ability to bequest. Since the HRS follows the same households over time, interviewing them every two years, we investigate whether these financial security measures are associated with decisions made leading up to and during retirement. Doing so allows us to track which decisions are associated with more secure finances as retired individuals continue to age. By examining these financial security measures and how certain financial decisions are related to them, we explore whether current retirees{\textquoteright} are able to balance between regular expenses, maintaining sufficient wealth to cover the costs of long-term care, should the need arise, protecting against longevity risks, and leaving a bequest to their heirs.}, keywords = {personal savings, retirement and retirement benefits}, doi = {https://doi.org/10.7249/WR1224}, author = {Philip Armour and Carman, Katherine and Hung, Angela} } @article {10018, title = {Sampling Weights: Revised for Tracker 2.0 \& Beyond}, year = {2019}, institution = {Survey Research Center, Institute for Social Research, University of Michigan}, address = {Ann Arbor, MI}, author = {HRS Staff} } @article {10374, title = {So Help Me, God: Religiosity and End-of-Life Choices in a Nationally Representative Sample.}, journal = {Journal of Palliative Medicine}, year = {2019}, month = {2019 Sep 25}, abstract = {

Studies show significant associations between the various dimensions of religiousness and end-of-life (EOL) decisions, such as individuals with high religiosity are more likely to choose aggressive care at EOL. However, these studies focused largely on smaller cancer populations. To our knowledge, there is no existing literature about the association between religiosity and EOL decisions within a national sample of older adults. The objective of this study was to investigate the association between religiosity and advance directive (AD) completion, and among those with an AD, documented EOL care preferences, using a nationally representative sample. This was an observational study. Descriptive statistics and logistic regression were conducted with 6051 decedents from the Health and Retirement Study using self-reported frequency of religious service attendance, importance of religion, and religious affiliation. The dependent variables were AD completion and care preference. The independent variables were self-reported frequency of religious service attendance, importance of religion, and religious affiliation. Protestants and Catholics had significantly lower odds of AD completion, compared with those with no religious preferences. Decedents who reported religion as very important had significantly lower odds of AD completion than decedents who said religion is not too important. Furthermore, decedents who attended religious services at least once a week, compared with those who do not attend, had significantly higher odds of completing an AD. Among those who completed an AD, neither religiosity nor religious affiliation was significantly associated with preference for prolonged care. Our study demonstrates the influence religiosity has on the development of ADs, prompting seriously ill patients{\textquoteright} religious needs to be recognized and supported. It further suggests that religious services may provide a good opportunity for promoting knowledge and completion of ADs.

}, keywords = {End-of-Life Choices, Religion}, issn = {1557-7740}, doi = {10.1089/jpm.2019.0209}, author = {Hoe, Deborah F and Enguidanos, Susan} } @article {9919, title = {Social Support and Preventive Healthcare Behaviors Among Couples in Later Life.}, journal = {Gerontologist}, year = {2019}, abstract = {

Background and Study Objectives: Intimate partners and close friends represent two major sources of social support that are central to one{\textquoteright}s health and health behaviors in later life. The aim of this study was to examine dyadic linkages between perceived social support (from spouses and friends) and preventive healthcare behaviors among coupled-individuals.

Design and Methods: Prospective data from the Health and Retirement Study (2010, 2012) were used to analyze a sample of coupled-individuals (dyad N = 1,902). A series of multilevel logistic regression (actor-partner interdependence) models were estimated to evaluate whether perceived social support from spouses and friends was associated with the likelihood of using two common forms of preventive healthcare services (i.e., influenza vaccination and cancer screenings).

Results: Apart from the role of perceived support from spouse on flu vaccinations, wives{\textquoteright} preventive healthcare behaviors were unrelated to perceived social support. In contrast, husbands{\textquoteright} preventive healthcare behaviors showed consistent associations with perceived social support from friends for the 2-year observation period. Further, husbands{\textquoteright} receipt of prostate cancer screening was associated with wives{\textquoteright} perceptions of social support from spouse as well as friends.

Discussion and Implications: These findings contributed to our understanding of the health advantages associated with being in a marital relationship for preventive healthcare behaviors, especially for men. Future research should unpack the pathways through which social support of various forms is associated with obtaining needed preventive health services.

}, keywords = {Marriage, Preventative Care, Social Support}, issn = {1758-5341}, doi = {10.1093/geront/gny144}, author = {Sae Hwang Han and Kyungmin Kim and Jeffrey A Burr} } @article {doi:10.1111/acps.13107, title = {Stability of clinically relevant depression symptoms in old-age across 11 cohorts: a multi-state study}, journal = {Acta Psychiatrica Scandinavica}, year = {2019}, abstract = {Aims To study the temporal dynamics of depression symptom episodes in old-age and the related influence of risk factors. Methods Data from 41 362 old adults (54.61\% women; mean age = 75.30, SD = 6.20) from the Ageing Trajectories of Health {\textendash} Longitudinal Opportunities and Synergies (ATHLOS) project were used. Depressive symptoms were followed over an 18-year period. A multi-state model, comprising three statuses (no depression, new clinically relevant episode of symptoms and episode persistence), was fitted. Multinomial regression was used to study the role of risk factors in status transition. Results Almost 85\% of participants showed no depression, but prevalence became lower over time (B = -0.25, P < 0.001). New episode point prevalence was over 5.30\% with a significant probability of moving to persistence status (transition probability = 0.27). Episode persistence became evident in 9.86\% of episode status transitions, with increasing rate over time (B = 0.54, P < 0.01). Loneliness was proven to be the strongest predictor of episode emergence (OR = 17.76) and persistence (OR = 5.93). Conclusions The course of depression tends to become chronic and unremitting in old-age. This study may help to plan interventions to tackle symptom escalation and risk factor influence.}, keywords = {ATHLOS project, clinically relevant symptom episode, late-life depression, Loneliness, multi-state model}, doi = {10.1111/acps.13107}, url = {https://onlinelibrary.wiley.com/doi/abs/10.1111/acps.13107}, author = {de la Torre-Luque, A. and de la Fuente, J. and Albert S{\'a}nchez-Niub{\'o} and Francisco F{\'e}lix Caballero and Matthew Prina and Muniz-Terrera, G. and Haro, J. M. and J. L. Ayuso-Mateos} } @article {9093, title = {Time discounting and economic decision-making in the older population}, journal = {The Journal of the Economics of Ageing}, volume = {14}, year = {2019}, abstract = {This paper examines heterogeneity in time discounting among a representative sample of elderly Americans, as well as its role in explaining key economic behaviors at older ages. We show how older Americans evaluate simple (hypothetical) inter-temporal choices in which payments today are compared with payments in the future. Using the indicators derived from this measure, we then demonstrate that differences in discounting patterns are associated with characteristics of particular importance in elderly populations. For example, cognitive deficits are associated with greater impatience, whereas bequest motives are associated with less impatience. We then relate our discounting measure to key economic outcomes and find that impatience is associated with lower wealth, fewer investments in health, and less planning for end of life care.}, keywords = {Decision making, Retirement Planning and Satisfaction, Self-control}, issn = {2212828X}, doi = {10.1016/j.jeoa.2017.05.001}, url = {http://www.sciencedirect.com/science/article/pii/S2212828X16300457}, author = {Huffman, David and Maurer, Raimond and Olivia S. Mitchell} } @article {10453, title = {TRANSITIONING OUT OF GRANDCHILDREN CAREGIVING: EFFECTS ON GRANDPARENTS{\textquoteright} EMOTIONAL WELL-BEING}, journal = {Innovation in Aging}, volume = {3}, year = {2019}, month = {2019/11/08}, pages = {S280 - S281}, abstract = {Research has suggested that grandparents caring for grandchildren experience both psychological gains and loss. Less clear is what happens to these grandparents after they exit from the caregiving role. This study used the Health and Retirement Study (HRS) 2010 to 2014 data to examine the effects of transitioning out of caregiving on the psychological well-being of grandparents. Psychological well-being was measured by the Positive and Negative Affect Schedule. We defined caregiving grandparents as grandparents who provide 100+ hours of care per year to their grandchildren. In the first wave, 8,278 respondents in the HRS were identified as caregiving grandparents. Among them, 3,914 continued to be caregivers and 4,364 transitioned out of the caregiving role by indicating they are no longer providing care in the second wave. Grandparents who transitioned out of caregiving are more likely to be older in age, less educated and not married. Linear regression analysis was conducted to compare the two groups (continuing vs. exiting caregiving) on positive and negative affect, controlling for the first wave{\textquoteright}s measures of the dependent variable, sociodemographic characteristics and health status of respondents. Results show that grandparents who continued caregiving had less decline in positive affect than grandparents who transitioned out of caregiving (b = -0.05, SE = 0.02, p<0.01), adjusting for covariates. But they were not significantly different in negative affect. These findings indicate that older adults may have fewer sources of joy after exiting the role of caregivers of their grandchildren.}, keywords = {emotional well-being, grandchildren caregiving, Grandparent childcare, Grandparents}, isbn = {2399-5300}, url = {https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6840433/}, author = {Rita Xiaochen Hu and Lydia W Li and Toni C Antonucci} } @article {10501, title = {Trends in Health and Mortality Inequalities in the United States}, number = {WP 2019-401}, year = {2019}, month = {09/2019}, institution = {Michigan Retirement Research Center}, address = {Ann Arbor, MI}, abstract = {Recent literature has documented a widening gap in mortality in the United States between individuals with high socioeconomic status (SES) and low SES. An important question is whether this trend will continue. In this paper we document trends and inequalities in the health status at ages 54 to 60 of individuals born between 1934 and 1959. We do so by using detailed subjective and objective measures of health in the Health and Retirement Study to examine contributors to mortality inequality and to forecast life expectancy. We found that the health of individuals 54 to 60 years old has generally declined in recent years. In particular, we found large increases in obesity rates, notable increases in diabetes and reported levels of pain, and lower self-reported health and subjective survival probabilities. We also found strong evidence for increasing health inequalities, as the health of individuals in these cohorts with high SES remained largely stable while that for individuals with low SES declined. When we forecast life expectancies using these predictor variables, as well as gender- and SES-specific time trends, we predict overall life expectancy to increase further. However, the increase is concentrated among high SES individuals, suggesting growing mortality inequality. Results are similar among men and women. }, keywords = {health, Inequality, Mortality}, url = {https://mrdrc.isr.umich.edu/pubs/trends-in-health-and-mortality-inequalities-in-the-united-states/}, author = {P{\'e}ter Hudomiet and Michael D Hurd and Susann Rohwedder} } @article {10085, title = {Unique effects of perceived neighborhood physical disorder and social cohesion on episodic memory and semantic fluency.}, journal = {Archives of Clinical Neuropsychology}, year = {2019}, abstract = {

Objective: Objective measures of neighborhood quality are associated with physical and mental health outcomes for older adults, but the relationship between perceived neighborhood quality and cognitive health has not been fully explored. Furthermore, positive and negative neighborhood characteristics may influence cognition through different mechanisms. The present study aimed to determine whether perceptions of neighborhood quality predict cognitive functioning in two domains, above and beyond individual-level risk factors, in a nationally representative sample of older adults.

Method: Using cross-sectional weighted data from 13,919 participants aged 51 and older from the Health and Retirement Study, linear regression models tested independent associations between perceived neighborhood quality (physical disorder and social cohesion) and cognition (episodic memory and semantic verbal fluency), controlling for sociodemographic characteristics, chronic disease burden, and depressive symptoms. Interaction terms tested whether neighborhood social cohesion moderated the relationship between neighborhood physical disorder and each cognitive outcome.

Results: Perception of greater neighborhood physical disorder was significantly associated with worse episodic memory, while perception of lower neighborhood social cohesion was significantly associated with worse semantic fluency. There were no significant interactions between physical disorder and social cohesion.

Conclusions: Results provide preliminary evidence for different mechanisms underlying associations between aspects of neighborhood quality and cognition (e.g., stress vs. social interaction). Additional intervention work is needed to determine whether improving neighborhood physical conditions and promoting social cohesion at the neighborhood level could reduce cognitive morbidity among older adults.

}, keywords = {Memory, Neighborhoods, Perception, Social Support}, issn = {1873-5843}, doi = {10.1093/arclin/acy098}, author = {Afsara B. Zaheed and Sharifian, Neika and A Zarina Kraal and Sol, Ketlyne and Hence, Alyssia and Laura B Zahodne} } @article {10.3389/fsoc.2019.00074, title = {Using Polygenic Scores in Social Science Research: Unraveling Childlessness}, journal = {Frontiers in Sociology}, volume = {4}, year = {2019}, pages = {74}, abstract = {Biological, genetic, and socio-demographic factors are all important in explaining reproductive behavior, yet these factors are typically studied in isolation. In this study, we explore an innovative sociogenomic approach, which entails including key socio-demographic (marriage, education, occupation, religion, cohort) and genetic factors related to both behavioral [age at first birth (AFB), number of children ever born (NEB)] and biological fecundity-related outcomes (endometriosis, age at menopause and menarche, polycystic ovary syndrome, azoospermia, testicular dysgenesis syndrome) to explain childlessness. We examine the association of all sets of factors with childlessness as well as the interplay between them. We derive polygenic scores (PGS) from recent genome-wide association studies (GWAS) and apply these in the Health and Retirement Study (N = 10,686) and Wisconsin Longitudinal Study (N = 8,284). Both socio-demographic and genetic factors were associated with childlessness. Whilst socio-demographic factors explain 19{\textendash}46\% in childlessness, the current PGS explains <1\% of the variance, and only PGSs from large GWASs are related to childlessness. Our findings also indicate that genetic and socio-demographic factors are not independent, with PGSs for AFB and NEB related to education and age at marriage. The explained variance by polygenic scores on childlessness is limited since it is largely a behavioral trait, with genetic explanations expected to increase somewhat in the future with better-powered GWASs. As genotyping of individuals in social science surveys becomes more prevalent, the method described in this study can be applied to other outcomes.}, keywords = {childlessness, polygenic score, social science}, issn = {2297-7775}, doi = {10.3389/fsoc.2019.00074}, url = {https://www.frontiersin.org/article/10.3389/fsoc.2019.00074}, author = {Verweij, Renske M. and Melinda C Mills and Stulp, Gert and Ilja M Nolte and Nicola Barban and Felix C Tropf and Carrell, Douglas T. and Aston, Kenneth I. and Krina T Zondervan and Rahmioglu, Nilufer and Dalgaard, Marlene and Skaarup, Carina and Hayes, M. Geoffrey and Dunaif, Andrea and Guo, Guang and Snieder, Harold} } @article {9932, title = {Using Skype to Beat the Blues: Longitudinal Data from a National Representative Sample.}, journal = {American Journal of Geriatric Psychiatry}, volume = {27}, year = {2019}, pages = {254-262}, abstract = {

OBJECTIVES: This study aimed to determine whether use of certain types of online communication technology is associated with subsequent depressive symptoms.

DESIGN: Nationally representative, population-based prospective cohort.

SETTING: Data were obtained from the 2012 and 2014 waves of the Health and Retirement Study (HRS).

PARTICIPANTS: 1,424 community-residing older adults (mean age, 64.8) in the United States.

MEASUREMENTS: We examined associations between use of four communication technologies (email, social networks, video chat, and instant messaging) in 2012 and depressive symptoms (eight-item Center for Epidemiologic Studies Depression scale) at two-year follow-up.

RESULTS: 564 participants (39.6\%) did not use any communication technologies, 314 (22.1\%) used email only, and 255 (17.9\%) used video chat (e.g., Skype). Compared to non-users (13.1\%, 95\% CI: 9.5-16.7\%) or those who used only email (14.3\%, 95\% CI: 10.1-18.5\%), users of video chat had approximately half the probability of depressive symptoms (6.9\%, 95\% CI: 3.5-10.3\%, Wald Chi test, Chi=13.82, p < 0.001; 7.6\%, 95\% CI: 3.6-11.6, Wald Chi test, Chi=13.56, p < 0.001). Use of email, social media, and instant messaging were not associated with a lower risk of depression.

CONCLUSIONS: Older adults who use video chat such as Skype, but not other common communication technologies, have a lower risk of developing depression.

}, keywords = {Depressive symptoms, Social Support, Technology}, issn = {1545-7214}, doi = {10.1016/j.jagp.2018.10.014}, author = {Alan R Teo and Markwardt, Sheila and Hinton, Ladson} } @article {McGrath2019, title = {Weakness and cognitive impairment are independently and jointly associated with functional decline in aging Americans}, journal = {Aging Clinical and Experimental Research}, year = {2019}, note = {cited By 0}, abstract = {Background: Discovering how certain health factors contribute to functional declines may help to promote successful aging. Aims: To determine the independent and joint associations of handgrip strength (HGS) and cognitive function with instrumental activities of daily living (IADL) and activities of daily living (ADL) disability decline in aging Americans. Methods: Data from 18,391 adults aged 50 years and over who participated in at least one wave of the 2006{\textendash}2014 waves of the Health and Retirement Study were analyzed. A hand-held dynamometer assessed HGS and cognitive functioning was examined with a modified version of the Telephone Interview of Cognitive Status. IADL and ADL abilities were self-reported. Participants were stratified into four distinct groups based on their HGS and cognitive function status. Separate covariate-adjusted multilevel models were conducted for the analyses. Results: Participants who were weak, had a cognitive impairment, and had both weakness and a cognitive impairment had 1.70 (95\% confidence interval (CI) 1.57{\textendash}1.84), 1.97 (CI 1.74{\textendash}2.23), and 3.13 (CI 2.73{\textendash}3.59) greater odds for IADL disability decline, respectively, and 2.26 (CI 2.03{\textendash}2.51), 1.26 (CI 1.05{\textendash}1.51), and 4.48 (CI 3.72{\textendash}5.39) greater odds for ADL disability decline, respectively. Discussion: HGS and cognitive functioning were independently and jointly associated with IADL and ADL disability declines. Individuals with both weakness and cognitive impairment demonstrated substantially higher odds for functional decline than those with either risk factor alone. Conclusions: Including measures of both HGS and cognitive functioning in routine geriatric assessments may help to identify those at greatest risk for declining functional capacity. {\textcopyright} 2019, Springer Nature Switzerland AG.}, keywords = {Cognition, cognitive impairment, Decline, functional health}, issn = {15940667}, doi = {10.1007/s40520-019-01351-y}, url = {https://www.ncbi.nlm.nih.gov/pubmed/31520335}, author = {Ryan P McGrath and Brenda Vincent and Kyle J Hackney and Soham Al Snih and Graham, J. and Thomas, L. and Ehlers, D.K. and Brian C Clark} } @article {MCGRATH2019, title = {Weakness May Have a Causal Association With Early Mortality in Older Americans: A Matched Cohort Analysis}, journal = {Journal of the American Medical Directors Association}, year = {2019}, abstract = {Objectives Quantifying the association between muscle weakness and mortality with carefully matched cohorts will help to better establish the impact of weakness on premature death. We used a matched cohort analysis in a national sample of older Americans to determine if those who were weak had a higher risk for mortality compared with control groups with incrementally higher strength capacities. Design Longitudinal panel. Setting Detailed interviews that included physical measures were conducted in person, whereas core interviews were often performed over the telephone. Participants Data from 19,729 Americans aged at least 50 years from the 2006-2014 waves of the Health and Retirement Study were analyzed. Measures A handgrip dynamometer was used to assess handgrip strength (HGS) in each participant. Men with HGS <26 kg were considered weak, >=26 kg were considered not weak, and >=32 kg were considered strong. Women with HGS <16 kg were classified as weak, >=16 kg were classified as not-weak, and >=20 kg were classified as strong. The National Death Index and postmortem interviews determined the date of death. The greedy matching algorithm was used to match cohorts. Results Of the 1077 weak and not-weak matched pairs, 401 weak (37.2\%) and 296 not-weak (27.4\%) older Americans died over an average 4.4 {\textpm} 2.5-year follow-up. There were 392 weak (37.0\%) and 243 strong (22.9\%) persons who died over a mean 4.5 {\textpm} 2.5-year follow-up from the 1057 weak and strong matched pairs. Those in the weak cohort had a 1.40 [95\% confidence interval (CI) 1.19, 1.64] and 1.54 (CI 1.30, 1.83) higher hazard for mortality relative to persons in the not-weak and strong control cohorts, respectively. Conclusions and Implications Our findings may indicate a causal association between muscle weakness and mortality in older Americans. Health care providers should include measures of HGS as part of routine health assessments and discuss the health risks of muscle weakness with their patients.}, keywords = {Aging, Epidemiology, Geriatrics, Hand Strength, Muscle Strength, sarcopenia}, issn = {1525-8610}, doi = {https://doi.org/10.1016/j.jamda.2019.10.016}, url = {http://www.sciencedirect.com/science/article/pii/S152586101930756X}, author = {Ryan P McGrath and Brenda Vincent and Mark D Peterson and Donald A Jurivich and Lindsey J Dahl and Kyle J Hackney and Brian C Clark} } @mastersthesis {10361, title = {Which Grandparents Matter? Gender-Specific Grandparent Effects}, volume = {PhD}, year = {2019}, pages = {31}, school = {University of Wisconsin-Madison}, abstract = {Despite of growing interests in multigenerational mobility research in recent years, we have little understanding of how gender may matter for the process of status transmissions across generations. Given women{\textquoteright}s longevity and greater exposure to their children and grandchildren, we might expect maternal grandmothers to have a stronger influence on grandchildren{\textquoteright}s outcomes. Using data from the Health and Retirement Study and consistent with this expectation, I find that maternal grandmothers{\textquoteright} education has a stronger association with grandchildren{\textquoteright}s education than the other three grandparents do, but only for grandsons not granddaughters. This paper emphasizes the importance of incorporating gender in studying multigenerational processes and influences and considers potential mechanisms behind grandparent effects. }, keywords = {gender, Grandparenting, Grandparents}, author = {Huixian, Li} } @article {10038, title = {Why everyone should save like they{\textquoteright}re going to retire early}, journal = {MarketWatch}, year = {2019}, publisher = {MarketWatch}, address = {San Francisco}, keywords = {Future, Retirement Planning and Satisfaction, Savings}, url = {https://www.marketwatch.com/story/why-everyone-should-save-like-theyre-going-to-retire-early-2019-04-10}, author = {Hester, Tanja} } @article {11240, title = {The Accuracy of Senior Households{\textquoteright} Estimates of Home Values: Application to the Reverse Mortgage Decision}, journal = {Real Estate Economics}, volume = {46}, year = {2018}, note = {https://doi.org/10.1111/1540-6229.12197}, month = {2018/09/01}, pages = {655 - 697}, abstract = {Abstract Using a unique data set of more than 14,000 senior homeowners in the United States, this study compares self-assessed home values to arm{\textquoteright}s length contemporaneous appraisals. In a sample of seniors who received counseling for a reverse mortgage, the absolute value of the assessment error averages 18.9\% of appraised value and it is biased upwards by 13.4\%. When adjusted to reflect the general population of seniors, the size and bias of the average error fall to 16.1\% and 4.2\%. Both the bias and the size of the error tend to be lower for households with higher income and credit scores but it is greater for black households. In our sample period of 2009?2011, house prices were falling. The greater the rate of price reduction, the greater is the upward bias and size of the assessment error. When seniors who applied for a reverse mortgage learn that they overvalued their home, their probability of closing the loan falls.}, keywords = {Decision making, Housing, Mortgages, Reverse Mortgage Decision}, isbn = {1080-8620}, url = {https://doi.org/10.1111/1540-6229.12197}, author = {Donald Haurin and Stephanie Moulton and Wei Shi} } @article {9638, title = {Adjusting after stroke: Changes in sense of purpose in life and the role of social support, relationship strain, and time.}, journal = {Journal of Health Psychology}, year = {2018}, type = {Journal}, abstract = {It is unclear how the onset of a major health condition, such as a stroke, may impact sense of purpose long-term and whether social factors influence this change. We examined changes in purpose in 716 stroke patients ( M = 72.09 years, 52.5\% female) who participated in the Health and Retirement Study between 2006 and 2014. Multilevel growth modeling indicated that recent stroke patients{\textquoteright} sense of purpose declined over time relative to pre-stroke purpose, whereas those suffering stroke prior to baseline demonstrated relative stability. Furthermore, social support was associated with initial levels but not change in sense of purpose.}, keywords = {Purpose in life, Social Support, Stroke}, issn = {1461-7277}, doi = {10.1177/1359105318772656}, author = {Nathan A Lewis and Brazeau, Hannah and Patrick L Hill} } @article {9945, title = {Alzheimer{\textquoteright}s disease risk factors as mediators of subjective memory impairment and objective memory decline: protocol for a construct-level replication analysis.}, journal = {BMC Geriatrics}, volume = {18}, year = {2018}, pages = {260}, abstract = {

BACKGROUND: Subjective memory impairment (SMI), or the perception of memory problems in the absence of objective memory deficits, is associated with negative outcomes of individual and societal significance, including a substantially increased risk of Alzheimer{\textquoteright}s disease (AD). However, little is known regarding the mediators that link SMI and memory decline in some individuals, or which older adults with SMI are at greatest risk for memory decline. In this study, we will examine modifiable AD risk factors (specifically affective symptoms and activity participation) as mediators underlying linkages among SMI and memory decline over time; furthermore, we will characterize SMI subgroups at highest risk for memory decline via this pathway.

METHODS: This study utilizes a series of construct-level replication analyses across four large longitudinal datasets to maximize the unique aspects of each dataset as well as test the reproducibility of findings across multiple populations to establish generalizability. The current study{\textquoteright}s sample (n > 40,000) is drawn from the Einstein Aging Study, Health and Retirement Study, Minority Aging Research Study, and National Health and Aging Trends Study. Participants must meet the following basic criteria for inclusion: age 55 or older and no evidence of cognitive impairment at baseline. We will use multilevel modeling to determine whether higher levels of SMI are related to increased affective symptoms and decreased activity participation, as well as whether this relationship is moderated by neuroticism, family history of AD, and race/ethnicity. Finally, we will test our full conceptual model that examines whether changes in affective symptoms and activity participation mediate the relationship between SMI and objective memory decline. Specifically, we will test moderated mediation as we hypothesize these relationships to hold among subgroups of older adults.

DISCUSSION: Discovery of modifiable AD risk factors that mediate the association between SMI and memory decline (the earliest and most central deficit in AD) will provide explicit, and potentially novel, targets for intervention. Additionally, identifying individuals at highest risk for negative reactions to SMI will serve to enrich samples for future research as well as to help guide the development of SMI assessment tools to identify older adults at greatest risk for debilitating outcomes.

}, keywords = {Alzheimer{\textquoteright}s disease, Cognition \& Reasoning, Memory, Self-reported health}, issn = {1471-2318}, doi = {10.1186/s12877-018-0954-5}, author = {Nikki L Hill and Mogle, Jacqueline} } @article {8803, title = {Antecedents of Gray Divorce: A Life Course Perspective.}, journal = {J Gerontol B Psychol Sci Soc Sci}, volume = {73}, year = {2018}, month = {2018 08 14}, pages = {1022-1031}, abstract = {

Objectives: Increasingly, older adults are experiencing divorce, yet little is known about the risk factors associated with divorce after age 50 (termed "gray divorce"). Guided by a life course perspective, our study examined whether key later life turning points are related to gray divorce.

Method: We used data from the 1998-2012 Health and Retirement Study to conduct a prospective, couple-level discrete-time event history analysis of the antecedents of gray divorce. Our models incorporated key turning points (empty nest, retirement, and poor health) as well as demographic characteristics and economic resources.

Results: Contrary to our expectations, the onset of an empty nest, the wife{\textquoteright}s or husband{\textquoteright}s retirement, and the wife{\textquoteright}s or husband{\textquoteright}s chronic conditions were unrelated to the likelihood of gray divorce. Rather, factors traditionally associated with divorce among younger adults were also salient for older adults. Marital duration, marital quality, home ownership, and wealth were negatively related to the risk of gray divorce.

Discussion: Gray divorce is especially likely to occur among couples who are socially and economically disadvantaged, raising new questions about the consequences of gray divorce for individual health and well-being.

}, keywords = {Age Factors, Divorce, Female, Humans, Interviews as Topic, Male, Marriage, Middle Aged, Prospective Studies, Retirement, Risk Factors, Socioeconomic factors, Spouses, United States}, issn = {1758-5368}, doi = {10.1093/geronb/gbw164}, url = {http://psychsocgerontology.oxfordjournals.org/lookup/doi/10.1093/geronb/gbw164}, author = {Lin, I-Fen and Susan L. Brown and Matthew R Wright and Anna M Hammersmith} } @article {9786, title = {The association between CVD-related biomarkers and mortality in the Health and Retirement Survey}, journal = {Demographic Research}, volume = {38}, year = {2018}, pages = {1933-2002}, abstract = {OBJECTIVE In this article we test the predictive power of five different functional forms of CVDrelated biomarkers for all-cause and CVD mortality in the Health and Retirement Study (HRS). METHODS We use five different functional forms of biomarker: A risk factor index, risk factors separately, continuous biomarkers, risk groups comprising every possible combination of risk factors, and a cluster analytic approach to identify risk profiles in the sample. We use data from the Health and Retirement Study (HRS) with information on four collected biomarkers (glycated hemoglobin (hbA1c), high-density lipoprotein (HDL), total cholesterol, and C-reactive protein (CRP)) with an eight-year mortality follow-up period. RESULTS The results show that the additive index has comparatively high predictive power, relative to its simplicity. Risk profiles were identified in the data, with substantial differences in mortality risk between the profiles. The more complex functional forms improve prediction only moderately compared to the simple index, although we can identify groups with an elevated mortality risk that are not identified in more parsimonious approaches. CONCLUSIONS Depending on the specific research question, both a very simple modeling of biomarker information and more detailed examinations of specific complex risk profiles can be appropriate. CONTRIBUTION The study provides initial guidelines for the measurement of commonly used biomarkers, which can be a reference for other studies that use biomarkers as health indicators or for mortality prediction.}, keywords = {Biomarkers, Genetics, Mortality, Survey Methodology}, doi = {10.4054/DemRes.2018.38.62}, url = {https://www.demographic-research.org/volumes/vol38/62/}, author = {Kr{\"o}ger, Hannes and Rasmus Hoffmann} } @article {9809, title = {Association Between Purpose in Life and Glucose Control Among Older Adults.}, journal = {Annals of Behavioral Medicine}, volume = {52}, year = {2018}, pages = {309-318}, abstract = {

Background: Greater purpose in life is associated with lower rates of certain chronic diseases. Whether purpose in life can protect against development of prediabetes or type 2 diabetes is unknown.

Purpose: To examine the association between purpose in life and blood glucose control among adults >=50 years.

Methods: We conducted a longitudinal cohort study of 3,907 participants of the Health and Retirement Study who at baseline did not have type 2 diabetes or prediabetes. Baseline purpose in life was measured using the Ryff and Keyes{\textquoteright} Scales of Psychological Well-Being and grouped into tertiles (high, medium, and low). We used multivariable linear regression to examine the association between baseline purpose in life and HbA1c over 4 years. Multivariable logistic regression was used to examine the association between baseline purpose and incident prediabetes or type 2 diabetes over the same period.

Results: After adjusting for sociodemographic factors, body mass index, physical activity, and physical and mental health factors, HbA1c was 0.07 percentage points lower among participants with high purpose than those with low purpose (95\% confidence interval [CI] -0.12 to -0.02; p = .011). Participants with high purpose had lower odds of developing prediabetes or type 2 diabetes than those with low purpose (adjusted odds ratio 0.78; 95\% CI 0.62 to 0.98; p = .037).

Conclusions: Among older adults, greater purpose in life is associated with a lower incidence of prediabetes or type 2 diabetes. Strategies to promote greater purpose in life should be tested as a part of type 2 diabetes prevention efforts.

}, keywords = {Biomarkers, Diabetes, Glutamic Acid, Purpose in life}, issn = {1532-4796}, doi = {10.1093/abm/kax012}, author = {Hafez, Dina and Michele M Heisler and Choi, Hwajung and Claire K. Ankuda and Winkelman, Tyler and Jeffrey T Kullgren} } @article {9747, title = {Association of telomere length with general cognitive trajectories: a meta-analysis of four prospective cohort studies}, journal = {Neurobiology of Aging}, volume = {69}, year = {2018}, month = {Jan-09-2018}, pages = {111 - 116}, abstract = {To investigate the association of telomere length (TL) with trajectories of general cognitive abilities, we used data on 5955 participants from the Sex Differences in Health and Aging Study and the Swedish Adoption/Twin Study of Aging in Sweden, and the Mayo Clinic Study of Aging, and the Health and Retirement Study in the United States. TL was measured at baseline, while general cognitive ability was assessed repeatedly up to 7 occasions. Latent growth curve models were used to examine the associations. One standard deviation increase of TL was associated with 0.021 unit increase (95\% confidence interval [CI]: 0.001, 0.042) of standardized mean general cognitive ability. After controlling for sex, the point estimate remained similar (0.019) with a wider CI (95\% CI: 0.002, 0.039). The association was attenuated with adjustment for educational attainment (0.009, 95\% CI: 0.009, 0.028). No strong evidence was observed for the association of TL and decline in general cognitive ability. Longer TL was associated with higher general cognitive ability levels in the age-adjusted models but not in the models including all covariates, nor with cognitive decline.}, keywords = {Cognitive Ability, Gender Differences, Telomeres}, issn = {01974580}, doi = {10.1016/j.neurobiolaging.2018.05.004}, url = {https://linkinghub.elsevier.com/retrieve/pii/S019745801830160Xhttps://api.elsevier.com/content/article/PII:S019745801830160X?httpAccept=text/xmlhttps://api.elsevier.com/content/article/PII:S019745801830160X?httpAccept=text/plain}, author = {Zhan, Yiqiang and Clements, Mark S. and Rosebud O. Roberts and Vassilaki, Maria and Druliner, Brooke R. and Boardman, Lisa A. and Ronald C Petersen and Chandra A Reynolds and Nancy L Pedersen and H{\"a}gg, Sara} } @article {9863, title = {Is Bridge Job Activity Overstated?}, journal = {Work, Aging and Retirement}, volume = {4}, year = {2018}, pages = {330-351}, abstract = {Considerable prior research has shown that most older Americans with career employment transition to bridge jobs before exiting the labor force. One criticism of this research is that bridge job activity may be overstated because the definition of a bridge job in the existing literature does not require a change in occupation. For some, the "bridge job" may just be another in a series of job changes, and not a prelude to retirement. This article investigates the extent to which bridge jobs involve a change in occupation or a switch to part-time status, both of which may signal the start of a retirement transition, as opposed to continued career employment, albeit with a different employer. We utilize the Health and Retirement Study (HRS), a nationally representative longitudinal dataset of older Americans that began in 1992. Among HRS respondents who were on a full-time career job at the time of the first interview and who changed jobs in subsequent waves, 48\% of the men and 39\% of the women also changed their (two-digit) occupation at the time of their first transition. Further, when hours worked is also considered, about 3 quarters of men and women experienced a change in occupation and/or a switch from full-time to part-time status. We conclude that most career workers who changed jobs later in life did in fact do so as part of a retirement transition. Ignoring these subtleties does result in an overestimate of bridge job activity, but only a modest one.}, keywords = {Bridge employment, Employment and Labor Force, Gender Differences, Retirement Planning and Satisfaction}, issn = {2054-4642}, doi = {10.1093/workar/way006}, url = {https://academic.oup.com/workar/article/4/4/330/4999804http://academic.oup.com/workar/article-pdf/4/4/330/25835505/way006.pdf}, author = {Kevin E. Cahill and Michael D. Giandrea and Joseph F. Quinn}, editor = {Henkens, Kene} } @article {9476, title = {British government targets a modern public health scourge: Loneliness}, journal = {The Los Angeles Times}, year = {2018}, address = {Los Angeles}, keywords = {Cross-National, Depressive symptoms, Loneliness, Policy, Public Health}, url = {http://www.latimes.com/science/sciencenow/la-sci-sn-minister-of-loneliness-20180118-story.html}, author = {Healy, Melissa} } @article {9124, title = {Chronic illnesses and depressive symptoms among older people: Functional limitations as a mediator and self-perceptions of aging as a moderator.}, journal = {Journal of Aging and Health}, volume = {30}, year = {2018}, pages = {1188-1204}, abstract = {

OBJECTIVE: This research examined the mediation of functional limitations in the relationship between chronic illnesses and depressive symptoms among older Americans along with tests for the moderation of self-perceptions of aging.

METHOD: Data from the Health and Retirement Study (2008, 2010, and 2012) were used. Longitudinal mediation models were tested using a sample of 3,382 Americans who responded to psychosocial questions and were over 65 years old in 2008.

RESULTS: Functional limitations mediated the linkage between chronic illnesses and depressive symptoms. Negative self-perceptions of aging exacerbated the effects of chronic illnesses on depressive symptoms.

DISCUSSION: Health care professionals should be aware of depressive symptoms in older adults reporting chronic illnesses and particularly in those reporting functional limitations. To decrease the risk of depressive symptoms caused by chronic illnesses, negative self-perceptions of aging may need to be challenged.

}, keywords = {Chronic disease, Depressive symptoms, Self-perception}, issn = {1552-6887}, doi = {10.1177/0898264317711609}, author = {Jina Han} } @article {9480, title = {The co-development of perceived support and the Big Five in middle and older adulthood}, journal = {International Journal of Behavioral Development}, volume = {42}, year = {2018}, pages = {26-33}, abstract = {The current study examined whether relationships also influence personality trait development during middle and older adulthood, focusing on the individual{\textquoteright}s perception of support from the relationship partner. Using data from the Health and Retirement Study (n = 20,422; mean age = 65.9 years), we examined the longitudinal relationships between Big Five personality trait levels and perceived support from children, family, friends, and spouses. Results found that participants who reported more positive social support and lower negative support also tended to score higher on conscientiousness, extraversion, agreeableness, and openness to experience, but lower on neuroticism. Moreover, changes in positive support across relationship partners coincided with trait changes over time, in the form of more positive support was associated with seemingly adaptive changes on the Big Five. Findings are discussed with respect to identifying social influences on personality development in adulthood.}, keywords = {Personality, Retirement Planning and Satisfaction, Self-reported health, Social Support}, issn = {0165-0254}, doi = {10.1177/0165025417690262}, author = {Patrick L Hill and Sara J Weston} } @article {9437, title = {Cognitive Ability, Personality, and Pathways to Retirement: An Exploratory Study}, journal = {Work, Aging and Retirement}, volume = {4}, year = {2018}, pages = {52-66}, abstract = {This article describes an exploratory study that investigates the extent to which two sets of psychological factors, fluid cognitive ability and personality traits, predict late-in-life work and retirement outcomes. Using longitudinal data from the Health and Retirement Study, we first provide a detailed characterization of within-subject work-to-retirement pathways, spanning 14 years of data for each individual, and identify the most frequent pathway classes. We found that only 37\% of workers followed the "standard" pattern of retiring completely from a full-time job. We then examined how cognitive ability and personality traits predict these work-to-retirement pathways. We found that individuals with better cognitive ability work longer, both in full- and in part-time jobs, and extraversion is a strong predictor of working longer, mainly in part-time jobs. These results are robust to the inclusion of many covariates, including demographics, health, socioeconomic status, and labor market variables. Although the observed patterns match individuals{\textquoteright} retirement expectations to some extent, there also seems to be evidence of some surprise. Practical implications and suggestions for future research are discussed.}, keywords = {Bridge employment, Cognition \& Reasoning, Personality, Retirement Planning and Satisfaction}, issn = {2054-4642}, doi = {10.1093/workar/wax030}, url = {http://academic.oup.com/workar/article/4/1/52/4762671http://academic.oup.com/workar/article-pdf/4/1/52/23296931/wax030.pdf}, author = {P{\'e}ter Hudomiet and Andrew M Parker and Susann Rohwedder}, editor = {Gwenith G Fisher} } @article {9761, title = {Cohort Differences in Parental Financial Help to Adult Children.}, journal = {Demography}, volume = {55}, year = {2018}, pages = {1567-1582}, abstract = {In this article, we examine birth cohort differences in parents{\textquoteright} provision of monetary help to adult children with particular focus on the extent to which cohort differences in family structure and the transition to adulthood influence these changes. Using data from the Health and Retirement Study from 1994 to 2010, we compare financial help to children of three respondent cohorts as the parents in these birth cohorts from ages 53-58 to 57-62. We find that transfers to children have increased among more recent cohorts. Two trends-declining family size and children{\textquoteright}s delay in marriage-account for part of the increase across cohorts. However, other trends, such as the increase in the number of stepchildren and increasing child{\textquoteright}s income level, tend to decrease the observed cohort trend.}, keywords = {Adult children, Cohort Studies, Financial aid, Intergenerational transfers}, issn = {1533-7790}, doi = {10.1007/s13524-018-0687-2}, author = {John C Henretta and Matthew F. Van Voorhis and Beth J Soldo} } @article {9164, title = {A comparison of subjective and objective job demands and fit with personal resources as predictors of retirement timing in a national U.S. Sample}, journal = {Work, Aging and Retirement}, volume = {4}, year = {2018}, chapter = {37{\textendash}51}, abstract = {Population aging and attendant pressures on public budgets have spurred considerable interest in understanding factors that influence retirement timing. A range of sociodemographic and economic characteristics predict both earlier and later retirement. Less is known about the role of job characteristics on the work choices of older workers. Researchers are increasingly using the subjective ratings of job characteristics available in the Health and Retirement Study in conjunction with more objective measures of job characteristics from the Occupational Information Network (O*NET) database. Employing a theoretically-informed model of job demands-personal resources fit, we constructed mismatch measures between resources and job demands (both subjectively and objectively assessed) in physical, emotional, and cognitive domains. When we matched comparable measures across the 2 data sources in the domains of physical, emotional, and cognitive job demands, we found that both sources of information held predictive power in relation to retirement timing. Physical and emotional but not cognitive mismatch were associated with earlier retirement. We discuss theoretical and practical implications of these findings and directions for future research.}, keywords = {Comparisons, Job stressors, Retirement Planning and Satisfaction}, issn = {2054-4642}, doi = {10.1093/workar/wax016}, url = {https://academic.oup.com/workar/article-lookup/doi/10.1093/workar/wax016}, author = {Amanda Sonnega and Helppie-McFall, Brooke and P{\'e}ter Hudomiet and Robert J. Willis and Gwenith G Fisher} } @article {9629, title = {Cross-national health comparisons using the Rasch model: findings from the 2012 US Health and Retirement Study and the 2012 Mexican Health and Aging Study}, journal = {Quality of Life Research}, volume = {27}, year = {2018}, month = {09/2018}, pages = {2431-2441}, abstract = {Purpose Cross-national comparisons of patterns of population aging have emerged as comparable national micro-data have become available. This study creates a metric using Rasch analysis and determines the health of American and Mexican older adult populations. Methods Secondary data analysis using representative samples aged 50 and older from 2012 U.S. Health and Retirement Study (n = 20,554); 2012 Mexican Health and Aging Study (n = 14,448). We developed a function measurement scale using Rasch analysis of 22 daily tasks and physical function questions. We tested psychometrics of the scale including factor analysis, fit statistics, internal consistency, and item difficulty. We investigated differences in function using multiple linear regression controlling for demographics. Lastly, we conducted subgroup analyses for chronic conditions. Results The created common metric demonstrated a unidimensional structure with good item fit, an acceptable precision (person reliability = 0.78), and an item difficulty hierarchy. The American adults appeared less functional than adults in Mexico (β = - 0.26, p < 0.0001) and across two chronic conditions (arthritis, β = - 0.36; lung problems, β = - 0.62; all p < 0.05). However, American adults with stroke were more functional than Mexican adults (β = 0.46, p = 0.047). Conclusions The Rasch model indicates that Mexican adults were more functional than Americans at the population level and across two chronic conditions (arthritis and lung problems). Future studies would need to elucidate other factors affecting the function differences between the two countries.}, keywords = {Arthritis, Chronic conditions, Comparisons, Disabilities, MHAS}, issn = {09629343}, url = {https://link-springer-com.proxy.lib.umich.edu/article/10.1007\%2Fs11136-018-1878-4}, author = {Ickpyo Hong and Timothy A Reistetter and D{\'\i}az-Venegas, Carlos and Alejandra Michaels-Obregon and Rebeca Wong} } @article {9589, title = {Dementia Prevalence in the United States in 2000 and 2012: Estimates Based on a Nationally Representative Study.}, journal = {Journals of Gerontology Series B: Psychological Sciences and Soc Sciences}, volume = {73}, year = {2018}, pages = {S10-S19}, abstract = {

Objectives: Age- and sex-specific rates of dementia are estimated in the U.S. population aged 65 or older in 2000 and 2012 using a large nationally representative dataset, the Health and Retirement Study (HRS), and accounting for mortality selection and specificities of the interview protocol.

Method: A latent cognitive ability model is estimated by maximum simulated likelihood. Prevalence of dementia is identified using HRS cognition measures and the Aging, Demographics and Memory Study (ADAMS), a subset of the HRS (n = 856) with clinical assessment for dementia. Different cognitive measures are collected in self and proxy interviews. From 2006 onward, the HRS collected fewer interviews by proxy. Selection into proxy interviews is modeled as well as survival into the ADAMS sample from the previous HRS interview.

Results: The prevalence of dementia decreased from 12.0\% (SE = 0.48\%) in 2000 to 10.5\% (SE = 0.49\%) in 2012 in the 65+ population, a statistically significant decline of 12.6\% (p < .01). The percentage change in prevalence was larger among males (16.6\% vs 9.5\%), and younger individuals.

Discussion: The prevalence of dementia among those 65 or older decreased between 2000 and 2012, although less rapidly than reported in other studies. The difference is primarily due to our modeling selection into proxy interviews.

}, keywords = {Cognitive Ability, Dementia}, issn = {1758-5368}, doi = {10.1093/geronb/gbx169}, author = {P{\'e}ter Hudomiet and Michael D Hurd and Susann Rohwedder} } @article {9475, title = {Determinants of health trajectories in England and the US: an approach to identify different patterns of healthy aging.}, journal = {Journals of Gerontology Series A: Biological Sciences and Medical Sciences}, volume = {73}, year = {2018}, pages = {1512-1518}, abstract = {

Background: Aging is a multidimensional process with a remarkable inter-individual variability. This study is focused on identifying groups of population with similar aging patterns, and to define the health trajectories of these groups. Socio-demographic and health determinants of these trajectories are also identified.

Methods: Data from the English Longitudinal Study of Aging (ELSA) and the Health and Retirement Study (HRS) were used. A set of self-reported health items and measured tests were used to generate a latent health metric by means of a Bayesian multilevel IRT model, assessing the ability of the metric to predict mortality. Then, a Growth Mixture Model (GMM) was conducted in each study to identify latent classes and assess health trajectories. Kaplan-Meier survival curves were obtained for each class and a multinomial logistic regression was used to identify determinants of these trajectories.

Results: The health score generated showed an adequate ability to predict mortality over ten years in ELSA [AUC=0.74; 95\% CI=(0.72,0.75)] and HRS [AUC=0.74; 95\% CI=(0.73,0.75)]. By means of GMM, four latent classes were identified in ELSA and five in HRS. Chronic conditions, no qualification and low level of household wealth were associated to the classes which showed a higher mortality in both studies.

Conclusion: The method based on the creation of a common metric of health and the use of GMM to identify similar patterns of aging, allows for the comparison of trajectories of health across longitudinal surveys. Multimorbidity, educational level and household wealth could be considered as determinants associated to these trajectories.

}, keywords = {Cross-National, Health Trajectories, Successful aging}, issn = {1758-535X}, doi = {10.1093/gerona/gly006}, author = {de la Fuente, Javier and Francisco F{\'e}lix Caballero and Albert S{\'a}nchez-Niub{\'o} and Demosthenes B Panagiotakos and Matthew Prina and Arndt, Holger and Haro, Josep Maria and Chatterji, Somnath and Ayuso-Mateos, Jos{\'e} Luis} } @article {9827, title = {Do Older SSDI Applicants Denied Benefits on the Basis of their Work Capacity Return to Work After Denial?}, number = {2083857692}, year = {2018}, month = {09/2018}, institution = {Princeton}, address = {Princeton, NJ}, abstract = {Key Findings: * Very few older denied SSDI applicants returned to work in the years following denial. * Among those who worked in the years before or after application, average earnings were lower after initial denial relative to before applying for SSDI. * The majority of older SSDI applicants denied on the basis of residual work capacity ultimately receive SSDI before full retirement age (FRA), either after appeal or reapplication. In this issue brief, we document the post-denial employment and benefit experiences of older applicants who are initially denied Social Security Disability Insurance (SSDI) for {\textquotedblleft}work capacity{\textquotedblright} reasons. Specifically, a disability examiner determined that these applicants had a severe impairment, but denied benefits because the applicants{\textquoteright} residual functional capacity allowed them to perform past work or other work. For simplicity, we use {\textquotedblleft}work capacity{\textquotedblright} denials for these cases, though that is not SSA{\textquoteright}s official nomenclature. We follow the experience of older SSDI applicants from the time they receive an initial denial for SSDI benefits through full retirement age (FRA; age 65 or 66, depending on their birth year). The information in this brief highlights findings from a longer manuscript (Schimmel Hyde et al. 2018). Our findings shed light on the types of policies that might be most beneficial to older workers who experience disability onset to remain working and therefore delay claiming Social Security benefits.}, keywords = {Disabilities, Insurance, Social Security, Work}, url = {https://search.proquest.com/docview/2083857692/abstract/40375250D95640A2PQ/1?accountid=14667}, author = {Jody Schimmel Hyde and April Yanyuan Wu} } @article {9050, title = {Economic downturns, retirement and long-term cognitive function among older Americans.}, journal = {Journals of Gerontology, Series B: Psychological Sciences and Social Sciences}, volume = {73}, year = {2018}, month = {2017 Apr 11}, pages = {744-754}, abstract = {

Objective: Workers approaching retirement may be particularly vulnerable to economic downturns. This study assesses whether exposure to economic downturns around retirement age leads to poorer cognitive function in later life.

Method: Longitudinal data for 13,577 individuals in the Health and Retirement Study were linked to unemployment rates in state of residence. Random- and fixed-effect models were used to examine whether downturns at 55-64 years of age were associated with cognitive functioning levels and decline at >=65 years, measured by the Wechsler Adult Intelligence Scale-Revised.

Results: Longer exposure to downturns at 55-64 years of age was associated with lower levels of cognitive function at >=65 years. Compared to individuals experiencing only up to 1 year in a downturn at 55-64 years of age, individuals experiencing two downturns at these ages had 0.09 point (95\% Confidence Interval [CI, -0.17, -0.02]) lower cognitive functioning scores at >=65 years (3 years: b = -0.17, 95\%CI [-0.29, -0.06]; 4 years: b = -0.14, 95\%CI [-0.25, -0.02]; >=5 years: b = -0.22, 95\%CI [-0.38, -0.06]). Downturns at 55-64 years of age were not associated with rates of cognitive decline.

Discussion: Exposure to downturns around retirement is associated with a long-lasting decline in cognitive function in later life. Policies mitigating the impact of downturns on older workers may help to maintain cognitive function in later life.

}, keywords = {Cognitive Ability, Economic Downturn, Retirement Planning and Satisfaction}, issn = {1758-5368}, doi = {10.1093/geronb/gbx035}, author = {Hessel, Philipp and Carlos J Riumallo-Herl and Anja K Leist and Lisa F Berkman and Mauricio Avendano} } @article {8807, title = {Educational and Gender Differences in Health Behavior Changes After a Gateway Diagnosis.}, journal = {J Aging Health}, volume = {30}, year = {2018}, month = {2018 03}, pages = {342-364}, abstract = {

OBJECTIVE: Hypertension represents a gateway diagnosis to more serious health problems that occur as people age. We examine educational differences in three health behavior changes people often make after receiving this diagnosis in middle or older age, and test whether these educational differences depend on (a) the complexity of the health behavior change and (b) gender.

METHOD: We use data from the Health and Retirement Study and conduct logistic regression analysis to examine the likelihood of modifying health behaviors post diagnosis.

RESULTS: We find educational differences in three behavior changes-antihypertensive medication use, smoking cessation, and physical activity initiation-after a hypertension diagnosis. These educational differences in health behaviors were stronger among women compared with men.

DISCUSSION: Upon receiving a hypertension diagnosis, education is a more important predictor of behavior changes for women compared with men, which may help explain gender differences in the socioeconomic gradient in health in the United States.

}, keywords = {Aged, Attitude to Health, Educational Status, Exercise, Female, Health Behavior, Humans, Hypertension, Male, Middle Aged, Retirement, Sex Factors, Smoking cessation, United States}, issn = {1552-6887}, doi = {10.1177/0898264316678756}, url = {http://jah.sagepub.com/cgi/doi/10.1177/0898264316678756}, author = {Elaine M Hernandez and Rachel Margolis and Robert A Hummer} } @article {9591, title = {Educational Differences in the Prevalence of Dementia and Life Expectancy with Dementia: Changes from 2000 to 2010.}, journal = {Journals of Gerontology Series B: Psychological Sciences \& Social Sciences}, volume = {73}, year = {2018}, pages = {S20-S28}, abstract = {

Objectives: This article provides the first estimates of educational differences in age-specific prevalence, and changes in prevalence over time, of dementia by education levels in the United States. It also provides information on life expectancy, and changes in life expectancy, with dementia and cognitively healthy life for educational groups.

Method: Data on cognition from the 2000 and 2010 Health and Retirement Study are used to classify respondents as having dementia, cognitive impairment without dementia (CIND), or being cognitively intact. Vital statistics data are used to estimate life tables for education groups and the Sullivan method is used to estimate life expectancy by cognitive state.

Results: People with more education have lower prevalence of dementia, more years of cognitively healthy life, and fewer years with dementia. Years spent in good cognition increased for most sex-education groups and, conversely, years spent with dementia decreased for some. Mortality reduction was the most important factor in increasing cognitively healthy life. Change in the distribution of educational attainment has played a major role in the reduction of life with dementia in the overall population.

Discussion: Differences in the burden of cognitive loss by education point to the significant cost of low social status both to individuals and to society.

}, keywords = {Dementia, Education, Mortality}, issn = {1758-5368}, doi = {10.1093/geronb/gbx135}, author = {Eileen M. Crimmins and Saito, Yasuhiko and Jung K Kim and Yuan S Zhang and Sasson, Isaac and Mark D Hayward} } @article {9007, title = {An Exploration of Factors Associated With Ageist Stereotype Threat in a Medical Setting.}, journal = {Journals of Gerontology, Series B: Psychological Sciences and Social Sciences}, volume = {73}, year = {2018}, month = {2017 Mar 28}, pages = {1160-1165}, abstract = {

Objectives: Experiencing stereotype threat in a medical setting may be triggered by routine clinical activities, and may be detrimental to healthcare processes and outcomes. This study estimated the prevalence of, and identified factors associated with, reporting ageist stereotype threat in a medical setting using a nationally representative dataset.

Methods: Participants were community-dwelling adults aged 50 and older who had visited the doctor at least once in the past 2 years (n = 1,662). We analyzed data from the Health and Retirement Study using multivariate logistic regression.

Results: 8.31\% of participants felt worry or fear that they were judged by medical staff because of their age. Previous experiences of age discrimination (adjusted odds ratio [AOR] = 2.47, p < .01), poorer self-perceptions of aging (AOR = 1.34, p < .05), and having greater control over one{\textquoteright}s health (AOR = 0.84, p < .05) were associated with reporting stereotype threat because of age.

Discussion: Future research should investigate if measures to reduce age discrimination and to improve self-perceptions of aging and individual control over health protect against experiencing ageist stereotype threat in healthcare settings.

}, keywords = {Ageism, Medical setting, Older Adults, Stereotypes}, issn = {1758-5368}, doi = {10.1093/geronb/gbx034}, author = {Sandi Phibbs and Hooker, Karen} } @article {9577, title = {Exploring the Rise of Mortgage Borrowing among Older Americans}, number = {WP$\#$2018-3}, year = {2018}, month = {05/2018}, institution = {Center for Retirement Research at Boston College}, address = {Chestnut Hill}, abstract = {This paper documents and examines the rise in mortgage usage among older Americans over the past 30 years. It uses data from a variety of sources including the Health and Retirement Study, Decennial Census, American Community Survey, Survey of Consumer Finances, and the American Housing Survey. We begin by documenting the large increase in mortgage usage among older Americans across age and income distributions. We then use regression analysis to test for causes of the mortgage increase and subgroup heterogeneity, in particular focusing on changing health, bequest motives, and tax policy incentives. This paper found that: Americans over age 60 are more than three times as likely to have mortgage debt in 2015 compared to 1980, a 24-percentage point increase. This is a consistent increase across the income distribution.Increases to homeownership account for some of the rise in mortgages, but this has increased by only 9 percentage points among Americans over age 60 between 1980 and 2015.Younger age groups have had much smaller increases, and sometimes decreases, in mortgage usage and homeownership over the same time period.Changes in household characteristics, such as education, urbanization, race, income, and marriage rates explain only a small portion of the increase in mortgage rates. Households with below-median assets, and those without pensions, account for a greater share of the rise in older households{\textquoteright} mortgage borrowing. Changes in subjective health and bequest motives explain little of the rise in mortgage rates. Variation in the mortgage interest deduction explains part of the differential increase in mortgage usage by age. The policy implications of the paper are: Policymakers should be aware that the beneficiaries of mortgage and homeownership subsidies, such as the mortgage interest deduction, have changed substantially over the past 30 years.Increased mortgage usage has coincided with less total debt among seniors relative to younger cohorts and has not resulted in increased delinquency. This may indicate that the negative aspects of increased mortgage usage are limited. Further investigation into the causes and consequences of mortgage usage is needed in considering appropriate policy responses.}, keywords = {Financial Health, Homeownership, Mortgages, Retirement Planning and Satisfaction}, url = {http://crr.bc.edu/working-papers/exploring-the-rise-of-mortgage-borrowing-among-older-americans/}, author = {Collins, J. Michael and Hembre, Erik and Urban, Carly} } @book {9781, title = {Future Directions for the Demography of Aging: Proceedings of a Workshop}, series = {Demography of Aging}, year = {2018}, publisher = {The National Academies Press}, organization = {The National Academies Press}, address = {Washington, DC}, abstract = {Almost 25 years have passed since the Demography of Aging (1994) was published by the National Research Council. Future Directions for the Demography of Aging is, in many ways, the successor to that original volume. The Division of Behavioral and Social Research at the National Institute on Aging (NIA) asked the National Academies of Sciences, Engineering, and Medicine to produce an authoritative guide to new directions in demography of aging. The papers published in this report were originally presented and discussed at a public workshop held in Washington, D.C., August 17-18, 2017. The workshop discussion made evident that major new advances had been made in the last two decades, but also that new trends and research directions have emerged that call for innovative conceptual, design, and measurement approaches. The report reviews these recent trends and also discusses future directions for research on a range of topics that are central to current research in the demography of aging. Looking back over the past two decades of demography of aging research shows remarkable advances in our understanding of the health and well-being of the older population. Equally exciting is that this report sets the stage for the next two decades of innovative research{\textendash}a period of rapid growth in the older American population.}, doi = {10.17226/25064}, author = {Mark D Hayward and Malay K. Majmundar} } @article {10712, title = {Gene discovery and polygenic prediction from a genome-wide association study of educational attainment in 1.1 million individuals.}, journal = {Nature Genetics}, volume = {50}, year = {2018}, month = {2018 07 23}, pages = {1112-1121}, abstract = {

Here we conducted a large-scale genetic association analysis of educational attainment in a sample of approximately 1.1 million individuals and identify 1,271 independent genome-wide-significant SNPs. For the SNPs taken together, we found evidence of heterogeneous effects across environments. The SNPs implicate genes involved in brain-development processes and neuron-to-neuron communication. In a separate analysis of the X chromosome, we identify 10 independent genome-wide-significant SNPs and estimate a SNP heritability of around 0.3\% in both men and women, consistent with partial dosage compensation. A joint (multi-phenotype) analysis of educational attainment and three related cognitive phenotypes generates polygenic scores that explain 11-13\% of the variance in educational attainment and 7-10\% of the variance in cognitive performance. This prediction accuracy substantially increases the utility of polygenic scores as tools in research.

}, keywords = {Adult, Aged, Aged, 80 and over, Cohort Studies, Educational Status, Female, Genome-Wide Association Study, Humans, Male, Middle Aged, Multifactorial Inheritance, Phenotype, Polymorphism, Single Nucleotide}, issn = {1546-1718}, doi = {10.1038/s41588-018-0147-3}, author = {Lee, James J and Wedow, Robbee and Okbay, Aysu and Kong, Edward and Maghzian, Omeed and Zacher, Meghan and Nguyen-Viet, Tuan Anh and Bowers, Peter and Sidorenko, Julia and Richard Karlsson Linn{\'e}r and Mark Alan Fontana and Kundu, Tushar and Lee, Chanwook and Hui Liu and Li, Ruoxi and Royer, Rebecca and Pascal N Timshel and Walters, Raymond K and Willoughby, Emily A and Yengo, Loic and Alver, Maris and Bao, Yanchun and Clark, David W and Day, Felix R and Furlotte, Nicholas A and Joshi, Peter K and Kathryn E Kemper and Kleinman, Aaron and Langenberg, Claudia and M{\"a}gi, Reedik and Joey W Trampush and Verma, Shefali Setia and Wu, Yang and Lam, Max and Jing Hua Zhao and Zheng, Zhili and Jason D Boardman and Campbell, Harry and Freese, Jeremy and Kathleen Mullan Harris and Caroline Hayward and Herd, Pamela and Kumari, Meena and Lencz, Todd and Luan, Jian{\textquoteright}an and Anil K. Malhotra and Andres Metspalu and Lili Milani and Ong, Ken K and Perry, John R B and David J Porteous and Ritchie, Marylyn D and Smart, Melissa C and Smith, Blair H and Tung, Joyce Y and Wareham, Nicholas J and James F Wilson and Jonathan P. Beauchamp and Dalton C Conley and T{\~o}nu Esko and Lehrer, Steven F and Patrik K E Magnusson and Oskarsson, Sven and Pers, Tune H and Matthew R Robinson and Thom, Kevin and Watson, Chelsea and Chabris, Christopher F and Meyer, Michelle N and David I Laibson and Yang, Jian and Johannesson, Magnus and Philipp D Koellinger and Turley, Patrick and Peter M Visscher and Daniel J. Benjamin and Cesarini, David} } @article {9550, title = {Genetic markers of dopaminergic transmission predict performance for older males but not females.}, journal = {Neurobiology of Aging}, volume = {66}, year = {2018}, pages = {.e11-180.e21}, abstract = {Mobility and memory declines with aging can limit independence. Several single-nucleotide polymorphisms have been associated with cognitive performance, but studies investigating motor function are scant. We examined 4 single-nucleotide polymorphisms involved in dopaminergic metabolism: BDNF (Val66Met), DRD3 (Ser9Gly), DBH (C>T), and COMT (Val158Met) for their relationship to motor and cognitive function in healthy older adults (n~= 4605 and n~= 7331) who participated in the U.S. Health and Retirement Study. Individuals with genotypes associated with reduced dopamine metabolism exhibited poorer balance and memory. We found the most pronounced effects in the oldest participants (aged 85+ years), supporting the notion that age-related declines in dopamine availability contribute to magnified genotype effects with advancing age. Moreover, males demonstrated stronger associations than did females between a number of beneficial dopamine alleles and cognitive scores, suggesting that sex differences in dopaminergic transmission interact with genotype to influence performance. These findings point to common genetic variants related to dopaminergic metabolism that characterizes individual differences in motor and cognitive function in older adults.}, keywords = {Cognitive Ability, Gender Differences, Genetics}, issn = {1558-1497}, doi = {10.1016/j.neurobiolaging.2018.02.005}, author = {Kathleen E Hupfeld and David E Vaillancourt and Rachael D Seidler} } @article {9877, title = {Genome-wide association meta-analysis in 269,867 individuals identifies new genetic and functional links to intelligence}, journal = {Nature Genetics}, volume = {50}, year = {2018}, month = {Jan-07-2018}, pages = {912 - 919}, abstract = {Intelligence is highly heritable1 and a major determinant of human health and well-being2. Recent genome-wide meta-analyses have identified 24 genomic loci linked to variation in intelligence3-7, but much about its genetic underpinnings remains to be discovered. Here, we present a large-scale genetic association study of intelligence (n = 269,867), identifying 205 associated genomic loci (190 new) and 1,016 genes (939 new) via positional mapping, expression quantitative trait locus (eQTL) mapping, chromatin interaction mapping, and gene-based association analysis. We find enrichment of genetic effects in conserved and coding regions and associations with 146 nonsynonymous exonic variants. Associated genes are strongly expressed in the brain, specifically in striatal medium spiny neurons and hippocampal pyramidal neurons. Gene set analyses implicate pathways related to nervous system development and synaptic structure. We confirm previous strong genetic correlations with multiple health-related outcomes, and Mendelian randomization analysis results suggest protective effects of intelligence for Alzheimer{\textquoteright}s disease and ADHD and bidirectional causation with pleiotropic effects for schizophrenia. These results are a major step forward in understanding the neurobiology of cognitive function as well as genetically related neurological and psychiatric disorders. }, keywords = {Genome-Wide Association Study, Intelligence, Meta-analyses}, issn = {1061-4036}, doi = {10.1038/s41588-018-0152-6}, url = {http://www.nature.com/articles/s41588-018-0152-6http://www.nature.com/articles/s41588-018-0152-6.pdfhttp://www.nature.com/articles/s41588-018-0152-6http://www.nature.com/articles/s41588-018-0152-6.pdf}, author = {Savage, Jeanne E. and Philip R Jansen and Stringer, Sven and Watanabe, Kyoko and Bryois, Julien and Christiaan de Leeuw and Nagel, Mats and Awasthi, Swapnil and Barr, Peter B. and Coleman, Jonathan R. I. and Grasby, Katrina L. and Anke R Hammerschlag and Kaminski, Jakob A. and Karlsson, Robert and Krapohl, Eva and Lam, Max and Nygaard, Marianne and Chandra A Reynolds and Joey W Trampush and Young, Hannah and Zabaneh, Delilah and H{\"a}gg, Sara and Narelle K Hansell and Ida Karlsson and Linnarsson, Sten and Grant W Montgomery and Mu{\~n}oz-Manchado, Ana B. and Quinlan, Erin B. and Schumann, Gunter and Skene, Nathan G. and Webb, Bradley T. and White, Tonya and Dan E Arking and Avramopoulos, Dimitrios and Robert M Bilder and Bitsios, Panos and Katherine E Burdick and Tyrone D. Cannon and Chiba-Falek, Ornit and Christoforou, Andrea and Elizabeth T. Cirulli and Congdon, Eliza and Corvin, Aiden and Gail Davies and Ian J Deary and DeRosse, Pamela and Dickinson, Dwight and Djurovic, Srdjan and Donohoe, Gary and Conley, Emily Drabant and Johan G Eriksson and Espeseth, Thomas and Nelson A. Freimer and Giakoumaki, Stella and Giegling, Ina and Gill, Michael and David C. Glahn and Ahmad R Hariri and Hatzimanolis, Alex and Matthew C Keller and Knowles, Emma and Koltai, Deborah and Konte, Bettina and Lahti, Jari and Stephanie Le Hellard and Lencz, Todd and David C Liewald and London, Edythe and Astri J Lundervold and Anil K. Malhotra and Melle, Ingrid and Morris, Derek and Anna C Need and William E R Ollier and Aarno Palotie and Payton, Antony and Pendleton, Neil and Russell A Poldrack and Katri R{\"a}ikk{\"o}nen and Reinvang, Ivar and Roussos, Panos and Rujescu, Dan and Fred W Sabb and Matthew A Scult and Smeland, Olav B. and Smyrnis, Nikolaos and John M Starr and Vidar M Steen and Nikos C Stefanis and Richard E Straub and Sundet, Kjetil and Henning Tiemeier and Aristotle N Voineskos and Daniel R Weinberger and Elisabeth Widen and Yu, Jin and Gon{\c c}alo R Abecasis and Andreassen, Ole A. and Breen, Gerome and Christiansen, Lene and Debrabant, Birgit and Danielle M. Dick and Heinz, Andreas and Hjerling-Leffler, Jens and Mohammed Arfan Ikram and Kendler, Kenneth S. and Nicholas G Martin and Sarah E Medland and Nancy L Pedersen and Plomin, Robert and Tinca J Polderman and Ripke, Stephan and van der Sluis, Sophie and Patrick F. Sullivan and Scott Vrieze and Margaret J Wright and Posthuma, Danielle} } @proceedings {9934, title = {Health and Retirement Study Presentations at AEA/ASSA 2019}, journal = {Allied Social Science Associations Meeting 2019}, year = {2018}, publisher = {Health and Retirement Study}, address = {Atlanta, GA}, author = {HRS Staff} } @article {9255, title = {Health benefits associated with three helping behaviors: Evidence for incident cardiovascular disease.}, journal = {Journals of Gerontology, Series B: Psychological Sciences and Social Sciences}, volume = {73}, year = {2018}, pages = {492-500}, abstract = {

Objective: The purpose of this study was to investigate the association between three helping behaviors and incident cardiovascular disease (CVD; heart attack, stroke; fatal and nonfatal), with an exploration of gender differences. The study is framed within the caregiving system model. Helping others is argued to be an evolved characteristic of humans that yields beneficial health effects.

Methods: Data were taken from the 2004-2014 waves of the Health and Retirement Study. The three forms of helping others considered were formal volunteering, informal helping, and caregiving for a parent or spouse. Cox proportional hazards models were estimated for gender-stratified samples.

Results: Women who volunteered showed a lower risk of incident CVD compared to women who did not volunteer. Men who informally helped others in the community exhibited a lower risk of incident CVD compared to men who did not provide this form of help. Caregiving status was generally not associated with incident CVD for women or men.

Discussion: The results demonstrated that specific types of prosocial behavior may be beneficial for women and men. However, tests for effect differences showed that gender did not moderate the relationships between these helping behaviors and CVD risk.

}, keywords = {Caregiving, Heart disease, Mortality, Volunteerism}, issn = {1758-5368}, doi = {10.1093/geronb/gbx082}, author = {Jeffrey A Burr and Sae Hwang Han and Lee, Hyo Jung and Jane Tavares and Jan E Mutchler} } @article {9878, title = {Health Equity and Hospital Readmissions: Does Inclusion of Patient Functional and Social Complexity Improve Predictiveness?}, journal = {Journal of General Internal Medicine}, volume = {34}, year = {2018}, pages = {26-28}, abstract = {Medicare{\textquoteright}s Hospital Readmissions Reduction Program (HRRP) was intended to encourage hospitals to improve care for older adults. However, the program has raised health equity concerns because its risk-adjustment model does not account for patient social complexity; the concern is that HRRP may aggravate healthcare disparities by penalizing financially challenged hospitals and reducing their resources to improve care.1 While the HRRP assesses hospitals for penalties based upon readmission performance that is adjusted for patient age, sex, and clinical severity of illness, it does not account for functional and social patient factors. }, keywords = {Age differences, Gender Differences, Health Disparities, Hospitalization}, issn = {0884-8734}, doi = {10.1007/s11606-018-4635-z}, author = {Geoffrey J Hoffman and Hsuan, Charleen and Thomas M Braun and Ninez Ponce} } @article {9354, title = {Healthy Aging Among Older Black and White Men: What Is the Role of Mastery?}, journal = {The Journals of Gerontology Series B: Psychological Sciences and Social Sciences}, volume = {73}, year = {2018}, pages = {248-257}, abstract = {

Objectives: This research explores black-white differences in healthy aging and investigates whether mastery acts as a buffer against poor health for older black and white men.

Methods: Using data from the Health and Retirement Study (HRS) (2008-2012), a series of binary logit models were created to assess healthy aging over a 2-year period. Healthy aging was defined as good subjective health and free of disability at both waves. Mastery was lagged, and analyses (n = 4,892) controlled for social and health factors.

Results: Black-white disparities in healthy aging were observed, where older black men had lower odds of healthy aging. Mastery was associated with higher odds of healthy aging, and race moderated the relationship between mastery and healthy aging. The predicted probability of healthy aging was relatively flat across all levels of mastery among black men, yet white men saw consistent gains in the probability of healthy aging with higher levels of mastery. In race-stratified models, mastery was not a significant predictor of healthy aging among black men.

Discussion: High levels of mastery are linked to positive health-often acting as a buffer against stressful life events. However, among older black men, higher levels of mastery did not necessarily equate to healthy aging.

}, keywords = {Health Conditions and Status, Men{\textquoteright}s health, Racial/ethnic differences}, issn = {1758-5368}, doi = {10.1093/geronb/gbx105}, author = {Kenzie Latham-Mintus and Ashley Vowels and Huskins, Kyle} } @proceedings {9884, title = {HRS Exhibits at APPAM 2018}, journal = {Association for Public Policy Analysis \& Management}, year = {2018}, publisher = {Health and Retirement Study, Survey Research Center, Institute for Social Research, University of Michigan}, address = {Washington, DC}, author = {HRS Staff} } @proceedings {9885, title = {HRS Presentations at GSA 2018}, journal = {Gerontological Society of America Annual Meeting}, year = {2018}, month = {11/2018}, pages = {1-14}, publisher = {Health and Retirement Study, Survey Research Center, Institute for Social Research, University of Michigan}, address = {Boston, MA}, author = {HRS Staff} } @book {9608, title = {Impact of Divorce on Retirement Security}, series = {Working Papers}, year = {2018}, pages = {66}, publisher = {RAND Corporation}, organization = {RAND Corporation}, abstract = {In this paper, we consider the implications of divorce on retirement security. We introduce a theory that highlights how specialization within a divorcing household and timing of divorce relative to planned timing of retirement savings can have a negative impact on retirement security. Using panel data from the Health and Retirement Study (HRS), we evaluate differences in accumulated total and liquid retirement wealth at retirement ages. We replicate past findings that find a negative relationship between ever-divorced individuals and asset accumulation, particularly for women. We find that the negative relationship in our sample between wealth and divorce without remarriage is worse for women who divorce in their 30s than for women who divorce in their 50s whereas for men the relationship is worse for men who divorce in their 50s compared to men who divorce in their 30s. Using the household nature of our data, we compare assets of households before a separation leading to a divorce to those of each individual after that separation. We find evidence of swapping and liquidation of retirement and housing assets: 51 percent of separating households with liquid pre-separation retirement assets will have at least one household member with zero liquid retirement assets after separation. Finally, we develop a methodology to evaluate whether near-retirement divorce impacts retirement decumulation. We conduct a differences-indifferences matching analysis that assigns individuals who eventually divorce within the HRS to similar, but non-divorcing, individuals at first interview. This analysis controls for observed differences between the average divorcee and the average continuously married person, as well as permanent unobserved differences. We find that separated women are more likely to delay Social Security retirement benefit claiming until age 65 or 66, but otherwise we find no significant evidence that divorce is associated with differential decumulation of liquid retirement assets. }, keywords = {Divorce, Marriage, Retirement Planning and Satisfaction, Savings}, doi = {10.7249/WR1201}, url = {https://www.rand.org/pubs/working_papers/WR1201.html}, author = {Hung, Angela and Knapp, David} } @mastersthesis {10287, title = {Individual Characteristics Associated with Dementia Risk in Minority Populations}, volume = {Master of Arts in Social Gerontology}, year = {2018}, note = {Copyright - Database copyright ProQuest LLC; ProQuest does not claim copyright in the individual underlying works; Last updated - 2019-02-20}, pages = {86}, school = {University of Nebraska at Omaha}, type = {phd}, abstract = {U.S. minority populations are continuously growing. Concurrent with this growth is an increase in persons with cognitive impairment and dementia, especially in vulnerable populations. Despite this increase, there has been a comparative lack of minority focused research, especially in regards to comprehensive models which examine demographics, education, and health. This study utilized the ADAMS dataset (Health and Retirement Study) to investigate the predictive variables of age, sex, marital status, employment, education, and health within the context of ethnicity. Results showed that age, minority status, disability, lower education, cardiovascular disease, and increased number of comorbidities positively predicted development of both cognitive impairment not dementia and dementia. This evidence, in the context of ethnicity, and the burden of health, education, and demographics on minority persons, gives cause for increased support and development of culturally sensitive and focused programming to better serve minority populations.}, keywords = {ADAMS, Dementia, Ethnic studies, ethnicity, Gerontology, Health and environmental sciences, HRS, Minority, Public Health, Social Sciences}, isbn = {9780438864016}, author = {Sarah B Hubner} } @article {9565, title = {Informal caregiving costs for CVD projected to double by 2035}, journal = {Healio}, year = {2018}, publisher = {Healio}, address = {Thorofare, New Jersey}, keywords = {Cardiovascular disease, Caregiving, Economics, News}, url = {https://www.healio.com/cardiology/chd-prevention/news/online/\%7B184a689e-3874-4e64-b563-6e7a3a66dfd7\%7D/informal-caregiving-costs-for-cvd-projected-to-double-by-2035} } @article {6515, title = {Later Life Marital Dissolution and Repartnership Status: A National Portrait.}, journal = {J Gerontol B Psychol Sci Soc Sci}, volume = {73}, year = {2018}, month = {2018 Aug 14}, pages = {1032-1042}, abstract = {

OBJECTIVES: Our study compares two types of later life marital dissolution that occur after age 50-divorce and widowhood-and their associations with repartnership status (i.e., remarried, cohabiting, or unpartnered).

METHOD: We used data from the Health and Retirement Study to provide a portrait of later life divorce and widowhood for women and men. Next, we tested whether marital dissolution type is related to women{\textquoteright}s and men{\textquoteright}s repartnered status, distinguishing among remarrieds, cohabitors, and unpartnereds, net of key sociodemographic indicators.

RESULTS: Divorcees are more often repartnered through either remarriage or cohabitation than are widoweds. This gap persists among women net of an array of sociodemographic factors. For men, the differential is reduced to nonsignificance with the inclusion of these factors.

DISCUSSION: Later life marital dissolution increasingly occurs through divorce rather than widowhood, and divorce is more often followed by repartnership. The results from this study suggest that gerontological research should not solely focus on widowhood but also should pay attention to divorce and repartnering during later life.

}, keywords = {Age Factors, Aged, Aged, 80 and over, Divorce, Female, Humans, Longitudinal Studies, Male, Marriage, Middle Aged, Socioeconomic factors, Spouses, United States, Widowhood}, issn = {1758-5368}, doi = {10.1093/geronb/gbw051}, url = {http://psychsocgerontology.oxfordjournals.org/content/early/2016/04/29/geronb.gbw051.abstract}, author = {Susan L. Brown and Lin, I-Fen and Anna M Hammersmith and Matthew R Wright} } @article {9004, title = {Later-Life Disability in Environmental Context: Why Living Arrangements Matter.}, journal = {Gerontologist}, volume = {58}, year = {2018}, month = {04/2018}, abstract = {

Background and Objectives: Household social and environmental context are key elements of the disablement process, yet few studies explicitly examine the relationship between household composition, housing type, and disability progression. This study investigates the risk of older adults{\textquoteright} disability progression by type of living arrangement (e.g., household composition, housing type) and whether the relationship varies by socioeconomic status.

Research Design and Methods: We used Health and Retirement Study data (waves 1998-2012; n = 41,467 total observations) and fit time-series logistic regression models to estimate increases in activities of daily living (ADLs) and instrumental activities of daily living (IADLs) limitations. Because living arrangements are influenced by financial resources, we also stratified analyses by wealth.

Results: Disability rates were highest among those living alone or with nonfamily others and in self-described fair/poor quality housing. Overall, disability risk was more strongly associated with wealth than living arrangements. For more affluent older adults, living alone was associated with a decreased risk of IADL disability; for the least affluent older adults, living alone had the opposite association-increased risk of both ADL and IADL disability.

Discussion and Implications: Later-life disability progression should be understood in the context of both household environment and wealth. Household composition and housing characteristics were associated with disability progression and the risk of increasing disability was consistently higher for those in the lowest wealth quintile. These findings identify where older adults with disabilities live and that comprehensive interventions to reduce disability progression should consider household social and environmental context, as well as wealth.

}, keywords = {Disabilities, Living arrangements, Nursing homes, Older Adults}, issn = {1758-5341}, doi = {10.1093/geront/gnx019}, author = {Carrie Elizabeth Henning-Smith and Shippee, Tetyana and Benjamin D Capistrant} } @article {9774, title = {Life insurance holdings and well-being of surviving spouses}, journal = {Contemporary Economic Policy}, volume = {36}, year = {2018}, pages = {526 - 538}, abstract = {Premature death of a breadwinner can have devastating financial consequences on surviving dependents. This study investigates the role of life insurance in mitigating the long-run financial consequences of spousal mortality. Using the Health and Retirement Study, we examine individuals whose spouses died during or soon after his or her peak earnings years. After controlling for socioeconomic status, we find that sizable lump-sum life insurance payouts do not significantly influence spousal well-being. }, keywords = {Bereavement, Life insurance, Marriage, Well-being}, doi = {10.1111/coep.2018.36.issue-310.1111/coep.12211}, author = {Harris, Timothy F. and Yelowitz, Aaron} } @article {9582, title = {Lifestyle index for mortality prediction using multiple ageing cohorts in the USA, UK and Europe.}, journal = {Scientific Reports}, volume = {8}, year = {2018}, pages = {6644}, abstract = {Current mortality prediction indexes are mainly based on functional morbidity and comorbidity, with limited information for risk prevention. This study aimed to develop and validate a modifiable lifestyle-based mortality predication index for older adults. Data from 51,688 participants (56\% women) aged >=50 years in 2002 Health and Retirement Study, 2002 English Longitudinal Study of Ageing and 2004 Survey of Health Ageing and Retirement in Europe were used to estimate coefficients of the index with cohort-stratified Cox regression. Models were validated across studies and compared to the Lee index (having comorbid and morbidity predictors). Over an average of 11-year follow-up, 10,240 participants died. The lifestyle index includes smoking, drinking, exercising, sleep quality, BMI, sex and age; showing adequate model performance in internal validation (C-statistic 0.79; D-statistic 1.94; calibration slope 1.13) and in all combinations of internal-external cross-validation. It outperformed Lee index (e.g. differences in C-statistic = 0.01, D-statistic = 0.17, P < 0.001) consistently across health status. The lifestyle index stratified participants into varying mortality risk groups, with those in the top quintile having 13.5\% excess absolute mortality risk over 10 years than those in the bottom 50th centile. Our lifestyle index with easy-assessable behavioural factors and improved generalizability may maximize its usability for personalized risk management.}, keywords = {Cross-National, Functional status, Mortality}, issn = {2045-2322}, doi = {10.1038/s41598-018-24778-1}, author = {Liao, Jing and Muniz-Terrera, Graciela and Shaun Scholes and Hao, Yuantao and Chen, Yu-Ming} } @article {8493, title = {Linked Lives: Dyadic Associations of Mastery Beliefs With Health (Behavior) and Health (Behavior) Change Among Older Partners.}, journal = {J Gerontol B Psychol Sci Soc Sci}, volume = {73}, year = {2018}, month = {2018 06 14}, pages = {787-798}, abstract = {

Objectives: Mastery beliefs are known to contribute to healthy aging. However, it is an open question whether individual mastery-health associations impact the health of close long-term partners.

Method: We applied actor-partner interdependence models to 4-wave, 6-year longitudinal dyadic data from married and cohabitating partners in the Health and Retirement Study (N = 1,981 partners; age at baseline: M = 67 years, SD = 8.93, range 50-94 years).

Results: Higher individual mastery beliefs were associated with better individual physical health and health behaviors. Higher mastery beliefs were associated with subsequent increases in light physical activity. Having a partner with higher levels of mastery was uniquely associated with fewer functional limitations, better self-rated health, and more physical activity. Actor {\texttimes} Partner interaction effects for functional limitations indicated multiplicative associations of actor and partner mastery with health. Of note, mastery-health associations for individuals and their partners were invariant across age, gender, education, employment status, perceived stress over one{\textquoteright}s own and partner{\textquoteright}s health, and cognition.

Discussion: Findings suggest that partner mastery beliefs matter for the health (behaviors) of older adults. We discuss possible mechanisms underlying partner interrelations in mastery and health, their age invariance, and consider implications arising from our results.

}, keywords = {Aged, Aged, 80 and over, Dominance-Subordination, Female, Health Behavior, Health Status, Humans, Male, Marriage, Middle Aged, Models, Theoretical, Psychological Tests, Risk Reduction Behavior, Surveys and Questionnaires}, issn = {1758-5368}, doi = {10.1093/geronb/gbw058}, url = {http://www.ncbi.nlm.nih.gov/pubmed/27229003}, author = {Drewelies, Johanna and William J. Chopik and Christiane A Hoppmann and Jacqui Smith and Denis Gerstorf} } @article {9765, title = {Major Depression and Subthreshold Depression among Older Adults Receiving Home Care.}, journal = {American Journal of Geriatric Psychiatry}, volume = {26}, year = {2018}, month = {05/2018}, pages = {939-949}, abstract = {

OBJECTIVE: This study aims to estimate the prevalence and correlates of major and subthreshold depression and the extent of treatment utilization in older adults receiving home care.

METHODS: The study sample included 811 community-dwelling adults aged 60 and over who received paid home care during the 2008-2014 waves of the Health and Retirement Study. Depression was assessed using short forms of the Composite International Diagnostic Interview and the Center for Epidemiologic Studies Depression Scale. Logistic regression was used to examine correlates of depression type and treatment utilization.

RESULTS: One in two older home care recipients suffered from probable depression; 13.4\% of the sample suffered from major depression and an additional 38.7\% met study criteria for subthreshold depression. The majority (72.7\%) of participants with major depression and almost half (44.5\%) of participants with subthreshold depression reported taking medication for anxiety or depression. One-third (33.2\%) of older home care recipients with major depression and 14.2\% of those with subthreshold depression reported receiving formal psychiatric or psychological treatment. Males as compared with females and persons with pain problems as compared with no pain complaints had a higher risk of subthreshold and major depression. The receipt of medication or psychiatric treatment declined with age. African Americans were less likely to receive medication for anxiety or depression compared with non-Hispanic whites.

CONCLUSION: Depression affects a substantial proportion of older adults receiving home care and may be inappropriately treated. Future research is needed to develop optimal strategies for integrating depression assessment and treatment into home care.

}, keywords = {Caregiving, Community-dwelling, Depressive symptoms}, issn = {1545-7214}, doi = {10.1016/j.jagp.2018.05.001}, author = {Xiang, Xiaoling and Amanda N Leggett and Himle, Joseph A and Helen C Kales} } @mastersthesis {10323, title = {Marital Biography and Well-Being in Later Life: The Role of Remarriage, Disruption Pathways, and Duration on Health, Parent-Child Contact, and Ambivalence Toward Children}, volume = {PhD}, year = {2018}, note = {Copyright - Database copyright ProQuest LLC; ProQuest does not claim copyright in the individual underlying works; Last updated - 2018-09-06}, pages = {170}, school = {Bowling Green State University}, type = {phd}, abstract = {In 2015, nearly 30\% of individuals aged 50 and older had two or more marriages compared to 19\% in 1980, indicating that a growing share of older adults either divorced or were widowed during early or midlife and later remarried. Although widowhood remains a common exit from marriage in later life, divorce to people over 50 is also on the rise. Despite increasingly complex marital biographies of older adults, few researchers have examined differences between disruption pathways (i.e., one divorce, one widowhood, or multiple disruptions) and whether remarriage is associated with fewer costs of marital disruption. It is also unclear whether duration remarried or unmarried relates to better or worse health after different disruption pathways. Using the 1992{\textendash}2014 Health and Retirement Study, I investigate the associations of different disruption pathways, subsequent remarriage relative to being unmarried, and duration remarried or unmarried with older adults{\textquoteright} mental and physical health, contact with children, and ambivalence toward children. I also account for gender differences as the health and parent-child ties of men and women often differ in later life. This dissertation underscores the need to pay attention to older people with multiple disruptions, as they are often disadvantaged in health and parent-child relationships relative to older adults with one divorce or widowhood. The findings regarding the role of remarriage for each well-being outcome are mixed. Remarriage is beneficial for the mental health of men relative to being unmarried after any type of disruption, and for the physical health of divorced women. Although remarriage relates to more frequent parent-child contact for divorced men, remarriage relates to less contact among women after one widowhood or multiple disruptions. Remarriage also links to greater ambivalence among men after multiple disruptions. Duration also matters, but not uniformly across outcomes. Remarried men after multiple disruptions have worse mental health with more years remarried men after one divorce, indicating that duration remarried after multiple disruptions links to poorer mental health than duration remarried after one divorce. Although men with multiple disruptions have less contact with children than widowed men, additional years remarried yield more contact for men with multiple disruptions than for men with one widowhood. Moreover, women who remarry after widowhood have less contact with children than their unmarried counterparts, but each year remarried after widowhood is associated with more contact, suggesting these remarried women rebuild ties with children over time. In sum, my dissertation highlights the utility of employing different disruption pathways, subsequent remarriage, and duration remarried or unmarried to capture increasing complexity of marital biographies among older adults and to clarify its association with multiple dimensions of well-being.}, keywords = {0351:Gerontology, 0493:Aging, 0626:Sociology, 0628:Individual \& family studies, 0938:Demography, Aging, Demography, Families, Gerontology, Health and environmental sciences, Individual \& family studies, Marital disruption, Marital duration, Older Adults, Remarriage, Social Sciences, Sociology}, isbn = {9780438275652}, url = {https://etd.ohiolink.edu/pg_10?::NO:10:P10_ETD_SUBID:167588}, author = {Anna M Hammersmith} } @article {9866, title = {Medical Costs for Osteoporosis-Related Fractures in High-Risk Medicare Beneficiaries}, journal = {Journal of the American Geriatrics Society}, volume = {66}, year = {2018}, pages = {2298-2304}, abstract = {OBJECTIVES: To estimate the incremental direct medical care costs associated with first fracture observable in high-risk older adults. DESIGN: Retrospective analysis of claims and survey data over a 3-year period from the Health and Retirement Study (HRS), a nationally representative biennial study of individuals aged 50 and older. SETTING: United States. PARTICIPANTS: Participants were HRS respondents who consented to have their Medicare claims data linked to the HRS data, were aged 65 or older, had at least 1 risk factor for fracture observable in the data, and experienced a fracture between 1996 and 2008 (n = 689) and their propensity score{\textendash}matched controls (n = 689). MEASUREMENTS: Total Medicare, inpatient, outpatient, emergency department, physician office visit, and prescription drug care expenditures were primary outcomes. Two-staged generalized linear models were estimated using a difference-in-differences model. RESULTS: Fracture cases{\textquoteright} total Medicare expenditures increased by $13,929 (95\% confidence interval (CI)=$11,920{\textendash}15,938, p <.001) more than those of matched controls from the year before the index or fracture date to 1 year after the index date. Inpatient expenditures of $12,751 (95\% CI=$10,790{\textendash}14,7111, p <.001) more for fracture cases than comparison cases primarily drove this increase. Two and 3 years after fracture, there were no significant differences in growth in expenditures between the two groups. Results did not vary according to whether the fracture was at the hip or other site. CONCLUSION: Fractures impose a significant economic burden, especially in the first year after the fracture, in Medicare beneficiaries with at least 1 risk factor for fracture. Our sample was limited to community-dwelling individuals, and we are unable to control for fracture history before the study period. Costs may be greater for those in skilled nursing and similar facilities and for those who have had a previous fracture.}, keywords = {Medicare linkage, Medicare/Medicaid/Health Insurance, Risk Factors}, doi = {10.1111/jgs.15585}, url = {http://doi.wiley.com/10.1111/jgs.15585http://onlinelibrary.wiley.com/wol1/doi/10.1111/jgs.15585/fullpdfhttps://api.wiley.com/onlinelibrary/tdm/v1/articles/10.1111\%2Fjgs.15585}, author = {Kandice Kapinos and Fischer, Shira H. and Mulcahy, Andrew and Hayden, Orla and Barron, Richard} } @article {9806, title = {Meta-analysis of genome-wide association studies for height and body mass index in \~{}700000 individuals of European ancestry.}, journal = {Human Molecular Genetics}, volume = {27}, year = {2018}, pages = {3641-3649}, abstract = {Recent genome-wide association studies (GWAS) of height and body mass index (BMI) in \~{}250000 European participants have led to the discovery of \~{}700 and \~{}100 nearly independent single nucleotide polymorphisms (SNPs) associated with these traits, respectively. Here we combine summary statistics from those two studies with GWAS of height and BMI performed in \~{}450000 UK Biobank participants of European ancestry. Overall, our combined GWAS meta-analysis reaches N~\~{}700000 individuals and substantially increases the number of GWAS signals associated with these traits. We identified 3290 and 941 near-independent SNPs associated with height and BMI, respectively (at a revised genome-wide significance threshold of P~<~1~{\texttimes}~10-8), including 1185 height-associated SNPs and 751 BMI-associated SNPs located within loci not previously identified by these two GWAS. The near-independent genome-wide significant SNPs explain \~{}24.6\% of the variance of height and \~{}6.0\% of the variance of BMI in an independent sample from the Health and Retirement Study (HRS). Correlations between polygenic scores based upon these SNPs with actual height and BMI in HRS participants were \~{}0.44 and \~{}0.22, respectively. From analyses of integrating GWAS and expression quantitative trait loci (eQTL) data by summary-data-based Mendelian randomization, we identified an enrichment of eQTLs among lead height and BMI signals, prioritizing 610 and 138 genes, respectively. Our study demonstrates that, as previously predicted, increasing GWAS sample sizes continues to deliver, by the discovery of new loci, increasing prediction accuracy and providing additional data to achieve deeper insight into complex trait biology. All summary statistics are made available for follow-up studies.}, keywords = {BMI, Genetics, GWAS, Height}, issn = {1460-2083}, doi = {10.1093/hmg/ddy271}, author = {Yengo, Loic and Sidorenko, Julia and Kathryn E Kemper and Zheng, Zhili and Andrew R Wood and Michael N Weedon and Timothy M Frayling and Joel N Hirschhron and Yang, Jian and Peter M Visscher} } @article {9988, title = {Meta-analysis of genome-wide association studies for height and body mass index in \~{}700000 individuals of European ancestry}, journal = {Human Molecular Genetics}, volume = {27}, year = {2018}, pages = {3641-3649}, abstract = {Recent genome-wide association studies (GWAS) of height and body mass index (BMI) in similar to 250000 European participants have led to the discovery of similar to 700 and similar to 100 nearly independent single nucleotide polymorphisms (SNPs) associated with these traits, respectively. Here we combine summary statistics from those two studies with GWAS of height and BMI performed in similar to 450000 UK Biobank participants of European ancestry. Overall, our combined GWAS meta-analysis reaches N similar to 700000 individuals and substantially increases the number of GWAS signals associated with these traits. We identified 3290 and 941 near-independent SNPs associated with height and BMI, respectively (at a revised genome-wide significance threshold of P < 1 x 10(-8)), including 1185 height-associated SNPs and 751 BMI-associated SNPs located within loci not previously identified by these two GWAS. The near-independent genome-wide significant SNPs explain similar to 24.6\% of the variance of height and similar to 6.0\% of the variance of BMI in an independent sample from the Health and Retirement Study (HRS). Correlations between polygenic scores based upon these SNPs with actual height and BMI in HRS participants were similar to 0.44 and similar to 0.22, respectively. From analyses of integrating GWAS and expression quantitative trait loci (eQTL) data by summary-data-based Mendelian randomization, we identified an enrichment of eQTLs among lead height and BMI signals, prioritizing 610 and 138 genes, respectively. Our study demonstrates that, as previously predicted, increasing GWAS sample sizes continues to deliver, by the discovery of new loci, increasing prediction accuracy and providing additional data to achieve deeper insight into complex trait biology. All summary statistics are made available for follow-up studies.}, keywords = {BMI, Genetics, GWAS, Height}, issn = {0964-6906}, doi = {10.1093/hmg/ddy271}, author = {Yengo, Loic and Sidorenko, Julia and Kathryn E Kemper and Zheng, Zhili and Andrew R Wood and Michael N Weedon and Timothy M Frayling and Joel N Hirschhron and Yang, Jian and Peter M Visscher} } @article {doi:10.1111/1475-6773.12640, title = {Modeling Health Care Spending Growth of Older Adults}, journal = {Health Services Research}, volume = {53}, year = {2018}, pages = {138-155}, abstract = {Objective To forecast out-of-pocket health care spending among older adults. Long-term forecasts allow policy makers to explore potential impacts of policy scenarios, but existing microsimulations do not incorporate details of supplemental insurance coverage and income effects on health care spending. Data Sources Dynamic microsimulation calibrated to survey and administrative data. Study Design We augment Urban Institute{\textquoteright}s Dynamic Simulation of Income Model (DYNASIM) with modules that incorporate demand responses and economic equilibria, with dynamics driven by exogenous technological change. A lengthy technical appendix provides details of the microsimulation model and economic assumptions for readers interested in applying these techniques. Principal Findings The model projects total out-of-pocket spending (point of care plus premiums) as a share of income for adults aged 65 and older. People with lower incomes and poor health fare worse, despite protections of Medicaid. Spending rises 40 percent from 2012 to 2035 (from 10 to 14 percent of income) for the median beneficiary, but it increases from 5 to 25 percent of income for low-income beneficiaries and from 23 to 29 percent for the near poor who are in fair/poor health. Conclusions Despite Medicare coverage, near-poor seniors will face out-of-pocket spending that would render them, in practical terms, underinsured.}, keywords = {Health Care Costs, Health Insurance, Medicare Beneficiaries, simulations}, doi = {10.1111/1475-6773.12640}, url = {https://onlinelibrary.wiley.com/doi/abs/10.1111/1475-6773.12640}, author = {Hatfield, Laura A. and Melissa Favreault and McGuire, Thomas G. and M.E. Chernew} } @article {9254, title = {Moderate alcohol use and apolipoprotein E-4 (ApoE-4): Independent effects on cognitive outcomes in later life.}, journal = {Journal of Clinical and Experimental Neuropsychology}, volume = {40}, year = {2018}, pages = {326-337}, abstract = {

OBJECTIVES: Substantive past research suggests that moderate alcohol use confers beneficial health outcomes. The study of moderate alcohol use and cognition has produced variable findings. The primary goal was to examine the relationship between alcohol use and cognitive aging over time (Experiment 1), in a demographically representative, longitudinal survey of older adults. Experiment 2 examined the hypothesis that apolipoprotein E-4 (ApoE-4) would moderate the relationship between moderate drinking and performance on cognitive domains.

METHOD: The sample was drawn from the Aging, Demographics, and Memory Study (ADAMS) supplement of the Health and Retirement Study (HRS) and included 856 participants over age 65 in 2001. Follow-up data were from 2002, 2006, and 2008. Alcohol use was measured via self-report. Control variables included gender, age, race, number of years of education, medical burden (total number of medical diseases), and marital status.

RESULTS: Results of Experiment 1 indicated that moderate alcohol use was significantly associated with better baseline functioning across cognitive measures (p~<=~.05), but had no significant effect on rate of change over time across cognitive domains. Results of Experiment 2 indicated that while ApoE-4 carriage did not moderate the relationship between alcohol use and cognitive performance, generally, both ApoE-4 and moderate alcohol use were significant predictors of cognitive performance.

CONCLUSIONS: Overall, findings from this study support past findings that moderate alcohol use is associated with better cognitive functioning among community-dwelling older adults, and these relative benefits appear to persist throughout later life. However, the role of individual differences on manifestation of benefit remain very poorly understood. Future research should further examine the respective roles of demographic differences associated with cognitive aging, genetic moderators, and the influence of social interaction.

}, keywords = {Alcohol Consumption, APoE4, Cognitive Ability}, issn = {1744-411X}, doi = {10.1080/13803395.2017.1343803}, author = {Herring, Danielle and Daniel Paulson} } @article {9810, title = {Mother{\textquoteright}s education and late-life disparities in memory and dementia risk among US military veterans and non-veterans.}, journal = {Journal of Epidemiology and Community Health}, volume = {72}, year = {2018}, pages = {1162-1167}, abstract = {

BACKGROUND: Adverse childhood socioeconomic status (cSES) predicts higher late-life risk of memory loss and dementia. Veterans of U.S. wars are eligible for educational and economic benefits that may offset cSES disadvantage. We test whether cSES disparities in late-life memory and dementia are smaller among veterans than non-veterans.

METHODS: Data came from US-born men in the 1995-2014 biennial surveys of the Health and Retirement Study (n=7916 born 1928-1956, contributing n=38 381 cognitive assessments). Childhood SES was represented by maternal education. Memory and dementia risk were assessed with brief neuropsychological assessments and proxy reports. Military service (veteran/non-veteran) was evaluated as a modifier of the effect of maternal education on memory and dementia risk. We employed linear or logistic regression models to test whether military service modified the effect of maternal education on memory or dementia risk, adjusted for age, race, birthplace and childhood health.

RESULTS: Low maternal education was associated with worse memory than high maternal education (β = -0.07 SD, 95\% CI -0.08 to -0.05), while veterans had better memory than non-veterans (β = 0.03 SD, 95\% CI 0.02 to 0.04). In interaction analyses, maternal education disparities in memory were smaller among veterans than non-veterans (difference in disparities = 0.04 SD, 95\% CI 0.01 to 0.08, p = 0.006). Patterns were similar for dementia risk.

CONCLUSIONS: Disparities in memory by maternal education were smaller among veterans than non-veterans, suggesting military service and benefits partially offset the deleterious effects of low maternal education on late-life cognitive outcomes.

}, keywords = {Cognitive Ability, Dementia, Education, Memory, Veterans}, issn = {1470-2738}, doi = {10.1136/jech-2018-210771}, author = {Anusha M Vable and Chloe W Eng and Elizabeth R Mayeda and Basu, Sanjay and Jessica R Marden and Hamad, Rita and M. Maria Glymour} } @article {9481, title = {Neighborhoods, sleep quality, and cognitive decline: Does where you live and how well you sleep matter?}, journal = {Alzheimer{\textquoteright}s \& Dementia}, volume = {14}, year = {2018}, pages = {454-461}, abstract = {Introduction We evaluated the association between neighborhood socioeconomic status (NSES) and sleep quality on cognitive decline in the Health and Retirement Study. Methods Health and Retirement Study participants (n = 8090), aged 65+ with DNA and multiple biennial cognitive observations (abbreviated Telephone Interview for Cognitive Status), were included. Participants were grouped into quartiles of NSES and sleep quality scores. We adjusted for apolipoprotein E ε4, demographic, and cardiovascular risk factors. Random effects modeling evaluated cognitive change over time. Results NSES and sleep were significantly associated with cognitive decline, and there was a significant interaction between them (P = .02). Significant differences between high/low NSES and high/low sleep quality (P < .0001) were found. Discussion Sleep and NSES were associated with cognitive decline; the association between sleep and cognition appeared stronger among those with low NSES. The association between low NSES, poor sleep quality, and cognitive decline was roughly equivalent to the association between apolipoprotein E ε4 and cognitive decline.}, keywords = {Cognitive Ability, Neighborhoods, Sleep, Socioeconomic factors}, issn = {15525260}, doi = {10.1016/j.jalz.2017.10.007}, url = {https://pubmed.ncbi.nlm.nih.gov/29396109/}, author = {Jaimie C Hunter and Elizabeth P. Handing and Casanova, Ramon and Kuchibhatla, Maragatha and Michael W Lutz and Saldana, Santiago and Brenda L Plassman and Kathleen M Hayden} } @article {9978, title = {A new model for interdependent durations}, journal = {Quantitative Economics}, volume = {9}, year = {2018}, pages = {1299-1333}, abstract = {This paper introduces a bivariate version of the generalized accelerated failure time model. It allows for simultaneity in the econometric sense that the two realized outcomes depend structurally on each other. Another feature of the proposed model is that it will generate equal durations with positive probability. Our approach takes a stylized economic model that leads to a univariate generalized accelerated failure time model as a starting point. In this model, agents decide when to transition from an initial state to a new one, and the covariates influence the difference in the utility flow in the two states. We introduce simultaneity by allowing the utility flow to depend on the status of the other person. The econometric model is then completed by assuming that the observed outcome is the Nash bargaining solution in that simple economic model. The advantage of this approach is that it includes independent realizations from the generalized accelerated failure time model as a special case, and deviations from this special case can be given an economic interpretation. We established identification under assumptions that are similar to those in the literature on nonparametric estimation of duration models. We illustrate the model by studying the joint retirement decisions in married couples using the Health and Retirement Study. In that example, it seems reasonable to allow for the possibility that each partner{\textquoteright}s optimal retirement time depends on the retirement time of the spouse. Moreover, the data suggest that the wife and the husband retire at the same time for a nonnegligible fraction of couples. The main empirical finding is that the simultaneity is economically important. In our preferred specification, the indirect utility associated with being retired increases by approximately 5\% when one{\textquoteright}s spouse retires.}, keywords = {Couples, Retirement Planning and Satisfaction}, issn = {1759-7323}, doi = {10.3982/QE439}, url = {http://qeconomics.org/ojs/index.php/qe/article/view/622}, author = {Bo E. Honor{\'e} and {\'A}ureo de Paula} } @article {9602, title = {Occupational and educational inequalities in exit from employment at older ages: evidence from seven prospective cohorts}, journal = {Occupational and Environmental Medicine}, volume = {75}, year = {2018}, month = {Dec-05-2018}, pages = {369 - 377}, abstract = {Objectives Past studies have identified socioeconomic inequalities in the timing and route of labour market exit at older ages. However, few studies have compared these trends cross-nationally and existing evidence focuses on specific institutional outcomes (such as disability pension and sickness absence) in Nordic countries. We examined differences by education level and occupational grade in the risks of work exit and health-related work exit. Methods Prospective longitudinal data were drawn from seven studies (n=99 164). Participants were in paid work at least once around age 50. Labour market exit was derived based on reductions in working hours, changes in self-reported employment status or from administrative records. Health-related exit was ascertained by receipt of health-related benefit or pension or from the reported reason for stopping work. Cox regression models were estimated for each study, adjusted for baseline self-rated health and birth cohort. Results There were 50 003 work exits during follow-up, of which an average of 14\% (range 2-32\%) were health related. Low level education and low occupational grade were associated with increased risks of health-related exit in most studies. Low level education and occupational grade were also associated with an increased risk of any exit from work, although with less consistency across studies. Conclusions Workers with low socioeconomic position have an increased risk of health-related exit from employment. Policies that extend working life may disadvantage such workers disproportionally, especially where institutional support for those exiting due to poor health is minimal.}, keywords = {Education, Employment and Labor Force, Europe, Health Disparities, Work}, issn = {1351-0711}, doi = {10.1136/oemed-2017-10461910.1136/oemed-2017-104619.supp1}, url = {http://oem.bmj.com/content/75/5/369}, author = {Carr, Ewan and Fleischmann, Maria and Goldberg, Marcel and Kuh, Diana and Murray, Emily T and Stafford, Mai and Stansfeld, Stephen and Vahtera, Jussi and Xue, Baowen and Zaninotto, Paola and Zins, Marie and Head, Jenny} } @conference {11642, title = {Occupational Changes Following Disability Onset in the Late Working Years}, booktitle = {6th Annual Meeting of the Disability Research Consortium}, year = {2018}, publisher = {Mathematica Policy Research }, organization = {Mathematica Policy Research }, abstract = {The onset of a work-limiting health condition in the years approaching retirement significantly reduces earnings and income, and leads to a sustained increase in the risk for poverty in both the late working years and into retirement. Schimmel and Stapleton (2012) found that earnings among older workers two years after the onset of a work-limiting health condition were 50 percent lower on average, and poverty rates were nearly double the rates for individuals who did not report a work-limiting health condition. Wu and Schimmel Hyde (forthcoming) reported that the likelihood of poverty in retirement was significantly higher for Social Security Disability Insurance (SSDI) beneficiaries and denied applicants{\textemdash}both groups who had substantial medical conditions{\textemdash}relative to older adults who had never sought SSDI before retirement{\textemdash}and who were presumably healthier than the two SSDI groups.}, keywords = {Disabilities, Disability, Disability onset, Occupation, Occupational choice}, url = {https://www.mathematica.org/-/media/internet/conferences/2018/drc-annual-meeting/summaries/occupational-changes-following-disability-onset-in-the-late-working-years-summary.pdf}, author = {April Yanyuan Wu and Jody Schimmel Hyde} } @article {9464, title = {Older Adults Undergoing Total Hip or Knee Arthroplasty: Chronicling Changes in Their Multimorbidity Profile in the Last Two Decades.}, journal = {Journal of Arthroplasty}, volume = {33}, year = {2018}, pages = {976-982}, abstract = {

BACKGROUND: Despite the ubiquitous use of total hip arthroplasty (THA) and total knee arthroplasty (TKA) in older adults, little is known about the multimorbidity (MM) profile of this patient population. This study evaluates the temporal trends of MM, hypothesizing that patients with MM have had an increasingly greater representation in THA and TKA patients over time.

METHODS: Data on a US representative sample of older adults from the linked Health and Retirement Study and Medicare data from 1993 to 2012 were used. The Health and Retirement Study is a biennial survey that collects data on a broad array of measures, including self-reported chronic conditions and geriatric syndromes, which were used to account for MM. Medicare data were used to identify fee-for-service Medicare beneficiaries who underwent THA (n~= 479) or TKA (n~= 998) during the study years, which were grouped into 3 periods: 1993-1999, 2000-2006, and 2007-2012. Multivariable logistic regression analysis was conducted to obtain age-, gender-, and race-adjusted time trends for MM.

RESULTS: Compared to the earliest study period, and for both THA and TKA patients, there were significantly fewer patients with stroke and/or poor cognitive performance in the most recent study period. In addition, more TKA than THA patients presented with 2+ chronic conditions. Nearly 70\% presented with co-occurring chronic conditions and geriatric syndromes, and this percentage did not change significantly over time.

CONCLUSION: The high representation of THA and TKA patients presenting with co-occurring chronic conditions and geriatric syndromes in this patient population warrants detailed exploration of the effects of geriatric syndromes on postoperative outcomes.

}, keywords = {Chronic conditions, Comorbidity, Functional limitations, Joint replacement}, issn = {1532-8406}, doi = {10.1016/j.arth.2017.11.014}, author = {Siran M Koroukian and Nicholas K Schiltz and David F Warner and Alison K Klika and Carlos A. Higuera-Rueda and Wael K. Barsoum} } @article {9832, title = {Parental Investments in College and Later Cash Transfers}, journal = {Demography}, volume = {55}, year = {2018}, month = {10/2018}, pages = {1705-1725}, abstract = {Parents often provide generous financial transfers to their adult children, perhaps assisting with college expenses, recognizing major life course events, or cushioning against negative financial shocks. Because resources are limited, a transfer made to one child likely affects transfers made to others in the family. Despite such possibilities, data limitations have led previous authors to focus almost exclusively on a single type of transfer made at a single point in time. Using data from the Health and Retirement Study, we examine the relationships among parental transfers for college and later cash transfers to all children within a family. We find that parents typically spend differentially on the postsecondary schooling of their children but find no evidence that this differential spending is offset by later cash transfers.}, keywords = {College, Family transfers, Finances, Social Support}, issn = {0070-3370}, doi = {10.1007/s13524-018-0703-6}, url = {http://link.springer.com/10.1007/s13524-018-0703-6http://link.springer.com/content/pdf/10.1007/s13524-018-0703-6.pdfhttp://link.springer.com/content/pdf/10.1007/s13524-018-0703-6.pdfhttp://link.springer.com/article/10.1007/s13524-018-0703-6/fulltext.html}, author = {Steven Haider and Kathleen McGarry} } @article {9708, title = {Pathways to death: The co-occurrence of physical and mental health in the last years of life}, journal = {Demographic Research}, volume = {38}, year = {2018}, month = {Jan-01-2018}, pages = {1619 - 1634}, abstract = {Background: Physical and mental health are important markers of quality of life. Little is known about how they unfold in tandem in the last years of life. Objective: We take a life-course perspective to identify typical joint trajectories of functional limitations and depression in the last eight years before death. Our objective is to assess whether there is only a linear association between functional limitations and depression or if we also find groups marked by high and increasing functional limitations but low depression, and vice versa. Methods: Data from 10 waves of the Health and Retirement Study that cover US Americans who died between 2003{\textendash}2014 are analyzed with sequence, cluster, and multinomial logistic regression methods. Results: Results show five typical trajectories of joint functional limitations and depression. Corroborating previous findings, three groups support a linear positive relationship between functional limitations and depression. Beyond previous research, we find two resilient groups of medium and high functional limitations combined with stable low depression. The five groups are highly stratified by social status, gender, marital status, and subjective life expectancy reported at the beginning of the trajectories. Conclusions: Physical and mental health trajectories at the end of life are not only linearly associated. Medium and high functional limitations go along with a polarized pattern of either stable high or stable low depression. Contribution: The nonlinear relationship between functional limitations and depression in the last years of life represented by the {\textquoteleft}Resilient{\textquoteright} groups of medium and high functional limitations with low depression have gone largely unnoticed in previous research and should be investigated in future studies.}, doi = {10.4054/DemRes.2018.38.53}, url = {https://www.demographic-research.org/volumes/vol38/53/}, author = {Marcel Raab and Fasang, Anette and Hess, Moritz} } @article {11237, title = {The Postretirement Well-Being of Workers With Disabilities}, journal = {Journal of Disability Policy Studies}, volume = {30}, year = {2018}, note = {doi: 10.1177/1044207318793161}, month = {2019/06/01}, pages = {46 - 55}, abstract = {Older workers who develop significant limitations in health or functioning face declines in income and consumption and an increased likelihood of poverty in the years prior to retirement. We assess the extent to which those differences persist after reaching retirement age. We use the Health and Retirement Study (HRS) linked to Social Security Administration (SSA) records to compare the postretirement financial well-being of workers who experienced disability onset during their working years with those who did not, based on their claiming behavior for Social Security disability and retirement benefits. We find that even after full retirement age, gaps that emerged prior to retirement persist; those who experienced disability prior to retirement had lower incomes, were more likely to be in poverty, and had significantly lower wealth. Workers with disabilities who claimed Social Security Disability Insurance (DI) fared better than those who were rejected for such benefits, yet both groups were worse off than those who delayed claiming benefits until they were eligible for Social Security Old Age and Survivors Insurance (OASI) benefits. Our findings indicate that any changes to the Social Security benefit structure must be mindful of the short- and longer term implications for already-vulnerable groups of workers.}, keywords = {Disabilities, Disability, Retirement, Well-being}, isbn = {1044-2073}, url = {https://doi.org/10.1177/1044207318793161}, author = {April Yanyuan Wu and Jody Schimmel Hyde} } @article {9435, title = {Postsecondary Schooling and Parental Resources: Evidence from the PSID and HRS}, journal = {Education Finance and Policy}, volume = {13}, year = {2018}, pages = {72-96}, abstract = {We examine the association between young adult postsecondary schooling and parental financial resources using two datasets that contain high-quality data on parental resources: the Panel Study of Income Dynamics (PSID) and the Health and Retirement Study (HRS). We find the association to be pervasiveit exists for income and wealth, it extends far up the income and wealth distributions, it remains even after we control for a host of other characteristics, and it continues beyond simply beginning postsecondary schooling to completing a four-year degree. Using the Transition to Adulthood supplement to the PSID, we also find that financial resources strongly affect postsecondary schooling for all levels of high school achievement, and particularly for those at the highest level.}, keywords = {Education, Inequality, Parents, PSID}, issn = {1557-3060}, doi = {10.1162/edfp_a_00219}, url = {http://www.mitpressjournals.org/doi/abs/10.1162/edfp_a_00219http://www.mitpressjournals.org/doi/pdf/10.1162/EDFP_a_00219}, author = {Steven Haider and Kathleen McGarry} } @article {6965, title = {The Potential Effects of Obesity on Social Security Claiming Behavior and Retirement Benefits.}, journal = {J Gerontol B Psychol Sci Soc Sci}, volume = {73}, year = {2018}, month = {2018 Apr 16}, pages = {723-732}, publisher = {19}, abstract = {

OBJECTIVES: Obesity prevalence among Americans has increased for nearly three decades. We explore the relationship between the rise in obesity and Social Security retirement benefit claiming, a decision impacting nearly all aging Americans. Specifically, we investigate whether obesity can affect individuals{\textquoteright} decision to claim benefits early, a choice that has important implications for financial security in retirement, particularly for those with lower socioeconomic status (SES).

METHOD: We use a microsimulation model called MINT6 (Modeling Income in the Near Term, version 6) to demonstrate the potential effects of obesity on subjective life expectancy and claiming behavior. We impute obesity status using data from the National Health and Nutrition Examination Survey (NHANES), which describes the distribution of obesity prevalence within the United States by gender, poverty status, and race/ethnicity.

RESULTS: We find that the rise in obesity and the consequent incidence of obesity-related diseases may lead some individuals to make claiming decisions that lead to lower monthly and lifetime Social Security retirement benefits. Further, we find that the potential economic impact of this decision is larger for those with lower SES.

DISCUSSION: We present a behavioral perspective by addressing the potential effects that obesity can have on individuals{\textquoteright} retirement decisions and their resulting Social Security retirement benefits.

}, keywords = {Aged, Female, Humans, Life Expectancy, Male, Obesity, Pensions, Poverty, Social Class, Social Security, United States}, issn = {1758-5368}, doi = {10.1093/geronb/gbw016}, author = {Michael D Hurd and James P Smith and Julie M Zissimopoulos} } @article {9744, title = {Poverty dynamics, poverty thresholds and mortality: An age-stage Markovian model}, journal = {PLOS ONE}, volume = {13}, year = {2018}, month = {Apr-05-2019}, pages = {e0195734}, abstract = {Recent studies have examined the risk of poverty throughout the life course, but few have considered how transitioning in and out of poverty shape the dynamic heterogeneity and mortality disparities of a cohort at each age. Here we use state-by-age modeling to capture individual heterogeneity in crossing one of three different poverty thresholds (defined as 1{\texttimes}, 2{\texttimes} or 3{\texttimes} the {\textquotedblleft}official{\textquotedblright} poverty threshold) at each age. We examine age-specific state structure, the remaining life expectancy, its variance, and cohort simulations for those above and below each threshold. Survival and transitioning probabilities are statistically estimated by regression analyses of data from the Health and Retirement Survey RAND data-set, and the National Longitudinal Survey of Youth. Using the results of these regression analyses, we parameterize discrete state, discrete age matrix models. We found that individuals above all three thresholds have higher annual survival than those in poverty, especially for mid-ages to about age 80. The advantage is greatest when we classify individuals based on 1{\texttimes} the {\textquotedblleft}official{\textquotedblright} poverty threshold. The greatest discrepancy in average remaining life expectancy and its variance between those above and in poverty occurs at mid-ages for all three thresholds. And fewer individuals are in poverty between ages 40-60 for all three thresholds. Our findings are consistent with results based on other data sets, but also suggest that dynamic heterogeneity in poverty and the transience of the poverty state is associated with income-related mortality disparities (less transience, especially of those above poverty, more disparities). This paper applies the approach of age-by-stage matrix models to human demography and individual poverty dynamics. In so doing we extend the literature on individual poverty dynamics across the life course.}, keywords = {Life Expectancy, Mortality, Poverty, Socioeconomic factors}, doi = {10.1371/journal.pone.0195734}, url = {http://dx.doi.org/10.1371/journal.pone.0195734}, author = {Bernstein, Shayna Fae and David Rehkopf and Tuljapurkar, Shripad and Horvitz, Carol C.}, editor = {Komarova, Natalia L.} } @article {9975, title = {Predictors and implications of accelerated cognitive aging}, journal = {Biodemography and Social Biology}, volume = {64}, year = {2018}, pages = {83-101}, abstract = {Aging is a major risk factor for both normal and pathological cognitive decline. However, individuals vary in their rate of age-related decline. We developed an easily interpretable composite measure of cognitive age, and related both the level of cognitive age and cognitive slope to sociodemographic, genetic, and disease indicators and examined its prediction of dementia transition. Using a sample of 19,594 participants from the Health and Retirement Study, cognitive age was derived from a set of performance tests administered at each wave. Our findings reveal different conclusions as they relate to levels versus slopes of cognitive age, with more pronounced differences by sex and race/ethnicity for absolute levels of cognitive decline rather than for rates of declines. We also find that both level and slope of cognitive age are inversely related to education, as well as increased for persons with APOE ?4 and/or diabetes. Finally, results show that the slope in cognitive age predicts subsequent dementia among non-demented older adults. Overall, our study suggests that this measure is applicable to cross-sectional and longitudinal studies on cognitive aging, decline, and dementia with the goal of better understanding individual differences in cognitive decline.}, keywords = {BMI, Cognition \& Reasoning, Risk Factors, Socioeconomic factors}, issn = {1948-5565}, doi = {10.1080/19485565.2018.1552513}, url = {https://www.tandfonline.com/doi/full/10.1080/19485565.2018.1552513https://www.tandfonline.com/doi/pdf/10.1080/19485565.2018.1552513}, author = {Morgan E. Levine and Harrati, Amal and Eileen M. Crimmins} } @article {9526, title = {Protein-altering variants associated with body mass index implicate pathways that control energy intake and expenditure in obesity.}, journal = {Nat Genet}, volume = {50}, year = {2018}, month = {2018 Jan}, pages = {26-41}, abstract = {

Genome-wide association studies (GWAS) have identified >250 loci for body mass index (BMI), implicating pathways related to neuronal biology. Most GWAS loci represent clusters of common, noncoding variants from which pinpointing causal genes remains challenging. Here we combined data from 718,734 individuals to discover rare and low-frequency (minor allele frequency (MAF) < 5\%) coding variants associated with BMI. We identified 14 coding variants in 13 genes, of which 8 variants were in genes (ZBTB7B, ACHE, RAPGEF3, RAB21, ZFHX3, ENTPD6, ZFR2 and ZNF169) newly implicated in human obesity, 2 variants were in genes (MC4R and KSR2) previously observed~to be mutated in extreme obesity and 2 variants were in GIPR. The effect sizes of rare variants are ~10 times larger than those of common variants, with the largest effect observed in carriers of an MC4R mutation introducing a stop codon (p.Tyr35Ter, MAF = 0.01\%), who weighed ~7 kg more than non-carriers. Pathway analyses based on the variants associated with BMI~confirm enrichment of neuronal genes and provide new evidence for adipocyte and energy expenditure biology, widening the potential of genetically supported therapeutic targets in obesity.

}, issn = {1546-1718}, doi = {10.1038/s41588-017-0011-x}, author = {Turcot, Val{\'e}rie and Lu, Yingchang and Highland, Heather M and Schurmann, Claudia and Justice, Anne E and Fine, Rebecca S and Bradfield, Jonathan P and T{\~o}nu Esko and Giri, Ayush and Graff, Mariaelisa and Guo, Xiuqing and Hendricks, Audrey E and Karaderi, Tugce and Lempradl, Adelheid and Locke, Adam E and Mahajan, Anubha and Marouli, Eirini and Sivapalaratnam, Suthesh and Young, Kristin L and Alfred, Tamuno and Feitosa, Mary F and Masca, Nicholas G D and Alisa Manning and Medina-Gomez, Carolina and Mudgal, Poorva and Ng, Maggie C Y and Reiner, Alex P and Vedantam, Sailaja and Willems, Sara M and Thomas W Winkler and Gon{\c c}alo R Abecasis and Aben, Katja K and Alam, Dewan S and Alharthi, Sameer E and Matthew A. Allison and Amouyel, Philippe and Asselbergs, Folkert W and Auer, Paul L and Balkau, Beverley and Bang, Lia E and Barroso, In{\^e}s and Bastarache, Lisa and Benn, Marianne and Bergmann, Sven and Bielak, Lawrence F and Bl{\"u}her, Matthias and Boehnke, Michael and Boeing, Heiner and Boerwinkle, Eric and B{\"o}ger, Carsten A and Bork-Jensen, Jette and Bots, Michiel L and Erwin P Bottinger and Bowden, Donald W and Brandslund, Ivan and Breen, Gerome and Brilliant, Murray H and Broer, Linda and Brumat, Marco and Burt, Amber A and Adam S Butterworth and Campbell, Peter T and Cappellani, Stefania and Carey, David J and Catamo, Eulalia and Caulfield, Mark J and Chambers, John C and Daniel I Chasman and Yii-Der I Chen and Chowdhury, Rajiv and Cramer Christensen and Chu, Audrey Y and Cocca, Massimiliano and Collins, Francis S and Cook, James P and Corley, Janie and Jordi Corominas Galbany and Cox, Amanda J and Crosslin, David S and Cuellar-Partida, Gabriel and D{\textquoteright}Eustacchio, Angela and Danesh, John and Gail Davies and Bakker, Paul I W and Groot, Mark C H and Mutsert, Ren{\'e}e and Ian J Deary and George Dedoussis and Ellen W Demerath and Heijer, Martin and Anneke I den Hollander and Hester M den Ruijter and Joe G Dennis and Denny, Josh C and Angelantonio, Emanuele and Drenos, Fotios and Du, Mengmeng and Dub{\'e}, Marie-Pierre and Dunning, Alison M and Easton, Douglas F and Edwards, Todd L and Ellinghaus, David and Ellinor, Patrick T and Elliott, Paul and Evangelou, Evangelos and Farmaki, Aliki-Eleni and Farooqi, I Sadaf and Jessica Faul and Fauser, Sascha and Feng, Shuang and Ferrannini, Ele and Ferri{\`e}res, Jean and Florez, Jose C and Ford, Ian and Myriam Fornage and Franco, Oscar H and Franke, Andre and Franks, Paul W and Friedrich, Nele and Frikke-Schmidt, Ruth and Galesloot, Tessel E and Gan, Wei and Gandin, Ilaria and Paolo P. Gasparini and Gibson, Jane and Giedraitis, Vilmantas and Gjesing, Anette P and Gordon-Larsen, Penny and Gorski, Mathias and Hans-J{\"o}rgen Grabe and Grant, Struan F A and Grarup, Niels and Griffiths, Helen L and Grove, Megan L and Gudnason, Vilmundur and Gustafsson, Stefan and Jeffrey Haessler and Hakonarson, Hakon and Anke R Hammerschlag and Hansen, Torben and Tamara B Harris and Andrew T Hattersley and Have, Christian T and Caroline Hayward and He, Liang and Heard-Costa, Nancy L and Andrew C Heath and Iris M Heid and Helgeland, {\O}yvind and Hernesniemi, Jussi and Hewitt, Alex W and Oddgeir L Holmen and Hovingh, G Kees and Howson, Joanna M M and Hu, Yao and Huang, Paul L and Huffman, Jennifer E and Mohammed Arfan Ikram and Ingelsson, Erik and Jackson, Anne U and Jansson, Jan-H{\r a}kan and Jarvik, Gail P and Jensen, Gorm B and Jia, Yucheng and Johansson, Stefan and J{\o}rgensen, Marit E and J{\o}rgensen, Torben and Jukema, J Wouter and Kahali, Bratati and Kahn, Ren{\'e} S and K{\"a}h{\"o}nen, Mika and Kamstrup, Pia R and Kanoni, Stavroula and Kaprio, Jaakko and Karaleftheri, Maria and Sharon L R Kardia and Karpe, Fredrik and Kathiresan, Sekar and Kee, Frank and Lambertus A Kiemeney and Eric S Kim and Kitajima, Hidetoshi and Komulainen, Pirjo and Kooner, Jaspal S and Charles Kooperberg and Korhonen, Tellervo and Kovacs, Peter and Kuivaniemi, Helena and Kutalik, Zolt{\'a}n and Kuulasmaa, Kari and Kuusisto, Johanna and Laakso, Markku and Lakka, Timo A and Lamparter, David and Lange, Ethan M and Leslie A Lange and Langenberg, Claudia and Eric B Larson and Lee, Nanette R and Lehtim{\"a}ki, Terho and Lewis, Cora E and Li, Huaixing and Li, Jin and Li-Gao, Ruifang and Lin, Honghuang and Lin, Keng-Hung and Lin, Li-An and Lin, Xu and Lars Lind and Lindstr{\"o}m, Jaana and Linneberg, Allan and Liu, Ching-Ti and Liu, Dajiang J and Yongmei Liu and Ken Sin Lo and Lophatananon, Artitaya and Lotery, Andrew J and Loukola, Anu and Luan, Jian{\textquoteright}an and Lubitz, Steven A and Lyytik{\"a}inen, Leo-Pekka and M{\"a}nnist{\"o}, Satu and Marenne, Ga{\"e}lle and Mazul, Angela L and McCarthy, Mark I and McKean-Cowdin, Roberta and Sarah E Medland and Meidtner, Karina and Lili Milani and Mistry, Vanisha and Mitchell, Paul and Mohlke, Karen L and Moilanen, Leena and Moitry, Marie and Grant W Montgomery and Dennis O Mook-Kanamori and Moore, Carmel and Mori, Trevor A and Morris, Andrew D and Morris, Andrew P and M{\"u}ller-Nurasyid, Martina and Munroe, Patricia B and Michael A Nalls and Narisu, Narisu and Nelson, Christopher P and Neville, Matt and Sune Fallgaard Nielsen and Nikus, Kjell and Nj{\o}lstad, P{\r a}l R and B{\o}rge G Nordestgaard and Nyholt, Dale R and Jeff O{\textquoteright}Connell and O{\textquoteright}Donoghue, Michelle L and Ophoff, Roel A and Owen, Katharine R and Packard, Chris J and Padmanabhan, Sandosh and Palmer, Colin N A and Palmer, Nicholette D and Pasterkamp, Gerard and Patel, Aniruddh P and Pattie, Alison and Pedersen, Oluf and Peissig, Peggy L and Peloso, Gina M and Pennell, Craig E and Markus Perola and Perry, James A and Perry, John R B and Pers, Tune H and Person, Thomas N and Peters, Annette and Petersen, Eva R B and Peyser, Patricia A and Pirie, Ailith and Polasek, Ozren and Tinca J Polderman and Puolijoki, Hannu and Olli T Raitakari and Rasheed, Asif and Rauramaa, Rainer and Reilly, Dermot F and Renstrom, Frida and Rheinberger, Myriam and Ridker, Paul M and Rioux, John D and Rivas, Manuel A and Roberts, David J and Neil R Robertson and Robino, Antonietta and Rolandsson, Olov and Rudan, Igor and Ruth, Katherine S and Saleheen, Danish and Veikko Salomaa and Nilesh J Samani and Sapkota, Yadav and Sattar, Naveed and Schoen, Robert E and Schreiner, Pamela J and Schulze, Matthias B and Scott, Robert A and Segura-Lepe, Marcelo P and Svati H Shah and Sheu, Wayne H-H and Sim, Xueling and Slater, Andrew J and Small, Kerrin S and Albert Vernon Smith and Southam, Lorraine and Timothy Spector and Elizabeth K Speliotes and John M Starr and Stefansson, Kari and Steinthorsdottir, Valgerdur and Kathleen E Stirrups and Strauch, Konstantin and Heather M Stringham and Stumvoll, Michael and Sun, Liang and Surendran, Praveen and Swift, Amy J and Tada, Hayato and Tansey, Katherine E and Tardif, Jean-Claude and Kent D Taylor and Teumer, Alexander and Thompson, Deborah J and Thorleifsson, Gudmar and Thorsteinsdottir, Unnur and Thuesen, Betina H and T{\"o}njes, Anke and Tromp, Gerard and Trompet, Stella and Tsafantakis, Emmanouil and Tuomilehto, Jaakko and Tybjaerg-Hansen, Anne and Tyrer, Jonathan P and Uher, Rudolf and Andr{\'e} G Uitterlinden and Uusitupa, Matti and Laan, Sander W and Duijn, Cornelia M and Leeuwen, Nienke and van Setten, Jessica and Vanhala, Mauno and Varbo, Anette and Varga, Tibor V and Varma, Rohit and Digna R Velez Edwards and Vermeulen, Sita H and Veronesi, Giovanni and Vestergaard, Henrik and Vitart, Veronique and Vogt, Thomas F and V{\"o}lker, Uwe and Vuckovic, Dragana and Wagenknecht, Lynne E and Walker, Mark and Wallentin, Lars and Wang, Feijie and Wang, Carol A and Wang, Shuai and Wang, Yiqin and Erin B Ware and Wareham, Nicholas J and Warren, Helen R and Dawn M Waterworth and Wessel, Jennifer and White, Harvey D and Willer, Cristen J and Wilson, James G and Daniel Witte and Andrew R Wood and Wu, Ying and Yaghootkar, Hanieh and Yao, Jie and Yao, Pang and Laura M Yerges-Armstrong and Young, Robin and Zeggini, Eleftheria and Zhan, Xiaowei and Zhang, Weihua and Wei Zhao and Zhou, Wei and Krina T Zondervan and Rotter, Jerome I and Pospisilik, John A and Fernando Rivadeneira and Ingrid B Borecki and Deloukas, Panos and Timothy M Frayling and Lettre, Guillaume and Kari E North and Lindgren, Cecilia M and Joel N Hirschhron and Ruth J F Loos} } @article {9875, title = {Provider bias as a function of patient genotype: polygenic score analysis among diabetics from the Health and Retirement Study}, journal = {Obesity Science \& Practice}, volume = {4}, year = {2018}, month = {Jan-10-2018}, pages = {448 - 454}, abstract = {ObjectivePoor patient-provider interactions due to provider bias are associated with worse physiological and behavioural health outcomes for patients. Prior research has shown that patients with obesity perceive less favourable interactions compared with those with lower weights. This paper explores whether this association depends on patients{\textquoteright} cumulative polygenic score with respect to genes linked to obesity (i.e. a single variable quantifying the individual{\textquoteright}s genome-wide risk factors for high body mass index [BMI] or genetic liability) and whether providers react differentially to patients whose obesity is more genetic in nature compared with patients with diabetes caused by environmental factors. MethodsThe association between patients{\textquoteright} BMI category, their polygenic score for high BMI and their interaction was assessed for two measures of the patient-provider interaction within a sample of 521 older patients with diabetes from the Health and Retirement Study. ResultsParticularly for patients with obesity, the quality of the patient-provider interaction depended on genetic liability for high BMI controlling for demographic and clinical covariates. Providers responded less favourably to patients with diabetes influenced by environmental factors compared with individuals with high genetic liability. ConclusionsResults of this study suggest that a patient{\textquoteright}s genotype may elicit particular responses from their healthcare provider. When a provider judges a patient{\textquoteright}s high BMI to be environmentally driven rather than genetically oriented, patients receive reduced quality of care.}, keywords = {Bias, BMI, Genotype, Health Care Outcomes, Patient-physician Relationship}, doi = {10.1002/osp4.293}, url = {https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6180716/}, author = {Huibregtse, B. M. and Jason D Boardman} } @article {9353, title = {Psychosocial Mechanisms Underlying Older Black Men{\textquoteright}s Health.}, journal = {Journals of Gerontology, Series B: Psychological Sciences \& Social Sciences}, volume = {73}, year = {2018}, month = {01/2018}, pages = {188-197}, abstract = {

Objectives: To evaluate the psychosocial mechanisms underlying older Black men{\textquoteright}s self-rated health, we examined: (a) the individual, cumulative, and collective effects of stressors on health; (b) the direct effects of psychosocial resources on health; and (c) the stress-moderating effects of psychosocial resources.

Method: This study is based on a nationally representative sample of Black men aged 51-81 (N = 593) in the Health and Retirement Study (HRS). Ordinary least squares (OLS) regression models of the psychosocial determinants of self-rated health draw on data from the HRS 2010 and 2012 Core datasets and Psychosocial Modules.

Results: Each of the six measures of stressors as well as a cumulative measure of stressors are predictive of worse self-rated health. However, when considered collectively, only two stressors (chronic strains and traumatic events) have statistically significant effects. Furthermore, two of the five psychosocial resources examined (mastery and optimism) have statistically significant protective effects, and prayer moderates the harmful effects of traumatic events on self-rated health.

Discussion: Conventional measures of stressors and coping resources-originally developed to account for variance in health outcomes among predominantly white samples-may not capture psychosocial factors most salient for older Black men{\textquoteright}s health. Future research should incorporate psychosocial measures that reflect their unique experiences.

}, keywords = {Depressive symptoms, Discrimination, Intersectionality, Racial/ethnic differences}, issn = {1758-5368}, doi = {10.1093/geronb/gbx091}, author = {Tyson H Brown and Taylor W. Hargrove} } @article {9596, title = {On the Relationship between Cognitive Ability and Risk Preference}, journal = {Journal of Economic Perspectives}, volume = {32}, year = {2018}, month = {Jan-05-2018}, pages = {115 - 134}, abstract = {This paper will focus on the relationship between cognitive ability and decision-making under risk and uncertainty. Taken as a whole, this research indicates that cognitive ability is associated with risk-taking behavior in various contexts and life domains, including incentivized choices between lotteries in controlled environments, behavior in nonexperimental settings, and self-reported tendency to take risks. One pattern that emerges frequently in these studies is that cognitive ability tends to be positively correlated with avoidance of harmful risky situations, but it tends to be negatively correlated with risk aversion in advantageous situations. We conclude by discussing perspectives for future research, in particular the scope for the development of richer sets of elicitation instruments and measurement across a wider range of concepts. }, keywords = {Cognitive Ability, Decision making, Risk Taking}, issn = {0895-3309}, doi = {10.1257/jep.32.2.115}, url = {https://pubs.aeaweb.org/doi/10.1257/jep.32.2.115https://pubs.aeaweb.org/doi/pdf/10.1257/jep.32.2.115}, author = {Dohmen, Thomas and Falk, Armin and Huffman, David and Sunde, Uwe} } @article {9156, title = {The relationship between moderate alcohol consumption, depressive symptomatology, and C-reactive protein: the Health and Retirement Study.}, journal = {International Journal of Geriatric Psychiatry}, volume = {33}, year = {2018}, pages = {316-324}, abstract = {

OBJECTIVE: Moderate alcohol use has been broadly associated with health benefits among older adults, including improved mood. Aims of this study were to evaluate the relationship of moderate alcohol use and depressive symptomatology over a period of eight years, and to examine inflammation, indicated by C-reactive protein (CRP), as one mechanism by which this relationship functions.

METHODS: The study included 3177 community-dwelling participants over the age of 65 in 2008 drawn from the Health and Retirement Study. Data from the 2006, 2008, 2012, and 2014 waves were used. Alcohol use was measured via self-report and was dichotomized as abstinent (0 drinks per week) and moderate (1-14 drinks per week). Inflammation was measured using CRP, which was collected using an enzyme-linked immunosorbent assay and provided in units of μg/mL. Control variables included gender, age, body mass index (BMI), and medical burden.

RESULTS: A latent growth curve model with full information maximum likelihood was used, with results revealing that moderate drinkers endorsed fewer depressive symptoms at baseline and a steeper rate of change over time. Abstinent respondents{\textquoteright} depressive symptomatology was characterized by a more linear change rate. Further, moderate drinkers had lower CRP levels suggesting that inflammation partially mediates the relationship between moderate alcohol use and depressive symptomatology.

CONCLUSIONS: Moderate alcohol use predicts fewer depressive symptoms among older adults. This relationship is partially moderated by CRP and is eroded by the passage of time. Future research should identify additional mechanisms relating alcohol to positive health outcomes and less depressive symptomatology. Copyright {\textcopyright} 2017 John Wiley \& Sons, Ltd.

}, keywords = {Alcohol Consumption, C-reactive protein, Depressive symptoms}, issn = {1099-1166}, doi = {10.1002/gps.4746}, author = {Daniel Paulson and Mona Shah and Herring, Danielle and Rosanna G Scott and Herrera, Manuel and Brush, David and Bassett, Rachel} } @article {9299, title = {Religious Attendance and Body Mass: An Examination of Variations by Race and Gender.}, journal = {Journal of Religion and Health}, volume = {57}, year = {2018}, month = {12/2018}, pages = {2140-2152}, abstract = {Studies of the association between religious attendance and body mass have yielded mixed results. In this paper, we consider intersectional variations by race and gender to advance our understanding of these inconsistencies. We use data from the 2006-2008 Health and Retirement Study to examine the association between religious attendance and three indicators of body mass: overall body mass index, waist circumference, and waist-to-height ratio (n~=~11,457). For White women, attendance is either protective or unrelated to body mass. For Black women, attendance is consistently associated with increased body mass. We find that religious attendance is not associated with body mass among the men.}, keywords = {BMI, Gender Differences, Racial/ethnic differences, Religion}, issn = {1573-6571}, doi = {10.1007/s10943-017-0490-1}, author = {Godbolt, Dawn and Preeti Vaghela and Amy M. Burdette and Terrence D. Hill} } @mastersthesis {10315, title = {Selected Health Implications of Low Body Mass: Determinants and Health Outcomes}, volume = {PhD}, year = {2018}, note = {Copyright - Database copyright ProQuest LLC; ProQuest does not claim copyright in the individual underlying works; Last updated - 2019-03-04}, pages = {105}, school = {University of Iowa}, type = {phd}, abstract = {While the role of obesity in health outcomes has been well described, the role of low body mass index (BMI), body weight relative to height, has largely been ignored. Those with low BMI are commonly excluded completely or combined with the normal BMI category in BMI studies. However, there have been some studies indicating poorer health outcomes among those with lower BMI, particularly that of increased risk of mortality. The purpose of this study is to explore the role of low BMI throughout the lifespan. Data from the Health and Retirement Study was used to evaluate 1) the association between childhood health and socioeconomic status (SES) exposures and low BMI in midlife adulthood, 2) the association between low BMI and health related outcomes in midlife adulthood (ages 50 to 65), and 3) the association between low BMI in midlife and health related outcomes, including mortality, over a longer follow-up (maximum of 20 years). To increase sample size, two low BMI definitions were used: the traditional <18.5 definition and a definition of <=20 based on the J-shaped curves found in BMI mortality studies. Few significant results were found. Low BMI status was consistently associated with older age and female gender as well as current smoking status. Childhood exposure of respiratory disease and greater SES disadvantages was more common among those with low BMI in adulthood. In midlife adulthood, low BMI status was associated with increased difficulties with activities of daily living with either definition of low BMI. Increased risk of fracture was associated with a low BMI definition of <18.5. Increased risk of lung disease and decreased risk of high blood pressure was associated with a low BMI definition of <=20. An analysis of those 30 years old or older found low BMI to be associated with increased risk of mortality and decreased risk of diabetes regardless of low BMI definition. When low BMI was defined as <18.5, those with low BMI were also more likely to experience difficulty with one or more activities of daily living. When low BMI was defined as <=20, low BMI status was associated with greater risk of lung disease and decreased risk of high blood pressure. Further research is needed to fully characterize the role of low BMI on health outcomes as well as the role of SES on low BMI. Additionally, there is a need for greater understanding of the potential biological mechanisms of low BMI for health outcomes. Currently, there are few studies evaluating health outcomes and SES of low BMI. Limiting studies to the extreme upper end of the BMI spectrum limits the overall understanding of the role of BMI in health and may overlook unique characteristics and challenges those with low BMI may face.}, keywords = {0573:Public health, BMI, Health and environmental sciences, HRS, Life-course, Public Health, Underweight}, isbn = {9780438870680}, url = {https://ir.uiowa.edu/etd/6592/}, author = {Holcombe,Andrea L.} } @mastersthesis {10013, title = {Self-employment in later life: Implications for financial, physical, and mental well-being}, volume = {Doctor of Philosophy}, year = {2018}, school = {Washington University in St. Louis}, type = {Dissertation}, address = {St. Louis, MO}, abstract = {More than one in five working Americans aged 50 and older are self-employed, yet scholarship that examines the relationships between self-employment and personal health and financial well-being is limited. Using data from six biennial waves of the Health and Retirement Study, a nationally-representative panel study of Americans past 50 years of age, this quasi-experimental dissertation documents the characteristics of self-employed older adults in comparison to wage-and-salary workers, as well as compares self-employed and wage-and-salary workers in later life on a set of financial well-being and personal health outcomes. This study incorporates inverse probability of treatment weighting (also referred to as propensity score weighting) to control for selection into the {\textquotedblleft}treatment{\textquotedblright} of concern, self-employment. Among older Americans, this dissertation revealed that age, being male, reporting better health, and having higher levels of risk tolerance were predictive of self-employment, among other factors. Further, it found strong evidence that self-employment leads to reduced earnings from work, with some evidence that it increases health and wealth. This dissertation builds upon previous work while contributing to discussions about the causal effects of later-life self-employment, as well as program and policy developments to support longer working lives.}, keywords = {Employment and Labor Force, Self-employment, Well-being}, doi = {10.7936/K7P55MZ2}, url = {https://doi.org/10.7936/K7P55MZ2}, author = {Cal J. Halvorsen} } @article {9824, title = {Social Exclusion and Switching Barriers in Medicare Part D Choices}, journal = {Sustainability}, volume = {10}, year = {2018}, month = {Jan-07-2018}, pages = {2419}, abstract = {Previous studies have shown that Medicare beneficiaries do not tend to switch their prescription drug plans (Part D), even though they can greatly save on the money spent on drugs by switching plans. To explore this occurrence, the present study focused on the concept of social exclusion-one of the most important characteristics prevalent in the elderly. This study compared the impact of two types of social exclusion on the association between psychological cost and plan switching: active (or rejected) social exclusion and passive (or ignored) social exclusion. The study{\textquoteright}s aim was to examine the moderating effect of social exclusion on the relationship between the cost of switching and willingness to switch plan to build sustainable health care system. The Prescription Drug Study supplementary to the Health and Retirement Study (HRS) data were utilized for analysis by applying a Hierarchical Linear Model (HLM) (N = 1042). The findings suggest that active social exclusion moderates the relationship between the switching cost and willingness to switch plan. This study{\textquoteright}s findings will help policymakers better understand the elderly{\textquoteright}s decision-making process pertaining to plans and promote their informed plan decisions to build sustainable health care system. }, keywords = {Healthcare, Medicare, Medicare Part D, Prescription Medication}, doi = {10.3390/su10072419}, url = {http://www.mdpi.com/2071-1050/10/7/2419http://www.mdpi.com/2071-1050/10/7/2419/pdf}, author = {Ko, Dong and Bae, Young and Han, Jayoung} } @article {9127, title = {Structural racism in the workplace: Does perception matter for health inequalities?}, journal = {Social Science \& Medicine}, volume = {199}, year = {2018}, pages = {106-114}, abstract = {Structural racism has been linked to racial health inequalities and may operate through an unequal labor market that results in inequalities in psychosocial workplace environments (PWE). Experiences of the PWE may be a critical but understudied source of racial health disparities as most adults spend a large portion of their lives in the workplace, and work-related stress affects health outcomes. Further, it is not clear if the objective characteristics of the workplace are important for health inequalities or if these inequalities are driven by the perception of the workplace. Using data from the 2008 to 2012 waves of the Health and Retirement Study (HRS), a probability-based sample of US adults 50 years of age and older and the Department of Labor{\textquoteright}s Occupational Information Network (O*NET), we examine the role of both standardized, objective (O*NET) and survey-based, subjective (as in HRS) measures of PWEs on health and Black-White health inequalities. We find that Blacks experience more stressful PWEs and have poorer health as measured by self-rated health, episodic memory function, and mean arterial pressure. Mediation analyses suggest that these objective O*NET ratings, but not the subjective perceptions, partially explain the relationship between race and health. We discuss these results within the extant literature on workplace and health and health inequalities. Furthermore, we discuss the use of standardized objective measures of the PWE to capture racial inequalities in workplace environment.}, keywords = {Health Disparities, Racial/ethnic differences, Racism}, issn = {1873-5347}, doi = {10.1016/j.socscimed.2017.05.039}, author = {Courtney L McCluney and Lauren L Schmitz and Margaret T Hicken and Amanda Sonnega} } @article {12139, title = {Study of 300,486 individuals identifies 148 independent genetic loci influencing general cognitive function.}, journal = {Nature Communications}, volume = {9}, year = {2018}, pages = {2098}, abstract = {

General cognitive function is a prominent and relatively stable human trait that is associated with many important life outcomes. We combine cognitive and genetic data from the CHARGE and COGENT consortia, and UK Biobank (total N = 300,486; age 16-102) and find 148 genome-wide significant independent loci (P < 5 {\texttimes} 10) associated with general cognitive function. Within the novel genetic loci are variants associated with neurodegenerative and neurodevelopmental disorders, physical and psychiatric illnesses, and brain structure. Gene-based analyses find 709 genes associated with general cognitive function. Expression levels across the cortex are associated with general cognitive function. Using polygenic scores, up to 4.3\% of variance in general cognitive function is predicted in independent samples. We detect significant genetic overlap between general cognitive function, reaction time, and many health variables including eyesight, hypertension, and longevity. In conclusion we identify novel genetic loci and pathways contributing to the heritability of general cognitive function.

}, keywords = {Adolescent, Adult, Aged, Aged, 80 and over, Cognition, Genetic Loci, Genetic Predisposition to Disease, Humans, Mental Disorders, Middle Aged, Multifactorial Inheritance, Neurodegenerative Diseases, Neurodevelopmental Disorders, Polymorphism, Single Nucleotide, Reaction Time, Young Adult}, issn = {2041-1723}, doi = {10.1038/s41467-018-04362-x}, author = {Gail Davies and Lam, Max and Sarah E Harris and Joey W Trampush and Luciano, Michelle and W David Hill and Hagenaars, Saskia P and Ritchie, Stuart J and Riccardo E Marioni and Fawns-Ritchie, Chloe and David C Liewald and Okely, Judith A and Ahola-Olli, Ari V and Barnes, Catriona L K and Bertram, Lars and Joshua C. Bis and Katherine E Burdick and Christoforou, Andrea and DeRosse, Pamela and Djurovic, Srdjan and Espeseth, Thomas and Giakoumaki, Stella and Giddaluru, Sudheer and Gustavson, Daniel E and Caroline Hayward and Edith Hofer and Ikram, M Arfan and Karlsson, Robert and Knowles, Emma and Lahti, Jari and Leber, Markus and Li, Shuo and Mather, Karen A and Melle, Ingrid and Morris, Derek and Christopher J Oldmeadow and Palviainen, Teemu and Payton, Antony and Pazoki, Raha and Katja E Petrovic and Chandra A Reynolds and Sargurupremraj, Muralidharan and Scholz, Markus and Smith, Jennifer A and Smith, Albert V and Terzikhan, Natalie and Thalamuthu, Anbupalam and Trompet, Stella and Sven J van der Lee and Erin B Ware and Windham, B Gwen and Margaret J Wright and Yang, Jingyun and Yu, Jin and Ames, David and Amin, Najaf and Amouyel, Philippe and Andreassen, Ole A and Armstrong, Nicola J and Assareh, Amelia A and John R. Attia and Attix, Deborah and Avramopoulos, Dimitrios and David A Bennett and B{\"o}hmer, Anne C and Patricia A. Boyle and Brodaty, Henry and Campbell, Harry and Tyrone D. Cannon and Elizabeth T. Cirulli and Congdon, Eliza and Conley, Emily Drabant and Corley, Janie and Cox, Simon R and Dale, Anders M and Dehghan, Abbas and Danielle M. Dick and Dickinson, Dwight and Johan G Eriksson and Evangelou, Evangelos and Jessica Faul and Ford, Ian and Nelson A. Freimer and Gao, He and Giegling, Ina and Gillespie, Nathan A and Gordon, Scott D and Gottesman, Rebecca F and Michael E Griswold and Gudnason, Vilmundur and Tamara B Harris and Hartmann, Annette M and Hatzimanolis, Alex and Gerardo Heiss and Holliday, Elizabeth G and Joshi, Peter K and K{\"a}h{\"o}nen, Mika and Sharon L R Kardia and Ida Karlsson and Kleineidam, Luca and David S Knopman and Kochan, Nicole A and Konte, Bettina and Kwok, John B and Stephanie Le Hellard and Lee, Teresa and Lehtim{\"a}ki, Terho and Li, Shu-Chen and Lill, Christina M and Liu, Tian and Koini, Marisa and London, Edythe and Longstreth, Will T and Lopez, Oscar L and Loukola, Anu and Luck, Tobias and Astri J Lundervold and Lundquist, Anders and Lyytik{\"a}inen, Leo-Pekka and Nicholas G Martin and Grant W Montgomery and Murray, Alison D and Anna C Need and Noordam, Raymond and Nyberg, Lars and William E R Ollier and Papenberg, Goran and Pattie, Alison and Polasek, Ozren and Russell A Poldrack and Psaty, Bruce M and Reppermund, Simone and Steffi G Riedel-Heller and Rose, Richard J and Rotter, Jerome I and Roussos, Panos and Rovio, Suvi P and Saba, Yasaman and Fred W Sabb and Sachdev, Perminder S and Satizabal, Claudia L and Schmid, Matthias and Rodney J Scott and Matthew A Scult and Simino, Jeannette and Slagboom, P Eline and Smyrnis, Nikolaos and Soumar{\'e}, A{\"\i}cha and Nikos C Stefanis and Stott, David J and Richard E Straub and Sundet, Kjetil and Taylor, Adele M and Kent D Taylor and Tzoulaki, Ioanna and Tzourio, Christophe and Andr{\'e} G Uitterlinden and Vitart, Veronique and Aristotle N Voineskos and Kaprio, Jaakko and Wagner, Michael and Wagner, Holger and Weinhold, Leonie and Wen, K Hoyan and Elisabeth Widen and Yang, Qiong and Zhao, Wei and Hieab H Adams and Dan E Arking and Robert M Bilder and Bitsios, Panos and Boerwinkle, Eric and Chiba-Falek, Ornit and Corvin, Aiden and Philip L de Jager and Debette, St{\'e}phanie and Donohoe, Gary and Elliott, Paul and Fitzpatrick, Annette L and Gill, Michael and David C. Glahn and H{\"a}gg, Sara and Narelle K Hansell and Ahmad R Hariri and Ikram, M Kamran and Jukema, J Wouter and Vuoksimaa, Eero and Matthew C Keller and Kremen, William S and Lenore J Launer and Lindenberger, Ulman and Aarno Palotie and Nancy L Pedersen and Pendleton, Neil and David J Porteous and Katri R{\"a}ikk{\"o}nen and Olli T Raitakari and Ramirez, Alfredo and Reinvang, Ivar and Rudan, Igor and Schmidt, Reinhold and Schmidt, Helena and Peter W Schofield and Peter R Schofield and John M Starr and Vidar M Steen and Trollor, Julian N and Turner, Steven T and Cornelia M van Duijn and Villringer, Arno and Daniel R Weinberger and David R Weir and James F Wilson and Anil K. Malhotra and McIntosh, Andrew M and Gale, Catharine R and Seshadri, Sudha and Thomas H Mosley and Bressler, Jan and Lencz, Todd and Ian J Deary} } @article {9736, title = {Is subjective memory change in old age based on accurate monitoring of age-related memory change? Evidence from two longitudinal studies.}, journal = {Psychology and Aging}, volume = {33}, year = {2018}, pages = {273-287}, abstract = {Subjective memory change (SMC) in adulthood involves the perception that one{\textquoteright}s memory has declined from earlier levels of function. SMC has been conjectured to be more accurate than concurrent subjective memory because people use themselves as a standard of comparison. We used data from two longitudinal studies to contrast the accurate-monitoring-of-change hypothesis-actual memory change predicts SMC-against a constructed-judgment hypothesis that rated SMC is a function of rescaling concurrent memory beliefs without accessing actual memory change. It states that actual memory change has no predictive validity for SMC independent of concurrent memory beliefs. Data from both the Berlin Aging Study and the Health and Retirement Study (HRS) showed that older adults{\textquoteright} current memory complaints strongly predicted current SMC, and that there was little relationship of longitudinally measured memory change to SMC, controlling on memory complaints. In the HRS there were reliable latent-growth-curve slope correlations of over .20 for change in episodic memory with both slopes of change in SMC and in memory complaints, yet little relationship of SMC slopes to episodic memory slopes, controlling on memory-complaint slopes. The results falsify the accurate-monitoring-of-change hypothesis regarding the origins of SMC in older adults.}, keywords = {Memory, Self Report, Subjective Expectations}, issn = {0882-7974}, doi = {10.1037/pag0000232}, url = {http://doi.apa.org/getdoi.cfm?doi=10.1037/pag0000232http://psycnet.apa.org/journals/pag/33/2/273.pdf}, author = {Hertzog, Christopher and H{\"u}l{\"u}r, Gizem and Denis Gerstorf and Ann Pearman} } @article {9986, title = {Subjective memory problems and availability of emotional support}, journal = {Research on Aging}, volume = {40}, year = {2018}, pages = {978-1007}, abstract = {This study examines (1) whether subjective memory problems (SMP) influence perceived emotional support from and frequency of contact with family and friends; and, (2) the extent to which this relationship is moderated by gender, education, and functional limitations. We use the 2014 wave of the Health and Retirement Study, a nationally representative panel survey of adults aged 51 and over in the United States. While SMP does not affect perceived emotional support for younger group (YG; aged 51-64), in older group (OG; aged 65+), SMP is associated with reduced perceived support from friends. Also, SMP is predictive of fewer writing-based contact with children and friends among OG but not among YG. Lastly, we find that the effect of SMP on support from children is contingent upon activity of daily living (YG) and gender (OG), while the effect of SMP on writing-based contact with both children and friends is contingent upon education (YG only).}, keywords = {Cognition \& Reasoning, Depressive symptoms, Memory, Social Support}, issn = {0164-0275}, doi = {10.1177/0164027518797622}, author = {Jung-Hwa Ha and Pai, Manacy} } @article {9533, title = {The suddenly hot job market for workers over 50}, year = {2018}, publisher = {CNBC}, address = {Englewood Cliffs, NJ}, keywords = {Employment and Labor Force, News}, url = {https://www.cnbc.com/2018/03/20/the-suddenly-hot-job-market-for-workers-over-50.html}, author = {Halpert, Julie} } @article {9790, title = {Underreporting of Fall Injuries of Older Adults: Implications for Wellness Visit Fall Risk Screening.}, journal = {Journal of the American Geriatrics Society}, volume = {66}, year = {2018}, pages = {1195-1200}, abstract = {

OBJECTIVES: To compare the accuracy of and factors affecting the accuracy of self-reported fall-related injuries (SFRIs) with those of administratively obtained FRIs (AFRIs).

DESIGN: Retrospective observational study SETTING: United States PARTICIPANTS: Fee-for-service Medicare beneficiaries aged 65 and older (N=47,215).

MEASUREMENTS: We used 24-month self-report recall data from 2000-2012 Health and Retirement Study data to identify SFRIs and linked inpatient, outpatient, and ambulatory Medicare data to identify AFRIs. Sensitivity and specificity were assessed, with AFRIs defined using the University of California at Los Angeles/RAND algorithm as the criterion standard. Logistic regression models were used to identify sociodemographic and health predictors of sensitivity.

RESULTS: Overall sensitivity and specificity were 28\% and 92\%. Sensitivity was greater for the oldest adults (38\%), women (34\%), those with more functional limitations (47\%), and those with a prior fall (38\%). In adjusted results, several participant factors (being female, being white, poor functional status, depression, prior falls) were modestly associated with better sensitivity and specificity. Injury severity (requiring hospital care) most substantively improved SFRI sensitivity (73\%).

CONCLUSION: An overwhelming 72\% of individuals who received Medicare-reimbursed health care for FRIs failed to report a fall injury when asked. Future efforts to address underreporting in primary care of nonwhite and healthier older adults are critical to improve preventive efforts. Redesigned questions-for example, that address stigma of attributing injury to falling-may improve sensitivity.

}, keywords = {Doctor visits, Falls, Medicare linkage, Medicare/Medicaid/Health Insurance}, issn = {1532-5415}, doi = {10.1111/jgs.15360}, author = {Geoffrey J Hoffman and Ha, Jinkyung and Neil B. Alexander and Kenneth M. Langa and Mary Tinetti and Lillian C. Min} } @article {11457, title = {Utilization of Long-Term Care by an Aging Population}, year = {2018}, institution = {University of New Hampshire }, abstract = {The aging of the U.S. population is an ongoing trend. The U.S. Census Bureau projects that by 2050 one in every five Americans will be over 65,1 and that by 2060 the over-65 population will have doubled in absolute size and the over-85 population will have tripled.2 Life expectancy of a 65-year-old in 2014 compared to 1980 was 3.9 years longer for a man and 4.3 years longer for a woman.3}, keywords = {Aging, Long term health care, Long-term Care}, url = {https://carsey.unh.edu/publication/utilization-long-term-care}, author = {Reagan Baughman and Jon Hurdelbrink} } @article {9539, title = {What do we know about grandparents? Insights from current quantitative data and identification of future data needs}, journal = {European Journal of Ageing}, volume = {15}, year = {2018}, pages = {225{\textendash}235}, abstract = {Against the background of a {\textquoteleft}new wave{\textquoteright} of empirical studies investigating various aspects of grandparenthood across a broad range of regional contexts, this article aims to take stock of what has been achieved so far and which lessons we can learn from this for the future. Our focus is on the measurement of grandparenthood and grandparenting in quantitative social surveys and the implications this has for the substantive questions we can ask and the answers we can get out of such data. For several broader questions{\textemdash}who is a grandparent and when does this transition happen; what does it mean to be a grandparent; and what are the implications of grandparenthood for families?{\textemdash}we review previous questionnaire items from a variety of surveys as well as studies in which they were used. We identify relevant issues related to these questions which cannot be adequately addressed with currently available data, but should be considered in new or ongoing survey projects. The answers provided by recent studies as well as the many still open questions identified here indicate excellent prospects for scholarship on grandparents in the years to come.}, keywords = {Cross-National, Grandparents, Quantitative data, Transitions}, issn = {1613-9372}, doi = {10.1007/s10433-018-0468-1}, author = {Hank, Karsten and Cavrini, Giulia and Giorgio Di Gessa and Tomassini, Cecilia} } @article {9732, title = {Why is retirement often more costly for married women than for married men?}, year = {2018}, publisher = {Monthly Labor Review}, keywords = {Gender Differences, Marriage, Retirement Planning and Satisfaction}, url = {http://proxy.lib.umich.edu/login?url=https://search.proquest.com/docview/2050581532?accountid=14667}, author = {Hicks, Maureen Soyars} } @article {9779, title = {Will You Still Want Me Tomorrow? The dynamics of families{\textquoteright} long-term care arrangements}, journal = {Journal of Human Resources}, volume = {53}, year = {2018}, pages = {663-716}, abstract = {With data from the Assets and Health Dynamics Among the Oldest Old Survey, we estimate dynamic models of three dimensions of families{\textquoteright} eldercare arrangements: the use of each potential care arrangement, namely care provided by a spouse, care provided by an adult child, formal home healthcare, and/or institutional care; the selection of the primary care arrangement; and hours in each care arrangement. Our results indicate that both observed heterogeneity and positive true state dependence contribute to the persistence of care arrangements. Evidence of positive true state dependence for most or all modes of care in all models suggests that inertia generally dominates caregiver burnout. Our results indicate that formal care decisions depend on the cost and quality of care. As a result of inertia, the effectiveness of long-term care policy depends on timing: initial caregiving decisions are more sensitive than subsequent decisions to economic incentives.}, keywords = {Adult children, AHEAD, Caregiving, Community-dwelling, Long-term Care}, issn = {0022-166X}, doi = {10.3368/jhr.53.3.0213-5454R1}, url = {http://jhr.uwpress.org/lookup/doi/10.3368/jhr.53.3.0213-5454R1https://syndication.highwire.org/content/doi/10.3368/jhr.53.3.0213-5454R1}, author = {Hiedemann, Bridget and Sovinsky, Michelle and Steven N. Stern} } @book {8917, title = {Aging in the 21st Century: Challenges and Opportunities for Americans}, year = {2017}, publisher = {Institute for Social Research, University of Michigan}, organization = {Institute for Social Research, University of Michigan}, address = {Ann Arbor, Michigan}, url = {http://hrsonline.isr.umich.edu/sitedocs/databook/?page=1}, author = {HRS Staff} } @article {9298, title = {Aging research: Collaborations forge a promising future.}, journal = {Journal of the American Geriatric Society}, volume = {65}, year = {2017}, pages = {2441-2445}, abstract = {The National Institute on Aging (NIA), one of 27 institutes and centers at the National Institutes of Health (NIH), was founded in 1974 to conduct and support research on aging and the health and well-being of older people. The Institute{\textquoteright}s interests span the fundamental processes that contribute to aging and their impact on systems; diseases and conditions for which aging is a risk factor; and interventions that may prevent, delay, or treat these conditions or otherwise contribute to an extension of healthy, active years of life. Multiple fruitful research collaborations within and outside the federal government, spanning the breadth of the Institute{\textquoteright}s research activities, have marked NIA{\textquoteright}s growth over the past 40 years, as well as its current areas of ongoing research. This article discusses several highlights of these collaborations, including the Health and Retirement Study, geroscience research, falls injury prevention in elderly adults, and implementation of the National Plan to Address Alzheimer{\textquoteright}s Disease, from the perspective of past accomplishments and trends for the future.

}, keywords = {Meta-analyses, Research}, issn = {1532-5415}, doi = {10.1111/jgs.15052}, author = {Melinda S Kelley and Marie A. Bernard and Richard J Hodes} } @article {12135, title = {An Analysis of Two Genome-wide Association Meta-analyses Identifies a New Locus for Broad Depression Phenotype.}, journal = {Biological Psychiatry}, volume = {82}, year = {2017}, pages = {322-329}, abstract = {

BACKGROUND: The genetics of depression has been explored in genome-wide association studies that focused on either major depressive disorder or depressive symptoms with mostly negative findings. A broad depression phenotype including both phenotypes has not been tested previously using a genome-wide association approach. We aimed to identify genetic polymorphisms significantly associated with a broad phenotype from depressive symptoms to major depressive disorder.

METHODS: We analyzed two prior studies of 70,017 participants of European ancestry from general and clinical populations in the discovery stage. We performed a replication meta-analysis of 28,328 participants. Single nucleotide polymorphism (SNP)-based heritability and genetic correlations were calculated using linkage disequilibrium score regression. Discovery and replication analyses were performed using a p-value-based meta-analysis. Lifetime major depressive disorder and depressive symptom scores were used as the outcome measures.

RESULTS: The SNP-based heritability of major depressive disorder was 0.21 (SE = 0.02), the SNP-based heritability of depressive symptoms was 0.04 (SE = 0.01), and their genetic correlation was 1.001 (SE = 0.2). We found one genome-wide significant locus related to the broad depression phenotype (rs9825823, chromosome 3: 61,082,153, p = 8.2 {\texttimes} 10) located in an intron of the FHIT gene. We replicated this SNP in independent samples (p = .02) and the overall meta-analysis of the discovery and replication cohorts (1.0 {\texttimes} 10).

CONCLUSIONS: This large study identified a new locus for depression. Our results support a continuum between depressive symptoms and major depressive disorder. A phenotypically more inclusive approach may help to achieve the large sample sizes needed to detect susceptibility loci for depression.

}, keywords = {Acid Anhydride Hydrolases, depression, Depressive Disorder, Genetic Loci, Genetic Predisposition to Disease, Genome-Wide Association Study, Humans, Neoplasm Proteins, Phenotype, Whites}, issn = {1873-2402}, doi = {10.1016/j.biopsych.2016.11.013}, author = {Nese Direk and Williams, Stephanie and Smith, Jennifer A and Ripke, Stephan and Air, Tracy and Amare, Azmeraw T and Amin, Najaf and Baune, Bernhard T and David A Bennett and Blackwood, Douglas H R and Dorret I Boomsma and Breen, Gerome and Buttensch{\o}n, Henriette N and Byrne, Enda M and B{\o}rglum, Anders D and Castelao, Enrique and Cichon, Sven and Clarke, Toni-Kim and Marilyn C Cornelis and Dannlowski, Udo and Philip L de Jager and Demirkan, Ayse and Domenici, Enrico and Cornelia M van Duijn and Dunn, Erin C and Johan G Eriksson and T{\~o}nu Esko and Jessica Faul and Luigi Ferrucci and Myriam Fornage and Eco J. C. de Geus and Gill, Michael and Gordon, Scott D and Hans-J{\"o}rgen Grabe and van Grootheest, Gerard and Hamilton, Steven P and Catharina A Hartman and Andrew C Heath and Karin Hek and Hofman, Albert and Homuth, Georg and Horn, Carsten and Jouke-Jan Hottenga and Sharon L R Kardia and Kloiber, Stefan and Karestan C Koenen and Kutalik, Zolt{\'a}n and Ladwig, Karl-Heinz and Lahti, Jari and Douglas F Levinson and Lewis, Cathryn M and Lewis, Glyn and Li, Qingqin S and David J Llewellyn and Lucae, Susanne and Kathryn L Lunetta and MacIntyre, Donald J and Pamela A F Madden and Nicholas G Martin and McIntosh, Andrew M and Andres Metspalu and Milaneschi, Yuri and Grant W Montgomery and Mors, Ole and Thomas H Mosley and Joanne M Murabito and M{\"u}ller-Myhsok, Bertram and Markus M N{\"o}then and Nyholt, Dale R and O{\textquoteright}Donovan, Michael C and Brenda W J H Penninx and Pergadia, Michele L and Perlis, Roy and Potash, James B and Preisig, Martin and Shaun M Purcell and Quiroz, Jorge A and Katri R{\"a}ikk{\"o}nen and Rice, John P and Rietschel, Marcella and Rivera, Margarita and Schulze, Thomas G and Shi, Jianxin and Shyn, Stanley and Sinnamon, Grant C and Johannes H Smit and Smoller, Jordan W and Snieder, Harold and Toshiko Tanaka and Tansey, Katherine E and Teumer, Alexander and Uher, Rudolf and Umbricht, Daniel and Van der Auwera, Sandra and Erin B Ware and David R Weir and Weissman, Myrna M and Gonneke Willemsen and Yang, Jingyun and Zhao, Wei and Henning Tiemeier and Patrick F. Sullivan} } @article {8970, title = {Annuity Options in Public Pension Plans:The Curious Case of Social Security Leveling}, number = {No. 23262}, year = {2017}, month = {03/2017}, institution = {National Bureau of Economic Research}, address = {Cambridge, MA}, abstract = {Social Security Leveling is an annuity option that allows participants to receive a level income before and after age 62. The retiree receives a larger pension benefit prior to age 62, but then the pension benefit is lowered at age 62 when the individual is expected to claim Social Security benefits. This option is not uncommon in public pension plans, yet little is known about how this option is used in practice and its impact on well-being in retirement. Our study uses a combination of administrative records and survey data from recent North Carolina public sector retirees. We find that one-third of all retirees selecting a single life annuity between 2009 and 2014 opted for Social Security Leveling. The evidence suggests that individuals are choosing this option in a way that is consistent with their stated preferences and a consumption smoothing motive. However, we also see higher rates of ex post {\textquotedblleft}regret{\textquotedblright} in the annuity choice among those choosing the level income option.}, keywords = {Annuitization, Older Adults, Pensions, Social Security}, doi = {10.3386/w23262}, url = {http://www.nber.org/papers/w23262.pdf}, author = {Robert Clark and Hammond, Robert and Morrill, Melinda and Vanderweide, David} } @article {8564, title = {Are Changes in Self-Rated Health Associated With Memory Decline in Older Adults?}, journal = {J Aging Health}, volume = {29}, year = {2017}, month = {2017 12}, pages = {1410-1423}, abstract = {

OBJECTIVE: The association between patterns of change in self-rated health (SRH) and memory trajectories in older adults was examined using a systematic approach.

METHOD: Data from the Health and Retirement Study ( n = 6,016) and the English Longitudinal Study of Ageing ( n = 734) were analyzed. Individuals were grouped into five categories according to their pattern of change in SRH over 8 years: stable excellent/very good/good, stable fair/poor, improvement, decline, and fluctuating pattern without a trend. Memory was measured using immediate and delayed recall tests. Kruskal-Wallis, chi-squares tests, and linear mixed models were used to examine the association.

RESULTS: Different rates of decline in memory can be identified in the different patterns of change in SRH. Those who had a stable excellent/very good/good pattern had the slowest rate of decline.

DISCUSSION: Our findings suggest that SRH status and patterns of change could be used as a marker of cognitive decline in prevention screening programs.

}, keywords = {Aged, Cross-Sectional Studies, Diagnostic Self Evaluation, Female, Humans, Longitudinal Studies, Male, Memory Disorders, Self Report, United States}, issn = {1552-6887}, doi = {10.1177/0898264316661830}, url = {https://www.ncbi.nlm.nih.gov/pubmed/27481931}, author = {Bendayan, Rebecca and Andrea M Piccinin and Scott M Hofer and Muniz, Graciela} } @article {9009, title = {Arthritis and cognitive impairment in older adults.}, journal = {Rheumatology International}, volume = {37}, year = {2017}, pages = {955-961}, abstract = {Adults aged 65 or older with arthritis may be at increased risk for cognitive impairment [cognitive impairment but not dementia (CIND) or dementia]. Studies have found associations between arthritis and cognition impairments; however, none have examined whether persons with arthritis develop cognitive impairments at higher rates than those without arthritis. Using data from the Health and Retirement Study, we estimated the prevalence of cognitive impairments in older adults with and without arthritis, and examined associations between arthritis status and cognitive impairments. We calculated incidence density ratios (IDRs) using generalized estimating equations to estimate associations between arthritis and cognitive impairments adjusting for age, sex, race/ethnicity, marital status, education, income, depression, obesity, smoking, the number of chronic conditions, physical activity, and birth cohort. The prevalence of CIND and dementia did not significantly differ between those with and without arthritis (CIND: 20.8\%, 95\% CI 19.7-21.9 vs. 18.3\%, 95\% CI 16.8-19.8; dementia: 5.2\% 95\% CI 4.6-5.8 vs. 5.1\% 95\% CI 4.3-5.9). After covariate control, older adults with arthritis did not differ significantly from those without arthritis for either cognitive outcome (CIND IDR: 1.6, 95\% CI = 0.9-2.9; dementia IDR: 1.1, 95\% CI = 0.4-3.3) and developed cognitive impairments at a similar rate to those without arthritis. Older adults with arthritis were not significantly more at risk to develop cognitive impairments and developed cognitive impairments at a similar rate as older adults without arthritis over 6~years.}, keywords = {Arthritis, Cognitive Ability, Older Adults}, issn = {1437-160X}, doi = {10.1007/s00296-017-3698-1}, author = {Nancy A. Baker and Kamil E Barbour and Charles G Helmick and Matthew M. Zack and Soham Al Snih} } @article {8701, title = {The association between antidepressant use and hemoglobin A1C in older adults.}, journal = {Geriatr Nurs}, volume = {38}, year = {2017}, month = {2017 Mar - Apr}, pages = {141-145}, abstract = {

Depression is known to increase diabetes risk and worsen glycemic control in older adults, who already experience high rates of diabetes. The independent impact of antidepressants on glucose control is less clear. Data was drawn from the Health and Retirement Study, a large nationally-representative longitudinal study of retired individuals. Crude and adjusted linear models stratified by diabetes status were used to examine the cross-sectional associations between antidepressant use categorized by subclass and continuous hemoglobin A1C. The sample included 1,153 individuals, most over the age of 70. Antidepressant use was not associated with hemoglobin A1C in any model whether stratified or in the total combined sample. Antidepressants as a class were also not associated with hemoglobin A1C. These findings add to the literature suggesting that antidepressants are not associated with diabetes risk or glycemic control. Prospective studies with larger sample sizes are needed to confirm this finding.

}, keywords = {Aged, Aged, 80 and over, Antidepressive Agents, Blood Glucose, Cross-Sectional Studies, depression, Diabetes Mellitus, Type 2, Female, Glycated Hemoglobin A, Humans, Longitudinal Studies, Male, Risk Factors, Surveys and Questionnaires}, issn = {1528-3984}, doi = {10.1016/j.gerinurse.2016.09.002}, author = {Kammer, Jamie and Akiko S Hosler and Leckman-Westin, Emily and A. Gregory DiRienzo} } @article {6462, title = {Associations Among Individuals{\textquoteright} Perceptions of Future Time, Individual Resources, and Subjective Well-Being in Old Age.}, journal = {J Gerontol B Psychol Sci Soc Sci}, volume = {72}, year = {2017}, month = {2017 May 01}, pages = {388-399}, abstract = {

OBJECTIVES: Perceptions of future time are of key interest to aging research because of their implications for subjective well-being. Interestingly, perceptions about future time are only moderately associated with age when looking at the second half of life, pointing to a vast heterogeneity in future time perceptions among older adults. We examine associations between future time perceptions, age, and subjective well-being across two studies, including moderations by individual resources.

METHOD: Using data from the Berlin Aging Study (N = 516; Mage = 85 years), we link one operationalization (subjective nearness to death) and age to subjective well-being. Using Health and Retirement Study data (N = 2,596; Mage = 77 years), we examine associations of another future time perception indicator (subjective future life expectancy) and age with subjective well-being.

RESULTS: Consistent across studies, perceptions of limited time left were associated with poorer subjective well-being (lower life satisfaction and positive affect; more negative affect and depressive symptoms). Importantly, individual resources moderated future time perception-subjective well-being associations with those of better health exhibiting reduced future time perception-subjective well-being associations.

DISCUSSION: We discuss our findings in the context of the Model of Strength and Vulnerability Integration.

}, keywords = {Affect, Age Factors, Aged, Aged, 80 and over, Aging, Attitude, depression, Female, Forecasting, Health Status, Humans, Male, Personal Satisfaction}, issn = {1758-5368}, doi = {10.1093/geronb/gbv063}, url = {http://psychsocgerontology.oxfordjournals.org/content/early/2015/10/05/geronb.gbv063.abstract}, author = {Christiane A Hoppmann and Frank J Infurna and Ram, Nilam and Denis Gerstorf} } @article {6494, title = {Associations Between Arthritis and Change in Physical Function in U.S. Retirees.}, journal = {J Gerontol A Biol Sci Med Sci}, volume = {72}, year = {2017}, month = {2017 Jan}, pages = {127-133}, abstract = {

BACKGROUND: The aims of this study were to determine among retirees: the associations of arthritis with limitations in physical functions, and whether these associations changed differently with age for those with arthritis versus without arthritis.

METHODS: We identified retirees from the Health and Retirement Study, a nationally representative longitudinal panel study of U.S. adults >=51 years old. We calculated incidence density ratios (IDRs) using Poisson regression modeling with generalized estimating equations to estimate the associations between arthritis and limitations in four physical function measures (large muscle tasks, mobility, activities of daily living, and instrumental activities of daily living) adjusting for age, sex, race/ethnicity, marital status, education, total household income, depression, obesity, smoking, chronic conditions, physical activity, and cohort status. We examined interaction effects between arthritis and age to determine if the rate of change in physical function differed by arthritis status across age.

RESULTS: Over 8 years (2004-2012), significantly more retirees with arthritis had limitations with large muscle tasks (IDR 2.1: 95\% confidence interval 1.6, 2.8), mobility (IDR 1.6: 1.2, 2.2), activities of daily living (IDR 2.2: 1.0, 4.7), and instrumental activities of daily living (IDR 3.7: 1.9, 7.4) than retirees without arthritis. Retirees with arthritis did not develop limitations in mobility, activities of daily living, and instrumental activities of daily living at a different rate as they aged compared to those without arthritis.

CONCLUSIONS: Arthritis was associated with a greater prevalence of physical function limitations. Preventing limitations caused by arthritis is a key strategy to prevent disability in retirees.

}, keywords = {Activities of Daily Living, Age Factors, Aged, Arthritis, Case-Control Studies, Female, Health Status, Humans, Longitudinal Studies, Male, Middle Aged, Muscle Strength, Retirement, United States}, issn = {1758-535X}, doi = {10.1093/gerona/glw075}, url = {http://biomedgerontology.oxfordjournals.org/content/early/2016/04/26/gerona.glw075.abstract}, author = {Nancy A. Baker and Kamil E Barbour and Charles G Helmick and Matthew M. Zack and Soham Al Snih} } @article {9113, title = {Bringing functional status into a big data world: Validation of national Veterans Affairs functional status data}, journal = {PLoS One}, volume = {12}, year = {2017}, month = {Jan-06-2017}, pages = {e0178726}, abstract = {Background The ability to perform basic daily activities ({\textquotedblleft}functional status{\textquotedblright}) is key to older adults{\textquoteright} quality of life and strongly predicts health outcomes. However, data on functional status are seldom collected during routine clinical care in a way that makes them available for clinical use and research. Objectives To validate functional status data that Veterans Affairs (VA) medical centers recently started collecting during routine clinical care, compared to the same data collected in a structured research setting. Design Prospective validation study. Setting Seven VA medical centers that collected complete data on 5 activities of daily living (ADLs) and 8 instrumental activities of daily living (IADLs) from older patients attending primary care appointments. Participants Randomly selected patients aged 75 and older who had new ADL and IADL data collected during a primary care appointment (N = 252). We oversampled patients with ADL dependence and applied these sampling weights to our analyses. Measurements Telephone-based interviews using a validated measure to assess the same 5 ADLs and 8 IADLs. Results Mean age was 83 years, 96\% were male, and 75\% were white. Of 85 participants whom VA data identified as dependent in 1 or more ADLs, 74 (87\%) reported being dependent by interview; of 167 whom VA data identified as independent in ADLs, 149 (89\%) reported being independent. The sample-weighted sensitivity of the VA data for identifying ADL dependence was 45\% (95\% CI, 29\%, 62\%) compared to the reference standard, the specificity was 99\% (95\% CI, 99\%, >99\%), and the positive predictive value was 87\% (95\% CI, 79\%, 93\%). The weighted kappa statistic was 0.55 (95\% CI, 0.41, 0.68) for the agreement between VA data and research-collected data in identifying ADL dependence. Conclusion Overall agreement of VA functional status data with a reference standard was moderate, with fair sensitivity but high specificity and positive predictive value.}, keywords = {Daily activities, Functional status, Veterans}, doi = {10.1371/journal.pone.0178726 Free full text}, url = {http://dx.plos.org/10.1371/journal.pone.0178726}, author = {Rebecca T Brown and Kiya D Komaiko and Shi, Ying and Kathy Z Fung and W John Boscardin and Au-Yeung, Alvin and Tarasovsky, Gary and Jacob, Riya and Michael A Steinman}, editor = {Hernandez-Boussard, Tina} } @article {8936, title = {Clinical Trials Targeting Aging and Age-Related Multimorbidity}, journal = {The Journals of Gerontology Series A: Biological Sciences and Medical Sciences}, volume = {72}, year = {2017}, pages = {355-361}, abstract = {Background: There is growing interest in identifying interventions that may increase health span by targeting biological processes underlying aging. The design of efficient and rigorous clinical trials to assess these interventions requires careful consideration of eligibility criteria, outcomes, sample size, and monitoring plans. Methods: Experienced geriatrics researchers and clinical trialists collaborated to provide advice on clinical trial design. Results: Outcomes based on the accumulation and incidence of age-related chronic diseases are attractive for clinical trials targeting aging. Accumulation and incidence rates of multimorbidity outcomes were developed by selecting at-risk subsets of individuals from three large cohort studies of older individuals. These provide representative benchmark data for decisions on eligibility, duration, and assessment protocols. Monitoring rules should be sensitive to targeting aging-related, rather than disease-specific, outcomes. Conclusions: Clinical trials targeting aging are feasible, but require careful design consideration and monitoring rules.}, keywords = {Chronic disease, Clinical trials, Older Adults}, issn = {1079-5006}, doi = {10.1093/gerona/glw220}, url = {https://academic.oup.com/biomedgerontology/article-lookup/doi/10.1093/gerona/glw220https://academic.oup.com/biomedgerontology/article/2328606/Clinical-Trials-Targeting-Aging-and-AgeRelated}, author = {Mark A. Espeland and Eileen M. Crimmins and Brandon R. Grossardt and Jill P. Crandall and Jonathan A. L. Gelfond and Tamara B Harris and Stephen B Kritchevsky and JoAnn E Manson and Jennifer G Robinson and Walter A Rocca and Temprosa, Marinella and Thomas, Fridtjof and Robert B Wallace and Barzilai, Nir} } @article {9407, title = {Cognitive Disparities: The Impact of the Great Depression and Cumulative Inequality on Later-Life Cognitive Function}, journal = {Demography}, volume = {54}, year = {2017}, pages = {2125-2158}, abstract = {Population aging has driven a spate of recent research on later-life cognitive function. Greater longevity increases the lifetime risk of memory diseases that compromise the cognitive abilities vital to well-being. Alzheimer{\textquoteright}s disease, thought to be the most common underlying pathology for elders{\textquoteright} cognitive dysfunction (Willis and Hakim 2013), is already the sixth leading cause of death in the United States (Alzheimer{\textquoteright}s Association 2016). Understanding social determinants of pathological cognitive decline is key to crafting interventions, but evidence is inconclusive for how social factors interact over the life course to affect cognitive function. I study whether early-life exposure to the Great Depression is directly associated with later-life cognitive function, influences risky behaviors over the life course, and/or accumulates with other life-course disadvantages. Using growth curve models to analyze the Health and Retirement Study, I find that early-life exposure to the Great Depression is associated with fluid cognition, controlling for intervening factors{\textemdash}evidence for a critical period model. I find little support for a social trajectory model. Disadvantage accumulates over the life course to predict worse cognitive function, providing strong evidence for a cumulative inequality model. }, keywords = {Alzheimer{\textquoteright}s disease, Cognitive Ability, Great Depression, Race/ethnicity, Socioeconomic factors}, issn = {0070-3370}, doi = {10.1007/s13524-017-0629-4}, author = {Jo Mhairi Hale} } @article {9172, title = {The complex genetics of gait speed: genome-wide meta-analysis approach.}, journal = {Aging (Albany NY)}, volume = {9}, year = {2017}, pages = {209-246}, abstract = {Emerging evidence suggests that the basis for variation in late-life mobility is attributable, in part, to genetic factors, which may become increasingly important with age. Our objective was to systematically assess the contribution of genetic variation to gait speed in older individuals. We conducted a meta-analysis of gait speed GWASs in 31,478 older adults from 17 cohorts of the CHARGE consortium, and validated our results in 2,588 older adults from 4 independent studies. We followed our initial discoveries with network and eQTL analysis of candidate signals in tissues. The meta-analysis resulted in a list of 536 suggestive genome wide significant SNPs in or near 69 genes. Further interrogation with Pathway Analysis placed gait speed as a polygenic complex trait in five major networks. Subsequent eQTL analysis revealed several SNPs significantly associated with the expression of PRSS16, WDSUB1 and PTPRT, which in addition to the meta-analysis and pathway suggested that genetic effects on gait speed may occur through synaptic function and neuronal development pathways. No genome-wide significant signals for gait speed were identified from this moderately large sample of older adults, suggesting that more refined physical function phenotypes will be needed to identify the genetic basis of gait speed in aging.}, keywords = {Genetics, GWAS}, issn = {1945-4589}, doi = {10.18632/aging.101151}, author = {Ben-Avraham, Dan and Karasik, David and Joe Verghese and Kathryn L Lunetta and John D Eicher and Vered, Rotem and Deelen, Joris and Alice M. Arnold and Aron S Buchman and Toshiko Tanaka and Jessica Faul and Nethander, Maria and Myriam Fornage and Hieab H Adams and Amy M Matteini and Michele L Callisaya and Albert Vernon Smith and Lei Yu and Philip L de Jager and Denis A Evans and Gudnason, Vilmundur and Hofman, Albert and Pattie, Alison and Corley, Janie and Lenore J Launer and David S Knopman and Parimi, Neeta and Stephen T Turner and Bandinelli, Stefania and Beekman, Marian and Gutman, Danielle and Sharvit, Lital and Simon P Mooijaart and David C Liewald and Jeanine J Houwing-Duistermaat and Ohlsson, Claes and Moed, Matthijs and Vincent J Verlinden and Mellstr{\"o}m, Dan and Jos N van der Geest and Karlsson, Magnus and Dena G Hernandez and McWhirter, Rebekah and Yongmei Liu and Thomson, Russell and Tranah, Gregory J and Andr{\'e} G Uitterlinden and David R Weir and Wei Zhao and John M Starr and Mohammed Arfan Ikram and David A Bennett and Steven R Cummings and Ian J Deary and Tamara B Harris and Sharon L R Kardia and Thomas H Mosley and Velandai K Srikanth and Beverly G Windham and Anne B Newman and Jeremy D Walston and Gail Davies and Daniel S Evans and Eline P Slagboom and Luigi Ferrucci and Douglas P Kiel and Joanne M Murabito and Atzmon, Gil} } @article {8857, title = {Control beliefs and risk for 4-year mortality in older adults: a prospective cohort study.}, journal = {BMC Geriatr}, volume = {17}, year = {2017}, month = {2017 01 11}, pages = {13}, abstract = {

BACKGROUND: Control beliefs are important psychological factors that likely contribute to heterogeneity in health outcomes for older adults. We evaluated whether control beliefs are associated with risk for 4-year mortality, after accounting for established "classic" biomedical risk factors. We also determined if an enhanced risk model with control beliefs improved identification of individuals with low vs. high mortality risk.

METHODS: We used nationally representative data from the Health and Retirement Study (2006-2012) for adults 50~years or older in 2006 (n = 7313) or 2008 (n = 6301). We assessed baseline perceived global control (measured as 2 dimensions-"constraints" and "mastery"), and health-specific control. We also obtained baseline data for 12 established biomedical risk factors of 4-year mortality: age, sex, 4 medical conditions (diabetes mellitus, cancer, lung disease and heart failure), body mass index less than 25~kg/m, smoking, and 4 functional difficulties (with bathing, managing finances, walking several blocks and pushing or pulling heavy objects). Deaths within 4~years of follow-up were determined through interviews with respondents{\textquoteright} family and the National Death Index.

RESULTS: After accounting for classic biomedical risk factors, perceived constraints were significantly associated with higher mortality risk (third quartile scores~odds ratio [OR] 1.37, 95\% CI 1.03-1.81; fourth quartile scores~OR 1.45, 95\% CI, 1.09-1.92), while health-specific control was significantly associated with lower risk (OR 0.69-0.78 for scores above first quartile). Higher perceived mastery scores were not consistently associated with decreased risk. The enhanced model with control beliefs found an additional 3.5\% of participants (n = 222) with low predicted risk of 4-year mortality (i.e., 4\% or less); observed mortality for these individuals was 1.8\% during follow-up. Compared with participants predicted to have low mortality risk only by the classic biomedical model, individuals identified by only the enhanced model were older, had higher educational status, higher income, and higher prevalence of diabetes mellitus and cancer.

CONCLUSION: Control beliefs were significantly associated with risk for 4-year mortality; accounting for these factors improved identification of low-risk individuals. More work is needed to determine how assessment of control beliefs could enable targeting of clinical interventions to support at-risk older adults.

}, keywords = {Activities of Daily Living, Age Factors, Aged, Diabetes Mellitus, Female, Heart Failure, Humans, Internal-External Control, Lung Diseases, Male, Middle Aged, Neoplasms, Prospective Studies, Risk Factors, Self Concept, Survival Analysis}, issn = {1471-2318}, doi = {10.1186/s12877-016-0390-3}, url = {https://www.ncbi.nlm.nih.gov/pmc/articles/pmid/28077089/}, author = {Wei Duan-Porter and Susan Nicole Hastings and Brian Neelon and Courtney Harold Van Houtven} } @article {8686, title = {The Costs of Fall-Related Injuries among Older Adults: Annual Per-Faller, Service Component, and Patient Out-of-Pocket Costs.}, journal = {Health Serv Res}, volume = {52}, year = {2017}, month = {2017 10}, pages = {1794-1816}, abstract = {

OBJECTIVE: To estimate expenditures for fall-related injuries (FRIs) among older Medicare beneficiaries.

DATA SOURCES: The 2007-2009 Medicare claims and 2008 Health and Retirement Study (HRS) data for 5,497 (228 FRI and 5,269 non-FRI) beneficiaries.

STUDY DESIGN: FRIs were indicated by inpatient/outpatient ICD-9 diagnostic codes for fractures, trauma, dislocations, and by e-codes. A pre-post comparison group design was used to estimate the differential change in pre-post expenditures for the FRI relative to the non-FRI cohort (FRI expenditures). Out-of-pocket (OOP) costs, service category total annual FRI-related Medicare expenditures, expenditures related to the type of initial FRI treatment (inpatient, ED, outpatient), and the risk of persistently high expenditures (4th quartile for each post-FRI quarter) were estimated.

PRINCIPAL FINDINGS: Estimated FRI expenditures were $9,389 (95 percent CI: $5,969-$12,808). Inpatient, physician/outpatient, skilled nursing facility, and home health comprised 31, 18, 39, and 12 percent of the total. OOP costs were $1,363.0 (95 percent CI: $889-$1,837). Expenditures for FRIs initially treated in inpatient/ED/outpatient settings were $21,424/$6,142/$8,622. The FRI cohort had a 64 percent increased risk of persistently high expenditures. Total Medicare expenditures were $13 billion (95 percent CI: $9-$18 billion).

CONCLUSIONS: FRIs are associated with substantial, persistent Medicare expenditures. Cost-effectiveness of multifactorial falls prevention programs should be assessed using these expenditure estimates.

}, keywords = {Accidental Falls, Age Factors, Aged, Aged, 80 and over, Female, Financing, Personal, Health Expenditures, Health Services, Humans, Male, Medicare, Models, Econometric, Sex Factors, Socioeconomic factors, United States, Wounds and Injuries}, issn = {1475-6773}, doi = {10.1111/1475-6773.12554}, author = {Geoffrey J Hoffman and Hays, Ron D and Martin F Shapiro and Steven P Wallace and Susan L Ettner} } @article {9375, title = {Cultural and emotional determinants of cervical cancer screening among older Hispanic women}, journal = {Health Care for Women International}, volume = {38}, year = {2017}, pages = {1289-1312}, abstract = {Older adults are at highest risk of cancer and yet have the lowest rates of cancer screening participation. Older minority adults bear the burden of cancer screening disparities leading to late stage cancer diagnoses. This investigation, utilization data from the 2008 wave of the Health and Retirement study examined the cultural and emotional factors thought to influence cervical cancer screening among older Hispanic women. We utilized logistic regression models to conduct the analyses. Findings indicate that the emotional factors were not significant but the cultural factor, time orientation was a significant predictor for older Hispanics{\textquoteright} cervical cancer screening behaviors.}, keywords = {Cancer screenings, Depressive symptoms, Hispanics, Women and Minorities}, issn = {0739-9332}, doi = {10.1080/07399332.2017.1364740}, url = {https://www.tandfonline.com/doi/full/10.1080/07399332.2017.1364740https://www.tandfonline.com/doi/pdf/10.1080/07399332.2017.1364740}, author = {Tamara J. Cadet and Shanna Lynn Burke and Stewart, Kathleen and Howard, Tenial and Schonberg, Mara} } @article {8963, title = {Depressive symptomatology and fall risk among community-dwelling older adults.}, journal = {Social Science \& Medicine}, volume = {178}, year = {2017}, month = {04/2017}, pages = {206-213}, abstract = {

RATIONALE: Falls are common among older adults and may be related to depressive symptoms (DS). With advancing age, there is an onset of chronic conditions, sensory impairments, and activity limitations that are associated with falls and with depressive disorders. Prior cross-sectional studies have observed significant associations between DS and subsequent falls as well as between fractures and subsequent clinical depression and DS.

OBJECTIVE: The directionality of these observed relationship between falls and DS is in need of elaboration given that cross-sectional study designs can yield biased estimates of the DS-falls relationship.

METHODS: Using 2006-2010 Health and Retirement Study data, cross-lagged panel structural equation models were used to evaluate associations between falls and DS among 7233 community-dwelling adults ages >=65. Structural coefficients between falls and DS (in 2006{\textrightarrow}2008, 2008{\textrightarrow}2010) were estimated.

RESULTS: A good-fitting model was found: Controlling for baseline (2006) physical functioning, vision, chronic conditions, and social support and neighborhood social cohesion, falls were not associated with subsequent DS, but a 0.5 standard deviation increase in 2006 DS was associated with a 30\% increase in fall risk two years later. This DS-falls relationship was no longer significant when use of psychiatric medications, which was positively associated with falls, was included in the model.

CONCLUSION: Using sophisticated methods and a large U.S. sample, we found larger magnitudes of effect in the DS-falls relationship than in prior studies-highlighting the risk of falls for older adults with DS. Medical providers might assess older individuals for DS as well as use of psychotropic medications as part of a broadened falls prevention approach. National guidelines for fall risk assessments as well as quality indicators for fall prevention should include assessment for clinical depression.

}, keywords = {Community-dwelling, Depressive symptoms, Falls, Health Shocks, Older Adults, Restricted data}, issn = {1873-5347}, doi = {10.1016/j.socscimed.2017.02.020}, author = {Geoffrey J Hoffman and Hays, Ron D and Steven P Wallace and Martin F Shapiro and Susan L Ettner} } @article {12136, title = {Discovery and fine-mapping of adiposity loci using high density imputation of genome-wide association studies in individuals of African ancestry: African Ancestry Anthropometry Genetics Consortium.}, journal = {PLoS Genetics}, volume = {13}, year = {2017}, pages = {e1006719}, abstract = {

Genome-wide association studies (GWAS) have identified >300 loci associated with measures of adiposity including body mass index (BMI) and waist-to-hip ratio (adjusted for BMI, WHRadjBMI), but few have been identified through screening of the African ancestry genomes. We performed large scale meta-analyses and replications in up to 52,895 individuals for BMI and up to 23,095 individuals for WHRadjBMI from the African Ancestry Anthropometry Genetics Consortium (AAAGC) using 1000 Genomes phase 1 imputed GWAS to improve coverage of both common and low frequency variants in the low linkage disequilibrium African ancestry genomes. In the sex-combined analyses, we identified one novel locus (TCF7L2/HABP2) for WHRadjBMI and eight previously established loci at P < 5{\texttimes}10-8: seven for BMI, and one for WHRadjBMI in African ancestry individuals. An additional novel locus (SPRYD7/DLEU2) was identified for WHRadjBMI when combined with European GWAS. In the sex-stratified analyses, we identified three novel loci for BMI (INTS10/LPL and MLC1 in men, IRX4/IRX2 in women) and four for WHRadjBMI (SSX2IP, CASC8, PDE3B and ZDHHC1/HSD11B2 in women) in individuals of African ancestry or both African and European ancestry. For four of the novel variants, the minor allele frequency was low (<5\%). In the trans-ethnic fine mapping of 47 BMI loci and 27 WHRadjBMI loci that were locus-wide significant (P < 0.05 adjusted for effective number of variants per locus) from the African ancestry sex-combined and sex-stratified analyses, 26 BMI loci and 17 WHRadjBMI loci contained <= 20 variants in the credible sets that jointly account for 99\% posterior probability of driving the associations. The lead variants in 13 of these loci had a high probability of being causal. As compared to our previous HapMap imputed GWAS for BMI and WHRadjBMI including up to 71,412 and 27,350 African ancestry individuals, respectively, our results suggest that 1000 Genomes imputation showed modest improvement in identifying GWAS loci including low frequency variants. Trans-ethnic meta-analyses further improved fine mapping of putative causal variants in loci shared between the African and European ancestry populations.

}, keywords = {Adiposity, Anthropometry, Blacks, Body Mass Index, Chromosome Mapping, Female, Gene Frequency, Genetic Predisposition to Disease, Genome-Wide Association Study, Humans, Linkage Disequilibrium, Male, Obesity, Polymorphism, Single Nucleotide, Serine Endopeptidases, Transcription Factor 7-Like 2 Protein, Waist-Hip Ratio, Whites}, issn = {1553-7404}, doi = {10.1371/journal.pgen.1006719}, author = {Ng, Maggie C Y and Graff, Mariaelisa and Lu, Yingchang and Justice, Anne E and Mudgal, Poorva and Liu, Ching-Ti and Young, Kristin and Yanek, Lisa R and Feitosa, Mary F and Wojczynski, Mary K and Rand, Kristin and Brody, Jennifer A and Brian E Cade and Dimitrov, Latchezar and Duan, Qing and Guo, Xiuqing and Leslie A Lange and Michael A Nalls and Okut, Hayrettin and Tajuddin, Salman M and Bamidele O Tayo and Vedantam, Sailaja and Bradfield, Jonathan P and Chen, Guanjie and Chen, Wei-Min and Chesi, Alessandra and Irvin, Marguerite R and Padhukasahasram, Badri and Smith, Jennifer A and Zheng, Wei and Matthew A. Allison and Ambrosone, Christine B and Bandera, Elisa V and Traci M Bartz and Berndt, Sonja I and Bernstein, Leslie and Blot, William J and Erwin P Bottinger and John Carpten and Chanock, Stephen J and Chen, Yii-Der Ida and Conti, David V and Cooper, Richard S and Myriam Fornage and Freedman, Barry I and Garcia, Melissa and Phyllis J Goodman and Hsu, Yu-Han H and Hu, Jennifer and Huff, Chad D and Ingles, Sue A and John, Esther M and Rick A Kittles and Eric A Klein and Li, Jin and McKnight, Barbara and Nayak, Uma and Nemesure, Barbara and Ogunniyi, Adesola and Olshan, Andrew and Press, Michael F and Rohde, Rebecca and Rybicki, Benjamin A and Babatunde Salako and Sanderson, Maureen and Shao, Yaming and David S Siscovick and Stanford, Janet L and Stevens, Victoria L and Stram, Alex and Strom, Sara S and Vaidya, Dhananjay and Witte, John S and Yao, Jie and Zhu, Xiaofeng and Ziegler, Regina G and Alan B Zonderman and Adeyemo, Adebowale and Ambs, Stefan and Cushman, Mary and Jessica Faul and Hakonarson, Hakon and Levin, Albert M and Nathanson, Katherine L and Erin B Ware and David R Weir and Zhao, Wei and Zhi, Degui and Donna K Arnett and Grant, Struan F A and Sharon L R Kardia and Oloapde, Olufunmilayo I and Rao, D C and Charles N Rotimi and Sale, Michele M and L Keoki Williams and Zemel, Babette S and Becker, Diane M and Ingrid B Borecki and Michele K Evans and Tamara B Harris and Hirschhorn, Joel N and Li, Yun and Patel, Sanjay R and Psaty, Bruce M and Rotter, Jerome I and Wilson, James G and Bowden, Donald W and Cupples, L Adrienne and Christopher A Haiman and Ruth J F Loos and Kari E North} } @article {9264, title = {Distribution of lifetime nursing home use and of out-of-pocket spending}, journal = {Proceedings of the National Academy of Sciences}, volume = {114}, year = {2017}, pages = {9838{\textendash}9842}, keywords = {Consumption and Savings, Medical Expenses, Nursing homes, Spending}, issn = {0027-8424}, doi = {10.1073/pnas.1700618114}, url = {http://www.pnas.org/lookup/doi/10.1073/pnas.1700618114https://syndication.highwire.org/content/doi/10.1073/pnas.1700618114http://www.pnas.org/syndication/doi/10.1073/pnas.1700618114}, author = {Michael D Hurd and Pierre-Carl Michaud and Susann Rohwedder} } @article {9149, title = {Drawing down retirement wealth: Interactions between Social Security wealth and private retirement savings}, number = {WR-1165}, year = {2017}, month = {01/2017}, institution = {RAND Corporation}, address = {Santa Monica, CA}, keywords = {Consumption and Savings, Retirement Planning and Satisfaction, Social Security}, doi = {10.7249/WR1165}, url = {http://www.rand.org/pubs/working_papers/WR1165.html}, author = {Philip Armour and Hung, Angela} } @article {9616, title = {The Effect of Physical and Cognitive Decline at Older Ages on Work and Retirement: Evidence from Occupational Job Demands and Job Mismatch}, number = {wp372}, year = {2017}, pages = {1-84}, institution = {Michigan Retirement Research Center}, address = {Ann Arbor, MI}, abstract = {As workers age, their physical and cognitive abilities tend to decline. This could lead to a mismatch between workers{\textquoteright} resources and the demands of their jobs, restricting future work. We use longitudinal data from the Health and Retirement Study (HRS) linked to detailed occupational characteristics from the O*NET project to investigate how mismatches between job demands and workers{\textquoteright} resources in two physical and two cognitive domains affect retirement outcomes. We estimate how changes in physical and cognitive resources as well as their interactions with occupational job-demands affect changes in 1) subjective reports of work-limiting health problems; 2) mental health; and 3) subjective probabilities of working past age 65. We also estimate hazard models for transitions from full-time work to retirement. We found that declines in physical and cognitive resources are strong predictors of all outcomes: Fewer resources lead to greater reporting of work-limiting health problems; decline in mental health; smaller subjective probabilities of working full-time past age 65; and more transitions from work to retirement. The interaction of resources with job demands, however, is only statistically significant for workers with large-muscle limitations who are more likely to report changes in outcomes when they work in occupations that rely heavily on physical strength. In contrast, the effects of declines in fine motor skills and cognition do not show statistically significant differences by occupational job demands. It appears cognitive and fine motor skills, at least as measured in the HRS, are universally important determinants of working, not specific to certain occupations.}, keywords = {Cognitive Ability, Motor processes, Physical Ability, Work}, url = {http://mrrc.isr.umich.edu/wp372/}, author = {Michael D Hurd and Susann Rohwedder and Robert J. Willis and P{\'e}ter Hudomiet} } @article {9310, title = {The effects of leisure-time physical activity for optimism, life satisfaction, psychological well-being, and positive affect among older adults with loneliness}, journal = {Annals of Leisure Research}, volume = {20}, year = {2017}, pages = {406-415}, abstract = {The purpose of this study was to examine the effects of leisure-time physical activity (LTPA) involvement among older adults suffering from loneliness. Using data released from the Health and Retirement Study in 2008, this study investigated how participation in LTPA leads to well-being such as optimism, life satisfaction, psychological well-being, and positive affect among older adults with loneliness. Results indicated that the LTPA involvement was a significant predictor of optimism, life satisfaction, positive affect, and psychological well-being for older adults with a high level of loneliness. The interesting findings of this study were that LTPA enhanced positive emotions for older adults with loneliness and that positive emotions are one of the important factors in protecting individuals from illnesses.}, keywords = {Optimism, Retirement Planning and Satisfaction, Well-being}, issn = {1174-5398}, doi = {10.1080/11745398.2016.1238308}, url = {https://www.tandfonline.com/doi/full/10.1080/11745398.2016.1238308https://www.tandfonline.com/doi/pdf/10.1080/11745398.2016.1238308}, author = {Kim, Junhyoung and Lee, Sunwoo and Sanghee Chun and Areum Han and Jinmoo Heo} } @article {8675, title = {Effects of receipt of Social Security retirement benefits on older women{\textquoteright}s employment.}, journal = {J Women Aging}, volume = {29}, year = {2017}, month = {2017}, pages = {448-459}, abstract = {

Labor force participation of women has declined since 1999; however, labor force participation of women 62+ has increased. The 2000-2006 waves of Health and Retirement Study (HRS) data, the initial years of the continuing upward trajectory, were used to test the effects of receipt of Social Security retirement benefits on older women{\textquoteright}s employment. The models tested: (a) the effect of receipt of Social Security retirement benefits on whether employed; and (b) for women receiving Social Security retirement benefits, the effect of age elected receipt of benefits on whether employed. Both models included the effects of human capital characteristics and income sources. Receipt of Social Security benefits, pension income, and current age reduced the likelihood of employment; while educational level, good to excellent health, and nonmarried marital status increased the likelihood of employment. The older the woman was when she elected Social Security benefits, the more likely she was to be employed.

}, keywords = {Aged, Employment, Female, Humans, Middle Aged, Retirement, Social Security, United States, Women{\textquoteright}s Health, Women, Working}, issn = {1540-7322}, doi = {10.1080/08952841.2016.1214035}, author = {Gillen, Martie and Claudia J Heath} } @article {11644, title = {The Financial Vulnerability of Former Disability Beneficiaries in Retirement}, year = {2017}, institution = {Mathematica Policy Research}, abstract = {By their early 60s, one in four workers has experienced the onset of a work-limiting health condition (Johnson et al. 2007), and nearly four in five adults in this age group have experienced the onset of a chronic health condition (Smith 2003). Older workers who develop significant medical conditions or impairments face declines in earnings, income, and consumption and an increase in poverty (Schimmel and Stapleton 2012; Meyer and Mok 2014). In addition to these effects, leaving the labor force during peak earning years may have a lasting impact on financial security after retirement. In this brief, we consider the post-retirement financial well-being of workers based on whether they received Social Security Disability Insurance (DI). We compare their experiences to other workers who did not receive DI but claimed Old Age and Survivors{\textquoteright} Insurance (OASI) program. }, keywords = {Disabilities, Disability, disability discrimination, disability finance, Finance, Retirement}, url = {https://mathematica.org/publications/the-financial-vulnerability-of-former-disability-beneficiaries-in-retirement}, author = {Jody Schimmel Hyde and April Yanyuan Wu} } @article {9082, title = {Friendship and depression among couples in later life: The moderating effects of marital quality.}, journal = {Journals of Gerontology Series B: Psychological Sciences and Social Sciences}, year = {2017}, month = {2017 Apr 26}, abstract = {

Objectives: The aims of the study were to examine within-person associations between social interactions with friends (one{\textquoteright}s own and partner{\textquoteright}s) and depressive symptoms over time among couples in later life and to investigate whether marital quality moderated the associations.

Methods: We used longitudinal data from the Health and Retirement Study (2004-2012) to examine a sample of coupled individuals (dyad N = 6,833). Dyadic growth curve models were employed to test the study hypotheses.

Results: Results indicated that more frequent social interactions with friends were associated with fewer depressive symptoms of individuals and there were cross-spousal effects for this association. Further, marital quality moderated the within-person association between social interaction with friends and depressive symptoms such that the association was stronger for individuals experiencing poor marital quality compared to those with better marital quality.

Discussion: Friendship is an important contributor to individuals{\textquoteright} mental health in later life, with its benefits having far-reaching consequences for one{\textquoteright}s significant other. The implications of friendship interactions for other health domains also require investigation within the marital context.

}, keywords = {Depressive symptoms, Marriage, Social Relationships}, issn = {1758-5368}, doi = {10.1093/geronb/gbx046}, author = {Sae Hwang Han and Kyungmin Kim and Jeffrey A Burr} } @article {9308, title = {FTD Takes a Greater Financial Toll Than Alzheimer{\textquoteright}s}, journal = {Medscape}, volume = {2017}, year = {2017}, publisher = {WebMD}, address = {New York City, NY}, keywords = {Alzheimer{\textquoteright}s disease, Finances, FTD}, url = {https://www.medscape.com/viewarticle/886562}, author = {Harrison, Pam} } @article {9429, title = {Gene-by-Psychosocial Factor Interactions Influence Diastolic Blood Pressure in European and African Ancestry Populations: Meta-Analysis of Four Cohort Studies.}, journal = {Int J Environ Res Public Health}, volume = {14}, year = {2017}, abstract = {Inter-individual variability in blood pressure (BP) is influenced by both genetic and non-genetic factors including socioeconomic and psychosocial stressors. A deeper understanding of the gene-by-socioeconomic/psychosocial factor interactions on BP may help to identify individuals that are genetically susceptible to high BP in specific social contexts. In this study, we used a genomic region-based method for longitudinal analysis, Longitudinal Gene-Environment-Wide Interaction Studies (LGEWIS), to evaluate the effects of interactions between known socioeconomic/psychosocial and genetic risk factors on systolic and diastolic BP in four large epidemiologic cohorts of European and/or African ancestry. After correction for multiple testing, two interactions were significantly associated with diastolic BP. In European ancestry participants, outward/trait anger score had a significant interaction with the C10orf107 genomic region (p = 0.0019). In African ancestry participants, depressive symptom score had a significant interaction with the HFE genomic region (p = 0.0048). This study provides a foundation for using genomic region-based longitudinal analysis to identify subgroups of the population that may be at greater risk of elevated BP due to the combined influence of genetic and socioeconomic/psychosocial risk factors.}, keywords = {Blood pressure, Genetics, GWAS, Meta-analyses, Psychosocial, Socioeconomic factors}, issn = {1660-4601}, doi = {10.3390/ijerph14121596}, author = {Wei Zhao and Yasutake, Kalyn and August, Carmella and Scott M Ratliff and Jessica Faul and Boerwinkle, Eric and Chakravarti, Aravinda and Ana V. Diez-Roux and Gao, Yan and Michael E Griswold and Gerardo Heiss and Sharon L R Kardia and Alanna C Morrison and Musani, Solomon K and Mwasongwe, Stanford and Kari E North and Rose, Kathryn M and Sims, Mario and Yan V Sun and David R Weir and Belinda L Needham} } @article {9090, title = {Genetic architecture of epigenetic and neuronal ageing rates in human brain regions}, journal = {Nature Communications}, volume = {8}, year = {2017}, month = {Jun-05-2018}, abstract = {Identifying genes regulating the pace of epigenetic ageing represents a new frontier in genome-wide association studies (GWASs). Here using 1,796 brain samples from 1,163 individuals, we carry out a GWAS of two DNA methylation-based biomarkers of brain age: the epigenetic ageing rate and estimated proportion of neurons. Locus 17q11.2 is significantly associated (P=4.5 {\texttimes} 10 -9 ) with the ageing rate across five brain regions and harbours a cis-expression quantitative trait locus for EFCAB5 (P=3.4 {\texttimes} 10-20 ). Locus 1p36.12 is significantly associated (P=2.2 {\texttimes} 10-8 ) with epigenetic ageing of the prefrontal cortex, independent of the proportion of neurons. Our GWAS of the proportion of neurons identified two genome-wide significant loci (10q26 and 12p13.31) and resulted in a gene set that overlaps significantly with sets found by GWAS of age-related macular degeneration (P=1.4 {\texttimes} 10 -12 ), ulcerative colitis (P<1.0 {\texttimes} 10-20 ), type 2 diabetes (P=2.8 {\texttimes} 10-13 ), hip/waist circumference in men (P=1.1 {\texttimes} 10-9 ), schizophrenia (P=1.6 {\texttimes} 10-9 ), cognitive decline (P=5.3 {\texttimes} 10-4 ) and Parkinson{\textquoteright}s disease (P=8.6 {\texttimes} 10-3 ).}, keywords = {Genetics}, doi = {10.1038/ncomms15353}, url = {http://www.nature.com/doifinder/10.1038/ncomms15353http://www.nature.com/doifinder/10.1038/ncomms15353}, author = {Lu, Ake T and Hannon, Eilis and Morgan E. Levine and Eileen M. Crimmins and Lunnon, Katie and Mill, Jonathan and Daniel H. Geschwind and Horvath, Steve} } @article {8655, title = {Genome-Wide Association Study of Loneliness Demonstrates a Role for Common Variation.}, journal = {Neuropsychopharmacology}, volume = {42}, year = {2017}, month = {2017 Mar}, pages = {811-821}, abstract = {

Loneliness is a complex biological trait that has been associated with numerous negative health outcomes. The measurement and environmental determinants of loneliness are well understood, but its genetic basis is not. Previous studies have estimated the heritability of loneliness between 37 and 55\% using twins and family-based approaches, and have explored the role of specific candidate genes. We used genotypic and phenotypic data from 10 760 individuals aged ⩾50 years that were collected by the Health and Retirement Study (HRS) to perform the first genome-wide association study of loneliness. No associations reached genome-wide significance (p>5 {\texttimes} 10). Furthermore, none of the previously published associations between variants within candidate genes (BDNF, OXTR, RORA, GRM8, CHRNA4, IL-1A, CRHR1, MTHFR, DRD2, APOE) and loneliness were replicated (p>0.05), despite our much larger sample size. We estimated the chip heritability of loneliness and examined coheritability between loneliness and several personality and psychiatric traits. Our estimates of chip heritability (14-27\%) support a role for common genetic variation. We identified strong genetic correlations between loneliness, neuroticism, and a scale of {\textquoteright}depressive symptoms.{\textquoteright} We also identified weaker evidence for coheritability with extraversion, schizophrenia, bipolar disorder, and major depressive disorder. We conclude that loneliness, as defined in this study, is a modestly heritable trait that has a highly polygenic genetic architecture. The coheritability between loneliness and neuroticism may reflect the role of negative affectivity that is common to both traits. Our results also reflect the value of studies that probe the common genetic basis of salutary social bonds and clinically defined psychiatric disorders.

}, keywords = {Aged, depression, Extraversion, Psychological, Female, Genome-Wide Association Study, Humans, Loneliness, Male, Mental Disorders, Middle Aged, Neuroticism, Phenotype}, issn = {1740-634X}, doi = {10.1038/npp.2016.197}, url = {http://www.nature.com/doifinder/10.1038/npp.2016.197}, author = {Gao, Jianjun and Lea K. Davis and Amy B. Hart and Sanchez-Roige, Sandra and Han, Lide and John T. Cacioppo and Abraham A Palmer} } @article {12131, title = {Genome-wide meta-analysis associates HLA-DQA1/DRB1 and LPA and lifestyle factors with human longevity.}, journal = {Nature Communications}, volume = {8}, year = {2017}, pages = {910}, abstract = {

Genomic analysis of longevity offers the potential to illuminate the biology of human aging. Here, using genome-wide association meta-analysis of 606,059 parents{\textquoteright} survival, we discover two regions associated with longevity (HLA-DQA1/DRB1 and LPA). We also validate previous suggestions that APOE, CHRNA3/5, CDKN2A/B, SH2B3 and FOXO3A influence longevity. Next we show that giving up smoking, educational attainment, openness to new experience and high-density lipoprotein (HDL) cholesterol levels are most positively genetically correlated with lifespan while susceptibility to coronary artery disease (CAD), cigarettes smoked per day, lung cancer, insulin resistance and body fat are most negatively correlated. We suggest that the effect of education on lifespan is principally mediated through smoking while the effect of obesity appears to act via CAD. Using instrumental variables, we suggest that an increase of one body mass index unit reduces lifespan by 7 months while 1 year of education adds 11 months to expected lifespan.Variability in human longevity is genetically influenced. Using genetic data of parental lifespan, the authors identify associations at HLA-DQA/DRB1 and LPA and find that genetic variants that increase educational attainment have a positive effect on lifespan whereas increasing BMI negatively affects lifespan.

}, keywords = {Alleles, Body Mass Index, Coronary Disease, Education, Genetic Predisposition to Disease, Genome-Wide Association Study, HLA-DQ alpha-Chains, HLA-DRB1 Chains, Humans, Insulin Resistance, Life Style, Lipoprotein(a), Lipoproteins, HDL, Longevity, Lung Neoplasms, Obesity, Polymorphism, Single Nucleotide, Smoking, Socioeconomic factors}, issn = {2041-1723}, doi = {10.1038/s41467-017-00934-5}, author = {Joshi, Peter K and Nicola Pirastu and Kentistou, Katherine A and Fischer, Krista and Edith Hofer and Schraut, Katharina E and Clark, David W and Nutile, Teresa and Barnes, Catriona L K and Paul Rhj Timmers and Shen, Xia and Gandin, Ilaria and McDaid, Aaron F and Hansen, Thomas Folkmann and Gordon, Scott D and Giulianini, Franco and Boutin, Thibaud S and Abdellaoui, Abdel and Zhao, Wei and Medina-Gomez, Carolina and Traci M Bartz and Trompet, Stella and Leslie A Lange and Raffield, Laura and van der Spek, Ashley and Galesloot, Tessel E and Proitsi, Petroula and Yanek, Lisa R and Bielak, Lawrence F and Payton, Antony and Murgia, Federico and Concas, Maria Pina and Biino, Ginevra and Tajuddin, Salman M and Sepp{\"a}l{\"a}, Ilkka and Amin, Najaf and Boerwinkle, Eric and B{\o}rglum, Anders D and Campbell, Archie and Ellen W Demerath and Demuth, Ilja and Jessica Faul and Ford, Ian and Gialluisi, Alessandro and G{\"o}gele, Martin and Graff, Mariaelisa and Aroon Hingorani and Jouke-Jan Hottenga and Hougaard, David M and Hurme, Mikko A and Ikram, M Arfan and Jylh{\"a}, Marja and Kuh, Diana and Ligthart, Lannie and Lill, Christina M and Lindenberger, Ulman and Lumley, Thomas and M{\"a}gi, Reedik and Marques-Vidal, Pedro and Sarah E Medland and Lili Milani and Nagy, Reka and William E R Ollier and Peyser, Patricia A and Pramstaller, Peter P and Ridker, Paul M and Fernando Rivadeneira and Ruggiero, Daniela and Saba, Yasaman and Schmidt, Reinhold and Schmidt, Helena and Slagboom, P Eline and Smith, Blair H and Smith, Jennifer A and Sotoodehnia, Nona and Steinhagen-Thiessen, Elisabeth and van Rooij, Frank J A and Verbeek, Andr{\'e} L and Vermeulen, Sita H and Vollenweider, Peter and Wang, Yunpeng and Werge, Thomas and Whitfield, John B and Alan B Zonderman and Lehtim{\"a}ki, Terho and Michele K Evans and Pirastu, Mario and Fuchsberger, Christian and Bertram, Lars and Pendleton, Neil and Sharon L R Kardia and Ciullo, Marina and Becker, Diane M and Wong, Andrew and Psaty, Bruce M and Cornelia M van Duijn and Wilson, James G and Jukema, J Wouter and Lambertus A Kiemeney and Andr{\'e} G Uitterlinden and Franceschini, Nora and Kari E North and David R Weir and Andres Metspalu and Dorret I Boomsma and Caroline Hayward and Daniel I Chasman and Nicholas G Martin and Sattar, Naveed and Campbell, Harry and T{\~o}nu Esko and Kutalik, Zolt{\'a}n and James F Wilson} } @article {8960, title = {The "Good Times" Cohort in Later-Life.}, journal = {Research on Aging}, volume = {39}, year = {2017}, month = {2017 Apr}, pages = {526-548}, abstract = {Race differences in midlife circumstances explain much of the disability gap in older adulthood, but questions remain about whether early life selection processes are race invariant. To address this, we (1) isolate the 1930s cohort to explore potential race-specific life courses and (2) utilize a two-stage estimation procedure to examine the role of early-to-midlife selection in shaping later-life functional limitations. Using data on Black and White adults born 1931-1941 from the Health and Retirement Study (W2-W9), we estimate trajectories of later-life functional limitations after modeling midlife income and comorbidity as a function of early life factors. Fair/poor childhood health similarly impacts midlife morbidity for both races. Childhood disadvantage (poor family, father unemployed, and no father/deceased) had an adverse effect on midlife income for White but not for Black adults. An education gradient in functional limitations exists only for White adults. We interpret these findings in the sociohistorical context of this birth cohort.}, keywords = {Older Adults, Racial/ethnic differences}, issn = {1552-7573}, doi = {10.1177/0164027516655582}, author = {Jessica Kelley-Moore and Huang, Wenxuan} } @article {8896, title = {Health Status, Health Shocks, and Asset Adequacy Over Retirement Years.}, journal = {Research on Aging}, volume = {39}, year = {2017}, month = {2017 Jan}, pages = {222-248}, abstract = {

This article uses data on a sample of retirees drawn from the Health and Retirement Study (HRS) to examine changes in health over the retirement years and to estimate the effects of health changes in retirement on wealth. Using the framework of item response theory, we develop a novel measure of health that makes use of multiple indicators of physical health that are available in the HRS. We find that large negative shocks to the health of male retirees and their spouses are frequent in retirement and that when such shocks do occur, recovery to the preshock level of health is rare. Using a dynamic panel data model, we then estimate short- and long-run effects of changes in health on wealth. While our estimated short-run effects are modest, long-run estimates of the impact of health shocks on wealth are large, ranging from a 12\% to 20\% reduction in wealth by the 10th year, following a permanent one standard deviation decrease in health.

}, keywords = {Health Conditions and Status, Health Shocks, Older Adults, Retirement Planning and Satisfaction}, issn = {1552-7573}, doi = {10.1177/0164027516669567}, author = {Geoffrey L Wallace and Haveman, Robert and Barbara Wolfe} } @article {8698, title = {Hierarchy and Speed of Loss in Physical Functioning: A Comparison Across Older U.S. and English Men and Women.}, journal = {J Gerontol A Biol Sci Med Sci}, volume = {72}, year = {2017}, month = {2017 Aug 01}, pages = {1117-1122}, abstract = {

Background: We aimed to identify the hierarchy of rates of decline in 16 physical functioning measures in U.S. and English samples, using a systematic and integrative coordinated data analysis approach.

Methods: The U.S. sample consisted of 13,612 Health and Retirement Study participants, and the English sample consisted of 5,301 English Longitudinal Study of Ageing participants. Functional loss was ascertained using self-reported difficulties performing 6 activities of daily living and 10 mobility tasks. The variables were standardized, rates of decline were computed, and mean rates of decline were ranked. Mann-Whitney U tests were performed to compare rates of decline between studies.

Results: In both studies, the rates of decline followed a similar pattern; difficulty with eating was the activity that showed the slowest decline and climbing several flights of stairs and stooping, kneeling, or crouching the fastest declines. There were statistical differences in the speed of decline in all 16 measures between countries. American women had steeper declines in 10 of the measures than English women. Similar differences were found between American and English men.

Conclusions: Reporting difficulties climbing several flights of stairs without resting, and stooping, kneeling, or crouching are the first indicators of functional loss reported in both populations.

}, keywords = {Activities of Daily Living, Aged, Aging, Cross-Cultural Comparison, Disability Evaluation, Female, Geriatric Assessment, Health Status Disparities, Humans, Longitudinal Studies, Male, Middle Aged, Mobility Limitation, Self Report, Statistics, Nonparametric, United Kingdom, United States}, issn = {1758-535X}, doi = {10.1093/gerona/glw209}, author = {Bendayan, Rebecca and Cooper, Rachel and Elizabeth G Wloch and Scott M Hofer and Andrea M Piccinin and Graciela Mu{\~n}iz Terrera} } @article {8831, title = {Honest Labor Bears a Lovely Face: Will Late-Life Unemployment Impact Health and Satisfaction in Retirement?}, journal = {J Occup Environ Med}, volume = {59}, year = {2017}, month = {2017 02}, pages = {184-190}, abstract = {

OBJECTIVE: Unemployment among older adults during recessionary cycles has been tied to early retirement decisions and negative health outcomes. This study explored episodes of unemployment experienced between age 50 and retirement as predictors of retirement age and health outcomes.

METHODS: A total of 1540 participants from the U.S. Health and Retirement Study aged 50 years and older who transitioned from workforce to retirement were analyzed with descriptive statistics and multiple regression controlling for unemployment, demographics, and health status.

RESULTS: Late-life unemployment significantly related to earlier retirement age and lowered life satisfaction, independent of income effects. We found no main effect for late-life unemployment on physical health status.

CONCLUSIONS: Potential improvements in future life satisfaction might be gained if job search obstacles are removed for older unemployed adults, reducing reliance on involuntary early retirement as an income source.

}, keywords = {Age Factors, Aged, Chronic disease, depression, Female, Health Status, Health Surveys, Humans, Male, Mental Health, Middle Aged, Personal Satisfaction, Retirement, Unemployment, United States, Work}, issn = {1536-5948}, doi = {10.1097/JOM.0000000000000933}, url = {http://content.wkhealth.com/linkback/openurl?sid=WKPTLP:landingpage\&an=00043764-900000000-98945}, author = {Maren W Voss and Wendy Church Birmingham and Lori Wadsworth and Wei Chen and Bounsanga, Jerry and Gu, Yushan and Hung, Man} } @article {9141, title = {Household Retirement Saving: The Location of Savings Between Spouses}, year = {2017}, institution = {RAND Corporation}, address = {Santa Monica, CA}, abstract = {Retirement planning is often a joint household decision-making process, and therefore the household is often the more appropriate unit of analysis. However, retirement savings in tax advantaged accounts are held in the name of one individual. While spouses have rights to these assets in the case of divorce and in most cases of death, the separation of accounts in name may cause couples to treat their accounts as separate, with each spouse making decisions separately. In order to optimize retirement planning, couples should consider the entire household portfolio together, accounting for the characteristics of the retirement accounts, the age of the spouses, and income differences between spouses. With separate accounts, one spouse may not be aware of the contributions or assets accumulated in the other spouse{\textquoteright}s accounts. This may lead to sub-optimal decision-making, as individuals in a couple may not fully optimize across all available retirement accounts. Little is known about how households divide retirement contributions and assets between spouses. In this project, we investigate how households locate contributions across tax deferred savings accounts that are nominally held in one spouse{\textquoteright}s name and how these decisions may impact accumulated assets. In particular we first document who within a couple nominally holds retirement assets. Using data from the Health and Retirement Study and Survey of Consumer Finances, we find that household retirement assets and contributions are more likely to be located in accounts held in the husband{\textquoteright}s name or the primary earner{\textquoteright}s name. In our regression analysis, we find that the location of contributions is largely driven by the distribution of earnings within couples.}, keywords = {Consumption and Savings, Marriage, Retirement Planning and Satisfaction}, doi = {10.7249/WR1166}, url = {http://www.rand.org/pubs/working_papers/WR1166.html}, author = {Carman, Katherine and Hung, Angela} } @article {RePEc:red:sed017:1584, title = {How Much Consumption Insurance in the U.S.?}, year = {2017}, institution = {Society for Economic Dynamics}, abstract = {Most of what the profession knows about joint income and consumption dynamics at the household level in the U.S. is based on the data from the Panel Study of Income Dynamics (PSID). We find that there are two sets of households in the PSID that differ dramatically in the dynamics of their income and consumption. Households headed by the original PSID males and their sons have a highly persistent income process, and permanent shocks to their income almost fully pass through to consumption. Household headed by males who marry daughters of the original PSID members have a much less persistent income process and a dramatically higher degree of insurance. These differences are surprising but highly robust. Conditional on income dynamics, the degree of insurance in each subsample is consistent with the prediction of the standard incomplete-markets model. This is in contrast to the famous puzzle in Blundell, Pistaferri, and Preston (2008) of excess insurance of permanent income shocks for the combined sample.}, keywords = {consumption, Consumption and Savings, Insurance}, url = {https://ideas.repec.org/p/red/sed017/1584.html}, author = {Iourii Manovskii and Dmytro Hryshko} } @article {9048, title = {HRS Institutional Review Board Information}, year = {2017}, month = {10/2017}, institution = {Survey Research Center, Institute for Social Research, University of Michigan}, address = {Ann Arbor, MI}, author = {David R Weir} } @article {9442, title = {Human longevity: 25 genetic loci associated in 389,166 UK biobank participants}, journal = {Aging}, volume = {9}, year = {2017}, pages = {2504-2520}, abstract = {We undertook a genome-wide association study (GWAS) of parental longevity in European descent UK Biobank participants. For combined mothers{\textquoteright} and fathers{\textquoteright} attained age, 10 loci were associated (p<5*10(-8)), including 8 previously identified for traits including survival, Alzheimer{\textquoteright}s and cardiovascular disease. Of these, 4 were also associated with longest 10\% survival (mother{\textquoteright}s age >= 90 years, father{\textquoteright}s >= 87 years), with 2 additional associations including MC2R intronic variants (coding for the adrenocorticotropic hormone receptor). Mother{\textquoteright}s age at death was associated with 3 additional loci (2 linked to autoimmune conditions), and 8 for fathers only. An attained age genetic risk score associated with parental survival in the US Health and Retirement Study and the Wisconsin Longitudinal Study and with having a centenarian parent (n=1,181) in UK Biobank. The results suggest that human longevity is highly polygenic with prominent roles for loci likely involved in cellular senescence and inflammation, plus lipid metabolism and cardiovascular conditions. There may also be gender specific routes to longevity.}, keywords = {Cross-National, Genetics, Genome, GWAS, Longevity}, doi = {10.18632/aging.101334}, url = {http://www.aging-us.com/article/101334/texthttp://www.aging-us.com/article/101334/text?_escaped_fragment_=}, author = {Luke C Pilling and Kuo, Chia-Ling and Sicinski, Kamil and Tamosauskaite, Jone and George A Kuchel and Lorna W. Harries and Herd, Pamela and Robert B Wallace and Luigi Ferrucci and David Melzer} } @article {8820, title = {The Impact of Disability and Social Determinants of Health on Condition-Specific Readmissions beyond Medicare Risk Adjustments: A Cohort Study.}, journal = {J Gen Intern Med}, volume = {32}, year = {2017}, month = {2017 01}, pages = {71-80}, abstract = {

BACKGROUND: Readmission rates after pneumonia, heart failure, and acute myocardial infarction hospitalizations are risk-adjusted for age, gender, and medical comorbidities and used to penalize hospitals.

OBJECTIVE: To assess the impact of disability and social determinants of health on condition-specific readmissions beyond current risk adjustment.

DESIGN, SETTING, AND PARTICIPANTS: Retrospective cohort study of Medicare patients using 1) linked Health and Retirement Study-Medicare claims data (HRS-CMS) and 2) Healthcare Cost and Utilization Project State Inpatient Databases (Florida, Washington) linked with ZIP Code-level measures from the Census American Community Survey (ACS-HCUP). Multilevel logistic regression models assessed the impact of disability and selected social determinants of health on readmission beyond current risk adjustment.

MAIN MEASURES: Outcomes measured were readmissions <=30~days after hospitalizations for pneumonia, heart failure, or acute myocardial infarction. HRS-CMS models included disability measures (activities of daily living [ADL] limitations, cognitive impairment, nursing home residence, home healthcare use) and social determinants of health (spouse, children, wealth, Medicaid, race). ACS-HCUP model measures were ZIP Code-percentage of residents >=65~years of age with ADL difficulty, spouse, income, Medicaid, and patient-level and hospital-level race.

KEY RESULTS: For pneumonia, >=3 ADL difficulties (OR 1.61, CI 1.079-2.391) and prior home healthcare needs (OR 1.68, CI 1.204-2.355) increased readmission in HRS-CMS models (N = 1631); ADL difficulties (OR 1.20, CI 1.063-1.352) and {\textquoteright}other{\textquoteright} race (OR 1.14, CI 1.001-1.301) increased readmission in ACS-HCUP models (N = 27,297). For heart failure, children (OR 0.66, CI 0.437-0.984) and wealth (OR 0.53, CI 0.349-0.787) lowered readmission in HRS-CMS models (N = 2068), while black (OR 1.17, CI 1.056-1.292) and {\textquoteright}other{\textquoteright} race (OR 1.14, CI 1.036-1.260) increased readmission in ACS-HCUP models (N = 37,612). For acute myocardial infarction, nursing home status (OR 4.04, CI 1.212-13.440) increased readmission in HRS-CMS models (N = 833); {\textquoteright}other{\textquoteright} patient-level race (OR 1.18, CI 1.012-1.385) and hospital-level race (OR 1.06, CI 1.001-1.125) increased readmission in ACS-HCUP models (N = 17,496).

CONCLUSIONS: Disability and social determinants of health influence readmission risk when added to the current Medicare risk adjustment models, but the effect varies by condition.

}, keywords = {Activities of Daily Living, Cognitive Dysfunction, Comorbidity, Disability Evaluation, Female, Heart Failure, Humans, Logistic Models, Male, Myocardial Infarction, Patient Readmission, Pneumonia, Retrospective Studies, Risk Adjustment, Social determinants of health}, issn = {1525-1497}, doi = {10.1007/s11606-016-3869-x}, url = {http://link.springer.com/10.1007/s11606-016-3869-xhttp://link.springer.com/content/pdf/10.1007/s11606-016-3869-x.pdfhttp://link.springer.com/content/pdf/10.1007/s11606-016-3869-x.pdfhttp://link.springer.com/article/10.1007/s11606-016-3869-x/fulltext.html}, author = {Meddings, Jennifer and Reichert, Heidi and Shawna N Smith and Theodore J Iwashyna and Kenneth M. Langa and Timothy P Hofer and Laurence F McMahon} } @article {9075, title = {Individual survival curves comparing subjective and observed mortality risks.}, journal = {Health Economics}, volume = {26}, year = {2017}, month = {12/2017}, pages = {e285-e303}, abstract = {We compare individual survival curves constructed from objective (actual mortality) and elicited subjective information (probability of survival to a given target age). We develop a methodology to estimate jointly subjective and objective individual survival curves accounting for rounding on subjective reports of perceived survival. We make use of the long follow-up period in the Health and Retirement Study and the high quality of mortality data to estimate individual survival curves that feature both observed and unobserved heterogeneity. This allows us to compare objective and subjective estimates of remaining life expectancy for various groups and compare welfare effects of objective and subjective mortality risk using the life cycle model of consumption. We find that subjective and objective hazards are not the same. The median welfare loss from misperceptions of mortality risk when annuities are not available is 7\% of current wealth at age 65 whereas more than 25\% of respondents have losses larger than 60\% of wealth. When annuities are available and exogenously given, the welfare loss is substantially lower.}, keywords = {Mortality, NDI, Survival curves}, issn = {1099-1050}, doi = {10.1002/hec.3506}, author = {Luc Bissonnette and Michael D Hurd and Pierre-Carl Michaud} } @article {9144, title = {The influence of psychosocial and cognitive factors on perceived threat of Alzheimer{\textquoteright}s Disease}, journal = {American Journal of Alzheimer{\textquoteright}s Disease \& Other Dementias}, volume = {32}, year = {2017}, pages = {289-299}, abstract = {This study explored psychosocial and cognitive predictors of perceived threat of Alzheimer{\textquoteright}s disease (AD). Respondents were 1641 adults (mean age: 64.4; 54\% female; 82\% white) who completed a module in the Health and Retirement Study, a nationally representative survey of adults aged >=50. Findings show that perceived threat was significantly higher for those aged 50 to 64 (P < .001) and 65 to 74 (P < .05) than for those >=75. Respondents with a family history of AD had significantly greater perceived threat (P < .001) than those with no experience. Stronger endorsement of the beliefs that stress (P < .01) or genetics (P < .01) are important AD risk factors was significantly associated with greater perceived threat, as was having more depressive symptoms (P < .01), poorer self-rated memory (P < .01), and lower cognitive function (P < .01). Personal experience moderated the relationship between perceived threat and 2 variables: age and self-rated memory. Understanding perceived AD threat may inform practice and policies centered on early and accurate diagnosis.}, keywords = {Alzheimer{\textquoteright}s disease, Perception, Psychosocial}, issn = {1533-3175}, doi = {10.1177/1533317517714552}, url = {http://journals.sagepub.com/doi/10.1177/1533317517714552}, author = {Jenny E Ostergren and Steven G Heeringa and Carlos F. Mendes de Leon and Cathleen M. Connell and J Scott Roberts} } @article {8507, title = {The Influence of the Transportation Environment on Driving Reduction and Cessation.}, journal = {Gerontologist}, volume = {57}, year = {2017}, month = {2017 10 01}, pages = {824-832}, abstract = {

Purpose of the Study: Driving is by far the most common mode of transportation in the United States, but driving ability is known to decline as people experience age-related functional declines. Some older adults respond to such declines by self-limiting their driving to situations with a low perceived risk of crashing, and many people eventually stop driving completely. Previous research has largely focused on individual and interpersonal predictors of driving reduction and cessation (DRC). The purpose of this study was to assess the influence of the transportation environment on DRC.

Design and Methods: Data were combined from the Health and Retirement Study, the Urban Mobility Scorecard, and StreetMap North America (GIS data). Longitudinal survival analysis techniques were used to analyze seven waves of data spanning a 12-year period.

Results: As roadway density and congestion increased in the environment, the odds of DRC also increased, even after controlling for individual and interpersonal predictors. Other predictors of DRC included demographics, relationship status, health, and household size.

Implications: The current study identified an association between the transportation environment and DRC. Future research is needed to determine whether a causal link can be established. If so, modifications to the physical environment (e.g., creating livable communities with goods and services in close proximity) could reduce driving distances in order to improve older drivers{\textquoteright} ability to remain engaged in life. In addition, older individuals who wish to age in place should consider how their local transportation environment may affect their quality of life.

}, keywords = {Aged, Aging, Automobile Driving, environment, Family Characteristics, Female, Geographic Information Systems, Health Status, Humans, Longitudinal Studies, Male, Marital Status, Risk, Survival Analysis, Transportation, United States}, issn = {1758-5341}, doi = {10.1093/geront/gnw088}, url = {http://www.ncbi.nlm.nih.gov/pubmed/27342439}, author = {Jonathon M Vivoda and Steven G Heeringa and Amy J Schulz and Grengs, Joe and Cathleen M. Connell} } @article {9313, title = {Interaction between Social/Psychosocial Factors and Genetic Variants on Body Mass Index: A Gene-Environment Interaction Analysis in a Longitudinal Setting}, journal = {International Journal of Environmental Research and Public Health}, volume = {14}, year = {2017}, month = {09/2017}, pages = {1153}, abstract = {Obesity, which develops over time, is one of the leading causes of chronic diseases such as cardiovascular disease. However, hundreds of BMI (body mass index)-associated genetic loci identified through large-scale genome-wide association studies (GWAS) only explain about 2.7\% of BMI variation. Most common human traits are believed to be influenced by both genetic and environmental factors. Past studies suggest a variety of environmental features that are associated with obesity, including socioeconomic status and psychosocial factors. This study combines both gene/regions and environmental factors to explore whether social/psychosocial factors (childhood and adult socioeconomic status, social support, anger, chronic burden, stressful life events, and depressive symptoms) modify the effect of sets of genetic variants on BMI in European American and African American participants in the Health and Retirement Study (HRS). In order to incorporate longitudinal phenotype data collected in the HRS and investigate entire sets of single nucleotide polymorphisms (SNPs) within gene/region simultaneously, we applied a novel set-based test for gene-environment interaction in longitudinal studies (LGEWIS). Childhood socioeconomic status (parental education) was found to modify the genetic effect in the gene/region around SNP rs9540493 on BMI in European Americans in the HRS. The most significant SNP (rs9540488) by childhood socioeconomic status interaction within the rs9540493 gene/region was suggestively replicated in the Multi-Ethnic Study of Atherosclerosis (MESA) (p = 0.07).}, keywords = {BMI, Genetics, Obesity}, doi = {10.3390/ijerph14101153}, url = {http://www.mdpi.com/1660-4601/14/10/1153http://www.mdpi.com/1660-4601/14/10/1153/pdf}, author = {Wei Zhao and Erin B Ware and He, Zihuai and Sharon L R Kardia and Jessica Faul} } @article {9210, title = {Knowledge of future job loss and implications for unemployment insurance}, journal = {American Economic Review}, volume = {107}, year = {2017}, pages = {1778-1823}, keywords = {Employment and Labor Force, Job loss, Unemployment}, issn = {0002-8282}, doi = {10.1257/aer.20151655}, url = {http://pubs.aeaweb.org/doi/10.1257/aer.20151655http://pubs.aeaweb.org/doi/pdf/10.1257/aer.20151655}, author = {Hendren, Nathaniel} } @article {9373, title = {The Life Course, Cohort Dynamics, and International Differences in Aging Trajectories}, journal = {Demography}, volume = {54}, year = {2017}, pages = {2043{\textendash}2071}, abstract = {In recent years, population health research has focused on understanding the determinants of later-life health. Two strands of that work have focused on (1) international comparisons of later-life health and (2) assessing the early-life origins of disease and disability and the importance of life course processes. However, the less frequently examined intersection of these approaches remains an important frontier. The present study contributes to the integration of these approaches. We use the Health and Retirement Study family of data sets and a cohort dynamic approach to compare functional health trajectories across 12 high-income countries and to examine the role of life course processes and cohort dynamics in contributing to variation in those trajectories. We find substantial international variation in functional health trajectories and an important role of cohort dynamics in generating that variation, with younger cohorts often less healthy at comparable ages than the older cohorts they are replacing. We further find evidence of heterogeneous effects of life course processes on health trajectories. The results have important implications for future trends in morbidity and mortality as well as public policy. }, keywords = {Cross-National, Life trajectories, SHARE}, issn = {0070-3370}, doi = {10.1007/s13524-017-0624-9}, url = {http://link.springer.com/10.1007/s13524-017-0624-9http://link.springer.com/content/pdf/10.1007/s13524-017-0624-9.pdfhttp://link.springer.com/content/pdf/10.1007/s13524-017-0624-9.pdfhttp://link.springer.com/article/10.1007/s13524-017-0624-9/fulltext.html}, author = {Steven A Haas and Oi, Katsuya and Zhou, Zhangjun} } @article {8892, title = {Lifecourse transitions, gender and drinking in later life}, journal = {Ageing and Society}, volume = {37}, year = {2017}, month = {Jan-03-2017}, pages = {462 - 494}, abstract = {Older people consume less alcohol than any other adult age group. However, in recent years survey data on alcohol consumption in the United Kingdom have shown that while younger age groups have experienced a decline in alcohol consumption, drinking behaviours among the elderly have not reduced in the same way. This paper uses data from the English Longitudinal Study of Ageing to analyse both the frequency and quantity of older adult{\textquoteright}s alcohol consumption using a lifecourse approach over a ten-year period. Overall drinking declined over time and the analysis examined how socio-economic characteristics, partnership, employment and health statuses were associated with differences in drinking behaviours and how these changed over time. Higher wealth and level of education were associated with drinking more and drinking more frequently for men and women. Poorer self-rated health was associated with less frequent consumption and older people with poor and deteriorating health reported a steeper decline in the frequency of alcohol consumption over time. Men who were not in a partnership drank more than other men. For women, loss of a partner was associated with a steeper decline in drinking behaviours. These findings have implications for programmes to promote responsible drinking among older adults as they suggest that, for the most part, characteristics associated with sustaining wellbeing in later life are also linked to consuming more alcohol.}, keywords = {Alcohol Consumption, Gender Differences, Older Adults, Women and Minorities}, issn = {0144-686X}, doi = {10.1017/S0144686X15001178}, url = {https://www.cambridge.org/core/product/identifier/S0144686X15001178/type/journal_article}, author = {Holdsworth, Clare and Frisher, Martin and Mendoca, Marina and de Olivieria, Cesar and Pikhart, Hynek and Shelton, Nicola} } @article {9453, title = {Likelihood that expectations of informal care will be met at onset of caregiving need: a retrospective study of older adults in the USA.}, journal = {BMJ Open}, volume = {7}, year = {2017}, pages = {e017791}, abstract = {

BACKGROUND: Ageing adults are likely to expect informal caregiving assistance from a friend or family member, reflecting the reality that most long-term care (LTC) is provided by family and friends. The purpose of the study was to determine the likelihood that expectations of care will be unmet at the onset of functional disability, and the factors that impact that likelihood.

METHODS: Community-dwelling respondents from biannual repeated assessments (2006-2010) of the Health and Retirement Study over age 65 who expressed a caregiving expectation prior to need were included in the final analytical sample (n=1352). Logistic regression and change models were specified to address impact of variables on unmet expectations.

RESULTS: Expectations of care were unmet for almost one-third (32\%) of the sample, among whom 30\% were not receiving needed care. Unmet expectations were associated with being unmarried, older and having a higher number of ADL deficits. Change over time in the number of predictor variables influenced the likelihood of unmet expectations.

CONCLUSIONS: Unplanned dependence on formal care systems and/or having unmet care needs places elders at risk of negative outcomes. Knowledge of factors that impact whether expected care is eventually received provides robust evidence for counselling individuals regarding the need to plan for additional LTC services.

}, keywords = {Caregiving, Community-dwelling, Marriage, Social Support}, issn = {2044-6055}, doi = {10.1136/bmjopen-2017-017791}, author = {Abrahamson, Kathleen and Hass, Zachary and Laura Sands} } @article {8903, title = {Marital Biography, Social Security Receipt, and Poverty.}, journal = {Research on Aging}, volume = {39}, year = {2017}, month = {2017 Jan}, pages = {86-110}, abstract = {

Increasingly, older adults are unmarried, which could mean a larger share is at risk of economic disadvantage. Using data from the 2010 Health and Retirement Study, we chart the diverse range of marital biographies, capturing marital sequences and timing, of adults who are age eligible for Social Security and examine three indicators of economic well-being: Social Security receipt, Social Security benefit levels, and poverty status. Partnereds are disproportionately likely to receive Social Security and they enjoy relatively high Social Security benefits and very low poverty levels. Among singles, economic well-being varies by marital biography and gender. Gray divorced and never-married women face considerable economic insecurity. Their Social Security benefits are relatively low, and their poverty rates are quite high (over 25\%), indicating Social Security alone is not sufficient to prevent these women from falling into poverty. By comparison, gray widoweds are the most advantaged singles.

}, keywords = {Gender Differences, Marriage, Older Adults, Poverty, Social Security}, issn = {1552-7573}, doi = {10.1177/0164027516656139}, author = {Lin, I-Fen and Susan L. Brown and Anna M Hammersmith} } @article {9613, title = {Mom and Dad We{\textquoteright}re Broke, Can You Help? A Comparative Study of Financial Transfers Within Families Before and After the Great Recession}, number = {WP$\#$2017-16}, year = {2017}, month = {11/2017}, pages = {2-36}, institution = {Center for Retirement Research at Boston College}, address = {Boston, MA}, abstract = {This paper examines financial transfers within families before and after the great recession. Transfers within families have historically been an important source of wealth accumulation for younger generations, but what happens to these transfers when incomes and wealth are distorted by a recession? We document patterns of financial transfers within families in the U.S. and Germany before and after the Great Recession. This paper uses data from the Health and Retirement Study (HRS) and the Survey of Health, Aging and Retirement in Europe (SHARE). Critical components of the analysis include the estimation of a difference-in-differences model to compare transfer behavior over time, and multiple triple-difference-in-differences models to further study how transfer behavior differs for different population groups. Key limitations are related to available data. The SHARE data used do not contain information for year 2007, which thus had to be excluded from the analysis. In addition, harmonizing both datasets might introduce some potential of errors. The paper found that: Transfers from parents to children are procyclical. Fewer U.S. and German parents made transfers to their adult children in 2009 than in 2005, and transfer rates appear to start recovering earlier in Germany than in the U.S. The estimated decline from 2005 to 2009 was 3 percentage points in the U.S. (8 percent) and 7.5 percentage points in Germany (29 percent).Households who did fairly well during the recession reduce transfers in the same way than households who were not hit by a financial shock.Households who experienced non-employment also did not reduce transfers compared to households who did not experience non-employment. The policy implications of the findings are: Private financial transfers are important for social policy because they may be an important source of economic security during recessions, especially in countries where the social safety net is less generous.Understanding how transfer behavior within family changes during recessions under different public safety nets can inform design of policies to promote economic security and equity.In terms of our study, we (for example) find no relationships between public transfers crowding out private transfers. This result can be used to make current public policies more efficient.}, keywords = {Family Roles/Relationships, Finances, Recession}, url = {http://crr.bc.edu/wp-content/uploads/2017/11/wp_2017-16-1.pdf}, author = {Mary K. Hamman and Daniela Hochfellner and Pia Homrighausen} } @article {9049, title = {Mortality selection in a genetic sample and implications for association studies.}, journal = {International Journal of Epidemiolpgy}, volume = {46}, year = {2017}, month = {08/2017}, abstract = {

Background: Mortality selection occurs when a non-random subset of a population of interest has died before data collection and is unobserved in the data. Mortality selection is of general concern in the social and health sciences, but has received little attention in genetic epidemiology. We tested the hypothesis that mortality selection may bias genetic association estimates, using data from the US-based Health and Retirement Study (HRS).

Methods: We tested mortality selection into the HRS genetic database by comparing HRS respondents who survive until genetic data collection in 2006 with those who do not. We next modelled mortality selection on demographic, health and social characteristics to calculate mortality selection probability weights. We analysed polygenic score associations with several traits before and after applying inverse-probability weighting to account for mortality selection. We tested simple associations and time-varying genetic associations (i.e. gene-by-cohort interactions).

Results: We observed mortality selection into the HRS genetic database on demographic, health and social characteristics. Correction for mortality selection using inverse probability weighting methods did not change simple association estimates. However, using these methods did change estimates of gene-by-cohort interaction effects. Correction for mortality selection changed gene-by-cohort interaction estimates in the opposite direction from increased mortality selection based on analysis of HRS respondents surviving through 2012.

Conclusions: Mortality selection may bias estimates of gene-by-cohort interaction effects. Analyses of HRS data can adjust for mortality selection associated with observables by including probability weights. Mortality selection is a potential confounder of genetic association studies, but the magnitude of confounding varies by trait.

}, keywords = {Genetics, GWAS, Mortality}, issn = {1464-3685}, doi = {10.1093/ije/dyx041}, author = {Benjamin W Domingue and Daniel W. Belsky and Harrati, Amal and Dalton C Conley and David R Weir and Jason D Boardman} } @article {9019, title = {Multiple Chronic Conditions, Resilience, and Workforce Transitions in Later Life: A Socio-Ecological Model.}, journal = {The Gerontologist}, volume = {57}, year = {2017}, month = {2017 Apr 01}, pages = {269-281}, abstract = {

Purpose of the Study: Despite the growing prevalence of multiple chronic conditions (MCC), a problem that disproportionally affects older adults, few studies have examined the impact of MCC status on changes in workforce participation in later life. Recent research suggests that resilience, the ability to recover from adversity, may buffer the negative impact of chronic disease. Guided by an adapted socio-ecological risk and resilience conceptual model, this study examined the buffering effect of resilience on the relationship between individual and contextual risks, including MCC, and workforce transitions (i.e., leaving the workforce, working fewer hours, working the same hours, or working more hours).

Design and Methods: Using the Health and Retirement Study, this study pooled a sample of 4,861 older workers aged 51 and older with 2 consecutive biannual waves of data. Nonnested multinomial logistic regression analysis was applied.

Results: MCC are related to higher risk of transitioning out of the workforce. Resilience buffered the negative effects of MCC on workforce engagement and remained independently associated with increased probability of working the same or more hours compared with leaving work.

Implications: MCC are associated with movement out of the paid workforce in later life. Despite the challenges MCC impose on older workers, having higher levels of resilience may provide the psychological resources needed to sustain work engagement in the face of new deficits. These findings suggest that identifying ways to bolster resilience may enhance the longevity of productive workforce engagement.

}, keywords = {Comorbidity, Resilience, Retirement Planning and Satisfaction}, issn = {1758-5341}, doi = {10.1093/geront/gnv101}, author = {Kendra Jason and Dawn C Carr and Tiffany R Washington and Tandrea S Hilliard and Chivon A Mingo} } @article {12138, title = {New Blood Pressure-Associated Loci Identified in Meta-Analyses of 475 000 Individuals.}, journal = {Circulation: Cardiovascular Genetics}, volume = {10}, year = {2017}, pages = {e001778}, abstract = {

BACKGROUND: Genome-wide association studies have recently identified >400 loci that harbor DNA sequence variants that influence blood pressure (BP). Our earlier studies identified and validated 56 single nucleotide variants (SNVs) associated with BP from meta-analyses of exome chip genotype data. An additional 100 variants yielded suggestive evidence of association.

METHODS AND RESULTS: Here, we augment the sample with 140 886 European individuals from the UK Biobank, in whom 77 of the 100 suggestive SNVs were available for association analysis with systolic BP or diastolic BP or pulse pressure. We performed 2 meta-analyses, one in individuals of European, South Asian, African, and Hispanic descent (pan-ancestry, ≈475 000), and the other in the subset of individuals of European descent (≈423 000). Twenty-one SNVs were genome-wide significant (<5{\texttimes}10) for BP, of which 4 are new BP loci: rs9678851 (missense, ), rs7437940 (), rs13303 (missense, ), and rs1055144 (). In addition, we identified a potentially independent novel BP-associated SNV, rs3416322 (missense, ) at a known locus, uncorrelated with the previously reported SNVs. Two SNVs are associated with expression levels of nearby genes, and SNVs at 3 loci are associated with other traits. One SNV with a minor allele frequency <0.01, (rs3025380 at ) was genome-wide significant.

CONCLUSIONS: We report 4 novel loci associated with BP regulation, and 1 independent variant at an established BP locus. This analysis highlights several candidate genes with variation that alter protein function or gene expression for potential follow-up.

}, keywords = {Antiporters, Blood pressure, Cell Adhesion Molecules, Neuronal, Databases, Factual, Genetic Loci, Genome-Wide Association Study, Genotype, Humans, Microfilament Proteins, Phenotype, Polymorphism, Single Nucleotide, Receptors, Lymphocyte Homing}, issn = {1942-3268}, doi = {10.1161/CIRCGENETICS.117.001778}, author = {Kraja, Aldi T and Cook, James P and Warren, Helen R and Surendran, Praveen and Liu, Chunyu and Evangelou, Evangelos and Alisa Manning and Grarup, Niels and Drenos, Fotios and Sim, Xueling and Smith, Albert Vernon and Amin, Najaf and Alexandra I Blakemore and Bork-Jensen, Jette and Brandslund, Ivan and Farmaki, Aliki-Eleni and Fava, Cristiano and Ferreira, Teresa and Herzig, Karl-Heinz and Giri, Ayush and Giulianini, Franco and Grove, Megan L and Guo, Xiuqing and Sarah E Harris and Have, Christian T and Havulinna, Aki S and Zhang, He and J{\o}rgensen, Marit E and K{\"a}r{\"a}j{\"a}m{\"a}ki, AnneMari and Charles Kooperberg and Linneberg, Allan and Little, Louis and Liu, Yongmei and Bonnycastle, Lori L and Lu, Yingchang and M{\"a}gi, Reedik and Mahajan, Anubha and Malerba, Giovanni and Riccardo E Marioni and Mei, Hao and Menni, Cristina and Alanna C Morrison and Padmanabhan, Sandosh and Walter R Palmas and Poveda, Alaitz and Rauramaa, Rainer and Nigel W Rayner and Riaz, Muhammad and Rice, Ken and Melissa Richard and Smith, Jennifer A and Southam, Lorraine and Stan{\v c}{\'a}kov{\'a}, Alena and Kathleen E Stirrups and Tragante, Vinicius and Tuomi, Tiinamaija and Tzoulaki, Ioanna and Varga, Tibor V and Weiss, Stefan and Yiorkas, Andrianos M and Young, Robin and Zhang, Weihua and Barnes, Michael R and Cabrera, Claudia P and Gao, He and Boehnke, Michael and Boerwinkle, Eric and Chambers, John C and Connell, John M and Cramer Christensen and de Boer, Rudolf A and Ian J Deary and George Dedoussis and Deloukas, Panos and Dominiczak, Anna F and D{\"o}rr, Marcus and Joehanes, Roby and Edwards, Todd L and T{\~o}nu Esko and Myriam Fornage and Franceschini, Nora and Franks, Paul W and Gambaro, Giovanni and Leif C Groop and Hallmans, G{\"o}ran and Hansen, Torben and Caroline Hayward and Heikki, Oksa and Ingelsson, Erik and Tuomilehto, Jaakko and J{\"a}rvelin, Marjo-Riitta and Sharon L R Kardia and Karpe, Fredrik and Kooner, Jaspal S and Lakka, Timo A and Langenberg, Claudia and Lars Lind and Ruth J F Loos and Laakso, Markku and McCarthy, Mark I and Melander, Olle and Mohlke, Karen L and Morris, Andrew P and Palmer, Colin N A and Pedersen, Oluf and Polasek, Ozren and Neil Poulter and Province, Michael A and Psaty, Bruce M and Ridker, Paul M and Rotter, Jerome I and Rudan, Igor and Veikko Salomaa and Nilesh J Samani and Peter Sever and Skaaby, Tea and Stafford, Jeanette M and John M Starr and van der Harst, Pim and van der Meer, Peter and Cornelia M van Duijn and Vergnaud, Anne-Claire and Gudnason, Vilmundur and Wareham, Nicholas J and Wilson, James G and Willer, Cristen J and Daniel Witte and Zeggini, Eleftheria and Saleheen, Danish and Adam S Butterworth and Danesh, John and Asselbergs, Folkert W and Wain, Louise V and Georg B Ehret and Daniel I Chasman and Caulfield, Mark J and Elliott, Paul and Lindgren, Cecilia M and Levy, Daniel and Newton-Cheh, Christopher and Munroe, Patricia B and Howson, Joanna M M} } @article {8950, title = {Personality and Employment Transitions at Older Ages: Direct and Indirect Effects through Non-Monetary Job Characteristics}, journal = {Labour}, volume = {31}, year = {2017}, pages = {127-152}, abstract = {We study whether individuals with different personality traits systematically exhibit different retirement trajectories. We find weak direct associations between personality and employment transitions. On the other hand, personality does contribute indirectly to these transitions by moderating the effects of non-monetary job characteristics. Specifically, workers with different traits are observed to follow different retirement paths when faced with similar physical demands, computer skills requirements, job flexibility, and age discrimination in the workplace. Contrary with other economic domains, conscientiousness does not have the strongest association with retirement; the other components of the Big Five personality traits show more salient patterns.}, keywords = {Employment and Labor Force, Jobs, Older Adults, Personality}, doi = {10.1111/labr.12090}, url = {http://doi.wiley.com/10.1111/labr.12090http://onlinelibrary.wiley.com/wol1/doi/10.1111/labr.12090/fullpdfhttps://api.wiley.com/onlinelibrary/tdm/v1/articles/10.1111\%2Flabr.12090}, author = {Marco Angrisani and Michael D Hurd and Erik Meijer and Andrew M Parker and Susann Rohwedder} } @article {9135, title = {Planning for retirement? The importance of time preferences}, number = {Working Paper No. 23501}, year = {2017}, month = {06/2017}, institution = {National Bureau of Economic Research}, address = {Cambridge, MA}, abstract = {Ensuring retirement income security is a priority for individuals, employers, and policymakers. Using merged administrative and survey data for public sector workers in North Carolina, we explore how workers{\textquoteright} characteristics and preferences are associated with planning and saving for retirement. We then assess the {\textquotedblleft}quality{\textquotedblright} of a retirement plan and whether retirement behavior is consistent with these plans. The findings indicate that the way that individuals discount future consumption is associated with the extent of their retirement planning and preparedness. We find that individuals who engage in retirement planning are better prepared to meet their retirement goals upon leaving their career jobs.}, keywords = {Consumption and Savings, Retirement Planning and Satisfaction}, doi = {10.3386/w23501}, url = {http://www.nber.org/papers/w23501.pdf}, author = {Robert Clark and Hammond, Robert and Khalaf, Christelle and Morrill, Melinda} } @article {9001, title = {Predictive validity of the Work Ability Index and its individual items in the general population.}, journal = {Scandinavian Journal of Public Health}, volume = {45}, year = {2017}, pages = {350-356}, abstract = {

AIM: This study assesses the predictive ability of the full Work Ability Index (WAI) as well as its individual items in the general population.

METHODS: The Work, Health and Retirement Study (WHRS) is a stratified random national sample of 25-75-year-olds living in Sweden in 2000 that received a postal questionnaire ( n = 6637, response rate = 53\%). Current and subsequent sickness absence was obtained from registers. The ability of the WAI to predict long-term sickness absence (LTSA; ⩾ 90 consecutive days) during a period of four years was analysed by logistic regression, from which the Area Under the Receiver Operating Characteristic curve (AUC) was computed.

RESULTS: There were 313 incident LTSA cases among 1786 employed individuals. The full WAI had acceptable ability to predict LTSA during the 4-year follow-up (AUC = 0.79; 95\% CI 0.76 to 0.82). Individual items were less stable in their predictive ability. However, three of the individual items: current work ability compared with lifetime best, estimated work impairment due to diseases, and number of diagnosed current diseases, exceeded AUC > 0.70. Excluding the WAI item on number of days on sickness absence did not result in an inferior predictive ability of the WAI.

CONCLUSIONS: The full WAI has acceptable predictive validity, and is superior to its individual items. For public health surveys, three items may be suitable proxies of the full WAI; current work ability compared with lifetime best, estimated work impairment due to diseases, and number of current diseases diagnosed by a physician.

}, keywords = {Older Adults, Self-reported health}, issn = {1651-1905}, doi = {10.1177/1403494817702759}, author = {Lundin, Andreas and Leijon, Ola and Vaez, Marjan and Hallgren, Mats and Torg{\'e}n, Margareta} } @book {9219, title = {Preventing Cognitive Decline and Dementia: A Way Forward}, year = {2017}, publisher = {National Academies Press}, organization = {National Academies Press}, address = {Washington, D.C.}, abstract = {Societies around the world are concerned about dementia and the other forms of cognitive impairment that affect many older adults. We now know that brain changes typically begin years before people show symptoms, which suggests a window of opportunity to prevent or delay the onset of these conditions. Emerging evidence that the prevalence of dementia is declining in high-income countries offers hope that public health interventions will be effective in preventing or delaying cognitive impairments. Until recently, the research and clinical communities have focused primarily on understanding and treating these conditions after they have developed. Thus, the evidence base on how to prevent or delay these conditions has been limited at best, despite the many claims of success made in popular media and advertising. Today, however, a growing body of prevention research is emerging. Preventing Cognitive Decline and Dementia: A Way Forward assesses the current state of knowledge on interventions to prevent cognitive decline and dementia, and informs future research in this area. This report provides recommendations of appropriate content for inclusion in public health messages from the National Institute on Aging.}, keywords = {Alzheimer{\textquoteright}s disease, Cognitive Ability, Dementia, Preventative Medicine}, isbn = {978-0-309-45959-4}, doi = {10.17226/24782}, url = {https://www.nap.edu/catalog/24782}, editor = {Leshner, Alan I. and Landis, Story and Stroud, Clare and Downey, Autumn} } @article {9098, title = {Processes linking religious involvement and telomere length.}, journal = {Biodemography and Social Biology}, volume = {63}, year = {2017}, month = {2017}, pages = {167-188}, abstract = {

Although numerous studies suggest that religious involvement is associated with better health and longer life expectancies, it is unclear whether these general patterns extend to cellular aging. The mechanisms linking indicators of religious involvement with indicators of cellular aging are also undefined. We employed longitudinal data from the 2004 and 2008 Health and Retirement Study, a national probability sample of Americans aged 50 and older, to test whether average telomere length varied according to level of religious attendance. We also tested several potential mechanisms. Our results showed that respondents who attended religious services more frequently in 2004 also exhibited fewer stressful events, lower rates of smoking, fewer symptoms of depression, and lower levels of C-reactive protein in 2008. Respondents who increased their level of attendance from 2004 to 2008 also exhibited lower rates of smoking in 2008. Although religious attendance was not directly associated with telomere length, our mediation analyses revealed significant indirect effects through depression and smoking, but not stressful events or C-reactive protein. We conclude that religious attendance may promote telomere length indirectly by reducing symptoms of depression and the risk of smoking. There was no evidence to support stressful events or C-reactive protein as mechanisms of religious attendance.

}, keywords = {Religion, Telomeres}, issn = {1948-5573}, doi = {10.1080/19485565.2017.1311204}, author = {Terrence D. Hill and Preeti Vaghela and Christopher G. Ellison and Rote, Sunshine} } @article {8804, title = {Psychosocial correlates of cervical cancer screening among older Hispanic women.}, journal = {Soc Work Health Care}, volume = {56}, year = {2017}, month = {2017 02}, pages = {124-139}, abstract = {

Early detection through screening can reduce mortality rates of cervical cancer, and yet Hispanic women who have incidence rates higher than their non-Hispanic White counterparts are least likely to participate in cancer screening initiatives. This study utilized data from the 2008 wave of the Health and Retirement Study to investigate the psychosocial correlates associated with older Hispanic women{\textquoteright}s participation in cervical cancer screening services. Logistic regression models were used. Findings indicated that greater life satisfaction and religiosity were associated with a greater likelihood of participating in cervical cancer screening. Despite ongoing national conversations, evidence indicates there is agreement that underserved women need to be screened, particularly the older Hispanic population.

}, keywords = {Adult, Aged, Aged, 80 and over, Attitude to Health, Early Detection of Cancer, Female, Hispanic Americans, Humans, Logistic Models, Mass Screening, Middle Aged, Uterine Cervical Neoplasms}, issn = {1541-034X}, doi = {10.1080/00981389.2016.1263268}, url = {https://www.tandfonline.com/doi/full/10.1080/00981389.2016.1263268}, author = {Tamara J. Cadet and Stewart, Kathleen and Howard, Tenial} } @article {9136, title = {Quantifying the life-cycle benefits of a prototypical early childhood program}, number = {Working Paper No. 23479}, year = {2017}, month = {06/2017}, institution = {National Bureau of Economic Research}, address = {Cambridge, MA}, abstract = {This paper quantifies the experimentally evaluated life-cycle benefits of a widely implemented early childhood program targeting disadvantaged families. We join experimental data with non-experimental data using economic models to forecast its life-cycle benefits. Our baseline estimate of the internal rate of return (benefit/cost ratio) is 13.7\% (7.3). We conduct extensive sensitivity analyses to account for model estimation error, forecasting error, and judgments made about the empirical magnitudes of non-market benefits. We examine the performance of widely used, ad hoc estimates of long-term benefit/cost ratios based on short-term measures of childhood test scores and find them wanting.}, keywords = {Childhood adversity, Lifecycles}, doi = {10.3386/w23479}, url = {http://www.nber.org/papers/w23479.pdf}, author = {Garcia, Jorge Luis and Heckman, James J. and Leaf, Duncan Ermini and Prados, Mar{\'\i}a Jos{\'e}} } @article {8904, title = {Racial and ethnic differences in smoking changes after chronic disease diagnosis among middle-aged and older adults in the United States.}, journal = {BMC Geriatrics}, volume = {17}, year = {2017}, month = {2017 Feb 08}, pages = {48}, abstract = {

BACKGROUND: Middle-aged and older Americans from underrepresented racial and ethnic backgrounds are at risk for greater chronic disease morbidity than their white counterparts. Cigarette smoking increases the severity of chronic illness, worsens physical functioning, and impairs the successful management of symptoms. As a result, it is important to understand whether smoking behaviors change after the onset of a chronic condition. We assessed the racial/ethnic differences in smoking behavior change after onset of chronic diseases among middle-aged and older adults in the US.

METHODS: We use longitudinal data from the Health and Retirement Study (HRS 1992-2010) to examine changes in smoking status and quantity of cigarettes smoked after a new heart disease, diabetes, cancer, stroke, or lung disease diagnosis among smokers.

RESULTS: The percentage of middle-aged and older smokers who quit after a new diagnosis varied by racial/ethnic group and disease: for white smokers, the percentage ranged from 14\% after diabetes diagnosis to 32\% after cancer diagnosis; for black smokers, the percentage ranged from 15\% after lung disease diagnosis to 40\% after heart disease diagnosis; the percentage of Latino smokers who quit was only statistically significant after stoke, where 38\% quit. In logistic models, black (OR = 0.43, 95\% CI: 0.19-0.99) and Latino (OR = 0.26, 95\% CI: 0.11-0.65) older adults were less likely to continue smoking relative to white older adults after a stroke, and Latinos were more likely to continue smoking relative to black older adults after heart disease onset (OR = 2.69, 95\% CI [1.05-6.95]). In models evaluating changes in the number of cigarettes smoked after a new diagnosis, black older adults smoked significantly fewer cigarettes than whites after a new diagnosis of diabetes, heart disease, stroke or cancer, and Latino older adults smoked significantly fewer cigarettes compared to white older adults after newly diagnosed diabetes and heart disease. Relative to black older adults, Latinos smoked significantly fewer cigarettes after newly diagnosed diabetes.

CONCLUSIONS: A large majority of middle-aged and older smokers continued to smoke after diagnosis with a major chronic disease. Black participants demonstrated the largest reductions in smoking behavior. These findings have important implications for tailoring secondary prevention efforts for older adults.

}, keywords = {Chronic disease, Health Conditions and Status, Older Adults, Racial/ethnic differences, Smoking}, issn = {1471-2318}, doi = {10.1186/s12877-017-0438-z}, author = {Ana R Qui{\~n}ones and Corey L Nagel and Jason T Newsom and Nathalie Huguet and Sheridan, Paige and Stephen M Thielke} } @article {9249, title = {Racial and socioeconomic disparities in disabling chronic pain: Findings from the Health and Retirement Study.}, journal = {The Journal of Pain: Official Journal of the American Pain Society}, volume = {18}, year = {2017}, pages = {1459-1467}, abstract = {The U.S. National Pain Strategy calls for increased population research on "high impact chronic pain," i.e., longstanding pain that substantially limits participation in daily activities. Using data from the nationally-representative Health and Retirement Study (HRS), we investigated the prevalence of high-impact chronic pain in U.S. adults over age 50 overall and within population subgroups. We also explored sociodemographic variation in pain-related disability within specific activity domains. Data are from a subsample of HRS respondents (n=1,925) who were randomly selected for a supplementary pain module in 2010. Our outcome was operationalized as pain duration of >7 months and a disability rating of >7 (0 to 10 scale) in at least one domain: family/home, leisure, social activities, work, or basic activities. Overall, 8.2\% (95\% C.I. = 6.7 to 10.1\%) of adults over age 50 met criteria for high-impact chronic pain. This proportion rose to 17.1\% (95\% C.I. = 12.3 to 23.4\%) among individuals in the lowest wealth quartile. Prevalence differences by education, race/ethnicity and age were not significant. Arthritis and depression were significantly associated with high-impact pain in multivariable analysis. Among adults with any chronic pain, African Americans and individuals in the lowest wealth quartile reported more pain-related disability across activity domains.

PERSPECTIVE: High-impact chronic pain is unequally distributed among midlife and older U.S. adults. Efforts to reduce the burden of disabling chronic pain should prioritize socioeconomically vulnerable groups, who may have the least access to multi-modal pain treatment to improve function.}, keywords = {Chronic pain, Racial/ethnic differences, Socioeconomic factors}, issn = {1528-8447}, doi = {10.1016/j.jpain.2017.07.005}, author = {Mary R Janevic and Sara J McLaughlin and Alicia A Heapy and Thacker, Casey and John D Piette} } @article {8886, title = {Rare and low-frequency coding variants alter human adult height.}, journal = {Nature}, volume = {542}, year = {2017}, month = {2017 Feb 09}, pages = {186-190}, abstract = {

Height is a highly heritable, classic polygenic trait with approximately 700 common associated variants identified through genome-wide association studies so far. Here, we report 83 height-associated coding variants with lower minor-allele frequencies (in the range of 0.1-4.8\%) and effects of up to 2 centimetres per allele (such as those in IHH, STC2, AR and CRISPLD2), greater than ten times the average effect of common variants. In functional follow-up studies, rare height-increasing alleles of STC2 (giving an increase of 1-2 centimetres per allele) compromised proteolytic inhibition of PAPP-A and increased cleavage of IGFBP-4 in vitro, resulting in higher bioavailability of insulin-like growth factors. These 83 height-associated variants overlap genes that are mutated in monogenic growth disorders and highlight new biological candidates (such as ADAMTS3, IL11RA and NOX4) and pathways (such as proteoglycan and glycosaminoglycan synthesis) involved in growth. Our results demonstrate that sufficiently large sample sizes can uncover rare and low-frequency variants of moderate-to-large effect associated with polygenic human phenotypes, and that these variants implicate relevant genes and pathways.

}, issn = {1476-4687}, doi = {10.1038/nature21039}, author = {Marouli, Eirini and Graff, Mariaelisa and Medina-Gomez, Carolina and Ken Sin Lo and Andrew R Wood and Kjaer, Troels R and Fine, Rebecca S and Lu, Yingchang and Schurmann, Claudia and Highland, Heather M and R{\"u}eger, Sina and Thorleifsson, Gudmar and Justice, Anne E and Lamparter, David and Kathleen E Stirrups and Turcot, Val{\'e}rie and Young, Kristin L and Thomas W Winkler and T{\~o}nu Esko and Karaderi, Tugce and Locke, Adam E and Masca, Nicholas G D and Ng, Maggie C Y and Mudgal, Poorva and Rivas, Manuel A and Vedantam, Sailaja and Mahajan, Anubha and Guo, Xiuqing and Gon{\c c}alo R Abecasis and Aben, Katja K and Adair, Linda S and Alam, Dewan S and Albrecht, Eva and Allin, Kristine H and Matthew A. Allison and Amouyel, Philippe and Appel, Emil V and Arveiler, Dominique and Asselbergs, Folkert W and Auer, Paul L and Balkau, Beverley and Banas, Bernhard and Bang, Lia E and Benn, Marianne and Bergmann, Sven and Bielak, Lawrence F and Bl{\"u}her, Matthias and Boeing, Heiner and Boerwinkle, Eric and B{\"o}ger, Carsten A and Bonnycastle, Lori L and Bork-Jensen, Jette and Bots, Michiel L and Erwin P Bottinger and Bowden, Donald W and Brandslund, Ivan and Breen, Gerome and Brilliant, Murray H and Broer, Linda and Burt, Amber A and Adam S Butterworth and Carey, David J and Caulfield, Mark J and Chambers, John C and Daniel I Chasman and Yii-Der I Chen and Chowdhury, Rajiv and Cramer Christensen and Chu, Audrey Y and Cocca, Massimiliano and Collins, Francis S and Cook, James P and Corley, Janie and Jordi Corominas Galbany and Cox, Amanda J and Cuellar-Partida, Gabriel and Danesh, John and Gail Davies and de Bakker, Paul I W and de Borst, Gert J and de Denus, Simon and de Groot, Mark C H and de Mutsert, Ren{\'e}e and Ian J Deary and George Dedoussis and Ellen W Demerath and Anneke I den Hollander and Joe G Dennis and Di Angelantonio, Emanuele and Drenos, Fotios and Du, Mengmeng and Dunning, Alison M and Easton, Douglas F and Ebeling, Tapani and Edwards, Todd L and Ellinor, Patrick T and Elliott, Paul and Evangelou, Evangelos and Farmaki, Aliki-Eleni and Jessica Faul and Feitosa, Mary F and Feng, Shuang and Ferrannini, Ele and Marco M Ferrario and Ferri{\`e}res, Jean and Florez, Jose C and Ford, Ian and Myriam Fornage and Franks, Paul W and Frikke-Schmidt, Ruth and Galesloot, Tessel E and Gan, Wei and Gandin, Ilaria and Paolo P. Gasparini and Giedraitis, Vilmantas and Giri, Ayush and Giorgia G Girotto and Gordon, Scott D and Gordon-Larsen, Penny and Gorski, Mathias and Grarup, Niels and Grove, Megan L and Gudnason, Vilmundur and Gustafsson, Stefan and Hansen, Torben and Kathleen Mullan Harris and Tamara B Harris and Andrew T Hattersley and Caroline Hayward and He, Liang and Iris M Heid and Heikkil{\"a}, Kauko and Helgeland, {\O}yvind and Hernesniemi, Jussi and Hewitt, Alex W and Lynne J Hocking and Hollensted, Mette and Oddgeir L Holmen and Hovingh, G Kees and Howson, Joanna M M and Hoyng, Carel B and Huang, Paul L and Hveem, Kristian and Mohammed Arfan Ikram and Ingelsson, Erik and Jackson, Anne U and Jansson, Jan-H{\r a}kan and Jarvik, Gail P and Jensen, Gorm B and Jhun, Min A and Jia, Yucheng and Jiang, Xuejuan and Johansson, Stefan and J{\o}rgensen, Marit E and J{\o}rgensen, Torben and Jousilahti, Pekka and Jukema, J Wouter and Kahali, Bratati and Kahn, Ren{\'e} S and K{\"a}h{\"o}nen, Mika and Kamstrup, Pia R and Kanoni, Stavroula and Kaprio, Jaakko and Karaleftheri, Maria and Sharon L R Kardia and Karpe, Fredrik and Kee, Frank and Keeman, Renske and Lambertus A Kiemeney and Kitajima, Hidetoshi and Kluivers, Kirsten B and Kocher, Thomas and Komulainen, Pirjo and Kontto, Jukka and Kooner, Jaspal S and Charles Kooperberg and Kovacs, Peter and Kriebel, Jennifer and Kuivaniemi, Helena and K{\"u}ry, S{\'e}bastien and Kuusisto, Johanna and La Bianca, Martina and Laakso, Markku and Lakka, Timo A and Lange, Ethan M and Leslie A Lange and Langefeld, Carl D and Langenberg, Claudia and Eric B Larson and Lee, I-Te and Lehtim{\"a}ki, Terho and Lewis, Cora E and Li, Huaixing and Li, Jin and Li-Gao, Ruifang and Lin, Honghuang and Lin, Li-An and Lin, Xu and Lars Lind and Lindstr{\"o}m, Jaana and Linneberg, Allan and Liu, Yeheng and Yongmei Liu and Lophatananon, Artitaya and Luan, Jian{\textquoteright}an and Lubitz, Steven A and Lyytik{\"a}inen, Leo-Pekka and Mackey, David A and Pamela A F Madden and Alisa Manning and M{\"a}nnist{\"o}, Satu and Marenne, Ga{\"e}lle and Marten, Jonathan and Nicholas G Martin and Mazul, Angela L and Meidtner, Karina and Andres Metspalu and Mitchell, Paul and Mohlke, Karen L and Dennis O Mook-Kanamori and Morgan, Anna and Morris, Andrew D and Morris, Andrew P and M{\"u}ller-Nurasyid, Martina and Munroe, Patricia B and Michael A Nalls and Nauck, Matthias and Nelson, Christopher P and Neville, Matt and Sune Fallgaard Nielsen and Nikus, Kjell and Nj{\o}lstad, P{\r a}l R and B{\o}rge G Nordestgaard and Ntalla, Ioanna and Jeff O{\textquoteright}Connell and Oksa, Heikki and Loes M Olde Loohuis and Ophoff, Roel A and Owen, Katharine R and Packard, Chris J and Padmanabhan, Sandosh and Palmer, Colin N A and Pasterkamp, Gerard and Patel, Aniruddh P and Pattie, Alison and Pedersen, Oluf and Peissig, Peggy L and Peloso, Gina M and Pennell, Craig E and Markus Perola and Perry, James A and Perry, John R B and Person, Thomas N and Pirie, Ailith and Polasek, Ozren and Posthuma, Danielle and Olli T Raitakari and Rasheed, Asif and Rauramaa, Rainer and Reilly, Dermot F and Reiner, Alex P and Renstrom, Frida and Ridker, Paul M and Rioux, John D and Neil R Robertson and Robino, Antonietta and Rolandsson, Olov and Rudan, Igor and Ruth, Katherine S and Saleheen, Danish and Veikko Salomaa and Nilesh J Samani and Sandow, Kevin and Sapkota, Yadav and Sattar, Naveed and Schmidt, Marjanka K and Schreiner, Pamela J and Schulze, Matthias B and Scott, Robert A and Segura-Lepe, Marcelo P and Svati H Shah and Sim, Xueling and Sivapalaratnam, Suthesh and Small, Kerrin S and Albert Vernon Smith and Jennifer A Smith and Southam, Lorraine and Timothy Spector and Elizabeth K Speliotes and John M Starr and Steinthorsdottir, Valgerdur and Heather M Stringham and Stumvoll, Michael and Surendran, Praveen and {\textquoteright}t Hart, Leen M and Tansey, Katherine E and Tardif, Jean-Claude and Kent D Taylor and Teumer, Alexander and Thompson, Deborah J and Thorsteinsdottir, Unnur and Thuesen, Betina H and T{\"o}njes, Anke and Tromp, Gerard and Trompet, Stella and Tsafantakis, Emmanouil and Tuomilehto, Jaakko and Tybjaerg-Hansen, Anne and Tyrer, Jonathan P and Uher, Rudolf and Andr{\'e} G Uitterlinden and Ulivi, Sheila and van der Laan, Sander W and Van Der Leij, Andries R and Cornelia M van Duijn and van Schoor, Natasja M and van Setten, Jessica and Varbo, Anette and Varga, Tibor V and Varma, Rohit and Digna R Velez Edwards and Vermeulen, Sita H and Vestergaard, Henrik and Vitart, Veronique and Vogt, Thomas F and Vozzi, Diego and Walker, Mark and Wang, Feijie and Wang, Carol A and Wang, Shuai and Wang, Yiqin and Wareham, Nicholas J and Warren, Helen R and Wessel, Jennifer and Willems, Sara M and Wilson, James G and Daniel Witte and Woods, Michael O and Wu, Ying and Yaghootkar, Hanieh and Yao, Jie and Yao, Pang and Laura M Yerges-Armstrong and Young, Robin and Zeggini, Eleftheria and Zhan, Xiaowei and Zhang, Weihua and Jing Hua Zhao and Wei Zhao and Wei Zhao and Zheng, He and Zhou, Wei and Rotter, Jerome I and Boehnke, Michael and Kathiresan, Sekar and McCarthy, Mark I and Willer, Cristen J and Stefansson, Kari and Ingrid B Borecki and Liu, Dajiang J and Kari E North and Heard-Costa, Nancy L and Pers, Tune H and Lindgren, Cecilia M and Oxvig, Claus and Kutalik, Zolt{\'a}n and Fernando Rivadeneira and Ruth J F Loos and Timothy M Frayling and Joel N Hirschhron and Deloukas, Panos and Lettre, Guillaume} } @article {12137, title = {Rare variants in fox-1 homolog A (RBFOX1) are associated with lower blood pressure.}, journal = {PLoS Genetics}, volume = {13}, year = {2017}, pages = {e1006678}, abstract = {

Many large genome-wide association studies (GWAS) have identified common blood pressure (BP) variants. However, most of the identified BP variants do not overlap with the linkage evidence observed from family studies. We thus hypothesize that multiple rare variants contribute to the observed linkage evidence. We performed linkage analysis using 517 individuals in 130 European families from the Cleveland Family Study (CFS) who have been genotyped on the Illumina OmniExpress Exome array. The largest linkage peak was observed on chromosome 16p13 (MLOD = 2.81) for systolic blood pressure (SBP). Follow-up conditional linkage and association analyses in the linkage region identified multiple rare, coding variants in RBFOX1 associated with reduced SBP. In a 17-member CFS family, carriers of the missense variant rs149974858 are normotensive despite being obese (average BMI = 60 kg/m2). Gene-based association test of rare variants using SKAT-O showed significant association with SBP (p-value = 0.00403) and DBP (p-value = 0.0258) in the CFS participants and the association was replicated in large independent replication studies (N = 57,234, p-value = 0.013 for SBP, 0.0023 for PP). RBFOX1 is expressed in brain tissues, the atrial appendage and left ventricle in the heart, and in skeletal muscle tissues, organs/tissues which are potentially related to blood pressure. Our study showed that associations of rare variants could be efficiently detected using family information.

}, keywords = {Adult, Blood pressure, Body Mass Index, Chromosomes, Human, Pair 16, Family Health, Female, Gene Expression, Gene Frequency, Genetic Linkage, Genetic Predisposition to Disease, Genome-Wide Association Study, Genotype, Humans, Male, Middle Aged, Pedigree, Polymorphism, Single Nucleotide, RNA Splicing Factors, Whites}, issn = {1553-7404}, doi = {10.1371/journal.pgen.1006678}, author = {He, Karen Y and Wang, Heming and Brian E Cade and Nandakumar, Priyanka and Giri, Ayush and Erin B Ware and Jeffrey Haessler and Liang, Jingjing and Smith, Jennifer A and Franceschini, Nora and Le, Thu H and Charles Kooperberg and Edwards, Todd L and Sharon L R Kardia and Lin, Xihong and Chakravarti, Aravinda and Redline, Susan and Zhu, Xiaofeng} } @article {8816, title = {Receipt of Caregiving and Fall Risk in US Community-dwelling Older Adults.}, journal = {Med Care}, volume = {55}, year = {2017}, month = {2017 04}, pages = {371-378}, abstract = {

BACKGROUND: Falls and fall-related injuries (FRI) are common and costly occurrences among older adults living in the community, with increased risk for those with physical and cognitive limitations. Caregivers provide support for older adults with physical functioning limitations, which are associated with fall risk.

DESIGN: Using the 2004-2012 waves of the Health and Retirement Study, we examined whether receipt of low (0-13 weekly hours) and high levels (>=14 weekly hours) of informal care or any formal care is associated with lower risk of falls and FRIs among community-dwelling older adults. We additionally tested whether serious physical functioning (>=3 activities of daily living) or cognitive limitations moderated this relationship.

RESULTS: Caregiving receipt categories were jointly significant in predicting noninjurious falls (P=0.03) but not FRIs (P=0.30). High levels of informal care category (P=0.001) and formal care (P<0.001) had stronger associations with reduced fall risk relative to low levels of informal care. Among individuals with >=3 activities of daily living, fall risks were reduced by 21\% for those receiving high levels of informal care; additionally, FRIs were reduced by 42\% and 58\% for those receiving high levels of informal care and any formal care. High levels of informal care receipt were also associated with a 54\% FRI risk reduction among the cognitively impaired.

CONCLUSIONS: Fall risk reductions among older adults occurred predominantly among those with significant physical and cognitive limitations. Accordingly, policy efforts involving fall prevention should target populations with increased physical functioning and cognitive limitations. They should also reduce financial barriers to informal and formal caregiving.

}, keywords = {Accidental Falls, Activities of Daily Living, Aged, Aged, 80 and over, Caregivers, Female, Geriatric Assessment, Humans, Independent Living, Longitudinal Studies, Male, Middle Aged, Risk Assessment, Risk Factors, United States}, issn = {1537-1948}, doi = {10.1097/MLR.0000000000000677}, url = {http://content.wkhealth.com/linkback/openurl?sid=WKPTLP:landingpage\&an=00005650-900000000-98801}, author = {Geoffrey J Hoffman and Hays, Ron D and Steven P Wallace and Martin F Shapiro and Yakusheva, Olga and Susan L Ettner} } @article {6454, title = {Reciprocal Effects Between Health and Social Support in Older Adults{\textquoteright} Relationships With Their Children and Friends.}, journal = {Res Aging}, volume = {39}, year = {2017}, month = {2017 Feb}, pages = {300-321}, abstract = {

This study examined the longitudinal reciprocal effects between health and social support in older adults{\textquoteright} relationships with their children and friends. Data are from the 2006 and 2010 waves of the Health and Retirement Study ( N = 3,760). We focused on three specific aspects of social support: frequency of contact, positive interactions, and negative interactions. We used autoregressive cross-lagged models to examine the bidirectional effects between social support and health. When the bidirectional effects between health and social support were simultaneously examined, the longitudinal effect of social support on health was not significant. In contrast, older adults{\textquoteright} poor health was associated with decreased contact and decreased positive interactions with friends as well as with increased negative interactions with their adult children and friends. The findings suggest that older adults{\textquoteright} poor health has a negative impact on their social relationships and that such effect surpasses the impact of social relationships on health.

}, issn = {1552-7573}, doi = {10.1177/0164027515611182}, url = {http://roa.sagepub.com/content/early/2015/10/15/0164027515611182.abstract}, author = {Jung-Hwa Ha and Kahng, Sang Kyoung and Namkee G Choi} } @article {8578, title = {The relationship between family support; pain and depression in elderly with arthritis.}, journal = {Psychol Health Med}, volume = {22}, year = {2017}, month = {2017 01}, pages = {75-86}, abstract = {

The prevalence and chronic nature of arthritis make it the most common cause of disability among U.S.A adults. Family support reduces the negative impact of chronic conditions generally but its role in pain and depression for arthritic conditions is not well understood. A total of 844 males (35.0\%) and 1567 females (65.0\%) with arthritic conditions (n~=~2411) were drawn from the 2012 Health and Retirement Study to examine the effect of family support on pain and depressive symptoms. Using regression analysis and controlling for age, ethnicity, gender, marital/educational status and employment/income, physical function/disability status, pain and antidepressant medications, and other clinical indicators of chronic health conditions, we examined the effects of family support (spouse, children, other) on pain and depression levels. Results indicated that depressive symptoms decreased significantly with strong family and spousal support (p~<~.05). Pain decreased as support levels increased, but was non-statistically significant. This study provides new insights into the relationship between family support, pain, and depression for individuals with arthritis. Future longitudinal studies are needed to evaluate family support and relationships over a wider spectrum of demographics.

}, keywords = {Aged, Aged, 80 and over, Aging, Arthralgia, Arthritis, depression, Family, Female, Humans, Male, Middle Aged, Social Support, United States}, issn = {1465-3966}, doi = {10.1080/13548506.2016.1211293}, url = {https://www.ncbi.nlm.nih.gov/pubmed/27427504}, author = {Hung, Man and Bounsanga, Jerry and Maren W Voss and Anthony B. Crum and Wei Chen and Wendy Church Birmingham} } @article {9175, title = {The relationship of health insurance and mortality: Is lack of insurance deadly?}, journal = {Annals of Internal Medicine}, year = {2017}, month = {Mar-06-2019}, abstract = {About 28 million Americans are currently uninsured, and millions more could lose coverage under policy reforms proposed in Congress. At the same time, a growing number of policy leaders have called for going beyond the Affordable Care Act to a single-payer national health insurance system that would cover every American. These policy debates lend particular salience to studies evaluating the health effects of insurance coverage. In 2002, an Institute of Medicine review concluded that lack of insurance increases mortality, but several relevant studies have appeared since that time. This article summarizes current evidence concerning the relationship of insurance and mortality. The evidence strengthens confidence in the Institute of Medicine{\textquoteright}s conclusion that health insurance saves lives: The odds of dying among the insured relative to the uninsured is 0.71 to 0.97.}, keywords = {Medicare/Medicaid/Health Insurance, Mortality}, issn = {0003-4819}, doi = {10.7326/M17-1403}, url = {http://annals.org/article.aspx?doi=10.7326/M17-1403}, author = {Woolhandler, Steffie and Himmelstein, David U.} } @article {8905, title = {The Relationship of Obesity to Hospice Use and Expenditures: A Cohort Study.}, journal = {Annals of Internal Medicine}, year = {2017}, month = {2017 Feb 07}, abstract = {

Background: Obesity complicates medical, nursing, and informal care in severe illness, but its effect on hospice use and Medicare expenditures is unknown.

Objective: To describe the associations between body mass index (BMI) and hospice use and Medicare expenditures in the last 6 months of life.

Design: Retrospective cohort.

Setting: The HRS (Health and Retirement Study).

Participants: 5677 community-dwelling Medicare fee-for-service beneficiaries who died between 1998 and 2012.

Measurements: Hospice enrollment, days enrolled in hospice, in-home death, and total Medicare expenditures in the 6 months before death. BMI was modeled as a continuous variable with a quadratic functional form.

Results: For decedents with BMI of 20 kg/m2, the predicted probability of hospice enrollment was 38.3\% (95\% CI, 36.5\% to 40.2\%), hospice duration was 42.8 days (CI, 42.3 to 43.2 days), probability of in-home death was 61.3\% (CI, 59.4\% to 63.2\%), and total Medicare expenditures were $42~803 (CI, $41~085 to $44~521). When BMI increased to 30 kg/m2, the predicted probability of hospice enrollment decreased by 6.7 percentage points (CI, -9.3 to -4.0 percentage points), hospice duration decreased by 3.8 days (CI, -4.4 to -3.1 days), probability of in-home death decreased by 3.2 percentage points (CI, -6.0 to -0.4 percentage points), and total Medicare expenditures increased by $3471 (CI, $955 to $5988). For morbidly obese decedents (BMI >=40 kg/m2), the predicted probability of hospice enrollment decreased by 15.2 percentage points (CI, -19.6 to -10.9 percentage points), hospice duration decreased by 4.3 days (CI, -5.7 to -2.9 days), and in-home death decreased by 6.3 percentage points (CI, -11.2 to -1.5 percentage points) versus decedents with BMI of 20 kg/m2.

Limitation: Baseline data were self-reported, and the interval between reported BMI and time of death varied.

Conclusion: Among community-dwelling decedents in the HRS, increasing obesity was associated with reduced hospice use and in-home death and higher Medicare expenditures in the last 6 months of life.

Primary Funding Source: Robert Wood Johnson Foundation Clinical Scholars Program.

}, keywords = {Hospice, Medicare/Medicaid/Health Insurance, Obesity, Older Adults}, issn = {1539-3704}, doi = {10.7326/M16-0749}, author = {Tamara B Harris and Byhoff, Elena and Chithra R Perumalswami and Kenneth M. Langa and Alexi A Wright and Jennifer J Griggs} } @article {9427, title = {Religion, a social determinant of mortality? A 10-year follow-up of the Health and Retirement Study}, journal = {PLOS ONE}, volume = {12}, year = {2017}, pages = {e0189134}, abstract = {The social determinants of health framework has brought a recognition of the primary importance of social forces in determining population health. Research using this framework to understand the health and mortality impact of social, economic, and political conditions, however, has rarely included religious institutions and ties. We investigate a well-measured set of social and economic determinants along with several measures of religious participation as predictors of adult mortality. Respondents (N = 18,370) aged 50 and older to the Health and Retirement Study were interviewed in 2004 and followed for all-cause mortality to 2014. Exposure variables were religious attendance, importance, and affiliation. Other social determinants of health included gender, race/ethnicity, education, household income, and net worth measured at baseline. Confounders included physical and mental health. Health behaviors and social ties were included as potential explanatory variables. Cox proportional hazards regressions were adjusted for complex sample design. After adjustment for confounders, attendance at religious services had a dose-response relationship with mortality, such that respondents who attended frequently had a 40\% lower hazard of mortality (HR = 0.60, 95\% CI 0.53{\textendash}0.68) compared with those who never attended. Those for whom religion was {\textquotedblleft}very important{\textquotedblright} had a 4\% higher hazard (HR = 1.04, 95\% CI 1.01{\textendash}1.07); religious affiliation was not associated with risk of mortality. Higher income and net worth were associated with a reduced hazard of mortality as were female gender, Latino ethnicity, and native birth. Religious participation is multi-faceted and shows both lower and higher hazards of mortality in an adult US sample in the context of a comprehensive set of other social and economic determinants of health.}, keywords = {Gender Differences, Mortality, Racial/ethnic differences, Religion}, doi = {10.1371/journal.pone.0189134}, author = {Idler, Ellen and Blevins, John and Kiser, Mimi and Hogue, Carol}, editor = {Anglewicz, Philip} } @article {9312, title = {Retiring (Again and Again) in America}, journal = {Bloomberg Businessweek}, year = {2017}, month = {10/2017}, keywords = {Bridge employment, Employment and Labor Force, Retirement Planning and Satisfaction}, url = {https://www.bloomberg.com/news/articles/2017-09-28/retiring-again-and-again-in-america}, author = {Hymowitz, Carol} } @article {9236, title = {Reverse Mortgage Motivations and Outcomes: Insights From Survey Data}, journal = {Cityscape}, volume = {19}, year = {2017}, pages = {73-97}, abstract = {The primary goal of this article is to inform assumptions used by researchers and policy-makers to model the demand for and takeup of reverse mortgages. Our article describes the characteristics of more than 1,700 households that sought counseling for a reverse mortgage between 2006 and 2011; of those households, 74 percent obtained a reverse mortgage. Using data collected at the time of counseling and also followup survey data collected in 2014, we summarize self-reported motivations for seeking a reverse mortgage, including reasons for not getting a reverse mortgage, if applicable. We also compare the characteristics of households that seek reverse mortgages with the general population of senior homeowners using the 2008, 2010, and 2014 waves of the Health and Retirement Study. A final goal of the article is to compare selected outcomes of reverse mortgage borrowers with outcomes in the general population of senior homeowners}, keywords = {Housing, Mortgages}, issn = {1936-007X}, url = {https://www.huduser.gov/portal/periodicals/cityscpe/vol19num1/article4.html}, author = {Stephanie Moulton and C{\"a}zilia Loibl and Donald Haurin} } @article {9042, title = {Sample Sizes and Response Rates}, year = {2017}, month = {04/2017}, institution = {Survey Research Center, Institute for Social Research, University of Michigan}, address = {Ann Arbor, MI}, author = {HRS Staff} } @article {12120, title = {Single-trait and multi-trait genome-wide association analyses identify novel loci for blood pressure in African-ancestry populations.}, journal = {PLoS Genetics}, volume = {13}, year = {2017}, pages = {e1006728}, abstract = {

Hypertension is a leading cause of global disease, mortality, and disability. While individuals of African descent suffer a disproportionate burden of hypertension and its complications, they have been underrepresented in genetic studies. To identify novel susceptibility loci for blood pressure and hypertension in people of African ancestry, we performed both single and multiple-trait genome-wide association analyses. We analyzed 21 genome-wide association studies comprised of 31,968 individuals of African ancestry, and validated our results with additional 54,395 individuals from multi-ethnic studies. These analyses identified nine loci with eleven independent variants which reached genome-wide significance (P < 1.25{\texttimes}10-8) for either systolic and diastolic blood pressure, hypertension, or for combined traits. Single-trait analyses identified two loci (TARID/TCF21 and LLPH/TMBIM4) and multiple-trait analyses identified one novel locus (FRMD3) for blood pressure. At these three loci, as well as at GRP20/CDH17, associated variants had alleles common only in African-ancestry populations. Functional annotation showed enrichment for genes expressed in immune and kidney cells, as well as in heart and vascular cells/tissues. Experiments driven by these findings and using angiotensin-II induced hypertension in mice showed altered kidney mRNA expression of six genes, suggesting their potential role in hypertension. Our study provides new evidence for genes related to hypertension susceptibility, and the need to study African-ancestry populations in order to identify biologic factors contributing to hypertension.

}, keywords = {African Americans, Animals, Basic Helix-Loop-Helix Transcription Factors, Blood pressure, Cadherins, Case-Control Studies, Female, Genetic Loci, Genome-Wide Association Study, Humans, Hypertension, Male, Membrane Proteins, Mice, Multifactorial Inheritance, Polymorphism, Single Nucleotide}, issn = {1553-7404}, doi = {10.1371/journal.pgen.1006728}, author = {Liang, Jingjing and Le, Thu H and Digna R Velez Edwards and Bamidele O Tayo and Gaulton, Kyle J and Smith, Jennifer A and Lu, Yingchang and Jensen, Richard A and Chen, Guanjie and Yanek, Lisa R and Schwander, Karen and Tajuddin, Salman M and Sofer, Tamar and Kim, Wonji and Kayima, James and McKenzie, Colin A and Fox, Ervin and Michael A Nalls and Young, J Hunter and Yan V Sun and Lane, Jacqueline M and Cechova, Sylvia and Zhou, Jie and Tang, Hua and Myriam Fornage and Musani, Solomon K and Wang, Heming and Lee, Juyoung and Adeyemo, Adebowale and Dreisbach, Albert W and Forrester, Terrence and Chu, Pei-Lun and Anne Cappola and Michele K Evans and Alanna C Morrison and Martin, Lisa W and Kerri Wiggins and Hui, Qin and Zhao, Wei and Jackson, Rebecca D and Erin B Ware and Jessica Faul and Reiner, Alex P and Bray, Michael and Denny, Joshua C and Thomas H Mosley and Walter R Palmas and Guo, Xiuqing and George J Papanicolaou and Alan Penman and Polak, Joseph F and Kenneth Rice and Taylor, Ken D and Boerwinkle, Eric and Erwin P Bottinger and Liu, Kiang and Neil Risch and Hunt, Steven C and Charles Kooperberg and Alan B Zonderman and Laurie, Cathy C and Becker, Diane M and Cai, Jianwen and Ruth J F Loos and Psaty, Bruce M and David R Weir and Sharon L R Kardia and Donna K Arnett and Won, Sungho and Edwards, Todd L and Redline, Susan and Cooper, Richard S and Rao, D C and Rotter, Jerome I and Charles N Rotimi and Levy, Daniel and Chakravarti, Aravinda and Zhu, Xiaofeng and Franceschini, Nora} } @article {6491, title = {Social Activities, Incident Cardiovascular Disease, and Mortality.}, journal = {J Aging Health}, volume = {29}, year = {2017}, month = {2017 Mar}, pages = {268-288}, abstract = {

OBJECTIVE: This study examined the relationships between social activities, incident cardiovascular disease (CVD), and non-CVD mortality among older adults in the United States.

METHOD: Data from the Health and Retirement Study (2006-2010) were employed. Two measures of social engagement, volunteering and informal helping, along with two measures of social participation, attendance at religious services and social group meetings, were included. Mediation models for health behaviors were estimated.

RESULTS: Multinomial logistic regression models demonstrated that volunteering provided the most consistent results in terms of a lower risk of incident CVD and mortality. Furthermore, volunteering at higher time commitments is related to lower CVD incidence and death; informally helping others at a modest time commitment is related to lower risk of death only. Health behaviors mediated the relationships. Social participation was not related to either CVD or mortality.

DISCUSSION: Social activity is a modifiable behavior that may be considered a potential health intervention.

}, keywords = {Aged, Aged, 80 and over, Cardiovascular Diseases, Female, Humans, Incidence, Leisure activities, Logistic Models, Male, Middle Aged, Retirement, United States}, issn = {1552-6887}, doi = {10.1177/0898264316635565}, url = {http://jah.sagepub.com/content/early/2016/03/03/0898264316635565.abstract}, author = {Sae Hwang Han and Jane Tavares and Evans, Molly and Jane S Saczynski and Jeffrey A Burr} } @article {9335, title = {Social Isolation and Medicare Spending: Among Older Adults, Objective Isolation Increases Expenditures While Loneliness Does Not}, journal = {Journal of Aging and Health}, volume = {29}, year = {2017}, pages = {1119-1143}, abstract = {Objective: The purpose of this study was to evaluate the impact of objective isolation and loneliness on Medicare spending and outcomes. Method: We linked Health and Retirement Study data to Medicare claims to analyze objective isolation (scaled composite of social contacts and network) and loneliness (positive response to three-item loneliness scale) as predictors of subsequent Medicare spending. In multivariable regression adjusting for health and demographics, we determined marginal differences in Medicare expenditures. Secondary outcomes included spending by setting, and mortality. Results: Objective isolation predicts greater spending, US$1,644 (p <.001) per beneficiary annually, whereas loneliness predicts reduced spending, {\textquoteright}US$768 (p <.001). Increased spending concentrated in inpatient and nursing home (skilled nursing facilities [SNFs]) care; despite more health care, objectively isolated beneficiaries had 31\% (p <.001) greater risk of death. Loneliness did not predict SNF use or mortality, but predicted slightly less inpatient and outpatient care. Discussion: Objectively isolated seniors have higher Medicare spending, driven by increased hospitalization and institutionalization, and face greater mortality. Policies supporting social connectedness could reap significant savings. }, keywords = {Depressive symptoms, Isolation, Loneliness, Medicare expenditures, Medicare linkage, Medicare/Medicaid/Health Insurance, Social Support}, issn = {0898-2643}, doi = {10.1177/0898264317703559}, url = {http://journals.sagepub.com/doi/10.1177/0898264317703559http://journals.sagepub.com/doi/pdf/10.1177/0898264317703559}, author = {Jonathan G Shaw and Farid, Monica and Claire No{\"e}l-Miller and Joseph, Neesha and Houser, Ari and Steven Asch and Bhattacharya, Jay and Flowers, Lynda} } @article {12133, title = {SOS2 and ACP1 Loci Identified through Large-Scale Exome Chip Analysis Regulate Kidney Development and Function.}, journal = {Journal of the American Society of Nephrology }, volume = {28}, year = {2017}, pages = {981-994}, abstract = {

Genome-wide association studies have identified >50 common variants associated with kidney function, but these variants do not fully explain the variation in eGFR. We performed a two-stage meta-analysis of associations between genotypes from the Illumina exome array and eGFR on the basis of serum creatinine (eGFRcrea) among participants of European ancestry from the CKDGen Consortium (: 111,666; : 48,343). In single-variant analyses, we identified single nucleotide polymorphisms at seven new loci associated with eGFRcrea (, , and ; <3.7{\texttimes}10), of which most were common and annotated as nonsynonymous variants. Gene-based analysis identified associations of functional rare variants in three genes with eGFRcrea, including a novel association with the SOS Ras/Rho guanine nucleotide exchange factor 2 gene, (=5.4{\texttimes}10 by sequence kernel association test). Experimental follow-up in zebrafish embryos revealed changes in glomerular gene expression and renal tubule morphology in the embryonic kidney of and -knockdowns. These developmental abnormalities associated with altered blood clearance rate and heightened prevalence of edema. This study expands the number of loci associated with kidney function and identifies novel genes with potential roles in kidney formation.

}, keywords = {Animals, Exome, Genetic Loci, Genome-Wide Association Study, Glomerular Filtration Rate, Humans, kidney, Protein Tyrosine Phosphatases, Proto-Oncogene Proteins, Son of Sevenless Proteins, Zebrafish}, issn = {1533-3450}, doi = {10.1681/ASN.2016020131}, author = {Li, Man and Li, Yong and Weeks, Olivia and Mijatovic, Vladan and Teumer, Alexander and Huffman, Jennifer E and Tromp, Gerard and Fuchsberger, Christian and Gorski, Mathias and Lyytik{\"a}inen, Leo-Pekka and Nutile, Teresa and Sedaghat, Sanaz and Sorice, Rossella and Tin, Adrienne and Yang, Qiong and Ahluwalia, Tarunveer S and Dan E Arking and Bihlmeyer, Nathan A and B{\"o}ger, Carsten A and Carroll, Robert J and Daniel I Chasman and Marilyn C Cornelis and Dehghan, Abbas and Jessica Faul and Feitosa, Mary F and Gambaro, Giovanni and Paolo P. Gasparini and Giulianini, Franco and Iris M Heid and Huang, Jinyan and Imboden, Medea and Jackson, Anne U and Janina Jeff and Jhun, Min A and Katz, Ronit and Kifley, Annette and Kilpel{\"a}inen, Tuomas O and Kumar, Ashish and Laakso, Markku and Li-Gao, Ruifang and Kurt Lohman and Lu, Yingchang and M{\"a}gi, Reedik and Malerba, Giovanni and Mihailov, Evelin and Mohlke, Karen L and Dennis O Mook-Kanamori and Robino, Antonietta and Ruderfer, Douglas and Salvi, Erika and Schick, Ursula M and Schulz, Christina-Alexandra and Smith, Albert V and Smith, Jennifer A and Traglia, Michela and Laura M Yerges-Armstrong and Zhao, Wei and Goodarzi, Mark O and Kraja, Aldi T and Liu, Chunyu and Wessel, Jennifer and Boerwinkle, Eric and Ingrid B Borecki and Bork-Jensen, Jette and Erwin P Bottinger and Braga, Daniele and Brandslund, Ivan and Brody, Jennifer A and Campbell, Archie and Carey, David J and Cramer Christensen and Coresh, Josef and Crook, Errol and Curhan, Gary C and Cusi, Daniele and de Boer, Ian H and de Vries, Aiko P J and Denny, Joshua C and Devuyst, Olivier and Dreisbach, Albert W and Endlich, Karlhans and T{\~o}nu Esko and Franco, Oscar H and Fulop, Tibor and Gerhard, Glenn S and Gl{\"u}mer, Charlotte and Gottesman, Omri and Grarup, Niels and Gudnason, Vilmundur and Hansen, Torben and Tamara B Harris and Caroline Hayward and Lynne J Hocking and Hofman, Albert and Hu, Frank B and Husemoen, Lise Lotte N and Jackson, Rebecca D and J{\o}rgensen, Torben and J{\o}rgensen, Marit E and K{\"a}h{\"o}nen, Mika and Sharon L R Kardia and K{\"o}nig, Wolfgang and Charles Kooperberg and Kriebel, Jennifer and Lenore J Launer and Lauritzen, Torsten and Lehtim{\"a}ki, Terho and Levy, Daniel and Linksted, Pamela and Linneberg, Allan and Liu, Yongmei and Ruth J F Loos and Lupo, Antonio and Meisinger, Christine and Melander, Olle and Andres Metspalu and Mitchell, Paul and Nauck, Matthias and N{\"u}rnberg, Peter and Orho-Melander, Marju and Parsa, Afshin and Pedersen, Oluf and Peters, Annette and Peters, Ulrike and Polasek, Ozren and David J Porteous and Nicole M Probst-Hensch and Psaty, Bruce M and Qi, Lu and Olli T Raitakari and Reiner, Alex P and Rettig, Rainer and Ridker, Paul M and Fernando Rivadeneira and Rossouw, Jacques E and Schmidt, Frank and David S Siscovick and Soranzo, Nicole and Strauch, Konstantin and Toniolo, Daniela and Stephen T Turner and Andr{\'e} G Uitterlinden and Ulivi, Sheila and Velayutham, Dinesh and V{\"o}lker, Uwe and V{\"o}lzke, Henry and Waldenberger, Melanie and Wang, Jie Jin and David R Weir and Daniel Witte and Kuivaniemi, Helena and Caroline S Fox and Franceschini, Nora and Goessling, Wolfram and K{\"o}ttgen, Anna and Chu, Audrey Y} } @article {9071, title = {Stimulus Effects of Investment Tax Incentives: Production versus Purchases}, number = {No. 23391}, year = {2017}, institution = {National Bureau of Economic Research}, address = {Cambridge, MA}, abstract = {The distinction between production and purchases of investment goods is essential for quantifying the response to changes in investment tax incentives. If investment goods are tradeable, a large fraction of the demand from changes in tax subsidies will be met from abroad. This difference between production and purchases implies that investment tax incentives will lead to more capital accumulation, but less stimulus to economic activity relative to a no-trade counterfactual. Domestic capacity to produce investment goods is less than perfectly elastic because of quasi-fixed factors of production, adjustment costs, and specialization of labor. This paper builds these features into a DGSE model where key parameters are estimated to match the reduced-form response of investment production and purchases to tax incentives. Typical investment tax policies result in equipment purchases that are split roughly half between domestic and foreign production of equipment.}, keywords = {Economics, Stimulus effects, Taxes}, doi = {10.3386/w23391}, url = {http://www.nber.org/papers/w23391.pdf}, author = {Christopher L House and Mocanu, Ana Maria and Matthew D. Shapiro} } @article {9323, title = {Taking Your Grandparents to Museums Could Improve Their Health}, journal = {Artsy}, year = {2017}, type = {Editorial}, keywords = {Editorial, Health Conditions and Status, News}, url = {https://www.artsy.net/article/artsy-editorial-grandparents-museums-improve-health}, author = {Herzig, Ilana} } @article {9223, title = {USDA Food Access Information All Respondents 1992-2014}, year = {2017}, month = {07/2017}, institution = {Health and Retirement Study, Survey Research Center, Institute for Social Research}, address = {Ann Arbor, MI}, keywords = {Meta-analyses, User guide}, author = {HRS Staff} } @article {9225, title = {What{\textquoteright}s the secret to a long life?}, journal = {The Bulletin}, year = {2017}, month = {07/28/2017}, chapter = {Home/Health}, address = {Bend, OR}, keywords = {Alcohol Consumption, News, Obesity, Risk Factors}, url = {http://www.bendbulletin.com/health/5460302-151/whats-the-secret-to-a-long-life}, author = {Markian Hawryluk} } @article {10776, title = {Why Are U.S. Households Claiming Social Security Later?}, number = {WP$\#$2017-3}, year = {2017}, institution = {Center for Retirement Research at Boston College}, abstract = {Over the past two decades, the share of individuals claiming Social Security at the Early Eligibility Age has dropped, and the average retirement age has increased. At the same time, Social Security rules have changed substantially, employer-sponsored retirement plans have shifted from defined benefit (DB) to defined contribution (DC), health has improved, and mortality has decreased. In theory, all of these changes could lead to a trend toward later claiming. Disentangling the effect of any one change is difficult because they have been occurring simultaneously. This paper uses the Gustman and Steinmeier structural model of retirement timing to investigate which of these changes matter most by simulating their effects on the original cohort (1931-1941 birth years) of the Health and Retirement Study (HRS). The predicted behavior is then compared to the actual retirements of the Early Baby Boomer cohort (1948-1953 birth years) to see how much of the later cohort{\textquoteright}s delayed claiming and retirement can be explained by these changes.}, keywords = {Social Security, Social Security Benefits}, url = {https://crr.bc.edu/working-papers/why-are-u-s-households-claiming-social-security-later/}, author = {Wenliang Hou and Alicia H. Munnell and Yinji Li and Geoffrey T. Sanzenbacher} } @conference {9104, title = {Air pollution and cognitive performances}, booktitle = {Environmental and Natural Resources Conservation: Theoretical and Empirical Issues}, year = {2016}, address = {Montpellier, France}, keywords = {Climate, Cognitive Ability, Pollution, Restricted data}, author = {Anthony Heyes and Alexandre Sauquet} } @article {8521, title = {Alternate Wave Question Cross-Reference Table}, year = {2016}, month = {2016}, publisher = {Health and Retirement Study}, address = {Ann Arbor}, keywords = {Cancer screenings, Income, Jobs, Survey Methodology}, url = {http://hrsonline.isr.umich.edu/sitedocs/XrefAlternateWaveQs2014.pdf} } @article {6514, title = {Changes in Visual Function in the Elderly Population in the United States: 1995-2010.}, journal = {Ophthalmic Epidemiol}, volume = {23}, year = {2016}, month = {2016 Jun}, pages = {137-44}, chapter = {1}, abstract = {

PURPOSE: To document recent trends in visual function among the United States population aged 70+ years and investigate how the trends can be explained by inter-temporal changes in: (1) population sociodemographic characteristics, and chronic disease prevalence, including eye diseases (compositional changes); and (2) effects of the above factors on visual function (structural changes).

METHODS: Data from the 1995 Asset and Health Dynamics among the Oldest Old (AHEAD) and the 2010 Health and Retirement Study (HRS) were merged with Medicare Part B claims in the interview years and the 2 previous years. Decomposition analysis was performed. Respondents from both studies were aged 70+ years. The outcome measure was respondent self-reported visual function on a 6-point scale (from 6 = blind to 1 = excellent).

RESULTS: Overall, visual function improved from slightly worse than good (3.14) in 1995 to slightly better than good (2.98) in 2010. A decline in adverse effects of aging on vision was found. Among the compositional changes were higher educational attainment leading to improved vision, and higher prevalence of such diseases as diabetes mellitus, which tended to lower visual function. However, compared to compositional changes, structural changes were far more important, including decreased adverse effects of aging, diabetes mellitus (when not controlling for eye diseases), and diagnosed glaucoma.

CONCLUSION: Although the US population has aged and is expected to age further, visual function improved among elderly persons, especially among persons 80+ years, likely reflecting a favorable role of structural changes identified in this study in mitigating the adverse effect of ongoing aging on vision.

}, keywords = {Age Factors, Aged, Aged, 80 and over, Aging, Chronic disease, Cross-Sectional Studies, Female, Humans, Male, Medicare Part B, Prevalence, Self Report, Socioeconomic factors, United States, Visual Acuity, Visually Impaired Persons}, issn = {1744-5086}, doi = {10.3109/09286586.2015.1057603}, url = {http://dx.doi.org/10.3109/09286586.2015.1057603}, author = {Chen, Yiqun and Hahn, Paul and Frank A Sloan} } @article {8749, title = {Characteristics of Decedents in Medicare Advantage and Traditional Medicare}, journal = {JAMA Internal Medicine}, volume = {176}, year = {2016}, month = {Jan-07-2016}, pages = {1020}, abstract = {Approximately 25\% of all Medicare expenditures are for care received in the last year of life.1 Much research has been done to understand cost and utilization patterns for Medicare beneficiaries at the end of life (EOL).2 However, when assessing EOL costs, most studies focus on decedents with traditional fee-for-service (FFS) Medicare owing to the lack of cost and utilization data for the 30\% of Medicare beneficiaries in Medicare Advantage (MA) plans.3 This gap is a cause for concern because utilization and quality of care may differ between MA and FFS beneficiaries.4- 6 We sought to examine differences in characteristics of decedents in MA and FFS Medicare based on detailed survey data. Methods The Health and Retirement Study (HRS) is a biennial longitudinal survey of a nationally representative cohort of US adults 51 years or older that measures a broad range of questions about health and aging. Between interview cycles, the HRS identifies participants who have died using information from family members and the National Death Index. We included decedents 65 years or older who died between the 1998 and 2012 survey waves and who authorized their HRS responses to be linked to Medicare data. We compared demographic, health, and functional and cognitive characteristics of all HRS decedents enrolled in Medicare FFS and MA plans using χ2 and t test. We performed multivariable ordinal regressions to determine if demographic differences between the Medicare groups explained differences in health, functional, and cognitive status. We used multiple imputation for missing data. The study was exempt from institutional review board approval because the data looked only at decedents. There were no significant differences in results of multivariable analyses using imputed or nonimputed variables (Table 1). Results Of the 9385 decedents included in our analysis, 2280 (24.3\%) were continuously enrolled in MA plans for the last 6 months of life and 7105 (75.7\%) were continuously enrolled in Medicare FFS. The FFS beneficiaries were significantly older than MA beneficiaries at the time of death, and the 2 groups differed with respect to marital status, race, net worth, and educational attainment (Table 1). The MA decedents were less likely to have supplemental insurance compared with FFS decedents, including Medicaid or private insurance. The MA decedents were more likely to be living in urban areas and in the Northeast or West, whereas FFS decedents resided commonly in the Midwest and South. The MA and FFS decedents did not differ in having an advance directive or having discussed their EOL treatment preferences with their health care proxy. At their last survey before death, FFS beneficiaries were more likely than MA beneficiaries to rate their health as {\textquotedblleft}poor,{\textquotedblright} to have limitations in activities of daily living (ADL) and instrumental activities of daily living (IADL), and to have dementia. After adjusting for demographic differences between FFS and MA decedents in our sample, differences between FFS and MA decedents in self-rated health, functional limitations, and cognitive status remained significant (Table 2). Discussion The FFS beneficiaries were sicker than MA beneficiaries during the last year of life, with worse functional status, higher rates of dementia, and poorer self-rated health. These are important considerations because policymakers and researchers consider patient-specific factors related to high EOL costs in the Medicare population. Because MA beneficiaries are, on average, younger and more independent at the EOL, their health care utilization and costs may differ from those enrolled in FFS. Prior research6 shows that MA beneficiaries have lower inpatient and Emergency Department utilization at the EOL, and increased hospice enrollment compared with FFS beneficiaries. This pattern may arise from improved EOL management by MA plans but could also reflect a less chronically impaired population, with fewer acute care needs at the EOL owing to better social support and functional and cognitive status.}, keywords = {Health Conditions and Status, Medicare/Medicaid/Health Insurance, Older Adults}, issn = {2168-6106}, doi = {10.1001/jamainternmed.2016.2266}, url = {http://archinte.jamanetwork.com/article.aspx?doi=10.1001/jamainternmed.2016.2266}, author = {Byhoff, Elena and Tamara B Harris and John Z. Ayanian} } @article {8485, title = {Claims-based Identification Methods and the Cost of Fall-related Injuries Among US Older Adults.}, journal = {Med Care}, volume = {54}, year = {2016}, month = {2016 07}, pages = {664-71}, abstract = {

OBJECTIVES: Compare expenditures of fall-related injuries (FRIs) using several methods to identify FRIs in administrative claims data.

RESEARCH DESIGN: Using 2007-2009 Medicare claims and 2008 Health and Retirement Survey data, FRIs were identified using external-cause-of-injury (e-codes 880/881/882/884/885/888) only, e-codes plus a broad set of primary diagnosis codes, and a newer approach using e-codes and diagnostic and procedural codes. Linear regression models adjusted for sociodemographic, health, and geographic characteristics were used to estimate per-FRI, service component, patient cost share, expenditures by type of initial FRI treatment (inpatient, emergency department only, outpatient), and total annual FRI-related Medicare expenditures.

SUBJECTS: The analysis included 5497 community-dwelling adults >=65 (228 FRI, 5269 non-FRI individuals) with continuous Medicare coverage and alive during the 24-month study.

RESULTS: The 3 FRI identification methods produced differing distributions of index FRI type and varying estimated expenditures: $12,171 [95\% confidence interval (CI), $4662-$19,680], $5648 (95\% CI, $3819-$7476), and $9388 (95\% CI, $5969-$12,808). In all models, most spending occurred in hospital, outpatient, and skilled nursing facility (SNF) settings, but greater proportions of SNF and outpatient spending were observed with commonly used FRI identification methods. Patient cost-sharing was estimated at $691-$1900 across the 3 methods. Inpatient-treated index FRIs were more expensive than emergency department and outpatient-treated FRIs across all methods, but were substantially higher when identifying FRI using only e-codes. Estimated total FRI-related Medicare expenditures were highly variable across methods.

CONCLUSIONS: FRIs are costly, with implications for Medicare and its beneficiaries. However, expenditure estimates vary considerably based on the method used to identify FRIs.

}, keywords = {Accidental Falls, Aged, Aged, 80 and over, Cross-Over Studies, Female, Humans, Insurance Claim Review, Male, Medicare, United States, Wounds and Injuries}, issn = {1537-1948}, doi = {10.1097/MLR.0000000000000531}, url = {http://www.ncbi.nlm.nih.gov/pubmed/27057747}, author = {Geoffrey J Hoffman and Hays, Ron D and Martin F Shapiro and Steven P Wallace and Susan L Ettner} } @article {8536, title = {Cognitive Ability and Post-Retirement Asset Decumulation}, journal = {Journal of Family and Economic Issues}, volume = {37}, year = {2016}, month = {Jan-06-2016}, pages = {242 - 253}, abstract = {Post-retirement asset decumulation decisions are complex and may be affected by cognitive abilities. Estimating uncertainties such as life expectancy and medical costs, and incorporating them effectively into decumulation decisions may be especially difficult as retirees face age-related changes in cognition. This may result in rates of decumulation that are contradictory to the goals that motivated accumulation, leading to potentially large utility losses. We investigated the relevance of cognitive ability to asset decumulation decisions within our sample. We found that cognitive ability was a significant predictor of the rate of asset decumulation, and that those with lower levels of cognitive ability were decumulating at a significantly lower rate. We also showed that the level of cognitive ability influenced the effects of expected longevity, market returns, and medical costs. While the estimates for these factors were consistent between those with high and low cognitive ability, there were significant differences in how the estimates were incorporated into the asset decumulation decisions of the two groups.}, keywords = {Cognitive Ability, Consumption and Savings, Retirement Planning and Satisfaction}, issn = {1058-0476}, doi = {10.1007/s10834-015-9453-4}, url = {http://link.springer.com/10.1007/s10834-015-9453-4http://link.springer.com/content/pdf/10.1007/s10834-015-9453-4http://link.springer.com/content/pdf/10.1007/s10834-015-9453-4.pdfhttp://link.springer.com/article/10.1007/s10834-015-9453-4/fulltext.html}, author = {Chris Browning and Huston, Sandra and Michael S. Finke} } @article {8682, title = {A Comparison of Educational Differences on Physical Health, Mortality, and Healthy Life Expectancy in Japan and the United States.}, journal = {J Aging Health}, volume = {28}, year = {2016}, month = {2016 10}, pages = {1256-78}, abstract = {

OBJECTIVE: This study examined the educational gradient of health and mortality between two long-lived populations: Japan and the United States.

METHOD: This analysis is based on the Nihon University Japanese Longitudinal Study of Aging and the Health and Retirement Study to compare educational gradients in multiple aspects of population health-life expectancy with/without disability, functional limitations, or chronic diseases, using prevalence-based Sullivan life tables.

RESULTS: Our results show that education coefficients from physical health and mortality models are similar for both Japan and American populations, and older Japanese have better mortality and health profiles.

DISCUSSION: Japan{\textquoteright}s compulsory national health service system since April 1961 and living arrangements with adult children may play an important role for its superior health profile compared with that of the United States.

}, keywords = {Activities of Daily Living, Age Distribution, Aged, Cause of Death, Cross-Cultural Comparison, Educational Status, Employment, Family Characteristics, Female, Health Status, Health Surveys, Healthy Lifestyle, Humans, Japan, Life Expectancy, Life Tables, Longitudinal Studies, Male, Middle Aged, Regression Analysis, Retirement, Sex Distribution, United States}, issn = {1552-6887}, doi = {10.1177/0898264316656505}, author = {Chi-Tsun Chiu and Mark D Hayward and Saito, Yasuhiko} } @article {8537, title = {Correlates and predictors of loneliness in older-adults: a review of quantitative results informed by qualitative insights.}, journal = {Int Psychogeriatr}, volume = {28}, year = {2016}, month = {2016 Apr}, pages = {557-76}, abstract = {

BACKGROUND: Older persons are particularly vulnerable to loneliness because of common age-related changes and losses. This paper reviews predictors of loneliness in the older population as described in the current literature and a small qualitative study.

METHODS: Peer-reviewed journal articles were identified from psycINFO, MEDLINE, and Google Scholar from 2000-2012. Overall, 38 articles were reviewed. Two focus groups were conducted asking older participants about the causes of loneliness.

RESULTS: Variables significantly associated with loneliness in older adults were: female gender, non-married status, older age, poor income, lower educational level, living alone, low quality of social relationships, poor self-reported health, and poor functional status. Psychological attributes associated with loneliness included poor mental health, low self-efficacy beliefs, negative life events, and cognitive deficits. These associations were mainly studied in cross-sectional studies. In the focus groups, participants mentioned environmental barriers, unsafe neighborhoods, migration patterns, inaccessible housing, and inadequate resources for socializing. Other issues raised in the focus groups were the relationship between loneliness and boredom and inactivity, the role of recent losses of family and friends, as well as mental health issues, such as shame and fear.

CONCLUSIONS: Future quantitative studies are needed to examine the impact of physical and social environments on loneliness in this population. It is important to better map the multiple factors and ways by which they impact loneliness to develop better solutions for public policy, city, and environmental planning, and individually based interventions. This effort should be viewed as a public health priority.

}, keywords = {Aged, Aged, 80 and over, Aging, Cross-Sectional Studies, Female, Focus Groups, Humans, Loneliness, Male, Marital Status, Motor Activity, Qualitative Research, Quality of Life, Residence Characteristics, Sex Factors, Social Environment, social isolation, Socioeconomic factors}, issn = {1741-203X}, doi = {10.1017/S1041610215001532}, url = {http://www.journals.cambridge.org/abstract_S1041610215001532}, author = {Cohen-Mansfield, Jiska and Hazan, Haim and Lerman, Yaffa and Shalom, Vera} } @article {8499, title = {Differences Among Older Adults in the Types of Dental Services Used in the United States.}, journal = {Inquiry}, volume = {53}, year = {2016}, month = {2016}, abstract = {

The purpose of this article is to explore differences in the socioeconomic, demographic characteristics of older adults in the United States with respect to their use of different types of dental care services. The 2008 Health and Retirement Study (HRS) collected information about patterns of dental care use and oral health from individuals aged 55 years and older in the United States. We analyze these data and explore patterns of service use by key characteristics before modeling the relationship between service use type and those characteristics. The most commonly used service category was fillings, inlays, or bonding, reported by 43.6\% of those with any utilization. Just over one third of those with any utilization reported a visit for a crown, implant, or prosthesis, and one quarter reported a gum treatment or tooth extraction. The strongest consistent predictors of use type are denture, dentate, and oral health status along with dental insurance coverage and wealth. Our results provide insights into the need for public policies to address inequalities in access to dental services among an older US population. Our findings show that lower income, less wealthy elderly with poor oral health are more likely to not use any dental services rather than using only preventive dental care, and that cost prevents most non-users who say they need dental care from going to the dentist. These results suggest a serious access problem and one that ultimately produces even worse oral health and expensive major procedures for this population in the future.

}, keywords = {Aged, Dental Care, Female, Humans, Insurance, Dental, Male, Middle Aged, Surveys and Questionnaires, United States}, issn = {1945-7243}, doi = {10.1177/0046958016652523}, url = {http://www.ncbi.nlm.nih.gov/pubmed/27284127}, author = {Richard J. Manski and Jody Schimmel Hyde and Haiyan Chen and John F Moeller} } @article {8937, title = {The effect of job loss on health: Evidence from biomarkers}, journal = {Labour Economics}, volume = {41}, year = {2016}, month = {Jan-08-2016}, pages = {194 - 203}, abstract = {We estimate the effect of job loss on objective measures of physiological dysregulation using biomarker measures collected by the Health and Retirement Study in 2006 and 2008 and longitudinal self-reports of work status. We distinguish between group or individual layoffs, and business closures. Workers who are laid off from their job have lower health as measured by biomarker, whereas workers laid off in the context of a business closure do not. Estimates matching respondents wave-by-wave on self-reported health conditions and subjective job loss expectations prior to job loss, suggest strong effects of layoffs on biomarkers, in particular for glycosylated hemoglobin (HbA1c). A layoff could increase annual mortality rates by 10.3\%, consistent with other evidence of the effect of group layoffs on mortality.}, keywords = {Biomarkers, Health Shocks, Job loss, Older Adults, Retirement Planning and Satisfaction}, issn = {09275371}, doi = {10.1016/j.labeco.2016.05.014}, url = {http://linkinghub.elsevier.com/retrieve/pii/S0927537116300288http://api.elsevier.com/content/article/PII:S0927537116300288?httpAccept=text/xmlhttp://api.elsevier.com/content/article/PII:S0927537116300288?httpAccept=text/plain}, author = {Pierre-Carl Michaud and Eileen M. Crimmins and Michael D Hurd} } @article {8714, title = {Employer Accommodation and Labor Supply of Disabled Workers.}, journal = {Labour Econ}, volume = {41}, year = {2016}, month = {2016 Aug}, pages = {291-303}, abstract = {

We examine the factors that influence employer accommodation of newly disabled workers and how effective such accommodations are in retaining workers and discouraging disability insurance applications. Using the Health and Retirement Study, we find that only a quarter of newly disabled older workers in their 50s are accommodated by their employers in some way following onset of a disability. Importantly, we find that few employer characteristics explain which workers are accommodated; rather, employee characteristics, particularly the presence of personality traits correlated with assertiveness and open communication, are highly predictive of accommodation. We also find that if employer accommodation rates could be increased, disabled workers would be significantly more likely to delay labor force exit for up to two years. However, accommodation does not appear to reduce subsequent disability insurance claiming.

}, issn = {0927-5371}, doi = {10.1016/j.labeco.2016.05.013}, url = {http://linkinghub.elsevier.com/retrieve/pii/S0927537116300276http://api.elsevier.com/content/article/PII:S0927537116300276?httpAccept=text/xmlhttp://api.elsevier.com/content/article/PII:S0927537116300276?httpAccept=text/plain}, author = {Matthew J Hill and Nicole Maestas and Kathleen J Mullen} } @mastersthesis {8982, title = {Essays in the economics of long-term care utilization.}, volume = {Ph.D.}, year = {2016}, school = {University of New Hampshire}, address = {Durham, NH}, abstract = { This research examines three factors {\textendash} macroeconomic conditions, the Deficit Reduction Act of 2005, and inter-vivos transfers {\textendash} that influence both the availability of long-term care services and the use of these services. The first essay explores how changes in the macroeconomy, specifically the 2007-2009 {\textquotedblleft}Great Recession,{\textquotedblright} affect the utilization of paid and unpaid long-term care services. It is theoretically unclear how long-term care use should be affected by such downturns, as an individual{\textquoteright}s health status, wealth, insurance coverage and access to care are all likely to change during a significant downturn such as the {\textquotedblleft}Great Recession.{\textquotedblright} Using data from the 1998-2012 waves of the Health and Retirement Study, a survey that follows Americans over the age of 50 as they begin to transition into retirement, we estimate the effects of changes in the unemployment rate at both the national and county levels on long-term care use. We find consistent evidence that overall care use declines significantly during downturns, with additional results suggesting that these results may be driven by reductions in individual wealth and improvements in individual health status. The second essay examines how the implementation of the Deficit Reduction Act of 2005, a policy that imposed stricter regulations about how individuals could {\textquotedblleft}spend down{\textquotedblright} their assets to become Medicaid eligible, impacts both asset transfers and long-term care use among the elderly. Using data from the 1998-2010 waves of the Health and Retirement Study, I estimate the effects of this policy using a difference-in-difference framework. Overall, individuals seem to substitute from making inter-vivos transfers to holding assets in trusts in response to the enactment of the Deficit Reduction Act. With regard to care use, individuals seem to substitute from in-home long-term care to more visits to both doctors and adult day care facilities following the DRA, an effect primarily driven by the wealthiest and youngest individuals. The third essay investigates the relationship between parent-to-child inter-vivos asset transfers and future informal care provision by that child. Using data from the 1998 {\textendash} 2010 waves of the Health and Retirement Study, I am able to use the timing of the transfers and the care use to describe this relationship. The results suggest that the receipt of an inter-vivos transfer during the previous two years is strongly positively correlated with that child{\textquoteright}s likelihood of providing care during the previous month. In addition, I confirm a previous finding in the literature that child{\textquoteright}s gender, relationship to the parent and geographical proximity to the parent all significantly influence the child{\textquoteright}s decision to provide care.}, keywords = {Economics, Inter Vivos Transfers, Older Adults, Retirement Planning and Satisfaction}, url = {http://pqdtopen.proquest.com/doc/1842643629.html?FMT=AI\&pubnum=10161840}, author = {Hurdelbrink, Jonathan R.} } @mastersthesis {8991, title = {Essays on loss aversion and household portfolio choice.}, volume = {Ph.D.}, year = {2016}, school = {University of Illinois - Urbana-Champaign}, type = {Dissertation}, address = {Champaign, Illinois}, abstract = {This dissertation studies how loss-aversion, i.e., people{\textquoteright}s behavioral tendency to be more sensitive to potential losses than the same amount of potential gains, affects households{\textquoteright} insurance buying decisions and savings decisions. The first chapter, "Prospect Theory and Insurance Demand," tries to answer the question of why a substantial fraction of households remains uninsured even if classical expected utility theory predicts that it is beneficial to own insurance. This chapter posits that prospect theory{\textquoteright}s loss-aversion and reference point dependence can address the under-insurance puzzle and tests the theory. This chapter finds empirical evidence consistent with prospect theory using the American Life Panel (ALP) data: loss-averse individuals have a low ownership rate of long-term care insurance, supplemental disability insurance, and private health insurance; they express a low willingness to pay for health insurance; they are unwilling to purchase health insurance in a hypothetical insurance choice experiment. These results are consistent with prospect theory, which predicts that loss-aversion may decrease insurance demand if individuals{\textquoteright} reference points are {\textquoteright}the wealth level when they do not engage in insurance contracts.{\textquoteright} Under such reference points, individuals may regard insurance as a "risky investment" because they may lose premiums if a pre-specified bad event does not occur. Hence, those who are more sensitive to potential losses in premiums are unwilling to buy insurance. The second chapter investigates how loss-aversion affects individuals{\textquoteright} decisions about saving using the Health and Retirement Study (HRS) data. Specifically, this chapter empirically tests if prospect theory{\textquoteright}s loss aversion decreases insurance demands and increases savings demands. Loss-averse individuals may be unwilling to buy term-life insurance because term-life insurance can be regarded as a risky investment. Instead, they may choose a more safe option to prepare for uncertain future events by increasing precautionary saving. This chapter tests this prediction and finds empirical evidence consistent with it: loss-averse individuals are less likely to own term-life insurance and more likely to own whole-life insurance, which serves as a partial savings instrument. These individuals also hold a higher level of wealth than others, suggesting that they tend to save more (presumably for precautionary motives), all other things being equal. The third chapter explores the socially optimal level of insurance given that households are subject to behavioral biases, especially narrow framing and loss aversion. The central issue of this normative analysis is whether or not a social welfare function (SWF) should take into consideration the behavioral components of preferences. One school of thought claims that social planners should not consider behavioral components since they are anomalies or mistakes that are often self-destructive. Another school of thought argues that social planners should respect behavioral components because{\textellipsis} Advisors/Committee Members: Brown, Jeffrey R (advisor), Miller, Nolan H (advisor), Brown, Jeffrey R (Committee Chair), Miller, Nolan H (Committee Chair), Molitor, David (committee member), Weisbenner, Scott J (committee member).}, keywords = {Older Adults, Portfolios, Risk Aversion}, url = {http://hdl.handle.net/2142/92776}, author = {Hwang, In Do} } @article {8360, title = {Estimating the Co-Development of Cognitive Decline and Physical Mobility Limitations in Older US Adults}, journal = {Demography}, volume = {53}, year = {2016}, note = {Times Cited: 0 0}, pages = {337-364}, publisher = {53}, abstract = {This study examines the co-development of cognitive and physical function in older Americans using an age-heterogeneous sample drawn from the Health and Retirement Study (1998-2008). We used multiple-group parallel process latent growth models to estimate the association between trajectories of cognitive function as measured by immediate word recall scores, and limitations in physical function as measured as an index of functional mobility limitations. Nested model fit testing was used to assess model fit for the separate trajectories followed by estimation of an unconditional parallel process model. Controls for demographic characteristics, socioeconomic status, and chronic health conditions were added to the best-fitting parallel process model. Pattern mixture models were used to assess the sensitivity of the parameter estimates to the effect of selective attrition. Results indicated that favorable cognitive health and mobility at initial measurement were associated with faster decline in the alternate functional domain. The cross-process associations remained significant when we adjusted estimates for the influence of covariates and selective attrition. Demographic and socioeconomic characteristics were consistently associated with initial cognitive and physical health but had few relations with change in these measures.}, keywords = {Health Conditions and Status}, doi = {10.1007/s13524-016-0458-x}, author = {Nicholas J Bishop and Eggum-Wilkens, Natalie D. and Steven A Haas and Jennie J. Kronenfeld} } @article {8879, title = {Genetic associations at 53 loci highlight cell types and biological pathways relevant for kidney function.}, journal = {Nat Commun}, volume = {7}, year = {2016}, month = {2016 Jan 21}, pages = {10023}, abstract = {

Reduced glomerular filtration rate defines chronic kidney disease and is associated with cardiovascular and all-cause mortality. We conducted a meta-analysis of genome-wide association studies for estimated glomerular filtration rate (eGFR), combining data across 133,413 individuals with replication in up to 42,166 individuals. We identify 24 new and confirm 29 previously identified loci. Of these 53 loci, 19 associate with eGFR among individuals with diabetes. Using bioinformatics, we show that identified genes at eGFR loci are enriched for expression in kidney tissues and in pathways relevant for kidney development and transmembrane transporter activity, kidney structure, and regulation of glucose metabolism. Chromatin state mapping and DNase I hypersensitivity analyses across adult tissues demonstrate preferential mapping of associated variants to regulatory regions in kidney but not extra-renal tissues. These findings suggest that genetic determinants of eGFR are mediated largely through direct effects within the kidney and highlight important cell types and biological pathways.

}, keywords = {Chronic disease, Genome-Wide Association Study, Genotype, Humans}, issn = {2041-1723}, doi = {10.1038/ncomms10023}, author = {Pattaro, Cristian and Teumer, Alexander and Gorski, Mathias and Chu, Audrey Y and Li, Man and Mijatovic, Vladan and Garnaas, Maija and Tin, Adrienne and Sorice, Rossella and Yong Li and Taliun, Daniel and Olden, Matthias and Foster, Meredith and Qiong Yang and Chen, Ming-Huei and Pers, Tune H and Andrew D Johnson and Ko, Yi-An and Fuchsberger, Christian and Bamidele O Tayo and Michael A Nalls and Feitosa, Mary F and Isaacs, Aaron and Dehghan, Abbas and d{\textquoteright}Adamo, Pio and Adebawole Adeyemo and Dieffenbach, Aida Karina and Alan B Zonderman and Ilja M Nolte and van der Most, Peter J and Alan F Wright and Alan R Shuldiner and Alanna C Morrison and Hofman, Albert and Albert Vernon Smith and Dreisbach, Albert W and Franke, Andre and Andr{\'e} G Uitterlinden and Andres Metspalu and T{\"o}njes, Anke and Lupo, Antonio and Robino, Antonietta and Johansson, {\r A}sa and Demirkan, Ayse and Kollerits, Barbara and Freedman, Barry I and Ponte, Belen and Ben A Oostra and Paulweber, Bernhard and Kr{\"a}mer, Bernhard K and Mitchell, Braxton D and Buckley, Brendan M and Peralta, Carmen A and Caroline Hayward and Helmer, Catherine and Charles N Rotimi and Shaffer, Christian M and M{\"u}ller, Christian and Cinzia Felicita Sala and Cornelia M van Duijn and Saint-Pierre, Aude and Daniel Ackermann and Daniel Shriner and Ruggiero, Daniela and Toniolo, Daniela and Lu, Yingchang and Cusi, Daniele and Czamara, Darina and Ellinghaus, David and David S Siscovick and Ruderfer, Douglas and Gieger, Christian and Grallert, Harald and Rochtchina, Elena and Atkinson, Elizabeth J and Holliday, Elizabeth G and Boerwinkle, Eric and Salvi, Erika and Erwin P Bottinger and Murgia, Federico and Fernando Rivadeneira and Ernst, Florian and Kronenberg, Florian and Hu, Frank B and Navis, Gerjan J and Curhan, Gary C and Georg B Ehret and Homuth, Georg and Coassin, Stefan and Thun, Gian-Andri and Pistis, Giorgio and Gambaro, Giovanni and Malerba, Giovanni and Grant W Montgomery and Gu{\dh}ny Eir{\'\i}ksd{\'o}ttir and Jacobs, Gunnar and Guo Li and Wichmann, H-Erich and Campbell, Harry and Schmidt, Helena and Wallaschofski, Henri and V{\"o}lzke, Henry and Brenner, Hermann and Kroemer, Heyo K and Kramer, Holly and Lin, Honghuang and Irene Mateo Leach and Ford, Ian and Guessous, Idris and Rudan, Igor and Prokopenko, Inga and Ingrid B Borecki and Iris M Heid and Kolcic, Ivana and Persico, Ivana and Jukema, J Wouter and James F Wilson and Felix, Janine F and Divers, Jasmin and Lambert, Jean-Charles and Stafford, Jeanette M and Gaspoz, Jean-Michel and Jennifer A Smith and Jessica Faul and Wang, Jie Jin and Ding, Jingzhong and Joel N Hirschhron and John R. Attia and Whitfield, John B and Chalmers, John and Viikari, Jorma and Coresh, Josef and Denny, Joshua C and Karjalainen, Juha and Fernandes, Jyotika K and Endlich, Karlhans and Butterbach, Katja and Keene, Keith L and Kurt Lohman and Portas, Laura and Lenore J Launer and Lyytik{\"a}inen, Leo-Pekka and Yengo, Loic and Lude L Franke and Luigi Ferrucci and Rose, Lynda M and Kedenko, Lyudmyla and Rao, Madhumathi and Struchalin, Maksim and Kleber, Marcus E and Cavalieri, Margherita and Haun, Margot and Marilyn C Cornelis and Ciullo, Marina and Pirastu, Mario and de Andrade, Mariza and McEvoy, Mark A and Woodward, Mark and Adam, Martin and Cocca, Massimiliano and Nauck, Matthias and Imboden, Medea and Waldenberger, Melanie and Pruijm, Menno and Metzger, Marie and Stumvoll, Michael and Michele K Evans and Sale, Michele M and K{\"a}h{\"o}nen, Mika and Boban, Mladen and Bochud, Murielle and Rheinberger, Myriam and Verweij, Niek and Bouatia-Naji, Nabila and Nicholas G Martin and Nicholas D Hastie and Nicole M Probst-Hensch and Soranzo, Nicole and Devuyst, Olivier and Olli T Raitakari and Gottesman, Omri and Franco, Oscar H and Polasek, Ozren and Paolo P. Gasparini and Munroe, Patricia B and Ridker, Paul M and Mitchell, Paul and Muntner, Paul and Meisinger, Christa and Johannes H Smit and Kovacs, Peter and Wild, Philipp S and Froguel, Philippe and Rettig, Rainer and M{\"a}gi, Reedik and Biffar, Reiner and Schmidt, Reinhold and Middelberg, Rita P S and Carroll, Robert J and Brenda W J H Penninx and Rodney J Scott and Katz, Ronit and Sedaghat, Sanaz and Sarah Wild and Sharon L R Kardia and Ulivi, Sheila and Hwang, Shih-Jen and Enroth, Stefan and Kloiber, Stefan and Trompet, Stella and Stengel, Benedicte and Hancock, Stephen J and Stephen T Turner and Rosas, Sylvia E and Stracke, Sylvia and Tamara B Harris and Zeller, Tanja and Zemunik, Tatijana and Lehtim{\"a}ki, Terho and Illig, Thomas and Aspelund, Thor and Nikopensius, Tiit and T{\~o}nu Esko and Toshiko Tanaka and Gyllensten, Ulf and V{\"o}lker, Uwe and Emilsson, Valur and Vitart, Veronique and Aalto, Ville and Gudnason, Vilmundur and Chouraki, Vincent and Chen, Wei-Min and Igl, Wilmar and M{\"a}rz, Winfried and Koenig, Wolfgang and Lieb, Wolfgang and Ruth J F Loos and Yongmei Liu and Snieder, Harold and Pramstaller, Peter P and Parsa, Afshin and Jeff O{\textquoteright}Connell and Susztak, Katalin and Hamet, Pavel and Tremblay, Johanne and de Boer, Ian H and B{\"o}ger, Carsten A and Goessling, Wolfram and Daniel I Chasman and K{\"o}ttgen, Anna and Kao, W H Linda and Caroline S Fox} } @article {8618, title = {Genetic variants associated with subjective well-being, depressive symptoms, and neuroticism identified through genome-wide analyses.}, journal = {Nat Genet}, volume = {48}, year = {2016}, month = {2016 06}, pages = {624-33}, abstract = {

Very few genetic variants have been associated with depression and neuroticism, likely because of limitations on sample size in previous studies. Subjective well-being, a phenotype that is genetically correlated with both of these traits, has not yet been studied with genome-wide data. We conducted genome-wide association studies of three phenotypes: subjective well-being (n = 298,420), depressive symptoms (n = 161,460), and neuroticism (n = 170,911). We identify 3 variants associated with subjective well-being, 2 variants associated with depressive symptoms, and 11 variants associated with neuroticism, including 2 inversion polymorphisms. The two loci associated with depressive symptoms replicate in an independent depression sample. Joint analyses that exploit the high genetic correlations between the phenotypes (|ρ^| ≈ 0.8) strengthen the overall credibility of the findings and allow us to identify additional variants. Across our phenotypes, loci regulating expression in central nervous system and adrenal or pancreas tissues are strongly enriched for association.

}, keywords = {Anxiety Disorders, Bayes Theorem, depression, Genome-Wide Association Study, Humans, Neuroticism, Phenotype, Polymorphism, Single Nucleotide}, issn = {1546-1718}, doi = {10.1038/ng.3552}, author = {Okbay, Aysu and Baselmans, Bart M L and De Neve, Jan-Emmanuel and Turley, Patrick and Nivard, Michel G and Mark Alan Fontana and Meddens, S Fleur W and Richard Karlsson Linn{\'e}r and Cornelius A Rietveld and Derringer, Jaime and Gratten, Jacob and Lee, James J and Liu, Jimmy Z and de Vlaming, Ronald and Ahluwalia, Tarunveer S and Buchwald, Jadwiga and Cavadino, Alana and Frazier-Wood, Alexis C and Furlotte, Nicholas A and Garfield, Victoria and Geisel, Marie Henrike and Gonzalez, Juan R and Haitjema, Saskia and Karlsson, Robert and van der Laan, Sander W and Ladwig, Karl-Heinz and J. Lahti and Sven J van der Lee and Penelope A Lind and Tian Liu and Lindsay K Matteson and Mihailov, Evelin and Michael B Miller and Minica, Camelia C and Ilja M Nolte and Dennis O Mook-Kanamori and van der Most, Peter J and Christopher J Oldmeadow and Qian, Yong and Olli T Raitakari and Rawal, Rajesh and Realo, Anu and Rueedi, Rico and Schmidt, B{\"o}rge and Albert Vernon Smith and Stergiakouli, Evie and Toshiko Tanaka and Kent D Taylor and Wedenoja, Juho and J{\"u}rgen Wellmann and Westra, Harm-Jan and Willems, Sara M and Wei Zhao and Amin, Najaf and Bakshi, Andrew and Patricia A. Boyle and Cherney, Samantha and Cox, Simon R and Gail Davies and Davis, Oliver S P and Ding, Jun and Nese Direk and Eibich, Peter and Emeny, Rebecca T and Fatemifar, Ghazaleh and Jessica Faul and Luigi Ferrucci and Andreas J Forstner and Gieger, Christian and Gupta, Richa and Tamara B Harris and Harris, Juliette M and Holliday, Elizabeth G and Jouke-Jan Hottenga and Philip L de Jager and Marika A Kaakinen and Kajantie, Eero and Karhunen, Ville and Kolcic, Ivana and Kumari, Meena and Lenore J Launer and Lude L Franke and Li-Gao, Ruifang and Koini, Marisa and Loukola, Anu and Marques-Vidal, Pedro and Grant W Montgomery and Mosing, Miriam A and Paternoster, Lavinia and Pattie, Alison and Katja E Petrovic and Pulkki-Raback, Laura and Quaye, Lydia and Katri R{\"a}ikk{\"o}nen and Rudan, Igor and Rodney J Scott and Jennifer A Smith and Angelina R Sutin and Trzaskowski, Maciej and Anna A E Vinkhuyzen and Lei Yu and Zabaneh, Delilah and John R. Attia and David A Bennett and Klaus Berger and Bertram, Lars and Dorret I Boomsma and Snieder, Harold and Chang, Shun-Chiao and Francesco Cucca and Ian J Deary and Cornelia M van Duijn and Johan G Eriksson and B{\"u}ltmann, Ute and Eco J. C. de Geus and Groenen, Patrick J F and Gudnason, Vilmundur and Hansen, Torben and Catharina A Hartman and Haworth, Claire M A and Caroline Hayward and Andrew C Heath and Hinds, David A and Hypp{\"o}nen, Elina and Iacono, William G and J{\"a}rvelin, Marjo-Riitta and J{\"o}ckel, Karl-Heinz and Kaprio, Jaakko and Sharon L R Kardia and Keltikangas-J{\"a}rvinen, Liisa and Kraft, Peter and Laura D Kubzansky and Lehtim{\"a}ki, Terho and Patrik K E Magnusson and Nicholas G Martin and McGue, Matt and Andres Metspalu and Melinda C Mills and de Mutsert, Ren{\'e}e and Oldehinkel, Albertine J and Pasterkamp, Gerard and Nancy L Pedersen and Plomin, Robert and Polasek, Ozren and Power, Christine and Rich, Stephen S and Rosendaal, Frits R and Hester M. den Ruijter and Schlessinger, David and Schmidt, Helena and Svento, Rauli and Schmidt, Reinhold and Alizadeh, Behrooz Z and Thorkild I. A. S{\o}rensen and Timothy Spector and Andrew Steptoe and Antonio Terracciano and A. Roy Thurik and Nicholas J Timpson and Henning Tiemeier and Andr{\'e} G Uitterlinden and Vollenweider, Peter and Wagner, Gert G and David R Weir and Yang, Jian and Dalton C Conley and Hofman, Albert and Johannesson, Magnus and David I Laibson and Sarah E Medland and Meyer, Michelle N and Pickrell, Joseph K and T{\~o}nu Esko and Krueger, Robert F and Jonathan P. Beauchamp and Philipp D Koellinger and Daniel J. Benjamin and Bartels, Meike and Cesarini, David} } @article {8653, title = {Genetic variants near MLST8 and DHX57 affect the epigenetic age of the cerebellum.}, journal = {Nat Commun}, volume = {7}, year = {2016}, month = {2016 Feb 02}, pages = {10561}, abstract = {

DNA methylation (DNAm) levels lend themselves for defining an epigenetic biomarker of aging known as the {\textquoteright}epigenetic clock{\textquoteright}. Our genome-wide association study (GWAS) of cerebellar epigenetic age acceleration identifies five significant (P<5.0 {\texttimes} 10(-8)) SNPs in two loci: 2p22.1 (inside gene DHX57) and 16p13.3 near gene MLST8 (a subunit of mTOR complex 1 and 2). We find that the SNP in 16p13.3 has a cis-acting effect on the expression levels of MLST8 (P=6.9 {\texttimes} 10(-18)) in most brain regions. In cerebellar samples, the SNP in 2p22.1 has a cis-effect on DHX57 (P=4.4 {\texttimes} 10(-5)). Gene sets found by our GWAS analysis of cerebellar age acceleration exhibit significant overlap with those of Alzheimer{\textquoteright}s disease (P=4.4 {\texttimes} 10(-15)), age-related macular degeneration (P=6.4 {\texttimes} 10(-6)), and Parkinson{\textquoteright}s disease (P=2.6 {\texttimes} 10(-4)). Overall, our results demonstrate the utility of a new paradigm for understanding aging and age-related diseases: it will be fruitful to use epigenetic tissue age as endophenotype in GWAS.

}, keywords = {Adaptor Proteins, Signal Transducing, Aging, Cell Line, Cerebellum, Epigenesis, Genetic, Gene Expression Regulation, Genetic Variation, Genome-Wide Association Study, Humans, Linkage Disequilibrium, mTOR Associated Protein, LST8 Homolog}, issn = {2041-1723}, doi = {10.1038/ncomms10561}, author = {Lu, Ake T and Hannon, Eilis and Morgan E. Levine and Hao, Ke and Eileen M. Crimmins and Lunnon, Katie and Kozlenkov, Alexey and Mill, Jonathan and Dracheva, Stella and Horvath, Steve} } @article {8881, title = {Genome-wide analysis identifies 12 loci influencing human reproductive behavior.}, journal = {Nat Genet}, volume = {48}, year = {2016}, month = {2016 Dec}, pages = {1462-1472}, abstract = {

The genetic architecture of human reproductive behavior-age at first birth (AFB) and number of children ever born (NEB)-has a strong relationship with fitness, human development, infertility and risk of neuropsychiatric disorders. However, very few genetic loci have been identified, and the underlying mechanisms of AFB and NEB are poorly understood. We report a large genome-wide association study of both sexes including 251,151 individuals for AFB and 343,072 individuals for NEB. We identified 12 independent loci that are significantly associated with AFB and/or NEB in a SNP-based genome-wide association study and 4 additional loci associated in a gene-based effort. These loci harbor genes that are likely to have a role, either directly or by affecting non-local gene expression, in human reproduction and infertility, thereby increasing understanding of these complex traits.

}, issn = {1546-1718}, doi = {10.1038/ng.3698}, author = {Nicola Barban and Jansen, Rick and de Vlaming, Ronald and Vaez, Ahmad and Mandemakers, Jornt J and Felix C Tropf and Shen, Xia and James F Wilson and Daniel I Chasman and Ilja M Nolte and Tragante, Vinicius and van der Laan, Sander W and Perry, John R B and Kong, Augustine and Ahluwalia, Tarunveer S and Albrecht, Eva and Laura M Yerges-Armstrong and Atzmon, Gil and Auro, Kirsi and Kristin L. Ayers and Bakshi, Andrew and Ben-Avraham, Danny and Klaus Berger and Bergman, Aviv and Bertram, Lars and Bielak, Lawrence F and Bjornsdottir, Gyda and Bonder, Marc Jan and Broer, Linda and Bui, Minh and Barbieri, Caterina and Cavadino, Alana and Chavarro, Jorge E and Turman, Constance and Maria Pina Concas and Cordell, Heather J and Gail Davies and Eibich, Peter and Eriksson, Nicholas and T{\~o}nu Esko and Eriksson, Joel and Falahi, Fahimeh and Felix, Janine F and Mark Alan Fontana and Lude L Franke and Gandin, Ilaria and Gaskins, Audrey J and Gieger, Christian and Gunderson, Erica P and Guo, Xiuqing and Caroline Hayward and He, Chunyan and Edith Hofer and Huang, Hongyan and Joshi, Peter K and Kanoni, Stavroula and Karlsson, Robert and Kiechl, Stefan and Kifley, Annette and Kluttig, Alexander and Kraft, Peter and Lagou, Vasiliki and Lecoeur, Cecile and Lahti, Jari and Li-Gao, Ruifang and Penelope A Lind and Tian Liu and Makalic, Enes and Mamasoula, Crysovalanto and Lindsay K Matteson and Mbarek, Hamdi and McArdle, Patrick F and McMahon, George and Meddens, S Fleur W and Mihailov, Evelin and Michael B Miller and Missmer, Stacey A and Monnereau, Claire and van der Most, Peter J and Myhre, Ronny and Michael A Nalls and Nutile, Teresa and Ioanna Panagiota Kalafati and Porcu, Eleonora and Prokopenko, Inga and Rajan, Kumar B and Rich-Edwards, Janet and Cornelius A Rietveld and Robino, Antonietta and Rose, Lynda M and Rueedi, Rico and Ryan, Kathleen A and Saba, Yasaman and Schmidt, Daniel and Jennifer A Smith and Stolk, Lisette and Streeten, Elizabeth and T{\"o}njes, Anke and Thorleifsson, Gudmar and Ulivi, Sheila and Wedenoja, Juho and J{\"u}rgen Wellmann and Willeit, Peter and Yao, Jie and Yengo, Loic and Jing Hua Zhao and Wei Zhao and Zhernakova, Daria V and Amin, Najaf and Andrews, Howard and Balkau, Beverley and Barzilai, Nir and Bergmann, Sven and Biino, Ginevra and Bisgaard, Hans and B{\o}nnelykke, Klaus and Dorret I Boomsma and Buring, Julie E and Campbell, Harry and Cappellani, Stefania and Ciullo, Marina and Cox, Simon R and Francesco Cucca and Toniolo, Daniela and Davey-Smith, George and Ian J Deary and George Dedoussis and Deloukas, Panos and Cornelia M van Duijn and Eco J. C. de Geus and Johan G Eriksson and Jessica Faul and Cinzia Felicita Sala and Froguel, Philippe and Paolo P. Gasparini and Giorgia G Girotto and Hans-J{\"o}rgen Grabe and Greiser, Karin Halina and Groenen, Patrick J F and de Haan, Hugoline G and Haerting, Johannes and Tamara B Harris and Andrew C Heath and Heikkil{\"a}, Kauko and Hofman, Albert and Homuth, Georg and Holliday, Elizabeth G and John L Hopper and Hypp{\"o}nen, Elina and Jacobsson, Bo and Vincent Jaddoe and Johannesson, Magnus and Jugessur, Astanand and K{\"a}h{\"o}nen, Mika and Kajantie, Eero and Sharon L R Kardia and Keavney, Bernard and Kolcic, Ivana and Koponen, P{\"a}ivikki and Kovacs, Peter and Kronenberg, Florian and Kutalik, Zolt{\'a}n and La Bianca, Martina and Lachance, Genevieve and Iacono, William G and Lai, Sandra and Lehtim{\"a}ki, Terho and David C Liewald and Lindgren, Cecilia M and Yongmei Liu and Luben, Robert and Lucht, Michael and Luoto, Riitta and Magnus, Per and Patrik K E Magnusson and Nicholas G Martin and McGue, Matt and McQuillan, Ruth and Sarah E Medland and Meisinger, Christa and Mellstr{\"o}m, Dan and Andres Metspalu and Traglia, Michela and Lili Milani and Mitchell, Paul and Grant W Montgomery and Dennis O Mook-Kanamori and de Mutsert, Ren{\'e}e and Nohr, Ellen A and Ohlsson, Claes and Olsen, J{\o}rn and Ong, Ken K and Paternoster, Lavinia and Pattie, Alison and Brenda W J H Penninx and Markus Perola and Peyser, Patricia A and Pirastu, Mario and Polasek, Ozren and Power, Chris and Kaprio, Jaakko and Raffel, Leslie J and Katri R{\"a}ikk{\"o}nen and Olli T Raitakari and Ridker, Paul M and Ring, Susan M and Roll, Kathryn and Rudan, Igor and Ruggiero, Daniela and Rujescu, Dan and Veikko Salomaa and Schlessinger, David and Schmidt, Helena and Schmidt, Reinhold and Schupf, Nicole and Johannes H Smit and Sorice, Rossella and Timothy Spector and John M Starr and St{\"o}ckl, Doris and Strauch, Konstantin and Stumvoll, Michael and Swertz, Morris A and Thorsteinsdottir, Unnur and A. Roy Thurik and Nicholas J Timpson and Tung, Joyce Y and Andr{\'e} G Uitterlinden and Vaccargiu, Simona and Viikari, Jorma and Vitart, Veronique and V{\"o}lzke, Henry and Vollenweider, Peter and Vuckovic, Dragana and Waage, Johannes and Wagner, Gert G and Wang, Jie Jin and Wareham, Nicholas J and David R Weir and Gonneke Willemsen and Willeit, Johann and Alan F Wright and Krina T Zondervan and Stefansson, Kari and Krueger, Robert F and Lee, James J and Daniel J. Benjamin and Cesarini, David and Philipp D Koellinger and den Hoed, Marcel and Snieder, Harold and Melinda C Mills} } @article {8607, title = {GENOME-WIDE ASSOCIATION STUDY (GWAS) AND GENOME-WIDE BY ENVIRONMENT INTERACTION STUDY (GWEIS) OF DEPRESSIVE SYMPTOMS IN AFRICAN AMERICAN AND HISPANIC/LATINA WOMEN.}, journal = {Depress Anxiety}, volume = {33}, year = {2016}, month = {2016 Apr}, pages = {265-80}, abstract = {

BACKGROUND: Genome-wide association studies (GWAS) have made little progress in identifying variants linked to depression. We hypothesized that examining depressive symptoms and considering gene-environment interaction (GxE) might improve efficiency for gene discovery. We therefore conducted a GWAS and genome-wide by environment interaction study (GWEIS) of depressive symptoms.

METHODS: Using data from the SHARe cohort of the Women{\textquoteright}s Health Initiative, comprising African Americans (n = 7,179) and Hispanics/Latinas (n = 3,138), we examined genetic main effects and GxE with stressful life events and social support. We also conducted a heritability analysis using genome-wide complex trait analysis (GCTA). Replication was attempted in four independent cohorts.

RESULTS: No SNPs achieved genome-wide significance for main effects in either discovery sample. The top signals in African Americans were rs73531535 (located 20 kb from GPR139, P = 5.75 {\texttimes} 10(-8) ) and rs75407252 (intronic to CACNA2D3, P = 6.99 {\texttimes} 10(-7) ). In Hispanics/Latinas, the top signals were rs2532087 (located 27 kb from CD38, P = 2.44 {\texttimes} 10(-7) ) and rs4542757 (intronic to DCC, P = 7.31 {\texttimes} 10(-7) ). In the GEWIS with stressful life events, one interaction signal was genome-wide significant in African Americans (rs4652467; P = 4.10 {\texttimes} 10(-10) ; located 14 kb from CEP350). This interaction was not observed in a smaller replication cohort. Although heritability estimates for depressive symptoms and stressful life events were each less than 10\%, they were strongly genetically correlated (rG = 0.95), suggesting that common variation underlying self-reported depressive symptoms and stressful life event exposure, though modest on their own, were highly overlapping in this sample.

CONCLUSIONS: Our results underscore the need for larger samples, more GEWIS, and greater investigation into genetic and environmental determinants of depressive symptoms in minorities.

}, keywords = {African Americans, Aged, depression, Female, Gene-Environment Interaction, Genome-Wide Association Study, Hispanic Americans, Humans, Life Change Events, Middle Aged, Phenotype, Polymorphism, Single Nucleotide, Risk Factors, Self Report}, issn = {1520-6394}, doi = {10.1002/da.22484}, author = {Dunn, Erin C and Wiste, Anna and Radmanesh, Farid and Almli, Lynn M and Gogarten, Stephanie M and Sofer, Tamar and Jessica Faul and Sharon L R Kardia and Jennifer A Smith and David R Weir and Wei Zhao and Soare, Thomas W and Saira S Mirza and Karin Hek and Henning Tiemeier and Goveas, Joseph S and Sarto, Gloria E and Snively, Beverly M and Marilyn C Cornelis and Karestan C Koenen and Kraft, Peter and Shaun M Purcell and Ressler, Kerry J and Rosand, Jonathan and Wassertheil-Smoller, Sylvia and Smoller, Jordan W} } @article {8883, title = {Genome-wide association study identifies 74 loci associated with educational attainment.}, journal = {Nature}, volume = {533}, year = {2016}, month = {2016 05 26}, pages = {539-42}, abstract = {

Educational attainment is strongly influenced by social and other environmental factors, but genetic factors are estimated to account for at least 20\% of the variation across individuals. Here we report the results of a genome-wide association study (GWAS) for educational attainment that extends our earlier discovery sample of 101,069 individuals to 293,723 individuals, and a replication study in an independent sample of 111,349 individuals from the UK Biobank. We identify 74 genome-wide significant loci associated with the number of years of schooling completed. Single-nucleotide polymorphisms associated with educational attainment are disproportionately found in genomic regions regulating gene expression in the fetal brain. Candidate genes are preferentially expressed in neural tissue, especially during the prenatal period, and enriched for biological pathways involved in neural development. Our findings demonstrate that, even for a behavioural phenotype that is mostly environmentally determined, a well-powered GWAS identifies replicable associated genetic variants that suggest biologically relevant pathways. Because educational attainment is measured in large numbers of individuals, it will continue to be useful as a proxy phenotype in efforts to characterize the genetic influences of related phenotypes, including cognition and neuropsychiatric diseases.

}, keywords = {Alzheimer{\textquoteright}s disease, Bipolar Disorder, Cognitive Ability, Education, Fetus, Genome-Wide Association Study, Humans, Molecular Sequence Annotation, Polymorphism, Single Nucleotide, Schizophrenia, United Kingdom}, issn = {1476-4687}, doi = {10.1038/nature17671}, author = {Okbay, Aysu and Jonathan P. Beauchamp and Mark Alan Fontana and Lee, James J and Pers, Tune H and Cornelius A Rietveld and Turley, Patrick and Chen, Guo-Bo and Emilsson, Valur and Meddens, S Fleur W and Oskarsson, Sven and Pickrell, Joseph K and Thom, Kevin and Pascal N Timshel and de Vlaming, Ronald and Abdel Abdellaoui and Ahluwalia, Tarunveer S and Bacelis, Jonas and Baumbach, Clemens and Bjornsdottir, Gyda and Brandsma, Johannes H and Maria Pina Concas and Derringer, Jaime and Furlotte, Nicholas A and Galesloot, Tessel E and Giorgia G Girotto and Gupta, Richa and Hall, Leanne M and Sarah E Harris and Edith Hofer and Horikoshi, Momoko and Huffman, Jennifer E and Kaasik, Kadri and Ioanna Panagiota Kalafati and Karlsson, Robert and Kong, Augustine and Lahti, Jari and Sven J van der Lee and Christiaan de Leeuw and Penelope A Lind and Lindgren, Karl-Oskar and Tian Liu and Mangino, Massimo and Marten, Jonathan and Mihailov, Evelin and Michael B Miller and van der Most, Peter J and Christopher J Oldmeadow and Payton, Antony and Pervjakova, Natalia and Wouter J Peyrot and Qian, Yong and Olli T Raitakari and Rueedi, Rico and Salvi, Erika and Schmidt, B{\"o}rge and Schraut, Katharina E and Jianxin Shi and Albert Vernon Smith and Poot, Raymond A and St Pourcain, Beate and Teumer, Alexander and Thorleifsson, Gudmar and Verweij, Niek and Vuckovic, Dragana and J{\"u}rgen Wellmann and Westra, Harm-Jan and Yang, Jingyun and Wei Zhao and Zhihong Zhu and Alizadeh, Behrooz Z and Amin, Najaf and Bakshi, Andrew and Baumeister, Sebastian E and Biino, Ginevra and B{\o}nnelykke, Klaus and Patricia A. Boyle and Campbell, Harry and Cappuccio, Francesco P and Gail Davies and De Neve, Jan-Emmanuel and Deloukas, Panos and Demuth, Ilja and Ding, Jun and Eibich, Peter and Eisele, Lewin and Eklund, Niina and Jessica Faul and Feitosa, Mary F and Andreas J Forstner and Gandin, Ilaria and Gunnarsson, Bjarni and Halld{\'o}rsson, Bjarni V and Tamara B Harris and Andrew C Heath and Lynne J Hocking and Holliday, Elizabeth G and Homuth, Georg and Horan, Michael A and Jouke-Jan Hottenga and Philip L de Jager and Joshi, Peter K and Jugessur, Astanand and Marika A Kaakinen and K{\"a}h{\"o}nen, Mika and Kanoni, Stavroula and Keltigangas-J{\"a}rvinen, Liisa and Lambertus A Kiemeney and Kolcic, Ivana and Koskinen, Seppo and Kraja, Aldi T and Kroh, Martin and Kutalik, Zolt{\'a}n and Latvala, Antti and Lenore J Launer and Lebreton, Ma{\"e}l P and Douglas F Levinson and Paul Lichtenstein and Lichtner, Peter and David C Liewald and Loukola, Anu and Pamela A F Madden and M{\"a}gi, Reedik and M{\"a}ki-Opas, Tomi and Riccardo E Marioni and Marques-Vidal, Pedro and Meddens, Gerardus A and McMahon, George and Meisinger, Christa and Meitinger, Thomas and Milaneschi, Yusplitri and Lili Milani and Grant W Montgomery and Myhre, Ronny and Nelson, Christopher P and Nyholt, Dale R and William E R Ollier and Aarno Palotie and Paternoster, Lavinia and Nancy L Pedersen and Katja E Petrovic and David J Porteous and Katri R{\"a}ikk{\"o}nen and Ring, Susan M and Robino, Antonietta and Rostapshova, Olga and Rudan, Igor and Rustichini, Aldo and Veikko Salomaa and Sanders, Alan R and Sarin, Antti-Pekka and Schmidt, Helena and Rodney J Scott and Smith, Blair H and Jennifer A Smith and Staessen, Jan A and Steinhagen-Thiessen, Elisabeth and Strauch, Konstantin and Antonio Terracciano and Tobin, Martin D and Ulivi, Sheila and Vaccargiu, Simona and Quaye, Lydia and van Rooij, Frank J A and Venturini, Cristina and Anna A E Vinkhuyzen and V{\"o}lker, Uwe and V{\"o}lzke, Henry and Vonk, Judith M and Vozzi, Diego and Waage, Johannes and Erin B Ware and Gonneke Willemsen and John R. Attia and David A Bennett and Klaus Berger and Bertram, Lars and Bisgaard, Hans and Dorret I Boomsma and Ingrid B Borecki and B{\"u}ltmann, Ute and Chabris, Christopher F and Francesco Cucca and Cusi, Daniele and Ian J Deary and George Dedoussis and Cornelia M van Duijn and Johan G Eriksson and Franke, Barbara and Lude L Franke and Paolo P. Gasparini and Gejman, Pablo V and Gieger, Christian and Hans-J{\"o}rgen Grabe and Gratten, Jacob and Groenen, Patrick J F and Gudnason, Vilmundur and van der Harst, Pim and Caroline Hayward and Hinds, David A and Hoffmann, Wolfgang and Hypp{\"o}nen, Elina and Iacono, William G and Jacobsson, Bo and J{\"a}rvelin, Marjo-Riitta and J{\"o}ckel, Karl-Heinz and Kaprio, Jaakko and Sharon L R Kardia and Lehtim{\"a}ki, Terho and Lehrer, Steven F and Patrik K E Magnusson and Nicholas G Martin and McGue, Matt and Andres Metspalu and Pendleton, Neil and Brenda W J H Penninx and Markus Perola and Nicola Pirastu and Pirastu, Mario and Polasek, Ozren and Posthuma, Danielle and Power, Christine and Province, Michael A and Nilesh J Samani and Schlessinger, David and Schmidt, Reinhold and Thorkild I. A. S{\o}rensen and Timothy Spector and Stefansson, Kari and Thorsteinsdottir, Unnur and A. Roy Thurik and Nicholas J Timpson and Henning Tiemeier and Tung, Joyce Y and Andr{\'e} G Uitterlinden and Vitart, Veronique and Vollenweider, Peter and David R Weir and James F Wilson and Alan F Wright and Dalton C Conley and Krueger, Robert F and George Davey Smith and Hofman, Albert and David I Laibson and Sarah E Medland and Meyer, Michelle N and Yang, Jian and Johannesson, Magnus and Peter M Visscher and T{\~o}nu Esko and Philipp D Koellinger and Cesarini, David and Daniel J. Benjamin} } @article {8614, title = {GWAS analysis of handgrip and lower body strength in older adults in the CHARGE consortium.}, journal = {Aging Cell}, volume = {15}, year = {2016}, month = {2016 10}, pages = {792-800}, abstract = {

Decline in muscle strength with aging is an important predictor of health trajectory in the elderly. Several factors, including genetics, are proposed contributors to variability in muscle strength. To identify genetic contributors to muscle strength, a meta-analysis of genomewide association studies of handgrip was conducted. Grip strength was measured using a handheld dynamometer in 27~581 individuals of European descent over 65~years of age from 14 cohort studies. Genomewide association analysis was conducted on ~2.7 million imputed and genotyped variants (SNPs). Replication of the most significant findings was conducted using data from 6393 individuals from three cohorts. GWAS of lower body strength was also characterized in a subset of cohorts. Two genomewide significant (P-value< 5~{\texttimes}~10(-8) ) and 39 suggestive (P-value< 5~{\texttimes}~10(-5) ) associations were observed from meta-analysis of the discovery cohorts. After meta-analysis with replication cohorts, genomewide significant association was observed for rs752045 on chromosome 8 (β~=~0.47, SE~=~0.08, P-value~=~5.20~{\texttimes}~10(-10) ). This SNP is mapped to an intergenic region and is located within an accessible chromatin region (DNase hypersensitivity site) in skeletal muscle myotubes differentiated from the human skeletal muscle myoblasts cell line. This locus alters a binding motif of the CCAAT/enhancer-binding protein-β (CEBPB) that is implicated in muscle repair mechanisms. GWAS of lower body strength did not yield significant results. A common genetic variant in a chromosomal region that regulates myotube differentiation and muscle repair may contribute to variability in grip strength in the elderly. Further studies are needed to uncover the mechanisms that link this genetic variant with muscle strength.

}, keywords = {Adult, Aged, Chromatin Immunoprecipitation, Cohort Studies, Epigenesis, Genetic, Genome-Wide Association Study, Hand Strength, Humans, Molecular Sequence Annotation, Muscle Strength, Polymorphism, Single Nucleotide, Quantitative Trait Loci, Reproducibility of Results}, issn = {1474-9726}, doi = {10.1111/acel.12468}, author = {Amy M Matteini and Toshiko Tanaka and Karasik, David and Atzmon, Gil and Chou, Wen-Chi and John D Eicher and Andrew D Johnson and Alice M. Arnold and Michele L Callisaya and Gail Davies and Daniel S Evans and Holtfreter, Birte and Kurt Lohman and Kathryn L Lunetta and Mangino, Massimo and Albert Vernon Smith and Jennifer A Smith and Teumer, Alexander and Lei Yu and Dan E Arking and Aron S Buchman and Chibinik, Lori B and Philip L de Jager and Jessica Faul and Melissa E Garcia and Gillham-Nasenya, Irina and Gudnason, Vilmundur and Hofman, Albert and Hsu, Yi-Hsiang and Ittermann, Till and Lahousse, Lies and David C Liewald and Yongmei Liu and Lopez, Lorna and Fernando Rivadeneira and Rotter, Jerome I and Siggeirsdottir, Kristin and John M Starr and Thomson, Russell and Tranah, Gregory J and Andr{\'e} G Uitterlinden and V{\"o}lker, Uwe and V{\"o}lzke, Henry and David R Weir and Kristine Yaffe and Wei Zhao and Wei Vivian Zhuang and Zmuda, Joseph M and David A Bennett and Steven R Cummings and Ian J Deary and Luigi Ferrucci and Tamara B Harris and Sharon L R Kardia and Kocher, Thomas and Stephen B Kritchevsky and Psaty, Bruce M and Seshadri, Sudha and Timothy Spector and Velandai K Srikanth and Beverly G Windham and Zillikens, M Carola and Anne B Newman and Jeremy D Walston and Douglas P Kiel and Joanne M Murabito} } @article {8561, title = {How Family Status and Social Security Claiming Options Shape Optimal Life Cycle Portfolios}, journal = {Review of Financial Studies}, volume = {29}, year = {2016}, month = {Jul-04-2016}, pages = {937 - 978}, abstract = {We show how optimal household decisions regarding work, retirement, saving, portfolio allocations, and life insurance are shaped by the complex financial options embedded in U.S. Social Security rules and uncertain family transitions. Our life cycle model predicts sharp consumption drops on retirement, an age-62 peak in claiming rates, and earlier claiming by wives versus husbands and single women. Moreover, life insurance is mainly purchased on men{\textquoteright}s lives. Our model, which takes Social Security rules seriously, generates wealth and retirement outcomes that are more consistent with the data, in contrast to earlier and less realistic models}, keywords = {Gender Differences, Older Adults, Retirement Planning and Satisfaction, Social Security}, issn = {0893-9454}, doi = {10.1093/rfs/hhv070}, url = {http://rfs.oxfordjournals.org/lookup/doi/10.1093/rfs/hhv070}, author = {Hubener, Andreas and Maurer, Raimond and Olivia S. Mitchell} } @article {9029, title = {How Has Pension Income Changed Between 1992 and 2010?}, number = {WP$\#$2016-3}, year = {2016}, institution = {Center for Retirement Research at Boston College}, address = {Chestnut Hill, MA}, abstract = {Using data from the 1992, 1998, 2004, and 2010 waves of the Health and Retirement Study (HRS), this paper compares pension participation, pension wealth, projected retirement income, and replacement rates attributable to past service, by pension type for households ages 51-56. The analysis includes workers{\textquoteright} pension coverage during both current and past jobs. Defined contribution (DC) wealth is simply the current account balance. DC income is calculated by projecting current plan balances to retirement, assuming no further contributions, and assuming that households then annuitize. Defined benefit (DB) wealth and income are calculated by apportioning projected benefits to past and future service. }, url = {http://crr.bc.edu/wp-content/uploads/2016/07/wp_2016-3.pdf}, author = {Alicia H. Munnell and Wenliang Hou and Anthony Webb and Yinji Li} } @article {8404, title = {The impact of hearing impairment and noise-induced hearing injury on quality of life in the active-duty military population: challenges to the study of this issue.}, journal = {Mil Med Res}, volume = {3}, year = {2016}, month = {2016}, pages = {11}, publisher = {3}, abstract = {

The objectives of this research were to 1) summarize the available evidence on the impact of hearing loss on quality of life (QOL) among U.S. active-duty service members, 2) describe the QOL instruments that have been used to quantify the impact of hearing loss on quality of life, 3) examine national population-level secondary databases and report on their utility for studying the impact of hearing loss on QOL among active-duty service members, and 4) provide recommendations for future studies that seek to quantify the impact of hearing loss in this population. There is a lack of literature that addresses the intersection of hearing impairment, the military population, and quality of life measures. For audiological research, U.S. military personnel offer a unique research population, as they are exposed to noise levels and blast environments that are highly unusual in civilian work settings and can serve as a model population for studying the impact on QOL associated with these conditions. Our team recommends conducting a study on the active-duty service member population using a measurement instrument suitable for determining decreases in QOL specifically due to hearing loss.

}, issn = {2095-7467}, doi = {10.1186/s40779-016-0082-5}, url = {http://mmrjournal.biomedcentral.com/articles/10.1186/s40779-016-0082-5}, author = {Alamgir, Hasanat and Caryn A Turner and Nicole J Wong and Sharon P. Cooper and Jose A. Betancourt and Henry, James and Andrew J Senchak and Tanisha L. Hammill and Mark D Packer} } @article {5894, title = {Improved Wealth Measures in the Health and Retirement Study: Asset Reconciliation and Cross-Wave Imputation}, year = {2016}, abstract = {In this report, we present improved wealth measures for the Health and Retirement Study (HRS), which aim to reduce the effect of observation error on wealth levels and changes in wealth. The new wealth measures take account of the asset verification section in the HRS and use cross-wave information, most notably the value of the same asset in adjacent waves, in the imputation models, so imputed values better preserve serial correlation in the asset values. We document how we dealt with several methodological challenges in the implementation of these improvements. The corrections from the asset verification data reduce the standard deviations of wave-to-wave changes by substantial amounts (up to 57 percent for total wealth). The most important effect of the cross-wave imputations is a considerable reduction of the number of spikes and trenches (large changes in value followed by large changes back).}, keywords = {Demographics, Methodology}, author = {Michael D Hurd and Erik Meijer and Moldoff, Michael and Susann Rohwedder} } @article {8495, title = {Life Course Pathways to Racial Disparities in Cognitive Impairment among Older Americans.}, journal = {J Health Soc Behav}, volume = {57}, year = {2016}, month = {2016 06}, pages = {184-99}, abstract = {

Blacks are especially hard hit by cognitive impairment at older ages compared to whites. Here, we take advantage of the Health and Retirement Study (1998-2010) to assess how this racial divide in cognitive impairment is associated with the racial stratification of life course exposures and resources over a 12-year period among 8,946 non-Hispanic whites and blacks ages 65 and older in 1998. We find that blacks suffer from a higher risk of moderate/severe cognitive impairment at baseline and during the follow-up. Blacks are also more likely to report childhood adversity and to have grown up in the segregated South, and these early-life adversities put blacks at a significantly higher risk of cognitive impairment. Adulthood socioeconomic status is strongly associated with the risk of cognitive impairment, net of childhood conditions. However, racial disparities in cognitive impairment, though substantially reduced, are not eliminated when controlling for these life course factors.

}, keywords = {African Continental Ancestry Group, Aged, Aged, 80 and over, Aging, Cognitive Dysfunction, European Continental Ancestry Group, Female, Health Status Disparities, Humans, Male, Neuropsychological tests, Risk Factors, Severity of Illness Index, United States}, issn = {2150-6000}, doi = {10.1177/0022146516645925}, url = {http://www.ncbi.nlm.nih.gov/pubmed/27247126}, author = {Zhang, Zhenmei and Mark D Hayward and Yu, Yan-Liang} } @article {8496, title = {Life Satisfaction and Psychological Well-Being of Older Adults With Cancer Experience: The Role of Optimism and Volunteering.}, journal = {Int J Aging Hum Dev}, volume = {83}, year = {2016}, month = {2016 09}, pages = {274-89}, abstract = {

Promoting health and well-being among individuals of advancing age is a significant issue due to increased incidence of cancer among older adults. This study demonstrates the benefits of expecting positive outcomes and participating in volunteer activities among older adults with cancer. We used a nationally representative sample of 2,670 individuals who have experienced cancer from the 2008 wave of the Health and Retirement Study. We constructed a structural equation model to explore the associations of optimism, volunteerism, life satisfaction, and psychological well-being. The level of optimism was a significant predictor of volunteerism, which in turn affected life satisfaction and psychological well-being. The level of engagement in volunteer activities was found to have significant path coefficients toward both life satisfaction and psychological well-being. Our study provides evidence that older adults who have experienced cancer and maintained a positive outlook on their lives and engaged in personally meaningful activities tended to experience psychological well-being and life satisfaction.

}, keywords = {Aged, Aged, 80 and over, Aging, Female, Humans, Male, Middle Aged, Neoplasms, Optimism, Personal Satisfaction, Volunteers}, issn = {1541-3535}, doi = {10.1177/0091415016652406}, url = {http://www.ncbi.nlm.nih.gov/pubmed/27273518}, author = {Jinmoo Heo and Sanghee Chun and Lee, Sunwoo and Kim, Junhyoung} } @article {9152, title = {Living longer, working longer}, journal = {Commentary (The RAND Blog)}, year = {2016}, publisher = {The RAND Corporation}, address = {Santa Monica, CA}, keywords = {Employment and Labor Force, Social Security}, url = {https://www.rand.org/blog/2016/08/living-longer-working-longer.html}, author = {Michael D Hurd and Susann Rohwedder} } @article {8545, title = {Management of diabetes mellitus in older people with comorbidities.}, journal = {BMJ}, volume = {353}, year = {2016}, month = {2016 06 15}, pages = {i2200}, abstract = {

Diabetes mellitus is a chronic disease of aging that affects more than 20\% of people over 65. In older patients with diabetes, comorbidities are highly prevalent and their presence may alter the relative importance, effectiveness, and safety of treatments for diabetes. Randomized controlled trials have shown that intensive glucose control produces microvascular and cardiovascular benefits but typically after extended treatment periods (five to nine years) and with exposure to short term risks such as mortality (in one trial) and hypoglycemia. Decision analysis, health economics, and observational studies have helped to illustrate the importance of acknowledging life expectancy, hypoglycemia, and treatment burden when setting goals in diabetes. Guidelines recommend that physicians individualize the intensity of glucose control and treatments on the basis of the prognosis (for example, three tiers based on comorbidities and functional impairments) and preferences of individual patients. Very few studies have attempted to formally implement and study these concepts in clinical practice. To better meet the treatment needs of older patients with diabetes and comorbidities, more research is needed to determine the risks and benefits of intensifying, maintaining, or de-intensifying treatments in this population. This research effort should extend to the development and study of decision support tools as well as targeted care management.

}, keywords = {Aged, Aging, Blood Glucose, Comorbidity, Diabetes Mellitus, Type 2, Disease Management, Female, Glycemic Index, Guidelines as Topic, Health Services Needs and Demand, Humans, Hypoglycemic Agents, Male, Precision Medicine, Quality of Life}, issn = {1756-1833}, doi = {10.1136/bmj.i2200}, url = {https://www.ncbi.nlm.nih.gov/pubmed/27307175}, author = {Huang, Elbert S} } @article {8539, title = {Medicare Part D and Portfolio Choice {\textdagger}}, journal = {American Economic Review}, volume = {106}, year = {2016}, month = {Jan-05-2016}, pages = {339 - 342}, abstract = {Economic theory suggests that medical spending risk affects the extent to which households are willing to accept financial risk, and consequently their investment portfolios. In this study, we focus on the elderly for whom medical spending represents a substantial risk. We exploit the exogenous reduction in prescription drug spending risk due to the introduction of Medicare Part D in the U.S. in 2006 to identify the causal effect of medical spending risk on portfolio choice. Consistent with theory, we find that Medicare-eligible persons increased risky investment after the introduction of prescription drug coverage, relative to a younger, ineligible cohort.}, keywords = {Healthcare, Investing, Medicare/Medicaid/Health Insurance, Older Adults}, issn = {0002-8282}, doi = {10.1257/aer.p20161125}, url = {http://pubs.aeaweb.org/doi/10.1257/aer.p20161125}, author = {Padmaja Ayyagari and Daifeng He} } @article {8885, title = {Meta-analysis identifies common and rare variants influencing blood pressure and overlapping with metabolic trait loci.}, journal = {Nat Genet}, volume = {48}, year = {2016}, month = {2016 Oct}, pages = {1162-70}, abstract = {

Meta-analyses of association results for blood pressure using exome-centric single-variant and gene-based tests identified 31 new loci in a discovery stage among 146,562 individuals, with follow-up and meta-analysis in 180,726 additional individuals (total n = 327,288). These blood pressure-associated loci are enriched for known variants for cardiometabolic traits. Associations were also observed for the aggregation of rare and low-frequency missense variants in three genes, NPR1, DBH, and PTPMT1. In addition, blood pressure associations at 39 previously reported loci were confirmed. The identified variants implicate biological pathways related to cardiometabolic traits, vascular function, and development. Several new variants are inferred to have roles in transcription or as hubs in protein-protein interaction networks. Genetic risk scores constructed from the identified variants were strongly associated with coronary disease and myocardial infarction. This large collection of blood pressure-associated loci suggests new therapeutic strategies for hypertension, emphasizing a link with cardiometabolic risk.

}, issn = {1546-1718}, doi = {10.1038/ng.3660}, author = {Liu, Chunyu and Kraja, Aldi T and Jennifer A Smith and Brody, Jennifer A and Franceschini, Nora and Joshua C. Bis and Kenneth Rice and Alanna C Morrison and Lu, Yingchang and Weiss, Stefan and Guo, Xiuqing and Walter R Palmas and Martin, Lisa W and Yii-Der I Chen and Surendran, Praveen and Drenos, Fotios and Cook, James P and Auer, Paul L and Chu, Audrey Y and Giri, Ayush and Wei Zhao and Jakobsdottir, Johanna and Lin, Li-An and Stafford, Jeanette M and Amin, Najaf and Mei, Hao and Yao, Jie and Voorman, Arend and Larson, Martin G and Grove, Megan L and Albert Vernon Smith and Hwang, Shih-Jen and Chen, Han and Huan, Tianxiao and Kosova, Gulum and Stitziel, Nathan O and Kathiresan, Sekar and Nilesh J Samani and Schunkert, Heribert and Deloukas, Panos and Li, Man and Fuchsberger, Christian and Pattaro, Cristian and Gorski, Mathias and Charles Kooperberg and George J Papanicolaou and Rossouw, Jacques E and Jessica Faul and Sharon L R Kardia and Bouchard, Claude and Raffel, Leslie J and Andr{\'e} G Uitterlinden and Franco, Oscar H and Ramachandran S Vasan and O{\textquoteright}Donnell, Christopher J and Kent D Taylor and Liu, Kiang and Erwin P Bottinger and Gottesman, Omri and Daw, E Warwick and Giulianini, Franco and Ganesh, Santhi and Salfati, Elias and Tamara B Harris and Lenore J Launer and D{\"o}rr, Marcus and Felix, Stephan B and Rettig, Rainer and V{\"o}lzke, Henry and Eric S Kim and Lee, Wen-Jane and Lee, I-Te and Sheu, Wayne H-H and Tsosie, Krystal S and Digna R Velez Edwards and Yongmei Liu and Correa, Adolfo and David R Weir and V{\"o}lker, Uwe and Ridker, Paul M and Boerwinkle, Eric and Gudnason, Vilmundur and Reiner, Alexander P and Cornelia M van Duijn and Ingrid B Borecki and Edwards, Todd L and Chakravarti, Aravinda and Rotter, Jerome I and Psaty, Bruce M and Ruth J F Loos and Myriam Fornage and Georg B Ehret and Newton-Cheh, Christopher and Levy, Daniel and Daniel I Chasman} } @mastersthesis {8721, title = {Modeling longitudinal mediation of within-person changes}, volume = {M.A.}, year = {2016}, pages = {75}, school = {The University of North Carolina at Chapel Hill}, type = {Thesis}, address = {Chapel Hill}, abstract = {Mediation analysis concerns the discovery of mechanisms that transmit an effect from one variable to another. At times, social scientists propose hypotheses involving mediation of within-person changes (e.g., do within-person changes in cognitive ability mediate the relation between changes in depression and changes in disability?) The current manuscript introduces an approach within the latent change score (LCS) modeling framework to test such hypotheses. This approach is compared to existing methods, including the cross-lagged panel model (CLPM; Cole \& Maxwell, 2003) and the LCS mediation model (Selig \& Preacher, 2009). Results from (1) a single-replication simulation and (2) an empirical example utilizing data from the Health and Retirement study are presented.}, keywords = {Latent change score, Meta-analyses, Older Adults, Psychosocial, Self-reported health}, isbn = {9781369014662}, url = {http://proxy.lib.umich.edu/login?url=http://search.proquest.com/docview/1829616915?accountid=14667}, author = {Henk, Corinne M.} } @article {8348, title = {Modifiable Risk Factors for New-Onset Slow Gait in Older Adults}, journal = {Journal of the American Medical Directors Association}, volume = {17}, year = {2016}, pages = {421-425}, publisher = {17}, abstract = {AbstractObjective Despite the growing importance of slow gait as a universal screen of health, systematic investigation of risk factors for incident slow gait is lacking. Our objective was to identify potentially modifiable risk factors for incident slow gait. Design Prospective cohort study. Setting The Health and Retirement Study, a nationally representative US sample. Participants A total of 2306 individuals age 65 and older (56.5 women) from the 2008 wave with timed walks at baseline and 4 years later. Measurements Incident slow gait (walking speed 1 SD below age and sex means) was the outcome. Fifteen potentially modifiable medical and lifestyle risk factors were examined as predictors. Results Incident slow gait developed in 243 participants (11 ) at 4 years. Physical inactivity (adjusted relative risk aRR 1.94), cognitive impairment (aRR 1.77), muscle weakness (aRR 1.48), pain (aRR 1.45), obesity (aRR 1.35), vision (aRR 1.36), and falls (aRR 1.32) predicted increased risk of developing incident slow gait. Together, these risk factors accounted for 77 (95 confidence interval 14 95) of the Population Attributable Risk for incident slow gait. Conclusion A limited set of potentially modifiable risk factors is associated with new-onset slow gait in older adults. These findings provide a foundation for developing clinical guidelines and preventive interventions for slow gait.}, keywords = {Health Conditions and Status, Healthcare}, doi = {10.1016/j.jamda.2016.01.017}, url = {http://www.sciencedirect.com/science/article/pii/S1525861016000554}, author = {Joe Verghese and Wang, Cuiling and Allali, Gilles and Holtzer, Roee and Emmeline Ayers} } @article {8514, title = {Neuroimaging overuse is more common in Medicare compared with the VA.}, journal = {Neurology}, volume = {87}, year = {2016}, month = {2016 Aug 23}, pages = {792-8}, abstract = {

OBJECTIVE: To inform initiatives to reduce overuse, we compared neuroimaging appropriateness in a large Medicare cohort with a Department of Veterans Affairs (VA) cohort.

METHODS: Separate retrospective cohorts were established in Medicare and in VA for headache and neuropathy from 2004 to 2011. The Medicare cohorts included all patients enrolled in the Health and Retirement Study (HRS) with linked Medicare claims (HRS-Medicare; n = 1,244 for headache and 998 for neuropathy). The VA cohorts included all patients receiving services in the VA (n = 93,755 for headache and 183,642 for neuropathy). Inclusion criteria were age over 65 years and an outpatient visit for incident neuropathy or a primary headache. Neuroimaging use was measured with Current Procedural Terminology codes and potential overuse was defined using published criteria for use with administrative data. Increasingly specific appropriateness criteria excluded nontarget conditions for which neuroimaging may be appropriate.

RESULTS: For both peripheral neuropathy and headache, potentially inappropriate imaging was more common in HRS-Medicare compared with the VA. Forty-nine percentage of all headache patients received neuroimaging in HRS-Medicare compared with 22.1\% in the VA (p < 0.001) and differences persist when analyzing more specific definitions of overuse. A total of 23.7\% of all HRS-Medicare incident neuropathy patients received neuroimaging compared with 9.0\% in the VA (p < 0.001), and the difference persisted after excluding nontarget conditions.

CONCLUSIONS: Overuse of neuroimaging is likely less common in the VA than in a Medicare population. Better understanding the reasons for the more selective use of neuroimaging in the VA could help inform future initiatives to reduce overuse of diagnostic testing.

}, keywords = {Aged, Aged, 80 and over, Cohort Studies, Female, Headache Disorders, Primary, Humans, Male, Medicare, Neuroimaging, Peripheral Nervous System Diseases, United States, United States Department of Veterans Affairs, Unnecessary Procedures}, issn = {1526-632X}, doi = {10.1212/WNL.0000000000002963}, url = {http://www.ncbi.nlm.nih.gov/pubmed/27402889}, author = {James F. Burke and Eve A Kerr and Ryan J McCammon and Holleman, Rob and Kenneth M. Langa and Brian C. Callaghan} } @article {5896, title = {A new model for interdependent durations with an application to joint retirement}, year = {2016}, institution = {London, Centre for Microdata Methods and Practice}, abstract = {This paper introduces a bivariate version of the generalized accelerated failure time model. It allows for simultaneity in the econometric sense that the two realized outcomes depend structurally on each other. Another feature of the proposed model is that it will generate equal durations with positive probability. The motivating example is retirement decisions by married couples. In that example it seems reasonable to allow for the possibility that each partner{\textquoteright}s optimal retirement time depends on the retirement time of the spouse. Moreover, the data suggest that the wife and the husband retire at the same time for a nonnegligible fraction of couples. Our approach takes as a starting point a stylized economic model that leads to a univariate generalized accelerated failure time model. The covariates of that generalized accelerated failure time model act as utility-flow shifters in the economic model. We introduce simultaneity by allowing the utility flow in retirement to depend on the retirement status of the spouse. The econometric model is then completed by assuming that the observed outcome is the Nash bargaining solution in that simple economic model. The advantage of this approach is that it includes independent realizations from the generalized accelerated failure time model as a special case, and deviations from this special case can be given an economic interpretation. We illustrate the model by studying the joint retirement decisions in married couples using the Health and Retirement Study. We provide a discussion of relevant identifying variation and estimate our model using indirect inference. The main empirical finding is that the simultaneity seems economically important. In our preferred specification the indirect utility associated with being retired increases by approximately 5 when one{\textquoteright}s spouse retires. The estimated model also predicts that the marginal effect of a change in the husbands{\textquoteright} pension plan on wives{\textquoteright} retirement dates is about 3.3 of the direct effect on the husbands{\textquoteright}.}, keywords = {Adult children, Methodology, Pensions, Retirement Planning and Satisfaction}, author = {Bo E. Honor{\'e} and {\'A}ureo de Paula} } @article {8973, title = {Pension Participation, Wealth, and Income: 1992-2010}, number = {2016-3}, year = {2016}, institution = {Center for Retirement Research at Boston College}, abstract = {Using data from the 1992, 1998, 2004, and 2010 waves of the Health and Retirement Study (HRS), this paper compares pension participation, pension wealth, projected retirement income, and replacement rates attributable to past service, by pension type for households ages 51-56. The analysis includes workers{\textquoteright} pension coverage during both current and past jobs. Defined contribution (DC) wealth is simply the current account balance. DC income is calculated by projecting current plan balances to retirement, assuming no further contributions, and assuming that households then annuitize. Defined benefit (DB) wealth and income are calculated by apportioning projected benefits to past and future service.}, url = {http://crr.bc.edu/working-papers/pension-participation-wealth-and-income-1992-2010/}, author = {Alicia H. Munnell and Wenliang Hou and Anthony Webb and Yinji Li} } @article {8876, title = {Personality Polygenes, Positive Affect, and Life Satisfaction.}, journal = {Twin Res Hum Genet}, volume = {19}, year = {2016}, month = {2016 Oct}, pages = {407-17}, abstract = {

Approximately half of the variation in wellbeing measures overlaps with variation in personality traits. Studies of non-human primate pedigrees and human twins suggest that this is due to common genetic influences. We tested whether personality polygenic scores for the NEO Five-Factor Inventory (NEO-FFI) domains and for item response theory (IRT) derived extraversion and neuroticism scores predict variance in wellbeing measures. Polygenic scores were based on published genome-wide association (GWA) results in over 17,000 individuals for the NEO-FFI and in over 63,000 for the IRT extraversion and neuroticism traits. The NEO-FFI polygenic scores were used to predict life satisfaction in 7 cohorts, positive affect in 12 cohorts, and general wellbeing in 1 cohort (maximal N = 46,508). Meta-analysis of these results showed no significant association between NEO-FFI personality polygenic scores and the wellbeing measures. IRT extraversion and neuroticism polygenic scores were used to predict life satisfaction and positive affect in almost 37,000 individuals from UK Biobank. Significant positive associations (effect sizes <0.05\%) were observed between the extraversion polygenic score and wellbeing measures, and a negative association was observed between the polygenic neuroticism score and life satisfaction. Furthermore, using GWA data, genetic correlations of -0.49 and -0.55 were estimated between neuroticism with life satisfaction and positive affect, respectively. The moderate genetic correlation between neuroticism and wellbeing is in line with twin research showing that genetic influences on wellbeing are also shared with other independent personality domains.

}, keywords = {Genetics, Happiness, Polygenic Prediction, SSGAC, Well-being}, issn = {1832-4274}, doi = {10.1017/thg.2016.65}, author = {Weiss, Alexander and Baselmans, Bart M L and Edith Hofer and Yang, Jingyun and Okbay, Aysu and Penelope A Lind and Michael B Miller and Ilja M Nolte and Wei Zhao and Hagenaars, Saskia P and Jouke-Jan Hottenga and Lindsay K Matteson and Snieder, Harold and Jessica Faul and Catharina A Hartman and Patricia A. Boyle and Henning Tiemeier and Mosing, Miriam A and Pattie, Alison and Gail Davies and David C Liewald and Schmidt, Reinhold and Philip L de Jager and Andrew C Heath and Markus Jokela and John M Starr and Oldehinkel, Albertine J and Johannesson, Magnus and Cesarini, David and Hofman, Albert and Sarah E Harris and Jennifer A Smith and Keltikangas-J{\"a}rvinen, Liisa and Pulkki-Raback, Laura and Schmidt, Helena and Jacqui Smith and Iacono, William G and McGue, Matt and David A Bennett and Nancy L Pedersen and Patrik K E Magnusson and Ian J Deary and Nicholas G Martin and Dorret I Boomsma and Bartels, Meike and Luciano, Michelle} } @article {8822, title = {Pleiotropic Associations of Allelic Variants in a 2q22 Region with Risks of Major Human Diseases and Mortality.}, journal = {PLoS Genet}, volume = {12}, year = {2016}, month = {2016 Nov}, pages = {e1006314}, abstract = {

Gaining insights into genetic predisposition to age-related diseases and lifespan is a challenging task complicated by the elusive role of evolution in these phenotypes. To gain more insights, we combined methods of genome-wide and candidate-gene studies. Genome-wide scan in the Atherosclerosis Risk in Communities (ARIC) Study (N = 9,573) was used to pre-select promising loci. Candidate-gene methods were used to comprehensively analyze associations of novel uncommon variants in Caucasians (minor allele frequency~2.5\%) located in band 2q22.3 with risks of coronary heart disease (CHD), heart failure (HF), stroke, diabetes, cancer, neurodegenerative diseases (ND), and mortality in the ARIC study, the Framingham Heart Study (N = 4,434), and the Health and Retirement Study (N = 9,676). We leveraged the analyses of pleiotropy, age-related heterogeneity, and causal inferences. Meta-analysis of the results from these comprehensive analyses shows that the minor allele increases risks of death by about 50\% (p = 4.6{\texttimes}10-9), CHD by 35\% (p = 8.9{\texttimes}10-6), HF by 55\% (p = 9.7{\texttimes}10-5), stroke by 25\% (p = 4.0{\texttimes}10-2), and ND by 100\% (p = 1.3{\texttimes}10-3). This allele also significantly influences each of two diseases, diabetes and cancer, in antagonistic fashion in different populations. Combined significance of the pleiotropic effects was p = 6.6{\texttimes}10-21. Causal mediation analyses show that endophenotypes explained only small fractions of these effects. This locus harbors an evolutionary conserved gene-desert region with non-coding intergenic sequences likely involved in regulation of protein-coding flanking genes ZEB2 and ACVR2A. This region is intensively studied for mutations causing severe developmental/genetic disorders. Our analyses indicate a promising target region for interventions aimed to reduce risks of many major human diseases and mortality.

}, keywords = {Activin Receptors, Type II, Atherosclerosis, Chromosomes, Human, Pair 2, Coronary Disease, Diabetes Mellitus, Female, Genetic Association Studies, Genetic Diseases, Inborn, Genetic Pleiotropy, Genetic Predisposition to Disease, Genome-Wide Association Study, Heart Failure, Homeodomain Proteins, Humans, Male, Repressor Proteins, Risk Factors, Stroke, Zinc Finger E-box Binding Homeobox 2}, issn = {1553-7404}, doi = {10.1371/journal.pgen.1006314}, url = {https://www.ncbi.nlm.nih.gov/pmc/articles/pmid/27832070/}, author = {Alexander M Kulminski and He, Liang and Culminskaya, Irina and Loika, Yury and Kernogitski, Yelena and Konstantin G Arbeev and Loiko, Elena and Liubov S Arbeeva and Bagley, Olivia and Duan, Matt and Arseniy P Yashkin and Fang, Fang and Kovtun, Mikhail and Svetlana Ukraintseva and Wu, Deqing and Anatoliy Yashin}, editor = {Barsh, Gregory S.} } @article {8402, title = {Preliminary Detection of Relations Among Dynamic Processes With Two-Occasion Data}, journal = {Structural Equation Modeling}, volume = {23}, year = {2016}, note = {Export Date: 9 September 2015 Article in Press}, pages = {180-193}, publisher = {23}, abstract = {Most novel analytic methods for longitudinal data are applicable to studies spanning three time-points of data at a minimum, whereas methods for two-occasion data have garnered comparatively little attention. Here, we address this limitation by introducing the two-wave latent change score (2W-LCS) model, a technique appropriate for preliminary detection of relations among dynamic processes with two-occasion data. The 2W-LCS model is well suited for the investigation of hypotheses in which changes in a construct are posited as predictors of changes in another construct. In an empirical illustration using data of elderly Hispanics from the Health and Retirement Study, we demonstrate how the 2W-LCS model provides the best match to theories rooted in changes, and highlight the advantages of this approach over other modeling alternatives (i.e., Little, Preacher, Selig, and Card, 2007; Selig and Preacher, 2009). 2015, Routledge. All rights reserved.}, keywords = {Methodology}, doi = {10.1080/10705511.2015.1030022}, url = {http://www.scopus.com/inward/record.url?eid=2-s2.0-84939133366andpartnerID=40andmd5=1d363cc0f73ccff4fa0eda079882d1f0}, author = {Henk, Corinne M. and Castro-Schilo, L.} } @article {8684, title = {Racial and Ethnic Differences in End-of-Life Medicare Expenditures.}, journal = {Journal of the American Geriatrics Society}, volume = {64}, year = {2016}, pages = {1789-1797}, abstract = {

OBJECTIVES: To determine to what extent demographic, social support, socioeconomic, geographic, medical, and End-of-Life (EOL) planning factors explain racial and ethnic variation in Medicare spending during the last 6~months of life.

DESIGN: Retrospective cohort study.

SETTING: Health and Retirement Study (HRS).

PARTICIPANTS: Decedents who participated in HRS between 1998 and 2012 and previously consented to survey linkage with Medicare claims (N~=~7,105).

MEASUREMENTS: Total Medicare expenditures in the last 180~days of life according to race and ethnicity, controlling for demographic factors, social supports, geography, illness burden, and EOL planning factors, including presence of advance directives, discussion of EOL treatment preferences, and whether death had been expected.

RESULTS: The analysis included 5,548 (78.1\%) non-Hispanic white, 1,030 (14.5\%) non-Hispanic black, and 331 (4.7\%) Hispanic adults and 196 (2.8\%) adults of other race or ethnicity. Unadjusted results suggest that average EOL Medicare expenditures were $13,522 (35\%, P~<~.001) more for black decedents and $16,341 (42\%, P~<~.001) more for Hispanics than for whites. Controlling for demographic, socioeconomic, geographic, medical, and EOL-specific factors, the Medicare expenditure difference between groups fell to $8,047 (22\%, P~<~.001) more for black and $6,855 (19\%, P~<~.001) more for Hispanic decedents than expenditures for non-Hispanic whites. The expenditure differences between groups remained statistically significant in all models.

CONCLUSION: Individuals-level factors, including EOL planning factors do not fully explain racial and ethnic differences in Medicare spending in the last 6~months of life. Future research should focus on broader systemic, organizational, and provider-level factors to explain these differences.

}, keywords = {African Continental Ancestry Group, Aged, Aged, 80 and over, Cohort Studies, Comorbidity, Cross-Cultural Comparison, Ethnic Groups, European Continental Ancestry Group, Female, Health Care Surveys, Health Expenditures, Hispanic Americans, Humans, Life Support Care, Longitudinal Studies, Male, Medicare, Rate Setting and Review, Social Support, Socioeconomic factors, Terminal Care, United States}, issn = {1532-5415}, doi = {10.1111/jgs.14263}, author = {Byhoff, Elena and Tamara B Harris and Kenneth M. Langa and Theodore J Iwashyna} } @article {8593, title = {Racial and Socioeconomic Variation in Genetic Markers of Telomere Length: A Cross-Sectional Study of U.S. Older Adults.}, journal = {EBioMedicine}, volume = {11}, year = {2016}, pages = {296-301}, abstract = {

BACKGROUND: Shorter telomere length (TL) has been associated with stress and adverse socioeconomic conditions, yet U.S. blacks have longer TL than whites. The role of genetic versus environmental factors in explaining TL by race and socioeconomic position (SEP) remains unclear.

METHODS: We used data from the U.S. Health and Retirement Study (N=11,934) to test the hypothesis that there are differences in TL-associated SNPs by race and SEP. We constructed a TL polygenic risk score (PRS) and examined its association with race/ethnicity, educational attainment, assets, gender, and age.

RESULTS: U.S. blacks were more likely to have a lower PRS for TL, as were older individuals and men. Racial differences in TL were statistically accounted for when controlling for population structure using genetic principal components. The GWAS-derived SNPs for TL, however, may not have consistent associations with TL across different racial/ethnic groups.

CONCLUSIONS: This study showed that associations of race/ethnicity with TL differed when accounting for population stratification. The role of race/ethnicity for TL remains uncertain, however, as the genetic determinants of TL may differ by race/ethnicity. Future GWAS samples should include racially diverse participants to allow for better characterization of the determinants of TL in human populations.

}, keywords = {Age Factors, Aged, Aged, 80 and over, Alleles, Cross-Sectional Studies, Ethnic Groups, Female, Gene Frequency, Genetic Markers, Genome-Wide Association Study, Geriatric Assessment, Humans, Male, Middle Aged, Polymorphism, Single Nucleotide, Population Surveillance, Socioeconomic factors, Telomere Homeostasis, United States}, issn = {2352-3964}, doi = {10.1016/j.ebiom.2016.08.015}, author = {Hamad, Rita and Tuljapurkar, Shripad and David Rehkopf} } @article {6521, title = {Racial/Ethnic Differences in Insomnia Trajectories Among U.S. Older Adults}, journal = {The American Journal of Geriatric Psychiatry}, volume = {24}, year = {2016}, pages = {575-584}, chapter = {575}, abstract = {Objectives Insomnia is reported to be more prevalent in minority racial/ethnic groups. Little is known, however, about racial/ethnic differences in changes in insomnia severity over time, particularly among older adults. We examined racial/ethnic differences in trajectories of insomnia severity among middle-aged and older adults. Design Data were drawn from five waves of the Health and Retirement Study (2002 2010), a nationally representative longitudinal biennial survey of adults aged andgt; 50 years. Setting Population-based. Participants 22,252 participants from non-Hispanic white, non-Hispanic black, Hispanic, and other racial/ethnic groups. Measurements Participants reported the severity of four insomnia symptoms; summed scores ranged from 4 (no insomnia) to 12 (severe insomnia). We assessed change in insomnia across the five waves as a function of race/ethnicity. Results Across all participants, insomnia severity scores increased 0.19 points (95 CI: 0.14 0.24; t = 7.52; design df = 56; p andlt; 0.001) over time after adjustment for sex, race/ethnicity, education, and baseline age. After adjusting for the number of accumulated health conditions and body mass index, this trend decreased substantially and even changed direction (B = 0.24; 95 CI: 0.29 to 0.19; t = 9.22; design df = 56; p andlt; 0.001). The increasing trajectory was significantly more pronounced in Hispanics compared with non-Hispanic whites, even after adjustment for number of accumulated health conditions, body mass index, and number of depressive symptoms. Conclusions Although insomnia severity increases with age largely due to the accumulation of health conditions this trend appears more pronounced among Hispanic older adults than in non-Hispanic whites. Further research is needed to determine the reasons for a different insomnia trajectory among Hispanics.}, keywords = {Health Conditions and Status, Other}, doi = {10.1016/j.jagp.2016.02.049}, url = {http://www.sciencedirect.com/science/article/pii/S1064748116002153}, author = {Christopher N Kaufmann and Ramin Mojtabai and Hock, Rebecca S. and Roland J. Thorpe Jr. and Sarah L. Canham and Chen, Lian-Yu and Alexandra M. V. Wennberg and Lenis P. Chen-Edinboro and Adam P Spira} } @article {6436, title = {Responses to Financial Loss During the Great Recession: An Examination of Sense of Control in Late Midlife}, journal = {The Journals of Gerontology Series B: Psychological Sciences and Social Sciences}, volume = {71}, year = {2016}, pages = {734-744}, chapter = {734}, abstract = {Objectives. The Great Recession shocked the primary institutions that help individuals and families meet their needs and plan for the future. This study examines middle-aged adults experiences of financial loss and considers how socioeconomic and interpersonal resources facilitate or hinder maintaining a sense of control in the face of economic uncertainty.Method. Using the 2006 and 2010 waves of the Health and Retirement Study, change in income and wealth, giving help to and receiving help from others, household complexity, and sense of control were measured among middle-aged adults (n = 3,850; age = 51 60 years).Results. Socioeconomic resources predicted both the level of and change in the engagement of interpersonal resources prior to and during the Great Recession. Experiences of financial loss were associated with increased engagement of interpersonal resources and decreased sense of control. The effect of financial loss was dampened by education. Sense of control increased with giving help and decreased with household complexity.Discussion. Findings suggest that, across socioeconomic strata, proportional loss in financial resources resulted in a loss in sense of control. However, responses to financial loss differed by socioeconomic status, which differentiated the ability to maintain a sense of control following financial loss.}, keywords = {Adult children, Demographics, Healthcare, Net Worth and Assets, Other, Public Policy}, doi = {10.1093/geronb/gbv054}, url = {http://psychsocgerontology.oxfordjournals.org/content/early/2015/08/21/geronb.gbv054.abstract}, author = {Shannon T. Mejia and Richard A. Settersten Jr. and Michelle C Odden and Hooker, Karen} } @article {10465, title = {The Role of Medical Expenditure Risk in Portfolio Allocation Decisions}, journal = {Health Economics}, volume = {26}, year = {2016}, month = {2016/10/09}, abstract = {Economic theory suggests that medical spending risk affects the extent to which households are willing to accept financial risk, and consequently their investment portfolios. In this study, we focus on the elderly for whom medical spending represents a substantial risk. We exploit the exogenous reduction in prescription drug spending risk because of the introduction of Medicare Part D in the U.S. in 2006 to identify the causal effect of medical spending risk on portfolio choice. Consistent with theory, we find that Medicare-eligible persons increased risky investment after the introduction of prescription drug coverage, relative to a younger, ineligible cohort. Copyright {\textcopyright} 2016 John Wiley \& Sons, Ltd.}, keywords = {allocation decisions, Medical Expenses, Portfolios}, url = {https://www.researchgate.net/publication/308993822_The_Role_of_Medical_Expenditure_Risk_in_Portfolio_Allocation_Decisions}, author = {Padmaja Ayyagari and Daifeng He} } @article {8488, title = {Self-reported herpes zoster, pain, and health care seeking in the Health and Retirement Study: implications for interpretation of health care-based studies.}, journal = {Ann Epidemiol}, volume = {26}, year = {2016}, month = {2016 06}, pages = {441-446.e3}, abstract = {

PURPOSE: To describe self-reported herpes zoster (HZ) and explore factors that could impact interpretation of results from health care-based HZ studies.

METHODS: We performed logistic regression using data from the 2008 Health and Retirement Study (HRS) to evaluate risk factors for having a history of HZ and experiencing severe HZ pain, and predictors for seeking health care for HZ.

RESULTS: Among 14,564 respondents aged >=55~years, women were more likely than men to report a history of HZ (15.7\% vs. 11.6\%, P~<~.01). Blacks (6.4\% vs. 14.7\% in whites, P~<~.01) and respondents with less than a high school diploma (12.2\% vs.14.2\% in respondents with at least a high school diploma, P~= .01) were less likely to report a history of HZ. Women, blacks, Hispanics, and those with less than a high school diploma were more likely to report severe HZ pain. Most (91.1\%) respondents sought health care for HZ; Hispanics (64.2\% vs. 92.1\% in whites, P~<~.001) and those with recurrent HZ were less likely to seek health care for HZ, whereas those with severe pain were more likely (95.4\% vs. 87.9\% in those without severe pain, P~<~.01).

CONCLUSIONS: HRS provides a new platform for studies of HZ, one which allowed us to uncover issues that warrant particular attention when interpreting results of health care-based studies.

}, keywords = {Age Factors, Aged, Aged, 80 and over, Cross-Sectional Studies, Female, Health Surveys, Herpes Zoster, Humans, Independent Living, Logistic Models, Male, Middle Aged, Outcome Assessment, Health Care, pain, Pain Measurement, Patient Acceptance of Health Care, Reproducibility of Results, Retirement, Risk Assessment, Self Report, Severity of Illness Index, Sex Factors, Treatment Outcome, United States}, issn = {1873-2585}, doi = {10.1016/j.annepidem.2016.04.006}, url = {http://www.ncbi.nlm.nih.gov/pubmed/27180114}, author = {Hales, Craig M and Harpaz, Rafael and Bialek, Stephanie R} } @article {8534, title = {Somatic, positive and negative domains of the Center for Epidemiological Studies Depression (CES-D) scale: a meta-analysis of genome-wide association studies.}, journal = {Psychol Med}, volume = {46}, year = {2016}, month = {2016 06}, pages = {1613-23}, abstract = {

BACKGROUND: Major depressive disorder (MDD) is moderately heritable, however genome-wide association studies (GWAS) for MDD, as well as for related continuous outcomes, have not shown consistent results. Attempts to elucidate the genetic basis of MDD may be hindered by heterogeneity in diagnosis. The Center for Epidemiological Studies Depression (CES-D) scale provides a widely used tool for measuring depressive symptoms clustered in four different domains which can be combined together into a total score but also can be analysed as separate symptom domains.

METHOD: We performed a meta-analysis of GWAS of the CES-D symptom clusters. We recruited 12 cohorts with the 20- or 10-item CES-D scale (32 528 persons).

RESULTS: One single nucleotide polymorphism (SNP), rs713224, located near the brain-expressed melatonin receptor (MTNR1A) gene, was associated with the somatic complaints domain of depression symptoms, with borderline genome-wide significance (p discovery = 3.82 {\texttimes} 10-8). The SNP was analysed in an additional five cohorts comprising the replication sample (6813 persons). However, the association was not consistent among the replication sample (p discovery+replication = 1.10 {\texttimes} 10-6) with evidence of heterogeneity.

CONCLUSIONS: Despite the effort to harmonize the phenotypes across cohorts and participants, our study is still underpowered to detect consistent association for depression, even by means of symptom classification. On the contrary, the SNP-based heritability and co-heritability estimation results suggest that a very minor part of the variation could be captured by GWAS, explaining the reason of sparse findings.

}, keywords = {depression, Depressive Disorder, Major, Genome-Wide Association Study, Humans, Polymorphism, Single Nucleotide, Receptor, Melatonin, MT1, Somatoform Disorders}, issn = {1469-8978}, doi = {10.1017/S0033291715002081}, url = {https://www.ncbi.nlm.nih.gov/pubmed/26997408}, author = {Demirkan, A and J. Lahti and Nese Direk and Viktorin, A. and Kathryn L Lunetta and Antonio Terracciano and Michael A Nalls and Toshiko Tanaka and Karin Hek and Myriam Fornage and J{\"u}rgen Wellmann and Marilyn C Cornelis and Ollila, H. M. and Lei Yu and Luke C Pilling and Isaacs, A and Aarno Palotie and Wei Vivian Zhuang and Alan B Zonderman and Jessica Faul and Angelina R Sutin and Osorio Meirelles and Mulas, A and Hofman, A and Andr{\'e} G Uitterlinden and Fernando Rivadeneira and Markus Perola and Wei Zhao and Veikko Salomaa and Kristine Yaffe and Luik, A I and Yongmei Liu and Ding, J and Paul Lichtenstein and Land{\'e}n, M and Elisabeth Widen and David R Weir and David J Llewellyn and Murray, A and Sharon L R Kardia and Johan G Eriksson and Karestan C Koenen and Patrik K E Magnusson and Luigi Ferrucci and Thomas H Mosley and Francesco Cucca and Ben A Oostra and David A Bennett and Paunio, T. and Klaus Berger and Tamara B Harris and Nancy L Pedersen and Joanne M Murabito and Henning Tiemeier and Cornelia M van Duijn and Katri R{\"a}ikk{\"o}nen} } @article {12193, title = {Studying Cognitive Aging and Dementia in the Health and Retirement Study: Design and Measurement Strategies to Improve Research}, year = {2016}, publisher = {National Institute on Aging}, address = {Bethesda, MD}, keywords = {cognitive aging, Dementia}, author = {M. Maria Glymour and Scott M Hofer} } @article {8505, title = {Telomere length and health outcomes: A two-sample genetic instrumental variables analysis.}, journal = {Exp Gerontol}, volume = {82}, year = {2016}, month = {2016 09}, pages = {88-94}, abstract = {

OBJECTIVE: Previous studies linking telomere length (TL) and health have been largely associational. We apply genetic instrumental variables (IV) analysis, also known as Mendelian randomization, to test the hypothesis that shorter TL leads to poorer health. This method reduces bias from reverse causation or confounding.

METHODS: We used two approaches in this study that rely on two separate data sources: (1) individual-level data from the Health and Retirement Study (HRS) (N=3734), and (2) coefficients from genome-wide association studies (GWAS). We employed two-sample genetic IV analyses, constructing a polygenic risk score (PRS) of TL-associated single nucleotide polymorphisms. The first approach examined the association of the PRS with nine individual health outcomes in HRS. The second approach took advantage of estimates available in GWAS databases to estimate the impact of TL on five health outcomes using an inverse variance-weighted meta-analytic technique.

RESULTS: Using individual-level data, shorter TL was marginally statistically significantly associated with decreased risk of stroke and increased risk of heart disease. Using the meta-analytic approach, shorter TL was associated with increased risk of coronary artery disease (OR 1.02 per 100 base pairs, 95\%CI: 1.00, 1.03).

DISCUSSION: With the exception of a small contribution to heart disease, our findings suggest that TL may be a marker of disease rather than a cause. They also demonstrate the utility of the inverse variance-weighted meta-analytic approach when examining small effect sizes.

}, keywords = {Aged, Aging, Coronary Artery Disease, Databases, Factual, Female, Humans, Longitudinal Studies, Male, Middle Aged, Molecular Epidemiology, Polymorphism, Single Nucleotide, Self Report, Telomere, Telomere Homeostasis, United States}, issn = {1873-6815}, doi = {10.1016/j.exger.2016.06.005}, url = {http://www.ncbi.nlm.nih.gov/pubmed/27321645}, author = {Hamad, Rita and Stefan Walter and David Rehkopf} } @mastersthesis {8730, title = {Three essays in life-cycle labor supply and human capital formation}, volume = {Ph.D.}, year = {2016}, pages = {137}, school = {The University of Wisconsin - Madison}, type = {Dissertation}, address = {Madison}, abstract = {This dissertation consists of three independent essays on earnings dynamics, educational production function, and retirement. Each chapter explains labor supply and human capital formation from a life-cycle perspective. In the first chapter, I investigate how two different kinds of uncertainty jointly affect young workers{\textquoteright} decisions. This paper introduces the possibility of multidimensional learning about worker ability and job match quality into a model of work decisions. This mechanism has a unique prediction, negative sorting into job mobility that fades away over time, which is verified in the NLSY79 data if the AFQT score carries over some information unused by workers and employers. I estimate the structural model, which also has flexible skill accumulation, by indirect inference. From simulation results on earnings dynamics, I find that the contribution of job shopping to average earnings growth is higher than previous estimates; also, individual heterogeneity in earnings growth is mostly explained by the process of resolving uncertainties. In the second chapter, which is joint work with Keunkwan Ryu, we estimate the effects of high school class size on college entrance exam scores, using Korean administrative data. For the identification, we exploit quasi-experimental variation in class size arising from distinct institutional settings in Korea: especially, students are separately educated by major from grade 11 with different class sizes between majors. By using multi-level differencing and instrumental variable techniques, we find the effects of high school class size reduction on the test scores are positive but small. In the third chapter, I examine the effects of life expectancy on retirement and related decisions. I construct a structural model which has a realistic description of complicated dynamic incentives facing the elderly, including Social Security. Furthermore, individual heterogeneity in survival beliefs are flexibly modeled, directly using subjective survival probabilities in the Health and Retirement Study (HRS) data. The estimated model suggests that many people in the data believed their wealth was over-annuitized; they would have chosen to work and save less if their average life expectancy had increased. This result partially explains the early retirement puzzle in the last century.}, keywords = {Annuitization, Employment and Labor Force, Life Expectancy, Older Adults, Retirement Planning and Satisfaction}, isbn = {9781339835891}, url = {http://proxy.lib.umich.edu/login?url=http://search.proquest.com/docview/1796375588?accountid=14667}, author = {Han, Joseph} } @article {8842, title = {Time discounting and economic decision-making among the elderly}, number = {Working Paper No. 22438}, year = {2016}, month = {07/2016}, pages = {1-40}, institution = {National Bureau of Economic Research}, address = {Cambridge, MA}, abstract = {This paper evaluates the extent of heterogeneity in time discounting among elderly Americans, as well as its role in explaining older peoples{\textquoteright} key behaviors. We first show how older Americans evaluate simple (hypothetical) intertemporal choices in which payments now are compared with payments in the future. This adds to the literature on time horizon experiments by focusing on a nationally representative sample of persons age 70+. Using the indicators derived from this experiment, we show how differences in discounting patterns are associated with characteristics of particular importance in elderly populations, such as serious health and mental conditions. We then relate our discounting measure to key outcome variables including wealth, the timing of retirement, investments in health, and decisions about end of life care.}, keywords = {Decision making, Health Conditions and Status, Older Adults}, doi = {10.3386/w22438}, url = {http://www.nber.org/papers/w22438.pdf}, author = {Huffman, David and Maurer, Raimond and Olivia S. Mitchell} } @article {8340, title = {Trajectories of depressive symptoms and oral health outcomes in a community sample of older adults.}, journal = {Int J Geriatr Psychiatry}, volume = {31}, year = {2016}, note = {Export Date: 9 September 2015 Article in Press}, month = {2016 Jan}, pages = {83-91}, publisher = {31}, abstract = {

OBJECTIVE: Adverse outcomes associated with chronic depressive symptoms are of clinical importance. The objective was to identify subgroups of older adults based on their trajectories of depressive symptoms over a 10-year period and determine if these subgroups predicted oral health outcomes.

METHODS: The sample was 944 adults aged 65+ who participated in the oral health module of the the Health and Retirement Survey in 2008. Depressive symptoms were measured with a modified version of the Center for Epidemiologic Studies-Depression (CES-D) scale. Latent class trajectory analysis was used to identify distinct subgroups of elders based on their CES-D scores from 1998-2008. Group membership was used to predict self-rated oral health, overall mouth condition (problems with bleeding gums, gum sensitivity, and food avoidance), and edentulism in 2008.

RESULTS: Three distinct subgroups were identified using zero-inflated Poisson regression models: (i) minimal depressive symptoms over the study period (43\%), (ii) low but generally stable level of depressive symptoms (41\%), and (iii) moderate symptoms and higher CES-D scores than the other groups over the 10 years (16\%). Controlling for demographic and health variables and edentulism status, having a trajectory of moderate symptoms was associated with poorer mouth condition (p < 0.0001) and poorer self-rated oral health (p = 0.0003) compared with those with minimal symptoms. Having low levels of depressive symptoms was not significantly associated with these two outcomes. Group membership was not significantly associated with the probability of edentulism.

CONCLUSIONS: Chronic moderate depressive symptoms are associated with poorer oral health in older adults.

}, keywords = {Aged, Aged, 80 and over, Chronic disease, Depressive Disorder, Female, Humans, Longitudinal Studies, Male, Oral Health, Regression Analysis}, issn = {1099-1166}, doi = {10.1002/gps.4292}, author = {Celia F. Hybel and Joan M. Bennett and Lawrence R Landerman and Jersey Liang and Brenda L Plassman and Bei Wu} } @article {8529, title = {Using Multiple-hierarchy Stratification and Life Course Approaches to Understand Health Inequalities: The Intersecting Consequences of Race, Gender, SES, and Age.}, journal = {J Health Soc Behav}, volume = {57}, year = {2016}, month = {2016 06}, pages = {200-22}, abstract = {

This study examines how the intersecting consequences of race-ethnicity, gender, socioeconomics status (SES), and age influence health inequality. We draw on multiple-hierarchy stratification and life course perspectives to address two main research questions. First, does racial-ethnic stratification of health vary by gender and/or SES? More specifically, are the joint health consequences of racial-ethnic, gender, and socioeconomic stratification additive or multiplicative? Second, does this combined inequality in health decrease, remain stable, or increase between middle and late life? We use panel data from the Health and Retirement Study (N = 12,976) to investigate between- and within-group differences in in self-rated health among whites, blacks, and Mexican Americans. Findings indicate that the effects of racial-ethnic, gender, and SES stratification are interactive, resulting in the greatest racial-ethnic inequalities in health among women and those with higher levels of SES. Furthermore, racial-ethnic/gender/SES inequalities in health tend to decline with age. These results are broadly consistent with intersectionality and aging-as-leveler hypotheses.

}, keywords = {Age Factors, Aged, Aging, Continental Population Groups, Female, Health Status Disparities, Health Surveys, Humans, Male, Middle Aged, Sex Factors, Social Class, Socioeconomic factors}, issn = {2150-6000}, doi = {10.1177/0022146516645165}, url = {https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4905600/}, author = {Tyson H Brown and Liana J Richardson and Taylor W. Hargrove and Courtney S Thomas} } @article {12198, title = {Using the Health and Retirement Study for Disability Policy Research: A Review}, year = {2016}, publisher = {National Institute on Aging}, address = {Bethesda, MD}, abstract = {The Health and Retirement Study (HRS) is a preeminent data source for research related to the experiences of workers nearing retirement, including the large share of those workers who experience a health shock or disability onset after age 50. In this article, we highlight key information collected from HRS respondents that benefits disability policy research and the body of knowledge that has resulted from this information. Our main goal is to identify from this research experience potential improvements in data collection and documentation that would further strengthen the HRS as a data source for disability policy researchers.}, keywords = {Disability, Policy, Workers}, author = {Jody Schimmel Hyde and David Stapleton} } @article {8523, title = {Work a Little, Play a Little: A New Retirement Strategy}, journal = {The New York Times}, number = {B3}, year = {2016}, month = {May 20, 2016}, pages = {3}, chapter = {B}, address = {New York}, keywords = {Older Adults, Part-time work, Retirement Planning and Satisfaction}, url = {http://www.nytimes.com/2016/05/21/your-money/work-a-little-play-a-little-a-new-retirement-strategy.html}, author = {Hannon, Kerry} } @book {9151, title = {Workforce Downsizing and Restructuring in the Department of Defense: The Voluntary Separation Incentive Payment Program Versus Involuntary Separation}, series = {Research Reports}, year = {2016}, pages = {106}, publisher = {RAND Corporation}, organization = {RAND Corporation}, address = {Santa Monica, CA}, abstract = {The U.S. Department of Defense (DoD) plans to reduce the size of its civilian workforce through 2021. An important downsizing tool available to personnel managers is the Voluntary Separation Incentive Payment (VSIP), but its cap, $25,000, has not been adjusted since 1993. The authors of this report used RAND{\textquoteright}s dynamic retention model (DRM) for DoD civilians to compare the cost-effectiveness of alternative approaches to achieving a given downsizing. These include packages of VSIP, voluntary early retirement authority (VERA), and involuntary separation if also needed, versus using involuntary separation alone. Increasing the VSIP cap to $41,000 (the real value of VSIP in 2015 dollars) increases voluntary separations by about 45 percent and, compared with the $25,000 cap, would result in greater net savings to DoD and greater net savings in government outlays over five years. Although the apparent cost savings, as reflected in the budget, are greater when involuntary separations are used, there are off-budget costs, such as workplace turmoil, disruption, and lower morale, associated with involuntary separation. The authors used the DRM to estimate the cost borne by employees who are involuntarily separated in terms of the value of the loss of employment, net of the severance pay they receive. Such costs could potentially hurt retention and workforce productivity among those who remain. Using this broader concept of cost that includes both the cost to the government and the cost borne by employees, VSIP generates more net savings and is more cost-effective at the margin than involuntary separation.}, keywords = {Military service}, isbn = {9780833096388}, doi = {10.7249/RR1540}, url = {http://www.rand.org/pubs/research_reports/RR1540.html}, author = {Asch, Beth and Hosek, James and Mattock, Michael and Knapp, David and Kavanagh, Jennifer} } @article {8206, title = {Adverse Selection in the Annuity Market and the Role for Social Security}, journal = {Journal of Political Economy}, volume = {123}, year = {2015}, note = {Times Cited: 0 0}, pages = {941-984}, publisher = {123}, abstract = {I study the role of social security in providing insurance when there is adverse selection in the annuity market. I calculate welfare gain from mandatory annuitization in the social security system relative to a laissez-faire benchmark, using a model in which individuals have private information about their mortality. I estimate large heterogeneity in mortality using the Health and Retirement Study. Despite that, I find small welfare gain from mandatory annuitization. Social security has a large effect on annuity prices because it crowds out demand by high-mortality individuals. Welfare gain would have been significantly larger in the absence of this effect.}, keywords = {Net Worth and Assets, Pensions, Social Security}, doi = {10.1086/681593}, author = {Hosseini, Roozbeh} } @article {MOULTON201517, title = {An analysis of default risk in the Home Equity Conversion Mortgage (HECM) program}, journal = {Journal of Urban Economics}, volume = {90}, year = {2015}, pages = {17-34}, abstract = {While reverse mortgages are intended as a tool to enable financial security for older homeowners, in 2014, nearly 12 percent of reverse mortgage borrowers in the federally insured Home Equity Conversion Mortgage (HECM) program were in default on their property taxes or homeowners insurance. Unlike the traditional mortgage market, there were no risk-based underwriting guidelines for HECMs through 2014. In response to the relatively high default rate, a variety of policy responses were implemented, including establishing underwriting guidelines. However, there is a lack of data and analysis to inform such criteria. Our analysis follows 30,000 seniors counseled for reverse mortgages between 2006 and 2011. The data includes comprehensive financial and credit report attributes, not typically available in analyses of reverse mortgage borrowers. Using a bivariate probit model that accounts for selection, we estimate the likelihood of tax and insurance default. Financial characteristics that increase default risk include the percentage of funds withdrawn in the first month of the loan, a lower credit score, higher property tax to income ratio, low or no unused revolving credit, and a history of being past due on mortgage payments or having a tax lien on the property. Our estimate of the elasticity of default with respect to credit scores is similar to that for closed-end home equity loans, but higher than that for HELOCs. We simulate the effects of alternative underwriting criteria and policy changes on the probability of take-up and default. Reductions in the default rate with a minimal effect on participation can be achieved by requiring that participants with low credit scores set aside some of their HECM funds for future property tax and insurance payments, a form of escrowing.}, keywords = {Mortgage default, property taxes, Reverse mortgages, Senior housing}, issn = {0094-1190}, doi = {https://doi.org/10.1016/j.jue.2015.08.002}, url = {https://www.sciencedirect.com/science/article/pii/S0094119015000509}, author = {Stephanie Moulton and Donald Haurin and Wei Shi} } @article {8195, title = {Anchoring vignettes in the Health and Retirement Study: how do medical professionals and disability recipients characterize the severity of work limitations?}, journal = {PLoS One}, volume = {10}, year = {2015}, month = {2015}, pages = {e0126218}, publisher = {10}, abstract = {

PURPOSE: Recent studies report systematic differences in how individuals categorize the severity of identical health and work limitation vignettes. We investigate how health professionals and disability recipients characterize the severity of work limitations and whether their reporting patterns are robust to demographic, education, and health characteristics. We use the results to illustrate the potential impact of reporting heterogeneity on the distribution of work disability estimated from self-reported categorical health and disability data.

METHOD: Nationally representative data on anchoring disability vignettes from the 2004 Health and Retirement Study (HRS) are used to investigate how respondents with an occupation background in health and Social Security disability beneficiaries categorize work limitation vignettes. Using pain, cardiovascular health, and depression vignettes, we estimate generalized ordered probit models (N = 2,660 individuals or 39,681 person-vignette observations) that allow the severity thresholds to vary by respondent characteristics.

RESULTS: We find that health professionals (excluding nurses) and disability recipients tend to classify identical work limitations as more severe compared to non-health professional non-disabled respondents. For disability recipients, the differences are most pronounced and particularly visible in the tails of the work limitations distribution. For health professionals, we observe smaller differences, affecting primarily the classification of mildly and moderately severe work limitations. The patterns for health professionals (excluding nurses) are robust to demographics, education, and health conditions. The greater likelihood of viewing the vignette person as more severely work limited observed among disability recipients is mostly explained by the fact that these respondents also tend to be in poorer health which itself predicts a more inclusive scale.

CONCLUSIONS: Knowledge of reporting scales from health professionals and disabled individuals can benefit researchers in a broad range of applications in health and disability research. They may be useful as reference scales to evaluate disability survey data. Such knowledge may be beneficial when studying disability programs. Given the increasing availability of anchoring vignette data in surveys, this is a promising area for future evaluation research.

}, keywords = {Aged, Cardiovascular Diseases, depression, Disabled Persons, Female, Health Personnel, Humans, Male, Middle Aged, pain, Retirement, Self Report}, issn = {1932-6203}, doi = {10.1371/journal.pone.0126218}, url = {http://dx.doi.org/10.1371 2Fjournal.pone.0126218}, author = {Frank Heiland and Yin, Na} } @article {8212, title = {Are older adults living in more equal counties healthier than older adults living in more unequal counties? A propensity score matching approach.}, journal = {Soc Sci Med}, volume = {141}, year = {2015}, note = {Times Cited: 0 0}, month = {2015 Sep}, pages = {82-90}, publisher = {141}, abstract = {

We assessed the potential contextual effect of income inequality on health by: 1) comparing individuals with similar socioeconomic status (SES) but who reside in counties with different levels of income inequality; and 2) examining whether the potential effect of county-level income inequality on health varies across SES groups. We used the Health and Retirement Study, a nationally representative study of Americans over the age of 50. Using propensity score matching, we selected SES-comparable individuals living in high-income inequality counties and in low-income inequality counties. We examined differences in self-rated overall health outcomes and in other specific physical/mental health outcomes between the two groups using logistic regression (n~=~34,994) and imposing different sample restrictions based on residential duration in the area. We then used logistic regression with interactions to assess whether, and if so how, health outcomes differed among participants of different SES groups defined by wealth, income, and education. In bivariate analyses of the unmatched full sample, adults living in high-income inequality counties have worse health outcomes for most health measures. After propensity score matching, adults in high-income inequality counties had worse self-rated health status (AOR~=~1.12; 95\% CI 1.04-1.19) and were more likely to report diagnosed psychiatric problems (AOR~=~1.08; 95\% CI 0.99-1.19) than their matched counterparts in low-income inequality counties. These associations were stronger with longer-term residents in the area. Adverse health outcomes associated with living in high-income inequality counties were significant particularly for individuals in the 30(th) or greater percentiles of income/wealth distribution and those without a college education. In summary, after using more precise matching methods to compare individuals with similar characteristics and addressing measurement error by excluding more recently arrived county residents, adults living in high-income inequality counties had worse reported overall physical and mental health than adults living in low-income inequality counties.

}, keywords = {Aged, Aged, 80 and over, Female, Health Status Indicators, Health Surveys, Healthcare Disparities, Humans, Logistic Models, Male, Middle Aged, Propensity Score, Self Report, Socioeconomic factors}, issn = {1873-5347}, doi = {10.1016/j.socscimed.2015.07.020}, author = {Choi, Hwajung and Sarah A. Burgard and Irma Elo and Michele M Heisler} } @article {8619, title = {The association between lower educational attainment and depression owing to shared genetic effects? Results in ~25,000 subjects.}, journal = {Mol Psychiatry}, volume = {20}, year = {2015}, month = {2015 Jun}, pages = {735-43}, abstract = {

An association between lower educational attainment (EA) and an increased risk for depression has been confirmed in various western countries. This study examines whether pleiotropic genetic effects contribute to this association. Therefore, data were analyzed from a total of 9662 major depressive disorder (MDD) cases and 14,949 controls (with no lifetime MDD diagnosis) from the Psychiatric Genomics Consortium with additional Dutch and Estonian data. The association of EA and MDD was assessed with logistic regression in 15,138 individuals indicating a significantly negative association in our sample with an odds ratio for MDD 0.78 (0.75-0.82) per standard deviation increase in EA. With data of 884,105 autosomal common single-nucleotide polymorphisms (SNPs), three methods were applied to test for pleiotropy between MDD and EA: (i) genetic profile risk scores (GPRS) derived from training data for EA (independent meta-analysis on ~120,000 subjects) and MDD (using a 10-fold leave-one-out procedure in the current sample), (ii) bivariate genomic-relationship-matrix restricted maximum likelihood (GREML) and (iii) SNP effect concordance analysis (SECA). With these methods, we found (i) that the EA-GPRS did not predict MDD status, and MDD-GPRS did not predict EA, (ii) a weak negative genetic correlation with bivariate GREML analyses, but this correlation was not consistently significant, (iii) no evidence for concordance of MDD and EA SNP effects with SECA analysis. To conclude, our study confirms an association of lower EA and MDD risk, but this association was not because of measurable pleiotropic genetic effects, which suggests that environmental factors could be involved, for example, socioeconomic status.

}, keywords = {Adult, Aged, Cohort Studies, Depressive Disorder, Major, Educational Status, Estonia, Female, Gene-Environment Interaction, Genetic Association Studies, Genotype, Humans, Likelihood Functions, Male, Middle Aged, Netherlands, Odds Ratio, Polymorphism, Single Nucleotide, Psychiatric Status Rating Scales, Regression Analysis}, issn = {1476-5578}, doi = {10.1038/mp.2015.50}, author = {Wouter J Peyrot and Lee, S H and Milaneschi, Y and Abdel Abdellaoui and Byrne, E M and T{\~o}nu Esko and Eco J. C. de Geus and Hemani, G and Jouke-Jan Hottenga and Kloiber, S and Douglas F Levinson and Lucae, S and Nicholas G Martin and Sarah E Medland and Andres Metspalu and Lili Milani and Markus M N{\"o}then and Potash, J B and Rietschel, M and Cornelius A Rietveld and Ripke, S and Jianxin Shi and Gonneke Willemsen and Zhihong Zhu and Dorret I Boomsma and Naomi R. Wray and Brenda W J H Penninx} } @article {8284, title = {Comorbidities, smoking status, and life expectancy among individuals eligible for lung cancer screening}, journal = {Cancer}, volume = {121}, year = {2015}, pages = {4341}, publisher = {121}, abstract = {In the current study, the authors determine how the screening-eligible US population differs from National Lung Screening Trial participants in terms of characteristics that affect their ability to benefit from screening. The population eligible for lung cancer screening in the United States is older and more likely to have comorbidities and smoke, and has a shorter life expectancy than participants in the National Lung Screening Trial.}, keywords = {Expectations, Health Conditions and Status}, author = {Howard, David H. and Richards, Thomas B. and Bach, Peter B. and Kegler, Michelle C. and Berg, Carla J.} } @article {8241, title = {Comorbidity and functional trajectories from midlife to old age: the Health and Retirement Study.}, journal = {J Gerontol A Biol Sci Med Sci}, volume = {70}, year = {2015}, month = {2015 Mar}, pages = {332-8}, publisher = {70}, abstract = {

BACKGROUND: The number of diseases and physical functioning difficulties tend to increase with age. The aim of this study was to examine the trajectories of physical functioning across age groups and whether the trajectories differ according to disease status in different population subgroups.

METHODS: Repeat data from a nationally representative population sample, the Health and Retirement Study, was used. Participants were 10,709 men and 13,477 women aged 60-107 years at baseline with biennial surveys from 1992 to 2010. Average length of follow-up was 10.3 years ranging from 0 to 18 years. Disease status and physical functioning was asked about at all study phases and 10 items were summed to obtain a physical functioning score (0-10).

RESULTS: Age modified the relationship between number of chronic diseases and physical functioning with older participants having more physical functioning difficulties with increasing number of diseases. An average 70-year-old participant with no diseases had 0.89 (95\% CI: 0.85-0.93) physical functioning difficulties, with one disease 1.72 (95\% CI: 1.69-1.76) difficulties, with two diseases 2.57 (95\% CI: 2.52-2.62) difficulties, and with three or more diseases 3.82 (95\% CI: 3.76-3.88) difficulties. Of the individual diseases memory-related diseases, stroke, pulmonary diseases, and arthritis were associated with significantly higher physical functioning difficulties compared with other diseases.

CONCLUSIONS: Comorbidity is associated with greater burden of physical functioning difficulties. Of the studied diseases, memory-related diseases, stroke, pulmonary diseases, and arthritis alone or in combination limit most physical functioning.

}, keywords = {Activities of Daily Living, Age Factors, Aged, Aged, 80 and over, Chronic disease, Comorbidity, Female, Health Status, Humans, Longitudinal Studies, Male, Middle Aged, Retirement, Socioeconomic factors, United States}, issn = {1758-535X}, doi = {10.1093/gerona/glu113}, url = {http://biomedgerontology.oxfordjournals.org/content/early/2014/07/23/gerona.glu113.abstract}, author = {Stenholm, Sari and Westerlund, Hugo and Head, Jenny and Hyde, Martin and Ichiro Kawachi and Pentti, Jaana and Mika Kivim{\"a}ki and Vahtera, Jussi} } @article {8617, title = {Comprehensive gene- and pathway-based analysis of depressive symptoms in older adults.}, journal = {J Alzheimers Dis}, volume = {45}, year = {2015}, month = {2015}, pages = {1197-206}, abstract = {

Depressive symptoms are common in older adults and are particularly prevalent in those with or at elevated risk for dementia. Although the heritability of depression is estimated to be substantial, single nucleotide polymorphism-based genome-wide association studies of depressive symptoms have had limited success. In this study, we performed genome-wide gene- and pathway-based analyses of depressive symptom burden. Study participants included non-Hispanic Caucasian subjects (n = 6,884) from three independent cohorts, the Alzheimer{\textquoteright}s Disease Neuroimaging Initiative (ADNI), the Health and Retirement Study (HRS), and the Indiana Memory and Aging Study (IMAS). Gene-based meta-analysis identified genome-wide significant associations (ANGPT4 and FAM110A, q-value = 0.026; GRM7-AS3 and LRFN5, q-value = 0.042). Pathway analysis revealed enrichment of association in 105 pathways, including multiple pathways related to ERK/MAPK signaling, GSK3 signaling in bipolar disorder, cell development, and immune activation and inflammation. GRM7, ANGPT4, and LRFN5 have been previously implicated in psychiatric disorders, including the GRM7 region displaying association with major depressive disorder. The ERK/MAPK signaling pathway is a known target of antidepressant drugs and has important roles in neuronal plasticity, and GSK3 signaling has been previously implicated in Alzheimer{\textquoteright}s disease and as a promising therapeutic target for depression. Our results warrant further investigation in independent and larger cohorts and add to the growing understanding of the genetics and pathobiology of depressive symptoms in aging and neurodegenerative disorders. In particular, the genes and pathways demonstrating association with depressive symptoms may be potential therapeutic targets for these symptoms in older adults.

}, keywords = {Aged, Cohort Studies, depression, European Continental Ancestry Group, Female, Genotyping Techniques, Humans, Male, Psychiatric Status Rating Scales}, issn = {1875-8908}, doi = {10.3233/JAD-148009}, author = {Nho, Kwangsik and Vijay K Ramanan and Horgusluoglu, Emrin and Sungeun Kim and Mark H Inlow and Shannon L Risacher and Brenna C McDonald and Martin R Farlow and Tatiana Foroud and Gao, Sujuan and Christopher M. Callahan and Hugh C Hendrie and Alexander B Niculescu and Andrew J Saykin} } @article {12129, title = {Contribution of common non-synonymous variants in PCSK1 to body mass index variation and risk of obesity: a systematic review and meta-analysis with evidence from up to 331 175 individuals.}, journal = {Human Molecular Genetics}, volume = {24}, year = {2015}, pages = {3582-3594}, abstract = {

Polymorphisms rs6232 and rs6234/rs6235 in PCSK1 have been associated with extreme obesity [e.g. body mass index (BMI) >= 40 kg/m(2)], but their contribution to common obesity (BMI >= 30 kg/m(2)) and BMI variation in a multi-ethnic context is unclear. To fill this gap, we collected phenotypic and genetic data in up to 331 175 individuals from diverse ethnic groups. This process involved a systematic review of the literature in PubMed, Web of Science, Embase and the NIH GWAS catalog complemented by data extraction from pre-existing GWAS or custom-arrays in consortia and single studies. We employed recently developed global meta-analytic random-effects methods to calculate summary odds ratios (OR) and 95\% confidence intervals (CIs) or beta estimates and standard errors (SE) for the obesity status and BMI analyses, respectively. Significant associations were found with binary obesity status for rs6232 (OR = 1.15, 95\% CI 1.06-1.24, P = 6.08 {\texttimes} 10(-6)) and rs6234/rs6235 (OR = 1.07, 95\% CI 1.04-1.10, P = 3.00 {\texttimes} 10(-7)). Similarly, significant associations were found with continuous BMI for rs6232 (β = 0.03, 95\% CI 0.00-0.07; P = 0.047) and rs6234/rs6235 (β = 0.02, 95\% CI 0.00-0.03; P = 5.57 {\texttimes} 10(-4)). Ethnicity, age and study ascertainment significantly modulated the association of PCSK1 polymorphisms with obesity. In summary, we demonstrate evidence that common gene variation in PCSK1 contributes to BMI variation and susceptibility to common obesity in the largest known meta-analysis published to date in genetic epidemiology.

}, keywords = {Alleles, Body Mass Index, Genetic Predisposition to Disease, Genetic Variation, Humans, Obesity, Odds Ratio, Polymorphism, Single Nucleotide, Proprotein Convertase 1}, issn = {1460-2083}, doi = {10.1093/hmg/ddv097}, author = {Nead, Kevin T and Li, Aihua and Wehner, Mackenzie R and Neupane, Binod and Gustafsson, Stefan and Adam S Butterworth and Engert, James C and Davis, A Darlene and Hegele, Robert A and Miller, Ruby and den Hoed, Marcel and Khaw, Kay-Tee and Kilpel{\"a}inen, Tuomas O and Wareham, Nick and Edwards, Todd L and Hallmans, G{\"o}ran and Varga, Tibor V and Sharon L R Kardia and Smith, Jennifer A and Zhao, Wei and Jessica Faul and David R Weir and Mi, Jie and Xi, Bo and Quinteros, Samuel Canizales and Cooper, Cyrus and Sayer, Avan Aihie and Jameson, Karen and Gr{\o}ntved, Anders and Myriam Fornage and Stephen Sidney and Hanis, Craig L and Highland, Heather M and H{\"a}ring, Hans-Ulrich and Heni, Martin and Lasky-Su, Jessica and Weiss, Scott T and Gerhard, Glenn S and Still, Christopher and Melka, Melkaey M and Pausova, Zdenka and Paus, Tom{\'a}{\v s} and Grant, Struan F A and Hakonarson, Hakon and Price, R Arlen and Wang, Kai and Scherag, Andre and Hebebrand, Johannes and Hinney, Anke and Franks, Paul W and Timothy M Frayling and McCarthy, Mark I and Hirschhorn, Joel N and Ruth J F Loos and Ingelsson, Erik and Gerstein, Hertzel C and Yusuf, Salim and Beyene, Joseph and Anand, Sonia S and Meyre, David} } @article {8144, title = {Control Beliefs and Risk for Death, Stroke and Myocardial Infarction in Middle-aged and Older Adults: An Observational Study.}, journal = {J Gen Intern Med}, volume = {30}, year = {2015}, note = {Export Date: 29 May 2015 Article in Press}, month = {2015 Aug}, pages = {1156-63}, publisher = {30}, abstract = {

BACKGROUND: Chronic health conditions account for the largest proportion of illness-related mortality and morbidity as well as most of healthcare spending in the USA. Control beliefs may be important for outcomes in individuals with chronic illness.

OBJECTIVE: To determine whether control beliefs are associated with the risk for death, incident stroke and incident myocardial infarction (MI), particularly for individuals with diabetes mellitus (DM) and/or hypertension.

DESIGN: Retrospective cohort study.

PARTICIPANTS: A total of 5,662 respondents to the Health and Retirement Study with baseline health, demographic and psychological data in 2006, with no history of previous stroke or MI.

MAIN MEASURES: Perceived global control, measured as two dimensions--"constraints" and "mastery"--and health-specific control were self-reported. Event-free survival was measured in years, where "event" was the composite of death, incident stroke and MI. Year of stroke or MI was self-reported; year of death was obtained from respondents{\textquoteright} family.

KEY RESULTS: Mean baseline age was 66.2 years; 994 (16.7\%) had DM and 3,023 (53.4\%) hypertension. Overall, 173 (3.1\%) suffered incident strokes, 129 (2.3\%) had incident MI, and 465 (8.2\%) died. There were no significant interactions between control beliefs and baseline DM or hypertension in predicting event-free survival. Elevated adjusted hazard ratios (HRs) were associated with DM (1.33, 95 \% CI 1.07-1.67), hypertension (1.31, 95\% CI 1.07-1.61) and perceived constraints in the third (1.55, 95\% CI 1.12-2.15) and fourth quartiles (1.61, 95\% CI 1.14-2.26). Health-specific control scores in the third (HR 0.78, 95\% CI 0.59-1.03) and fourth quartiles (HR 0.70, 95\% CI 0.53-0.92) were protective, but only the latter category had a statistically significant decreased risk. Combined high perceived constraints and low health-specific control had the highest risk (HR 1.93, 95\% CI 1.41-2.64).

CONCLUSIONS: Control beliefs were not associated with differential risk for those with DM and/or hypertension, but they predicted significant differences in event-free survival for the general cohort.

}, keywords = {Aged, Diabetes Mellitus, Female, Health Knowledge, Attitudes, Practice, Humans, Hypertension, Longitudinal Studies, Male, Middle Aged, Myocardial Infarction, Patients, Retrospective Studies, Risk Factors, Stroke, Treatment Outcome}, issn = {1525-1497}, doi = {10.1007/s11606-015-3275-9}, author = {Wei Duan-Porter and Susan Nicole Hastings and Brian Neelon and Courtney Harold Van Houtven} } @article {8194, title = {Correlates and Moderators of Change in Subjective Memory and Memory Performance: Findings from the Health and Retirement Study}, journal = {Gerontology}, volume = {61}, year = {2015}, note = {Times Cited: 1 0 1}, pages = {232-240}, publisher = {61}, abstract = {Aging researchers have long been interested in understanding individuals{\textquoteright} subjective perceptions of their own memory functioning. Previous research has shown that subjective memory ratings are partly based on memory performance but also reflect the influence of other factors, such as depressive symptoms. The aim of the present study was to examine (1) longitudinal associations between trajectories of subjective memory and memory performance, (2) variables that predict levels of and changes in subjective memory and memory performance, and (3) variables that moderate associations between these constructs. We applied a latent growth curve model to four occasions of data from 15,824 participants of the Health and Retirement Study (HRS; mean age at baseline = 64.27 years, SD = 9.90; 58 women). Results revealed that latent changes in subjective memory were correlated with latent changes in memory performance (f = 0.49), indicating that participants who reported steeper declines of subjective memory indeed showed steeper declines of memory performance over time. Three major patterns of associations emerged with respect to predictors of subjective memory and subjective memory change. First, the level of memory performance showed stronger associations with age, gender, and education, whereas subjective memory was more strongly associated with subjective age and personality traits. For example, women performed better than men on the episodic memory test, but there were no gender differences in subjective memory. Also, older age was associated with steeper declines of memory performance but with less decline of subjective memory. Second, personality traits that predicted subjective memory intercepts did not predict subjective memory slopes. Third, the strength of associations between levels and slopes of subjective memory and memory performance varied as a function of gender, education, depressive symptoms, and personality traits. Conscientiousness moderated the relationship of the level of subjective memory to the level of memory performance, consistent with the hypothesis that persons high in conscientiousness more accurately monitor memory successes and failures. The results reinforce the importance of depressive symptoms as a predictor of subjective memory but also indicate that a broader perspective on the reasons why memory complaints have modest correlations with memory itself is needed. (C) 2015 S. Karger AG, Basel}, keywords = {Demographics, Expectations, Health Conditions and Status}, doi = {10.1159/000369010}, author = {Hueluer, Gizem and Hertzog, Christopher and Ann M. Pearman and Denis Gerstorf} } @article {8271, title = {Development and demonstration of a state model for the estimation of incidence of partly undetected chronic diseases}, journal = {BMC MEDICAL RESEARCH METHODOLOGY}, volume = {15}, year = {2015}, pages = {98}, publisher = {15}, abstract = {Background: Estimation of incidence of the state of undiagnosed chronic disease provides a crucial missing link for the monitoring of chronic disease epidemics and determining the degree to which changes in prevalence are affected or biased by detection. Methods: We developed a four-part compartment model for undiagnosed cases of irreversible chronic diseases with a preclinical state that precedes the diagnosis. Applicability of the model is tested in a simulation study of a hypothetical chronic disease and using diabetes data from the Health and Retirement Study (HRS). Results: A two dimensional system of partial differential equations forms the basis for estimating incidence of the undiagnosed and diagnosed disease states from the prevalence of the associated states. In the simulation study we reach very good agreement between the estimates and the true values. Application to the HRS data demonstrates practical relevance of the methods. Discussion: We have demonstrated the applicability of the modeling framework in a simulation study and in the analysis of the Health and Retirement Study. The model provides insight into the epidemiology of undiagnosed chronic diseases.}, keywords = {Health Conditions and Status, Methodology}, author = {Ralph Brinks and Barbara H. Bardenheier and Annika Hoyer and Ji Lin and Sandra Landwehr and Edward W Gregg} } @article {8884, title = {Directional dominance on stature and cognition in~diverse human populations.}, journal = {Nature}, volume = {523}, year = {2015}, month = {2015 Jul 23}, pages = {459-62}, abstract = {

Homozygosity has long been associated with rare, often devastating, Mendelian disorders, and Darwin was one of the first to recognize that inbreeding reduces evolutionary fitness. However, the effect of the more distant parental relatedness that is common in modern human populations is less well understood. Genomic data now allow us to investigate the effects of homozygosity on traits of public health importance by observing contiguous homozygous segments (runs of homozygosity), which are inferred to be homozygous along their complete length. Given the low levels of genome-wide homozygosity prevalent in most human populations, information is required on very large numbers of people to provide sufficient power. Here we use runs of homozygosity to study 16 health-related quantitative traits in 354,224 individuals from 102 cohorts, and find statistically significant associations between summed runs~of homozygosity and four complex traits: height, forced expiratory lung volume in one second, general cognitive ability and educational attainment (P < 1 {\texttimes} 10(-300), 2.1 {\texttimes} 10(-6), 2.5 {\texttimes} 10(-10) and 1.8 {\texttimes} 10(-10), respectively). In each case, increased homozygosity was associated with decreased trait value, equivalent to the offspring of first cousins being 1.2 cm shorter and having 10 months{\textquoteright} less education. Similar effect sizes were found across four continental groups and populations with different degrees of genome-wide homozygosity, providing evidence that homozygosity, rather than confounding, directly contributes to phenotypic variance. Contrary to earlier reports in substantially smaller samples, no evidence was seen of an influence of genome-wide homozygosity on blood pressure and low density lipoprotein cholesterol, or ten other cardio-metabolic traits. Since directional dominance is predicted for traits under directional evolutionary selection, this study provides evidence that increased stature and cognitive function have been positively selected in human evolution, whereas many important risk factors for late-onset complex diseases may not have been.

}, keywords = {Biological Evolution, Blood pressure, Body Height, Cholesterol, Cognitive Ability, Cohort Studies, Education, Female, Forced Expiratory Volume, Genome, Homozygote, Humans, Lung Volume Measurements, Male, Phenotype}, issn = {1476-4687}, doi = {10.1038/nature14618}, author = {Joshi, Peter K and T{\~o}nu Esko and Mattsson, Hannele and Eklund, Niina and Gandin, Ilaria and Nutile, Teresa and Jackson, Anne U and Schurmann, Claudia and Albert Vernon Smith and Zhang, Weihua and Okada, Yukinori and Stan{\v c}{\'a}kov{\'a}, Alena and Jessica Faul and Wei Zhao and Traci M Bartz and Maria Pina Concas and Franceschini, Nora and Enroth, Stefan and Vitart, Veronique and Trompet, Stella and Guo, Xiuqing and Daniel I Chasman and Jeff O{\textquoteright}Connell and Corre, Tanguy and Nongmaithem, Suraj S and Chen, Yuning and Mangino, Massimo and Ruggiero, Daniela and Traglia, Michela and Farmaki, Aliki-Eleni and Kacprowski, Tim and Bjonnes, Andrew and van der Spek, Ashley and Wu, Ying and Giri, Anil K and Yanek, Lisa R and Wang, Lihua and Edith Hofer and Cornelius A Rietveld and McLeod, Olga and Marilyn C Cornelis and Pattaro, Cristian and Verweij, Niek and Baumbach, Clemens and Abdel Abdellaoui and Warren, Helen R and Vuckovic, Dragana and Mei, Hao and Bouchard, Claude and Perry, John R B and Cappellani, Stefania and Saira S Mirza and Benton, Miles C and Broeckel, Ulrich and Sarah E Medland and Penelope A Lind and Malerba, Giovanni and Alexander W Drong and Yengo, Loic and Bielak, Lawrence F and Zhi, Degui and van der Most, Peter J and Daniel Shriner and M{\"a}gi, Reedik and Hemani, Gibran and Karaderi, Tugce and Wang, Zhaoming and Tian Liu and Demuth, Ilja and Jing Hua Zhao and Meng, Weihua and Lataniotis, Lazaros and van der Laan, Sander W and Bradfield, Jonathan P and Andrew R Wood and Bonnefond, Amelie and Ahluwalia, Tarunveer S and Hall, Leanne M and Salvi, Erika and Yazar, Seyhan and Carstensen, Lisbeth and de Haan, Hugoline G and Abney, Mark and Afzal, Uzma and Matthew A. Allison and Amin, Najaf and Asselbergs, Folkert W and Bakker, Stephan J L and Barr, R Graham and Baumeister, Sebastian E and Daniel J. Benjamin and Bergmann, Sven and Boerwinkle, Eric and Erwin P Bottinger and Campbell, Archie and Chakravarti, Aravinda and Chan, Yingleong and Chanock, Stephen J and Chen, Constance and Yii-Der I Chen and Collins, Francis S and Connell, John and Correa, Adolfo and Cupples, L Adrienne and Gail Davies and D{\"o}rr, Marcus and Georg B Ehret and Ellis, Stephen B and Feenstra, Bjarke and Feitosa, Mary F and Ford, Ian and Caroline S Fox and Timothy M Frayling and Friedrich, Nele and Geller, Frank and Scotland, Generation and Gillham-Nasenya, Irina and Gottesman, Omri and Graff, Misa and Grodstein, Francine and Gu, Charles and Haley, Chris and Hammond, Christopher J and Sarah E Harris and Tamara B Harris and Nicholas D Hastie and Heard-Costa, Nancy L and Heikkil{\"a}, Kauko and Lynne J Hocking and Homuth, Georg and Jouke-Jan Hottenga and Huang, Jinyan and Huffman, Jennifer E and Hysi, Pirro G and Mohammed Arfan Ikram and Ingelsson, Erik and Joensuu, Anni and Johansson, {\r A}sa and Jousilahti, Pekka and Jukema, J Wouter and K{\"a}h{\"o}nen, Mika and Kamatani, Yoichiro and Kanoni, Stavroula and Kerr, Shona M and Khan, Nazir M and Philipp D Koellinger and Koistinen, Heikki A and Kooner, Manraj K and Kubo, Michiaki and Kuusisto, Johanna and Lahti, Jari and Lenore J Launer and Lea, Rodney A and Lehne, Benjamin and Lehtim{\"a}ki, Terho and David C Liewald and Lars Lind and Loh, Marie and Lokki, Marja-Liisa and London, Stephanie J and Loomis, Stephanie J and Loukola, Anu and Lu, Yingchang and Lumley, Thomas and Lundqvist, Annamari and M{\"a}nnist{\"o}, Satu and Marques-Vidal, Pedro and Masciullo, Corrado and Matchan, Angela and Mathias, Rasika A and Matsuda, Koichi and Meigs, James B and Meisinger, Christa and Meitinger, Thomas and Menni, Cristina and Mentch, Frank D and Mihailov, Evelin and Lili Milani and Montasser, May E and Grant W Montgomery and Alanna C Morrison and Myers, Richard H and Nadukuru, Rajiv and Navarro, Pau and Nelis, Mari and Nieminen, Markku S and Ilja M Nolte and O{\textquoteright}Connor, George T and Ogunniyi, Adesola and Padmanabhan, Sandosh and Walter R Palmas and Pankow, James S and Patarcic, Inga and Pavani, Francesca and Peyser, Patricia A and Pietilainen, Kirsi and Neil Poulter and Prokopenko, Inga and Ralhan, Sarju and Redmond, Paul and Rich, Stephen S and Rissanen, Harri and Robino, Antonietta and Rose, Lynda M and Rose, Richard and Cinzia Felicita Sala and Babatunde Salako and Veikko Salomaa and Sarin, Antti-Pekka and Saxena, Richa and Schmidt, Helena and Scott, Laura J and Scott, William R and Sennblad, Bengt and Seshadri, Sudha and Peter Sever and Shrestha, Smeeta and Smith, Blair H and Jennifer A Smith and Soranzo, Nicole and Sotoodehnia, Nona and Southam, Lorraine and Stanton, Alice V and Stathopoulou, Maria G and Strauch, Konstantin and Strawbridge, Rona J and Suderman, Matthew J and Tandon, Nikhil and Tang, Sian-Tsun and Kent D Taylor and Bamidele O Tayo and T{\"o}glhofer, Anna Maria and Tomaszewski, Maciej and T{\v s}ernikova, Natalia and Tuomilehto, Jaakko and Andr{\'e} G Uitterlinden and Vaidya, Dhananjay and van Hylckama Vlieg, Astrid and van Setten, Jessica and Vasankari, Tuula and Vedantam, Sailaja and Vlachopoulou, Efthymia and Vozzi, Diego and Vuoksimaa, Eero and Waldenberger, Melanie and Erin B Ware and Wentworth-Shields, William and Whitfield, John B and Sarah Wild and Gonneke Willemsen and Yajnik, Chittaranjan S and Yao, Jie and Zaza, Gianluigi and Zhu, Xiaofeng and Salem, Rany M and Melbye, Mads and Bisgaard, Hans and Nilesh J Samani and Cusi, Daniele and Mackey, David A and Cooper, Richard S and Froguel, Philippe and Pasterkamp, Gerard and Grant, Struan F A and Hakonarson, Hakon and Luigi Ferrucci and Scott, Robert A and Morris, Andrew D and Palmer, Colin N A and George Dedoussis and Deloukas, Panos and Bertram, Lars and Lindenberger, Ulman and Berndt, Sonja I and Lindgren, Cecilia M and Nicholas J Timpson and T{\"o}njes, Anke and Munroe, Patricia B and Thorkild I. A. S{\o}rensen and Charles N Rotimi and Donna K Arnett and Oldehinkel, Albertine J and Sharon L R Kardia and Balkau, Beverley and Gambaro, Giovanni and Morris, Andrew P and Johan G Eriksson and Margaret J Wright and Nicholas G Martin and Hunt, Steven C and John M Starr and Ian J Deary and Griffiths, Lyn R and Henning Tiemeier and Nicola Pirastu and Kaprio, Jaakko and Wareham, Nicholas J and P{\'e}russe, Louis and Wilson, James G and Giorgia G Girotto and Caulfield, Mark J and Olli T Raitakari and Dorret I Boomsma and Gieger, Christian and van der Harst, Pim and Hicks, Andrew A and Kraft, Peter and Sinisalo, Juha and Knekt, Paul and Johannesson, Magnus and Patrik K E Magnusson and Hamsten, Anders and Schmidt, Reinhold and Ingrid B Borecki and Vartiainen, Erkki and Becker, Diane M and Bharadwaj, Dwaipayan and Mohlke, Karen L and Boehnke, Michael and Cornelia M van Duijn and Sanghera, Dharambir K and Teumer, Alexander and Zeggini, Eleftheria and Andres Metspalu and Paolo P. Gasparini and Ulivi, Sheila and Ober, Carole and Toniolo, Daniela and Rudan, Igor and David J Porteous and Ciullo, Marina and Timothy Spector and Caroline Hayward and Dupuis, Jos{\'e}e and Ruth J F Loos and Alan F Wright and Chandak, Giriraj R and Vollenweider, Peter and Alan R Shuldiner and Ridker, Paul M and Rotter, Jerome I and Sattar, Naveed and Gyllensten, Ulf and Kari E North and Pirastu, Mario and Psaty, Bruce M and David R Weir and Laakso, Markku and Gudnason, Vilmundur and Takahashi, Atsushi and Chambers, John C and Kooner, Jaspal S and David P Strachan and Campbell, Harry and Joel N Hirschhron and Markus Perola and Polasek, Ozren and James F Wilson} } @article {8668, title = {Disease incidence and mortality among older Americans and Europeans.}, journal = {Demography}, volume = {52}, year = {2015}, month = {2015 Apr}, pages = {593-611}, abstract = {

Recent research has shown a widening gap in life expectancy at age 50 between the United States and Europe as well as large differences in the prevalence of diseases at older ages. Little is known about the processes determining international differences in the prevalence of chronic diseases. Higher prevalence of disease could result from either higher incidence or longer disease-specific survival. This article uses comparable longitudinal data from 2004 and 2006 for populations aged 50 to 79 from the United States and from a selected group of European countries to examine age-specific differences in prevalence and incidence of heart disease, stroke, lung disease, diabetes, hypertension, and cancer as well as mortality associated with each disease. Not surprisingly, we find that Americans have higher disease prevalence. For heart disease, diabetes, and cancer, incidence is lower in Europe when we control for sociodemographic and health behavior differences in risk, and these differences explain much of the prevalence gap at older ages. On the other hand, incidence is higher in Europe for lung disease and not different between Europe and the United States for hypertension and stroke. Our findings do not suggest a survival advantage conditional on disease in Europe compared with the United States. Therefore, the origin of the higher disease prevalence at older ages in the United States is to be found in higher prevalence earlier in the life course and, for some conditions, higher incidence between ages 50 and 79.

}, keywords = {Age Distribution, Aged, Chronic disease, Europe, Health Behavior, Humans, Incidence, Middle Aged, Neoplasms, Prevalence, Risk Factors, Sex Distribution, Socioeconomic factors, United States}, issn = {0070-3370}, doi = {10.1007/s13524-015-0372-7}, author = {Sole-Auro, Aida and Pierre-Carl Michaud and Michael D Hurd and Eileen M. Crimmins} } @article {8219, title = {Effect of APOE and CD33 on Cognitive Decline.}, journal = {PLoS One}, volume = {10}, year = {2015}, note = {Times Cited: 1 0 1}, month = {2015}, pages = {e0130419}, publisher = {10}, abstract = {

OBJECTIVE: An Alzheimer{\textquoteright}s disease (AD) diagnosis is preceded by a long period of cognitive decline. We previously demonstrated increased risk of decline among individuals possessing one or more APOE ε4 alleles together with a family history of AD. The objective of this study is to investigate the possibility that such an increased risk might be due to AD risk genes with small effects in combination with APOE.

METHODS: Participants in the Health and Retirement Study (HRS) over the age of 65, who contributed DNA, and had two or more evaluations with an abbreviated version of the modified Telephone Interview for Cognitive Status (TICS-m) were eligible for the study (n = 7451). A genetic risk score (g-score) was derived using AD risk genes{\textquoteright} meta-analyses data, assigning risk according to the number of risk alleles and summed over all the risk genes. Trajectories of cognitive function were modeled in four groups of Caucasian participants with and without one or more APOE ε4 alleles and either a high or low g-score: APOE ε4-/low g-score; APOE ε4-/high g-score; APOE ε4+/low g-score; and APOE ε4+/high g-score. Post hoc analyses evaluated interactions between individual genes and APOE.

RESULTS: Individuals in the APOE ε4+/high g-score group exhibited the greatest cognitive decline over time (p<.0001). This risk appeared to be greater than the sum of the effects of either high g-score or APOE ε4 alone. When gene interactions were individually tested with APOE, a statistically significant interaction with CD33 was discovered (p = 0.04) although the interaction was no longer significant when adjusted for multiple comparisons.

CONCLUSIONS: Individuals with multiple AD risk genes in addition to having one or more APOE ε4 alleles are at greater risk of cognitive decline than individuals with either APOE ε4 or a high genetic risk score. Among those with one or more APOE ε4 alleles, having one or more copies of the CD33 C (risk) allele may further increase the risk of cognitive decline.

}, keywords = {Aged, Apolipoproteins E, Cognition Disorders, Female, Genetic Predisposition to Disease, Humans, Male, Polymorphism, Single Nucleotide, Sialic Acid Binding Ig-like Lectin 3}, issn = {1932-6203}, doi = {10.1371/journal.pone.0130419}, author = {Kathleen M Hayden and Michael W Lutz and Kuchibhatla, Maragatha and Cassandra M Germain and Brenda L Plassman} } @mastersthesis {6215, title = {Essays in industrial organization}, volume = {3712084}, year = {2015}, note = {Copyright - Copyright ProQuest Dissertations Publishing 2015 Last updated - 2015-09-08 First page - n/a}, month = {2015}, pages = {92}, school = {The University of Chicago}, type = {Ph.D.}, address = {Chicago}, abstract = {Chapter 1 considers markets where there are gains to committing to a contract but the contract is not enforceable. Contracts in these markets typically contain some feature that locks the noncommittal agent, such as a penalty for defaulting on a contract. I argue that these lock-in mechanisms might lead to inefficient contract provisions when there is some uncertainty in the agent{\textquoteright}s valuation of the contract, and such uncertainty cannot be contracted. I then apply this argument when examining the extent to which life insurance contracts drafted today exhibit this form of ex-post inefficiency. There are a few reasons why one would suspect the existence of excessive insurance provisions in the life insurance industry. First, premiums in life insurance contracts are heavily front-loaded to subsidize subsequent premiums. The front-loading of premiums in these contracts and reduction of future premiums, as nicely pointed out by Hendel and Lizzeri (2003), allows firms to insure against rising premiums (insurance against reclassification risk) by reducing the policyholder{\textquoteright}s incentive to drop a contract and shop for a possibly less expensive policy. Indeed, I find that the level at which these contracts are front-loaded eliminates any future incentive for policyholders to repurchase a contract. I also provide evidence that a policyholder{\textquoteright}s preference for insuring against mortality risks changes stochastically over time. Despite heavy premium front-loading, almost 40\% of policyholders allow their insurance to lapse within the first 10 years. Considering that premiums are lower than the cost of supplying mortality risk insurance and that preferences for such insurance changes over time, one would suspect excessive ex-post life insurance provisions. The core analysis of Chapter 1 discusses why the market for term life insurance contracts fail to fully protect policyholders from reclassification risk. Hendel and Lizzeri (2003) argue that such failure arises from the policyholder{\textquoteright}s limited-commitment and credit constraints. In particular, they surmise that a policyholder{\textquoteright}s credit constraint prevents the level of front-loading necessary to prevent all healthy policyholders from eventually walking out. The anticipated default of healthy policyholders then leads to a partial break-down in reclassification risk insurance. I investigate this premise and find that limited commitment alone fails to explain the break-down in full reclassification risk insurance observed in the life-insurance industry. I find that efforts to mitigate ex-post inefficient insurance provisions led to the breakdown of full reclassification risk insurance in this market. Chapter 2 is a joint work with Juliette Caminade and explains why prices of champagne fall during the holiday season. In this chapter, we document countercyclical prices in the sparkling wine market during the holiday season. While quantity demand doubles, prices uniformly decrease and decreases by 16\% on average. We examine the role of changes in aggregate elasticity during high demand periods. Using Nielsen retail data, we find that price elasticity for sparkling wine increases by 50\% during the holidays. We then use household-level data to document how the change in demand is driven by the entry of a large share of new consumers. These consumers are responsible for a quarter of sales during the holidays and are more price elastic. For instance, they spend less on other alcoholic beverages, and they are more likely to use coupons for their purchases or buy generic products. These suggestive facts are confirmed by the results of our household level demand estimation, where we find that changes to aggregate elasticity is driven by the entry of a more elastic segment.}, keywords = {Consumption and Savings, Employment and Labor Force, Healthcare, Methodology, Net Worth and Assets, Other, Risk Taking}, url = {http://proxy.lib.umich.edu/login?url=http://search.proquest.com/docview/1707673975?accountid=14667http://mgetit.lib.umich.edu/?ctx_ver=Z39.88-2004\&ctx_enc=info:ofi/enc:UTF-8\&rfr_id=info:sid/Dissertations+\%26+Theses+\%40+CIC+Institutions\&rft_val_fmt=info:of}, author = {Bayot, Denrick Go} } @mastersthesis {6017, title = {Essays on the economics and econometrics of human capital}, volume = {3712723}, year = {2015}, note = {Copyright - Copyright ProQuest Dissertations Publishing 2015 Last updated - 2015-08-25 First page - n/a}, month = {2015}, pages = {161}, school = {The University of Chicago}, type = {Ph.D.}, address = {Chicago}, abstract = {This thesis is composed by three distinct chapters. They are related by their common theme: the economic analysis of the process of human capital formation. The first chapter distills and extends the recent research on the economics of human development and social mobility. It critically analyzes the literature on the role of early life conditions in shaping multiple life skills with emphasis on the importance of critical and sensitive investments periods in influencing skill development. It develops economic models that rationalize the empirical evidence on treatment effects of social programs and on family influence. It investigates the empirical support of recent claims, made by part of the literature, on the relevance of credit constraints in limiting skill development. It shows how credit constraints are not a major force explaining differences in the amount of parental and self-investments in skills and how untargeted income transfer policies to poor families do not significantly boost child outcomes. The second chapter compares the performance of maximum likelihood and simulated methods of moments in estimating dynamic discrete choice models. It presents a structural model of education and shows how it can be used to estimate heterogeneous returns from schooling choices which account for their continuation values. Continuation values have a large impact on returns, but are ignored in the measures commonly used to assess the value of schooling choices. The estimates from the model are used to compute a synthetic dataset. This is used to assess the ability of maximum likelihood and simulated methods of moments to recover the model parameters. It finally proposes a Monte Carlo exercise to gain confidence on the performance of a simulated method of moments algorithm. The last chapter proposes a method to assess long run impacts on earnings of early interventions even in absence of long-term data collection on earnings histories for program participants. It combines the methodological approaches of the literature on program evaluation, data combination and forecasting to develop estimators of the average treatment effects. This exercise allows a more complete cost-benefit evaluation of social programs accounting for benefits over the whole life cycle.}, keywords = {Methodology, Net Worth and Assets, Other}, url = {http://proxy.lib.umich.edu/login?url=http://search.proquest.com/docview/1705542399?accountid=14667http://mgetit.lib.umich.edu/?ctx_ver=Z39.88-2004\&ctx_enc=info:ofi/enc:UTF-8\&rfr_id=info:sid/Dissertations+\%26+Theses+\%40+CIC+Institutions\&rft_val_fmt=info:of}, author = {Mosso, Stefano} } @article {8920, title = {Future Monetary Costs of Dementia in the United States under Alternative Dementia Prevalence Scenarios.}, journal = {Journal of Population Ageing}, volume = {8}, year = {2015}, month = {2015 Mar}, pages = {101-112}, abstract = {

Population aging will likely lead to increases is health care spending and the ability of governments to support entitlement programs such as Medicare and Medicaid. Dementia is a chronic condition that is especially pertinent because of its strong association with old age and because care for dementia is labor intensive and expensive. Indeed, prior research has found that if current dementia prevalence rates persist population aging will generate very large increases in health care spending for dementia. In this study we considered two alternative assumptions or scenarios about future prevalence. The first adjusts the prevalence projections using recent research that suggests dementia prevalence may be declining. The second uses growth hypertension, obesity and diabetes, and the relationship between dementia and these conditions to adjust future prevalence rates. We find under the first scenario that if the rates of decline in age-specific dementia rates persist, future costs will be much less than previous estimates, about 40\% lower. Under the second scenario, the growth in those conditions makes only small differences in costs.

}, keywords = {Dementia, Forecasting, Health Conditions and Status, Older Adults}, issn = {1874-7884}, doi = {10.1007/s12062-015-9112-4}, author = {Michael D Hurd and Martorell, Paco and Kenneth M. Langa} } @article {8297, title = {Genetic contributions to variation in general cognitive function: a meta-analysis of genome-wide association studies in the CHARGE consortium (N=53949).}, journal = {Mol Psychiatry}, volume = {20}, year = {2015}, note = {Times Cited: 0 0}, month = {2015 Feb}, pages = {183-92}, publisher = {20}, abstract = {

General cognitive function is substantially heritable across the human life course from adolescence to old age. We investigated the genetic contribution to variation in this important, health- and well-being-related trait in middle-aged and older adults. We conducted a meta-analysis of genome-wide association studies of 31 cohorts (N=53,949) in which the participants had undertaken multiple, diverse cognitive tests. A general cognitive function phenotype was tested for, and created in each cohort by principal component analysis. We report 13 genome-wide significant single-nucleotide polymorphism (SNP) associations in three genomic regions, 6q16.1, 14q12 and 19q13.32 (best SNP and closest gene, respectively: rs10457441, P=3.93 {\texttimes} 10(-9), MIR2113; rs17522122, P=2.55 {\texttimes} 10(-8), AKAP6; rs10119, P=5.67 {\texttimes} 10(-9), APOE/TOMM40). We report one gene-based significant association with the HMGN1 gene located on chromosome 21 (P=1 {\texttimes} 10(-6)). These genes have previously been associated with neuropsychiatric phenotypes. Meta-analysis results are consistent with a polygenic model of inheritance. To estimate SNP-based heritability, the genome-wide complex trait analysis procedure was applied to two large cohorts, the Atherosclerosis Risk in Communities Study (N=6617) and the Health and Retirement Study (N=5976). The proportion of phenotypic variation accounted for by all genotyped common SNPs was 29\% (s.e.=5\%) and 28\% (s.e.=7\%), respectively. Using polygenic prediction analysis, ~1.2\% of the variance in general cognitive function was predicted in the Generation Scotland cohort (N=5487; P=1.5 {\texttimes} 10(-17)). In hypothesis-driven tests, there was significant association between general cognitive function and four genes previously associated with Alzheimer{\textquoteright}s disease: TOMM40, APOE, ABCG1 and MEF2C.

}, keywords = {Aged, Aged, 80 and over, Atherosclerosis, Cognition, Cognition Disorders, Cohort Studies, Female, Genetic Predisposition to Disease, Genome-Wide Association Study, HMGN1 Protein, Humans, Male, Middle Aged, Neuropsychological tests, Phenotype, Polymorphism, Single Nucleotide, Scotland}, issn = {1476-5578}, doi = {10.1038/mp.2014.188}, author = {Gail Davies and Armstrong, N. and Joshua C. Bis and Bressler, J. and Chouraki, V. and Giddaluru, S. and Edith Hofer and Carla A Ibrahim-Verbaas and Kirin, M. and J. Lahti and Sven J van der Lee and Stephanie Le Hellard and Tian Liu and Riccardo E Marioni and Christopher J Oldmeadow and Postmus, I. and Albert Vernon Smith} } @article {8882, title = {Genetic studies of body mass index yield new insights for obesity biology.}, journal = {Nature}, volume = {518}, year = {2015}, month = {2015 Feb 12}, pages = {197-206}, abstract = {

Obesity is heritable and predisposes to many diseases. To understand the genetic basis of obesity better, here we conduct a genome-wide association study and Metabochip meta-analysis of body mass index (BMI), a measure commonly used to define obesity and assess adiposity, in up to 339,224 individuals. This analysis identifies 97 BMI-associated loci (P~<~5~{\texttimes}~10(-8)), 56 of which are novel. Five loci demonstrate clear evidence of several independent association signals, and many loci have significant effects on other metabolic phenotypes. The 97 loci account for \~{}2.7\% of BMI variation, and genome-wide estimates suggest that common variation accounts for >20\% of BMI variation. Pathway analyses provide strong support for a role of the central nervous system in obesity susceptibility and implicate new genes and pathways, including those related to synaptic function, glutamate signalling, insulin secretion/action, energy metabolism, lipid biology and adipogenesis.

}, keywords = {Age Factors, BMI, Continental Population Groups, Energy Metabolism, Europe, Female, Genome-Wide Association Study, Glutamic Acid, Humans, Insulin, Male, Obesity, Polymorphism, Single Nucleotide, Quantitative Trait Loci, Synapses}, issn = {1476-4687}, doi = {10.1038/nature14177}, author = {Locke, Adam E and Kahali, Bratati and Berndt, Sonja I and Justice, Anne E and Pers, Tune H and Day, Felix R and Powell, Corey and Vedantam, Sailaja and Buchkovich, Martin L and Yang, Jian and Croteau-Chonka, Damien C and T{\~o}nu Esko and Fall, Tove and Ferreira, Teresa and Gustafsson, Stefan and Kutalik, Zolt{\'a}n and Luan, Jian{\textquoteright}an and M{\"a}gi, Reedik and Randall, Joshua C and Thomas W Winkler and Andrew R Wood and Workalemahu, Tsegaselassie and Jessica Faul and Jennifer A Smith and Jing Hua Zhao and Wei Zhao and Chen, Jin and Rudolf Ferhmann and Hedman, {\r A}sa K and Karjalainen, Juha and Schmidt, Ellen M and Absher, Devin and Amin, Najaf and Anderson, Denise and Beekman, Marian and Bolton, Jennifer L and Bragg-Gresham, Jennifer L and Buyske, Steven and Demirkan, Ayse and Deng, Guohong and Georg B Ehret and Feenstra, Bjarke and Feitosa, Mary F and Fischer, Krista and Goel, Anuj and Gong, Jian and Jackson, Anne U and Kanoni, Stavroula and Kleber, Marcus E and Kristiansson, Kati and Lim, Unhee and Lotay, Vaneet and Mangino, Massimo and Irene Mateo Leach and Medina-Gomez, Carolina and Sarah E Medland and Michael A Nalls and Palmer, Cameron D and Pasko, Dorota and Pechlivanis, Sonali and Peters, Marjolein J and Prokopenko, Inga and Shungin, Dmitry and Stan{\v c}{\'a}kov{\'a}, Alena and Strawbridge, Rona J and Yun Ju Sung and Toshiko Tanaka and Teumer, Alexander and Trompet, Stella and van der Laan, Sander W and van Setten, Jessica and Jana V. van Vliet-Ostaptchouk and Wang, Zhaoming and Yengo, Loic and Zhang, Weihua and Isaacs, Aaron and Albrecht, Eva and {\"A}rnl{\"o}v, Johan and Arscott, Gillian M and Attwood, Antony P and Bandinelli, Stefania and Barrett, Amy and Bas, Isabelita N and Bellis, Claire and Bennett, Amanda J and Berne, Christian and Blagieva, Roza and Bl{\"u}her, Matthias and B{\"o}hringer, Stefan and Bonnycastle, Lori L and B{\"o}ttcher, Yvonne and Boyd, Heather A and Bruinenberg, Marcel and Caspersen, Ida H and Yii-Der I Chen and Robert Clark and Daw, E Warwick and de Craen, Anton J M and Delgado, Graciela and Dimitriou, Maria and Doney, Alex S F and Eklund, Niina and Estrada, Karol and Eury, Elodie and Folkersen, Lasse and Fraser, Ross M and Melissa E Garcia and Geller, Frank and Giedraitis, Vilmantas and Gigante, Bruna and Alan S Go and Golay, Alain and Goodall, Alison H and Gordon, Scott D and Gorski, Mathias and Hans-J{\"o}rgen Grabe and Grallert, Harald and Grammer, Tanja B and Gr{\"a}{\ss}ler, J{\"u}rgen and Gr{\"o}nberg, Henrik and Groves, Christopher J and Gusto, Ga{\"e}lle and Jeffrey Haessler and Hall, Per and Haller, Toomas and Hallmans, G{\"o}ran and Catharina A Hartman and Hassinen, Maija and Caroline Hayward and Heard-Costa, Nancy L and Helmer, Quinta and Hengstenberg, Christian and Oddgeir L Holmen and Jouke-Jan Hottenga and James, Alan L and Janina Jeff and Johansson, {\r A}sa and Jolley, Jennifer and Juliusdottir, Thorhildur and Kinnunen, Leena and Koenig, Wolfgang and Koskenvuo, Markku and Kratzer, Wolfgang and Laitinen, Jaana and Lamina, Claudia and Leander, Karin and Lee, Nanette R and Lichtner, Peter and Lars Lind and Lindstr{\"o}m, Jaana and Ken Sin Lo and Lobbens, St{\'e}phane and Lorbeer, Roberto and Lu, Yingchang and Mach, Fran{\c c}ois and Patrik K E Magnusson and Mahajan, Anubha and McArdle, Wendy L and McLachlan, Stela and Menni, Cristina and Merger, Sigrun and Mihailov, Evelin and Lili Milani and Moayyeri, Alireza and Monda, Keri L and Morken, Mario A and Mulas, Antonella and M{\"u}ller, Gabriele and M{\"u}ller-Nurasyid, Martina and Musk, Arthur W and Nagaraja, Ramaiah and Markus M N{\"o}then and Ilja M Nolte and Pilz, Stefan and Nigel W Rayner and Renstrom, Frida and Rettig, Rainer and Ried, Janina S and Ripke, Stephan and Neil R Robertson and Rose, Lynda M and Sanna, Serena and Scharnagl, Hubert and Scholtens, Salome and Schumacher, Fredrick R and Scott, William R and Seufferlein, Thomas and Jianxin Shi and Albert Vernon Smith and Smolonska, Joanna and Stanton, Alice V and Steinthorsdottir, Valgerdur and Kathleen E Stirrups and Heather M Stringham and Sundstr{\"o}m, Johan and Swertz, Morris A and Swift, Amy J and Syv{\"a}nen, Ann-Christine and Tan, Sian-Tsung and Bamidele O Tayo and Thorand, Barbara and Thorleifsson, Gudmar and Tyrer, Jonathan P and Uh, Hae-Won and Vandenput, Liesbeth and Verhulst, Frank C and Vermeulen, Sita H and Verweij, Niek and Vonk, Judith M and Lindsay L Waite and Warren, Helen R and Dawn M Waterworth and Michael N Weedon and Wilkens, Lynne R and Willenborg, Christina and Wilsgaard, Tom and Wojczynski, Mary K and Wong, Andrew and Alan F Wright and Zhang, Qunyuan and Brennan, Eoin P and Murim Choi and Dastani, Zari and Alexander W Drong and Eriksson, Per and Franco-Cereceda, Anders and G{\r a}din, Jesper R and Gharavi, Ali G and Goddard, Michael E and Handsaker, Robert E and Huang, Jinyan and Karpe, Fredrik and Kathiresan, Sekar and Keildson, Sarah and Kiryluk, Krzysztof and Kubo, Michiaki and Lee, Jong-Young and Liang, Liming and Lifton, Richard P and Ma, Baoshan and McCarroll, Steven A and McKnight, Amy J and Min, Josine L and Moffatt, Miriam F and Grant W Montgomery and Joanne M Murabito and Nicholson, George and Nyholt, Dale R and Okada, Yukinori and Perry, John R B and Dorajoo, Rajkumar and Reinmaa, Eva and Salem, Rany M and Sandholm, Niina and Scott, Robert A and Stolk, Lisette and Takahashi, Atsushi and Tanaka, Toshihiro and Ferdinand M van {\textquoteright}t Hooft and Anna A E Vinkhuyzen and Westra, Harm-Jan and Wei Zhang and Krina T Zondervan and Andrew C Heath and Arveiler, Dominique and Bakker, Stephan J L and Beilby, John and Bergman, Richard N and Blangero, John and Bovet, Pascal and Campbell, Harry and Caulfield, Mark J and Cesana, Giancarlo and Chakravarti, Aravinda and Daniel I Chasman and Chines, Peter S and Collins, Francis S and Crawford, Dana C and Cupples, L Adrienne and Cusi, Daniele and Danesh, John and de Faire, Ulf and Hester M den Ruijter and Dominiczak, Anna F and Erbel, Raimund and Erdmann, Jeanette and Johan G Eriksson and Farrall, Martin and Felix, Stephan B and Ferrannini, Ele and Ferri{\`e}res, Jean and Ford, Ian and Forouhi, Nita G and Forrester, Terrence and Franco, Oscar H and Gansevoort, Ron T and Gejman, Pablo V and Gieger, Christian and Gottesman, Omri and Gudnason, Vilmundur and Gyllensten, Ulf and Hall, Alistair S and Tamara B Harris and Andrew T Hattersley and Hicks, Andrew A and Hindorff, Lucia A and Aroon Hingorani and Hofman, Albert and Homuth, Georg and Hovingh, G Kees and Humphries, Steve E and Hunt, Steven C and Hypp{\"o}nen, Elina and Illig, Thomas and Jacobs, Kevin B and J{\"a}rvelin, Marjo-Riitta and J{\"o}ckel, Karl-Heinz and Johansen, Berit and Jousilahti, Pekka and Jukema, J Wouter and Jula, Antti M and Kaprio, Jaakko and Kastelein, John J P and Keinanen-Kiukaanniemi, Sirkka M and Lambertus A Kiemeney and Knekt, Paul and Kooner, Jaspal S and Charles Kooperberg and Kovacs, Peter and Kraja, Aldi T and Kumari, Meena and Kuusisto, Johanna and Lakka, Timo A and Langenberg, Claudia and Loic Le Marchand and Lehtim{\"a}ki, Terho and Lyssenko, Valeriya and M{\"a}nnist{\"o}, Satu and Marette, Andr{\'e} and Matise, Tara C and McKenzie, Colin A and McKnight, Barbara and Moll, Frans L and Morris, Andrew D and Morris, Andrew P and Murray, Jeffrey C and Nelis, Mari and Ohlsson, Claes and Oldehinkel, Albertine J and Ong, Ken K and Pamela A F Madden and Pasterkamp, Gerard and Peden, John F and Peters, Annette and Postma, Dirkje S and Pramstaller, Peter P and Price, Jackie F and Qi, Lu and Olli T Raitakari and Rankinen, Tuomo and Rao, D C and Rice, Treva K and Ridker, Paul M and Rioux, John D and Ritchie, Marylyn D and Rudan, Igor and Veikko Salomaa and Nilesh J Samani and Saramies, Jouko and Sarzynski, Mark A and Schunkert, Heribert and Schwarz, Peter E H and Peter Sever and Alan R Shuldiner and Sinisalo, Juha and Stolk, Ronald P and Strauch, Konstantin and T{\"o}njes, Anke and Tr{\'e}gou{\"e}t, David-Alexandre and Tremblay, Angelo and Tremoli, Elena and Virtamo, Jarmo and Vohl, Marie-Claude and V{\"o}lker, Uwe and Waeber, G{\'e}rard and Gonneke Willemsen and Witteman, Jacqueline C and Zillikens, M Carola and Adair, Linda S and Amouyel, Philippe and Asselbergs, Folkert W and Assimes, Themistocles L and Bochud, Murielle and Boehm, Bernhard O and Boerwinkle, Eric and Bornstein, Stefan R and Erwin P Bottinger and Bouchard, Claude and Cauchi, St{\'e}phane and Chambers, John C and Chanock, Stephen J and Cooper, Richard S and de Bakker, Paul I W and George Dedoussis and Luigi Ferrucci and Franks, Paul W and Froguel, Philippe and Leif C Groop and Christopher A Haiman and Hamsten, Anders and Hui, Jennie and Hunter, David J and Hveem, Kristian and Kaplan, Robert C and Mika Kivim{\"a}ki and Kuh, Diana and Laakso, Markku and Yongmei Liu and Nicholas G Martin and M{\"a}rz, Winfried and Melbye, Mads and Andres Metspalu and Moebus, Susanne and Munroe, Patricia B and Nj{\o}lstad, Inger and Ben A Oostra and Palmer, Colin N A and Nancy L Pedersen and Markus Perola and P{\'e}russe, Louis and Peters, Ulrike and Power, Chris and Quertermous, Thomas and Rauramaa, Rainer and Fernando Rivadeneira and Saaristo, Timo E and Saleheen, Danish and Sattar, Naveed and Eric E Schadt and Schlessinger, David and Eline P Slagboom and Snieder, Harold and Timothy Spector and Thorsteinsdottir, Unnur and Stumvoll, Michael and Tuomilehto, Jaakko and Andr{\'e} G Uitterlinden and Uusitupa, Matti and van der Harst, Pim and Walker, Mark and Wallaschofski, Henri and Wareham, Nicholas J and Watkins, Hugh and David R Weir and Wichmann, H-Erich and James F Wilson and Zanen, Pieter and Ingrid B Borecki and Deloukas, Panos and Caroline S Fox and Iris M Heid and Jeff O{\textquoteright}Connell and David P Strachan and Stefansson, Kari and Cornelia M van Duijn and Gon{\c c}alo R Abecasis and Lude L Franke and Timothy M Frayling and McCarthy, Mark I and Peter M Visscher and Scherag, Andre and Willer, Cristen J and Boehnke, Michael and Mohlke, Karen L and Lindgren, Cecilia M and Beckmann, Jacques S and Barroso, In{\^e}s and Kari E North and Ingelsson, Erik and Joel N Hirschhron and Ruth J F Loos and Elizabeth K Speliotes} } @article {8167, title = {Grandchild care, intergenerational transfers, and grandparents labor supply}, journal = {Review of Economics of the Household}, volume = {13}, year = {2015}, pages = {359-384}, publisher = {13}, abstract = {One-fifth of children aged below five with employed mothers benefit from grandparent provided child care as their main source of daycare in the US. Using data from the health and retirement study, we investigate how grandchild care needs relate to intergenerational transfers of time and money and grandparents labor supply behavior. We find that grandparents with a new born grandchild are more likely to provide grandchild care while married grandparents are also more likely to be employed and provide financial help. Grandparents with grandchildren living close by provided higher time transfers while married grandmothers with resident grandchildren also worked longer hours.}, keywords = {Adult children, Healthcare}, doi = {10.1007/s11150-013-9221-x}, url = {http://dx.doi.org/10.1007/s11150-013-9221-x}, author = {Ho, Christine} } @article {8606, title = {GWAS of longevity in CHARGE consortium confirms APOE and FOXO3 candidacy.}, journal = {J Gerontol A Biol Sci Med Sci}, volume = {70}, year = {2015}, month = {2015 Jan}, pages = {110-8}, abstract = {

BACKGROUND: The genetic contribution to longevity in humans has been estimated to range from 15\% to 25\%. Only two genes, APOE and FOXO3, have shown association with longevity in multiple independent studies.

METHODS: We conducted a meta-analysis of genome-wide association studies including 6,036 longevity cases, age >=90 years, and 3,757 controls that died between ages 55 and 80 years. We additionally attempted to replicate earlier identified single nucleotide polymorphism (SNP) associations with longevity.

RESULTS: In our meta-analysis, we found suggestive evidence for the association of SNPs near CADM2 (odds ratio [OR] = 0.81; p value = 9.66 {\texttimes} 10(-7)) and GRIK2 (odds ratio = 1.24; p value = 5.09 {\texttimes} 10(-8)) with longevity. When attempting to replicate findings earlier identified in genome-wide association studies, only the APOE locus consistently replicated. In an additional look-up of the candidate gene FOXO3, we found that an earlier identified variant shows a highly significant association with longevity when including published data with our meta-analysis (odds ratio = 1.17; p value = 1.85{\texttimes}10(-10)).

CONCLUSIONS: We did not identify new genome-wide significant associations with longevity and did not replicate earlier findings except for APOE and FOXO3. Our inability to find new associations with survival to ages >=90 years because longevity represents multiple complex traits with heterogeneous genetic underpinnings, or alternatively, that longevity may be regulated by rare variants that are not captured by standard genome-wide genotyping and imputation of common variants.

}, keywords = {Aged, Aged, 80 and over, Apolipoproteins E, Cell Adhesion Molecules, Cohort Studies, Female, Forkhead Box Protein O3, Forkhead Transcription Factors, Genome-Wide Association Study, Humans, Longevity, Male, Middle Aged, Polymorphism, Single Nucleotide, Receptors, Kainic Acid}, issn = {1758-535X}, doi = {10.1093/gerona/glu166}, url = {https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4296168/}, author = {Broer, Linda and Aron S Buchman and Deelen, Joris and Daniel S Evans and Jessica Faul and Kathryn L Lunetta and Sebastiani, Paola and Jennifer A Smith and Albert Vernon Smith and Toshiko Tanaka and Lei Yu and Alice M. Arnold and Aspelund, Thor and Emelia J Benjamin and Philip L de Jager and Gu{\dh}ny Eir{\'\i}ksd{\'o}ttir and Melissa E Garcia and Hofman, Albert and Kaplan, Robert C and Sharon L R Kardia and Douglas P Kiel and Ben A Oostra and Orwoll, Eric S and Parimi, Neeta and Psaty, Bruce M and Fernando Rivadeneira and Rotter, Jerome I and Seshadri, Sudha and Andrew B Singleton and Henning Tiemeier and Andr{\'e} G Uitterlinden and Wei Zhao and Bandinelli, Stefania and David A Bennett and Luigi Ferrucci and Gudnason, Vilmundur and Tamara B Harris and Karasik, David and Lenore J Launer and Thomas T Perls and Eline P Slagboom and Tranah, Gregory J and David R Weir and Anne B Newman and Cornelia M van Duijn and Joanne M Murabito} } @article {8205, title = {Historical improvements in well-being do not hold in late life: Birth- and death-year cohorts in the United States and Germany.}, journal = {Dev Psychol}, volume = {51}, year = {2015}, note = {Times Cited: 0 0}, month = {2015 Jul}, pages = {998-1012}, publisher = {51}, abstract = {

One key objective of life span research is to examine how individual development is shaped by the historical time people live in. Secular trends favoring later-born cohorts on fluid cognitive abilities have been widely documented, but findings are mixed for well-being. It remains an open question whether secular increases in well-being seen in earlier phases of life also manifest in the last years of life. To examine this possibility, we made use of longitudinal data obtained from the mid-1980s until the late 2000s in 2 large national samples in the United States (Health and Retirement Study [HRS]) and Germany (German Socio-Economic Panel [SOEP]). We operationally defined historical time from 2 complementary perspectives: birth-year cohorts based on the years in which people were born (earlier: 1930s vs. later: 1940s) and death-year cohorts based on the years in which people died (earlier: 1990s vs. later: 2000s). To control for relevant covariates, we used case-matched groups based on age (at death) and education and covaried for gender, health, and number of observations. Results from both countries revealed that well-being in old age was indeed developing at higher levels among later-born cohorts. However, for later-deceased cohorts, no evidence for secular increases in well-being was found. To the contrary, later-dying SOEP participants reported lower levels of well-being at age 75 and 2 years prior to death and experienced steeper late-life declines. Our results suggest that secular increases in well-being observed in old age do not manifest in late life, where "manufactured" survival may be exacerbating age- and mortality-related declines.

}, keywords = {Aged, Aging, Cohort Effect, depression, Epidemiologic Research Design, Female, Germany, Health Status, Health Surveys, Humans, Longitudinal Studies, Male, Propensity Score, United States}, issn = {1939-0599}, doi = {10.1037/a0039349}, author = {H{\"u}l{\"u}r, Gizem and Ram, Nilam and Denis Gerstorf} } @article {8143, title = {How much do respondents in the health and retirement study know about their contributions to tax-deferred contribution plans? A cross-cohort comparison}, journal = {Journal of Pension Economics and Finance}, volume = {14}, year = {2015}, note = {Export Date: 6 August 2014 Article in Press}, pages = {203-239}, publisher = {14}, abstract = {We use information from Social Security earnings records to examine the accuracy of survey responses regarding participation in tax-deferred pension plans. As employer-provided defined benefit pensions are replaced by voluntary contribution plans, employees{\textquoteright} understanding of the link between their annual contributions and their post-retirement wealth is becoming increasingly important. We examine the extent to which wage-earners in the Health and Retirement Study (HRS) correctly report their inclusion in tax-deferred contribution plans and, conditional on inclusion, their annual contributions. We use three samples representing different cohorts in three different periods: the original HRS cohort interviewed in 1992 at ages 51-56, the War Babies cohort interviewed in 1998 at ages 51-56, and the Early Baby Boomer cohort interviewed in 2004 at the same ages. Our findings indicate that while respondents interviewed in 1998 and 2004 were more likely to correctly report whether they were included in defined contribution plans, they were no more accurate when reporting whether they had contributed to their plans than respondents interviewed in 1992. Contributors in the three cohorts, moreover, overstated their annual contributions and thus would be likely to realize lower than expected account balances at retirement. The magnitude of this error is not negligible. In all three cohorts, the mean reporting error (the absolute difference between respondent-reported and Social Security earnings record contributions) was approximately 1.5 times larger than the mean contribution in the W-2 earnings record. Copyright Cambridge University Press 2014 This is a work of the U.S. Government and is not subject to copyright protection in the United States.}, keywords = {Employment and Labor Force, Pensions, Social Security}, doi = {10.1017/S1474747214000237}, author = {Irena Dushi and Honig, Marjorie} } @article {8170, title = {How well do individuals predict the selling prices of their homes?}, journal = {Journal of Housing Economics}, volume = {29}, year = {2015}, note = {Export Date: 9 September 2015}, pages = {12-25}, publisher = {29}, abstract = {The accuracy of property values estimated by homeowners is an open empirical question that requires an evaluation of the reported values using a market assessment. Using information on selling prices from the Health and Retirement Study and the American Housing Survey, and after accounting for possible measurement error in reporting and selection regarding those who we observe selling, we find evidence that homeowners overestimate the value of their properties by around 8 with an estimated range between 3.4 and 12.7 (95 CI). 2015.}, keywords = {Housing, Methodology}, doi = {10.1016/j.jhe.2015.04.001}, url = {http://www.scopus.com/inward/record.url?eid=2-s2.0-84936102548andpartnerID=40andmd5=17ba0e3e060e90bbe8714681ba524863}, author = {Hugo Ben{\'\i}tez-Silva and Sel{\c c}uk Eren and Frank Heiland and Jimenez-Martin, Sergi} } @inbook {5260, title = {Inter-Cohort Variation in the Consequences of U.S. Military Service for Men{\textquoteright}s Mid- to Late-Life Body Mass Index Trajectories}, booktitle = {A Life Course Perspective on Health Trajectories and Transitions}, year = {2015}, pages = {133-154}, publisher = {Springer}, organization = {Springer}, address = {New York}, abstract = {Body mass index (BMI) is an important health indicator that changes with age and may be shaped in important ways by prior military service. While a high proportion of older men in the United States served in the military, to date, there has been no longitudinal, population-representative study of veteran status differences in men s mid- to late-life BMI trajectories. In this chapter, we use data from the 1992 2010 Health and Retirement Study (HRS) and growth curve models to examine veteran status differences in mid- to late-life BMI trajectories for cohorts of men born in the United States during the first half of the twentieth century. Without any controls in the models, veterans exhibit lower BMI, on average, than non-veterans. Once we add controls for birth cohort, early-life characteristics that occur prior to military service, potentially mediating mid- to late-life characteristics, and methodological controls for proxy report, attrition, and death during the study period, the effect of veteran status is small, marginally significant, and positive net of other factors, veterans are marginally heavier than their non-veteran counterparts. Taken together, our analyses demonstrate the large effect of the secular trend in increased weight across the population younger cohorts are substantially heavier than older cohorts regardless of their veteran status and a substantively small but consistent, positive intra-cohort effect of veteran status.}, keywords = {Demographics, Health Conditions and Status, Methodology}, author = {Janet M Wilmoth and Andrew S London and Christine L Himes}, editor = {Burton-Jeangros, Claudine and Cullati, St{\'e}phane and Sacker, Amanda and Blane, David} } @article {8295, title = {Internet Use and Well-Being in Older Adults}, journal = {Cyberpsychology Behavior and Social Networking}, volume = {18}, year = {2015}, note = {Times Cited: 0 0}, pages = {268-272}, publisher = {18}, abstract = {The Internet has become an important social context in the lives of older adults. Extant research has focused on the use of the Internet and how it influences well-being. However, conflicting findings exist. The purpose of the study was to develop an integrative research model in order to determine the nature of the relationships among Internet use, loneliness, social support, life satisfaction, and psychological well-being. Specifically, loneliness and social support were tested as potential mediators that may modify the relationship between Internet use and indicators of well-being. Data from the U.S. Health and Retirement Study (HRS) were used, and the association among Internet use, social support, loneliness, life satisfaction, and psychological well-being was explored. The sample consisted of 5,203 older adults (aged 65 years and older). The results indicated that higher levels of Internet use were significant predictors of higher levels of social support, reduced loneliness, and better life satisfaction and psychological well-being among older adults.}, keywords = {Adult children, Health Conditions and Status, Other}, doi = {10.1089/cyber.2014.0549}, author = {Jinmoo Heo and Sanghee Chun and Lee, Sunwoo and Lee, Kyung Hee and Kim, Junhyoung} } @article {8889, title = {Large-scale genomic analyses link reproductive aging to hypothalamic signaling, breast cancer susceptibility and BRCA1-mediated DNA repair.}, journal = {Nat Genet}, volume = {47}, year = {2015}, month = {2015 Nov}, pages = {1294-303}, abstract = {

Menopause timing has a substantial impact on infertility and risk of disease, including breast cancer, but the underlying mechanisms are poorly understood. We report a dual strategy in \~{}70,000 women to identify common and low-frequency protein-coding variation associated with age at natural menopause (ANM). We identified 44 regions with common variants, including two regions harboring additional rare missense alleles of large effect. We found enrichment of signals in or near genes involved in delayed puberty, highlighting the first molecular links between the onset and end of reproductive lifespan. Pathway analyses identified major association with DNA damage response (DDR) genes, including the first common coding variant in BRCA1 associated with any complex trait. Mendelian randomization analyses supported a causal effect of later ANM on breast cancer risk (\~{}6\% increase in risk per year; P = 3 {\texttimes} 10(-14)), likely mediated by prolonged sex hormone exposure rather than DDR mechanisms.

}, keywords = {Age Factors, Aging, BRCA1 Protein, Breast Neoplasms, DNA Repair, Female, Genome, Genome-Wide Association Study, Genotype, Humans, Hypothalamus, Menopause, Middle Aged, Models, Genetic, Older Adults, Phenotype, Reproduction, Signal Transduction}, issn = {1546-1718}, doi = {10.1038/ng.3412}, author = {Day, Felix R and Ruth, Katherine S and Thompson, Deborah J and Kathryn L Lunetta and Pervjakova, Natalia and Daniel I Chasman and Stolk, Lisette and Finucane, Hilary K and Sulem, Patrick and Bulik-Sullivan, Brendan and T{\~o}nu Esko and Andrew D Johnson and Elks, Cathy E and Franceschini, Nora and He, Chunyan and Altmaier, Elisabeth and Brody, Jennifer A and Lude L Franke and Huffman, Jennifer E and Keller, Margaux F and McArdle, Patrick F and Nutile, Teresa and Porcu, Eleonora and Robino, Antonietta and Rose, Lynda M and Schick, Ursula M and Jennifer A Smith and Teumer, Alexander and Traglia, Michela and Vuckovic, Dragana and Yao, Jie and Wei Zhao and Albrecht, Eva and Amin, Najaf and Corre, Tanguy and Jouke-Jan Hottenga and Mangino, Massimo and Albert Vernon Smith and Toshiko Tanaka and Gon{\c c}alo R Abecasis and Andrulis, Irene L and Anton-Culver, Hoda and Antoniou, Antonis C and Arndt, Volker and Alice M. Arnold and Barbieri, Caterina and Beckmann, Matthias W and Beeghly-Fadiel, Alicia and Benitez, Javier and Bernstein, Leslie and Bielinski, Suzette J and Blomqvist, Carl and Boerwinkle, Eric and Bogdanova, Natalia V and Bojesen, Stig E and Manjeet K. Bolla and Borresen-Dale, Anne-Lise and Boutin, Thibaud S and Brauch, Hiltrud and Brenner, Hermann and Br{\"u}ning, Thomas and Burwinkel, Barbara and Campbell, Archie and Campbell, Harry and Chanock, Stephen J and Chapman, J Ross and Yii-Der I Chen and Chenevix-Trench, Georgia and Couch, Fergus J and Coviello, Andrea D and Cox, Angela and Czene, Kamila and Darabi, Hatef and De Vivo, Immaculata and Ellen W Demerath and Joe G Dennis and Devilee, Peter and D{\"o}rk, Thilo and Dos-Santos-Silva, Isabel and Dunning, Alison M and John D Eicher and Fasching, Peter A and Jessica Faul and Figueroa, Jonine and Flesch-Janys, Dieter and Gandin, Ilaria and Melissa E Garcia and Garc{\'\i}a-Closas, Montserrat and Giles, Graham G and Giorgia G Girotto and Goldberg, Mark S and Gonz{\'a}lez-Neira, Anna and Goodarzi, Mark O and Grove, Megan L and Gudbjartsson, Daniel F and Gu{\'e}nel, Pascal and Guo, Xiuqing and Christopher A Haiman and Hall, Per and Hamann, Ute and Henderson, Brian E and Lynne J Hocking and Hofman, Albert and Homuth, Georg and Hooning, Maartje J and John L Hopper and Hu, Frank B and Huang, Jinyan and Humphreys, Keith and Hunter, David J and Jakubowska, Anna and Jones, Samuel E and Kabisch, Maria and Karasik, David and Knight, Julia A and Kolcic, Ivana and Charles Kooperberg and Kosma, Veli-Matti and Kriebel, Jennifer and Kristensen, Vessela and Lambrechts, Diether and Langenberg, Claudia and Li, Jingmei and Li, Xin and Lindstr{\"o}m, Sara and Yongmei Liu and Luan, Jian{\textquoteright}an and Lubinski, Jan and M{\"a}gi, Reedik and Mannermaa, Arto and Manz, Judith and Margolin, Sara and Marten, Jonathan and Nicholas G Martin and Masciullo, Corrado and Meindl, Alfons and Michailidou, Kyriaki and Mihailov, Evelin and Lili Milani and Milne, Roger L and M{\"u}ller-Nurasyid, Martina and Michael A Nalls and Neale, Benjamin M and Nevanlinna, Heli and Neven, Patrick and Anne B Newman and B{\o}rge G Nordestgaard and Olson, Janet E and Padmanabhan, Sandosh and Peterlongo, Paolo and Peters, Ulrike and Petersmann, Astrid and Peto, Julian and Pharoah, Paul D P and Nicola Pirastu and Pirie, Ailith and Pistis, Giorgio and Polasek, Ozren and David J Porteous and Psaty, Bruce M and Pylk{\"a}s, Katri and Radice, Paolo and Raffel, Leslie J and Fernando Rivadeneira and Rudan, Igor and Rudolph, Anja and Ruggiero, Daniela and Cinzia Felicita Sala and Sanna, Serena and Sawyer, Elinor J and Schlessinger, David and Schmidt, Marjanka K and Schmidt, Frank and Schmutzler, Rita K and Schoemaker, Minouk J and Scott, Robert A and Seynaeve, Caroline M and Simard, Jacques and Sorice, Rossella and Southey, Melissa C and St{\"o}ckl, Doris and Strauch, Konstantin and Swerdlow, Anthony and Kent D Taylor and Thorsteinsdottir, Unnur and Toland, Amanda E and Tomlinson, Ian and Truong, Th{\'e}r{\`e}se and Tryggvadottir, Laufey and Stephen T Turner and Vozzi, Diego and Wang, Qin and Wellons, Melissa and Gonneke Willemsen and James F Wilson and Winqvist, Robert and Wolffenbuttel, Bruce B H R and Alan F Wright and Yannoukakos, Drakoulis and Zemunik, Tatijana and Wei Zhang and Zygmunt, Marek and Bergmann, Sven and Dorret I Boomsma and Buring, Julie E and Luigi Ferrucci and Grant W Montgomery and Gudnason, Vilmundur and Timothy Spector and Cornelia M van Duijn and Alizadeh, Behrooz Z and Ciullo, Marina and Crisponi, Laura and Easton, Douglas F and Paolo P. Gasparini and Gieger, Christian and Tamara B Harris and Caroline Hayward and Sharon L R Kardia and Kraft, Peter and McKnight, Barbara and Andres Metspalu and Alanna C Morrison and Reiner, Alex P and Ridker, Paul M and Rotter, Jerome I and Toniolo, Daniela and Andr{\'e} G Uitterlinden and Ulivi, Sheila and V{\"o}lzke, Henry and Wareham, Nicholas J and David R Weir and Laura M Yerges-Armstrong and Price, Alkes L and Stefansson, Kari and Visser, Jenny A and Ong, Ken K and Chang-Claude, Jenny and Joanne M Murabito and Perry, John R B and Murray, Anna} } @article {8244, title = {A Life Course Approach to Inequality: Examining Racial/Ethnic Differences in the Relationship between Early Life Socioeconomic Conditions and Adult Health Among Men.}, journal = {Ethn Dis}, volume = {25}, year = {2015}, month = {2015 Aug 07}, pages = {313-20}, publisher = {25}, abstract = {

OBJECTIVE: Previous research has documented a relationship between childhood socioeconomic conditions and adult health, but less is known about racial/ethnic differences in this relationship, particularly among men. This study utilizes a life course approach to investigate racial/ethnic differences in the relationships among early and later life socioeconomic circumstances and health in adulthood among men.

DESIGN: Panel data from the Health and Retirement Study and growth curve models are used to examine group differences in the relationships among childhood and adult socioeconomic factors and age-trajectories of self-rated health among White, Black and Mexican American men aged 51-77 years (N=4147).

RESULTS: Multiple measures of childhood socioeconomic status (SES) predict health in adulthood for White men, while significantly fewer measures of childhood SES predict health for Black and Mexican American men. Moreover, the health consequences of childhood SES diminish with age for Black and Mexican American men. The childhood SES-adult health relationship is largely explained by measures of adult SES for White men.

CONCLUSIONS: The life course pathways linking childhood SES and adult health differ by race/ethnicity among men. Similar to arguments that the universality of the adult SES-health relationship should not be assumed, results from our study suggest that scholars should not assume that the significance and nature of the association between childhood SES and health in adulthood is similar across race/ethnicity among men.

}, keywords = {Adult, Aged, ethnicity, Humans, Life Change Events, Male, Men{\textquoteright}s health, Middle Aged, Racial Groups, Socioeconomic factors, United States}, issn = {1049-510X}, doi = {10.18865/ed.25.3.313}, author = {Taylor W. Hargrove and Tyson H Brown} } @article {8325, title = {Long-Term BMI Trajectories and Health in Older Adults: Hierarchical Clustering of Functional Curves}, journal = {Journal of Aging and Health}, volume = {27}, year = {2015}, pages = {1443-1461}, publisher = {27}, abstract = {Objective: This project contributes to the emerging research that aims to identify distinct body mass index (BMI) trajectory types in the population. We identify clusters of long-term BMI curves among older adults and determine how the clusters differ with respect to initial health. Method: Health and Retirement Study cohort (N = 9,893) with BMI information collected in up to 10 waves (1992-2010) is analyzed using a powerful cutting-edge approach: hierarchical clustering of BMI functions estimated via the Principal Analysis by Conditional Expectations (PACE) algorithm. Results: Three BMI trajectory clusters emerged for each gender: stable, gaining, and losing. The initial health of the gaining and stable groups in both genders was comparable; the losing cluster experienced significantly poorer health at baseline. Discussion: BMI trajectories among older adults cluster into distinct types in both genders, and the clusters vary substantially in initial health. Weight loss but not gain is associated with poor initial health in this age group.}, keywords = {Demographics, Health Conditions and Status, Methodology}, doi = {10.1177/0898264315584329}, url = {http://jah.sagepub.com/content/early/2015/04/22/0898264315584329.abstract}, author = {Zajacova, Anna and Huzurbazar, Snehalata and Greenwood, Mark and Nguyen, Huong} } @mastersthesis {6337, title = {Long-term effects of economic fluctuations on health and cognition in Europe and the United States}, volume = {Ph.D.}, year = {2015}, month = {2015}, pages = {211}, school = {London School of Economics and Political Science (LSE)}, type = {Ph.D.}, address = {London}, abstract = {Several studies suggest that population health improves during recessions and deteriorates during economic expansions. However, the majority of these studies only focus on the short-term or contemporaneous effects of economic fluctuations on health. As a result, very little evidence exists on potential long-term health effects of exposure to booms or recessions. This can be regarded as a major gap in knowledge, given the fact that most diseases are the results of exposure or behaviours during a longer period of time. Furthermore, a large body of research also suggests that many risks associated with recessions may accumulate over the course of life and lead to a gradual deterioration in health. By focusing only on the short-term effects, most studies thus ignore potential longrun health effects of economic fluctuations. This thesis aims to bridge the gap between studies on the population level assessing the short-term effects of economic fluctuations on health, and studies on the individual level, which have analysed the health-effects of risks associated with a declining economy including unemployment, job loss and job insecurity. In order to assess potential longterm effects of business cycles on health, I linked historical information on macroeconomic fluctuations during the 20th century to individual-level data from the Survey of Health, Ageing and Retirement in Europe (SHARE) as well as the U.S. Health and Retirement Study (HRS). This approach makes it possible to identify the state of the economy during different life-course periods for every respondent and relate it to health outcomes measured in later life. Regarding the macroeconomic conditions at any given age as largely exogenous, the four empirical papers included in this thesis thereby assess the relationship between business cycles and health during three different life-course periods: the time around graduation from full-time education, middle and late adulthood as well as the years nearing retirement. Overall, the results suggest that individuals who experienced less favourable economic conditions during these life-course periods have a higher risk of having additional limitations in physical functioning, lower levels of cognitive functioning, as well as higher risks of cardiovascular disease in later life. In contrast to studies showing that population health improves during recessions, these findings suggest that potential short-term improvements in health may be outweighed by deteriorations in health in the long run. They also raise important questions about the role of potential mechanisms linking differential exposure to the business cycle to health in later life.}, keywords = {Cross-National, Event History/Life Cycle, Health Conditions and Status, Methodology, Public Policy, SHARE}, author = {Hessel, Philipp} } @mastersthesis {6334, title = {No Place Like Home? Disability and Living Arrangements in Later Life}, volume = {Ph.D.}, year = {2015}, month = {2015}, pages = {259}, school = {University of Minnesota}, abstract = {Current literature on the relationships between disability and both the physical and social environments of one{\textquoteright}s living arrangement is scarce. The relationship between disability and living arrangements in later life is inherently complex, yet it has the potential to impact older adults{\textquoteright} lives in significant ways. With this dissertation, I sought to address this gap in the literature and add to our understanding of how older adults{\textquoteright} environments and functional statuses interact. My specific aims were to: 1.) Describe the living arrangements of older adults with disabilities; 2.) Estimate the risk of developing disability by type of living arrangement (both housing type and household composition) for older adults; and, 3.) Estimate the risk of having a change in living arrangement by disability status for older adults. For all three aims, I also examined how the relationships between living arrangements and disability differed by age and socio-economic status. Data came from the American Community Survey (2012; n=504,371 adults age 65 and older) and the Health and Retirement Study (1998-2012; n=43,182 observations.) In Aim 1, I found that disability was most prevalent for older adults living in situations other than with a spouse only and that the odds of disability was highest for older adults living with children (without a spouse.) Compared with living in a single-family home, the odds of disability were higher for older adults living in mobile homes and large apartment buildings. In Aim 2, I found that living in a nursing home or with others was associated with an increased risk of disability, but that living alone was associated with a decreased risk of disabilities related to Instrumental Activities of Daily Living (IADLs.) This latter finding only held true for more affluent older adults, however; the poorest older adults faced an increased risk of disability if they lived alone. Finally, in Aim 3, I found that having IADL and ADL (Activities of Daily Living) disabilities together was predictive of moving, long nursing home stays, and death. ADL and IADL disabilities separately were predictive of long nursing home stays and death, while prior living arrangements were more predictive of moving than individual ADL or IADL disability status. For all of my findings, disability rates were highest among the poorest and oldest older adults. Older adults with the lowest socioeconomic status were also more likely to live alone, with non-spousal others, in rented homes, and in mobile homes or apartment buildings. This population may need additional resources to foster supportive living arrangements and to mitigate disability risk. These findings can be used to identify where older adults with disabilities live and where to target interventions to prevent worsening disability.}, keywords = {Demographics, Health Conditions and Status, Healthcare, Methodology, Public Policy, Retirement Planning and Satisfaction}, author = {Carrie Elizabeth Henning-Smith} } @article {5873, title = {Occupations and Work Characteristics: Effects on Retirement Expectations and Timing}, year = {2015}, institution = {Ann Arbor, MI, Michigan Retirement Research Center}, abstract = {Population aging and attendant pressures on public budgets have spurred considerable interest in understanding factors that influence retirement timing. A range of sociodemographic and economic characteristics have been shown to predict both earlier and later retirement. Less is known about the role of occupations and their characteristics on the work choices of older workers. Knowing more about the occupations that workers seem to stay in longer or leave earlier may point the way to policy interventions that are beneficial to both individuals and system finances. This project uses detailed occupational categories and work characteristics in the Health and Retirement Study (HRS) linked to information in the Occupational Information Network (O NET) to examine compositional changes in occupations held by older workers over time; to provide some basic and interesting information about relationships between occupations and their characteristics and retirement expectations and outcomes; and to shed some light on which occupations and associated characteristics might encourage or discourage longer working lives. There are large percentage changes (increases in decreases) in the percentage of older workers in occupations over time. Considering detailed as opposed to aggregated occupational categories yields interesting additional information. Jobs that HRS respondents say entail less physical effort, less stress, and jobs that have not increased in difficulty in recent decades, and those in which people can reduce hours if desired, are associated with longer work. While the traditional blue collar-retire earlier and white collar-work longer associations emerge, we find interesting exceptions that suggest fruitful directions for future research.}, keywords = {Employment and Labor Force, Retirement Planning and Satisfaction}, author = {McFall, Brooke Helppie and Amanda Sonnega and Robert J. Willis and P{\'e}ter Hudomiet} } @article {8282, title = {Older Adults Reporting More Diabetes Mellitus Care Have Greater 9 Year Survival}, journal = {Journal of the American Geriatrics Society}, volume = {63}, year = {2015}, pages = {2455}, publisher = {63}, abstract = {To determine whether receiving more recommended diabetes mellitus (DM) care processes (tests and screenings) would translate into better 9-year survival for middle-aged and older adults. Longitudinal mortality analysis using the Health and Retirement Study Diabetes Mailout Survey. Health and Retirement Study (HRS). Individuals aged 51 and older (n = 1,879; mean age 68.8 or - 8.7, 26.5 aged a yen 75) with self-reported DM who completed the Diabetes Mailout Survey and the core 2002 HRS survey. A composite measure of five self-reported diabetes mellitus care process measures were dichotomized as greater (3-5 processes) versus fewer (0-2 processes) care processes provided. Cox proportional hazards models were used to test relationships between reported measures and mortality, controlling for sociodemographic characteristics, function, comorbidities, geriatric conditions, and insulin use. Prevalence of self-reported care processes was 80.1 for glycosylated hemoglobin test, 75.9 for urine test, 67.5 for eye examination, 67.7 for aspirin counseling, and 48.2 for diabetes education. In 9 years, 32.1 respondents died. Greater care correlated with 24 lower risk of dying (adjusted hazard ratio = 0.76, 95 confidence interval = 0.64-0.91) at 9-year follow up. When respondents were age-stratified (a yen 75 vs 75) longer survival was statistically significant only in the older age group. Although it is not possible to account for differences in adherence to care that may also affect survival, this study demonstrates that monitoring of and counseling about types of DM care processes are associated with long-term survival benefit even in individuals aged 75 and older with DM.}, keywords = {Health Conditions and Status, Healthcare}, author = {Benjamin H Han and Caroline S Blaum and Rosie Ferris and Lillian C. Min and Pearl G. Lee} } @article {8925, title = {Older Adults{\textquoteright} Residential Proximity to Their Children: Changes After Cardiovascular Events.}, journal = {Journals of Gerontology Series B: Psychological Sciences and Social Sciencess}, volume = {70}, year = {2015}, month = {2015 Nov}, pages = {995-1004}, abstract = {

OBJECTIVES: To assess changes in family residential proximity after a first cardiovascular (CV) event among older adults and to identify families most likely to experience such moves.

METHOD: Using a nationally representative longitudinal study of older adults in the United States, we identified respondents with no prior diagnosis of CV disease (CVD). We examined subsequent development of stroke, heart attack, and/or heart failure among these older adults and examined changes in their residential proximity to their closest child before and after the CV event. We then compared the likelihood of changes in proximity between families with and without CV events. Finally, we determined which types of families are most likely to relocate following a CV event.

RESULTS: Having a first CV event increases the 2-year predicted probability of children and adult parents moving in with and closer to each other (relative risk ratio = 1.61 and 1.55, respectively). Families are especially likely to move after a first CV event if the older person experiencing the event is spouseless or has a daughter.

DISCUSSION: CVD is a leading cause of disability, which in turn creates a significant need for personal care among older adults. Assessment of changes in family residential proximity responding to CV events is important to fully understand the consequences of older adults{\textquoteright} CV events including the cost of caregiving.

}, keywords = {Cardiovascular health, Heart disease, Older Adults, Proximity, Social Support}, issn = {1758-5368}, doi = {10.1093/geronb/gbu076}, author = {Choi, Hwajung and Robert F. Schoeni and Kenneth M. Langa and Michele M Heisler} } @article {8269, title = {Patient Characteristics and Differences in Hospital Readmission Rates}, journal = {JAMA internal medicine}, volume = {175}, year = {2015}, pages = {1803}, publisher = {175}, abstract = {IMPORTANCE Medicare penalizes hospitals with higher than expected readmission rates by up to 3 of annual inpatient payments. Expected rates are adjusted only for patients{\textquoteright} age, sex, discharge diagnosis, and recent diagnoses. OBJECTIVE To assess the extent to which a comprehensive set of patient characteristics accounts for differences in hospital readmission rates. DESIGN, SETTING, AND PARTICIPANTS Using survey data from the nationally representative Health and Retirement Study (HRS) and linked Medicare claims for HRS participants enrolled in Medicare who were hospitalized from 2009 to 2012 (n = 8067 admissions), we assessed 29 patient characteristics from survey data and claims as potential predictors of 30-day readmission when added to standard Medicare adjustments of hospital readmission rates. We then compared the distribution of these characteristics between participants admitted to hospitals with higher vs lower hospital-wide readmission rates reported by Medicare. Finally, we estimated differences in the probability of readmission between these groups of participants before vs after adjusting for the additional patient characteristics. MAIN OUTCOMES AND MEASURES All-cause readmission within 30 days of discharge. RESULTS Of the additional 29 patient characteristics assessed, 22 significantly predicted readmission beyond standard adjustments, and 17 of these were distributed differently between hospitals in the highest vs lowest quintiles of publicly reported hospital-wide readmission rates (P = .04 for all comparisons). Almost all of these differences (16 of 17) indicated that participants admitted to hospitals in the highest quintile of readmission rates were more likely to have characteristics that were associated with a higher probability of readmission. The difference in the probability of readmission between participants admitted to hospitals in the highest vs lowest quintile of hospital-wide readmission rates was reduced by 48 from 4.41 percentage points with standard adjustments used by Medicare to 2.29 percentage points after adjustment for all patient characteristics assessed (reduction in difference: -2.12; 95 CI, -3.33 to -0.67; P = .003). CONCLUSIONS AND RELEVANCE Patient characteristics not included in Medicare{\textquoteright}s current risk-adjustment methods explained much of the difference in readmission risk between patients admitted to hospitals with higher vs lower readmission rates. Hospitals with high readmission rates may be penalized to a large extent based on the patients they serve.}, keywords = {Healthcare, Medicare/Medicaid/Health Insurance, Methodology, Public Policy}, author = {Barnett, M. L. and John Hsu and J. Michael McWilliams} } @article {8304, title = {Patterns of Weight Gain in Middle-Aged and Older US Adults, 1992-2010}, journal = {Epidemiology}, volume = {26}, year = {2015}, note = {Times Cited: 0 0}, pages = {165-168}, publisher = {26}, abstract = {Background: Cross-sectional analyses of national data have found that persons with high baseline body mass index (BMI) gain weight faster than persons at the median and that those whose weight was below the median gain very little weight. However, it is not clear whether these population-level changes reflect patterns at the individual level. Methods: We examined longitudinal changes in BMI in initially underweight, normal-weight, overweight, and obese US men and women using individual-level repeat data from the Health and Retirement Study (n = 15,895; age range, 40-69 years at baseline). Linear mixed-effect regression was used to model 6-year change in self-reported BMI during 4 study periods (1992/1994-1998/2000, 1996/1998-2002/2004, 2000/2002-2006/2008, and 2004-2010). Results: In the first 6-year period, the mean increase in BMI was greatest among persons who were initially normal weight (0.3 kg/m(2) 95 confidence interval = 0.2 to 0.4 ) and overweight (0.2 kg/m(2) 0.1 to 0.3 ). Weight gain accelerated in these groups with each subsequent period. Weight gain was less for initially class-I obese participants, and a net decrease in BMI was observed for class-II obese participants. Conclusion: These analyses suggest that the change in mean BMI among middle-aged and older US adults between 1992 and 2010 resulted mainly from accelerated weight gain among persons who were initially normal weight and overweight.}, keywords = {Health Conditions and Status}, doi = {10.1097/ede.0000000000000228}, author = {Stenholm, Sari and Vahtera, Jussi and Ichiro Kawachi and Pentti, Jaana and Halonen, Jaana I. and Westerlund, Hugo and Razak, Fahad and S. V. Subramanian and Mika Kivim{\"a}ki} } @article {8290, title = {Purpose in life and incidence of sleep disturbances}, journal = {Journal of Behavioral Medicine}, volume = {38}, year = {2015}, note = {Times Cited: 0 0}, pages = {590-597}, publisher = {38}, abstract = {Purpose in life has been linked with better mental health, physical health, and health behaviors, but the association between purpose and sleep is understudied. Sleep disturbances increase with age and as the number of older adults rapidly increases, it is ever more important to identify modifiable factors that are associated with reduced incidence of sleep disturbances. We used multiple logistic regression models and data from the Health and Retirement Study, a nationally representative panel study of American adults over the age of 50, to examine whether higher purpose was linked with a reduced incidence of sleep disturbances. Among 4144 respondents reporting minimal or no sleep disturbances at baseline, higher purpose was associated with a lower incidence of sleep disturbances over the 4-year follow-up. After adjusting for sociodemographic factors, each unit increase in purpose (on a six-point scale) was associated with a 16 reduced odds of developing sleep disturbances (OR 0.84, 95 CI 0.77-0.92). The association between purpose and sleep disturbances remained after adjusting for sociodemographic, behavioral, psychological, and health covariates. Should future research replicate our findings, this area of research may lead to innovative efforts that improve the quality of sleep in older adults.}, keywords = {Health Conditions and Status}, doi = {10.1007/s10865-015-9635-4}, author = {Eric S Kim and Hershner, Shelley D. and Victor J Strecher} } @article {8147, title = {Racial/Ethnic Disparities in Men{\textquoteright}s Health: Examining Psychosocial Mechanisms}, journal = {Family and community health}, volume = {38}, year = {2015}, note = {Times Cited: 0 0}, pages = {307-18}, publisher = {38}, abstract = {This study uses data from the Health and Retirement Study and an approach informed by the Biopsychosocial Model of Racism as a Stressor to examine the extent to which socioeconomic status, stressors, discrimination, and neighborhood conditions are mechanisms underlying racial/ethnic disparities in functional limitations among men. Results reveal that racial/ethnic differences in socioeconomic status, stressors, discrimination, and neighborhood conditions-individually and collectively-account for a substantial proportion of racial/ethnic disparities in functional limitations. Findings suggest that the social determinants of health for men of color need to be more seriously considered in investigations of and efforts to address health disparities.}, keywords = {Demographics, Health Conditions and Status, Women and Minorities}, doi = {10.1097/fch.0000000000000080}, author = {Tyson H Brown and Taylor W. Hargrove and Griffith, Derek M.} } @article {6480, title = {The relationships among perceived discrimination, self-perceptions of aging, and depressive symptoms: a longitudinal examination of age discrimination}, journal = {Aging and Mental Health}, volume = {19}, year = {2015}, pages = {747-755}, chapter = {747}, abstract = {Objectives: This study examined the relationship between changes in perceived discrimination and changes in depressive symptoms among older people. The association between perceived age discrimination and depressive symptoms was also analyzed longitudinally along with tests to determine whether self-perception of aging mediates this association. Method: Data from two waves (2008 and 2012) of the Health and Retirement Study were used. Longitudinal models were tested using a nationally representative sample of 3921 participants who responded to psychosocial questionnaires in both waves and answered questions about perceived everyday discrimination and attributions of discrimination in 2008. Results: Changes in perceived discrimination was significantly associated with changes in depressive symptoms over time. Perceived age discrimination was significantly related to a change in depressive symptoms over four years and self-perceptions of aging mediated the relationship between perceived age discrimination and depressive symptoms. Conclusion: Findings demonstrate the importance of recognizing perceived discrimination and negative self-perceptions of aging as well as how the negative effects of age discrimination on self-perceptions of aging can be risk factors for the development of depressive symptoms in late life.}, keywords = {Demographics, Employment and Labor Force, Health Conditions and Status}, doi = {10.1080/13607863.2014.962007}, url = {http://dx.doi.org/10.1080/13607863.2014.962007}, author = {Jina Han and Virginia E. Richardson} } @article {8153, title = {A Research Note on Transitions in Out-of-Pocket Spending on Dental Services.}, journal = {Res Aging}, volume = {37}, year = {2015}, month = {2015 Aug}, pages = {646-66}, publisher = {37}, abstract = {

OBJECTIVE: We analyze correlates of the direction and magnitude of changes in out-of-pocket (OOP) payments for dental care by older Americans over a recent 4-year period.

METHODS: We analyzed data from the 2006 and 2008 waves of the Health and Retirement Study. We estimated multinomial logistic models of the direction and linear regression models of the amounts of OOP changes over survey periods.

RESULTS: Financial-based factors were more strongly associated with the direction and magnitude of changing self-payments for dental care than were health factors.

DISCUSSION: Findings suggested that dental coverage, income, and wealth and changes in these financial factors were more strongly correlated with the persistence of and changes in OOP payments for dental care over time than were health status and changes in health status. The sensitivity to dental coverage changes should be considered as insurance and retirement policy reforms are deliberated.

}, keywords = {Aged, Aged, 80 and over, Dental Care, Female, Health Expenditures, Humans, Insurance, Dental, Longitudinal Studies, Male, Middle Aged, United States}, issn = {1552-7573}, doi = {10.1177/0164027514552681}, url = {http://roa.sagepub.com/content/early/2014/10/03/0164027514552681.abstract}, author = {Richard J. Manski and John F Moeller and Haiyan Chen and Jody Schimmel Hyde and John V Pepper and Patricia A St Clair} } @article {5874, title = {The Retirement and Social Security Benefit Claiming of U.S. Military Retirees}, year = {2015}, institution = {Ann Arbor, MI, Michigan Retirement Research Center}, abstract = {After serving 20 years in the active component of the U.S. military, service members can retire from the military, as young as age 38, and begin collecting a monthly pension benefit for the remainder of their life. In this paper, we ask: do active duty military retirees exit the labor force earlier or later because of their access to military retirement benefits? Do they alter their Social Security claiming decisions? We theorize that access to a consistent source of income may encourage earlier retirement through a standard income effect, but the military pension may also increase a retiree s post-military job search, allowing for a greater wage and improved job satisfaction due to a better employer-employee match. Access to a steady source of pension income may also reduce short-term liquidity constraints, encouraging military retirees to delay claiming their Social Security benefit in order to benefit from delayed retirement. We estimate the impact of military retiree pension income on retirement empirically using the 1992 Health and Retirement Study cohort. We identify the military pension effect in a difference-in-difference model by exploiting a surprise change in military-retiree benefits in 2001 that extended Tricare health benefits to Medicare eligible military retirees and their spouses through the end of their lives. TFL eliminated the need to purchase Medigap coverage, thereby eliminating a cost that could cut into disposable income from their military annuity. A key limitation of the analysis is that the HRS includes relatively few military retirees.}, keywords = {Demographics, Pensions, Retirement Planning and Satisfaction, Social Security}, author = {Knapp, David and Asch, Beth and Hosek, James and Mattock, Michael} } @mastersthesis {6339, title = {Risk Predictors, Outcomes, and Costs of Falls among Older Adults Living in the Community}, volume = {3689159}, year = {2015}, month = {2015}, pages = {393}, school = {University of California, Los Angeles}, type = {Ph.D.}, address = {Los Angeles}, abstract = {Background: Non-injurious falls (NIFs) and fall-related injuries (FRI) among older adults are common and impose substantial health burdens. Risks include health and health behavior factors, medications, and environmental hazards. Non-injurious falls (NIFs) and fall-related injuries (FRIs) may particularly compromise older adults{\textquoteright} ability to engage in social and recreational activities and activities of daily living and can generate chronic stress, resulting in depressive symptoms. Previous studies have used depression to predict falls, but are potentially subject to endogeneity bias by not controlling for other temporal associations between falls and depression. With 2.5 million and .75 million FRIs treated in emergency departments and hospitals, respectively, FRIs also have important Medicare cost implications. However, existing FRI cost estimates are inconsistent, ranging from $2,000 to $26,000, and traditional FRI identification methods likely undercount FRIs. Three studies were conducted to assess relationships between (1) falls and caregiving, (2) falls and depressive symptoms, and (3) FRIs and Medicare costs. Methods: First, 10 survey waves of pooled data from the 2000-2010 Health and Retirement Study (HRS) were used to compare risks of NIFs and FRIs among respondents receiving and not receiving formal and/or informal caregiving assistance in the past two years. Stratified models were used to assess whether cognitive impairment modified the relationship between caregiving receipt and fall risk. Next, using 2006-10 HRS data, "cross-lagged panel" analyses using structural equation modeling were conducted to evaluate temporal associations between falls and depressive symptoms. Structural coefficients of pathways between falls and depressive symptoms (in 2006[arrow right]2008 and 2008[arrow right]2010) were estimated, controlling for baseline (2006) latent factors: poor physical health status (indicated by vision, hearing, cognitive status, activities of daily living, chronic disease, and functional limitations), perceived social support, and social cohesion. Finally, 2007-9 Inpatient, Outpatient, Carrier, Skilled Nursing Facility, Home Health, Durable Medical Equipment, and Hospice Medicare claims and linked 2008 HRS survey data were used to estimate the difference in predicted medical cost change scores (12-month post-index minus 12-month pre-index costs) for an FRI compared to a non-FRI cohort. For this analysis, linear regression models adjusted for sociodemographic characteristics, indicators of health status (sensory impairments, cognitive status, and indices for functional limitations and chronic health conditions), and geographic factors were used. Four different methods--using (1) external cause-of-injury codes (e-codes) and a select set of inpatient ICD-9 diagnostic codes, (2) e-codes, inpatient diagnostic and outpatient diagnostic and procedure codes, (3) e-codes and a broad set of diagnostic codes, and (4) e-codes only--were used to identify FRIs in the claims data. Population: Community-dwelling older adults (ages 65 and older). For the first study, 17,420 unique individuals (172 with cognitive impairment), with a total of 63,542 pooled person-wave observations; for the second study, 13,439 individuals; and for the third study, 5,548 individuals (103 FRI and 5,445 non-FRI) with continuous Medicare Parts A/B coverage and alive during the 24-month study period. Results: For the first study, adjusting for sociodemographic and health characteristics, relative to no care received, older adults receiving low levels of informal care had a 3 percentage-point increase in NIF risk and 2 percentage-point increase in FRI risk while those receiving high levels of informal care had a 4 percentage-point increase in FRI risk. However, those receiving both formal and informal care had a 4 percentage-point (or 20\%) decrease in NIF risk. Wald tests showed that those receiving formal care only or formal care and informal care had lower NIF and FRI risks than those receivin informal care only. Among those with cognitive impairment, older adults receiving informal and formal care generally had reduced NIF and FRI risks compared to those receiving no care. For the second study, both the NIF (χ 2 (dfs = 266) = 2,646.39, p <0.001, Comparative Fit Index (CFI) = 0.944, Root Mean Square Error of Approximation (RMSEA) = 0.026) and FRI (χ2 (dfs = 267) = 2,511.52, p <0.001, CFI = 0.945, RMSEA = 0.025) models had acceptable fit. Depressive symptoms predicted future NIFs (unstandardized structural probit coefficients = 0.85 for 2006[arrow right]2008 and 0.83 for 2008[arrow right]2010, p <0.001), a relationship potentially mediated by psychotropic drug use; however, NIFs did not predict future depressive symptoms. Depressive symptoms predicted future FRIs (unstandardized structural probit coefficients = 1.00, p <0.001 for 2006[arrow right]2008 and 0.95, p <0.001 for 2008[arrow right]2010). For the third study, average, unadjusted medical costs during the 12-month follow-up period were $23,429 and $9,818 for FRI and non-FRI cohort individuals, respectively. The estimated change score difference between the FRI and non-FRI cohort was $14,879 (p<0.001) using the first FRI identification method using e-codes and a select set of inpatient ICD-9 diagnostic codes. Change score differences were $6,587 for inpatient, $2,476 for outpatient, $4,595 for SNF, and $1,141 for HH. Overall change score differences were $11,678 (p<0.001), $8,963 (p<0.001), and $12,757 (p<0.001) using the second, third, and fourth FRI identification methods (using varying sets of e-codes and inpatient and outpatient diagnostic and procedural codes), respectively. An FRI increased the risk of persistently high costs using all identification methods. Findings were robust to the inclusion of pre-index costs as a predictor and respondents who died during the study. Conclusion: For the first study, caregiving receipt significantly predicted falls, but was not uniformly negatively associated with NIF and FRI risk. The 20\% risk reduction among those receiving formal and informal care was comparable to common falls prevention interventions. While informal care may encourage more activity and risk-taking, formal caregivers may prevent risky behaviors associated with falls and cognitively impaired individuals may particularly benefit from caregiving in preventing falls. For the second study, compared to latent indicators of poor physical health status and social factors, depressive symptoms are strong predictors of older adult NIFs and FRIs. Controlling for these confounders, a one standard deviation increase in depressive symptom levels was associated with a 22\% and 28\% increase in the risk of future NIFs and FRIs, respectively. However, NIFs and FRIs were not associated with greater odds of future increased depressive symptoms. For the third study, FRIs were associated with substantial and sustained increases in Medicare spending. Substantial increases in medical costs associated with FRIs were driven by inpatient (44\%), SNF (31\%), outpatient/carrier (17\%), and home health (8\%) costs and FRIs increased the probability of having high cost in the four quarters following an index FRI from 11.6\% to 19.5\%, reflecting a 67\% increase. The findings suggest a wide range of per-FRI as well as total FRI-related Medicare costs, depending upon the method used to identify FRIs in the claims data; per-FRI costs ranged from approximately $9,000 to $15,000 while total FRI-related Medicare costs ranged from $5 to $49 billion due to differing proportions of beneficiaries experiencing FRIs depending on the FRI identification method used. Implications: These findings suggest a potential opportunity for population health management of falls. To scale up falls prevention for falls costing Medicare billions of dollars per year, policymakers and providers should consider offering assistance to informal caregivers through educational outreach. Falls assessments should also include caregiving as an essential component. Prevention effo ts should include depressive symptomatology as a main falls risk factor and geriatric evaluations should emphasize the depressive symptoms--falls relationship. Current approaches to claims-based FRI identification and current FRI surveillance techniques may be inadequate. Given substantial, sustained costs of FRIs and known effectiveness of falls prevention efforts, Medicare should consider reimbursement for geriatric FRI risk prevention.}, keywords = {Consumption and Savings, Health Conditions and Status, Healthcare, Medicare/Medicaid/Health Insurance, Public Policy, Risk Taking}, author = {Geoffrey J Hoffman} } @article {8166, title = {Spouse and Child Availability for Newly Disabled Older Adults: Socioeconomic Differences and Potential Role of Residential Proximity.}, journal = {J Gerontol B Psychol Sci Soc Sci}, volume = {70}, year = {2015}, month = {2015 May}, pages = {462-9}, publisher = {70}, abstract = {

OBJECTIVES: To examine the potential role of child and spousal availability in facilitating community-based care for disabled older adults.

METHOD: We used the Health and Retirement Study, a nationally representative longitudinal study of older adults. The analysis sample included older adults who were nondisabled at baseline, but who then developed at least one activity of daily living (ADL) limitation over the subsequent 2-year period (N = 2,094). Using multivariate, multinomial logistic regression, we examined the association of child and spouse availability prior to disablement of the older adults with ADL care receipt status after the onset of disablement, after adjusting for other sociodemographic and clinical characteristics.

RESULTS: Lower socioeconomic status (SES) was associated with less availability of a spouse but greater availability of children at baseline. Compared with older adults who had no children nearby (i.e., all children lived further than 30 miles), older adults who had at least one child living with or near them prior to the onset of the ADL limitation were less likely to go to a nursing home (adjusted odds ratio [AOR]: 0.26 for coresident; AOR: 0.44 for 1- 30 miles) and less likely to depend on formal care (AOR: 0.39 for coresident; AOR: 0.51 for 1-30 miles) after the onset of new ADL limitation/s.

DISCUSSION: Understanding SES variations in the informal care resources, and potential role of child geographic availability, may inform the development of cost-effective community-based care programs and policies.

}, keywords = {Activities of Daily Living, Adult children, Aged, Aged, 80 and over, Aging, Disabled Persons, Female, Home Nursing, Humans, Male, Middle Aged, Nursing homes, Residence Characteristics, Social Class, Spouses}, issn = {1758-5368}, doi = {10.1093/geronb/gbu015}, url = {http://psychsocgerontology.oxfordjournals.org/content/early/2014/03/06/geronb.gbu015.abstract}, author = {Choi, Hwajung and Robert F. Schoeni and Kenneth M. Langa and Michele M Heisler} } @article {8518, title = {SSA Permissions Consent History: 1992-2012 (Public Version)}, year = {2015}, month = {11/2015}, pages = {5}, institution = {Survey Research Center, University of Michigan}, address = {Ann Arbor}, abstract = {The Health and Retirement Study (HRS) is a national longitudinal study of the economic, health, marital, and family status, as well as public and private support systems, of older Americans. The HRS is a rich source of longitudinal, cross-sectional data for researchers and policymakers who study aging. Funding for the Health and Retirement Study is provided by the National Institute on Aging at NIH (U01 AG009740), with supplemental support from the Social Security Administration. The study is conducted by the Institute for Social Research (ISR) at the University of Michigan.}, keywords = {Data collection, Meta-analyses, Survey Methodology} } @article {8180, title = {Subjective health expectations}, journal = {Journal of Policy Modeling}, volume = {37}, year = {2015}, note = {Export Date: 29 May 2015 Article in Press}, pages = {693-711}, publisher = {37}, abstract = {Subjective health expectations are derived using data from the U.S. Health and Retirement Study (HRS). We first use a Bayesian updating mechanism to correct for focal point responses and reporting errors of the original health expectations variable. We then test the quality of the health expectations measure and describe its correlation with various health indicators and other individual characteristics. Our results indicate that subjective health expectations do contain additional information that is not incorporated in subjective mortality expectations and that the rational expectations assumption cannot be rejected for subjective health expectations. Finally, the data suggest that individuals younger than 70 years of age seem to be more pessimistic about their health than individuals in their 70s. 2015 Society for Policy Modeling.}, keywords = {Employment and Labor Force, Expectations, Health Conditions and Status, Healthcare, Methodology, Other}, doi = {10.1016/j.jpolmod.2015.04.001}, author = {Kim P. Huynh and Jung, Juergen} } @article {8951, title = {Subjective mortality risk and bequests}, journal = {Journal of Econometrics}, volume = {188}, year = {2015}, month = {Jan-10-2015}, pages = {514 - 525}, abstract = {This paper investigates the ability of subjective expectations about life expectancy to predict wealth holding patterns in later life. Based on panel data from the Asset and Health Dynamics among the Oldest Old, we estimate a structural life-cycle model with bequests. Each individual{\textquoteright}s subjective survival rates in the future are estimated with data on his belief of survival probabilities to a target age. This estimation is build upon a Bayesian updating method developed in Gan et al. (2005). We find that life-cycle model using subjective survival rates performs better than using life-table survival rates in predicting wealth holdings. This result suggests that subjective survival expectations play an important role in deciding consumption and savings. In addition, the estimation results show that most bequests are involuntary or accidental.}, keywords = {Bequests, Mortality, Older Adults}, issn = {03044076}, doi = {10.1016/j.jeconom.2015.03.015}, author = {Gan, Li and Gong, Guan and Michael D Hurd and Daniel McFadden} } @article {8303, title = {Subjective Well-Being in Context: County- and State-Level Socioeconomic Factors and Individual Moderators}, journal = {Social Psychological and Personality Science}, volume = {6}, year = {2015}, note = {Times Cited: 0 0}, pages = {148-156}, publisher = {6}, abstract = {Subjective well-being (SWB) is not only influenced by people{\textquoteright}s individual characteristics but also by characteristics of the places where they live. Using data from the Health and Retirement Survey (N = 5,975), we examined whether two indicators of the socioeconomic context (unemployment and poverty rates) are associated with SWB in older adults. The main findings were (a) these contextual variables are differentially related to SWB on the county level and state level in terms of strength and direction, highlighting the importance of distinguishing between different levels of analysis; (b) poverty rate tends to be more strongly associated with life satisfaction and positive affect than with negative affect; and (c) county-level poverty rate is more strongly related to positive affect in poor individuals and county-level unemployment rate is more strongly related to SWB in nonretired individuals, suggesting that the socioeconomic context matters more for people who are directly affected by it.}, keywords = {Demographics, Employment and Labor Force, Expectations, Income}, doi = {10.1177/1948550614548075}, author = {Luhmann, Maike and Murdoch, James C., III and Louise C Hawkley} } @article {9044, title = {Tracker 2014 Data Description}, year = {2015}, month = {12/2015}, institution = {Survey Research Center, Institute for Social Research, University of Michigan}, address = {Ann Arbor, MI}, author = {HRS Staff} } @mastersthesis {8983, title = {Trends in Herpes Zoster Incidence from 1940 to 2008 Using a Cross-sectional Survey.}, volume = {Master of Science}, year = {2015}, month = {12/2015}, school = {Georgia State University}, address = {Atlanta, GA}, abstract = {Previous healthcare-based studies have reported increasing herpes zoster (HZ) incidence over time; however, this could be an artifact of increased healthcare utilization. This study is a cross-sectional analysis of 15,103 respondents in the 2008 wave of the Health and Retirement Study (HRS) to evaluate changes in HZ incidence from 1940 to 2008. Negative binomial regression is used to model the effect of calendar year, age of onset of HZ, gender and race/ethnicity on HZ incidence. A nonparametric method based on B-spline basis expansion is used to model the effect of calendar year to avoid imposing a predetermined functional form and produce flexible and accurate estimates. This study demonstrates increasing HZ incidence from 1940 to 2008 using self-reported HZ. Although the reason for this increase remains unknown, this study supports the assertion that this trend is real and not an artifact of increasing healthcare utilization for HZ over time. Advisors/Committee Members: Dr. Xin Qi, Dr. Gengsheng Qin, Dr. Yichuan Zhao.}, author = {Hales, Craig M} } @article {8919, title = {US Prevalence And Predictors Of Informal Caregiving For Dementia.}, journal = {Health Affairs}, volume = {34}, year = {2015}, month = {2015 Oct}, pages = {1637-41}, abstract = {In 2010, 5.5 million US adults ages seventy and older received informal care, including 3.6 million with cognitive impairment or probable dementia. Adults with probable dementia received 171 hours of monthly informal care, versus 89 and 66 hours for cognitively impaired without dementia and cognitively normal adults, respectively.}, keywords = {Caregiving, Dementia, Demographics, Long-term Care, Older Adults}, issn = {1544-5208}, doi = {10.1377/hlthaff.2015.0510}, author = {Esther M Friedman and Regina A Shih and Kenneth M. Langa and Michael D Hurd} } @article {8322, title = {Welfare-to-Work Reform and Intergenerational Support: Grandmothers{\textquoteright} Response to the 1996 PRWORA}, journal = {Journal of Marriage and Family}, volume = {77}, year = {2015}, note = {Times Cited: 0 0}, pages = {407-423}, publisher = {77}, abstract = {The 1996 Personal Responsibility and Work Opportunity Reconciliation Act (PRWORA; Pub. L. 104-193) in the United States aimed at encouraging work among low-income mothers with children below age 18. In this study, the author used a sample of 2,843 intergenerational family observations from the Health and Retirement Study to estimate the effects of the reform on single grandmothers who are related to those mothers. The results suggest that the reform decreased time transfers but increased money transfers from grandmothers. The results are consistent with an intergenerational family support network where higher child care subsidies motivated the family to shift away from grandmother provided child care and where grandmothers increased money transfers to either help cover the remaining cost of formal care or to partly compensate for the loss in benefits of welfare leavers.}, keywords = {Adult children, Healthcare, Public Policy}, doi = {10.1111/jomf.12172}, author = {Ho, Christine} } @mastersthesis {6333, title = {Well-being as a measure of inequality among the retirement-age population: An examination of the role of place, migration, and socioeconomic status in shaping happy and healthy older Americans}, volume = {Ph.D.}, year = {2015}, month = {2015}, pages = {156}, school = {University of New Hampshire}, address = {Durham, NH}, abstract = {The proportion of the U.S. population comprised of seniors {\textendash} those aged 65 and older {\textendash} is projected to increase from 13\% presently to 20\% by 2030. With this demographic change, it is important to consider how older residents are faring, which older residents do best, and what communities are doing to support this population. Rather than examining income or wealth as a dependent variable, I predict two measures of well-being among older U.S. residents{\textendash} one subjective and one objective. By linking survey data of the 50 and older population from the 2010 Health and Retirement Study (HRS) to a variety of county-level statistics from several government databases, this dissertation characterizes each respondent{\textquoteright}s community with respect to its demographics, economic structure, natural environment, social norms, and presence of community institutions. I examine the impact of individual and community characteristics, as well as whether someone had migrated within the last four years, on predicting well-being. My findings suggest that certain community variables may influence well-being {\textendash} namely that social institutions may need to be tailored to support the needs of older residents and that counties we think of as privileged counties (with respect to the racial and socioeconomic make-up of its residents) may need to do more to serve older residents. In sum though, these county characteristics have a very minimal impact in predicting the well-being of older residents. The predictors that seemed to matter more were those of the individuals aged 50 and over themselves: their demographic characteristics, employment status, health, and social connectedness all mattered with respect to understanding which individuals were doing well. Whether someone had moved to a new county in the last four years did not appear to offer value to predicting well-being in a causal manner.}, keywords = {Employment and Labor Force, Medicare/Medicaid/Health Insurance, Methodology, Public Policy, Retirement Planning and Satisfaction}, url = {http://gradworks.umi.com/10/00/10000388.html}, author = {Henly, Megan} } @mastersthesis {6210, title = {What impacts life satisfaction of aging adults following stressful life events?: An examination of the buffering effect of personal resources}, volume = {3700590}, year = {2015}, month = {2015}, pages = {158}, school = {Wayne State University}, type = {Ph.D.}, address = {Detroit}, abstract = {Purpose: Existing research has shown that elders experience changes in their life satisfaction following stressful life events. There is an abundance of literature supporting the predictive nature of not only stressful life events on life satisfaction, but social support, autonomy, and financial security. What the literature is lacking, is examination of the buffering effect of social support, autonomy, and financial security on the relationship between stressful life events and life satisfaction. This study hypothesizes that increases in social support, autonomy, and financial security will buffer the impact of SLEs for elders and thus, they will experience increases in their life satisfaction over time. It is also expected that social support and financial security will buffer differently among Black and White elders. Methods: The public use files of the Health and Retirement Study (HRS) between the years 2006 and 2012 are used to explore the interaction between social support, autonomy, and financial security with stressful life events and the impact on life satisfaction. Linear regression are conducted to explore each buffering impact on life satisfaction over time. Results: The research findings in this dissertation demonstrate that the changes in personal resources; social support, autonomy, and financial security; play an important role in changes in life satisfaction. Additionally, Black and White elders are impacted differently by changes in financial security. In general, the results from this study demonstrate that individuals who have declines in their personal resources following stressful life events also experience declines in their life satisfaction.}, keywords = {Adult children, Demographics, Health Conditions and Status, Healthcare, Methodology, Net Worth and Assets, Other, Retirement Planning and Satisfaction, Women and Minorities}, author = {Barragan, Cassandra} } @article {8186, title = {Why Retirees Claim Social Security at 62 and How It Affects Their Retirement Income: Evidence from the Health and Retirement Study}, journal = {Journal of Retirement}, volume = {2}, year = {2015}, pages = {25-39}, publisher = {2}, abstract = {Despite higher monthly benefits for those who delay, many people still claim Social Security retirement benefits at age 62, the earliest age of eligibility. This study uses data from the Health and Retirement Study to examine the demographic and occupational characteristics associated with early claiming, as well as the retirement income of early claimers compared with those who delay. The authors find that several work-related factors may cause people to claim Social Security benefits early and suggest they may face challenges in continuing to work at older ages. For example, those who worked in physically demanding blue-collar jobs were 55 more likely to claim benefits prior to their full retirement age, after controlling for other factors, compared with those in all other occupations. Other factors, such as having lower expectations of living to age 75 significantly increase the likelihood of claiming early. The median income for those who claim at full retirement age or later was 45 higher after claiming benefits than for those who claimed early and 33 higher at age 72. Even when comparing early and delayed claimers with similar total income after claiming, average household income for delayed claimers was higher at age 72 than for early claimers.}, keywords = {Retirement Planning and Satisfaction, Social Security}, doi = {10.3905/jor.2015.2.3.025}, author = {Glickman, Mark M. and Sharon Lynn Hermes} } @article {8032, title = {Age-related trajectories of physical functioning in work and retirement: The role of sociodemographic factors, lifestyle and disease}, journal = {Journal of Epidemiology and Community Health}, volume = {68}, year = {2014}, pages = {503-509}, publisher = {68}, abstract = {Background: Loss of physical functioning is an early marker of declining health in older people. The objective of this study was to examine the age-related trajectories of physical functioning among those in full-time work and retirement. Methods: Based on the Health and Retirement Study, participants who were working full-time or were in full-time retirement and 65-85 years of age during the follow-up period from 1992 to 2010 were included (n=17 844, n of observations from repeated measures in full-time work 5891 and in retirement 57 117). Details of physical functioning were asked about at all study phases and 10 items related to mobility and activities of daily living were summed to obtain a physical functioning score (0-10). Results: The number of physical functioning difficulties increased every 10 years by 0.17 (95 CI 0.04 to 0.29) when in full-time work and by 0.46 (95 CI 0.41 to 0.50) in retirement after adjusting for age, sex, race, education, total wealth, Body Mass Index, smoking, physical activity and number of diseases. Factors that were associated with a significantly greater increase in number of physical functioning difficulties in full-time work and retirement include lifestyle-related risks and chronic conditions. Conclusions: Physical functioning declines faster in retirement than in full-time work in employees aged 65 years or older and the difference is not explained by absence of chronic diseases and lifestyle-related risks. 2014 by the BMJ Publishing Group Ltd.}, keywords = {Demographics, Health Conditions and Status, Retirement Planning and Satisfaction}, doi = {10.1136/jech-2013-203555}, author = {Stenholm, Sari and Westerlund, Hugo and Salo, P. and Hyde, Martin and Pentti, Jaana and Head, Jenny and Mika Kivim{\"a}ki and Vahtera, Jussi} } @article {7966, title = {Aging children of long-lived parents experience slower cognitive decline}, journal = {Alzheimer{\textquoteright}s and Dementia}, volume = {10}, year = {2014}, pages = {S315-S322}, publisher = {10}, keywords = {Adult children, Expectations, Genetics, Health Conditions and Status}, doi = {10.1016/j.jalz.2013.07.002}, url = {http://www.sciencedirect.com/science/article/pii/S1552526013024965}, author = {Ambarish Dutta and Henley, William and Robine, Jean-Marie and David J Llewellyn and Kenneth M. Langa and Robert B Wallace and David Melzer} } @article {7998, title = {Around a quarter of all older people have disability during the last 2 years of life, with prevalence higher among women and those aged over 80 years}, journal = {Evidence Based Nursing}, volume = {17}, year = {2014}, pages = {124}, publisher = {17}, abstract = {Context The rapidly growing number of disabled elderly is expected to tax health delivery systems, whose focus has been the management of disease rather than the prevention and management of disability. The burden of caring for the disabled rests largely with family caregivers, who commonly experience physical and emotional strain. The network of community services designed to assist caregivers is fragmented, variable and costly. The activity of daily living (ADL) disability may be especially high among individuals near the end of life. Methods To determine the prevalence of disability in the 2 years preceding death, the authors used data from the Health and Retirement Study (HRS), a longitudinal study of health and wealth in a nationally representative sample of US adults aged 50 and over. The HRS surveyed participants every 2 years and determined the date of death in 99 of those involved. From a sample of 8232 decedents between 1995 and 2010, the authors estimated the national prevalence of disability in the last 24 months of life using restricted cubic spline models. The final spline model was entered into a multivariate regression to estimate the probability of disability in various subgroups. Findings At 24 months before death, the predicted prevalence of disability ranged from 15 for those aged 50 69 to 50 among those aged 90. Regardless of the starting prevalence of disability, the four age groups (50 69, 70 79, 80 89 and 90 ) showed similar linear rates of increase from 24 months to around 9 months before death, after which the prevalence of disability rose sharply. At all points in time women were more disabled than men.}, keywords = {Demographics, Disabilities, Health Conditions and Status, Healthcare}, doi = {10.1136/eb-2013-101629}, url = {http://ebn.bmj.com/content/early/2014/01/30/eb-2013-101629.short}, author = {Hirsch, Calvin H} } @inbook {5258, title = {Changing Working Conditions at the Onset of the Twenty-First Century: Facts from International Datasets}, booktitle = {The Impact of ICT on Quality of Working Life}, year = {2014}, pages = {25-41}, publisher = {Springer Netherlands}, organization = {Springer Netherlands}, chapter = {3}, abstract = {Modern societies are currently undergoing accelerated social change (see also Chap. 4). In this chapter, we are interested in whether these societal changes influence individual working conditions. More specifically, it is argued that the speeding up of production, consumption, and decision processes due to the implementation of new information and communication technologies (ICTs) and increased international competition confront employees with work intensification and increasing job insecurity. Using data from the European Working Conditions Surveys, we analyze trends in work intensity and job insecurity in Europe from 2000 onwards; using data from the Health and Retirement Study as well as the German Socio-Economic Panel, we also model individual change trajectories from 2000 onwards. The results show that employees differ in the extent to which they are confronted with changes in work intensity and job insecurity. European trend data suggest that work intensification occurred basically in conservative welfare states (i.e., Germany, France, and Spain), but not in the United Kingdom or Finland. Individual change trajectories show that nearly 30 of German and American workers have experienced an increase in work intensity over the past decade. Less-educated workers are the most affected. Moreover, job insecurity has risen for a majority of employees in Europe and America. Especially, well-educated workers who have thus far been in rather stable employment relations perceived an increase in job insecurity.}, keywords = {Cross-National, Employment and Labor Force, Other, Public Policy}, isbn = {978-94-017-8853-3}, doi = {10.1007/978-94-017-8854-0_3}, url = {http://dx.doi.org/10.1007/978-94-017-8854-0_3}, author = {Kubicek, Bettina and Korunka, Christian and Pa{\v s}kvan, Matea and Prem, Roman and Gerdenitsch, Cornelia}, editor = {Korunka, Christian and Hoonakker, Peter} } @article {8058, title = {Characterizing the Genetic Influences on Risk Aversion}, journal = {Biodemography and Social Biology}, volume = {60}, year = {2014}, note = {Times Cited: 0 SI 0}, pages = {185-198}, publisher = {60}, abstract = {Risk aversion has long been cited as an important factor in retirement decisions, investment behavior, and health. Some of the heterogeneity in individual risk tolerance is well understood, reflecting age gradients, wealth gradients, and similar effects, but much remains unexplained. This study explores genetic contributions to heterogeneity in risk aversion among older Americans. Using over 2 million genetic markers per individual from the U.S. Health and Retirement Study, I report results from a genome-wide association study (GWAS) on risk preferences using a sample of 10,455 adults. None of the single-nucleotide polymorphisms (SNPs) are found to be statistically significant determinants of risk preferences at levels stricter than 5 x 10(-8). These results suggest that risk aversion is a complex trait that is highly polygenic. The analysis leads to upper bounds on the number of genetic effects that could exceed certain thresholds of significance and still remain undetected at the current sample size. The findings suggest that the known heritability in risk aversion is likely to be driven by large numbers of genetic variants, each with a small effect size.}, keywords = {Genetics, Net Worth and Assets, Retirement Planning and Satisfaction, Risk Taking}, doi = {10.1080/19485565.2014.951986}, author = {Harrati, Amal} } @article {10277, title = {Chiropractic use in the Medicare population: prevalence, patterns, and associations with 1-year changes in health and satisfaction with care.}, journal = {J Manipulative Physiol Ther}, volume = {37}, year = {2014}, month = {2014 Oct}, pages = {542-51}, abstract = {

OBJECTIVE: The purpose of this study was to examine how chiropractic care compares to medical treatments on 1-year changes in self-reported function, health, and satisfaction with care measures in a representative sample of Medicare beneficiaries.

METHODS: Logistic regression using generalized estimating equations is used to model the effect of chiropractic relative to medical care on decline in 5 functional measures and 2 measures of self-rated health among 12170 person-year observations. The same method is used to estimate the comparative effect of chiropractic on 6 satisfaction with care measures. Two analytic approaches are used, the first assuming no selection bias and the second using propensity score analyses to adjust for selection effects in the outcome models.

RESULTS: The unadjusted models show that chiropractic is significantly protective against 1-year decline in activities of daily living, lifting, stooping, walking, self-rated health, and worsening health after 1 year. Persons using chiropractic are more satisfied with their follow-up care and with the information provided to them. In addition to the protective effects of chiropractic in the unadjusted model, the propensity score results indicate a significant protective effect of chiropractic against decline in reaching.

CONCLUSION: This study provides evidence of a protective effect of chiropractic care against 1-year declines in functional and self-rated health among Medicare beneficiaries with spine conditions, and indications that chiropractic users have higher satisfaction with follow-up care and information provided about what is wrong with them.

}, keywords = {Aged, Aged, 80 and over, Female, Humans, Male, Manipulation, Chiropractic, Medicare, Patient Satisfaction, Time Factors, Treatment Outcome, United States}, issn = {1532-6586}, doi = {10.1016/j.jmpt.2014.08.003}, url = {https://www.ncbi.nlm.nih.gov/pubmed/25233887}, author = {Paula A Weigel and Jason Hockenberry and Frederic D Wolinsky} } @article {8124, title = {Chronic obstructive pulmonary disease, cognitive impairment, and development of disability: the health and retirement study}, journal = {Annals of the American Thoracic Society}, volume = {11}, year = {2014}, note = {Times Cited: 0 0}, pages = {1362-70}, publisher = {11}, abstract = {RATIONALE: The relationship between chronic obstructive pulmonary disease (COPD) and cognitive impairment in leading to disability has not been characterized. OBJECTIVES: We aimed to investigate the prevalence and cumulative incidence of disability among adults with and without COPD and the association of COPD and cognitive impairment with disability. METHODS: We analyzed 2006-2008 waves of the Health and Retirement Study, a nationally representative longitudinal health survey. COPD was self-reported. Prevalent disability was defined as baseline dependency in one or more activities of daily living (ADLs) and incident disability as one or more additional ADL dependencies. We used a validated performance-based measure of cognition to identify dementia and mild cognitive impairment. Covariates included seven chronic diseases, four geriatric syndromes, and sociodemographics. We used logistic regression to test associations between COPD, cognitive status, and prevalent/incident disability. MEASUREMENTS AND MAIN RESULTS: Of 17,535 participants at least 53 years of age in wave 2006 (representing 77.7 million Americans), 9.5 reported COPD and 13.5 mild cognitive impairment; 17.5 of those with COPD had mild cognitive impairment. Prevalent disability for COPD was 12.8 (5.2 for no-COPD, P 0.001). An additional 9.2 with COPD developed incident disability at 2 years (4.0 for no-COPD, P 0.001). In adjusted models, COPD was associated with baseline (odds ratio, 2.0) and incident disability (odds ratio, 2.1; adjusted for baseline disability). Cognitive impairment had an additive effect to COPD. The COPD-disability association, prevalent/incident, was of similar or greater magnitude than that of other chronic diseases (e.g., stroke, diabetes). The associations were maintained in sensitivity analyses using alternative definitions of disability (dependency in two or more ADLs, dependency in instrumental ADLs), and in analysis excluding respondents with dementia. CONCLUSIONS: Both COPD and mild cognitive impairment increase the risk of disability. The risk conferred by COPD is significant and similar or higher than other chronic diseases.}, keywords = {Disabilities, Health Conditions and Status, Healthcare}, doi = {10.1513/AnnalsATS.201405-187OC}, author = {Martinez, Carlos H. and Richardson, Caroline R. and Han, MeiLan K. and Christine T Cigolle} } @article {10656, title = {Common genetic variants associated with cognitive performance identified using the proxy-phenotype method.}, journal = {Proc Natl Acad Sci U S A}, volume = {111}, year = {2014}, month = {2014 Sep 23}, pages = {13790-4}, abstract = {

We identify common genetic variants associated with cognitive performance using a two-stage approach, which we call the proxy-phenotype method. First, we conduct a genome-wide association study of educational attainment in a large sample (n = 106,736), which produces a set of 69 education-associated SNPs. Second, using independent samples (n = 24,189), we measure the association of these education-associated SNPs with cognitive performance. Three SNPs (rs1487441, rs7923609, and rs2721173) are significantly associated with cognitive performance after correction for multiple hypothesis testing. In an independent sample of older Americans (n = 8,652), we also show that a polygenic score derived from the education-associated SNPs is associated with memory and absence of dementia. Convergent evidence from a set of bioinformatics analyses implicates four specific genes (KNCMA1, NRXN1, POU2F3, and SCRT). All of these genes are associated with a particular neurotransmitter pathway involved in synaptic plasticity, the main cellular mechanism for learning and memory.

}, keywords = {Cell Adhesion Molecules, Neuronal, Cognition, Female, Humans, Learning, Male, Memory, Multifactorial Inheritance, Nerve Tissue Proteins, Neuronal Plasticity, Octamer Transcription Factors, Polymorphism, Single Nucleotide, Synaptic Transmission}, issn = {1091-6490}, doi = {10.1073/pnas.1404623111}, author = {Cornelius A Rietveld and T{\~o}nu Esko and Gail Davies and Pers, Tune H and Turley, Patrick and Benyamin, Beben and Chabris, Christopher F and Emilsson, Valur and Andrew D Johnson and Lee, James J and Christiaan de Leeuw and Riccardo E Marioni and Sarah E Medland and Michael B Miller and Rostapshova, Olga and Sven J van der Lee and Anna A E Vinkhuyzen and Amin, Najaf and Dalton C Conley and Derringer, Jaime and Cornelia M van Duijn and Fehrmann, Rudolf and Lude L Franke and Edward L Glaeser and Narelle K Hansell and Caroline Hayward and Iacono, William G and Carla A Ibrahim-Verbaas and Vincent Jaddoe and Karjalainen, Juha and David I Laibson and Paul Lichtenstein and David C Liewald and Patrik K E Magnusson and Nicholas G Martin and McGue, Matt and McMahon, George and Nancy L Pedersen and Pinker, Steven and David J Porteous and Posthuma, Danielle and Fernando Rivadeneira and Smith, Blair H and John M Starr and Henning Tiemeier and Nicholas J Timpson and Trzaskowski, Maciej and Andr{\'e} G Uitterlinden and Verhulst, Frank C and Mary E Ward and Margaret J Wright and George Davey Smith and Ian J Deary and Johannesson, Magnus and Plomin, Robert and Peter M Visscher and Daniel J. Benjamin and Cesarini, David and Philipp D Koellinger} } @article {10278, title = {The comparative effect of episodes of chiropractic and medical treatment on the health of older adults.}, journal = {J Manipulative Physiol Ther}, volume = {37}, year = {2014}, month = {2014 Mar-Apr}, pages = {143-54}, abstract = {

OBJECTIVES: The comparative effect of chiropractic vs medical care on health, as used in everyday practice settings by older adults, is not well understood. The purpose of this study is to examine how chiropractic compares to medical treatment in episodes of care for uncomplicated back conditions. Episodes of care patterns between treatment groups are described, and effects on health outcomes among an older group of Medicare beneficiaries over a 2-year period are estimated.

METHODS: Survey data from the nationally representative Survey on Assets and Health Dynamics among the Oldest Old were linked to participants{\textquoteright} Medicare Part B claims under a restricted Data Use Agreement with the Centers for Medicare and Medicaid Services. Logistic regression was used to model the effect of chiropractic use in an episode of care relative to medical treatment on declines in function and well-being among a clinically homogenous older adult population. Two analytic approaches were used, the first assumed no selection bias and the second using propensity score analyses to adjust for selection effects in the outcome models.

RESULTS: Episodes of care between treatment groups varied in duration and provider visit pattern. Among the unadjusted models, there was no significant difference between chiropractic and medical episodes of care. The propensity score results indicate a significant protective effect of chiropractic against declines in activities of daily living (ADLs), instrumental ADLs, and self-rated health (adjusted odds ratio [AOR], 0.49; AOR, 0.62; and AOR, 0.59, respectively). There was no difference between treatment types on declines in lower body function or depressive symptoms.

CONCLUSION: The findings from this study suggest that chiropractic use in episodes of care for uncomplicated back conditions has protective effects against declines in ADLs, instrumental ADLs, and self-rated health for older Medicare beneficiaries over a 2-year period.

}, keywords = {Activities of Daily Living, Aged, 80 and over, Back Pain, Episode of Care, Female, Humans, Male, Manipulation, Chiropractic, Treatment Outcome}, issn = {1532-6586}, doi = {10.1016/j.jmpt.2013.12.009}, url = {https://www.ncbi.nlm.nih.gov/pubmed/24636108}, author = {Paula A Weigel and Jason Hockenberry and Suzanne E Bentler and Frederic D Wolinsky} } @article {7999, title = {Connecting Social Environment Variables to the Onset of Major Specific Health Outcomes}, journal = {Psychology and Health}, volume = {29}, year = {2014}, pages = {753-767}, publisher = {29}, abstract = {Abstract Objective: The present research examined the effects of the social environment on the onset of specific health ailments. Design: Using data from the Health and Retirement Study, we examined participants? responses to social environment questions in 2006 as predictors of onset of different health conditions over the next four years. Main Outcome Measures: Healthy participants (n = 7514) reported on their number of social partners, interaction frequency, positive social support, and negative social support with respect to both their family and friends. These variables were used to predict onset of seven conditions in 2010: high blood pressure, heart condition, lung disease, cancer, stroke, diabetes, and arthritis. Results: Logistic regressions indicated that the social environment provided some predictive value for onset of most health outcomes, with more positive and less negative social support appearing to buffer against onset. Social environmental variables related to friendships appeared to play a greater role than the family indicators. However, no variable proved universally adaptive, and social indicators had little value in predicting onset of chronic conditions. Conclusion: The current findings point to the potential for the social environment to influence later health, while demonstrating the nuanced role that our social lives play with respect to health. Objective: The present research examined the effects of the social environment on the onset of specific health ailments. Design: Using data from the Health and Retirement Study, we examined participants? responses to social environment questions in 2006 as predictors of onset of different health conditions over the next four years. Main Outcome Measures: Healthy participants (n = 7514) reported on their number of social partners, interaction frequency, positive social support, and negative social support with respect to both their family and friends. These variables were used to predict onset of seven conditions in 2010: high blood pressure, heart condition, lung disease, cancer, stroke, diabetes, and arthritis. Results: Logistic regressions indicated that the social environment provided some predictive value for onset of most health outcomes, with more positive and less negative social support appearing to buffer against onset. Social environmental variables related to friendships appeared to play a greater role than the family indicators. However, no variable proved universally adaptive, and social indicators had little value in predicting onset of chronic conditions. Conclusion: The current findings point to the potential for the social environment to influence later health, while demonstrating the nuanced role that our social lives play with respect to health.}, keywords = {Adult children, Demographics, Health Conditions and Status}, doi = {10.1080/08870446.2014.884221}, url = {http://dx.doi.org/10.1080/08870446.2014.884221}, author = {Patrick L Hill and Sara J Weston and Joshua J Jackson} } @article {6471, title = {Contribution of Leisure-Time Physical Activity on Psychological Benefits Among Elderly Immigrants}, journal = {Applied Research in Quality of Life}, volume = {11}, year = {2014}, note = {Export Date: 20 January 2015 Article in Press}, pages = {461-470}, chapter = {461}, abstract = {Research provides evidence that leisure-time physical activity engagement promotes health and well-being among older adults. In this study, using data released from the Health and Retirement Study (HRS) in 2008, we focused on the exploration of the relationship between leisure-time physical activity and psychological benefits such as positive affect, optimism, psychological well-being, and life satisfaction among elderly immigrants. The results of this study demonstrated that leisure-time physical activities play an important role in gaining psychological benefits. This finding provided further evidence that leisure-time physical activities provides rich opportunities for elderly immigrants to experience psychological benefits, which may contribute to quality of life and successful aging.}, keywords = {Demographics, Health Conditions and Status, Retirement Planning and Satisfaction}, url = {http://www.scopus.com/inward/record.url?eid=2-s2.0-84910072781andpartnerID=40andmd5=41857df2ae7e029ce6a69f2190475ba5}, author = {Kim, Junhyoung and Sanghee Chun and Jinmoo Heo and Lee, Sunwoo and Areum Han} } @article {6474, title = {Cumulative Childhood Adversity, Educational Attainment, and Active Life Expectancy Among U.S. Adults}, journal = {Demography}, volume = {51}, year = {2014}, pages = {1-23}, chapter = {1}, abstract = {Studies of the early-life origins of adult physical functioning and mortality have found that childhood health and socioeconomic context are important predictors, often irrespective of adult experiences. However, these studies have generally assessed functioning and mortality as distinct processes and used cross-sectional prevalence estimates that neglect the interplay of disability incidence, recovery, and mortality. Here, we examine whether early-life disadvantages both shorten lives and increase the number and fraction of years lived with functional impairment. We also examine the degree to which educational attainment mediates and moderates the health consequences of early-life disadvantages. Using the 1998 2008 Health and Retirement Study, we examine these questions for non-Hispanic whites and blacks aged 50 100 years using multistate life tables. Within levels of educational attainment, adults from disadvantaged childhoods lived fewer total and active years, and spent a greater portion of life impaired compared with adults from advantaged childhoods. Higher levels of education did not ameliorate the health consequences of disadvantaged childhoods. However, because education had a larger impact on health than did childhood socioeconomic context, adults from disadvantaged childhoods who achieved high education levels often had total and active life expectancies that were similar to or better than those of adults from advantaged childhoods who achieved low education levels.}, keywords = {Adult children, Demographics, Health Conditions and Status, Methodology}, doi = {10.1007/s13524-013-0261-x}, url = {http://dx.doi.org/10.1007/s13524-013-0261-x}, author = {Jennifer Karas Montez and Mark D Hayward} } @article {8142, title = {Depression and risk of hospitalization for pneumonia in a cohort study of older Americans.}, journal = {J Psychosom Res}, volume = {77}, year = {2014}, note = {Times Cited: 0 0}, month = {2014 Dec}, pages = {528-34}, publisher = {77}, abstract = {

OBJECTIVE: The aim of this study is to determine if depression is independently associated with risk of hospitalization for pneumonia after adjusting for demographics, medical comorbidity, health-risk behaviors, baseline cognition and functional impairments.

METHODS: This secondary analysis of prospectively collected data examined a population-based sample of 6704 Health and Retirement Study (HRS) (1998-2008) participants>50years old who consented to have their interviews linked to their Medicare claims and were without a dementia diagnosis. The eight-item Center for Epidemiologic Studies Depression Scale and/or International Classification of Disease, Ninth Revision, Clinical Modification (ICD-9-CM) depression diagnoses were used to identify baseline depression. ICD-9-CM diagnoses were used to identify hospitalizations for which the principal discharge diagnosis was for bacterial or viral pneumonia. The odds of hospitalization for pneumonia for participants with depression relative to those without depression were estimated using logistic regression models. Population attributable fractions were calculated to determine the extent that hospitalizations for pneumonia could be attributable to depression.

RESULTS: After adjusting for demographic characteristics, clinical factors, and health-risk behaviors, depression was independently associated with increased odds of hospitalization for pneumonia (odds ratio [OR]: 1.28, 95\% confidence interval [95\%CI]: 1.08, 1.53). This association persisted after adjusting for baseline cognition and functional impairments (OR: 1.24, 95\%CI: 1.03, 1.50). In this cohort, 6\% (95\%CI: 2\%, 10\%) of hospitalizations for pneumonia were potentially attributable to depression.

CONCLUSION: Depression is independently associated with increased odds of hospitalization for pneumonia. This study provides additional rationale for integrating mental health care into medical settings in order to improve outcomes for older adults.

}, keywords = {Aged, Aged, 80 and over, Cohort Studies, Comorbidity, depression, Depressive Disorder, Female, Hospitalization, Humans, Logistic Models, Male, Middle Aged, Odds Ratio, Pneumonia, Risk Assessment, Risk Factors, United States}, issn = {1879-1360}, doi = {10.1016/j.jpsychores.2014.08.002}, author = {Dimitry S Davydow and Catherine L Hough and Zivin, Kara and Kenneth M. Langa and Wayne J Katon} } @article {7996, title = {Development and validation of a brief dementia screening indicator for primary care.}, journal = {Alzheimers Dement}, volume = {10}, year = {2014}, note = {Export Date: 21 April 2014 Source: Scopus Article in Press}, month = {2014 Nov}, pages = {656-665.e1}, publisher = {10}, abstract = {

BACKGROUND: Detection of "any cognitive impairment" is mandated as part of the Medicare annual wellness visit, but screening all patients may result in excessive false positives.

METHODS: We developed and validated a brief Dementia Screening Indicator using data from four large, ongoing cohort studies (the Cardiovascular Health Study [CHS]; the Framingham Heart Study [FHS]; the Health and Retirement Study [HRS]; the Sacramento Area Latino Study on Aging [SALSA]) to help clinicians identify a subgroup of high-risk patients to target for cognitive screening.

RESULTS: The final Dementia Screening Indicator included age (1 point/year; ages, 65-79 years), less than 12~years of education (9 points), stroke (6 points), diabetes mellitus (3 points), body mass index less than 18.5~kg/m(2) (8 points), requiring assistance with money or medications (10 points), and~depressive symptoms (6 points). Accuracy was good across the cohorts (Harrell{\textquoteright}s C statistic: CHS, 0.68; FHS, 0.77; HRS, 0.76; SALSA, 0.78).

CONCLUSIONS: The Dementia Screening Indicator is a simple tool that may be useful in primary care settings to identify high-risk patients to target for cognitive screening.

}, keywords = {Aged, Cohort Studies, Dementia, Female, Humans, Male, Mass Screening, Predictive Value of Tests, Primary Health Care, Proportional Hazards Models, Risk Assessment}, issn = {1552-5279}, doi = {10.1016/j.jalz.2013.11.006}, url = {http://www.scopus.com/inward/record.url?eid=2-s2.0-84893186546andpartnerID=40andmd5=3b617dce24578e022db389d90ad9ddd1}, author = {Deborah E Barnes and Alexa S. Beiser and Anne Lee and Kenneth M. Langa and Alain Koyama and Sarah R Preis and John Neuhaus and Ryan J McCammon and Kristine Yaffe and Seshadri, Sudha and Mary Haan and David R Weir} } @article {8042, title = {Diabetes associated with early labor-force exit: A comparison of sixteen high-income countries}, journal = {Health Affairs}, volume = {33}, year = {2014}, note = {Export Date: 29 January 2014 Source: Scopus}, pages = {110-115}, publisher = {33}, abstract = {The economic burden of diabetes and the effects of the disease on the labor force are of substantial importance to policy makers. We examined the impact of diabetes on leaving the labor force across sixteen countries, using data about 66,542 participants in the Survey of Health, Ageing and Retirement in Europe; the US Health and Retirement Survey; or the English Longitudinal Study of Ageing. After matching people with diabetes to those without the disease in terms of age, sex, and years of education, we used Cox proportional hazards analyses to estimate the effect of diabetes on time of leaving the labor force. Across the sixteen countries, people diagnosed with diabetes had a 30 percent increase in the rate of labor-force exit, compared to people without the disease. The costs associated with earlier labor-force exit are likely to be substantial. These findings further support the value of greater public- and privatesector investment in preventing and managing diabetes. 2014 Project HOPE- The People-to-People Health Foundation, Inc. A.}, keywords = {Employment and Labor Force, Healthcare}, url = {http://www.scopus.com/inward/record.url?eid=2-s2.0-84891794055andpartnerID=40andmd5=6065e630ae9199c709499cf87070f6fa}, author = {Juliet Rumball-Smith and Douglas Barthold and Nandi, Arijit and Jody Heymann} } @article {8066, title = {Does the Hispanic Paradox in U.S. Adult Mortality Extend to Disability?}, journal = {Population Research and Policy Review}, volume = {33}, year = {2014}, pages = {81-96}, publisher = {33}, abstract = {Studies consistently document a Hispanic paradox in U.S. adult mortality, whereby Hispanics have similar or lower mortality rates than non-Hispanic whites despite lower socioeconomic status. This study extends this line of inquiry to disability, especially among foreign-born Hispanics, since their advantaged mortality seemingly should be paired with health advantages more generally. We also assess whether the paradox extends to U.S.-born Hispanics to evaluate the effect of nativity. We calculate multistate life tables of life expectancy with disability to assess whether racial/ethnic and nativity differences in the length of disability-free life parallel differences in overall life expectancy. Our results document a Hispanic paradox in mortality for foreign-born and U.S.-born Hispanics. However, Hispanics low mortality rates are not matched by low disability rates. Their disability rates are substantially higher than those of non-Hispanic whites and generally similar to those of non-Hispanic blacks. The result is a protracted period of disabled life expectancy for Hispanics, both foreign- and U.S.-born.}, keywords = {Demographics, Disabilities, Health Conditions and Status, Women and Minorities}, doi = {10.1007/s11113-013-9312-7}, url = {http://dx.doi.org/10.1007/s11113-013-9312-7}, author = {Mark D Hayward and Robert A Hummer and Chi-Tsun Chiu and C{\'e}sar Gonz{\'a}lez-Gonz{\'a}lez and Rebeca Wong} } @article {5840, title = {The Effect of Job Loss on Health: Evidence from Biomarkers}, year = {2014}, institution = {Bonn, Germany, Institute for the Study of Labor}, abstract = {The effect of job loss on health may play an important role in the development of the SES-health gradient. In this paper, we estimate the effect of job loss on objective measures of physiological dysregulation using longitudinal data from the Health and Retirement Study and biomarker measures collected in 2006 and 2008. We use a variety of econometric methods to account for selection and reverse causality.Distinguishing between layoffs and business closures, we find no evidence that business closures lead to worse health outcomes. We also find no evidence that biomarker health measures predict subsequent job loss because of business closures. We do find evidence that layoffs lead to diminished health. Although this finding appears to be robust to confounders, we find that reverse causality tends to bias downward our estimates. Matching estimates, which account for self-reported health conditions prior to the layoff and subjective job loss expectations, suggest even stronger estimates of the effect of layoffs on health as measured from biomarkers, in particular for glycosylated hemoglobin (HbA1c) and C-reactive protein (CRP). Overall, we estimate that a layoff could increase annual mortality rates by 9.4 , which is consistent with other evidence of the effect of mass layoffs on mortality.}, keywords = {Demographics, Employment and Labor Force, Health Conditions and Status, Methodology}, author = {Pierre-Carl Michaud and Eileen M. Crimmins and Michael D Hurd} } @article {7994, title = {The Effects of Total Knee Arthroplasty on Physical Functioning and Health among the Under Age 65 Population}, journal = {Value in Health}, volume = {17}, year = {2014}, note = {Export Date: 6 August 2014 Article in Press}, pages = {605-610}, publisher = {17}, abstract = {Objectives: This study examined the effects of total knee arthroplasty on six measures of physical functioning, self-rated health, pain, earnings, and employment status among US adults aged 51 to 63 years at baseline. Methods: Data came from the Health and Retirement Study, a nationally representative longitudinal study conducted biannually. The analysis sample consisted of individuals aged 51 to 63 years at baseline with arthritis who were resurveyed at 2-year intervals from 1996 to 2010. Propensity score matching was used to compare outcomes of persons receiving total knee arthroplasty (TKA) with those of matched controls. Six measures of physical functioning were examined: lower-body mobility problems, instrumental activities of daily living limitations, activities of daily living limitations, and large muscle, fine motor, and gross motor limitations. Self-rated health and pain were also examined. The two employment-related outcomes were earnings and employment status. Results: Receipt of TKA was associated with better outcomes for several measures of physical functioning, especially mobility limitations, pain, and self-rated health. Receipt of TKA was not associated with increased earnings or employment. Conclusions: Receipt of TKA yields important improvements in physical function among persons with an arthritis diagnosis who received the procedure before reaching the age of 65 years. This study contributes to knowledge about the benefits of TKA in a community setting among nonelderly recipients of TKA. 2014 International Society for Pharmacoeconomics and Outcomes Research (ISPOR).}, keywords = {Employment and Labor Force, Health Conditions and Status, Healthcare}, doi = {10.1016/j.jval.2014.04.004}, author = {Linda K George and Hu, L. and Frank A Sloan} } @article {8134, title = {Efficient Use of Commercial Lists in U.S. Household Sampling}, journal = {Journal of Survey Statistics and Methodology}, volume = {2}, year = {2014}, pages = {182-209}, publisher = {2}, abstract = {Sampling households using commercial lists has the potential to reduce costs and efficiently identify some subgroups for which target sample sizes are desired. However, the information on the lists for demographics like age is usually incomplete and inaccurate. We demonstrate that this inexact information can still be used to improve the efficiency with which some, but not all, demographic subgroups can be located during sampling. The article also illustrates the use of nonlinear programming as a means for finding sample allocations that are subject to a variety of practical constraints. A commercial address list and data from the National Survey of Family Growth and the Health and Retirement Study are used to illustrate the calculation of allocations to strata of housing units defined by information on the list.}, keywords = {Methodology}, doi = {10.1093/jssam/smu006}, url = {http://jssam.oxfordjournals.org/content/2/2/182.abstract}, author = {Valliant, Richard and Hubbard, Frost and Lee, Sunghee and Chang, Chiungwen} } @article {8126, title = {Functional disability and cognitive impairment after hospitalization for myocardial infarction and stroke.}, journal = {Circ Cardiovasc Qual Outcomes}, volume = {7}, year = {2014}, note = {Times Cited: 1 0 1}, month = {2014 Nov}, pages = {863-71}, publisher = {7}, abstract = {

BACKGROUND: We assessed the acute and long-term effect of myocardial infarction (MI) and stroke on postevent functional disability and cognition while controlling for survivors{\textquoteright} changes in functioning over the years before the event.

METHODS AND RESULTS: Among participants in the nationally representative Health and Retirement Study with linked Medicare data (1998-2010), we determined within-person changes in functional limitations (basic and instrumental activities of daily living) and cognitive impairment after hospitalization for stroke (n=432) and MI (n=450), controlling for premorbid functioning using fixed-effects regression. In persons without baseline impairments, an acute MI yielded a mean acute increase of 0.41 functional limitations (95\% confidence interval [CI], 0.18-0.63) with a linear increase of 0.14 limitations/year in the following decade. These increases were 0.65 limitations (95\% CI, 0.07-1.23) and 0.27 limitations/year afterward for those with mild-to-moderate impairment at baseline. Stroke resulted in an acute increase of 2.07 (95\% CI, 1.51-2.63) limitations because of the acute event and an increase of 0.15 limitations/year afterward for those unimpaired at baseline. There were 2.65 new limitations (95\% CI, 1.86-3.44) and 0.19/year afterward for those with baseline mild-to-moderate impairment. Stroke hospitalization was associated with greater odds of moderate-to-severe cognitive impairment (odds ratio, 3.86; 95\% CI, 2.10-7.11) at the time of the event, after adjustment for premorbid cognition but MI hospitalization was not.

CONCLUSIONS: In this population-based cohort, most MI and stroke hospitalizations were associated with significant increases in functional disability at the time of the event and in the decade afterward. Survivors of MI and stroke warrant screening for functional disability over the long-term.

}, keywords = {Activities of Daily Living, Cognition, Cognition Disorders, Disability Evaluation, Disabled Persons, Female, Follow-Up Studies, Hospitalization, Humans, Incidence, Male, Middle Aged, Myocardial Infarction, Odds Ratio, Retrospective Studies, Stroke, Time Factors, United States}, issn = {1941-7705}, doi = {10.1161/HCQ.0000000000000008}, author = {Deborah A Levine and Dimitry S Davydow and Catherine L Hough and Kenneth M. Langa and Mary A M Rogers and Theodore J Iwashyna} } @article {8604, title = {Genetic diversity is a predictor of mortality in humans.}, journal = {BMC Genet}, volume = {15}, year = {2014}, month = {2014 Dec 29}, pages = {159}, abstract = {

BACKGROUND: It has been well-established, both by population genetics theory and direct observation in many organisms, that increased genetic diversity provides a survival advantage. However, given the limitations of both sample size and genome-wide metrics, this hypothesis has not been comprehensively tested in human populations. Moreover, the presence of numerous segregating small effect alleles that influence traits that directly impact health directly raises the question as to whether global measures of genomic variation are themselves associated with human health and disease.

RESULTS: We performed a meta-analysis of 17 cohorts followed prospectively, with a combined sample size of 46,716 individuals, including a total of 15,234 deaths. We find a significant association between increased heterozygosity and survival (P = 0.03). We estimate that within a single population, every standard deviation of heterozygosity an individual has over the mean decreases that person{\textquoteright}s risk of death by 1.57\%.

CONCLUSIONS: This effect was consistent between European and African ancestry cohorts, men and women, and major causes of death (cancer and cardiovascular disease), demonstrating the broad positive impact of genomic diversity on human survival.

}, keywords = {Genome-Wide Association Study, Heterozygote, Humans, Mortality, Polymorphism, Single Nucleotide, Proportional Hazards Models}, issn = {1471-2156}, doi = {10.1186/s12863-014-0159-7}, url = {https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4301661/}, author = {Bihlmeyer, Nathan A and Brody, Jennifer A and Albert Vernon Smith and Kathryn L Lunetta and Michael A Nalls and Jennifer A Smith and Toshiko Tanaka and Gail Davies and Lei Yu and Saira S Mirza and Teumer, Alexander and Coresh, Josef and Pankow, James S and Franceschini, Nora and Scaria, Anish and Oshima, Junko and Psaty, Bruce M and Gudnason, Vilmundur and Gu{\dh}ny Eir{\'\i}ksd{\'o}ttir and Tamara B Harris and Li, Hanyue and Karasik, David and Douglas P Kiel and Melissa E Garcia and Yongmei Liu and Jessica Faul and Sharon L R Kardia and Wei Zhao and Luigi Ferrucci and Allerhand, Michael and David C Liewald and Redmond, Paul and John M Starr and Philip L de Jager and Nese Direk and Mohammed Arfan Ikram and Andr{\'e} G Uitterlinden and Homuth, Georg and Lorbeer, Roberto and Hans-J{\"o}rgen Grabe and Lenore J Launer and Joanne M Murabito and Andrew B Singleton and David R Weir and Bandinelli, Stefania and Ian J Deary and David A Bennett and Henning Tiemeier and Kocher, Thomas and Lumley, Thomas and Dan E Arking} } @article {8076, title = {Housing wealth, psychological well-being, and cognitive functioning of older Americans}, journal = {The journals of gerontology. Series B, Psychological sciences and social sciences}, volume = {69}, year = {2014}, note = {Times Cited: 0}, pages = {253-62}, publisher = {69}, abstract = {OBJECTIVES: Economic security around retirement age may be an important determinant of psychological and cognitive well-being of older adults. This study examines the impact of the dramatic increase in housing prices from the mid-1990s to the mid-2000s on psychological and cognitive outcomes among Americans born between 1924 and 1960. METHOD: Our quasi-experimental empirical strategy exploits geographic differences in housing market price trends during the housing boom (from the mid-1990s until 2006). We use individual-level data from the Health and Retirement Study (HRS) and estimates of housing values from DataQuick, a California-based real estate consultancy firm, to estimate the association of housing price increases with psychological and cognitive outcomes at follow-up. RESULTS: Greater housing appreciation over the follow-up period was associated with a significantly lower risk of anxiety (for women) and an improved performance on some but not all cognitive tasks. Effects for depressive symptoms, positive and negative affect, and life satisfaction were all in the beneficial direction but not statistically significant. The effects of price run-ups were concentrated on homeowners, as opposed to renters, suggestive of wealth-driven effects. DISCUSSION: Housing market volatility may influence the psychological and cognitive health of older adults, highlighting potential health consequences of pro-home ownership policies, which may be especially important in light of recent dramatic housing price declines.}, keywords = {Demographics, Health Conditions and Status, Housing, Other}, doi = {10.1093/geronb/gbt114}, author = {Hamoudi, Amar and Jennifer B Dowd} } @article {6476, title = {The Identification of Regions of Significance in the Effect of Multimorbidity on Depressive Symptoms Using Longitudinal Data: An Application of the Johnson-Neyman Technique}, journal = {Gerontology}, volume = {60}, year = {2014}, note = {Export Date: 21 April 2014 Source: Scopus Article in Press}, pages = {274-281}, chapter = {274}, abstract = {Background: The investigation of multimorbidity and aging is complex and highly intertwined with aging-related changes in physical and cognitive capabilities, and mental health and is known to affect psychological distress and quality of life. Under these circumstances it is important to understand how the effects of chronic conditions evolve over time relative to aging-related and end-of-life changes. The identification of periods in time where multimorbidity impacts particular outcomes such as depressive symptoms, versus periods of time where this is not the case, reduces the complexity of the phenomenon. Objective: We present the Johnson-Neyman (J-N) technique in the context of a curvilinear longitudinal model with higher-order terms to probe moderators and to identify regions of statistical significance. In essence, the J-N technique allows one to identify conditions under which moderators impact an outcome from conditions where these effects are not significant. Methods: To illustrate the use of the J-N technique in a longitudinal sample, we used data from the Health and Retirement Study. Analyses were based on time-to-death models including participants who died within the study duration of 12 years. Results: Multimorbidity differentially affects rates of change in depression. For some periods in time the effects are statistically significant while in other periods the same effects are not statistically different from zero. Conclusion: The J-N technique is useful to continuously probe moderating effects and to identify particular interactions with the model for time when certain effects are or are not statistically significant. In the context of multimorbidity this method is particularly useful for interpreting the complex interactions with differential change over time. 2014 S. Karger AG, Basel.}, keywords = {Health Conditions and Status, Methodology}, url = {http://www.scopus.com/inward/record.url?eid=2-s2.0-84895711235andpartnerID=40andmd5=d4f89914e4429927b0a42ae963405bcf}, author = {Rast, P. and Rush, J. and Andrea M Piccinin and Scott M Hofer} } @inbook {5261, title = {The Lifetime Risk of Nursing Home Use}, booktitle = {Discoveries in the Economics of Aging}, year = {2014}, pages = {81-109}, publisher = {University of Chicago Press}, organization = {University of Chicago Press}, address = {Chicago}, abstract = {This paper estimates the lifetime risk and distribution of stays in nursing homes using 10 waves of data from the Health and Retirement Study covering the population over the age of 50. Using both non-parametric and parametric approaches which account for censoring, we estimate that a 50 year old has a 53 to 59 chance of ever entering a nursing home before he dies and that, conditional on any stay, the average duration is just over a year. We show that stays at the end of life which are typically not captured in core interviews are very important for assessing lifetime exposure. The HRS performs exit interviews with proxies for those who died. Excluding exit interviews yields lifetime risk under 40 . Being female, white and a non-smoker are associated with higher lifetime risk due to lower (competing) mortality risk and higher nursing home risk at older ages.}, keywords = {Health Conditions and Status, Healthcare}, author = {Michael D Hurd and Pierre-Carl Michaud and Susann Rohwedder}, editor = {David A Wise} } @article {8131, title = {Longitudinal Associations of Subjective Memory With Memory Performance and Depressive Symptoms: Between-Person and Within-Person Perspectives}, journal = {Psychology and Aging}, volume = {29}, year = {2014}, note = {Times Cited: 0 0}, pages = {814-827}, publisher = {29}, abstract = {Clinical diagnostic criteria for memory loss in adults typically assume that subjective memory ratings accurately reflect compromised memory functioning. Research has documented small positive between-person associations between subjective memory and memory performance in older adults. Less is known, however, about whether within-person fluctuations in subjective memory covary with within-person variance in memory performance and depressive symptoms. The present study applied multilevel models of change to 9 waves of data from 27,395 participants of the Health and Retirement Study (HRS; mean age at baseline = 63.78; SD = 10.30; 58 women) to examine whether subjective memory is associated with both between-person differences and within-person variability in memory performance and depressive symptoms and explored the moderating role of known correlates (age, gender, education, and functional limitations). Results revealed that across persons, level of subjective memory indeed covaried with level of memory performance and depressive symptoms, with small-to-moderate between-person standardized effect sizes (0.19 for memory performance and -0.21 for depressive symptoms). Within individuals, occasions when participants scored higher than usual on a test of episodic memory or reported fewer-than-average depressive symptoms generated above-average subjective memory. At the within-person level, subjective memory ratings became more sensitive to within-person alterations in memory performance over time and those suffering from functional limitations were more sensitive to within-person alterations in memory performance and depressive symptoms. We take our results to suggest that within-person changes in subjective memory in part reflect monitoring flux in one{\textquoteright}s own memory functioning, but are also influenced by flux in depressive symptoms.}, keywords = {Expectations, Health Conditions and Status, Methodology}, doi = {10.1037/a0037619}, author = {Hueluer, Gizem and Hertzog, Christopher and Ann M. Pearman and Ram, Nilam and Denis Gerstorf} } @article {10778, title = {New Evidence on the Risk of Requiring Long-Term Care}, number = {WP$\#$2014-12}, year = {2014}, institution = {Center for Retirement Research at Boston College}, abstract = {The expectation of needing long-term care is an essential input into optimal saving and long-term care insurance decisions. Previous optimization models have used the Robinson (2002) transition probabilities, which have not been systematically updated and which underpredict the use of care while overpredicting the average stay of people who enter care. We develop a new statistical model and use current data to estimate health impairment and care transition probabilities. We show that impairment and care use have declined and that, after incorporating the new transition probabilities, optimal long-term care insurance holdings are much lower and are close to actual holdings.}, keywords = {Long-term Care}, url = {https://crr.bc.edu/working-papers/new-evidence-on-the-risk-of-requiring-long-term-care/}, author = {Wenliang Hou and Friedberg, Leora and Wei Sun and Anthony Webb and Zhenyu Li} } @inbook {5262, title = {Older Adults as Consumers: An Examination of Differences by Birth Cohort}, booktitle = {The interdisciplinary science of consumption}, year = {2014}, pages = {292-298}, publisher = {The MIT Press}, organization = {The MIT Press}, abstract = {The U.S. and much of the developed world are currently undergoing a demographic transition marked by fundamental changes in the age structure of the population. These changes pose a number of challenges for society such as understanding the consumption patterns of middle aged and older people. In this chapter, the authors use data from the Health and Retirement Study to explore consumption patterns among five cohorts of adults age 50 and older. They found that older, compared to younger, birth cohorts of older adults reported less spending on food, transportation, trips and vacations, and durable goods; they spent more on donations and gifts; all cohorts reported similar levels of spending on health-related expenses. Results also identified a critical middle age group (i.e. ages 70 to 80), in which the greatest differences in consumption patterns were evident. Such findings may be useful for industry and organizations allowing them to be responsive and competitive by helping them target goods and products that meet the changing needs of an aging society}, keywords = {Demographics, Methodology}, isbn = {9780262325387}, doi = {10.7551/mitpress/9780262027670.003.0015}, author = {Fin, Debra N. and Yoon, Carolyn and Hartsell, Debra L. and Toni C Antonucci and Noah J Webster and McCullough, Wayne R.} } @article {7976, title = {Optimal Portfolio Choice with Annuities and Life Insurance for Retired Couples}, journal = {Review of Finance}, volume = {18}, year = {2014}, note = {Times Cited: 0}, pages = {147-188}, publisher = {18}, abstract = {Using a portfolio choice model, we derive the optimal demand for stocks, bonds, annuities, and term life insurance for a retired couple with uncertainty in both lifetimes. We show that the optimal portfolio is heavily weighted with joint annuities and that life insurance is purchased mainly to protect a surviving spouse from loss of annuitized income rather than for bequest. Consistent with these predictions, empirical analyses on Health and Retirement Study data indicate that life insurance holdings are related to the degree of asymmetry in the couple{\textquoteright}s annuitized income distribution.}, keywords = {Adult children, Insurance, Net Worth and Assets}, doi = {10.1093/rof/rfs046}, author = {Hubener, Andreas and Maurer, Raimond and Rogalla, Ralph} } @article {8112, title = {Parental Money Help to Children and Stepchildren}, journal = {Journal of Family Issues}, volume = {35}, year = {2014}, note = {Times Cited: 0}, pages = {1131-1153}, publisher = {35}, abstract = {Divorce and remarriage have reshaped the American family giving rise to questions about the place of stepchildren in remarried families. In this article, we examine money transfers from a couple to each of their children. We introduce characteristics of the family and estimate the role of shared family membership affecting all children in the family as well as the difference that stepchild status and other individual characteristics make in transfer flows. Data are from the Health and Retirement Study. There are two central results in the analysis. Overall, provision of financial help from parents to children is a family phenomenon. Although help to a particular child is episodic, differences between families in provision of help were much greater than the differences in helping one child versus another within families. Second, stepchild status does differentiate one child from another within a family. Stepchildren are disadvantaged, particularly stepchildren of the wife.}, keywords = {Adult children}, doi = {10.1177/0192513x13485077}, author = {John C Henretta and Matthew F. Van Voorhis and Beth J Soldo} } @article {8123, title = {Perceived neighbourhood social cohesion and myocardial infarction.}, journal = {J Epidemiol Community Health}, volume = {68}, year = {2014}, note = {Times Cited: 0 0}, month = {2014 Nov}, pages = {1020-6}, publisher = {68}, abstract = {

BACKGROUND: The main strategy for alleviating heart disease has been to target individuals and encourage them to change their health behaviours. Although important, emphasis on individuals has diverted focus and responsibility away from neighbourhood characteristics, which also strongly influence people{\textquoteright}s behaviours. Although a growing body of research has repeatedly demonstrated strong associations between neighbourhood characteristics and cardiovascular health, it has typically focused on negative neighbourhood characteristics. Only a few studies have examined the potential health enhancing effects of positive neighbourhood characteristics, such as perceived neighbourhood social cohesion.

METHODS: Using multiple logistic regression models, we tested whether higher perceived neighbourhood social cohesion was associated with lower incidence of myocardial infarction. Prospective data from the Health and Retirement Study--a nationally representative panel study of American adults over the age of 50--were used to analyse 5276 participants with no history of heart disease. Respondents were tracked for 4 years and analyses adjusted for relevant sociodemographic, behavioural, biological and psychosocial factors.

RESULTS: In a model that adjusted for age, gender, race, marital status, education and total wealth, each SD increase in perceived neighbourhood social cohesion was associated with a 22\% reduced odds of myocardial infarction (OR=0.78, 95\% CI 0.63 to 0.94. The association between perceived neighbourhood social cohesion and myocardial infarction remained even after adjusting for behavioural, biological and psychosocial covariates.

CONCLUSIONS: Higher perceived neighbourhood social cohesion may have a protective effect against myocardial infarction.

}, keywords = {Aged, Aged, 80 and over, Confounding Factors, Epidemiologic, Female, Health Behavior, Health Status, Health Surveys, Humans, Incidence, Interviews as Topic, Male, Mental Health, Middle Aged, Multilevel Analysis, Myocardial Infarction, Perception, Prospective Studies, Protective factors, Residence Characteristics, Self Report, Social Environment, Socioeconomic factors, United States}, issn = {1470-2738}, doi = {10.1136/jech-2014-204009}, author = {Eric S Kim and Armani M. Hawes and Jacqui Smith} } @article {7972, title = {Is personality associated with cancer incidence and mortality? An individual-participant meta-analysis of 2156 incident cancer cases among 42843 men and women}, journal = {British journal of cancer}, volume = {110}, year = {2014}, note = {Times Cited: 0}, pages = {1820-4}, publisher = {110}, abstract = {Background:The putative role of personality in cancer risk has been controversial, and the evidence remains inconclusive.Methods:We pooled data from six prospective cohort studies (British Household Panel Survey; Health and Retirement Study; Household, Income, and Labour Dynamics in Australia; Midlife in the United Survey; Wisconsin Longitudinal Study Graduate; and Sibling samples) for an individual-participant meta-analysis to examine whether personality traits of the Five Factor Model (extraversion, neuroticism, agreeableness, conscientiousness, and openness to experience) were associated with the incidence of cancer and cancer mortality in 42843 cancer-free men and women at baseline (mean age 52.2 years, 55.6 women).Results:During an average follow-up of 5.4 years, there were 2156 incident cancer cases. In random-effects meta-analysis adjusted for age, sex, and race/ethnicity, none of the personality traits were associated with the incidence of all cancers or any of the six site-specific cancers included in the analysis (lung, colon, breast, prostate, skin, and leukaemia/lymphoma). In the three cohorts with cause-specific mortality data (421 cancer deaths among 21835 participants), none of the personality traits were associated with cancer mortality.Conclusions:These data suggest that personality is not associated with increased risk of incident cancer or cancer-related mortality.}, keywords = {Health Conditions and Status}, doi = {10.1038/bjc.2014.58}, author = {Markus Jokela and G David Batty and Hintsa, T. and Marko Elovainio and Hakulinen, C. and Mika Kivim{\"a}ki} } @article {7997, title = {Personality change associated with chronic diseases: pooled analysis of four prospective cohort studies}, journal = {Psychological Medicine}, volume = {44}, year = {2014}, note = {Export Date: 21 April 2014 Source: Scopus Article in Press}, pages = {2629-2640}, publisher = {44}, abstract = {Background: Common chronic conditions, such as heart disease and cancer, are associated with increased psychological distress, functional limitations and shortened life expectancy, but whether these diseases alter aspects of personality remains unclear. Method: To examine whether the onset of heart disease, stroke, diabetes, cancer, hypertension, arthritis and respiratory disease is associated with subsequent changes in personality traits of the five-factor model, we pooled data from the Health and Retirement Study, the Midlife in the United States Survey, and the graduate and sibling samples of the Wisconsin Longitudinal Study for an individual-participant meta-analysis (total n = 17 493; mean age at baseline 55.8 years). Results: After adjustment for age, we observed consistent decreases in extraversion -0.25 T-scores per one disease; 95 confidence interval (CI) -0.40 to -0.10 , emotional stability (-0.40, 95 CI -0.61 to -0.19), conscientiousness (-0.44, 95 CI -0.57 to -0.30) and openness to experience (-0.25, 95 CI -0.37 to -0.13) but not in agreeableness (-0.05, 95 CI -0.19 to 0.08) after the onset of chronic diseases. The onset of each additional chronic disease accelerated the average age-related personality change by 2.5 years in decreasing extraversion, 5.5 years in decreasing conscientiousness, and 1.6 years in decreasing openness to experience, and attenuated the increasing levels of emotional stability by 1.9 years. Co-morbid conditions were associated with larger changes than single diseases, suggesting a dose-response association between morbidity and personality change. Conclusions: These results support the hypothesis that chronic diseases influence personality development in adulthood. Copyright Cambridge University Press 2014.}, keywords = {Health Conditions and Status, Methodology}, doi = {10.1017/S0033291714000257}, url = {http://www.scopus.com/inward/record.url?eid=2-s2.0-84893979073andpartnerID=40andmd5=090e38b137f79e574d4bd8d0e6c36699}, author = {Markus Jokela and Hakulinen, C. and Archana Singh-Manoux and Mika Kivim{\"a}ki} } @article {6481, title = {Personality Traits Predict the Onset of Disease}, journal = {Social Psychological and Personality Science}, volume = {6}, year = {2014}, pages = {309-317}, chapter = {309}, abstract = {While personality traits have been linked concurrently to health status and prospectively to outcomes such as mortality, it is currently unknown whether traits predict the diagnosis of a number of specific diseases (e.g., lung disease, heart disease, and stroke) that may account for their mortality effects more generally. A sample (N = 6,904) of participants from the Health and Retirement Study, a longitudinal study of older adults, completed personality measures and reported on current health conditions. Four years later, participants were followed up to see if they developed a new disease. Initial cross-sectional analyses replicated past findings that personality traits differ across disease groups. Longitudinal logistic regression analyses predicting new disease diagnosis suggest that traits are associated with the risk of developing disease most notably the traits of conscientiousness, neuroticism, and openness. Findings are discussed as a means to identify pathways between personality and health.}, keywords = {Health Conditions and Status, Healthcare}, doi = {10.1177/1948550614553248}, url = {http://spp.sagepub.com/content/early/2014/10/13/1948550614553248.abstract}, author = {Sara J Weston and Patrick L Hill and Joshua J Jackson} } @article {8102, title = {Predictors of Long-Term Nursing Home Placement Under Competing Risk: Evidence from the Health and Retirement Study}, journal = {Journal of the American Geriatrics Society}, volume = {62}, year = {2014}, note = {Times Cited: 0}, pages = {913-918}, publisher = {62}, abstract = {Objectives:To examine predictors of long-term nursing home placement (LTNHP) while controlling for mortality as a competing risk event. Design: Longitudinal. Setting: Health and Retirement Study, 1998-2010. Participants: Nationally representative sample of community-living older adults (N=10,385). Measurements: Longitudinal data were used with a maximum follow-up of 12years. First, a traditional Cox proportional hazards model was estimated treating death as an uninformative censoring event. A joint cause-specific hazards model that accounts for the competing risk of mortality in estimating the risk of LTNHP was then estimated. Results: The effect of adjusting for competing risk of mortality is evident for nearly all predictors of LTNHP. Predictors were over- or underestimated in the traditional Cox model, and several predictors changed in the direction of the association, whereas others changed in magnitude. For example, after controlling for mortality, women aged 85 and older had more than twice the risk (hazard ratio=7.23, 95 confidence interval=5.18-10.10) of LTNHP than evidenced in the traditional Cox model. Conclusion: Whenever possible, the competing risk of mortality should be recognized and adjusted in developing screening tools and predictive risk models for LTNHP.}, keywords = {Health Conditions and Status, Healthcare, Methodology, Risk Taking}, doi = {10.1111/jgs.12781}, author = {Castora-Binkley, Melissa and Meng, Hongdao and Hyer, Kathryn} } @article {8049, title = {Productivity improvements in hip and knee surgery}, journal = {Arthritis}, volume = {2014}, year = {2014}, note = {Times Cited: 0}, pages = {615784}, publisher = {2014}, abstract = {Productivity improvements that occur as technologies become widely used are not well documented. This study measured secular trends over 1998-2010 in productivity of hip and knee procedures gauged in terms of changes in physical function and pain after versus before surgery. We used data from the Health and Retirement Study. Health outcomes from surgery were measured by 6 physical functioning scales and 2 pain indicators. We used propensity score matching to obtain nonsurgery control groups. Not only were there substantial improvements in physical functioning and pain reduction after receipt of these procedures in all years, but also we documented improvements in health outcomes over time. Largest improvements were for reductions in numbers of Activity and Instrumental Activity of Daily Living limitations for knee procedures.}, keywords = {Health Conditions and Status, Healthcare, Other}, doi = {10.1155/2014/615784}, author = {Frank A Sloan and Linda K George and Hu, Linyan} } @article {7989, title = {Racial Variations of Parity Status as a Predictor of Disability Onset Among Old-Old Women}, journal = {Journal of Family Issues}, volume = {35}, year = {2014}, note = {Times Cited: 0}, pages = {291-311}, publisher = {35}, abstract = {This research investigates whether the capacity of parity status to predict disability onset varies by race among older women. Data from the Health and Retirement Study (1998-2008) were used, and a series of discrete-time event-history models were estimated using multinomial logistic regression. Disability onset was constructed from five common activities of daily living measures (i.e., difficulty dressing, bathing, eating, getting in/out of bed, and walking). The initial risk group was old-old women (i.e., born before 1925) without disability in 1998 (N = 2,229). Nulliparous and high-parity Black women born before 1925 were more likely to develop disability onset compared with White women with the same parity status. The results suggest that parity status among Black older women may be a salient risk factor for disability onset.}, keywords = {Adult children, Event History/Life Cycle, Health Conditions and Status, Healthcare, Women and Minorities}, doi = {10.1177/0192513x12468436}, author = {Kenzie Latham and Holcomb, Jeanne} } @inbook {5249, title = {Retirement Planning and Financial Literacy}, booktitle = {International Handbook on Ageing and Public Policy}, year = {2014}, pages = {474-490}, publisher = {Edward Elgar Publishing}, organization = {Edward Elgar Publishing}, address = {Northhampton, MA}, keywords = {Net Worth and Assets, Retirement Planning and Satisfaction}, author = {Annamaria Lusardi}, editor = {Harper, Sarah and Hamblin, Kate} } @article {8000, title = {The role of satisfaction and switching costs in Medicare Part D choices}, journal = {Research in Social and Administrative Pharmacy}, volume = {10}, year = {2014}, pages = {398-407}, publisher = {10}, abstract = {Background Most U.S. states had over 50 Medicare Prescription Drug Plans (PDPs) in 2007. Medicare beneficiaries are expected to switch Part D plans based on their health and financial needs; however, the switching rate has been low. Such consumer inertia potentially has negative effects on both beneficiaries and the insurance market, resulting in a critical need to investigate its cause. Objectives To 1) describe how Medicare beneficiaries who were satisfied with their current Part D plan differed from those who were not satisfied; 2) examine the effect of switching costs on consideration of switching among Medicare beneficiaries who were dissatisfied with their current Part D plan. Methods Data from the 2007 Prescription Drug Study supplement to the Health and Retirement Study (HRS) survey were used in this study. The satisfied and dissatisfied groups were compared in terms of cost variables, switching costs, and perception of Part D complexity. Structural equation modeling was used to examine relationships among switching costs, Part D complexity, cost variables, and consideration of switching for beneficiaries who were dissatisfied with their current Part D coverage. Results Out of 467 participants, a total of 255 (54.6 ) were satisfied with their current Part D plan. The satisfied group paid lower out-of-pocket costs ( 50.63 vs. 114.60) and premiums ( 30.88 vs. 40.77) than the dissatisfied group. They also had lower switching costs. Only 11.3 of the dissatisfied beneficiaries switched plans. Among respondents who were dissatisfied with their current plan, those who perceived Part D as complex had high switching costs and were less likely to consider switching plans. Out-of-pocket cost did not have a statistically significant association with consideration of switching. Conclusions Medicare beneficiaries who were satisfied with their current Part D plans had lower out-of-pocket costs and premiums as well as higher switching costs. Among beneficiaries who were dissatisfied with their current Part D plan, those who had higher switching costs were less likely to consider switching Part D plans.}, keywords = {Medicare/Medicaid/Health Insurance, Methodology, Retirement Planning and Satisfaction}, doi = {10.1016/j.sapharm.2013.06.010}, url = {http://www.sciencedirect.com/science/article/pii/S1551741113001290}, author = {Han, Jayoung and Michelle J Ko and Julie M. Urmie} } @article {7978, title = {Self-employment of older Americans: do recessions matter?}, journal = {Small Business Economics}, volume = {42}, year = {2014}, pages = {297}, publisher = {42}, abstract = {As high unemployment rates linger following the latest recession, job opportunities can be sparse, especially for older workers. This might prompt older Americans to seek out opportunities in self-employment. Alternatively, recession-related decreases in economic activity might make self-employment less attractive. Using the Health and Retirement Study, we find that unemployed respondents are more likely to enter self-employment and that these decisions are clearly affected by recessions, although the effects differ by recession and gender. Unlike men, women s self-employment decisions are very sensitive to other sources of household income, and women are less likely to become self-employed the deeper the recession.}, keywords = {Demographics, Employment and Labor Force, Methodology, Other, Public Policy}, author = {Biehl, Amelia M. and Gurley-Calvez, Tami and Hill, Brian} } @article {RePEc:upf:upfgen:1451, title = {Source of health insurance coverage and employment survival among newly disabled workers: Evidence from the health and retirement study}, year = {2014}, institution = {Universitat Pompeu Fabra}, abstract = {We use prospective longitudinal data on newly disabled older workers to examine the effect of employer sponsorship of health insurance (ESHI) on post-onset employment and disability insurance claiming. We compare outcomes of workers with ESHI and no access to spousal coverage prior to onset with outcomes of two comparison groups: individuals with ESHI who also have access to spousal coverage and those who are covered by a spouse{\textquoteright}s employer prior to onset. We find evidence of \"employment lock\" among the 20 percent of individuals whose disabilities do not impact their immediate physical capacity but are associated with high medical costs.}, keywords = {Disabilities, disability insurance, Disability onset, health, Health Insurance}, url = {https://ideas.repec.org/p/upf/upfgen/1451.html}, author = {Matthew J Hill and Nicole Maestas and Kathleen J Mullen} } @article {7993, title = {Testing the key assumption of heritability estimates based on genome-wide genetic relatedness.}, journal = {J Hum Genet}, volume = {59}, year = {2014}, month = {2014 Jun}, pages = {342-5}, publisher = {59}, abstract = {

Comparing genetic and phenotypic similarity among unrelated individuals seems a promising way to quantify the genetic component of traits while avoiding the problematic assumptions plaguing twin- and other kin-based estimates of heritability. One approach uses a Genetic Relatedness Estimation through Maximum Likelihood (GREML) model for individuals who are related at less than 0.025 to predict their phenotypic similarity by their genetic similarity. Here we test the key underlying assumption of this approach: that genetic relatedness is orthogonal to environmental similarity. Using data from the Health and Retirement Study (and two other surveys), we show two unrelated individuals may be more likely to have been reared in a similar environment (urban versus nonurban setting) if they are genetically similar. This effect is not eliminated by controls for population structure. However, when we include this environmental confound in GREML models, heritabilities do not change substantially and thus potential bias in estimates of most biological phenotypes is probably minimal.

}, keywords = {Body Height, Body Weight, Educational Status, Gene-Environment Interaction, Genome, Human, Humans, Likelihood Functions, Models, Genetic, Phenotype, Quantitative Trait, Heritable, Urban Population}, issn = {1435-232X}, doi = {10.1038/jhg.2014.14}, author = {Dalton C Conley and Mark L Siegal and Benjamin W Domingue and Kathleen Mullan Harris and Matthew B McQueen and Jason D Boardman} } @mastersthesis {6108, title = {Three essays in labor economics and the economics of education}, volume = {3634483}, year = {2014}, note = {Copyright - Copyright ProQuest, UMI Dissertations Publishing 2014 Last updated - 2014-10-25 First page - n/a}, month = {2014}, pages = {103}, school = {Michigan State University}, type = {Ph.D.}, address = {East Lansing, MI}, abstract = {In the first chapter of my dissertation, I examine the robustness of typical teacher quality measures to alternate ranking systems factoring in the dispersion of value-added. The typical measure used by researchers and school administrators to evaluate teachers is based on how the students{\textquoteright} achievement increases after being exposed to the teacher, or based on the teacher{\textquoteright}s {\textquoteleft}{\textquoteleft}value-added{\textquoteright}{\textquoteright}. When teacher value-added is heterogeneous across her students, then the typically used measure reflects differences in the average value-added the teacher provides. However, researchers, administrators, and parents may care not just about the average value-added, but also its variance. Encouragingly, ranking systems factoring in the dispersion produce similar rankings as the ranking system based only on the mean. In the second chapter, I examine the effect of measurement error in the dependent variable on quantile regression, because unlike OLS regression, even classical measurement error can generate bias. I examine the pattern and size of the bias using both simulation and an empirical example. The simulations indicate that classical error can cause bias and that non-classical measurement error, particularly heteroskedastic measurement error, has the potential to produce substantial bias. Using restricted access Health and Retirement Study data containing matched IRS W-2 earnings records, I examine whether estimates of the returns to education statistically differ using a precisely measured and mismeasured earnings variable. I find that returns to education are over-stated by roughly 1 percentage point at the median and 75th percentile using earnings reported by survey respondents. In the third chapter, my coauthors and I investigate how the precision and stability of a teacher{\textquoteright}s value-added estimate relates to student characteristics. We find that the year-to-year stability of teacher value-added estimates can depend on the previous achievement level of a teacher{\textquoteright}s students. The stability level of the estimates are typically 25\% to more than 50\% larger for teachers serving initially higher performing students. We offer a policy simulation demonstrating that teachers who serve low-achieving students may be differentially likely to be the recipient of sanctions in a high stakes policy based on value-added estimates.}, keywords = {Demographics, Employment and Labor Force, Methodology, Public Policy, Social Security}, url = {http://proxy.lib.umich.edu/login?url=http://search.proquest.com/docview/1612354970?accountid=14667http://mgetit.lib.umich.edu/?ctx_ver=Z39.88-2004\&ctx_enc=info:ofi/enc:UTF-8\&rfr_id=info:sid/Dissertations+\%26+Theses+\%40+CIC+Institutions\&rft_val_fmt=info:of}, author = {Stacy, Brian} } @article {8100, title = {Underwriting mortality risk using cognitive function tests}, journal = {Journal of insurance medicine (New York, N.Y.)}, volume = {44}, year = {2014}, note = {Times Cited: 0}, pages = {17-31}, publisher = {44}, abstract = {OBJECTIVE: Evaluate the association of selected cognitive function assessments, including two memory tests and two mental status tests, with all-cause mortality. METHOD: Associations between the selected cognitive function tests and mortality were assessed in a longitudinal dataset. The Health and Retirement Study (HRS) includes 27,648 individuals, most of whom were 65 years of age and older; study participants were followed for an average of 8.9 years, and over this interval, 8268 deaths occurred. The association of 4 cognitive function test scores at entry into the study and the observed rates of mortality were evaluated using both a traditional (actuarial) actual vs expected mortality method and a Cox proportional hazard model adjusted for age, gender, smoking, and other covariates. RESULTS: Each cognitive function test was shown to be independently associated with mortality after adjustment for covariates. Further, individual test scores, fit using a continuous model, were shown to be correlated with mortality outcomes. The associations appear to be stronger at a younger age when only age, gender, and smoking were adjusted, but such effect modifications were no longer statistically significant after additional covariates were adjusted. The associations did not appear to be attenuated in a pre-defined healthy subgroup, suggesting that the result could be extrapolated to applicants who would qualify for life insurance. CONCLUSIONS: Cognitive function, as measured by 4 simple screening tests, was shown to be significantly and independently associated with all-cause mortality in a longitudinal dataset of individuals, the majority of whom were 65 years of age and older.}, keywords = {Health Conditions and Status}, author = {Hu, Guizhou and Duncan, Ashlee and Bob Brown} } @article {7975, title = {Urinary Incontinence, Depression, and Economic Outcomes in a Cohort of Women Between the Ages of 54 and 65 Years}, journal = {Obstetrics and Gynecology}, volume = {123}, year = {2014}, pages = {822-827}, publisher = {123}, abstract = {OBJECTIVE: To estimate the association between urinary incontinence (UI) and probable depression, work disability, and workforce exit. METHODS: The analytic sample consisted of 4,511 women enrolled in the population-based Health and Retirement Study cohort. The analysis baseline was 1996, the year that questions about UI were added to the survey instrument, and at which time study participants were 54 65 years of age. Women were followed-up with biennial interviews until 2010 2011. Outcomes of interest were onset of probable depression, work disability, and workforce exit. Urinary incontinence was specified in different ways based on questions about experience and frequency of urine loss. We fit Cox proportional hazards regression models to the data, adjusting the estimates for baseline sociodemographic and health status variables previously found to confound the association between UI and the outcomes of interest. RESULTS: At baseline, 727 participants (survey-weighted prevalence, 16.6 ; 95 confidence interval CI 15.4 18.0) reported any UI, of which 212 (survey-weighted prevalence, 29.2 ; 95 CI 25.4 33.3) reported urine loss on more than 15 days in the past month; and 1,052 participants were categorized as having probable depression (survey-weighted prevalence, 21.6 ; 95 CI 19.8 23.6). Urinary incontinence was associated with increased risks for probable depression (adjusted hazard ratio, 1.43; 95 CI 1.27 1.62) and work disability (adjusted hazard ratio, 1.21; 95 CI 1.01 1.45), but not workforce exit (adjusted hazard ratio, 1.06; 95 CI 0.93 1.21). CONCLUSION: In a population-based cohort of women between ages 54 and 65 years, UI was associated with increased risks for probable depression and work disability. Improved diagnosis and management of UI may yield significant economic and psychosocial benefits. LEVEL OF EVIDENCE: II}, keywords = {Employment and Labor Force, Health Conditions and Status}, doi = {10.1097/AOG.0000000000000186}, url = {http://journals.lww.com/greenjournal/Fulltext/2014/04000/Urinary_Incontinence,_Depression,_and_Economic.15.aspx}, author = {Hung, Kristin J. and Awtrey, Christopher S. and Tsai, Alexander C.} } @article {8002, title = {Women s Timing of Receipt of Social Security Retirement Benefits}, journal = {Journal of Family and Economic Issues}, volume = {35}, year = {2014}, pages = {362-375}, publisher = {35}, abstract = {The 2000 2006 waves of Health and Retirement Study data were used to estimate the effects of human capital characteristics and income sources on women s timing of receipt of Social Security retirement benefits. Using logistic regression, the likelihood of early election of benefits was increased by earnings regardless of marital status; and, for married women, by husband s age being greater than wife s, and by other income. For married women, education decreased the likelihood of electing early benefits. For unmarried women, IRA/annuity income reduced the likelihood of early receipt of benefits. Using multinomial logistic regression, the likelihood of combinations of expected and actual benefit receipt options were estimated. A greater percentage of married, compared to unmarried, women expected and elected early benefits.}, keywords = {Retirement Planning and Satisfaction, Social Security, Women and Minorities}, doi = {10.1007/s10834-013-9374-z}, url = {http://dx.doi.org/10.1007/s10834-013-9374-z}, author = {Gillen, Martie and Claudia J Heath} } @article {7806, title = {Adults with cardiovascular disease who help others: a prospective study of health outcomes.}, journal = {J Behav Med}, volume = {36}, year = {2013}, note = {Copyright - Springer Science Business Media New York 2013 Last updated - 2013-04-30 DOI - 2922261571; 76454332; 69709; BVMD; 22481214; SPVLBVMD108653629414}, month = {2013 Apr}, pages = {199-211}, publisher = {36}, abstract = {

Little is known about the health impact of helping behaviors among individuals with high-risk chronic diseases such as cardiovascular disease (CVD). Using a nationally representative, longitudinal survey, we examined the subsequent health of adults with CVD (n~=~4,491) who spent time providing non-paid assistance to family and friends outside of their households compared with those who had provided no assistance. After both adjusting for baseline characteristics and using propensity score matching methods, spending up to 200~h over the prior 12~months helping others was associated with lower odds of experiencing a new CVD event or dying in the subsequent 2~years. Providing up to 100~h of assistance was associated with reporting fewer depressive symptoms. This threshold effect raises the question of whether assistance beyond a certain number of hours may impose a burden that mitigates health benefits from helping others. Health care providers could play an important role exploring ways that patients with CVD can provide beneficial levels of assistance to others in their own social networks or communities, thereby possibly also improving their own health.

}, keywords = {Activities of Daily Living, Aged, Cardiovascular Diseases, depression, Female, Health Status, Helping Behavior, Humans, Longitudinal Studies, Male, Middle Aged, Prospective Studies, Time Factors}, issn = {1573-3521}, doi = {10.1007/s10865-012-9414-4}, url = {http://search.proquest.com.proxy.lib.umich.edu/docview/1318045378?accountid=14667}, author = {Michele M Heisler and Choi, Hwajung and John D Piette and Ann Marie Rosland and Kenneth M. Langa and Stephanie Brown} } @article {7885, title = {Analysis of Cognitive, Functional, Health Service Use, and Cost Trajectories Prior to and Following Memory Loss}, journal = {The Journals of Gerontology Series B: Psychological Sciences and Social Sciences}, volume = {68}, year = {2013}, pages = {562-567}, publisher = {68}, abstract = {Objectives. This brief report examines whether significant changes in cognition, functional dependence, health service use, and out-of-pocket medical expenditures (OOPMD) occur in the years prior to a physician-identified memory problem in a nationally representative sample of older adults. Method. Longitudinal data from the RAND-Health and Retirement Survey were utilized. Those who reported a physician-identified memory problem (n = 387) were compared with a randomly selected control group of similar age, race, and gender who did not indicate a memory problem (n = 387). Multilevel linear models were used to construct trajectories for various measures of cognition, function, health service use, and OOPMD in the years prior to and following memory problem identification. Results. Several trajectories demonstrated significant rates of change in the years leading up to a physician-identified memory problem, including symptoms (mental status, fine motor skills, and instrumental activities of daily living) and utilization (OOPMD and overnight stays in hospital). Discussion. Preclinical declines in mental status and function and increases in hospital use and OOPMD are apparent prior to the formal identification of memory problems. Earlier identification of these changes might provide a basis for interventions that could alter the clinical course of dementia.}, keywords = {Health Conditions and Status, Healthcare}, doi = {10.1093/geronb/gbs078}, url = {http://psychsocgerontology.oxfordjournals.org/content/68/4/562.abstract}, author = {Joseph E Gaugler and Hovater, Martha and David L. Roth and Johnston, Joseph A. and Robert L Kane and Sarsour, Khaled} } @article {10279, title = {Chiropractic use and changes in health among older medicare beneficiaries: a comparative effectiveness observational study.}, journal = {J Manipulative Physiol Ther}, volume = {36}, year = {2013}, month = {2013 Nov-Dec}, pages = {572-84}, abstract = {

OBJECTIVE: The purpose of this study was to investigate the effect of chiropractic on 5 outcomes among Medicare beneficiaries: increased difficulties performing activities of daily living (ADLs), instrumental ADLs (IADLs), and lower body functions, as well as lower self-rated health and increased depressive symptoms.

METHODS: Among all beneficiaries, we estimated the effect of chiropractic use on changes in health outcomes among those who used chiropractic compared with those who did not, and among beneficiaries with back conditions, we estimated the effect of chiropractic use relative to medical care, both during a 2- to 15-year period. Two analytic approaches were used--one assumed no selection bias, whereas the other adjusted for potential selection bias using propensity score methods.

RESULTS: Among all beneficiaries, propensity score analyses indicated that chiropractic use led to comparable outcomes for ADLs, IADLs, and depressive symptoms, although there were increased risks associated with chiropractic for declines in lower body function and self-rated health. Propensity score analyses among beneficiaries with back conditions indicated that chiropractic use led to comparable outcomes for ADLs, IADLs, lower body function, and depressive symptoms, although there was an increased risk associated with chiropractic use for declines in self-rated health.

CONCLUSION: The evidence in this study suggests that chiropractic treatment has comparable effects on functional outcomes when compared with medical treatment for all Medicare beneficiaries, but increased risk for declines in self-rated health among beneficiaries with back conditions.

}, keywords = {Activities of Daily Living, Age Factors, Aged, Aged, 80 and over, Cohort Studies, Databases, Factual, Disability Evaluation, Female, Geriatric Assessment, Humans, Low Back Pain, Male, Manipulation, Chiropractic, Medicare, Mobility Limitation, Musculoskeletal Diseases, Patient Satisfaction, Quality of Life, Risk Assessment, Sex Factors, Treatment Outcome, United States}, issn = {1532-6586}, doi = {10.1016/j.jmpt.2013.08.008}, url = {https://www.ncbi.nlm.nih.gov/pubmed/24636108}, author = {Paula A Weigel and Jason Hockenberry and Suzanne E Bentler and Frederic D Wolinsky} } @article {7896, title = {Cohorts based on decade of death: no evidence for secular trends favoring later cohorts in cognitive aging and terminal decline in the AHEAD study.}, journal = {Psychol Aging}, volume = {28}, year = {2013}, month = {2013 Mar}, pages = {115-27}, publisher = {28}, abstract = {

Studies of birth-year cohorts examined over the same age range often report secular trends favoring later-born cohorts, who are cognitively fitter and show less steep cognitive declines than earlier-born cohorts. However, there is initial evidence that those advantages of later-born cohorts do not carry into the last years of life, suggesting that pervasive mortality-related processes minimize differences that were apparent earlier in life. Elaborating this work from an alternative perspective on cohort differences, we compared rates of cognitive aging and terminal decline in episodic memory between cohorts based on the year participants had died, earlier (between 1993 and 1999) or later in historical time (between 2000 and 2010). Specifically, we compared trajectories of cognitive decline in 2 death-year cohorts of participants in the Asset and Health Dynamics Among the Oldest Old study that were matched on age at death and education and controlled for a variety of additional covariates. Results revealed little evidence of secular trends favoring later cohorts. To the contrary, the cohort that died in the 2000s showed a less favorable trajectory of age-related memory decline than the cohort that died in the 1990s. In examinations of change in relation to time to death, the cohort dying in the 2000s experienced even steeper terminal declines than the cohort dying in the 1990s. We suggest that secular increases in "manufacturing" survival may exacerbate age- and mortality-related cognitive declines among the oldest old.

}, keywords = {Aged, Aged, 80 and over, Aging, Death, Epidemiologic Research Design, Female, Health Surveys, Humans, Longitudinal Studies, Male, Memory Disorders, Memory, Episodic, Time Factors, United States}, issn = {1939-1498}, doi = {10.1037/a0029965}, author = {H{\"u}l{\"u}r, Gizem and Frank J Infurna and Ram, Nilam and Denis Gerstorf} } @article {7914, title = {Dementia and out-of-pocket spending on health care services.}, journal = {Alzheimers Dement}, volume = {9}, year = {2013}, note = {Times Cited: 0}, month = {2013 Jan}, pages = {19-29}, publisher = {9}, abstract = {

BACKGROUND: High levels of out-of-pocket (OOP) spending for health care may lead patients to forego needed services and medications as well as hamper their ability to pay for other essential goods. Because it leads to disability and the loss of independence, dementia may put patients and their families at risk for high OOP spending, especially for long-term care services.

METHODS: We used data from the Aging, Demographics, and Memory Study, a nationally representative subsample (n = 743) of the Health and Retirement Study, to determine whether individuals with dementia had higher self-reported OOP spending compared with those with cognitive impairment without dementia and those with normal cognitive function. We also examined the relationship between dementia and utilization of dental care and prescription medications-two types of health care that are frequently paid for OOP. Multivariate and logistic regression models were used to adjust for the influence of potential confounders.

RESULTS: After controlling for demographics and comorbidities, those with dementia had more than three times the yearly OOP spending compared with those with normal cognition ($8216 for those with dementia vs. $2570 for those with normal cognition, P < .01). Higher OOP spending for those with dementia was mainly driven by greater expenditures on nursing home care (P < .01). Dementia was not associated with the likelihood of visiting the dentist (P = .76) or foregoing prescription medications owing to cost (P = .34).

CONCLUSIONS: Dementia is associated with high levels of OOP spending but not with the use of dental care or foregoing prescription medications, suggesting that excess OOP spending among those with dementia does not "crowd out" spending on these other health care services.

}, keywords = {Aged, Dementia, Female, Financing, Personal, Health Expenditures, Humans, Male}, issn = {1552-5279}, doi = {10.1016/j.jalz.2011.11.003}, author = {Delavande, Adeline and Michael D Hurd and Martorell, Paco and Kenneth M. Langa} } @article {8946, title = {Dementia Risk and Financial Decision Making by Older Households: The Impact of Information.}, journal = {Journal of Human Capital}, year = {2013}, month = {2013 Apr 01}, pages = {45}, abstract = {

The knowledge and reasoning ability needed to manage one{\textquoteright}s finances is a form of human capital. Alzheimer{\textquoteright}s disease and other dementias cause progressive declines in cognition that lead to a complete loss of functional capacities. In this paper we analyze the impact of information about cognitive decline on the choice of household financial decision-maker. Using longitudinal data on older married couples in a novel application of survival analysis, we find that as the financial decision maker{\textquoteright}s cognition declines, the management of finances is eventually turned over to his cognitively intact spouse, often well after difficulties handling money have already emerged. However, a memory disease diagnosis increases the hazard of switching the financial respondent by over 200 percent for couples who control their retirement accounts, like 401(k) accounts, relative to those who passively receive retirement income. This finding is consistent with a model of the value of information: households with the most to gain financially from preparation are most responsive to information about cognitive decline.

}, keywords = {Decision making, Dementia, Finances, Older Adults}, issn = {1932-8575}, doi = {10.2139/ssrn.2339225}, author = {Joanne W. Hsu and Robert J. Willis} } @article {7954, title = {Direct Social Support and Long-term Health Among Middle-Aged and Older Adults With Type 2 Diabetes Mellitus}, journal = {Journals of Gerontology Series B-Psychological Sciences and Social Sciences}, volume = {68}, year = {2013}, note = {Times Cited: 0}, pages = {933-943}, publisher = {68}, abstract = {Objectives. This study examined whether or not direct social support is associated with long-term health among middle-aged and older adults with diabetes mellitus. Method. Direct social support was assessed at baseline (2003) for 1,099 adults with type 2 diabetes mellitus from the Health and Retirement Study. Self-reported health status was examined at baseline and in 4 biennial survey waves (2003-2010). A series of ordinal logistic regression models examined whether or not the 7-item Diabetes Care Profile scale was associated with a subsequent change in health status over time. Additional analyses examined whether or not individual components of direct social support were associated with health status change. Results. After adjusting for baseline covariates, greater direct social support as measured by the Diabetes Care Profile was associated with improved health outcomes over time; however, this trend was not significant (p = .06). The direct social support measures that were associated with improved health over follow-up were support for taking medicines (odds ratio OR = 1.22), physical activity (OR = 1.26), and going to health care providers (OR = 1.22; all p .05). Discussion. Interventions that specifically target improving specific aspects of diabetes social support may be more effective in improving long-term health than less targeted efforts.}, keywords = {Adult children, Health Conditions and Status, Other}, doi = {10.1093/geronb/gbt100}, author = {Emily J Nicklett and Michele M Heisler and Spencer, Michael S. and Ann Marie Rosland} } @article {7888, title = {Do wealth disparities contribute to health disparities within racial/ethnic groups?}, journal = {Journal of Epidemiology and Community Health}, volume = {67}, year = {2013}, pages = {439-445}, publisher = {67}, abstract = {Background Though wide disparities in wealth have been documented across racial/ethnic groups, it is largely unknown whether differences in wealth are associated with health disparities within racial/ethnic groups. Methods Data from the Survey of Consumer Finances (2004, ages 25 64) and the Health and Retirement Survey (2004, ages 50 ), containing a wide range of assets and debts variables, were used to calculate net worth (a standard measure of wealth). Among non-Hispanic black, Hispanic and non-Hispanic white populations, we tested whether wealth was associated with self-reported poor/fair health status after accounting for income and education. Results Except among the younger Hispanic population, net worth was significantly associated with poor/fair health status within each racial/ethnic group in both data sets. Adding net worth attenuated the association between education and poor/fair health (in all racial/ethnic groups) and between income and poor/fair health (except among older Hispanics). Conclusions The results add to the literature indicating the importance of including measures of wealth in health research for what they may reveal about disparities not only between but also within different racial/ethnic groups.}, keywords = {Demographics, Health Conditions and Status, Net Worth and Assets}, doi = {10.1136/jech-2012-200999}, author = {Craig E Pollack and Cubbin, Catherine and Sania, Ayesha and Mark D Hayward and Donna M. Vallone and Flaherty, Brian and Paula Braveman} } @article {7831, title = {Editorial: Dawning of a New Age for Longitudinal Cohort Data}, journal = {Journal of Population Ageing}, volume = {6}, year = {2013}, pages = {1-4}, publisher = {6}, abstract = {Issue Title: Special Issue: Longitudinal Cohort Data}, keywords = {Demographics, Health Conditions and Status, Methodology, Other}, doi = {http://dx.doi.org/10.1007/s12062-013-9083-2}, author = {Richard M. Suzman and Harper, Sarah} } @article {7924, title = {Emergency room and inpatient use after cardiac pacemaker implantation}, journal = {The American journal of cardiology}, volume = {111}, year = {2013}, pages = {563}, publisher = {111}, abstract = {Although studies have demonstrated health benefits, there is limited evidence on utilization and cost changes associated with cardiac pacemaker implantation from national community samples. The aim of this study was to quantify changes in emergency room (ER) and hospital inpatient use and in Medicare payments per beneficiary/year after pacemaker implantation. Outcomes for pacemaker recipients after and before implantation and between pacemaker recipients and controls were compared using propensity score matching. Data came from Health and Retirement Study interviews merged with Medicare claims. Sample subjects were aged 68 years with diagnosed conduction disorders or cardiac dysrhythmias in the previous 3 years. Outcome measures were (1) ER visits, inpatient admissions and days, and Medicare payments for ER and inpatient care in the after period for the pacemaker versus control groups, defined per beneficiary/year, (2) difference in differences in the same 5 outcome variables, and (3) binary variables for whether or not utilization or payments were lower in the after versus before periods for the pacemaker versus control groups. In conclusion, most pacemaker recipients improved, as measured by reductions in use and payments in the after versus before period, and there were reductions in ER visits and hospital admissions for conditions commonly leading to pacemaker implantation.}, keywords = {Health Conditions and Status, Healthcare, Medicare/Medicaid/Health Insurance}, author = {Frank A Sloan and Linda K George and Hu, Linyan} } @article {7820, title = {Estimating Second Order Probability Beliefs from Subjective Survival Data.}, journal = {Decis Anal}, volume = {10}, year = {2013}, note = {Times Cited: 0}, month = {2013 Jun}, publisher = {10}, abstract = {

Based on subjective survival probability questions in the Health and Retirement Study (HRS), we use an econometric model to estimate the determinants of individual-level uncertainty about personal longevity. This model is built around the modal response hypothesis (MRH), a mathematical expression of the idea that survey responses of 0\%, 50\%, or 100\% to probability questions indicate a high level of uncertainty about the relevant probability. We show that subjective survival expectations in 2002 line up very well with realized mortality of the HRS respondents between 2002 and 2010. We show that the MRH model performs better than typically used models in the literature of subjective probabilities. Our model gives more accurate estimates of low probability events and it is able to predict the unusually high fraction of focal 0\%, 50\%, and 100\% answers observed in many data sets on subjective probabilities. We show that subjects place too much weight on parents{\textquoteright} age at death when forming expectations about their own longevity, whereas other covariates such as demographics, cognition, personality, subjective health, and health behavior are under weighted. We also find that less educated people, smokers, and women have less certain beliefs, and recent health shocks increase uncertainty about survival, too.

}, issn = {1545-8490}, doi = {10.1287/deca.2013.0266}, author = {P{\'e}ter Hudomiet and Robert J. Willis} } @article {7827, title = {Evidence that Self-Regulatory Mode Affects Retirement Savings}, journal = {Journal of Aging and Social Policy}, volume = {25}, year = {2013}, pages = {248-263}, publisher = {25}, abstract = {We examine how self-regulatory motivations of locomotion (initiation) and assessment (evaluation) are related to retirement wealth in middle-aged and older Americans. We test a hypothesis that high locomotion and some assessment levels predict high wealth levels. We use two national data sets: the 2008 Health and Retirement Study (N = 6,464) and the 2005 Midlife in the United States (N = 4,963). We found that a combination of high locomotion and moderate assessment motivation can maximize wealth accumulation. By creating this combination of locomotion and assessment motivations, policy interventions can be more effective in motivating wealth accumulation for retirement, such as a required annual review of retirement savings plans and understandable disclosure of the plans{\textquoteright} costs. PUBLICATION ABSTRACT}, keywords = {Consumption and Savings, Demographics, Health Conditions and Status, Net Worth and Assets, Public Policy, Retirement Planning and Satisfaction}, doi = {10.1080/08959420.2013.791788}, author = {Hyungsoo Kim and Franks, Becca and Higgins, E. Tory} } @mastersthesis {6315, title = {An Examination on Un-Retirement: Retirees Returning to Work}, volume = {3593208}, year = {2013}, note = {Copyright - Copyright ProQuest, UMI Dissertations Publishing 2013 Last updated - 2014-01-21 First page - n/a}, month = {2013}, pages = {112}, school = {Washington University in St. Louis}, type = {Ph.D.}, address = {St. Louis, MO}, abstract = {Research that examines retirees returning to work--defined here as un-retirement--is important, given increases in life expectancy and retirement insecurity. Unfortunately research in this area is nascent, limited in scope, and riddled with mixed findings. The current study is guided by three research questions: (1) how do economic resources, as well as human and social capital, relate to un-retirement?; (2) how do other productive activities, including formal and informal volunteering and caregiving, relate to un-retirement?; and (3) how does the retirement experience, including reasons to retire and retirement satisfaction, relate to un-retirement? The empirical literature on wealth and its association with un-retirement is mixed, and thus, an exploratory approach is taken. It is hypothesized that other economic resources (income, pension presence, and health insurances) are negatively related to un-retirement; for example, people with lower levels of income are more likely to return to work. It is hypothesized that higher levels of human capital and social capital are positively associated with un-retirement. It is also hypothesized that productive activities both compete with, and complement each other, and it depends on intensity and timing of events. Specifically, volunteering is a positively associated with un-retirement; that is volunteering complements going back to work. It is also suggested that caregiving is a barrier to un-retirement; that is, the two activities compete. It is hypothesized that forced retirement is positively associated with un-retirement. And finally, it is hypothesized that retirement satisfaction is negatively associated with un-retirement. Data were drawn from the Health and Retirement Study (HRS) which provided a nationally representative sample of fully retired older adults aged 62 and older in 1998 (n=8,334). This sample was followed to 2008, which offered a 10-year period to observe factors associated with un-retirement. The fully conditional specification imputation method was used to complete all missing values of the study variables. Survival analysis tested the hypotheses and yielded information on the significant factors associated with un-retirement. Findings reveal that total household net worth and income were not significantly related to un-retirement. Retirees who possessed a pension (p <.05, hazard ratio (HR):0.78, confidence limits (CL):0.63-0.97) and employer sponsored retiree health insurance (p <.05, HR:0.77, CL:0.62-0.95) were 22\% and 23\% less likely to return to work when compared to people who did not possess such economic resources for retirement. Generally, individuals with higher levels of human capital--better health (p <.0001, HR:1.31, CL:1.20-1.44), high-skilled (p <.05, HR:1.82, CL:1.20-2.75) and mid-skilled occupational workers (p <.05, HR:1.57, CL:1.07-2.28)--were more likely to return to work when compared to low-skilled occupational workers. This suggests that the probability of returning to work increased by 31\% for every one unit increase in self-rated health; and the probability of returning to work were 82\% and 57\% higher for high and mid-skilled workers compared to low-skilled workers. Education, however, was negatively related to un-retirement when other productive activities were examined ( p <.05, HR: 0.96, CL:0.93-0.99), which suggests that for every unit increase in education, the probability of returning to work decreased by 4\%. Certain dimensions of social capital were also significantly related to un-retirement; where the probability of returning to work increased by 75\% for people who were married to an employed spouse/partner ( p <.0001, HR:1.75, CL:1.36-2.23). Formal and informal volunteering were significant predictors to work; where volunteers were between 38\% and 58\% more likely to return to work when compared to non-volunteers. However, providing care to a spouse was a major barrier to returning to work; where caregivers were approximately 80\% less likely to return to work in subsequent waves when ompared to non-caregivers ( p <.01}, keywords = {Adult children, Employment and Labor Force, Healthcare, Methodology, Net Worth and Assets, Other, Retirement Planning and Satisfaction}, url = {http://search.proquest.com.proxy.lib.umich.edu/docview/1438181057?accountid=14667http://mgetit.lib.umich.edu/?ctx_ver=Z39.88-2004\&ctx_enc=info:ofi/enc:UTF-8\&rfr_id=info:sid/ProQuest+Dissertations+\%26+Theses+A\%26I\&rft_val_fmt=info:ofi/fmt:kev:mtx:dissertat}, author = {Guillermo Ernest Gonzales} } @article {7929, title = {Fall-associated difficulty with activities of daily living in functionally independent individuals aged 65 to 69 in the United States: a cohort study.}, journal = {J Am Geriatr Soc}, volume = {61}, year = {2013}, month = {2013 Jan}, pages = {96-100}, publisher = {61}, abstract = {

OBJECTIVES: To determine whether falling would be a marker for future difficulty with activities of daily (ADLs) that would vary according to fall frequency and associated injury.

DESIGN: Longitudinal analysis.

SETTING: Community.

PARTICIPANTS: Nationally representative cohort of 2,020 community-living, functionally independent older adults aged 65 to 69 at baseline followed from 1998 to 2008.

MEASUREMENTS: ADL difficulty.

RESULTS: Experiencing one fall with injury (odds ratio (OR) = 1.78, 95\% confidence interval (CI) = 1.29-2.48), at least two falls without injury (OR = 2.36, 95\% CI = 1.80-3.09), or at least two falls with at least one injury (OR = 3.75, 95\% CI = 2.55-5.53) in the prior 2 years was independently associated with higher rates of ADL difficulty after adjustment for sociodemographic, behavioral, and clinical covariates.

CONCLUSION: Falling is an important marker for future ADL difficulty in younger, functionally independent older adults. Individuals who fall frequently or report injury are at highest risk.

}, keywords = {Accidental Falls, Activities of Daily Living, Aged, Aging, Disability Evaluation, Disabled Persons, Female, Follow-Up Studies, Geriatric Assessment, Health Status, Humans, Male, Odds Ratio, Retrospective Studies, Risk Factors, United States, Wounds and Injuries}, issn = {1532-5415}, doi = {10.1111/jgs.12071}, author = {Nishant K. Sekaran and Choi, Hwajung and Rodney A. Hayward and Kenneth M. Langa} } @article {7801, title = {Functional disability, cognitive impairment, and depression after hospitalization for pneumonia.}, journal = {Am J Med}, volume = {126}, year = {2013}, month = {2013 Jul}, pages = {615-24.e5}, abstract = {

OBJECTIVE: The study objective was to examine whether hospitalization for pneumonia is associated with functional decline, cognitive impairment, and depression, and to compare this impairment with that seen after known disabling conditions, such as myocardial infarction or stroke.

METHODS: We used data from a prospective cohort of 1434 adults aged more than 50 years who survived 1711 hospitalizations for pneumonia, myocardial infarction, or stroke drawn from the Health and Retirement Study (1998-2010). Main outcome measures included the number of Activities and Instrumental Activities of Daily Living requiring assistance and the presence of cognitive impairment and substantial depressive symptoms.

RESULTS: Hospitalization for pneumonia was associated with 1.01 new impairments in Activities and Instrumental Activities of Daily Living (95\% confidence interval [CI], 0.71-1.32) among patients without baseline functional impairment and 0.99 new impairments in Activities and Instrumental Activities of Daily Living (95\% CI, 0.57-1.41) among those with mild-to-moderate baseline limitations, as well as moderate-to-severe cognitive impairment (odds ratio, 2.46; 95\% CI, 1.60-3.79) and substantial depressive symptoms (odds ratio, 1.63; 95\% CI, 1.06-2.51). Patients without baseline functional impairment who survived pneumonia hospitalization had more subsequent impairments in Activities and Instrumental Activities of Daily Living than those who survived myocardial infarction hospitalization. There were no significant differences in subsequent moderate-to-severe cognitive impairment or substantial depressive symptoms between patients who survived myocardial infarction or stroke and those who survived pneumonia.

CONCLUSIONS: Hospitalization for pneumonia in older adults is associated with subsequent functional and cognitive impairment. Improved pneumonia prevention and interventions to ameliorate adverse sequelae during and after hospitalization may improve outcomes.

}, keywords = {Activities of Daily Living, Aged, Aged, 80 and over, Cognitive Dysfunction, depression, Hospitalization, Humans, Logistic Models, Longitudinal Studies, Middle Aged, Myocardial Infarction, Pneumonia, Stroke}, issn = {1555-7162}, doi = {10.1016/j.amjmed.2012.12.006}, author = {Dimitry S Davydow and Catherine L Hough and Deborah A Levine and Kenneth M. Langa and Theodore J Iwashyna} } @article {8608, title = {Genome-wide association analysis of blood-pressure traits in African-ancestry individuals reveals common associated genes in African and non-African populations.}, journal = {Am J Hum Genet}, volume = {93}, year = {2013}, month = {2013 Sep 05}, pages = {545-54}, abstract = {

High blood pressure (BP) is more prevalent and contributes to more severe manifestations of cardiovascular disease (CVD) in African Americans than in any other United States ethnic group. Several small African-ancestry (AA) BP genome-wide association studies (GWASs) have been published, but their findings have failed to replicate to date. We report on a large AA BP GWAS meta-analysis that includes 29,378 individuals from 19 discovery cohorts and subsequent replication in additional samples of AA (n = 10,386), European ancestry (EA) (n = 69,395), and East Asian ancestry (n = 19,601). Five loci (EVX1-HOXA, ULK4, RSPO3, PLEKHG1, and SOX6) reached genome-wide significance (p < 1.0~{\texttimes} 10(-8)) for either systolic or diastolic BP in a transethnic meta-analysis after correction for multiple testing. Three of these BP loci (EVX1-HOXA, RSPO3, and PLEKHG1) lack previous associations with BP. We also identified one independent signal in a known BP locus (SOX6) and provide evidence for fine mapping in four additional validated BP loci. We also demonstrate that validated EA BP GWAS loci, considered jointly, show significant effects in AA samples. Consequently, these findings suggest that BP loci might have universal effects across studied populations, demonstrating that multiethnic samples are an essential component in identifying, fine mapping, and understanding their trait variability.

}, keywords = {Africa, African Continental Ancestry Group, Blood pressure, Cohort Studies, Databases, Genetic, Genetic Loci, Genetic Predisposition to Disease, Genome-Wide Association Study, Humans, Polymorphism, Single Nucleotide, Quantitative Trait, Heritable, Reproducibility of Results}, issn = {1537-6605}, doi = {10.1016/j.ajhg.2013.07.010}, author = {Franceschini, Nora and Fox, Ervin and Zhang, Zhaogong and Edwards, Todd L and Michael A Nalls and Yun Ju Sung and Bamidele O Tayo and Yan V Sun and Gottesman, Omri and Adebawole Adeyemo and Andrew D Johnson and Young, J Hunter and Kenneth Rice and Duan, Qing and Chen, Fang and Yun Li and Tang, Hua and Myriam Fornage and Keene, Keith L and Andrews, Jeanette S and Jennifer A Smith and Jessica Faul and Guangfa, Zhang and Guo, Wei and Liu, Yu and Murray, Sarah S and Musani, Solomon K and Srinivasan, Sathanur and Digna R Velez Edwards and Wang, Heming and Becker, Lewis C and Bovet, Pascal and Bochud, Murielle and Broeckel, Ulrich and Burnier, Michel and Carty, Cara and Daniel I Chasman and Georg B Ehret and Chen, Wei-Min and Chen, Guanjie and Wei Chen and Ding, Jingzhong and Dreisbach, Albert W and Michele K Evans and Guo, Xiuqing and Melissa E Garcia and Jensen, Rich and Keller, Margaux F and Lettre, Guillaume and Lotay, Vaneet and Martin, Lisa W and Moore, Jason H and Alanna C Morrison and Thomas H Mosley and Ogunniyi, Adesola and Walter R Palmas and George J Papanicolaou and Alan Penman and Polak, Joseph F and Ridker, Paul M and Babatunde Salako and Andrew B Singleton and Daniel Shriner and Kent D Taylor and Ramachandran S Vasan and Kerri Wiggins and Williams, Scott M and Yanek, Lisa R and Wei Zhao and Alan B Zonderman and Becker, Diane M and Berenson, Gerald and Boerwinkle, Eric and Erwin P Bottinger and Cushman, Mary and Charles B Eaton and Nyberg, Fredrik and Gerardo Heiss and Joel N Hirschhron and Howard, Virginia J and Karczewsk, Konrad J and Lanktree, Matthew B and Liu, Kiang and Yongmei Liu and Ruth J F Loos and Margolis, Karen and Snyder, Michael and Psaty, Bruce M and Schork, Nicholas J and David R Weir and Charles N Rotimi and Sale, Michele M and Tamara B Harris and Sharon L R Kardia and Hunt, Steven C and Donna K Arnett and Redline, Susan and Cooper, Richard S and Neil Risch and Rao, D C and Rotter, Jerome I and Chakravarti, Aravinda and Reiner, Alex P and Levy, Daniel and Keating, Brendan J and Zhu, Xiaofeng} } @article {8620, title = {GWAS of 126,559 individuals identifies genetic variants associated with educational attainment.}, journal = {Science}, volume = {340}, year = {2013}, month = {2013 Jun 21}, pages = {1467-71}, abstract = {

A genome-wide association study (GWAS) of educational attainment was conducted in a discovery sample of 101,069 individuals and a replication sample of 25,490. Three independent single-nucleotide polymorphisms (SNPs) are genome-wide significant (rs9320913, rs11584700, rs4851266), and all three replicate. Estimated effects sizes are small (coefficient of determination R(2) ≈ 0.02\%), approximately 1 month of schooling per allele. A linear polygenic score from all measured SNPs accounts for ≈2\% of the variance in both educational attainment and cognitive function. Genes in the region of the loci have previously been associated with health, cognitive, and central nervous system phenotypes, and bioinformatics analyses suggest the involvement of the anterior caudate nucleus. These findings provide promising candidate SNPs for follow-up work, and our effect size estimates can anchor power analyses in social-science genetics.

}, keywords = {Cognition, Educational Status, Endophenotypes, Female, Genetic Loci, Genome-Wide Association Study, Humans, Male, Multifactorial Inheritance, Polymorphism, Single Nucleotide}, issn = {1095-9203}, doi = {10.1126/science.1235488}, author = {Cornelius A Rietveld and Sarah E Medland and Derringer, Jaime and Yang, Jian and T{\~o}nu Esko and Martin, Nicolas W and Westra, Harm-Jan and Shakhbazov, Konstantin and Abdel Abdellaoui and Agrawal, Arpana and Albrecht, Eva and Alizadeh, Behrooz Z and Amin, Najaf and Barnard, John and Baumeister, Sebastian E and Benke, Kelly S and Bielak, Lawrence F and Boatman, Jeffrey A and Patricia A. Boyle and Gail Davies and Christiaan de Leeuw and Eklund, Niina and Daniel S Evans and Rudolf Ferhmann and Fischer, Krista and Gieger, Christian and Gjessing, H{\r a}kon K and H{\"a}gg, Sara and Harris, Jennifer R and Caroline Hayward and Holzapfel, Christina and Carla A Ibrahim-Verbaas and Ingelsson, Erik and Jacobsson, Bo and Joshi, Peter K and Jugessur, Astanand and Marika A Kaakinen and Kanoni, Stavroula and Karjalainen, Juha and Kolcic, Ivana and Kristiansson, Kati and Kutalik, Zolt{\'a}n and J. Lahti and Lee, Sang H and Lin, Peng and Penelope A Lind and Yongmei Liu and Kurt Lohman and Loitfelder, Marisa and McMahon, George and Vidal, Pedro Marques and Osorio Meirelles and Lili Milani and Myhre, Ronny and Nuotio, Marja-Liisa and Christopher J Oldmeadow and Katja E Petrovic and Wouter J Peyrot and Polasek, Ozren and Quaye, Lydia and Reinmaa, Eva and Rice, John P and Rizzi, Thais S and Schmidt, Helena and Schmidt, Reinhold and Albert Vernon Smith and Jennifer A Smith and Toshiko Tanaka and Antonio Terracciano and van der Loos, Matthijs J H M and Vitart, Veronique and V{\"o}lzke, Henry and J{\"u}rgen Wellmann and Lei Yu and Wei Zhao and Allik, J{\"u}ri and John R. Attia and Bandinelli, Stefania and Bastardot, Fran{\c c}ois and Jonathan P. Beauchamp and David A Bennett and Klaus Berger and Laura Bierut and Dorret I Boomsma and B{\"u}ltmann, Ute and Campbell, Harry and Chabris, Christopher F and Cherkas, Lynn and Chung, Mina K and Francesco Cucca and de Andrade, Mariza and Philip L de Jager and De Neve, Jan-Emmanuel and Ian J Deary and George Dedoussis and Deloukas, Panos and Dimitriou, Maria and Gu{\dh}ny Eir{\'\i}ksd{\'o}ttir and Elderson, Martin F and Johan G Eriksson and Jessica Faul and Luigi Ferrucci and Melissa E Garcia and Gr{\"o}nberg, Henrik and Gu{\dh}nason, Vilmundur and Hall, Per and Harris, Juliette M and Tamara B Harris and Nicholas D Hastie and Andrew C Heath and Dena G Hernandez and Hoffmann, Wolfgang and Hofman, Adriaan and Holle, Rolf and Holliday, Elizabeth G and Jouke-Jan Hottenga and Iacono, William G and Illig, Thomas and J{\"a}rvelin, Marjo-Riitta and K{\"a}h{\"o}nen, Mika and Kaprio, Jaakko and Kirkpatrick, Robert M and Kowgier, Matthew and Latvala, Antti and Lenore J Launer and Lawlor, Debbie A and Lehtim{\"a}ki, Terho and Li, Jingmei and Paul Lichtenstein and Lichtner, Peter and David C Liewald and Pamela A F Madden and Patrik K E Magnusson and M{\"a}kinen, Tomi E and Masala, Marco and McGue, Matt and Andres Metspalu and Mielck, Andreas and Michael B Miller and Grant W Montgomery and Mukherjee, Sutapa and Nyholt, Dale R and Ben A Oostra and Palmer, Lyle J and Aarno Palotie and Brenda W J H Penninx and Markus Perola and Peyser, Patricia A and Preisig, Martin and Katri R{\"a}ikk{\"o}nen and Olli T Raitakari and Realo, Anu and Ring, Susan M and Ripatti, Samuli and Fernando Rivadeneira and Rudan, Igor and Rustichini, Aldo and Veikko Salomaa and Sarin, Antti-Pekka and Schlessinger, David and Rodney J Scott and Snieder, Harold and St Pourcain, Beate and John M Starr and Sul, Jae Hoon and Surakka, Ida and Svento, Rauli and Teumer, Alexander and Henning Tiemeier and van Rooij, Frank J A and Van Wagoner, David R and Vartiainen, Erkki and Viikari, Jorma and Vollenweider, Peter and Vonk, Judith M and Waeber, G{\'e}rard and David R Weir and Wichmann, H-Erich and Elisabeth Widen and Gonneke Willemsen and James F Wilson and Alan F Wright and Dalton C Conley and Davey-Smith, George and Lude L Franke and Groenen, Patrick J F and Hofman, Albert and Johannesson, Magnus and Sharon L R Kardia and Krueger, Robert F and David I Laibson and Nicholas G Martin and Meyer, Michelle N and Posthuma, Danielle and A. Roy Thurik and Nicholas J Timpson and Andr{\'e} G Uitterlinden and Cornelia M van Duijn and Peter M Visscher and Daniel J. Benjamin and Cesarini, David and Philipp D Koellinger} } @inbook {5257, title = {Health and Wealth in Early Retirement}, booktitle = {Lifecycle Events and Their Consequences: Job Loss, Family Change, and Declines in Health}, year = {2013}, pages = {261-279}, publisher = {Stanford University}, organization = {Stanford University}, address = {Stanford, CA}, abstract = {Retirement years are a precarious time for many older Americans. Even if successful in accumulating resources expected to be sufficient to maintain their pre-retirement standard of living, many retirees face unexpected adverse health shocks after retirement. Because of the uncertainty of shocks to physical and cognitive health, there exists the potential for significant deterioration in resource adequacy both at the time of retirement and into the retirement years due to their occurrence. In this study, we select a sample of new retirees constructed from the Health and Retirement Study (HRS) data and follow them during the first decade of their retirement. Using these data, we identify the nature of shocks to physical and cognitive health for which individuals are at risk during their retirement years, and estimate both the absolute and relative risk of these shocks. We then estimate the impact of the occurrence of these shocks on wealth-based measures of retirement adequacy.}, keywords = {Health Conditions and Status, Income, Retirement Planning and Satisfaction}, author = {Geoffrey L Wallace and Haveman, Robert and Karen C. Holden and Barbara Wolfe}, editor = {Kenneth A. Couch and Mary C. Daly and Julie M Zissimopoulos} } @article {8953, title = {Heterogeneity in spending change at retirement.}, journal = {Journal of the Economics of Ageing}, volume = {1-2}, year = {2013}, month = {2013 Nov}, pages = {60-71}, abstract = {

The simple one-good model of life-cycle consumption requires that consumption be continuous over retirement; yet prior research based on partial measures of consumption or on synthetic panels indicates that spending drops at retirement, a result that has been called the retirement-consumption puzzle. Using panel data on total spending, nondurable spending and food spending, we find that spending declines at small rates at retirement, rates that could be explained by mechanisms such as the cessation of work-related expenses, unexpected retirement due to a health shock or by the substitution of time for spending. We find substantial heterogeneity in spending change at retirement: in the upper half of the wealth distribution spending increased. In the low-wealth population where spending did decline at higher rates, the main explanation for the decline appears to be early retirement due to poor health, possibly augmented by a short planning horizon by a minority of the population.

}, keywords = {Older Adults, Retirement Planning and Satisfaction}, issn = {2212-828X}, doi = {10.1016/j.jeoa.2013.09.002}, author = {Michael D Hurd and Susann Rohwedder} } @article {7963, title = {The impact of immigrant status and racial/ethnic group on differences in responses to a risk aversion measure}, journal = {Journal of Financial Counseling and Planning}, volume = {24}, year = {2013}, note = {Export Date: 21 April 2014 Source: Scopus}, pages = {63-76}, publisher = {24}, abstract = {Factors related to differences in risk aversion were analyzed with a measure of risk aversion inferred from answers to a hypothetical income gamble question in the U.S. Health and Retirement Study. Cumulative logistic regressions, controlling for income, age, gender, health status, current job status, and home ownership, showed that Blacks were more risk averse than Whites, but Hispanics born in the United States were not different from Whites. U.S. born respondents in an other group, largely Asian, were also not different from Whites. Hispanics and those in the other group who were immigrants were more risk averse than Whites. Racial/ethnic differences found in other risk aversion studies may be partly due to differences in immigrant status. 2013 Association for Financial Counseling and Planning Education. All rights of reproduction in any form reserved.}, keywords = {Demographics, Net Worth and Assets, Risk Taking}, url = {http://www.scopus.com/inward/record.url?eid=2-s2.0-84892566141andpartnerID=40andmd5=4e12b8c031640244bc493910cb0f6d15}, author = {Fang, M. C. and Sherman D. Hanna and Chatterjee, Swarn} } @mastersthesis {6243, title = {Investigating the relationship between recent dental visits, memory, and dementia risk factors}, volume = {3598460}, year = {2013}, note = {Copyright - Copyright ProQuest, UMI Dissertations Publishing 2013 Last updated - 2014-01-20 First page - n/a}, month = {2013}, pages = {112}, school = {Fielding Graduate University}, type = {Ph.D.}, address = {Santa Barbara, CA}, abstract = {Research has concluded in recent years that oral health status is associated with dementia. However, little has been understood about how dental visits, which are a modifiable lifestyle variable, affect memory. The current study applied generalized estimating equations models to the RAND Health and Retirement Study nationally representative longitudinal database in order to determine whether recent dental visits predicted (a) higher memory scores, (b) subjective memory status, and (c) perceived change in self-rated memory. Results indicated that persons with recent dental visits obtained better episodic memory scores, had better self-rated memory, and reported perceived change in self-rated memory. The findings suggested that visiting the dentist and maintaining oral health are crucial for healthy cognitive aging. It is concluded that older adults should regularly visit the dentist in order to maintain memory capabilities.}, keywords = {Gerontology, Health Conditions and Status, Healthcare, Methodology, Risk Taking}, url = {http://search.proquest.com.proxy.lib.umich.edu/docview/1459230336?accountid=14667http://mgetit.lib.umich.edu/?ctx_ver=Z39.88-2004\&ctx_enc=info:ofi/enc:UTF-8\&rfr_id=info:sid/ProQuest+Dissertations+\%26+Theses+A\%26I\&rft_val_fmt=info:ofi/fmt:kev:mtx:dissertat}, author = {Carlson, Holly I.} } @article {5971, title = {Labor Force Transitions at Older Ages: The Roles of Work Environment and Personality}, year = {2013}, institution = {Ann Arbor, The University of Michigan}, abstract = {Besides compensation and financial incentives, several other work-related factors may affect individual retirement decisions. Specifically, job characteristics such as autonomy, skill variety, task significance and difficulty, stress and physical demands, peer pressure and relations with co-workers, play a crucial role in determining psychological commitment to work at older ages. While financial preparedness for retirement and health shocks are often cited as main predictors of the choice to exit the labor force, there exists relatively little research documenting the extent to which the work environment itself and its interaction with economic variables influence retirement decisions. We document that job characteristics are associated with labor force transitions at older ages, in particular transitions to retirement and part-time employment. Additionally, we show that while personality traits do not directly drive labor force transitions, the effect of job characteristics on labor supply outcomes varies with the intensity of personality traits. We also document that job characteristics themselves are strongly related to personality traits. This suggests that, depending on their personality, individuals may select into specific jobs, whose characteristics ultimately shape their retirement paths.}, keywords = {Employment and Labor Force, Health Conditions and Status, Other, Retirement Planning and Satisfaction}, url = {http://www.mrrc.isr.umich.edu/publications/papers/pdf/wp295.pdf}, author = {Marco Angrisani and Michael D Hurd and Erik Meijer and Andrew M Parker and Susann Rohwedder} } @article {8516, title = {Level-of-Effort Paradata and Nonresponse Adjustment Models for a National Face-to-Face Survey}, year = {2013}, month = {08/2013}, institution = {Institute for Social Research, University of Michigan}, address = {Ann Arbor, Michigan}, abstract = {Survey samples are designed to produce unbiased estimates. Unfortunately, nonresponse may lead to bias if the responders and nonresponders are different with respect to the survey variables. One common approach to addressing nonresponse after data collection has been completed is to differentially weight responding cases such that the respondents match the full sample on the selected characteristics. The selection of the characteristics is a modeling step that assumes that conditional upon the selected characteristics, responders and nonresponders are equivalent. This method is known as nonresponse weighting. The method relies upon having data available for the entire sample that predicts both response and the survey variables themselves. These data can come from either the sampling frame or from paradata (Couper, 1998; Couper and Lyberg, 2005), that is, from process data created during data collection. If the available data are only useful for predicting response and not for predicting the survey variables, then adjustments based upon these data can only add noise to estimates. This is true even when the true probability of responding is known. In practice, the true probability is never known and estimates of it have associated sampling error and, possibly, misspecification error which may also add noise to estimates.}, keywords = {Bias, Data collection, Meta-analyses, Sample weight, Survey Methodology}, author = {James Wagner and Valliant, Richard and Hubbard, Frost and Jiang, Charley} } @article {7955, title = {Longer lived parents: protective associations with cancer incidence and overall mortality.}, journal = {J Gerontol A Biol Sci Med Sci}, volume = {68}, year = {2013}, note = {Times Cited: 0}, month = {2013 Nov}, pages = {1409-18}, publisher = {68}, abstract = {

BACKGROUND: Children of centenarians have lower cardiovascular disease prevalence and live longer. We aimed to estimate associations between the full range of parental attained ages and health status in a middle-aged U.S. representative sample.

METHODS: Using Health and Retirement Study data, models estimated disease incidence and mortality hazards for respondents aged 51-61 years at baseline, followed up for 18 years. Full adjustment included sex, race, smoking, wealth, education, body mass index, and childhood socioeconomic status. Mother{\textquoteright}s and father{\textquoteright}s attained age distributions were used to define short-, intermediate-, and long-lived groups, yielding a ranked parental longevity score (n = 6,055, excluding short-long discordance). Linear models (n = 8,340) tested mother{\textquoteright}s or father{\textquoteright}s attained ages, adjusted for each other.

RESULTS: With increasing mother{\textquoteright}s or father{\textquoteright}s survival (>65 years), all-cause mortality declined 19\% (hazard ratio [HR] = 0.81, 95\% CI: 0.76-0.86, p < .001) and 14\% per decade (HR = 0.87, 95\% CI: 0.81-0.92, p < .001). Estimates changed only modestly when fully adjusted. Parent-in-law survival was not associated with mortality (n = 1,809, HR = 1.00, 95\% CI: 0.90-1.12, p = .98). Offspring with one or two long-lived parents had lower cancer incidence (938 cases, HR per parental longevity score = 0.76, 95\% CI: 0.61-0.94, p = .01) versus two intermediate parents. Similar HRs for diabetes (HR = 0.89, 95\% CI: 0.84-0.96, p = .001), heart disease (HR = 0.88, 95\% CI: 0.82-0.93, p < .001), and stroke (HR = 0.86, 95\% CI: 0.78-0.95, p = .002) were significant, but there was no trend for arthritis.

CONCLUSIONS: The results provide the first robust evidence that increasing parental attained age is associated with lower cancer incidence in offspring. Health advantages of having centenarian parents extend to a wider range of parental longevity and may provide a quantitative trait of slower aging.

}, keywords = {Aged, Aged, 80 and over, Female, Humans, Incidence, Longevity, Male, Middle Aged, Mortality, Neoplasms, Parents}, issn = {1758-535X}, doi = {10.1093/gerona/glt061}, author = {Ambarish Dutta and Henley, William and Robine, Jean-Marie and Kenneth M. Langa and Robert B Wallace and David Melzer} } @article {7842, title = {Longer Term Effects of Total Knee Arthroplasty From a National Longitudinal Study}, journal = {Journal of Aging and Health}, volume = {25}, year = {2013}, note = {Copyright - Copyright SAGE PUBLICATIONS, INC. Sep 2013 Last updated - 2013-09-13 SubjectsTermNotLitGenreText - United States--US}, pages = {982}, publisher = {25}, abstract = {This study used data for 1996-2010 from a U.S. longitudinal sample of elderly individuals from the Health and Retirement Study (HRS) merged with Medicare claims data to assess changes in several dimensions of physical functioning and general health up to 68 months following total knee arthroplasty (TKA) receipt. Using propensity score matching, we assessed outcomes at follow-up for Medicare beneficiaries receiving TKA and a comparable group of beneficiaries with the same osteoarthritis diagnoses (controls). Receipt of TKA was most often associated with improvements in physical functioning, especially in physical functioning measures most directly related to the knee. General health of TKA recipients only improved relative to controls on 1 of the 3 study general health measures. Improvements in physical functioning of TKA recipients persisted in this longer term analysis of outcome in a nationally representative population study.}, keywords = {Demographics, Health Conditions and Status, Healthcare}, author = {Frank A Sloan and Linda K George and Hu, Linyan} } @article {11447, title = {Longevity risk, subjective survival expectations, and individual saving behavior}, journal = {Journal of Economic Behavior \& Organization}, volume = {86}, year = {2013}, pages = {200-220}, abstract = {We provide evidence of individuals{\textquoteright} awareness of longevity risk (the uncertainty about future survival probabilities) based on subjective survival expectations elicited in the Survey of Health, Ageing and Retirement in Europe (SHARE) and matching data on longevity risk from the Human Mortality Database. We find a positive relationship between the forecast dispersion in subjective survival estimates and longevity risk which indicates that individuals are to some extent aware of longevity risk. Our analysis of savings behavior shows that the dispersion in survival estimates is primarily explained by individuals disagreeing on the survival probability and not by their true awareness of the underlying uncertainty. Individuals do not save more on average when faced with longevity risk although theory suggests they should.}, keywords = {Forecast dispersion, longevity risk, Saving behavior, subjective survival expectations}, isbn = {0167-2681}, doi = {https://doi.org/10.1016/j.jebo.2012.11.012}, author = {Post, Thomas and Hanewald, Katja} } @article {7798, title = {Monetary costs of dementia in the United States.}, journal = {N Engl J Med}, volume = {368}, year = {2013}, month = {2013 Apr 04}, pages = {1326-34}, publisher = {386}, abstract = {

BACKGROUND: Dementia affects a large and growing number of older adults in the United States. The monetary costs attributable to dementia are likely to be similarly large and to continue to increase.

METHODS: In a subsample (856 persons) of the population in the Health and Retirement Study (HRS), a nationally representative longitudinal study of older adults, the diagnosis of dementia was determined with the use of a detailed in-home cognitive assessment that was 3 to 4 hours in duration and a review by an expert panel. We then imputed cognitive status to the full HRS sample (10,903 persons, 31,936 person-years) on the basis of measures of cognitive and functional status available for all HRS respondents, thereby identifying persons in the larger sample with a high probability of dementia. The market costs associated with care for persons with dementia were determined on the basis of self-reported out-of-pocket spending and the utilization of nursing home care; Medicare claims data were used to identify costs paid by Medicare. Hours of informal (unpaid) care were valued either as the cost of equivalent formal (paid) care or as the estimated wages forgone by informal caregivers.

RESULTS: The estimated prevalence of dementia among persons older than 70 years of age in the United States in 2010 was 14.7\%. The yearly monetary cost per person that was attributable to dementia was either $56,290 (95\% confidence interval [CI], $42,746 to $69,834) or $41,689 (95\% CI, $31,017 to $52,362), depending on the method used to value informal care. These individual costs suggest that the total monetary cost of dementia in 2010 was between $157 billion and $215 billion. Medicare paid approximately $11 billion of this cost.

CONCLUSIONS: Dementia represents a substantial financial burden on society, one that is similar to the financial burden of heart disease and cancer. (Funded by the National Institute on Aging.).

}, keywords = {Aged, Aged, 80 and over, Cost of Illness, Dementia, Female, Health Care Costs, Home Care Services, Home Nursing, Humans, Longitudinal Studies, Male, Medicare, Middle Aged, Nursing homes, United States}, issn = {1533-4406}, doi = {10.1056/NEJMsa1204629}, url = {http://www.nejm.org/doi/full/10.1056/NEJMsa1204629}, author = {Michael D Hurd and Martorell, Paco and Delavande, Adeline and Kathleen J Mullen and Kenneth M. Langa} } @article {7947, title = {Multidimensional Approaches to Examining Gender and Racial/Ethnic Stratification in Health}, journal = {Women, Gender, and Families of Color}, volume = {1}, year = {2013}, pages = {180-206}, publisher = {1}, abstract = {Extant research on health disparities has traditionally employed a unidimensional approach to stratification, focusing on gender and racial/ethnic inequality separately. Such studies implicitly assume that gender inequality is monolithic across racial/ethnic lines and that racial/ethnic stratification is similar for women and men. While informative, these traditional, unidimensional approaches artificially decouple gender and racial/ethnic inequality and, consequently, may obscure the gender-race/ethnicity-health relationship, thus limiting our understanding of the unique health experiences of women of color. This study extends prior research by using multidimensional approaches to examine whether gender and racial stratification combine in an additive or multiplicative fashion to shape functional health, consistent with double-jeopardy and intersectionality hypotheses, respectively. In addition, this study investigates the extent to which group differences in socioeconomic status (SES), health behaviors, and medical care explain gender-racial/ethnic disparities in health. We use data from the Health and Retirement Study, a nationally representative sample of older adults, to address these questions among a diverse sample of black, white, and Mexican American men and women. Results reveal that women of color have worse functional health than all other gender-racial/ethnic groups and that the joint impacts of gender and racial/ethnic oppression on functional health are additive among Mexican Americans and multiplicative among blacks. We find that multidimensional approaches namely, double-jeopardy and intersectionality as well as examination of various potential mediators of health disparities provide a better understanding of how health is shaped by multiple social locations.}, keywords = {Demographics, Healthcare, Women and Minorities}, author = {Tyson H Brown and Taylor W. Hargrove} } @article {10437, title = {A Multistate Transition Model for Analyzing Longitudinal Depression Data}, year = {2013}, institution = {BULLETIN of the MALAYSIAN MATHEMATICAL SCIENCES SOCIETY}, abstract = {In longitudinal data analysis, there are many practical situations where we need to deal with transitions to a number of states and which are repeated over time generating a large number of trajectories from beginning to end of the study. This problem becomes increasingly difficult to model if the number of follow-ups is increased for a set of longitudinal data. A covariate-dependent Markov transition model is proposed using the logistic link function for polytomous outcome data. A generalized and more flexible approach of constructing the likelihood function for the first or higher order is demonstrated in this paper to deal with the branching of a number of transition types starting from no depression at the beginning of the study. The proposed method can be employed to resolve a longstanding problem in dealing with modeling for transitions, reverse transitions and repeated transitions by reducing the number of trajectories to a large extent resulting in estimating relatively few parameters. The problem of depression in elderly, in terms of short and longterm health and economic consequence, needs to be assessed more critically. This study uses the longitudinal data from the six waves of the Health and Retirement Survey to examine the transition to depression, reverse transition from depression to no depression and also repeated transition from no depression to depression after experiencing a reverse transition during a study period. The results indicate that age is negatively associated with reverse and repeated transitions, gender is negatively associated with transition and reverse transition indicating that females are more likely to experience both. The proposed method clearly provides a wider range of useful information in revealing the dynamics of the depression pattern among elderly. }, url = {http://www.kurims.kyoto-u.ac.jp/EMIS/journals/BMMSS/pdf/v36n3/v36n3p8.pdf}, author = {M. Ataharul Islam and Rafiqul I Chowdhury and Huda, Shahariar} } @article {7950, title = {Physical Function Limitations Among Middle-Aged and Older Adults With Prediabetes One exercise prescription may not fit all}, journal = {Diabetes Care}, volume = {36}, year = {2013}, note = {Times Cited: 1}, pages = {3076-3083}, publisher = {36}, abstract = {OBJECTIVETo describe the prevalence of physical function limitations among a nationally representative sample of adults with prediabetes.RESEARCH DESIGN AND METHODSWe performed a cross-sectional analysis of 5,991 respondents 53 years of age from the 2006 wave of the Health and Retirement Study. All respondents self-reported physical function limitations and comorbidities (chronic diseases and geriatric conditions). Respondents with prediabetes reported no diabetes and had a measured glycosylated hemoglobin (HbA(1c)) of 5.7-6.4 . Descriptive analyses and logistic regressions were used to compare respondents with prediabetes versus diabetes (diabetes history or HbA(1c) 6.5 ) or normoglycemia (no diabetes history and HbA(1c) 5.7 ).RESULTSTwenty-eight percent of respondents 53 years of age had prediabetes; 32 had mobility limitations (walking several blocks and/or climbing a flight of stairs); 56 had lower-extremity limitations (getting up from a chair and/or stooping, kneeling, or crouching); and 33 had upper-extremity limitations (pushing or pulling heavy objects and/or lifting 10 lb). Respondents with diabetes had the highest prevalence of comorbidities and physical function limitations, followed by those with prediabetes, and then normoglycemia (P 0.05). Compared with respondents with normoglycemia, respondents with prediabetes had a higher odds of having functional limitations that affected mobility (odds ratio OR 1.48), the lower extremities (OR 1.35), and the upper extremities (OR 1.37) (all P 0.01). The higher odds of having lower-extremity limitations remained after adjusting for age, sex, and body mass index (OR 1.21, P 0.05).CONCLUSIONSComorbidities and physical function limitations are prevalent among middle-aged and older adults with prediabetes. Effective lifestyle interventions to prevent diabetes must accommodate physical function limitations.}, keywords = {Demographics, Disabilities, Event History/Life Cycle, Health Conditions and Status, Other, Risk Taking}, doi = {10.2337/dc13-0412}, author = {Pearl G. Lee and Christine T Cigolle and Ha, Jinkyung and Lillian C. Min and Susan L Murphy and Caroline S Blaum and Herman, William H.} } @article {7824, title = {Physical health effects of the housing boom: quasi-experimental evidence from the health and retirement study}, journal = {American Journal of Public Health}, volume = {103}, year = {2013}, pages = {1039-1045}, publisher = {103}, abstract = {Objectives. We examined the impact of the dramatic increases in housing prices in the United States in the 1990s and early 2000s on physical health outcomes among a representative sample of middle-aged and older Americans. Methods. Using a quasi-experimental design, we exploited geographic and time variation in housing prices using third-party valuation estimates of median single-family detached houses from 1988 to 2007 in each of 2400 zip codes combined with Health and Retirement Study data from 1992 to 2006 to test the impact of housing appreciation on physical health outcomes. Results. Respondents living in communities in which home values appreciated more rapidly had fewer functional limitations, performed better on interviewer-administered physical tasks, and had smaller waist circumference. Conclusions. Our results indicate that increases in housing wealth were associated with better health outcomes for homeowners in late middle age and older. The recent sharp decline in housing values for this group may likewise be expected to have important implications for health and should be examined as data become available.}, keywords = {Health Conditions and Status, Healthcare, Housing}, doi = {10.2105/AJPH.2012.301205}, author = {Hamoudi, Amar and Jennifer B Dowd} } @article {7927, title = {Predicting 10-year alcohol use trajectories among men age 50 years and older}, journal = {Am J Geriatr Psychiatry}, volume = {21}, year = {2013}, pages = {204}, publisher = {21}, abstract = {To describe common 10-year drinking trajectories followed by men age 50 years or older and identify risk factors for those trajectories. Longitudinal data were used to derive a semiparametric group-based model. Men from the Health and Retirement Study age 50-65 years in 1998 who completed three or more of the six interviews conducted from 1998 to 2008, including our 1998 baseline interview. Biannual data on number of drinks per drinking day were used to derive drinking trajectories. Risk factors included baseline age, race, ethnicity, education, marital status, retirement, smoking, binge drinking, vigorous exercise, body mass index, depression, pain, self-reported health, and chronic disease. The best-fitting model included consistent infrequent drinkers and nondrinkers (40.6 of cohort), increasing drinkers (5.5 ), decreasing drinkers (7.6 ), consistent at-risk drinkers (15.6 ), and consistent moderate drinkers (30.7 ). Adjusted logistic regression models comparing men with similar 1998 drinking levels who subsequently followed different trajectories identified significant risks associated with age, education, smoking, binge drinking, depression, pain, and self-reported health. To illustrate, odds ratios (ORs) and 95 confidence intervals (95 CIs) suggest that baseline infrequent drinkers were less likely to follow an increasing drinkers trajectory if they were older (OR: 0.57, 95 CI: 0.38-0.82) and smoked cigarettes (OR: 0.47, 95 CI: 0.30-0.74). Baseline drinkers were less likely to follow a decreasing trajectory if they reported more than 12 years of education (OR: 0.58, 95 CI: 0.42-0.82) and thought that their health was excellent or very good (OR: 0.54, 95 CI: 0.39-0.76). Only 30.7 of older men in this cohort were moderate drinkers throughout the follow-up. Many older men may benefit from brief counseling on the risks and benefits of drinking.}, keywords = {Health Conditions and Status, Risk Taking}, doi = {10.1097/JGP.0b013e3182423b4b}, author = {Janet Kay Bobo and April A Greek and Daniel H. Klepinger and Jerald R Herting} } @article {7811, title = {Predictors of Smoking Patterns After First Stroke}, journal = {Social Work in Health Care}, volume = {52}, year = {2013}, note = {Copyright - Copyright Taylor and Francis Group 2013 Last updated - 2013-06-04 CODEN - SWHCDO}, pages = {467}, publisher = {52}, abstract = {Persistent smoking following stroke is associated with poor outcomes including development of secondary stroke and increased mortality risk. This study uses longitudinal data from the U.S. Health and Retirement Study (1992-2008) to investigate whether depression and duration of inpatient hospital care impact smoking outcomes among stroke survivors (N = 745). Longer duration of care was associated with lower likelihood of persistent smoking. Depression was associated with greater cigarette consumption. Interaction effects were also significant, indicating that for survivors who experienced longer inpatient care there was a weaker association between depression and cigarette consumption. Implications for practice and research are discussed. PUBLICATION ABSTRACT}, keywords = {Health Conditions and Status, Public Policy}, url = {http://search.proquest.com.proxy.lib.umich.edu/docview/1364611528?accountid=14667http://mgetit.lib.umich.edu/?ctx_ver=Z39.88-2004andctx_enc=info:ofi/enc:UTF-8andrfr_id=info:sid/ProQ 3Apqrlandrft_val_fmt=info:ofi/fmt:kev:mtx:journalandrft.genre=articleandr}, author = {Michael J. McCarthy and Nathalie Huguet and Jason T Newsom and Mark S Kaplan and Bentson McFarland} } @article {8515, title = {Psychosocial and Lifestyle Questionnaire 2006 - 2010: Documentation Report}, year = {2013}, month = {02/2013}, pages = {62}, institution = {Survey Research Center, Institute for Social Research, University of Michigan}, address = {Ann Arbor}, abstract = {In 2004, HRS piloted a new feature for data collection in the form of self-administered questionnaires that were left with respondents upon the completion of an in-person Core Interview. Since 2006, this mode of data collection has been utilized to obtain information about participants{\textquoteright} evaluations of their life circumstances, subjective wellbeing, and lifestyle. This psychosocial information is obtained in each biennial wave from a rotating (random) 50\% of the core panel participants who complete the enhanced face-to-face interview (EFTF). Longitudinal data will be available at four-year intervals: the 2010 wave provides the first longitudinal psychosocial data from the 2006 participants. Some longitudinal data is also available for the 2004 participants in subsequent waves. Electronic versions of the HRS Participant (Psychosocial) Lifestyle Questionnaires used in the 2004 pilot, and the 2006, 2008, and 2010 waves are available on the HRS website (Documentation/Questionnaires - scroll down to the end of the Biennial Content to Psychosocial - Section LB). Because the questionnaire was left with respondents at the end of the EFTF interview for them to complete and mail back to study offices, the questionnaire came to be known and is referred to on the HRS website as the LeaveBehind (LB). We use the terms Participant Lifestyle Questionnaire and Leave-Behind (or LB) in this report to refer to the self-administered psychosocial data collection.}, keywords = {Data collection, Meta-analyses, Psychosocial, Question Characteristics}, author = {Jacqui Smith and Gwenith G Fisher and Lindsay H Ryan and Philippa J Clarke and House, Jim and David R Weir} } @article {7856, title = {Socioeconomic Status and Health Well-Being during Later Life: Potential Mediating Factors}, journal = {Sociological Spectrum}, volume = {33}, year = {2013}, note = {Times Cited: 0}, pages = {136-158}, publisher = {33}, abstract = {This study explores the socioeconomic status (SES)-perceived health association, with special attention on living arrangements. It improves upon existing explanations of causal mechanisms underlying the impact of SES on health among the elderly. Using Health and Retirement Study to run ordered logistic regression, it addresses the importance of living arrangements for self-reported health. Income and education are both important predictors of self-reported health and that after controlling them, living arrangements also affect self-reported health. Future research should highlight nuanced measures of living arrangements and should explore longitudinal analyses to determine the long-term effects of these factors on self-reported health.}, keywords = {Demographics, Health Conditions and Status, Healthcare, Methodology, Retirement Planning and Satisfaction}, doi = {10.1080/02732173.2013.732875}, author = {Hsu, Tze-Li and Cossman, Jeralynn S.} } @article {7839, title = {Symptoms of depression in survivors of severe sepsis: a prospective cohort study of older Americans.}, journal = {Am J Geriatr Psychiatry}, volume = {21}, year = {2013}, month = {2013 Sep}, pages = {887-97}, publisher = {21}, abstract = {

OBJECTIVES: To examine if incident severe sepsis is associated with increased risk of subsequent depressive symptoms and to assess which patient characteristics are associated with increased risk of depressive symptoms.

DESIGN: Prospective longitudinal cohort study.

SETTING: Population-based cohort of older U.S. adults interviewed as part of the Health and Retirement Study (1998-2006).

PARTICIPANTS: A total of 439 patients who survived 471 hospitalizations for severe sepsis and completed at least one follow-up interview.

MEASUREMENTS: Depressive symptoms were assessed with a modified version of the Center for Epidemiologic Studies Depression Scale. Severe sepsis was identified using a validated algorithm in Medicare claims.

RESULTS: The point prevalence of substantial depressive symptoms was 28\% at a median of 1.2~years before sepsis, and remained 28\% at a median of 0.9 years after sepsis. Neither incident severe sepsis (relative risk [RR]: 1.00; 95\% confidence interval [CI]:~0.73, 1.34) nor severe sepsis-related clinical characteristics were significantly associated with subsequent depressive symptoms. These results were robust to potential threats from missing data or alternative outcome definitions. After adjustment, presepsis substantial depressive symptoms (RR: 2.20; 95\% CI: 1.66, 2.90) and worse postsepsis functional impairment (RR: 1.08 per new limitation; 95\% CI: 1.03, 1.13) were independently associated with substantial depressive symptoms after sepsis.

CONCLUSIONS: The prevalence of substantial depressive symptoms in severe sepsis survivors is high but is not increased relative to their presepsis levels. Identifying this large subset of severe sepsis survivors at increased risk for major depression, and beginning interventions before hospital discharge, may improve outcomes.

}, keywords = {Aged, Aged, 80 and over, Cohort Studies, depression, Female, Hospitalization, Humans, Longitudinal Studies, Male, Poisson Distribution, Prospective Studies, Regression Analysis, Risk Factors, Sepsis, Severity of Illness Index, Survivors, United States}, issn = {1545-7214}, doi = {10.1016/j.jagp.2013.01.017}, author = {Dimitry S Davydow and Catherine L Hough and Kenneth M. Langa and Theodore J Iwashyna} } @article {7901, title = {Women{\textquoteright}s receipt of Social Security retirement benefits: expectations compared to elections.}, journal = {J Women Aging}, volume = {25}, year = {2013}, month = {2013}, pages = {321-36}, publisher = {25}, abstract = {

This research contributes knowledge regarding the options of early, normal, or delayed receipt of Social Security retirement benefits and research-based findings regarding women{\textquoteright}s expected and actual timing of election of Social Security retirement benefits. First, descriptive analyses of alternative retirement options, based on Social Security retirement benefit rules, are provided. Second, the 2000, 2002, 2004, and 2006 waves of Health and Retirement Study (HRS) data are used to analyze women{\textquoteright}s anticipated and actual election of Social Security retirement benefits. Third, based on these considerations, recommendations are made regarding Social Security retirement benefit receipt alternatives.

}, keywords = {Age Factors, Aged, Decision making, Female, Humans, Longitudinal Studies, Middle Aged, Pensions, Retirement, Social Security, Socioeconomic factors, Time Factors, United States}, issn = {1540-7322}, doi = {10.1080/08952841.2013.816219}, author = {Gillen, Martie and Claudia J Heath} } @article {7714, title = {Association of chronic diseases and impairments with disability in older adults: a decade of change?}, journal = {Med Care}, volume = {50}, year = {2012}, month = {2012 Jun}, pages = {501-7}, publisher = {50}, abstract = {

BACKGROUND: Little is known about how the relationship between chronic disease, impairment, and disability has changed over time among older adults.

OBJECTIVE: To examine how the associations of chronic disease and impairment with specific disability have changed over time.

RESEARCH DESIGN: Repeated cross-sectional analysis, followed by examining the collated sample using time interaction variables, of 3 recent waves of the Health and Retirement Study.

SUBJECTS: The subjects included 10,390, 10,621 and 10,557 community-dwelling adults aged 65 years and above in 1998, 2004, and 2008.

MEASUREMENTS: : Survey-based history of chronic diseases including hypertension, heart disease, heart failure, stroke, diabetes, cancer, chronic lung disease, and arthritis; impairments, including cognition, vision, and hearing; and disability, including mobility, complex activities of daily living (ADL), and self-care ADL.

RESULTS: Over time, the relationship of chronic diseases and impairments with disability was largely unchanged; however, the association between hypertension and complex ADL disability weakened from 1998 to 2004 and 2008 [odds ratio (OR) = 1.24; 99\% confidence interval (CI), 1.06-1.46; OR = 1.07; 99\% CI, 0.90-1.27; OR = 1.00; 99\% CI, 0.83-1.19, respectively], as it did for hypertension and self-care disability (OR = 1.32; 99\% CI, 1.13-1.54; OR=0.97; 99\% CI, 0.82-1.14; OR = 0.99; 99\% CI, 0.83-1.17). The association between diabetes and self-care disability strengthened from 1998 to 2004 and 2008 (OR = 1.21; 99\% CI, 1.01-1.46; OR = 1.37; 99\% CI, 1.15-1.64; OR = 1.52; 99\% CI, 1.29-1.79), as it also did for lung disease and self-care disability (OR = 1.64; 99\% CI, 1.33-2.03; OR = 1.63; 99\% CI, 1.32-2.01; OR = 2.11; 99\% CI, 1.73-2.57).

CONCLUSIONS: Although relationships between diseases, impairments, and disability were largely unchanged, disability became less associated with hypertension and more with diabetes and lung disease.

}, keywords = {Activities of Daily Living, Aged, Aging, Cardiovascular Diseases, Chronic disease, Cognition Disorders, Cross-Sectional Studies, Diabetes Mellitus, Disabled Persons, Female, Health Surveys, Hearing loss, Humans, Hypertension, Male, Mobility Limitation, Residence Characteristics, Respiratory Tract Diseases, Self Care, Socioeconomic factors, United States, Vision Disorders}, issn = {1537-1948}, doi = {10.1097/MLR.0b013e318245a0e0}, author = {William W. Hung and Joseph S. Ross and Boockvar, Kenneth S and Albert L Siu} } @article {10280, title = {Chiropractic episodes and the co-occurrence of chiropractic and health services use among older Medicare beneficiaries.}, journal = {Journal of Manipulative \& Physiological Therapeutics}, volume = {35}, year = {2012}, pages = {168-175}, abstract = {

OBJECTIVE: The purpose of this study was to define and characterize episodes of chiropractic care among older Medicare beneficiaries and to evaluate the extent to which chiropractic services were used in tandem with conventional medicine.

METHODS: Medicare Part B claims histories for 1991 to 2007 were linked to the nationally representative survey on Assets and Health Dynamics among the Oldest Old baseline interviews (1993-1994) to define episodes of chiropractic sensitive care using 4 approaches. Chiropractic and nonchiropractic patterns of service use were examined within these episodes of care. Of the 7447 Assets and Health Dynamics among the Oldest Old participants, 971 used chiropractic services and constituted the analytic sample.

RESULTS: There were substantial variations in the number and duration of episodes and the type and volume of services used across the 4 definitions. Depending on how the episode was constructed, the mean number of episodes per chiropractic user ranged from 3.74 to 23.12, the mean episode duration ranged from 4.7 to 28.8 days, the mean number of chiropractic visits per episode ranged from 0.88 to 2.8, and the percentage of episodes with co-occurrent use of chiropractic and nonchiropractic providers ranged from 4.9\% to 10.9\% over the 17-year period.

CONCLUSION: Treatment for back-related musculoskeletal conditions was sought from a variety of providers, but there was little co-occurrent service use or coordinated care across provider types within care episodes. Chiropractic treatment dosing patterns in everyday practice were much lower than that used in clinical trial protocols designed to establish chiropractic efficacy for back-related conditions.

}, keywords = {Age Factors, Aged, Aged, 80 and over, Chiropractic, Combined Modality Therapy, Episode of Care, Female, Geriatric Assessment, Health Care Surveys, Health Services, Humans, Incidence, Insurance Claim Reporting, Low Back Pain, Medicare Part B, Musculoskeletal Diseases, Primary Health Care, Retrospective Studies, Sex Factors, Treatment Outcome, United States}, issn = {1532-6586}, doi = {10.1016/j.jmpt.2012.01.011}, author = {Paula A Weigel and Jason Hockenberry and Suzanne E Bentler and Kaskie, Brian and Frederic D Wolinsky} } @article {7709, title = {Depressive symptoms in spouses of older patients with severe sepsis.}, journal = {Crit Care Med}, volume = {40}, year = {2012}, month = {2012 Aug}, pages = {2335-41}, abstract = {

OBJECTIVE: To examine whether spouses of patients with severe sepsis are at increased risk for depression independent of the spouse{\textquoteright}s presepsis history, whether this risk differs by sex, and is associated with a sepsis patient{\textquoteright}s disability after hospitalization.

DESIGN: Prospective longitudinal cohort study.

SETTING: Population-based cohort of U.S. adults over 50 yrs old interviewed as part of the Health and Retirement Study (1993-2008).

PATIENTS: Nine hundred twenty-nine patient-spouse dyads comprising 1,212 hospitalizations for severe sepsis.

MEASUREMENTS AND MAIN RESULTS: Severe sepsis was identified using a validated algorithm in Medicare claims. Depression was assessed with a modified version of the Center for Epidemiologic Studies Depression Scale. All analyses were stratified by gender. The prevalence of substantial depressive symptoms in wives of patients with severe sepsis increased by 14 percentage points at the time of severe sepsis (from 20\% at a median of 1.1 yrs presepsis to 34\% at a median of 1 yr postsepsis) with an odds ratio of 3.74 (95\% confidence interval: 2.20, 6.37), in multivariable regression. Husbands had an 8 percentage point increase in the prevalence of substantial depressive symptoms, which was not significant in multivariable regression (odds ratio 1.90, 95\% confidence interval 0.75, 4.71). The increase in depression was not explained by bereavement; women had greater odds of substantial depressive symptoms even when their spouse survived a severe sepsis hospitalization (odds ratio 2.86, 95\% confidence interval 1.06, 7.73). Wives of sepsis survivors who were disabled were more likely to be depressed (odds ratio 1.35 per activities of daily living limitation of sepsis survivor, 95\% confidence interval 1.12, 1.64); however, controlling for patient disability only slightly attenuated the association between sepsis and wives{\textquoteright} depression (odds ratio 2.61, 95\% confidence interval 0.93, 7.38).

CONCLUSIONS: Older women may be at greater risk for depression if their spouse is hospitalized for severe sepsis. Spouses of patients with severe sepsis may benefit from greater support and depression screening, both when their loved one dies and when their loved one survives.

}, keywords = {Age Factors, Aged, depression, Female, Hospitalization, Humans, Male, Multivariate Analysis, Prospective Studies, Psychiatric Status Rating Scales, Sepsis, Sex Factors, Spouses, Time Factors, United States}, issn = {1530-0293}, doi = {10.1097/CCM.0b013e3182536a81}, author = {Dimitry S Davydow and Catherine L Hough and Kenneth M. Langa and Theodore J Iwashyna} } @article {8954, title = {The Displacement Effect of Public Pensions on the Accumulation of Financial Assets.}, journal = {Fiscal Studies}, volume = {33}, year = {2012}, pages = {107-128}, abstract = {

The generosity of public pensions may depress private savings and provide incentives to retire early. While there is plenty of evidence supporting the latter effect, there remains considerable controversy whether public pensions crowd out private savings. This paper uses international micro-datasets collected over recent years to investigate whether public pensions displace private savings. The identification strategy relies not only on cross-country differences in generosity but also on differences in the progressivity or non-linearity of pension formulas across countries. We estimate that an extra dollar of pension wealth depresses accumulated financial assets around the time of retirement by 22 cents. An extra ten thousand dollars in public pension wealth reduces the average retirement age by roughly one month which implies an elasticity of retirement years with respect to pension wealth of -0.15.

}, keywords = {Finances, Older Adults, Pensions, Retirement Planning and Satisfaction}, issn = {0143-5671}, doi = {10.1111/j.1475-5890.2012.00154.x}, author = {Michael D Hurd and Pierre-Carl Michaud and Susann Rohwedder} } @article {7724, title = {The Effect of Long-Term Care Insurance on Home Care Use Among the Disabled Elders}, journal = {Journal of Family and Economic Issues}, volume = {33}, year = {2012}, note = {Copyright - Springer Science Business Media, LLC 2012 Language of summary - English Pages - 353-362 ProQuest ID - 1030719832 Last updated - 2012-08-02 Place of publication - New York Corporate institution author - Kim, So-yun; Hong, Gong-soog; Montalto, Catherine P DOI - 2726553411; 70920932; 53465; JFEI; SPVLJFEI108343339280}, pages = {353-362}, publisher = {33}, abstract = {Using the 1998-2004 Health and Retirement Study, this study uses Cox{\textquoteright}s model to explore the effects of private long-term care insurance ownership on first home care use among the disabled elderly. Results show that long-term care insurance ownership and Medicaid eligibility did not significantly increase the likelihood of using home care services, while income and homeownership lowered this likelihood. Functional limitation was the key determinant of home care use and those who lived with children were less likely to use home care services. Based on the findings, this study provides foundations for long-term care policies and long-term care planning programs. PUBLICATION ABSTRACT}, keywords = {Health Conditions and Status, Healthcare, Medicare/Medicaid/Health Insurance, Public Policy}, doi = {10.1007/s10834-011-9280-1}, url = {http://search.proquest.com.proxy.lib.umich.edu/docview/1030719832?accountid=14667http://mgetit.lib.umich.edu/?ctx_ver=Z39.88-2004andctx_enc=info:ofi/enc:UTF-8andrfr_id=info:sid/ProQ 3Aabiglobalandrft_val_fmt=info:ofi/fmt:kev:mtx:journalandrft.genre=articl}, author = {Kim, So-Yun and Gong-Soog Hong and Montalto, Catherine P.} } @article {7681, title = {Effect of obesity on falls, injury, and disability.}, journal = {J Am Geriatr Soc}, volume = {60}, year = {2012}, note = {Himes, Christine L Reynolds, Sandra L United States Journal of the American Geriatrics Society J Am Geriatr Soc. 2012 Jan;60(1):124-9. doi: 10.1111/j.1532-5415.2011.03767.x. Epub 2011 Dec 8.}, month = {2012 Jan}, pages = {124-9}, publisher = {60}, abstract = {

OBJECTIVES: To examine the effect of obesity on the propensity of older adults to fall, sustain a fall-related injury, and develop disability in activities of daily living (ADLs) after a fall.

DESIGN: Longitudinal population-based survey.

SETTING: Five waves of the Health and Retirement Study (HRS), 1998-2006.

PARTICIPANTS: Ten thousand seven hundred fifty-five respondents aged 65 and older in 31,602 person-intervals.

MEASUREMENTS: Falls within any 2-year interval (9,621 falls). Injuries requiring medical attention (3,130 injuries). Increased ADL disability after a fall within any 2-year interval (2,162 events). Underweight and three classes of obesity (body mass index (BMI) 30.0-34.9~kg/m(2) , Class 1) 35.0-39.9~kg/m(2) , Class 2; >=40.0~kg/m(2) , Class 3), calculated from self-reported height and weight. Self-reported presence of lower body limitation, pain, dizziness, or vision problems. Self-reported doctor{\textquoteright}s diagnosis of diabetes mellitus, stroke, or arthritis.

RESULTS: Compared with normal-weight respondents, the odds ratios (OR) for risk of falling were 1.12 (95\% confidence interval (CI)~=~1.01-1.24) for obesity Class 1, 1.26 (95\% CI~=~1.05-1.51) for obesity Class 2, and 1.50 (95\% CI~=~1.21-1.86) for obesity Class 3. Conditional on falling, only obesity Class 3 was related to a lower propensity for a fall-related injury (OR~=~0.62, 95\% CI~=~0.44-0.87). Obesity Classes 1 and 2 were associated with a higher risk of greater ADL disability after a fall than normal-weight respondents (OR~=~1.17, 95\% CI~=~1.02-1.34; OR~=~1.39, 95\% CI~=~1.10-1.75, respectively). Being underweight was not related to risk of falling or to reported injury or greater ADL limitation after a fall. The presence of measured health problems and chronic conditions was associated with greater risk of falling and, of those who fell, greater ADL limitation but not serious injury.

CONCLUSION: Obesity appears to be associated with greater risk of falling in older adults, as well as a higher risk of greater ADL disability after a fall. Obesity (BMI~>=~40~kg/m(2) ) may reduce the risk of injury from a fall. Further investigation of the mechanisms of obesity on falls and related health outcomes is warranted.

}, keywords = {Accidental Falls, Activities of Daily Living, Aged, Body Mass Index, Disability Evaluation, Disabled Persons, Female, Follow-Up Studies, Humans, Incidence, Male, Obesity, Odds Ratio, Prevalence, Retrospective Studies, Risk Factors, United States, Wounds and Injuries}, issn = {1532-5415}, doi = {10.1111/j.1532-5415.2011.03767.x}, author = {Christine L Himes and Sandra L Reynolds} } @article {5931, title = {Estimating Second Order Probability Beliefs from Subjective Survival Data}, number = {18258}, year = {2012}, institution = {National Bureau of Economic Research}, address = {Cambridge, MA}, abstract = {Based on subjective survival probability questions in the Health and Retirement Study, we use an econometric model to estimate the determinants of individual-level uncertainty about personal longevity. This model is built around the Modal Response Hypothesis (MRH), a mathematical expression of the idea that survey responses of 0, 50 or 100 percent to probability questions indicate a high level of uncertainty about the relevant probability. We show that subjective survival expectations in 2002 line up very well with realized mortality of the HRS respondents between 2002 and 2010. We show that the MRH model performs better than typically used models in the literature of subjective probabilities. Our model gives more accurate estimates of low probability events and it is able to predict the unusually high fraction of focal 0, 50 and 100 answers observed in many datasets on subjective probabilities.}, keywords = {Methodology}, doi = {10.3386/w18258}, author = {P{\'e}ter Hudomiet and Robert J. Willis} } @article {7704, title = {Family structure and the reproduction of inequality: Parents{\textquoteright} contribution to children{\textquoteright}s college costs.}, journal = {Soc Sci Res}, volume = {41}, year = {2012}, month = {2012 Jul}, pages = {876-87}, publisher = {41}, abstract = {

This article examines the role of family structure in the financial support parents provide for their children{\textquoteright}s college education. Data are from the Health and Retirement Study. We focus on aspects of family structure that affect parental support and estimate shared family variance in investments as well as within-family variation using a multilevel model. Family membership accounts for about 60\% of the variance in payment of college costs. Small family size, living with both biological parents (compared to one biological parent and a stepparent), higher parental education, and having older parents are associated with greater parental expenditures.

}, issn = {1096-0317}, doi = {10.1016/j.ssresearch.2012.02.008}, author = {John C Henretta and Douglas A. Wolf and Matthew F. Van Voorhis and Beth J Soldo} } @article {7747, title = {Grandparents Providing Care to Grandchildren: A Population-Based Study of Continuity and Change}, journal = {Journal of Family Issues}, volume = {33}, year = {2012}, pages = {1143-1167}, publisher = {33}, abstract = {This study examines transitions in grandchild care and the characteristics of grandparents making these transitions, using longitudinal data from a nationally representative sample of 13,626 grandparents in the 1998-2008 Health and Retirement Study. More than 60 of grandparents provided grandchild care over the 10-year period; more than 70 of those did it for 2 years or more. Grandparents with fewer functional limitations and more economic resources were more likely to start or continue nonresidential care, whereas relatively disadvantaged grandparents were more likely to start and continue coresidential care. Grandparents who were African American, younger, married, living with fewer minor children of their own, or had more grandchildren were more likely to start care, particularly nonresidential care. African Americans and Hispanics were more likely than Whites to start and continue coresidential care. These findings demonstrate the heterogeneity of caregiving and point to the lack of resources among those who provide coresidential care. PUBLICATION ABSTRACT}, keywords = {Caregiving, grandchildren, Grandparents, intergenerational relationship, Living arrangements}, doi = {10.1177/0192513X12438685}, author = {Ye Luo and Tracey A. LaPierre and Mary Elizabeth Hughes and Linda J. Waite} } @article {7695, title = {Health behavior change following chronic illness in middle and later life.}, journal = {J Gerontol B Psychol Sci Soc Sci}, volume = {67}, year = {2012}, month = {2012 May}, pages = {279-88}, publisher = {67B}, abstract = {

OBJECTIVES: Understanding lifestyle improvements among individuals with chronic illness is vital for targeting interventions that can increase longevity and improve quality of life.

METHODS: Data from the U.S. Health and Retirement Study were used to examine changes in smoking, alcohol use, and exercise 2-14 years after a diagnosis of heart disease, diabetes, cancer, stroke, or lung disease.

RESULTS: Patterns of behavior change following diagnosis indicated that the vast majority of individuals diagnosed with a new chronic condition did not adopt healthier behaviors. Smoking cessation among those with heart disease was the largest observed change, but only 40\% of smokers quit. There were no significant increases in exercise for any health condition. Changes in alcohol consumption were small, with significant declines in excessive drinking and increases in abstention for a few health conditions. Over the long term, individuals who made changes appeared to maintain those changes. Latent growth curve analyses up to 14 years after diagnosis showed no average long-term improvement in health behaviors.

DISCUSSION: Results provide important new information on health behavior changes among those with chronic disease and suggest that intensive efforts are required to help initiate and maintain lifestyle improvements among this population.

}, keywords = {Age Factors, Aged, Aged, 80 and over, Alcohol Drinking, Chi-Square Distribution, Chronic disease, Diabetes Mellitus, Exercise, Female, Health Behavior, Heart Diseases, Humans, Longitudinal Studies, Lung Diseases, Male, Middle Aged, Neoplasms, Smoking, Stroke, Time Factors}, issn = {1758-5368}, doi = {10.1093/geronb/gbr103}, author = {Jason T Newsom and Nathalie Huguet and Michael J. McCarthy and Pamela Ramage-Morin and Mark S Kaplan and Julie Bernier and Bentson McFarland and Jillian Oderkirk} } @article {7718, title = {The influence of diabetes psychosocial attributes and self-management practices on change in diabetes status.}, journal = {Patient Educ Couns}, volume = {87}, year = {2012}, note = {Zulman, Donna M Rosland, Ann-Marie Choi, Hwajung Langa, Kenneth M Heisler, Michele U01 AG09740/AG/NIA NIH HHS/ Ireland Patient Educ Couns. 2012 Apr;87(1):74-80. Epub 2011 Aug 15.}, month = {2012 Apr}, pages = {74-80}, publisher = {87}, abstract = {

OBJECTIVE: To examine the influence of diabetes psychosocial attributes and self-management on glycemic control and diabetes status change.

METHODS: Using data from the Health and Retirement Study, a nationally representative longitudinal study of U.S. adults >51 years, we examined cross-sectional relationships among diabetes psychosocial attributes (self-efficacy, risk awareness, care understanding, prioritization of diabetes, and emotional distress), self-management ratings, and glycemic control. We then explored whether self-management ratings and psychosocial attributes in 2003 predicted change in diabetes status in 2004.

RESULTS: In multivariate analyses (N=1834), all diabetes psychosocial attributes were associated with self-management ratings, with self-efficacy and diabetes distress having the strongest relationships (adj coeff=8.1, p<0.01 and -4.1, p<0.01, respectively). Lower self-management ratings in 2003 were associated cross-sectionally with higher hemoglobin A1C (adj coeff=0.16, p<0.01), and with perceived worsening diabetes status in 2004 (adj OR=1.36, p<0.05), with much of this latter relationship explained by diabetes distress.

CONCLUSION: Psychosocial attributes, most notably diabetes-related emotional distress, contribute to difficulty with diabetes self-management, poor glycemic control, and worsening diabetes status over time.

PRACTICE IMPLICATIONS: Self-management and adherence interventions should target psychosocial attributes such as disease-related emotional distress.

}, keywords = {Aged, Blood Glucose Self-Monitoring, Cross-Sectional Studies, Diabetes Mellitus, Type 1, Diabetes Mellitus, Type 2, Disease Management, Female, Glycated Hemoglobin, Health Knowledge, Attitudes, Practice, Health Status, Humans, Interviews as Topic, Male, Middle Aged, Multivariate Analysis, Risk Factors, Self Care, Self Efficacy, Severity of Illness Index, Social Support, Stress, Psychological, Surveys and Questionnaires, Treatment Outcome}, issn = {1873-5134}, doi = {10.1016/j.pec.2011.07.013}, url = {http://www.ncbi.nlm.nih.gov/pubmed/21840149}, author = {Donna M Zulman and Ann Marie Rosland and Choi, Hwajung and Kenneth M. Langa and Michele M Heisler} } @article {5943, title = {Investment Decisions in Retirement: The Role of Subjective Expectations}, year = {2012}, institution = {Ann Arbor, The University of Michigan}, abstract = {The rapid transition from defined benefit (DB) pension plans to defined contribution (DC) plans has a potential benefit of offering pension holders greater control over how their pension accumulations are invested. If pension holders are willing to take some risk, investments in the stock market could increase their economic preparation for retirement, and, indeed, economic theory as well as the typical advice of financial advisors calls for stock market investments. Yet, the rate of stock holding is much below what theory suggests it should be, undoing any benefit associated with the greater control coming from DC plans. The leading explanations for this under-investing include excessive risk aversion, costs of entry, and misperceptions about possible returns in the stock market. We show that excessive risk aversion is not able to account for the low fraction of stock holding. However, a model with heterogeneous subjective expectations about stock market returns is able to account for low stock market participation, and tracks the share of risky assets conditional on participation reasonably well. Based on the model with subjective expectations, we estimate a welfare loss of up to 12 compared to investment under rational expectations, if actual returns follow the same distribution as in the past 50 years. The policy implication is that there is considerable scope for welfare improvement as a result of consumer education regarding stock market returns. However, the welfare loss is much smaller if individuals are not very risk averse or if actual returns follow the same distribution as in the past 10 years}, keywords = {Net Worth and Assets, Pensions}, url = {http://www.mrrc.isr.umich.edu/publications/publications_download.cfm?pid=865}, author = {Marco Angrisani and Michael D Hurd and Erik Meijer} } @mastersthesis {6342, title = {Living Well: Empirical Evaluations of Economic Welfare and Subjective Well-Being}, volume = {3555725}, year = {2012}, note = {Copyright - Copyright ProQuest, UMI Dissertations Publishing 2012 Last updated - 2013-05-10 First page - n/a}, month = {2012}, pages = {118}, school = {University of California, Berkeley}, type = {Ph.D.}, abstract = {This thesis presents findings from three related but independent research projects on how policies and programs affect subjective well-being and psychological health, both generally and along specific domains. As I discuss in the Introduction (Chapter 1), the subjective experience is an important component of overall welfare, and tools for measuring Subjective Well-Being (SWB) are well validated. These measures are particularly useful when measuring the impact of policies, programs, and decisions for which income is a poor indicator of well-being. The first project, "Subjective Well-Being and Retirement: Analysis and Policy Recommendations" (Chapter 2) examines how individual-level happiness is on average influenced by the transition into retirement. By exploiting discontinuities in retirement incentives in 16 countries, an instrumental variables approach is utilized to estimate retirement so that it is exogenous to individual-level characteristics. Removing selection bias reveals a large, short-term positive effect followed by a steep decline. This supports theories of a multi-stage adjustment to retirement. Further, individuals facing later formal retirement experience a boost in SWB that is roughly equivalent in total value to those individual facing earlier retirement, suggesting that raising the formal retirement age is relatively neutral with regard to SWB in the long-term. The second project, "Whose Fault Is It?: No Fault Divorce and the Decline in Women{\textquoteright}s Happiness" (Chapter 3) explores the impact of the no-fault revolution, wherein the legal and economic barriers to divorce were drastically reduced in many states throughout the 70s and 80s. I expand upon previous research by including SWB as an important outcome, including overall SWB as well as marital-happiness, a domain-specific SWB measure. I find that women under low-barriers to divorce regimes are significantly less happy than other women, while men are significantly happier. The final project, "Paradox Lost?: Job Satisfaction, Gender Segregation, and the Paradox of the Contented Female Worker" investigates whether gender segregation has played a role in the well-documented "paradox of the contented female worker" (Crosby, 1982), wherein women report higher job satisfaction despite worse work conditions. Job satisfaction is a domain-specific form of SWB which is particularly important from an economic perspective, as high SWB at work is related to better productivity and lower turnover. I find that both men and women are happier in jobs that are dominated by women, suggesting that men and women may on average be making different decisions with regard to satisfaction / income tradeoffs. Although the chapters are meant to be stand-alone essays, in concert these papers argue that: 1) SWB is an important outcome variable and high levels of SWB is an important social goal; and 2) policies affect SWB and therefore SWB must be considered in cost-benefit analyses of policy impacts.}, keywords = {Adult children, Employment and Labor Force, Expectations, Health Conditions and Status, Methodology, Public Policy, Women and Minorities}, url = {http://search.proquest.com.proxy.lib.umich.edu/docview/1322967851?accountid=14667http://mgetit.lib.umich.edu/?ctx_ver=Z39.88-2004\&ctx_enc=info:ofi/enc:UTF-8\&rfr_id=info:sid/ProQuest+Dissertations+\%26+Theses+A\%26I\&rft_val_fmt=info:ofi/fmt:kev:mtx:dissertat}, author = {Horner, Elizabeth Mokyr} } @article {7692, title = {Loneliness, health, and mortality in old age: a national longitudinal study.}, journal = {Soc Sci Med}, volume = {74}, year = {2012}, month = {2012 Mar}, pages = {907-14}, publisher = {74}, abstract = {

This study examined the relationship between loneliness, health, and mortality using a U.S. nationally representative sample of 2101 adults aged 50 years and over from the 2002 to 2008 waves of the Health and Retirement Study. We estimated the effect of loneliness at one point on mortality over the subsequent six years, and investigated social relationships, health behaviors, and health outcomes as potential mechanisms through which loneliness affects mortality risk among older Americans. We operationalized health outcomes as depressive symptoms, self-rated health, and functional limitations, and we conceptualized the relationships between loneliness and each health outcome as reciprocal and dynamic. We found that feelings of loneliness were associated with increased mortality risk over a 6-year period, and that this effect was not explained by social relationships or health behaviors but was modestly explained by health outcomes. In cross-lagged panel models that tested the reciprocal prospective effects of loneliness and health, loneliness both affected and was affected by depressive symptoms and functional limitations over time, and had marginal effects on later self-rated health. These population-based data contribute to a growing literature indicating that loneliness is a risk factor for morbidity and mortality and point to potential mechanisms through which this process works.

}, keywords = {Aged, Aged, 80 and over, Aging, Cohort Studies, depression, Female, Health Behavior, Health Status, Humans, Interpersonal Relations, Loneliness, Longitudinal Studies, Male, Middle Aged, Mortality, Social Support, Socioeconomic factors, United States}, issn = {1873-5347}, doi = {10.1016/j.socscimed.2011.11.028}, url = {http://proquest.umi.com.proxy.lib.umich.edu/pqdweb?did=2601961601andFmt=7andclientId=17822andRQT=309andVName=PQD}, author = {Ye Luo and Louise C Hawkley and Linda J. Waite and John T. Cacioppo} } @mastersthesis {6326, title = {Longitudinal changes in self-reported expectations for nursing home use in the health and retirement study}, volume = {Ph.D.}, year = {2012}, note = {ISBN 9781267645487 Dissertation/thesis number 3539994 ProQuest document ID 1112070427}, month = {2012}, pages = {93}, school = {The University of Alabama}, type = {Ph.D.}, abstract = {The Behavioral Model of Health Services Use (Andersen, 1968; Andersen \& Newman, 1973) is a frequently used framework for examining the factors that bear upon the decision to pursue and utilize health services (Andersen \& Newman, 1973; Mui, Choi, \& Monk, 1998). According to this model, an individual{\textquoteright}s predisposing characteristics, their enabling resources, and their degree of need combine to determine whether or not they will pursue health services such as nursing home care. The current study investigated the relations between variables predicted by the Behavioral Model of Health Services Use to influence longitudinal expectations for nursing home use among adults 50 years of age and older. Variables of interest were drawn from the 2002-2008 waves of the Health and Retirement Study (HRS) and included demographics, previous health services use, possession of insurance that pays for nursing home care, social support, cognitive status, emotional health, and functional status. Results suggested that the variables selected based upon the Behavioral Model of Health Services Use exhibited a limited ability to predict changes in nursing home use expectations across time. Limitations of the current study, as well as potential areas for future studies, were discussed.}, keywords = {Expectations, Healthcare, Public Policy}, author = {Haley, Philip Parker} } @book {5289, title = {Longitudinal Data Analysis: a Practical Guide for Researchers In Aging, Health, And Social Sciences}, year = {2012}, publisher = {Routledge}, organization = {Routledge}, address = {New York}, abstract = {This book provides accessible treatment to state-of-the-art approaches to analyzing longitudinal studies. Comprehensive coverage of the most popular analysis tools allows readers to pick and choose the techniques that best fit their research. The analyses are illustrated with examples from 12 major longitudinal data sets including practical information about their content and design. Illustrations from popular software packages offer tips on how to interpret the results. Each chapter features suggested readings fur further study and a list of articles that further illustrate how to implement the analysis and report the results. An accompanying website provides syntax examples for several software packages for each of the chapter examples. Although many of the examples address health or social science questions related to aging, readers from other disciplines will find the analyses relevant to their work. In addition to demonstrating statistical analysis of longitudinal data, the book shows how to interpret and analyze the results within the context of the research design. Although most chapters emphasize the use of large studies collected over long term periods, much of the book is also relevant to researchers who analyze data collected in shorter time periods. The book opens with issues related to using publicly available data sets including a description of the goals, designs, and measures of the data. The next 10 chapters provide non-technical, practical introductions to the concepts and issues relevant to longitudinal analysis, including: weighting samples and adjusting designs for longitudinal studies; missing data and attrition; measurement issues related to longitudinal research; the use of ANOVA and regression for averaging change over time; mediation analysis for analyzing causal processes; growth curve models using multilevel regression; longitudinal hypotheses using structural equation modeling (SEM); latent growth curve models for evaluating individual trajectories of change; dynamic SEM models of change; and survival (event) analysis. Examples from longitudinal data sets such as the Health and Retirement Study, the Longitudinal Study of Aging, and Established Populations for Epidemiologic Studies of the Elderly as well as international data sets such as the Canadian National Population Health Survey and the English Longitudinal Study of Aging, illustrate key concepts. An ideal supplement for graduate level courses on data analysis and/or longitudinal modeling taught in psychology, gerontology, human development, family studies, medicine, sociology, social work, and other behavioral, social, and health sciences, this multidisciplinary book will also appeal to researchers in these fields.}, keywords = {Cross-National, Health Conditions and Status, Methodology}, author = {Jason T Newsom and Richard N Jones and Scott M Hofer} } @article {10194, title = {Parameter Estimation in Logistic Regression for Transition, Reverse Transition and Repeated Transition from Repeated Outcomes}, journal = {Applied Mathematics}, year = {2012}, month = {11/2012}, pages = {1739-1749}, abstract = {Covariate dependent Markov models dealing with estimation of transition probabilities for higher orders appear to be restricted because of over-parameterization. An improvement of the previous methods for handling runs of events by expressing the conditional probabilities in terms of the transition probabilities generated from Markovian assumptions was proposed using Chapman-Kolmogorov equations. Parameter estimation of that model needs extensive pre-processing and computations to prepare data before using available statistical softwares. A computer program developed using SAS/IML to estimate parameters of the model are demonstrated, with application to Health and Retirement Survey (HRS) data from USA. }, keywords = {Computer Program, Markov Model, Repeated Transition, Reverse Transition, Transition}, author = {Rafiqul I Chowdhury and M. Ataharul Islam and Huda, S. and Briollais, L.} } @article {5923, title = {Parental Investments in College and Later Cash Transfers}, year = {2012}, note = {electronic resource}, institution = {Cambridge, Mass., National Bureau of Economic Research}, abstract = {The rising cost of college tuition and the accompanying investment parents often make have received considerable attention recently. While classic models in economics make important predictions about the magnitudes of these investments, their distribution across children, and their relationship with later cash transfers, there has been little empirical work examining these predictions, especially with regards to the differential treatment of siblings. Using unique data from a supplement to the Health and Retirement Study, we find that parents typically invest differentially in the schooling of siblings, but we find no evidence that these investments are offset by later cash transfers.}, keywords = {Adult children, Consumption and Savings, Education, Public Policy}, url = {http://www.nber.org/papers/w18485}, author = {Steven Haider and Kathleen McGarry} } @article {5947, title = {Personality Traits and Economic Preparation for Retirement}, number = {wp279}, year = {2012}, institution = {Michigan Retirement and Disability Research Center, University of Michigan}, address = {Ann Arbor, MI}, abstract = {This paper assesses the effects of personality traits on economic preparation for retirement, wealth accumulation, and consumption, among persons 66 to 69 years of age. Among the five chief personality traits of neuroticism, extroversion, agreeableness, conscientiousness, and openness, we focus most on conscientiousness. We find levels of adequate economic preparation for retirement ranging from 29 percent to 90 percent and that conscientiousness positively affects the proportion of persons adequately prepared for retirement, while neuroticism negatively affects it. Both consumption and wealth increase with conscientiousness but wealth increases faster, indicating that more conscientious persons save more out of retirement resources.}, keywords = {Consumption and Savings, Health Conditions and Status, Net Worth and Assets, Retirement Planning and Satisfaction}, url = {https://ideas.repec.org/p/mrr/papers/wp279.html}, author = {Michael D Hurd and Angela Lee Duckworth and Susann Rohwedder and David R Weir} } @article {7767, title = {Presepsis depressive symptoms are associated with incident cognitive impairment in survivors of severe sepsis: a prospective cohort study of older Americans.}, journal = {J Am Geriatr Soc}, volume = {60}, year = {2012}, month = {2012 Dec}, pages = {2290-6}, publisher = {60}, abstract = {

OBJECTIVES: To test the hypothesis that presepsis depressive symptoms are associated with risk of new cognitive impairment in survivors of severe sepsis.

DESIGN: Prospective longitudinal cohort study.

SETTING: Population-based cohort of older U.S. adults interviewed as part of the Health and Retirement Study (1998-2006).

PARTICIPANTS: Four hundred forty-seven individuals with normal presepsis cognition who survived 540 hospitalizations for severe sepsis and completed at least one follow-up interview.

MEASUREMENTS: Severe sepsis was identified using a validated algorithm in Medicare claims. Depressive symptoms were assessed prospectively using a modified version of the Center for Epidemiologic Studies Depression Scale. Cognitive function was assessed using versions of the Telephone Interview for Cognitive Status (TICS). Logistic regression with robust standard errors was used to examine associations between substantial depressive symptoms at any interview before sepsis and incident cognitive impairment (mild or moderate to severe cognitive impairment) at any interview after sepsis.

RESULTS: The prevalence of substantial depressive symptoms in participants with normal cognition before sepsis was 38\% (95\% confidence interval (CI) = 34-42\%). After severe sepsis, 18\% (95\% CI = 15-20\%) of survivors had incident cognitive impairment. In unadjusted analyses, presepsis substantial depressive symptoms were associated with postsepsis incident cognitive impairment (odds ratio (OR) = 2.56, 95\% CI = 1.53-4.27). After adjustment for demographics, health-risk behaviors, clinical characteristics of the sepsis episode, and presepsis TICS scores, substantial presepsis depressive symptoms remained the strongest factor associated with postsepsis incident cognitive impairment (OR = 2.58, 95\% CI = 1.45-4.59).

CONCLUSION: Substantial presepsis depressive symptoms are independently associated with incident postsepsis cognitive impairment. Depressed older adults may be particularly at risk of developing cognitive impairment after a serious medical illness.

}, keywords = {Aged, Aged, 80 and over, Cognition Disorders, Cohort Studies, depression, Female, Humans, Longitudinal Studies, Male, Sepsis, Survivors}, issn = {1532-5415}, doi = {10.1111/jgs.12001}, author = {Dimitry S Davydow and Catherine L Hough and Kenneth M. Langa and Theodore J Iwashyna} } @article {7761, title = {Prevalence of cognitive impairment in older adults with heart failure.}, journal = {J Am Geriatr Soc}, volume = {60}, year = {2012}, month = {2012 Sep}, pages = {1724-9}, publisher = {60}, abstract = {

OBJECTIVES: To determine the prevalence of cognitive impairment in older adults with heart failure (HF).

DESIGN: Cross-sectional analysis of the 2004 wave of the nationally representative Health and Retirement Study linked to 2002 to 2004 Medicare administrative claims.

SETTING: United States, community.

PARTICIPANTS: Six thousand one hundred eighty-nine individuals aged 67 and older.

MEASUREMENTS: An algorithm was developed using a combination of self- and proxy report of a heart problem and the presence of one or more Medicare claims in administrative files using standard HF diagnostic codes. On the basis of the algorithm, three categories were created to characterize the likelihood of a HF diagnosis: high or moderate probability of HF, low probability of HF, and no HF. Cognitive function was assessed using a screening measure of cognitive function or according to proxy rating. Age-adjusted prevalence estimates of cognitive impairment were calculated for the three groups.

RESULTS: The prevalence of cognitive impairment consistent with dementia in older adults with HF was 15\%, and the prevalence of mild cognitive impairment was 24\%. The odds of dementia in those with HF were significantly higher, even after adjustment for age, education level, net worth, and prior stroke (odds ratio = 1.52, 95\% confidence interval = 1.14-2.02).

CONCLUSION: Cognitive impairment is common in older adults with HF and is independently associated with risk of dementia. A cognitive assessment should be routinely incorporated into HF-focused models of care.

}, keywords = {Aged, Aged, 80 and over, Algorithms, Chi-Square Distribution, Cognition Disorders, Cross-Sectional Studies, Demography, Female, Heart Failure, Humans, Logistic Models, Male, Medicare, Prevalence, United States}, issn = {1532-5415}, doi = {10.1111/j.1532-5415.2012.04097.x}, author = {Tanya R Gure and Caroline S Blaum and Bruno J Giordani and Todd M Koelling and Andrzej T Galecki and Susan J Pressler and Scott L Hummel and Kenneth M. Langa} } @article {7693, title = {Race/ethnic and nativity disparities in later life physical performance: the role of health and socioeconomic status over the life course.}, journal = {J Gerontol B Psychol Sci Soc Sci}, volume = {67}, year = {2012}, month = {2012 Mar}, pages = {238-48}, publisher = {67B}, abstract = {

OBJECTIVES: We examine race/ethnic and nativity differences in objective measures of physical performance (i.e., peak expiratory flow, grip strength, and gait speed) in a nationally representative sample of older Whites, Blacks, and Hispanics. We also examine whether detailed measures of childhood and adult health and socioeconomic status (SES) mediate race/ethnic differences in physical performance.

METHOD: We use data from the Health and Retirement Study, a population-based sample of older Americans born before 1947, and 3 measures of physical performance. Nested ordinary least squares models examine whether childhood and adult health and SES mediate race/ethnic differences in performance.

RESULTS: We find large and significant race/ethnic and nativity differences in lung function, grip strength, and gait speed. Adjusting for childhood and current adult health and SES reduces race/ethnic differences in physical performance but does not eliminate them entirely. Childhood health and SES as well as more proximal levels of SES are important determinants of race/ethnic disparities in later life physical performance.

DISCUSSION: The analysis highlights that a large proportion of race/ethnic and nativity disparities result from health and socioeconomic disadvantages in both early life and adulthood and thus suggests multiple intervention points at which disparities can be reduced.

}, keywords = {Aged, Aged, 80 and over, Aging, ethnicity, Female, Gait, Hand Strength, Health Status, Health Status Disparities, Health Surveys, Humans, Male, Middle Aged, Racial Groups, Respiratory Function Tests, Social Class, United States}, issn = {1758-5368}, doi = {10.1093/geronb/gbr155}, author = {Steven A Haas and Patrick M. Krueger and Leah Rohlfsen} } @article {7719, title = {The significance of education for mortality compression in the United States.}, journal = {Demography}, volume = {49}, year = {2012}, month = {2012 Aug}, pages = {819-40}, publisher = {49}, abstract = {

Recent studies of old-age mortality trends assess whether longevity improvements over time are linked to increasing compression of mortality at advanced ages. The historical backdrop of these studies is the long-term improvement in a population{\textquoteright}s socioeconomic resources that fueled longevity gains. We extend this line of inquiry by examining whether socioeconomic differences in longevity within a population are accompanied by old-age mortality compression. Specifically, we document educational differences in longevity and mortality compression for older men and women in the United States. Drawing on the fundamental cause of disease framework, we hypothesize that both longevity and compression increase with higher levels of education and that women with the highest levels of education will exhibit the greatest degree of longevity and compression. Results based on the Health and Retirement Study and the National Health Interview Survey Linked Mortality File confirm a strong educational gradient in both longevity and mortality compression. We also find that mortality is more compressed within educational groups among women than men. The results suggest that educational attainment in the United States maximizes life chances by delaying the biological aging process.

}, keywords = {Aged, Aged, 80 and over, Aging, Educational Status, Female, Health Status Disparities, Humans, Life Expectancy, Male, Middle Aged, Mortality, Mortality, Premature, Sex Distribution, Socioeconomic factors, United States}, issn = {0070-3370}, doi = {10.1007/s13524-012-0104-1}, url = {http://proquest.umi.com.proxy.lib.umich.edu/pqdweb?did=2712630621andFmt=7andclientId=17822andRQT=309andVName=PQD}, author = {Dustin C. Brown and Mark D Hayward and Jennifer Karas Montez and Robert A Hummer and Chi-Tsun Chiu and Mira M Hidajat} } @mastersthesis {6270, title = {Social Determinants and Depression in Later Life}, volume = {Ph.D.}, year = {2012}, note = {Depression 3544982 74191332 1237220473 2013-01-03 0351: Gerontology 66569 n/a Social sciences English Copyright ProQuest, UMI Dissertations Publishing 2012 Social determinants 9781267766014 2012 0347: Mental health Health and environmental sciences Older adults 2839293321 Cross-Denny, Bronwyn}, pages = {139}, school = {Fordham University}, type = {3544982}, address = {United States -- New York}, abstract = {The social determinants of health and mental health have come to the forefront as a global issue as a result of the World Health Organization{\textquoteright}s (WHO) initiative to close the health equity gap. The aim of this study is to examine social determinants and the impact on depression over the life span utilizing Cumulative Disadvantage Theory. A secondary data analysis was conducted on the 2010 wave of data from the Health and Retirement Study. A path analysis was used to determine predictors of depression in later life. Findings indicated that age and neighborhood cohesion were predictors of perceived discrimination. Although total causal effects were small for predictors of depression, results indicate a possible protective factor provided by neighborhood cohesion and social support. Implications for social work research and practice are discussed for addressing service needs of the growing older adult population.}, keywords = {Adult children, Demographics, Health Conditions and Status, Methodology}, url = {http://search.proquest.com.proxy.lib.umich.edu/docview/1237220473?accountid=14667}, author = {Cross-Denny, Bronwyn} } @article {7748, title = {Is There a Hispanic Epidemiologic Paradox in Later Life? A Closer Look at Chronic Morbidity}, journal = {Research on Aging}, volume = {34}, year = {2012}, pages = {548-571}, publisher = {34}, abstract = {This study examined the morbidity patterns of foreign-born Hispanics, U.S.-born Hispanics, Blacks, and Whites aged 53 years and older using seven self-reported physician-diagnosed chronic diseases as well as six biomarkers. Drawing on the 2006 Health and Retirement Study and its biomarker data, the authors found that foreign-born Hispanics had comparable or lower rates of high blood pressure, heart disease, cancer, arthritis, chronic lung disease, and stroke, controlling for age and gender. The health advantages were robust when socioeconomic conditions and health behaviors were controlled. Foreign-born Hispanics were not significantly different from U.S.-born Hispanics except for a lower risk for arthritis. In terms of biomarkers, foreign-born Hispanics were not statistically different from Whites except for having higher risks of high systolic blood pressure and blood glucose. Future research should explore multiple factors contributing to the lower rates of major chronic diseases among older Hispanics who have faced social disadvantages over the life course. PUBLICATION ABSTRACT}, keywords = {Demographics, Health Conditions and Status, Healthcare, Women and Minorities}, doi = {10.1177/0164027511429807}, author = {Zhang, Zhenmei and Mark D Hayward and Lu, Chuntian} } @mastersthesis {6329, title = {The Urban Neighborhood, Depressive Symptoms, and Age: Stress and Psychosocial Resources}, volume = {M.S.}, year = {2012}, note = {ISBN 9781267388599}, month = {2012}, pages = {104}, school = {University of California, Los Angeles}, address = {United States -- California}, abstract = {Background . Existing research shows that residents exposed to neighborhood socioeconomic disadvantage (NSD) have a relatively high risk of some types of mental illness. This study investigated whether this pattern is present for depressive symptoms among persons in late middle age to extreme old age, and if so why. Investigated factors include: stressors (neighborhood physical disorder and financial strain) and psychosocial resources (mastery, social support, and religious service attendance). Age differences were examined. Methods . This was a secondary analysis of data from the 2006 and 2008 Health and Retirement Study Psychosocial Supplemental Assessment. The analytic sample included 8,623 adults aged 52 to 104, residing in 3216 urban neighborhoods (census tracts). NSD was operationalized with a principal component of Census tract indicators (education, poverty, public assistance, and unemployment). Depressive symptoms were measured by an 8-item version of the Center for Epidemiologic Studies Depression Scale. Hierarchical linear regression estimated multilevel models. Results . NSD was positively associated with depressive symptoms, net of individual-level demographic characteristics used to control for selection. Exposure to stressors partially explained the association; while psychosocial resources suppressed it. A significant, curvilinear cross-level interaction with age was found: NSD is positively associated with symptoms among those under 64, but has little effect among persons 65 to 74 year, and is negative at older ages. Conclusion . The mental health disparity for depressive symptoms in NSD is partially due to greater exposure to stressors and fewer resources to counteract this exposure. The counter-intuitive inverse association among the oldest adults warrants further investigation.}, keywords = {Demographics, Health Conditions and Status, Healthcare, Public Policy, Risk Taking}, url = {http://proquest.umi.com.proxy.lib.umich.edu/pqdweb?did=2693777921\&Fmt=7\&clientId=17822\&RQT=309\&VName=PQD}, author = {Harig, Fredrick A.} } @article {7723, title = {Who Among the Elderly Owns Stocks? The Role of Cognitive Ability and Bequest Motive}, journal = {Journal of Family and Economic Issues}, volume = {33}, year = {2012}, note = {Copyright - Springer Science Business Media, LLC 2012 Language of summary - English Pages - 338-352 ProQuest ID - 1030719840 Last updated - 2012-08-02 Place of publication - New York Corporate institution author - Kim, Eun Jin; Hanna, Sherman D; Chatterjee, Swarn; Lindamood, Suzanne DOI - 2726553591; 70920932; 53465; JFEI; SPVLJFEI108343339295}, pages = {338-352}, publisher = {33}, abstract = {Conventional advice is to reduce risky investments as one ages. Such a generalized focus on risk avoidance may be inappropriate for elderly with longer life spans and those with financial goals that extend beyond their lifetime. To better understand risky asset holdings among the elderly, we investigated the effect of cognitive ability and bequest motive on stock ownership and stock purchase. Using the 2004 wave of the Health and Retirement Study, we found that one-third of elderly households held stocks and 36 of those elderly stockowners had recently acquired stocks. The respondent{\textquoteright}s cognitive ability and bequest motive were strongly related to stock ownership. Among those who owned stock, a bequest motive was positively related to a recent purchase of stocks. PUBLICATION ABSTRACT}, keywords = {Health Conditions and Status, Healthcare, Net Worth and Assets, Retirement Planning and Satisfaction}, doi = {10.1007/s10834-012-9295-2}, url = {http://search.proquest.com.proxy.lib.umich.edu/docview/1030719840?accountid=14667http://mgetit.lib.umich.edu/?ctx_ver=Z39.88-2004andctx_enc=info:ofi/enc:UTF-8andrfr_id=info:sid/ProQ 3Aabiglobalandrft_val_fmt=info:ofi/fmt:kev:mtx:journalandrft.genre=articl}, author = {Eun Jin Kim and Sherman D. Hanna and Chatterjee, Swarn and Lindamood, Suzanne} } @article {7634, title = {Childhood health and labor market inequality over the life course.}, journal = {J Health Soc Behav}, volume = {52}, year = {2011}, note = {Haas, Steven A Glymour, M Maria Berkman, Lisa F AG023399/AG/NIA NIH HHS/United States Research Support, N.I.H., Extramural Research Support, Non-U.S. Gov{\textquoteright}t United States Journal of health and social behavior J Health Soc Behav. 2011;52(3):298-313. doi: 10.1177/0022146511410431.}, month = {2011 Sep}, pages = {298-313}, publisher = {52}, abstract = {

The authors use data from the Health and Retirement Study{\textquoteright}s Earnings Benefit File, which links Health and Retirement Study to Social Security Administration records, to estimate the impact of childhood health on earnings curves between the ages of 25 and 50 years. They also investigate the extent to which diminished educational attainment, earlier onset of chronic health conditions, and labor force participation mediate this relationship. Those who experience poor childhood health have substantially diminished labor market earnings over the work career. For men, earnings differentials grow larger over the early to middle career and then slow down and begin to converge as they near 50 years of age. For women, earnings differentials emerge later in the career and show no evidence of convergence. Part of the child health earnings differential is accounted for by selection into diminished educational attainment, the earlier onset of chronic disease in adulthood, and, particularly for men, labor force participation.

}, keywords = {Child, Employment, Female, Health Status, Humans, Income, Male, Middle Aged, Models, Econometric, Retirement, Social Class, Social Security, Socioeconomic factors, United States}, issn = {2150-6000}, doi = {10.1177/0022146511410431}, author = {Steven A Haas and M. Maria Glymour and Lisa F Berkman} } @article {7644, title = {Conscientiousness and longevity: an examination of possible mediators.}, journal = {Health Psychol}, volume = {30}, year = {2011}, note = {Hill, Patrick L Turiano, Nicholas A Hurd, Michael D Mroczek, Daniel K Roberts, Brent W R01 AG021178-09/AG/NIA NIH HHS/United States United States Health psychology : official journal of the Division of Health Psychology, American Psychological Association Health Psychol. 2011 Sep;30(5):536-41.}, month = {2011 Sep}, pages = {536-41}, publisher = {30}, abstract = {

OBJECTIVE: Conscientious individuals tend to experience a number of health benefits, not the least of which being greater longevity. However, it remains an open question as to why this link with longevity occurs. The current study tested two possible mediators (physical health and cognitive functioning) of the link between conscientiousness and longevity.

METHOD: We tested these mediators using a 10-year longitudinal sample (N = 512), a subset of the long-running Health and Retirement Study of aging adults. Measures included an adjective-rating measure of conscientiousness, self-reported health conditions, and three measures of cognitive functioning (word recall, delayed recall, and vocabulary) included in the 1996 wave of the HRS study.

RESULTS: Our results found that conscientiousness significantly predicted greater longevity, even in a model including the two proposed mediator variables, gender, age, and years of education. Moreover, cognitive functioning appears to partially mediate this relationship.

CONCLUSIONS: This study replicates previous research showing that conscientious individuals tend to lead longer lives, and provides further insight into why this effect occurs. In addition, it underscores the importance of measurement considerations.

}, keywords = {Adult, Aged, Chronic disease, Cognition, Educational Status, Female, Health Behavior, Health Status, Humans, Longevity, Longitudinal Studies, Male, Middle Aged, Personality, Proportional Hazards Models, Psychological Tests}, issn = {1930-7810}, doi = {10.1037/a0023859}, author = {Patrick L Hill and Nicholas A. Turiano and Michael D Hurd and Daniel K. Mroczek and Brent W Roberts} } @article {5914, title = {Consumption and Differential Mortality}, number = {UM11-17}, year = {2011}, institution = {Michigan Retirement and Disability Research Center, University of Michigan}, address = {Ann Arbor, MI}, abstract = {It is well-established that differential mortality according to wealth or income introduces bias into age profiles of these variables when estimated on cross-sectional or synthetic cohort data. However, little is known about whether this association is also found with consumption, and if so, how strong this association is. In this paper we use panel data on total household spending from the Health and Retirement Study (HRS) and its supplemental study, the Consumption and Activities Mail Survey (CAMS), to estimate differences in consumption by survival status to the next survey wave. We quantify the bias in age profiles of consumption that results from differential mortality when estimating the age profiles on cross-sectional data or on synthetic cohort data. We find that the bias is smaller than that found for wealth or income.}, keywords = {Consumption and Savings, Demographics, Health Conditions and Status, Methodology}, url = {https://mrdrc.isr.umich.edu/projects/consumption-and-differential-mortality/}, author = {Michael D Hurd and Susann Rohwedder} } @article {7661, title = {Cytomegalovirus antibodies in dried blood spots: a minimally invasive method for assessing stress, immune function, and aging.}, journal = {Immun Ageing}, volume = {8}, year = {2011}, month = {2011 Jan 13}, pages = {3}, publisher = {8}, abstract = {

BACKGROUND: Cytomegalovirus (CMV) is a prevalent herpesvirus with links to both stress and aging. This paper describes and validates a minimally invasive method for assessing antibodies against CMV in finger stick whole blood spot samples for use as an indirect marker of an aspect of cell-mediated immunity.

RESULTS: Analysis of CMV in dried blood spot samples (DBS) was based on modifications of a commercially available protocol for quantifying CMV antibodies in serum or plasma. The method was evaluated through analysis of precision, reliability, linearity, and correlation between matched serum and DBS samples collected from 75 volunteers. Correlation between DBS and plasma values was linear and high (Pearson correlation R = .96), and precision, reliability, and linearity of the DBS assay were within acceptable ranges.

CONCLUSIONS: The validity of a DBS assay for CMV antibodies will enable its inclusion in population-based surveys and other studies collecting DBS samples in non-clinical settings, increasing scientific understanding of the interaction of social and biological stress and immune function.

}, issn = {1742-4933}, doi = {10.1186/1742-4933-8-3}, author = {Jennifer B Dowd and Allison E Aiello and Laura Chyu and Yuan-Yen Huang and Thomas W McDade} } @article {7529, title = {Development and validation of a brief cognitive assessment tool: the sweet 16.}, journal = {Arch Intern Med}, volume = {171}, year = {2011}, month = {2011 Mar 14}, pages = {432-7}, publisher = {171}, abstract = {

BACKGROUND: Cognitive impairment is often unrecognized among older adults. Meanwhile, current assessment instruments are underused, lack sensitivity, or may be restricted by copyright laws. To address these limitations, we created a new brief cognitive assessment tool: the Sweet 16.

METHODS: The Sweet 16 was developed in a cohort from a large post-acute hospitalization study (n=774) and compared with the Mini-Mental State Examination (MMSE). Equipercentile equating identified Sweet 16 cut points that correlated with widely used MMSE cut points. Sweet 16 performance characteristics were independently validated in a cohort from the Aging, Demographics, and Memory Study (n=709) using clinical consensus diagnosis, the modified Blessed Dementia Rating Scale, and the Informant Questionnaire on Cognitive Decline in the Elderly (IQCODE).

RESULTS: The Sweet 16 correlated highly with the MMSE (Spearman r, 0.94; P<.001). Validated against the IQCODE, the area under the curve was 0.84 for the Sweet 16 and 0.81 for the MMSE (P=.06). A Sweet 16 score of less than 14 (approximating an MMSE score <24) demonstrated a sensitivity of 80\% and a specificity of 70\%, whereas an MMSE score of less than 24 showed a sensitivity of 64\% and a specificity of 86\% against the IQCODE. When compared with clinical diagnosis, a Sweet 16 score of less than 14 showed a sensitivity of 99\% and a specificity of 72\% in contrast to an MMSE score with a sensitivity of 87\% and a specificity of 89\%. For education of 12 years or more, the area under the curve was 0.90 for the Sweet 16 and 0.84 for the MMSE (P=.03).

CONCLUSIONS: The Sweet 16 is simple, quick to administer, and will be available open access. The performance of the Sweet 16 is equivalent or superior to that of the MMSE.

}, keywords = {Aged, Aged, 80 and over, Cognition Disorders, Cohort Studies, Dementia, Female, Humans, Male, Neuropsychological tests, Surveys and Questionnaires}, issn = {1538-3679}, doi = {10.1001/archinternmed.2010.423}, author = {Tamara G Fong and Richard N Jones and James L Rudolph and Frances Margaret Yang and Tommet, Douglas and Habtemariam, Daniel and Edward R Marcantonio and Kenneth M. Langa and Sharon K Inouye} } @article {7655, title = {Dynamics of self-rated health and selective mortality.}, journal = {Empir Econ}, volume = {40}, year = {2011}, note = {P01 AG005842-24/NIA NIH HHS/United States Empirical economics Nihms264233 Empir Econ. 2011 Feb 1;40(1):119-140.}, month = {2011 Feb 01}, pages = {119-140}, publisher = {40}, abstract = {

Self-rated health status (SRHS) is one of the most frequently used health measures in empirical health economics. This article analyzes the first seven waves of the Health and Retirement Study (HRS) and finds that (1) all available lags have decreasing but significant predictive power for current SRHS and (2) SRHS and future mortality are strongly related which leads to a specific selection problem known as survivorship bias. A parsimonious joint model with an autocorrelated latent health component in both the SRHS and the mortality equation is suggested. It is better able to capture the empirical facts than commonly used models including random effects and/or state dependence and better able to correct the survivorship bias than commonly used strategies such as inverse probability weighting.

}, issn = {0377-7332}, doi = {10.1007/s00181-010-0422-3}, author = {Florian Heiss} } @article {7649, title = {Effects of smoking cessation on pain in older adults.}, journal = {Nicotine Tob Res}, volume = {13}, year = {2011}, note = {Shi, Yu Hooten, W Michael Warner, David O U01AG009740/AG/NIA NIH HHS/United States Research Support, N.I.H., Extramural Research Support, Non-U.S. Gov{\textquoteright}t England Nicotine and tobacco research : official journal of the Society for Research on Nicotine and Tobacco Nicotine Tob Res. 2011 Oct;13(10):919-25. Epub 2011 May 12.}, month = {2011 Oct}, pages = {919-25}, publisher = {13}, abstract = {

INTRODUCTION: Smokers are at increased risk of developing chronic pain and suffering higher pain intensity. However, nicotine has analgesic properties, and smokers may view smoking as a means to cope with pain. Smoking cessation is clearly beneficial to the long-term health of smokers. However, it is not known how abstinence from smoking affects pain. The aim of this study was to determine the association between smoking cessation and changes in pain symptoms by secondary analysis of a large longitudinal dataset of older adults.

METHODS: Secondary analyses were performed of longitudinal biennial survey data (1992 through 2006) from the nationally representative Health and Retirement Study of United States adults older than 50 years. Multivariate logistic regressions were utilized to determine the relationship between the changes in smoking status and changes in pain symptoms, controlling for demographics, depression, self-rated health, history of arthritis, and body mass index.

RESULTS: In multivariate analyses, among the 4,695 smokers who reported no pain or mild pain at enrollment, smoking status was not independently associated with exacerbation of pain (odds ratio [OR]: 0.95, 95\% CI: 0.84, 1.08). Among the 1,118 smokers who reported moderate to severe pain at enrollment, smoking status was not independently associated with improvement of pain (OR: 0.87, 95\% CI: 0.70, 1.08).

CONCLUSIONS: Smoking cessation was not independently associated with changes in pain symptoms in older adults. These results suggest that concerns regarding the effects of abstinence from smoking on pain should not pose a barrier to offering tobacco use interventions to smokers with chronic pain.

}, keywords = {Aged, Body Mass Index, depression, Female, Follow-Up Studies, Humans, Interviews as Topic, Logistic Models, Longitudinal Studies, Male, Middle Aged, Odds Ratio, pain, Pain Perception, Smoking, Smoking cessation, Smoking Prevention}, issn = {1469-994X}, doi = {10.1093/ntr/ntr097}, author = {Yu Shi and Hooten, W Michael and David O. Warner} } @article {5913, title = {The Effects of the Financial Crisis on Actual and Anticipated Consumption}, number = {WP 2011-255}, year = {2011}, institution = {Michigan Retirement and Disability Research Center, University of Michigan}, address = {Ann Arbor, MI}, abstract = {We studied how households adjust their spending in response to the financial crisis. Based on five waves of data from the Consumption and Activities Mail Survey, we quantified the reduction in total consumption and in specific categories of consumption in the older population at large and by stock ownership, both as a proxy for wealth and to test assumptions about whether stock ownership was associated with different responses. In particular, we compared consumption changes between 2007 and 2009 with consumption changes over prior years. We used panel data on anticipated changes in spending at retirement to quantify the effects of the financial crisis on well- being in retirement via a difference-in-differences approach.}, keywords = {Consumption and Savings, Net Worth and Assets, Public Policy, Retirement Planning and Satisfaction}, url = {https://mrdrc.isr.umich.edu/pubs/the-effects-of-the-financial-crisis-on-actual-and-anticipated-consumption-2/}, author = {Michael D Hurd and Susann Rohwedder} } @inbook {NBERc12443, title = {"Healthy, Wealthy and Wise?" Revisited: An Analysis of the Causal Pathways from Socioeconomic Status to Health}, booktitle = {Investigations in the Economics of Aging}, year = {2011}, pages = {267-317}, publisher = {University of Chicago Press}, organization = {University of Chicago Press}, abstract = {In health economics, there is little dispute that the socioeconomic status (SES) of individuals is positively correlated with their health status. The size of the body of literature documenting that wealthy and well- educated people generally enjoy better health and longer life is impressive.1 The robustness of this association is underscored by the fact that the so- called health- wealth gradient has been detected in different times, countries, populations, age structures, and for both men and women. Moreover, the results are largely insensitive to the choice of SES measures (such as wealth, income, education, occupation, or social class) and health outcomes.}, keywords = {health, socioeconomic status}, url = {http://www.nber.org/chapters/c12443}, author = {Till Stowasser and Florian Heiss and Daniel McFadden and Joachim Winter} } @article {7610, title = {How Does Health in Childhood Impact Labor Market Earnings Over the Life Course?}, journal = {Journal of Health and Social Behavior}, volume = {52}, year = {2011}, pages = {297-297}, publisher = {52}, abstract = {The authors use data from the Health and Retirement Study{\textquoteright}s Earnings Benefit File, which links Health and Retirement Study to Social Security Administration records, to estimate the impact of childhood health on earnings curves between the ages of 25 and 50 years. They also investigate the extent to which diminished educational attainment, earlier onset of chronic health conditions, and labor force participation mediate this relationship. Those who experience poor childhood health have substantially diminished labor market earnings over the work career. For men, earnings differentials grow larger over the early to middle career and then slow down and begin to converge as they near 50 years of age. For women, earnings differentials emerge later in the career and show no evidence of convergence. Part of the child health earnings differential is accounted for by selection into diminished educational attainment, the earlier onset of chronic disease in adulthood, and, particularly for men, labor force participation.}, keywords = {Demographics, Health Conditions and Status, Public Policy}, doi = {10.1177/0022146511410431}, author = {Steven A Haas and M. Maria Glymour and Lisa F Berkman} } @mastersthesis {6105, title = {Impact of Health Conditions on Cognitive Change in Later Life: A Cross-Study Comparative Analysis}, volume = {M.Sc.}, year = {2011}, note = {ISBN 9780494884256 Dissertation/thesis number MR88425 ProQuest document ID 1074789598}, month = {2011}, school = {University of Victoria (Canada)}, type = {M.Sc.}, abstract = {Relatively few studies have considered how changes in health are associated with changes in cognition in aging populations. Even fewer have investigated the similarities and differences of the health-cognition link evidenced across independent longitudinal studies of aging that differ in country and birth cohort. The main objective of the current research is to evaluate aging-related cognitive change in the context of physical health conditions and to compare patterns and synthesize results across several longitudinal studies of aging. This cross-study evaluation is based on data from three longitudinal studies of aging: 1) the OCTO-Twin Study, a longitudinal investigation of same-sex twin pairs drawn from the population-based Swedish Twin Registry (N = 702; 67\% female; mean age is 83.5), 2) the Health and Retirement Study (HRS), a study of middle-aged and older adults in the U.S. (N = 21,364; 57\% female; mean age is 65.8), and 3) the English Longitudinal Study of Aging (ELSA), a study of middle-aged and older adults in the U.K. (N = 11,397; 54\% female; mean age is 65.3). Data were analyzed using latent growth curve (LGC) analysis to evaluate 1) the impact of diagnosed health conditions and 2) the additive impact of comorbidity on level and rate of change in distinct cognitive outcomes. Our findings indicate that particular health conditions significantly impact initial status and rate of change in cognition, but do so differently across longitudinal studies of aging. The argument is made that the inclusion of health in our predictive models is essential as we try to parse out the effects of pathological aging vs. normative age-related change in cognition. The results of this study show the importance of replication in longitudinal research and for contrasting patterns of effects across independent studies in order to build a cumulative basis for further understanding of the dynamics among aging, health, and cognition in populations that differ in cohort, culture, and country.}, keywords = {Cross-National, Health Conditions and Status, Methodology, Public Policy}, author = {Sparks, Catharine} } @article {7640, title = {Implementation of Medicare Part D and nondrug medical spending for elderly adults with limited prior drug coverage.}, journal = {JAMA}, volume = {306}, year = {2011}, note = {McWilliams, J Michael Zaslavsky, Alan M Huskamp, Haiden A Comparative Study Research Support, Non-U.S. Gov{\textquoteright}t United States JAMA : the journal of the American Medical Association JAMA. 2011 Jul 27;306(4):402-9.}, month = {2011 Jul 27}, pages = {402-9}, publisher = {306}, abstract = {

CONTEXT: Implementation of Medicare Part D was followed by increased use of prescription medications, reduced out-of-pocket costs, and improved medication adherence. Its effects on nondrug medical spending remain unclear.

OBJECTIVE: To assess differential changes in nondrug medical spending following the implementation of Part D for traditional Medicare beneficiaries with limited prior drug coverage.

DESIGN, SETTING, AND PARTICIPANTS: Nationally representative longitudinal survey data and linked Medicare claims from 2004-2007 were used to compare nondrug medical spending before and after the implementation of Part D by self-reported generosity of prescription drug coverage before 2006. Participants included 6001 elderly Medicare beneficiaries from the Health and Retirement Study, including 2538 with generous and 3463 with limited drug coverage before 2006. Comparisons were adjusted for sociodemographic and health characteristics and checked for residual confounding by conducting similar comparisons for a control cohort from 2002-2005.

MAIN OUTCOME MEASURE: Nondrug medical spending assessed from claims, in total and by type of service (inpatient and skilled nursing facility vs physician services).

RESULTS: Total nondrug medical spending was differentially reduced after January 1, 2006, for beneficiaries with limited prior drug coverage (-$306/quarter [95\% confidence interval {CI}, -$586 to -$51]; P = .02), relative to beneficiaries with generous prior drug coverage. This differential reduction was explained mostly by differential changes in spending on inpatient and skilled nursing facility care (-$204/quarter [95\% CI, -$447 to $2]; P = .05). Differential reductions in spending on physician services (-$67/quarter [95\% CI, -$134 to -$5]; P = .03) were not associated with differential changes in outpatient visits (-0.06 visits/quarter [95\% CI, -0.21 to 0.08]; P = .37), suggesting reduced spending on inpatient physician services for beneficiaries with limited prior drug coverage. In contrast, nondrug medical spending in the control cohort did not differentially change after January 1, 2004, for beneficiaries with limited prior drug coverage in 2002 ($14/quarter [95\% CI, -$338 to $324]; P = .93), relative to beneficiaries with generous prior coverage.

CONCLUSION: Implementation of Part D was associated with significant differential reductions in nondrug medical spending for Medicare beneficiaries with limited prior drug coverage.

}, keywords = {Aged, Aged, 80 and over, Cost Control, Costs and Cost Analysis, Data collection, Female, Health Expenditures, Health Services, Humans, Insurance Claim Review, Longitudinal Studies, Male, Medicare Part D, Patient Care, Physicians, Skilled Nursing Facilities, United States}, issn = {1538-3598}, doi = {10.1001/jama.2011.1026}, author = {J. Michael McWilliams and Alan M. Zaslavsky and Haiden A. Huskamp} } @mastersthesis {6344, title = {The implications of Alzheimer{\textquoteright}s Risk for Household Financial Decision Making: Essays on the acquisition of human capital}, year = {2011}, school = {University of Michigan}, type = {Dissertation Chapter}, keywords = {Health Conditions and Status, Retirement Planning and Satisfaction}, url = {https://irs.princeton.edu/sites/g/files/toruqf276/files/uploads/documents/ReivsedRobertWillis.pdf}, author = {John Hsu} } @article {7586, title = {Incidence of dementia and cognitive impairment, not dementia in the United States.}, journal = {Ann Neurol}, volume = {70}, year = {2011}, month = {2011 Sep}, pages = {418-26}, abstract = {

OBJECTIVE: Estimates of incident dementia, and cognitive impairment, not dementia (CIND) (or the related mild cognitive impairment) are important for public health and clinical care policy. In this paper, we report US national incidence rates for dementia and CIND.

METHODS: Participants in the Aging, Demographic, and Memory Study (ADAMS) were evaluated for cognitive impairment using a comprehensive in-home assessment. A total of 456 individuals aged 72 years and older, who were not demented at baseline, were followed longitudinally from August 2001 to December 2009. An expert consensus panel assigned a diagnosis of normal cognition, CIND, or dementia and its subtypes. Using a population-weighted sample, we estimated the incidence of dementia, Alzheimer disease (AD), vascular dementia (VaD), and CIND by age. We also estimated the incidence of progression from CIND to dementia.

RESULTS: The incidence of dementia was 33.3 (standard error [SE], 4.2) per 1,000 person-years and 22.9 (SE, 2.9) per 1,000 person-years for AD. The incidence of CIND was 60.4 (SE, 7.2) cases per 1,000 person-years. An estimated 120.3 (SE, 16.9) individuals per 1,000 person-years progressed from CIND to dementia. Over a 5.9-year period, about 3.4 million individuals aged 72 and older in the United States developed incident dementia, of whom approximately 2.3 million developed AD, and about 637,000 developed VaD. Over this same period, almost 4.8 million individuals developed incident CIND.

INTERPRETATION: The incidence of CIND is greater than the incidence of dementia, and those with CIND are at high risk of progressing to dementia, making CIND a potentially valuable target for treatments aimed at slowing cognitive decline.

}, keywords = {Aged, Aged, 80 and over, Alzheimer disease, Cognition Disorders, Cohort Studies, Dementia, Diagnostic and Statistical Manual of Mental Disorders, disease progression, Female, Humans, Logistic Models, Longitudinal Studies, Male, Models, Statistical, United States}, issn = {1531-8249}, doi = {10.1002/ana.22362}, author = {Brenda L Plassman and Kenneth M. Langa and Ryan J McCammon and Gwenith G Fisher and Guy G Potter and James R Burke and David C Steffens and Norman L Foster and Bruno J Giordani and Frederick W Unverzagt and Kathleen A Welsh-Bohmer and Steven G Heeringa and David R Weir and Robert B Wallace} } @article {5920, title = {Inter-Vivos Giving Over the Lifecycle}, number = {WR-524-1}, year = {2011}, institution = {RAND Corporation }, address = {Santa Monica, CA}, abstract = {Inter-vivos cash transfers and bequests between family members total hundreds of billions of dollars each year. They may equalize resources within a generation of a family as well as across family generations. Transfers delayed to the end of life may represent a significant motive for saving. The authors use longitudinal data from the Health and Retirement Study on inter-vivos transfers that span up to twelve years to: describe financial transfers made by parents to children and their correlation with donor characteristics, examine age patterns in giving behavior, the persistence of transfers, and how transfers change in response to changes in marital status, economic status and health. Their empirical analysis is motivated by a dynamic life-cycle model with intervivos transfers as an argument in the utility function which generates hypotheses about the age pattern of transfers and how mortality risk, risk aversion and economic resources affect giving behavior.}, keywords = {Adult children, Consumption and Savings, Employment and Labor Force, Event History/Life Cycle, Women and Minorities}, doi = {https://doi.org/10.7249/WR524-1}, author = {Michael D Hurd and James P Smith and Julie M Zissimopoulos} } @article {7588, title = {Job Strain, Workplace Discrimination, and Hypertension among Older Workers: The Health and Retirement Study.}, journal = {Race Soc Probl}, volume = {3}, year = {2011}, month = {2011 Mar}, pages = {38-50}, publisher = {3}, abstract = {

Job strain has been associated with hypertension among younger workers; however, whether this relationship persists among older workers, particularly older racial/ethnic minorities, is unresolved. This study evaluated whether job strain and workplace discrimination are associated with hypertension and poor blood pressure control among older workers and whether these relationships vary by gender and race/ethnicity. Data were drawn from the Health and Retirement Study, and analysis was restricted to employed participants with complete information on job strain and blood pressure (N = 3,794). In adjusted models, high job strain was associated with lower likelihood of hypertension (odds ratio (OR): 0.75, 95\% confidence interval (CI): 0.63, 0.89) relative to low job strain. Stratified analyses indicated this association was only significant among white (OR: 0.71, 95\% CI: 0.58, 0.86) and male (OR: 0.61, 95\% CI: 0.47, 0.79) workers. High job strain was not significantly associated with hypertension among African American (OR: 1.14, 95\% CI: 0.63, 2.07) or Hispanic (OR: 0.56, 95\% CI: 0.29, 1.09) workers. Workplace discrimination was not associated with hypertension among any group. Neither job strain nor discrimination was associated with poor blood pressure control. These findings suggest that persistence in work characterized by high job strain in later life may signal resilience to the influence of work-related stressors on health. Future research efforts should examine the factors that contribute to gender and racial differences in these relationships.

}, issn = {1867-1748}, doi = {10.1007/s12552-011-9041-7}, author = {Briana Mezuk and Kershaw, Kiarri and Hudson, Darrell and Ah, Kyuang and Scott M Ratliff} } @article {7579, title = {Long-term declines in ADLs, IADLs, and mobility among older Medicare beneficiaries.}, journal = {BMC Geriatr}, volume = {11}, year = {2011}, month = {2011 Aug 16}, pages = {43}, publisher = {11}, abstract = {

BACKGROUND: Most prior studies have focused on short-term (<= 2 years) functional declines. But those studies cannot address aging effects inasmuch as all participants have aged the same amount. Therefore, the authors studied the extent of long-term functional decline in older Medicare beneficiaries who were followed for varying time lengths, and the authors also identified the risk factors associated with those declines.

METHODS: The analytic sample included 5,871 self- or proxy-respondents who had complete baseline and follow-up survey data that could be linked to their Medicare claims for 1993-2007. Functional status was assessed using activities of daily living (ADLs), instrumental ADLs (IADLs), and mobility limitations, with declines defined as the development of two of more new difficulties. Multiple logistic regression analysis was used to focus on the associations involving respondent status, health lifestyle, continuity of care, managed care status, health shocks, and terminal drop.

RESULTS: The average amount of time between the first and final interviews was 8.0 years. Declines were observed for 36.6\% on ADL abilities, 32.3\% on IADL abilities, and 30.9\% on mobility abilities. Functional decline was more likely to occur when proxy-reports were used, and the effects of baseline function on decline were reduced when proxy-reports were used. Engaging in vigorous physical activity consistently and substantially protected against functional decline, whereas obesity, cigarette smoking, and alcohol consumption were only associated with mobility declines. Post-baseline hospitalizations were the most robust predictors of functional decline, exhibiting a dose-response effect such that the greater the average annual number of hospital episodes, the greater the likelihood of functional status decline. Participants whose final interview preceded their death by one year or less had substantially greater odds of functional status decline.

CONCLUSIONS: Both the additive and interactive (with functional status) effects of respondent status should be taken into consideration whenever proxy-reports are used. Encouraging exercise could broadly reduce the risk of functional decline across all three outcomes, although interventions encouraging weight reduction and smoking cessation would only affect mobility declines. Reducing hospitalization and re-hospitalization rates could also broadly reduce the risk of functional decline across all three outcomes.

}, keywords = {Activities of Daily Living, Aged, Aged, 80 and over, Cohort Studies, Disabled Persons, Female, Follow-Up Studies, Geriatric Assessment, Health Surveys, Humans, Insurance Benefits, Longitudinal Studies, Male, Medicare, Mobility Limitation, Prospective Studies, Time Factors, United States}, issn = {1471-2318}, doi = {10.1186/1471-2318-11-43}, author = {Frederic D Wolinsky and Suzanne E Bentler and Jason Hockenberry and Michael P Jones and Maksym Obrizan and Paula A Weigel and Kaskie, Brian and Robert B Wallace} } @article {7564, title = {National estimates of the prevalence of Alzheimer{\textquoteright}s disease in the United States.}, journal = {Alzheimers Dement}, volume = {7}, year = {2011}, month = {2011 Jan}, pages = {61-73}, publisher = {7}, abstract = {

Several methods of estimating prevalence of dementia are presented in this article. For both Brookmeyer and the Chicago Health and Aging project (CHAP), the estimates of prevalence are derived statistically, forward calculating from incidence and survival figures. The choice of incidence rates on which to build the estimates may be critical. Brookmeyer used incidence rates from several published studies, whereas the CHAP investigators applied the incidence rates observed in their own cohort. The Aging, Demographics, and Memory Study (ADAMS) and the East Boston Senior Health Project (EBSHP) were sample surveys designed to ascertain the prevalence of Alzheimer{\textquoteright}s disease and dementia. ADAMS obtained direct estimates by relying on probability sampling nationwide. EBSHP relied on projection of localized prevalence estimates to the national population. The sampling techniques of ADAMS and EBSHP were rather similar, whereas their disease definitions were not. By contrast, EBSPH and CHAP have similar disease definitions internally, but use different calculation techniques, and yet arrive at similar prevalence estimates, which are considerably greater than those obtained by either Brookmeyer or ADAMS. Choice of disease definition may play the larger role in explaining differences in observed prevalence between these studies.

}, keywords = {Age Factors, Alzheimer disease, Community Health Planning, Data collection, Humans, Incidence, Models, Statistical, Prevalence, Sampling Studies, United States}, issn = {1552-5279}, doi = {10.1016/j.jalz.2010.11.007}, author = {Brookmeyer, Ron and Denis A Evans and Liesi Hebert and Kenneth M. Langa and Steven G Heeringa and Brenda L Plassman and Walter Kukull} } @article {8939, title = {Older adults who persistently present to the emergency department with severe, non-severe, and indeterminate episode patterns.}, journal = {BMC Geriatrrics}, volume = {11}, year = {2011}, pages = {65}, abstract = {

BACKGROUND: It is well known that older adults figure prominently in the use of emergency departments (ED) across the United States. Previous research has differentiated ED visits by levels of clinical severity and found health status and other individual characteristics distinguished severe from non-severe visits. In this research, we classified older adults into population groups that persistently present with severe, non-severe, or indeterminate patterns of ED episodes. We then contrasted the three groups using a comprehensive set of covariates.

METHODS: Using a unique dataset linking individual characteristics with Medicare claims for calendar years 1991-2007, we identified patterns of ED use among the large, nationally representative AHEAD sample consisting of 5,510 older adults. We then classified one group of older adults who persistently presented to the ED with clinically severe episodes and another group who persistently presented to the ED with non-severe episodes. These two groups were contrasted using logistic regression, and then contrasted against a third group with a persistent pattern of ED episodes with indeterminate levels of severity using multinomial logistic regression. Variable selection was based on Andersen{\textquoteright}s behavioral model of health services use and featured clinical status, demographic and socioeconomic characteristics, health behaviors, health service use patterns, local health care supply, and other contextual effects.

RESULTS: We identified 948 individuals (17.2\% of the entire sample) who presented a pattern in which their ED episodes were typically defined as severe and 1,076 individuals (19.5\%) who typically presented with non-severe episodes. Individuals who persistently presented to the ED with severe episodes were more likely to be older (AOR 1.52), men (AOR 1.28), current smokers (AOR 1.60), experience diabetes (AOR (AOR 1.80), heart disease (AOR 1.70), hypertension (AOR 1.32) and have a greater amount of morbidity (AOR 1.48) than those who persistently presented to the ED with non-severe episodes. When contrasted with 1,177 individuals with a persistent pattern of indeterminate severity ED use, persons with severe patterns were older (AOR 1.36), more likely to be obese (AOR 1.36), and experience heart disease (AOR 1.49) and hypertension (AOR 1.36) while persons with non-severe patterns were less likely to smoke (AOR 0.63) and have diabetes (AOR 0.67) or lung disease (AOR 0.58).

CONCLUSIONS: We distinguished three large, readily identifiable groups of older adults which figure prominently in the use of EDs across the United States. Our results suggest that one group affects the general capacity of the ED to provide care as they persistently present with severe episodes requiring urgent staff attention and greater resource allocation. Another group persistently presents with non-severe episodes and creates a considerable share of the excess demand for ED care. Future research should determine how chronic disease management programs and varied co-payment obligations might impact the use of the ED by these two large and distinct groups of older adults with consistent ED use patterns.

}, keywords = {Emergency services, Health Shocks, Medicare/Medicaid/Health Insurance, Older Adults}, issn = {1471-2318}, doi = {10.1186/1471-2318-11-65}, author = {Kaskie, Brian and Maksym Obrizan and Michael P Jones and Suzanne E Bentler and Paula A Weigel and Jason Hockenberry and Robert B Wallace and Robert L. Ohsfeldt and Gary E Rosenthal and Frederic D Wolinsky} } @article {7580, title = {A prospective cohort study of long-term cognitive changes in older Medicare beneficiaries.}, journal = {BMC Public Health}, volume = {11}, year = {2011}, month = {2011 Sep 20}, pages = {710}, publisher = {11}, abstract = {

BACKGROUND: Promoting cognitive health and preventing its decline are longstanding public health goals, but long-term changes in cognitive function are not well-documented. Therefore, we first examined long-term changes in cognitive function among older Medicare beneficiaries in the Survey on Assets and Health Dynamics among the Oldest Old (AHEAD), and then we identified the risk factors associated with those changes in cognitive function.

METHODS: We conducted a secondary analysis of a prospective, population-based cohort using baseline (1993-1994) interview data linked to 1993-2007 Medicare claims to examine cognitive function at the final follow-up interview which occurred between 1995-1996 and 2006-2007. Besides traditional risk factors (i.e., aging, age, race, and education) and adjustment for baseline cognitive function, we considered the reason for censoring (entrance into managed care or death), and post-baseline continuity of care and major health shocks (hospital episodes). Residual change score multiple linear regression analysis was used to predict cognitive function at the final follow-up using data from telephone interviews among 3,021 to 4,251 (sample size varied by cognitive outcome) baseline community-dwelling self-respondents that were >= 70 years old, not in managed Medicare, and had at least one follow-up interview as self-respondents. Cognitive function was assessed using the 7-item Telephone Interview for Cognitive Status (TICS-7; general mental status), and the 10-item immediate and delayed (episodic memory) word recall tests.

RESULTS: Mean changes in the number of correct responses on the TICS-7, and 10-item immediate and delayed word recall tests were -0.33, -0.75, and -0.78, with 43.6\%, 54.9\%, and 52.3\% declining and 25.4\%, 20.8\%, and 22.9\% unchanged. The main and most consistent risks for declining cognitive function were the baseline values of cognitive function (reflecting substantial regression to the mean), aging (a strong linear pattern of increased decline associated with greater aging, but with diminishing marginal returns), older age at baseline, dying before the end of the study period, lower education, and minority status.

CONCLUSIONS: In addition to aging, age, minority status, and low education, substantial and differential risks for cognitive change were associated with sooner vs. later subsequent death that help to clarify the terminal drop hypothesis. No readily modifiable protective factors were identified.

}, keywords = {Aged, Aged, 80 and over, Aging, Cognition, Cognition Disorders, Cohort Studies, Female, Humans, Interviews as Topic, Male, Medicare, Mental Health, Outcome Assessment, Health Care, Prospective Studies, Regression Analysis, Risk Factors, United States}, issn = {1471-2458}, doi = {10.1186/1471-2458-11-710}, author = {Frederic D Wolinsky and Suzanne E Bentler and Jason Hockenberry and Michael P Jones and Paula A Weigel and Kaskie, Brian and Robert B Wallace} } @article {7637, title = {Recent trends in chronic disease, impairment and disability among older adults in the United States.}, journal = {BMC Geriatr}, volume = {11}, year = {2011}, note = {Hung, William W Ross, Joseph S Boockvar, Kenneth S Siu, Albert L K08 AG032886/AG/NIA NIH HHS/United States U01AG009740/AG/NIA NIH HHS/United States Comparative Study Research Support, N.I.H., Extramural Research Support, Non-U.S. Gov{\textquoteright}t England BMC geriatrics BMC Geriatr. 2011 Aug 18;11:47.}, month = {2011 Aug 18}, pages = {47}, publisher = {11}, abstract = {

BACKGROUND: To examine concurrent prevalence trends of chronic disease, impairment and disability among older adults.

METHODS: We analyzed the 1998, 2004 and 2008 waves of the Health and Retirement Study, a nationally representative survey of older adults in the United States, and included 31,568 community dwelling adults aged 65 and over. Measurements include: prevalence of chronic diseases including hypertension, heart disease, stroke, diabetes, cancer, chronic lung disease and arthritis; prevalence of impairments, including impairments of cognition, vision, hearing, mobility, and urinary incontinence; prevalence of disability, including activities of daily living (ADLs) and instrumental activities of daily living (IADLs).

RESULTS: The proportion of older adults reporting no chronic disease decreased from 13.1\% (95\% Confidence Interval [CI], 12.4\%-13.8\%) in 1998 to 7.8\% (95\% CI, 7.2\%-8.4\%) in 2008, whereas the proportion reporting 1 or more chronic diseases increased from 86.9\% (95\% CI, 86.2\%-89.6\%) in 1998 to 92.2\% (95\% CI, 91.6\%-92.8\%) in 2008. In addition, the proportion reporting 4 or more diseases increased from 11.7\% (95\% CI, 11.0\%-12.4\%) in 1998 to 17.4\% (95\% CI, 16.6\%-18.2\%) in 2008. The proportion of older adults reporting no impairments was 47.3\% (95\% CI, 46.3\%-48.4\%) in 1998 and 44.4\% (95\% CI, 43.3\%-45.5\%) in 2008, whereas the proportion of respondents reporting 3 or more was 7.2\% (95\% CI, 6.7\%-7.7\%) in 1998 and 7.3\% (95\% CI, 6.8\%-7.9\%) in 2008. The proportion of older adults reporting any ADL or IADL disability was 26.3\% (95\% CI, 25.4\%-27.2\%) in 1998 and 25.4\% (95\% CI, 24.5\%-26.3\%) in 2008.

CONCLUSIONS: Multiple chronic disease is increasingly prevalent among older U.S. adults, whereas the prevalence of impairment and disability, while substantial, remain stable.

}, keywords = {Activities of Daily Living, Aged, Aged, 80 and over, Chronic disease, Disabled Persons, Female, Health Surveys, Humans, Longitudinal Studies, Male, United States, Visually Impaired Persons}, issn = {1471-2318}, doi = {10.1186/1471-2318-11-47}, author = {William W. Hung and Joseph S. Ross and Boockvar, Kenneth S and Albert L Siu} } @mastersthesis {6327, title = {The roles of self and society in the relationship between physical health, self-perception of aging, and depressive symptoms in later life}, volume = {Ph.D.}, year = {2011}, school = {The Ohio State University}, address = {Columbus, OH}, abstract = {Possibilities for increased morbidity in physical health in later life have been continuously discussed as important factors that can affect psychological well-being of older people. In addition, perceived emotional support has been widely examined as a protective source against depressive symptoms in later life. However, potential roles of self-perception of aging (one{\textquoteright}s own age stereotypes) that might be related to physical health, perceived emotional support, and depressive symptoms have been rarely studied. Furthermore, although there has been considerable interest in examining influence of self-perception of aging on physical and cognitive functioning of older individuals, the influence of self-perception of aging on mental health has not been widely studied. Since cognition can influence behavior and emotion, self-perception of aging can be an important cognitive predisposition of depressive symptoms of older individuals. Stereotype embodiment theory and the buffer theory of social support have suggested that age stereotypes and perceived emotional support can affect the construction of self-perception of aging in later life. However, little research has explored in an integrated manner about how self-perception of aging is related to both a discouraging societal impact on the self as constructing age schema and a protective role of the self through perceived emotional support in the aging process. In order to address the gaps in the literature, the current study aimed to achieve three goals: (1) to examine the mediating effect of self-perception of aging between physical health and depressive symptoms; (2) to test the moderating effect of age schema on the relationship between physical health and self-perception of aging; and (3) to estimate the moderating effect of perceived emotional support on the relationship between physical health and self-perception of aging. Physical health status was hypothesized to have an impact on depressive symptoms and to be mediated through self-perception of aging. Older individuals having age schema were expected to have more negative self-perception of aging than those without age schema under similar physical health conditions. Also, perceived emotional support was expected to moderate the relationship between physical health status and self-perception of aging. The study used a sample of 1240 community-dwelling older individuals aged 50 and over who participated in the leave-behind surveys from the 2004 and 2008 surveys of the Health and Retirement Study. Data were analyzed using Structural Equation Modeling. The results provided strong evidence for the mediating effect of self-perception of aging in the relationship between physical health and depressive symptoms. To a lesser extent, the moderating effect of age schema was supported; older individuals who had age schema were more likely to report negative self-perception of aging four years later than older individuals without age schema under the same physical health conditions. Although there was a significant main effect of perceived emotional support on self-perception of aging, no evidence was found for the interaction effect of perceived emotional support with physical health in predicting self-perception of aging. Study limitations and implications for future research and practice were discussed.}, keywords = {Health Conditions and Status, Healthcare}, url = {http://rave.ohiolink.edu/etdc/view?acc_num=osu1306851809}, author = {Jina Han} } @article {9043, title = {Sample Sizes and Response Rates }, year = {2011}, month = {Spring 2011}, institution = {Survey Research Center, Institute for Social Research, University of Michigan}, address = {Ann Arbor, MI}, author = {HRS Staff} } @article {7666, title = {Socioeconomic inequalities in old-age mortality: a comparison of Denmark and the USA.}, journal = {Soc Sci Med}, volume = {72}, year = {2011}, month = {2011 Jun}, pages = {1986-92}, publisher = {72}, abstract = {

Previous studies have reported important variations in the magnitude of health inequalities between countries that belong to different welfare systems. This suggests that there is scope for reducing health inequalities by means of country-level interventions. The present study adds to this literature by exploring whether the magnitude of socioeconomic inequalities in mortality is associated with social inequality levels. Denmark and the USA belong to fundamentally different welfare systems (social democratic and liberal) and our study thereby contributes to the ongoing debate on whether welfare systems are linked to health inequalities. We analyze Denmark and the USA in terms of socioeconomic differences in mortality above age 58. The data sources were Danish register data from 1980 to 2002 (n = 2,029,324), and survey data from the US Health and Retirement Study (HRS) from 1992 to 2006 (n = 9374). Survival analysis was used to study the impact of socioeconomic status on mortality and the magnitude of mortality differences between the two countries was compared. The results showed surprisingly that mortality differentials were larger in Denmark than in the USA even after controlling for a number of covariates: The poorest 10 percent of the Danish elderly population have a mortality rate ratio of 3.32 (men) and 3.70 (women) compared to the richest 25 percent. In the USA the corresponding rate ratios are 1.67 and 1.56. Low income seems to be a more powerful risk factor for mortality than low education. A number of possible explanations for higher mortality differences in Denmark are discussed: unintended positive correlation between generous health services and health inequality, early life influences, mortality selection, and relative deprivation.

}, keywords = {Aged, Aged, 80 and over, Analysis of Variance, Cross-Cultural Comparison, Denmark, Educational Status, Female, Health Expenditures, Humans, Income, Life Expectancy, Male, Middle Aged, Mortality, Political Systems, Social Class, Social Welfare, United States}, issn = {1873-5347}, doi = {10.1016/j.socscimed.2011.04.019}, author = {Rasmus Hoffmann} } @article {7565, title = {Sources of variability in estimates of the prevalence of Alzheimer{\textquoteright}s disease in the United States.}, journal = {Alzheimers Dement}, volume = {7}, year = {2011}, month = {2011 Jan}, pages = {74-9}, publisher = {7}, abstract = {

BACKGROUND: The prevalence of Alzheimer{\textquoteright}s disease (AD) in the United States was estimated at 2.3 million in 2002 by the Aging, Demographics, and Memory Study (ADAMS), which is almost 50\% less than the estimate of 4.5 million in 2000 derived from the Chicago Health and Aging Project.

METHODS: We considered how differences in diagnostic criteria may have contributed to these differences in AD prevalence.

RESULTS: We identified several important differences in diagnostic criteria that may have contributed to the differing estimates of AD prevalence. Two factors were especially noteworthy. First, the Diagnostic and Statistical Manual of Mental Disorders III-R and IV criteria of functional limitation documented by an informant used in ADAMS effectively concentrated the diagnosis of dementia toward a relatively higher level of cognitive impairment. ADAMS separately identified a category of cognitive impairment not dementia and within that group there were a substantial number of cases with "prodromal" AD (a maximum of 1.95 million with upweighting). Second, a substantial proportion of dementia in ADAMS was attributed to either vascular disease (representing a maximum of 0.59 million with upweighting) or undetermined etiology (a maximum of 0.34 million), whereas most dementia, including mixed dementia, was attributed to AD in the Chicago Health and Aging Project.

CONCLUSION: The diagnosis of AD in population studies is a complex process. When a diagnosis of AD excludes persons meeting criteria for vascular dementia, when not all persons with dementia are assigned an etiology, and when a diagnosis of dementia requires an informant report of functional limitations, the prevalence is substantially lower and the diagnosed cases most likely have a relatively higher level of impairment.

}, keywords = {Aged, Aged, 80 and over, Alzheimer disease, Community Health Planning, Comorbidity, Dementia, Diagnosis, Differential, Female, Humans, Incidence, Male, Prevalence, United States}, issn = {1552-5279}, doi = {10.1016/j.jalz.2010.11.006}, author = {Robert S Wilson and David R Weir and Sue E Leurgans and Denis A Evans and Liesi Hebert and Kenneth M. Langa and Brenda L Plassman and Brent J. Small and David A Bennett} } @article {7672, title = {Spousal associations between functional limitation and depressive symptom trajectories: Longitudinal findings from the study of Asset and Health Dynamics Among the Oldest Old (AHEAD).}, journal = {Health Psychol}, volume = {30}, year = {2011}, note = {Hoppmann, Christiane A Gerstorf, Denis Hibbert, Anita U01 AG009740-12/AG/NIA NIH HHS/United States U01AG009740/AG/NIA NIH HHS/United States Research Support, N.I.H., Extramural Research Support, Non-U.S. Gov{\textquoteright}t United States Nihms256806 Health Psychol. 2011 Mar;30(2):153-62.}, month = {2011 Mar}, pages = {153-62}, publisher = {30}, abstract = {

OBJECTIVE: To examine spousal associations between functional limitation and depressive symptom trajectories in a national sample of older long-term married couples.

DESIGN: We used 14.5-year longitudinal data on functional limitations and depressive symptoms from 1,704 couples participating in the Study of Asset and Health Dynamics Among the Oldest Old (AHEAD).

MAIN OUTCOME MEASURES: Activities of daily living and a short version of the Center for Epidemiologic Studies Depression scale were used.

RESULTS: Between-person difference findings corroborate previous research by showing that levels and changes in functional limitations and depressive symptoms are closely interrelated among wives and husbands. Our results further demonstrate sizable associations in levels and changes in functional limitations and depressive symptoms between spouses. For example, functional limitation levels in one spouse were associated with depressive symptom levels in the other spouse. Spousal associations remained after controlling for individual (age, education, cognition) and spousal covariates (marriage duration, number of children) and did not differ between women and men.

CONCLUSION: Our findings highlight the important role of marital relationships in shaping health trajectories in old age because they show that some of the well-documented between-person differences in functional limitations and depressive symptoms are in fact related to spouses.

}, keywords = {Activities of Daily Living, Aged, Aged, 80 and over, Aging, depression, Female, Humans, Longitudinal Studies, Male, Psychometrics, Spouses, United States}, issn = {1930-7810}, doi = {10.1037/a0022094}, author = {Christiane A Hoppmann and Denis Gerstorf and Anita Hibbert} } @article {7559, title = {STOCK MARKET CRASH AND EXPECTATIONS OF AMERICAN HOUSEHOLDS.}, journal = {J Appl Econ}, volume = {26}, year = {2011}, month = {2011}, pages = {393-415}, publisher = {26}, abstract = {

This paper utilizes data on subjective probabilities to study the impact of the stock market crash of 2008 on households{\textquoteright} expectations about the returns on the stock market index. We use data from the Health and Retirement Study that was fielded in February 2008 through February 2009. The effect of the crash is identified from the date of the interview, which is shown to be exogenous to previous stock market expectations. We estimate the effect of the crash on the population average of expected returns, the population average of the uncertainty about returns (subjective standard deviation), and the cross-sectional heterogeneity in expected returns (disagreement). We show estimates from simple reduced-form regressions on probability answers as well as from a more structural model that focuses on the parameters of interest and separates survey noise from relevant heterogeneity. We find a temporary increase in the population average of expectations and uncertainty right after the crash. The effect on cross-sectional heterogeneity is more significant and longer lasting, which implies substantial long-term increase in disagreement. The increase in disagreement is larger among the stockholders, the more informed, and those with higher cognitive capacity, and disagreement co-moves with trading volume and volatility in the market.

}, issn = {1514-0326}, doi = {10.1002/jae.1226}, author = {P{\'e}ter Hudomiet and Kezdi, Gabor and Robert J. Willis} } @article {8652, title = {Trends in Labor Force Participation: How Much is Due to Changes in Pensions?}, journal = {Journal of Population Ageing}, volume = {4}, year = {2011}, pages = {81-96}, abstract = {

In the United States, beginning in the late 1980s there was a substantial increase in the labor force participation of men and women in their 60s. Over the same time period the type of pension plans offered by employers shifted strongly from defined benefit plans to defined contribution plans. Defined benefit plans typically have optimal retirement ages embedded in their structure which induce early retirement, whereas defined contribution plans do not favor any particular retirement age. Based on panel data, this paper quantifies the increase in participation due to the change in pension structure. The main result is that the pension changes account for a considerable part of the increase, but other factors also made a contribution.

}, keywords = {Pension plantype, Retirement, Subjective probabilities}, issn = {1874-7884}, doi = {10.1007/s12062-011-9042-8}, author = {Michael D Hurd and Susann Rohwedder} } @article {7567, title = {Trends in the incidence and prevalence of Alzheimer{\textquoteright}s disease, dementia, and cognitive impairment in the United States.}, journal = {Alzheimers Dement}, volume = {7}, year = {2011}, month = {2011 Jan}, pages = {80-93}, publisher = {7}, abstract = {

Declines in heart disease and stroke mortality rates are conventionally attributed to reductions in cigarette smoking, recognition and treatment of hypertension and diabetes, effective medications to improve serum lipid levels and to reduce clot formation, and general lifestyle improvements. Recent evidence implicates these and other cerebrovascular factors in the development of a substantial proportion of dementia cases. Analyses were undertaken to determine whether corresponding declines in age-specific prevalence and incidence rates for dementia and cognitive impairment have occurred in recent years. Data spanning 1 or 2 decades were examined from community-based epidemiological studies in Minnesota, Illinois, and Indiana, and from the Health and Retirement Study, which is a national survey. Although some decline was observed in the Minnesota cohort, no statistically significant trends were apparent in the community studies. A significant reduction in cognitive impairment measured by neuropsychological testing was identified in the national survey. Cautious optimism appears justified.

}, keywords = {Age Factors, Alzheimer disease, Cognition Disorders, Cohort Studies, Community Health Planning, Dementia, Humans, Incidence, Prevalence, Residence Characteristics, Retrospective Studies, Time Factors, United States}, issn = {1552-5279}, doi = {10.1016/j.jalz.2010.11.002}, author = {Walter A Rocca and Ronald C Petersen and David S Knopman and Liesi Hebert and Denis A Evans and Kathleen S Hall and Gao, Sujuan and Frederick W Unverzagt and Kenneth M. Langa and Eric B Larson and Lon R White} } @article {7585, title = {Utilization of blood transfusion among older adults in the United States.}, journal = {Transfusion}, volume = {51}, year = {2011}, month = {2011 Apr}, pages = {710-8}, publisher = {51}, abstract = {

BACKGROUND: While there have been epidemiologic studies of blood donors, the characteristics of individuals who receive transfusions have not been well described for the US population.

STUDY DESIGN AND METHODS: Subjects were from the nationally representative Health and Retirement Study whose data were linked to Medicare files from 1991 through 2007 (n = 16,377). A cohort study was conducted to assess the frequency of transfusion in older Americans over time and to describe the characteristics of blood recipients.

RESULTS: Thirty-one percent (95\% confidence interval [CI], 30\%-33\%) of older Americans received at least one transfusion within a 10-year period and 5.8\% (95\% CI, 5.4\%-6.2\%) experienced repeated transfusion-related visits within 30 days. The mean number of transfusion-related visits was 2.3 over a 10-year period (95\% CI, 2.2-2.4). Older Americans who lived in the South were most likely to receive a transfusion (34\%), independent of demographic and health-related factors, while those who lived in the western United States were the least likely (26\%). Predictors of transfusion included smoking, low body mass index, and a history of cancer, diabetes mellitus, end-stage renal disease, and heart disease. African-Americans and Mexican-Americans had greater rates of blood utilization than other races and other Hispanics (respectively). There were also differences in transfusion utilization by education, marital status, religion, and alcohol use.

CONCLUSIONS: Transfusion is common in older Americans. Regional variations in blood use are not explained by patient characteristics alone.

}, keywords = {Age Distribution, Aged, Aged, 80 and over, Black or African American, Blood Transfusion, Female, Humans, Male, United States, White People}, issn = {1537-2995}, doi = {10.1111/j.1537-2995.2010.02937.x}, author = {Mary A M Rogers and Neil Blumberg and Heal, Joanna M and Kenneth M. Langa} } @article {7595, title = {Why Do Families Differ? Children{\textquoteright}s Care for an Unmarried Mother.}, journal = {J Marriage Fam}, volume = {73}, year = {2011}, month = {2011 Apr}, pages = {383-395}, publisher = {73}, abstract = {

An adult child{\textquoteright}s provision of care to an unmarried elderly mother varies both within and between families. Within-family differences address the variation in different children{\textquoteright}s behavior within in a family. Between-family differences refer to the propensities that members of a family-the children of one mother-share and that differentiate them from other families. Previous research suggests five hypotheses affecting either within-family or between-family differences. Data from multiple waves of the Asset and Health Dynamics Among the Oldest Old (AHEAD) cohort of the Health and Retirement Study (HRS; 16,719 observations on 5,607 mother-child dyads in 1,925 families) are used to estimate a multilevel model with a binary outcome. Results indicate substantial differences between families. Mother{\textquoteright}s characteristics, family composition, and family history account for about half the between-family differences.

}, issn = {0022-2445}, doi = {10.1111/j.1741-3737.2010.00813.x}, author = {John C Henretta and Beth J Soldo and Matthew F. Van Voorhis} } @article {7521, title = {Alcohol use trajectories in two cohorts of U.S. women aged 50 to 65 at baseline.}, journal = {J Am Geriatr Soc}, volume = {58}, year = {2010}, month = {2010 Dec}, pages = {2375-80}, publisher = {58}, abstract = {

OBJECTIVES: To examine drinking trajectories followed by two cohorts of older women over 8 to 10 years of follow-up.

DESIGN: Longitudinal analyses of two nationally representative cohorts using semiparametric group-based models weighted and adjusted for baseline age.

SETTING: Study data were obtained from detailed interviews conducted in the home or by telephone.

PARTICIPANTS: One cohort included 5,231 women in the Health and Retirement Study (HRS) aged 50 to 65 in 1996; the other included 1,658 women in the National Longitudinal Survey (NLS) aged 50 to 65 in 1995.

MEASUREMENTS: Both cohorts reported any recent drinking and average number of drinks per drinking day using similar but not identical questions. HRS women completed six interviews (one every other year) from 1996 to 2006. NLS women completed five interviews from 1995 to 2003.

RESULTS: All trajectory models yielded similar results. For HRS women, four trajectory groups were observed in the model based on drinks per day: increasing drinkers (4.9\% of cohort), infrequent and nondrinkers (61.8\%), consistent drinkers (25.9\%), and decreasing drinkers (7.4\%). Corresponding NLS values from the drinks per day model were 8.8\%, 61.4\%, 21.2\%, and 8.6\%, respectively. In 2006, the average number of drinks per day for HRS women in the increasing drinker and consistent drinker trajectories was 1.31 and 1.59, respectively. In 2003, these values for NLS women were 0.99 and 1.38, respectively.

CONCLUSION: Most women do not markedly change their drinking behavior after age 50, but some increase their alcohol use substantially, whereas others continue to exceed current recommendations. These findings underscore the importance of periodically asking older women about their drinking to assess, advise, and assist those who may be at risk for developing alcohol-related problems.

}, keywords = {Aged, Aging, Alcohol Drinking, Alcoholism, Cohort Studies, Female, Follow-Up Studies, Humans, Life Change Events, Middle Aged, Retirement, Risk Factors, Surveys and Questionnaires, United States}, issn = {1532-5415}, doi = {10.1111/j.1532-5415.2010.03180.x}, author = {Janet Kay Bobo and April A Greek and Daniel H. Klepinger and Jerald R Herting} } @article {5833, title = {The Effect of the Risk of Out-of-Pocket Spending for Health Care on Economic Preparation for Retirement}, year = {2010}, institution = {The University of Michigan, Michigan Retirement Research Center}, abstract = {After retirement, the primary sources of uncertainty with respect to an individual s economic status are longevity, investment outcomes and out-of-pocket spending on health care. In previous work, we estimated economic preparation for retirement, taking into account the risk of living to an advanced old age and the concomitant risk of running out of resources. But while we accounted for the average level out-of-pocket spending for health care, we did not account for the risk of out-of-pocket spending. In this paper we augment our model for this omission. We find that the risk of out-of-pocket health care spending reduces economic preparation for retirement from about 72 of persons in the age range 65-69 to about 63 . However, this relatively modest reduction is quite unequally distributed: about 57 of single persons are adequately prepared when health care spending is not stochastic, but just 44 when it is. Among single women who are not high school graduates the percentage adequately prepared declines from 33 to 15 .}, keywords = {Demographics, Healthcare, Retirement Planning and Satisfaction}, url = {http://ideas.repec.org/p/mrr/papers/wp232.html}, author = {Michael D Hurd and Susann Rohwedder} } @mastersthesis {6347, title = {The effects of disability on employment patterns among older workers}, volume = {Ph.D.}, year = {2010}, note = {ISBN: 9781124338187}, month = {2010}, pages = {135}, school = {Michigan State University}, type = {Dissertation}, address = {East Lansing, Michigan}, abstract = {Given the substantial number of individuals with disabilities and the sheer rapid growth of U.S. aging population, research on labor transition among older people with disability is vital for improving quality of life for society in general, as well as people with disabilities. Nonetheless, there has been a lack of research on labor transition and older individuals with disabilities in the literature. To reduce and further eliminate labor transition among older people with disabilities, as well as to provide effective interventions and policies for eliminating, it is imperative to investigate the existence of labor transition of older workers and elucidate mechanisms in which labor transition occur. The purpose of this study was to investigate the prevalence of late onset disability among older workers, the consequences for their acquired disability on employment patterns, and the determining factors affecting later-life employment transitions. Given a lack of research employing a national data set for employment and older workers with disabilities, this study examined older people aged 50 and over and used the object measures for define a disability. This study was tested chi-square, ANOVA test, binary and multinomial logistic regression. As an ex post facto design, this study employed the Health and Retirement Study data. Of the total 10,890 age-eligible (age over 50) full time workers who reported thoroughly free of disability (healthy) at the time of baseline interview, the final sampling consisted of 1,096 older workers reported functional or mental disability two years later. 506 male (46.2\%) and 590 female (53.8\%) reported that they are experiencing disabilities. It is about 10.1\% prevalence of an acquired disability among full time older workers. Surprisingly, the prevalence of mental disability was 7.3\% and the prevalence of functional disability was 2.7\% among older labor force participation. Findings for descriptive results show that about 62.4\% workers still kept their full time job even though older workers experienced some types of disabilities. Older workers at older ages were much more likely to change their job to a par-time or quit their job than younger workers. Older workers with mental disability consistently have a better chance of being employed and sustaining their full time job than older workers with functional disability. The findings also confirm that older workers with high levels of education, those who are white, those are female and those in white collar occupations seem to more likely continue their full time job Chi-square tests, independent t-test, and ANOVA found that significant differences existed in age, the level of education, type of disability, self employed status, current occupation, industry, and financial factors (earnings, household net assets, and Social Security Retirement Income) between older individuals who kept their job and who quit their full time job. The binary logistic regression and multinomial logistic results support that gender, high level of education, mental disability, self employed status, white collar occupation and white collar related industry, and not depending on social security retirement pension were independently associated with employed older workers. Implications for rehabilitation counselor practice, education and future research are discussed.}, keywords = {Disabilities, Employment and Labor Force, Health Conditions and Status, Healthcare, Retirement Planning and Satisfaction}, author = {Hwang, Ju Hee} } @article {7488, title = {The effects of positive and negative support from children on widowed older adults{\textquoteright} psychological adjustment: a longitudinal analysis.}, journal = {Gerontologist}, volume = {50}, year = {2010}, note = {Using Smart Source Parsing pp. Aug Gerontological Society of America, Washington DC}, month = {2010 Aug}, pages = {471-81}, publisher = {50}, abstract = {

PURPOSE: This article examines the extent to which positive and negative support from children prior to and after spousal loss and changes in support from pre- to post-loss affect widowed older adults{\textquoteright} depressive symptoms, anxiety, and anger 18 months following widowhood.

DESIGN AND METHODS: Analyses are based on the Changing Lives of Older Couples, a prospective study of 1,532 married individuals aged 65 years and older. The analytic sample includes 148 widowed persons who have at least one living child and participated in the baseline and two follow-up interviews conducted 6 and 18 months following widowhood.

RESULTS: The analyses revealed that higher levels of positive support from children 6 months following widowhood were associated with fewer depressive symptoms at the 18-month follow-up, whereas higher levels of negative support 18 months after loss and a decrease in positive support following loss were associated with more depressive symptoms. Greater negative support both prior to and after loss was associated with greater anxiety, whereas greater negative support 6 months after loss and an increase in negative support following loss were related to greater anger.

IMPLICATIONS: Given their differential impact on widowed persons{\textquoteright} psychological adjustment, both positive and negative aspects of social support as well as its changing nature should be considered in working with bereaved older adults.

}, keywords = {Adaptation, Psychological, Aged, Aged, 80 and over, Female, Humans, Longitudinal Studies, Male, Middle Aged, Parent-Child Relations, Widowhood}, issn = {1758-5341}, doi = {10.1093/geront/gnp163}, author = {Jung-Hwa Ha} } @article {5805, title = {The Effects of the Economic Crisis on the Older Population}, number = {WP 2010-231}, year = {2010}, institution = {The University of Michigan}, address = {Ann Arbor, MI}, abstract = {We study the effects of the 2007-2009 recession on the population age 55 and older. Households in and near retirement have suffered sizeable losses in assets as a result of the economic crisis. There are a number of ways in which households might respond: reduce spending and with that increase saving, work longer, and/or bequeath less. Using longitudinal data from the Health and Retirement Study and its supplemental surveys, we find that all of these adjustments have been important.}, keywords = {Employment and Labor Force, Public Policy, Retirement Planning and Satisfaction}, url = {https://deepblue.lib.umich.edu/bitstream/handle/2027.42/78348/wp231.pdf?sequence=1}, author = {Michael D Hurd and Susann Rohwedder} } @mastersthesis {6346, title = {Evaluating social factors in diabetes management by Mexican American ethnicity}, volume = {M.S.}, year = {2010}, note = {ISBN 9781124582528}, pages = {49}, school = {University of North Texas}, abstract = {Differences in Mexican American ethnicity, family and friend social support, and importance of diabetes self-management as related to diabetes management in the older adult population were evaluated with the University of Michigan Health and Retirement Study (HRS) 2003 Diabetes Study. Comparisons were made between Mexican Americans with Type II diabetes and similar non-Hispanic Caucasian and African American individuals with Type II diabetes. Neither family/friend social support nor importance of diabetes self-management were significant predictors of HbA1c levels. Results did not support the idea that perception of receiving support from family/friends or placing importance on diabetes self-management covaried with lower HbAlc level (family/friend: beta = -.13, t = -1.47, p = .143; self management: beta = .08, t = .55, p = .584).}, keywords = {Demographics, Health Conditions and Status, Healthcare, Public Policy}, author = {Huerta, Serina} } @article {7476, title = {Factors influencing cost-related nonadherence to medication in older adults: a conceptually based approach.}, journal = {Value Health}, volume = {13}, year = {2010}, month = {2010 Jun-Jul}, pages = {338-45}, publisher = {13}, abstract = {

OBJECTIVE: Although multiple noncost factors likely influence a patient{\textquoteright}s propensity to forego treatment in the face of cost pressures, little is known about how patients{\textquoteright} sociodemographic characteristics, physical and behavioral health comorbidities, and prescription regimens influence cost-related nonadherence (CRN) to medications. We sought to determine both financial and nonfinancial factors associated with CRN in a nationally representative sample of older adults.

METHODS: We used a conceptual model developed by Piette and colleagues that describes financial and nonfinancial factors that could increase someone{\textquoteright}s risk of CRN, including income, comorbidities, and medication regimen complexity. We used data from the 2004 wave of the Health and Retirement Study and the 2005 HRS Prescription Drug Study to examine the influence of factors within each of these domains on measures of CRN (including not filling, stopping, or skipping doses) in a nationally representative sample of Americans age 65+ in 2005.

RESULTS: Of the 3071 respondents who met study criteria, 20\% reported some form of CRN in 2005. As in prior studies, indicators of financial stress such as higher out-of-pocket payments for medications and lower net worth were significantly associated with CRN in multivariable analyses. Controlling for these economic pressures, relatively younger respondents (ages 65-74) and depressive symptoms were consistent independent risk factors for CRN.

CONCLUSIONS: Noncost factors influenced patients{\textquoteright} propensity to forego treatment even in the context of cost concerns. Future research encompassing clinician and health system factors should identify additional determinants of CRN beyond patients{\textquoteright} cost pressures.

}, keywords = {Aged, Aged, 80 and over, Chronic disease, Female, Financing, Personal, Health Status, Humans, Logistic Models, Male, Medication Adherence, Models, Econometric, Multivariate Analysis, Prescription Fees, Risk Factors, Socioeconomic factors, United States}, issn = {1524-4733}, doi = {10.1111/j.1524-4733.2009.00679.x}, author = {Zivin, Kara and Scott M Ratliff and Michele M Heisler and Kenneth M. Langa and John D Piette} } @article {7477, title = {Functional declines, social support, and mental health in the elderly: does living in a state supportive of home and community-based services make a difference?}, journal = {Soc Sci Med}, volume = {70}, year = {2010}, month = {2010 Apr}, pages = {1050-8}, publisher = {70}, abstract = {

This study examines how acute and chronic stresses associated with functional declines in seniors and their spouses are moderated by their informal and formal support contexts. In the United States, states vary greatly in their support for home and community-based services (HCBS) for seniors with disabilities. This state-to-state variation allowed us to examine mental health effects of living in a society supportive of HCBS for the oldest old, who are at high risk for low or declining functions in daily activities and cognitive abilities. Using a ten-year panel study of a nationally representative sample of the oldest old (>or=70 years old) covering the period 1993-2002, we conducted mixed-effects logistic regression analysis to incorporate time-varying characteristics of persons and states. As expected, low and declining functions in daily living and cognition constituted significant stressors among seniors and their spouse. Results demonstrated the important role of informal support available from non-spouse family/friends in lowering depression. Living in a state supportive of HCBS was associated with lower depression among seniors experiencing consistently low levels of function or recent functional declines, especially among those without informal support. Our findings were consistent with moderating or buffering models of formal support, suggesting that state HCBS support is effective mainly under conditions of high levels of stressors. Political will is needed to prepare US society to collectively support community-based long-term needs, given the difficulty of preparing ourselves fully for common, but often unexpected, functional declines in later life.

}, keywords = {Activities of Daily Living, Aged, Cognition, Community Health Services, depression, Disabled Persons, Female, Home Care Services, Humans, Logistic Models, Male, Mental Health, Multilevel Analysis, Risk Factors, Social Support, Spouses, State Government, Stress, Psychological, United States}, issn = {1873-5347}, doi = {10.1016/j.socscimed.2009.12.005}, author = {Muramatsu, Naoko and yin, Hongjun and Hedeker, Donald} } @article {7489, title = {Health outcomes of Experience Corps: a high-commitment volunteer program.}, journal = {Soc Sci Med}, volume = {71}, year = {2010}, note = {Using Smart Source Parsing pp. Jul Elsevier Science, Amsterdam The Netherlands}, month = {2010 Jul}, pages = {414-420}, publisher = {71}, abstract = {

Experience Corps (EC) is a high-commitment US volunteer program that brings older adults into public elementary schools to improve academic achievement of students. It is viewed as a health promotion program for the older volunteers. We evaluated the effects of the EC program on older adults{\textquoteright} health, using a quasi-experimental design. We included volunteers from 17 EC sites across the US. They were pre-tested before beginning their volunteer work and post-tested after two years of service. We compared changes over time between the EC participants (n = 167) and a matched comparison group of people from the US Health and Retirement Study (2004, 2006). We developed the comparison group by using the nearest available Mahalanobis metric matching within calipers combined with the boosted propensity scores of those participating in the EC. We corrected for clustering effects via survey regression analyses with robust standard errors and calculated adjusted post-test means of health outcomes, controlling for all covariates and the boosted propensity score of EC participants. We found that compared to the comparison group, the EC group reported fewer depressive symptoms and functional limitations after two years of participation in the program, and there was a statistical trend toward the EC group reporting less decline in self-rated health. Results of this study add to the evidence supporting high-intensity volunteering as a social model of health promotion for older adults.

}, keywords = {Activities of Daily Living, Aged, Aged, 80 and over, depression, Female, Health Promotion, Health Status, Humans, Male, Middle Aged, Program Evaluation, Regression Analysis, Self Concept, Volunteers}, issn = {1873-5347}, doi = {10.1016/j.socscimed.2010.04.009}, author = {S I Hong and Morrow-Howell, Nancy} } @article {7450, title = {Hospitalizations and deaths among adults with cardiovascular disease who underuse medications because of cost: a longitudinal analysis.}, journal = {Med Care}, volume = {48}, year = {2010}, note = {Using Smart Source Parsing Feb Comment In: Med Care. 2010 Feb;48(2):85-6 20057326 Index Medicus}, month = {2010 Feb}, pages = {87-94}, publisher = {48}, abstract = {

CONTEXT: It is well-documented that the financial burden of out-of-pocket expenditures for prescription drugs often leads people with medication-sensitive chronic illnesses to restrict their use of these medications. Less is known about the extent to which such cost-related medication underuse is associated with increases in subsequent hospitalizations and deaths.

OBJECTIVE: We compared the risk of hospitalizations among 5401 and of death among 6135 middle-aged and elderly adults with one or more cardiovascular diseases (diabetes, coronary artery disease, heart failure, and history of stroke) according to whether participants did or did not report restricting prescription medications because of cost.

DESIGN AND SETTING: A retrospective biannual cohort study across 4 cross-sectional waves of the Health and Retirement Study, a nationally representative survey of adults older than age 50. Using multivariate logistic regression to adjust for baseline differences in sociodemographic and health characteristics, we assessed subsequent hospitalizations and deaths between 1998 and 2006 for respondents who reported that they had or had not taken less medicine than prescribed because of cost.

RESULTS: Respondents with cardiovascular disease who reported underusing medications due to cost were significantly more likely to be hospitalized in the next 2 years, even after adjusting for other patient characteristics (adjusted predicted probability of 47\% compared with 38\%, P < 0.001). The more survey waves respondents reported cost-related medication underuse during 1998 to 2004, the higher the probability of being hospitalized in 2006 (adjusted predicted probability of 54\% among respondents reporting cost-related medication underuse in all 4 survey waves compared with 42\% among respondents reporting no underuse, P < 0.001). There was no independent association of cost-related medication underuse with death.

CONCLUSIONS: In this nationally representative cohort, middle-aged and elderly adults with cardiovascular disease who reported cutting back on medication use because of cost were more likely to report being hospitalized over a subsequent 2-year period after they had reported medication underuse. The more extensively respondents reported cost-related underuse over time, the higher their adjusted predicted probability of subsequent hospitalization.

}, keywords = {Aged, Aged, 80 and over, Cardiovascular Diseases, Female, Financing, Personal, Health Care Costs, Health Services Accessibility, Health Status Disparities, Hospitalization, Humans, Logistic Models, Longitudinal Studies, Male, Medication Adherence, Middle Aged, Multivariate Analysis, Risk Factors, United States}, issn = {1537-1948}, doi = {10.1097/MLR.0b013e3181c12e53}, author = {Michele M Heisler and Choi, Hwajung and Allison B Rosen and Sandeep Vijan and Mohammed U Kabeto and Kenneth M. Langa and John D Piette} } @article {5822, title = {Informal Care and Formal Home Care Use in Europe and the United States}, year = {2010}, abstract = {The provision of informal care by adult children is an important form of long-term care for older individuals and can reduce the use of medical services if they are substitutes. We examine how informal care by all children and formal care interact, which is critically important given demographic trends and the many policies proposed to promote informal care. The purpose of this study is to compare the United States and European countries, by merging data from the U.S. Health and Retirement Study (HRS) with its European counterpart, the Survey of Health, Ageing and Retirement in Europe (SHARE). We argue that the institutional setting is different across the Atlantic, as European home care schemes are predominantly publicly run, whereas the market plays a bigger role in the United States. We use a fexible simultaneous equations approach that allows for a different relationship between informal and formal home care in the two regions, using couples. We find that in Europe it is predominantly the supply of formalhome care that influences decisions by children to provide informal care, while in the United States parents{\textquoteright} decisions to use formal home care are based on the amount of informal care received and the amount of informal care provided by children is dependent on the amount of formal care.}, keywords = {Adult children, Cross-National, Healthcare, SHARE}, url = {ftp://cemfi-server.cemfi.es/pdf/papers/wshop/Holly_seminar.pdf}, author = {Holly, Alberto and Lufkin, Thomas and Edward C Norton and Courtney Harold Van Houtven} } @mastersthesis {6338, title = {Joint retirement process of dual-worker couples: Expectations, experience, and depressive symptoms}, volume = {Doctor of Philosophy}, year = {2010}, school = {The University of Wisconsin - Madison}, address = {Madison, WI}, abstract = {With the continuous increase in women{\textquoteright}s labor force participation, women now comprise about half of the labor force and the majority of couples are dual-worker couples. As a consequence, a growing number of couples have two retirements to coordinate at the end of their careers. Joint retirement happens when both spouses retire within a relatively short period of time and about twenty to forty percent of dual-worker couples retire jointly. It reflects the changing context of retirement and labor force participation in later life and has implications for individual well-being, academic research, and social policy regarding retirement. In this dissertation, I explore the joint retirement process by focusing on three phases: preretirement expectations, subsequent experience, and postretirement depressive symptoms. I examine how these phases are interconnected and to what degree characteristics of husbands and wives influence joint retirement. I use seven waves of panel data from the Health and Retirement Study (1992-2004). I find that about one in four dual-worker couples expect to retire jointly. Couples with higher preferences for shared leisure and couples receiving fewer intrinsic rewards from work are more likely to expect joint retirement. I find consistency between joint retirement expectations and subsequent experience. Couples in which both spouses expected joint retirement are over four times more likely to retire jointly compared to couples in which neither spouse expected to do so. When spouses had discordant expectations, joint retirement experience reflects husbands{\textquoteright} and wives{\textquoteright} expectations equally. Among couples in which both spouses expected to retire jointly, those who discussed retirement often are more likely to realize their expectations. I also find that joint retirement per se is not significantly related to postretirement depressive symptoms. Rather, the associations are contingent on previous expectations. Unlike findings of previous studies on consistency between expectations and subsequent experience, individuals who expected joint retirement are more likely to have restless sleep when they realized their expectations and retire jointly, compared to when they did not retire jointly. I speculate that poor health status and unrealistic expectations regarding retirement life may be reasons for this negative link. I conclude with discussion of the implications of this dissertation for research on retirement, social policy, and retirement education.}, keywords = {Demographics, Employment and Labor Force, Expectations, Health Conditions and Status, Other, Retirement Planning and Satisfaction}, author = {Ho, Jeong-Hwa} } @article {7520, title = {Lifetime marital history and mortality after age 50.}, journal = {J Aging Health}, volume = {22}, year = {2010}, month = {2010 Dec}, pages = {1198-212}, publisher = {22}, abstract = {

OBJECTIVES: This article examines the relationship between lifetime marital history and mortality after age 50.

METHOD: Data are drawn from the Health and Retirement Study birth cohort of 1931 to 1941. The analysis utilizes three measures of marital history: number of marriages, proportion time married, and age at first marriage.

RESULTS: Three or more marriages and a lower proportion of adult life spent married are each associated with a higher hazard of dying after age 50 for both men and women even after controlling for current marital status and socioeconomic status. Smoking behavior accounts for part of the relationship of marital history and status with mortality.

DISCUSSION: Research on marital status and health should consider marital history as well as current status. Two topics are particularly important: examining the relationship in different cohorts and disentangling the potentially causal role of health behaviors such as smoking.

}, keywords = {Age Factors, Aging, Cohort Studies, Female, Health Status, Humans, Interpersonal Relations, Male, Marital Status, Middle Aged, Mortality, Multivariate Analysis, Proportional Hazards Models, Residence Characteristics, Risk Assessment, Risk-Taking, Smoking, Time Factors, United States}, issn = {1552-6887}, doi = {10.1177/0898264310374354}, author = {John C Henretta} } @article {7538, title = {Loneliness matters: a theoretical and empirical review of consequences and mechanisms.}, journal = {Ann Behav Med}, volume = {40}, year = {2010}, month = {2010 Oct}, pages = {218-27}, publisher = {40}, abstract = {

As a social species, humans rely on a safe, secure social surround to survive and thrive. Perceptions of social isolation, or loneliness, increase vigilance for threat and heighten feelings of vulnerability while also raising the desire to reconnect. Implicit hypervigilance for social threat alters psychological processes that influence physiological functioning, diminish sleep quality, and increase morbidity and mortality. The purpose of this paper is to review the features and consequences of loneliness within a comprehensive theoretical framework that informs interventions to reduce loneliness. We review physical and mental health consequences of loneliness, mechanisms for its effects, and effectiveness of extant interventions. Features of a loneliness regulatory loop are employed to explain cognitive, behavioral, and physiological consequences of loneliness and to discuss interventions to reduce loneliness. Loneliness is not simply being alone. Interventions to reduce loneliness and its health consequences may need to take into account its attentional, confirmatory, and memorial biases as well as its social and behavioral effects.

}, keywords = {Cognition, Gene Expression, Health Status, Humans, Hypothalamo-Hypophyseal System, Immune System, Loneliness, Mental Health, Mortality, Pituitary-Adrenal System}, issn = {1532-4796}, doi = {10.1007/s12160-010-9210-8}, author = {Louise C Hawkley and John T. Cacioppo} } @article {7527, title = {A longitudinal study of chiropractic use among older adults in the United States.}, journal = {Chiropr Osteopat}, volume = {18}, year = {2010}, month = {2010 Dec 21}, pages = {34}, publisher = {18}, abstract = {

BACKGROUND: Longitudinal patterns of chiropractic use in the United States, particularly among Medicare beneficiaries, are not well documented. Using a nationally representative sample of older Medicare beneficiaries we describe the use of chiropractic over fifteen years, and classify chiropractic users by annual visit volume. We assess the characteristics that are associated with chiropractic use versus nonuse, as well as between different levels of use.

METHODS: We analyzed data from two linked sources: the baseline (1993-1994) interview responses of 5,510 self-respondents in the Survey on Assets and Health Dynamics Among the Oldest Old (AHEAD), and their Medicare claims from 1993 to 2007. Binomial logistic regression was used to identify factors associated with chiropractic use versus nonuse, and conditional upon use, to identify factors associated with high volume relative to lower volume use.

RESULTS: There were 806 users of chiropractic in the AHEAD sample yielding a full period prevalence for 1993-2007 of 14.6\%. Average annual prevalence between 1993 and 2007 was 4.8\% with a range from 4.1\% to 5.4\%. Approximately 42\% of the users consumed chiropractic services only in a single calendar year while 38\% used chiropractic in three or more calendar years. Chiropractic users were more likely to be women, white, overweight, have pain, have multiple comorbid conditions, better self-rated health, access to transportation, higher physician utilization levels, live in the Midwest, and live in an area with fewer physicians per capita. Among chiropractic users, 16\% had at least one year in which they exceeded Medicare{\textquoteright}s "soft cap" of 12 visits per calendar year. These over-the-cap users were more likely to have arthritis and mobility limitations, but were less likely to have a high school education. Additionally, these over-the-cap individuals accounted for 58\% of total chiropractic claim volume. High volume users saw chiropractors the most among all types of providers, even more than family practice and internal medicine combined.

CONCLUSION: There is substantial heterogeneity in the patterns of use of chiropractic services among older adults. In spite of the variability of use patterns, however, there are not many characteristics that distinguish high volume users from lower volume users. While high volume users accounted for a significant portion of claims, the enforcement of a hard cap on annual visits by Medicare would not significantly decrease overall claim volume. Further research to understand the factors causing high volume chiropractic utilization among older Americans is warranted to discern between patterns of "need" and patterns of "health maintenance".

}, issn = {1746-1340}, doi = {10.1186/1746-1340-18-34}, author = {Paula A Weigel and Jason Hockenberry and Suzanne E Bentler and Maksym Obrizan and Kaskie, Brian and Michael P Jones and Robert L. Ohsfeldt and Gary E Rosenthal and Robert B Wallace and Frederic D Wolinsky} } @article {12837, title = {Measuring the Spillover to Disability Insurance Due to the Rise in the Full Retirement Age}, year = {2010}, institution = {Center for Retirement Research at Boston College}, abstract = {The increase in the full retirement age in the Social Security program provides exogenous variation in the generosity in the Social Security Disability Insurance (SSDI) program, based only on birth year. We exploit this variation to estimate how responsive SSDI applications are to the financial incentive to apply. We find that a 1-percentage-point decrease in the retirement-to-disability benefit ratio leads to a 0.25-percentage-point increase in the SSDI application rate for the sample, which represents an 8-percent increase in applications per two years. When weighted to account for sampling design, we estimate that this change in the financial incentive accounted for about 5 percent of the SSDI applications in 2009. However, we do not find a corresponding increase in SSDI receipt based on the financial incentives{\textellipsis}}, keywords = {Disability, disability insurance, Retirement Age}, url = {https://crr.bc.edu/working-papers/measuring-the-spillover-to-disability-insurance-due-to-the-rise-in-the-full-retirement-age/}, author = {Norma B Coe and Haverstick, Kelly} } @inbook {5232, title = {Mind the Gap! Consumer Perceptions and Choices of Medicare Part D Prescription Drug Plans}, booktitle = {Research Findings in the Economics of Aging}, series = {The Economics of Aging}, year = {2010}, pages = {413-481}, publisher = {University of Chicago Press}, organization = {University of Chicago Press}, chapter = {14}, address = {Chicago}, abstract = {Medicare Part D provides prescription drug coverage through Medicare approved plans offered by private insurance companies and HMOs. In this paper, we study the role of current prescription drug use and health risks, related expectations, and subjective factors in the demand for prescription drug insurance. To characterize rational behavior in the complex Part D environment, we develop an intertemporal optimization model of enrollment decisions. We generally find that seniors{\textquoteright} choices respond to the incentives provided by their own health status and the market environment as predicted by the optimization model. The proportion of individuals who do not attain the optimal choice is small, but the margin for error is also small since enrollment is transparently optimal for most eligible seniors. Further, there is also evidence that seniors over-react to some salient features of the choice situation, do not take full account of the future benefit and cost consequences of their decisions, or the expected net benefits and risk properties of alternative plans.}, keywords = {End of life decisions, Healthcare, Medicare/Medicaid/Health Insurance}, isbn = {0-226-90306-0}, url = {https://www.nber.org/books-and-chapters/research-findings-economics-aging/mind-gap-consumer-perceptions-and-choices-medicare-part-d-prescription-drug-plans}, author = {Florian Heiss and Daniel McFadden and Joachim Winter}, editor = {David A Wise} } @article {7544, title = {Modifiable risk factors for incidence of pain in older adults.}, journal = {Pain}, volume = {151}, year = {2010}, month = {2010 Nov}, pages = {366-371}, publisher = {151}, abstract = {

Pain symptoms in aging populations have significant public health impact. The aim of this study was to determine risk factors for the incidence of pain in older adults, focusing on those factors that can be modified. Secondary analyses were performed of survey data from the nationally representative Health and Retirement Study of US adults older than 50 years. Generalized estimating equations logistic regressions were used to evaluate the effect of selected variables on the incidence of pain using biennial (1992 through 2006) data, determining the relationship between the incidence of pain and the potential risk factors. Of the 18,439 survey respondents in 2006, 34.1\% (95\% CI: 33.2\%, 35.0\%) reported that they were often troubled by pain; 24.3\% reported having moderate to severe pain; and 22.3\% reported that their daily life was affected by pain. Between 1992 and 2006, 7967 individuals reported new onset of pain in 169,762 person-years of follow-up, an incidence of 4.69 (4.59, 4.80) per 100 person-years. Depression and being overweight were independent predictors associated with an increased likelihood of incident pain. Current smoking increased the likelihood of incident pain only in those subjects who also reported depression. In conclusion, pain is a common symptom in older adults. Depression, smoking, and overweight are potentially modifiable risk factors and could be considered in the prevention and management of pain in older adults.

}, keywords = {Age Factors, Aged, Aged, 80 and over, Cross-Sectional Studies, Demography, depression, Female, Humans, Incidence, Longitudinal Studies, Male, Middle Aged, Overweight, pain, Prevalence, Retrospective Studies, Risk Assessment, Risk Factors, Smoking, United States}, issn = {1872-6623}, doi = {10.1016/j.pain.2010.07.021}, author = {Yu Shi and Hooten, W Michael and Rosebud O. Roberts and David O. Warner} } @article {5801, title = {Occupational Learning, Financial Knowledge, and the Accumulation of Retirement Wealth}, number = {WP 2010-237}, year = {2010}, institution = {Michigan Retirement Research Center, University of Michigan}, address = {Ann Arbor, MI}, abstract = {This study explores the relationship between general human capital investment, financial knowledge, occupational spillovers, and the accumulation of wealth in a primarily descriptive manner. Drawing upon human capital theory and following previous related work by Delavande, Rohwedder and Willis (2008), we hypothesized that individuals with daily exposure to financial knowledge through their occupation would benefit by having greater financial knowledge that would translate into greater wealth accumulation than individuals who do not enjoy such spillovers from their occupation. Using data from the Cognitive Economics Study and the Health and Retirement Study, we find strong evidence that individuals in financial occupations tend to have greater financial knowledge and moderate evidence that they also have greater wealth accumulation.}, keywords = {Health Conditions and Status, Net Worth and Assets}, url = {http://hdl.handle.net/2027.42/78354}, author = {Brooke Helppie and Kandice Kapinos and Robert J. Willis and Michigan Retirement Research Center} } @article {5809, title = {Participation and Contributions in Tax-deferred Retirement Accounts: Evidence from Social Security Records}, number = {WP 2009-219}, year = {2010}, institution = {University of Michigan Retirement and Disability Research Center}, address = {Ann Arbor, MI}, abstract = {Social Security Administration W-2 records contain employee annual tax-deferred contributions for 1990-2003 and sufficient information to calculate tax-deferred contributions for 1984-1989. We use this information to compare tax-deferred contribution profiles of three cohorts of respondents in the Health and Retirement Study to determine whether younger cohorts saved relatively more at the same stage of the life cycle than had older cohorts. We find that participation in tax-deferred retirement plans increased substantially for all cohorts from 1984 to 2003, and that respondents in more recent cohorts were more likely to participate in such plans than respondents of the same ages in the earliest cohort. Their contributions as a percent of earnings were not significantly larger than those of the earliest cohort, however. Despite the increased availability of these employer-provided plans throughout this period, participation rates and contribution amounts remained low among respondents in the lower half of the earnings distribution.}, keywords = {Pensions, Retirement Planning and Satisfaction, Social Security}, url = {https://mrdrc.isr.umich.edu/pubs/participation-and-contributions-in-tax-deferred-retirement-accounts-evidence-from-social-security-records/}, author = {Honig, Marjorie and Irena Dushi} } @article {7509, title = {Prevalence and predictors of fatigue in middle-aged and older adults: evidence from the health and retirement study.}, journal = {J Am Geriatr Soc}, volume = {58}, year = {2010}, month = {2010 Oct}, pages = {2033-4}, publisher = {58}, keywords = {Aged, Aged, 80 and over, Fatigue, Female, Health Surveys, Humans, Male, Middle Aged, Prevalence, Retirement, Retrospective Studies, Survival Rate, United States}, issn = {1532-5415}, doi = {10.1111/j.1532-5415.2010.03088.x}, author = {Meng, Hongdao and Hale, Lauren and Friedberg, Fred} } @article {7484, title = {Prior hospitalization and the risk of heart attack in older adults: a 12-year prospective study of Medicare beneficiaries.}, journal = {J Gerontol A Biol Sci Med Sci}, volume = {65}, year = {2010}, month = {2010 Jul}, pages = {769-77}, publisher = {65}, abstract = {

BACKGROUND: We investigated whether prior hospitalization was a risk factor for heart attacks among older adults in the survey on Assets and Health Dynamics among the Oldest Old.

METHODS: Baseline (1993-1994) interview data were linked to 1993-2005 Medicare claims for 5,511 self-respondents aged 70 years and older and not enrolled in managed Medicare. Primary hospital International Classification of Diseases, Ninth Revision, Clinical Modification (ICD-9-CM) 410.xx discharge codes identified postbaseline hospitalizations for acute myocardial infarctions (AMIs). Participants were censored at death or postbaseline managed Medicare enrollment. Traditional risk factors and other covariates were included. Recent postbaseline non-AMI hospitalizations (ie, prior hospitalizations) were indicated by a time-dependent marker, and sensitivity analyses identified their peak effect.

RESULTS: The total number of person-years of surveillance was 44,740 with a mean of 8.1 (median = 9.1) per person. Overall, 483 participants (8.8\%) suffered postbaseline heart attacks, with 423 participants (7.7\%) having their first-ever AMI. As expected, significant traditional risk factors were sex (men); race (whites); marital status (never being married); education (noncollege); geography (living in the South); and reporting a baseline history of angina, arthritis, diabetes, and heart disease. Risk factors were similar for both any postbaseline and first-ever postbaseline AMI analyses. The time-dependent recent non-AMI hospitalization marker did not alter the effects of the traditional risk factors but increased AMI risk by 366\% (adjusted hazards ratio = 4.66, p < .0001). Discussion. Our results suggest that some small percentage (<3\%) of heart attacks among older adults might be prevented if effective short-term postdischarge planning and monitoring interventions were developed and implemented.

}, keywords = {Aged, Educational Status, Female, Hospitalization, Humans, Male, Marital Status, Medicare, Myocardial Infarction, Patient Discharge, Proportional Hazards Models, Prospective Studies, Risk Factors, Sex Factors, United States}, issn = {1758-535X}, doi = {10.1093/gerona/glq003}, author = {Frederic D Wolinsky and Suzanne E Bentler and Li Liu and Michael P Jones and Kaskie, Brian and Jason Hockenberry and Elizabeth A Chrischilles and Kara B Wright and John F Geweke and Maksym Obrizan and Robert L. Ohsfeldt and Gary E Rosenthal and Robert B Wallace} } @article {5821, title = {Psychological Adjustment To Widowhood: The Role Of Income, Wealth And Time}, year = {2010}, institution = {Society of Actuaries Pension Section Research Committee}, abstract = {This paper uses data from two longitudinal surveys to examine the relationship between psychological well-being and financial well-being of older women and men, with specific interest in differences by marital status and duration of widowhood. The Wisconsin Longitudinal Study (WLS) provides a look at the consequences of relatively early widowhood. The Health and Retirement Study (HRS) has interviewed a representative sample of individuals 50 and older over the last two decades. We use the data from that survey to examine the adjustment to widow(er)hood over a larger age range, but with likely less precision to measure differences among women of a single age.}, keywords = {Net Worth and Assets, Women and Minorities}, url = {https://www.soa.org/globalassets/assets/Files/Research/Projects/research-2010-widowhood.pdf}, author = {Karen C. Holden and Jeungkun Kim and Beatriz Novak} } @article {7540, title = {Recent developments in longitudinal studies of aging in the United States.}, journal = {Demography}, volume = {47 Suppl}, year = {2010}, note = {Hauser, Robert M Weir, David AG-21079/AG/NIA NIH HHS/United States AG-9775/AG/NIA NIH HHS/United States U01 AG009740/AG/NIA NIH HHS/United States Research Support, N.I.H., Extramural Research Support, Non-U.S. Gov{\textquoteright}t United States Demography Demography. 2010;47 Suppl:S111-30.}, month = {2010}, pages = {S111-30}, publisher = {47 Suppl}, abstract = {

We review recent developments in longitudinal studies of aging, focusing on the Wisconsin Longitudinal Study (WLS) and the Health and Retirement Study (HRS). Both studies are part of a trend toward biosocial surveys in which biological measurement is joined with traditional survey techniques, and a related trend toward greater harmonization across studies. Both studies have collected DNA samples and are working toward genotyping that would allow broadly based association studies. Increased attention to psychological measurement of personality and of cognitive ability using adaptive testing structures has also been shared across the studies. The HRS has expanded its economic measurement to longitudinal studies of consumption and to broader-based measurement of pension and Social Security wealth. It has added biomarkers of cardiovascular risk. The WLS has developed an integrated approach to the study of death and bereavement and an innovative use of high school yearbook photographs to capture information about health in early life of its participants.

}, keywords = {Aging, Data collection, Demography, Genome-Wide Association Study, Health Status Indicators, Health Surveys, Humans, Longitudinal Studies, Research Design, Socioeconomic factors, United States}, issn = {0070-3370}, doi = {10.1353/dem.2010.0012}, author = {Hauser, Robert M. and David R Weir} } @article {8915, title = {Resources for Analysis of Family Data}, year = {2010}, publisher = {Institute for Social Research, University of Michigan}, abstract = {Understanding family connections - especially related to economic, emotional, and physical support for each other - and how they change with age is a central concern behind the design of the HRS. The information below is it to help data users navigate the detailed information in HRS on family relationships.}, url = {http://hrsonline.isr.umich.edu/index.php?p=famdat} } @article {7519, title = {The Retirement Life Course in America at the Dawn of the Twenty-First Century.}, journal = {Popul Res Policy Rev}, volume = {29}, year = {2010}, month = {2010 Jan 12}, pages = {893-919}, publisher = {29}, abstract = {

As the baby boom cohorts expand the number of U.S. retirees, population estimates of the employment, withdrawal and reentry behaviors of older Americans{\textquoteright} remain scarce. How long do people work? How frequently is retirement reversed? How many years are people retired? What is the modal age of retirement? And, how do the patterns for women compare to those for men? Using the 1992-2004 Health and Retirement Study, we estimate multistate working life tables to update information on the age-graded regularities of the retirement life course of men and women in the United States. We find that at age 50 men can expect to spend half of their remaining lives working for pay, while women can expect to spend just one-third. Half of all men and women have left the labor force by ages 63 and 61, respectively. Although the majority of retirement exits are final, variation in the nature and duration of the retirement process is substantial, as about a third of men{\textquoteright}s and women{\textquoteright}s exits are reversed. By quantifying these patterns for men and women, we provide a sound empirical basis for evaluating policy designed to address the financial pressures population aging places on public and private pension systems.

}, issn = {0167-5923}, doi = {10.1007/s11113-009-9173-2}, author = {David F Warner and Mark D Hayward and Melissa A. Hardy} } @article {7442, title = {Self-reported versus measured height and weight in the health and retirement study.}, journal = {J Am Geriatr Soc}, volume = {58}, year = {2010}, month = {2010 Feb}, pages = {412-3}, publisher = {58}, keywords = {Aged, Body Height, Body Weight, Female, Humans, Male, Middle Aged, Obesity, Population Surveillance, Prevalence, Reproducibility of Results, Sensitivity and Specificity, United States}, issn = {1532-5415}, doi = {10.1111/j.1532-5415.2009.02713.x}, author = {Meng, Hongdao and Xiaoxing He and Dixon, Denise} } @inbook {5247, title = {Spending Patterns in the Older Population}, booktitle = {Aging Consumer: Perspectives from Psychology and Economics}, series = {Marketing and Consumer Psychology Series}, year = {2010}, pages = {25-49}, publisher = {Routledge}, organization = {Routledge}, chapter = {2}, address = {New York}, abstract = {This chapter deals with the concrete differences in consumption behavior across a person{\textquoteright}s life span. Although there is a prevasive belief that households reduce consumption at retirement, the interpretation that consumers adjust their spending after discovering they have fewer economic resources than they had anticipated prior to retirement is not wholly consistent with empirial evidence. The spending habits of older adults are determined by a variety of factors like age, marital status, and economic resources. Specifically, as the population ages, it will tend to spend less on transportation services, vacations, and food; and more on health care and charitable giving.}, keywords = {Consumption and Savings, Demographics, Health Conditions and Status, Retirement Planning and Satisfaction}, isbn = {978-1-84872-810-3}, author = {Michael D Hurd and Susann Rohwedder}, editor = {Drolet, A. and Schwarz, Norbert and Yoon, Carolyn} } @article {7456, title = {Successful aging in the United States: prevalence estimates from a national sample of older adults.}, journal = {J Gerontol B Psychol Sci Soc Sci}, volume = {65B}, year = {2010}, month = {2010 Mar}, pages = {216-26}, publisher = {65B}, abstract = {

OBJECTIVES: To estimate the prevalence of successful aging in the United States, with the broad aim of contributing to the dialogue on Rowe and Kahn{\textquoteright}s concept of successful aging.

METHODS: Using data from the Health and Retirement Study, the prevalence of successful aging was calculated for adults aged 65 years and older at four time points: 1998, 2000, 2002, and 2004. Successful aging was operationalized in accordance with Rowe and Kahn{\textquoteright}s definition, which encompasses disease and disability, cognitive and physical functioning, social connections, and productive activities.

RESULTS: No greater than 11.9\% of older adults were aging "successfully" in any year. The adjusted odds of successful aging were generally lower for those of advanced age, male gender, and lower socioeconomic status. Between 1998 and 2004, the odds of successful aging declined by 25\%, after accounting for demographic changes in the older population.

DISCUSSION: Few older adults meet the criteria put forth in Rowe and Kahn{\textquoteright}s definition of successful aging, suggesting the need for modification if the concept is to be used for broad public health purposes. Disparities in successful aging were evident for socially defined subgroups, highlighting the importance of structural factors in enabling successful aging.

}, keywords = {Affect, Aged, Aging, Female, Health Status, Humans, Male, Middle Aged, Prevalence, United States}, issn = {1758-5368}, doi = {10.1093/geronb/gbp101}, author = {Sara J McLaughlin and Cathleen M. Connell and Steven G Heeringa and Lydia W Li and J Scott Roberts} } @article {5828, title = {Trigger Events and Financial Outcomes Among Older Households}, number = {WP 10-2}, year = {2010}, institution = {Center for Financial Security, University of Wisconsin-Madison}, address = {Madison, WI}, abstract = {Follow a sample of social security beneficiaries drawn from the Health and Retirement Study from their first year of retirement up to 15 years into retirement, we estimate rates at which retirees are subject to family structure change, cognitive decline, health decline, and other events. Then we assess the vulnerability of wealth and wealth-based adequacy measures to adverse events, drawing conclusions about the effect of events on a wealth-based measure and a wealth-based inadequacy measure. Our findings highlight the importance of cognitive and health decline as events with the potential to shape the evolution of wealth post-retirement.}, keywords = {Adult children, Health Conditions and Status, Healthcare, Net Worth and Assets, Social Security}, url = {https://cfs.wisc.edu/2010/09/10/trigger-events-and-financial-outcomes-among-older-households/}, author = {Geoffrey L Wallace and Haveman, Robert and Karen C. Holden and Barbara Wolfe} } @article {7504, title = {Using the Health and Retirement Study to Analyze Housing Decisions, Housing Values, and Housing Prices}, journal = {Cityscape: A Journal of Policy Development and Research}, volume = {12}, year = {2010}, note = {Using Smart Source Parsing pp}, pages = {149-58}, publisher = {12}, abstract = {Few existing surveys provide detailed longitudinal information on households and their homes. This article introduces a data source, the Health and Retirement Study (HRS), which has this detailed information but has received little attention by housing researchers to date. The HRS is a rich longitudinal data set that provides information on house values, house prices, and detailed personal characteristics of those who own and sell their homes. The HRS is a nationally representative longitudinal survey that originally sampled 7,700 households headed by an individual aged 51 to 61 in the first interviews in 1992 and 1993. It now also samples additional cohorts of older Americans. Although the HRS is the data set of choice when analyzing the retirement behavior, savings, and health status of older Americans, given its wealth of demographic, health, and socioeconomic data, it has been rarely used to answer questions regarding the housing market. A seldom used section of the questionnaire provides detailed information about real estate transactions by households, however, enabling researchers to repeatedly observe both self-reported house values and the actual selling prices of properties sold since 1992 (originally bought in the past five decades). The article describes a number of important housing-related measures available in the HRS and illustrates the usefulness of these data by conducting a statistical analysis of the accuracy of self-reported home values. Specifically, we analyze the predictive power of self-reported housing wealth when estimating housing prices using the HRS data. The evidence shows a slight overestimation of housing values by older Americans.}, keywords = {Consumption and Savings, Demographics, Housing, Income, Net Worth and Assets, Retirement Planning and Satisfaction}, author = {Hugo Ben{\'\i}tez-Silva and Sel{\c c}uk Eren and Frank Heiland and Jimenez-Martin, Sergi} } @article {5761, title = {Aging, Demographics and Memory Study (ADAMS): Sample Design, Weighting and Analysis for ADAMS}, year = {2009}, institution = {Institute for Social Research, University of Michigan}, address = {Ann Arbor, Michigan}, abstract = {This technical report describes the sample design, design-based weighting and analysis procedures for the Aging, Demographics and Memory Study (ADAMS), a national study that recruited Health and Retirement Study (HRS) panel members to undergo a psychometric evaluation and clinical assessment visit. Langa et al. (2005) describe the general design and methods for the ADAMS including relevant background on the HRS longitudinal sample. This document provides additional detail on the sample design for the ADAMS including a description of survey sample selection, sample attrition and nonresponse, population weights, design-based variance estimation and related topics of importance to analysts of the ADAMS data.}, keywords = {Health Conditions and Status, Methodology}, author = {Steven G Heeringa and Gwenith G Fisher and Michael D Hurd and Kenneth M. Langa and Mary Beth Ofstedal and Brenda L Plassman and Rogers, Willard and David R Weir} } @article {7366, title = {Association between cognitive function and social support with glycemic control in adults with diabetes mellitus.}, journal = {J Am Geriatr Soc}, volume = {57}, year = {2009}, month = {2009 Oct}, pages = {1816-24}, publisher = {57}, abstract = {

OBJECTIVES: To examine whether cognitive impairment in adults with diabetes mellitus is associated with worse glycemic control and to assess whether level of social support for diabetes mellitus care modifies this relationship.

DESIGN: Cross-sectional analysis.

SETTING: The 2003 Health and Retirement Study (HRS) Mail Survey on Diabetes and the 2004 wave of the HRS.

PARTICIPANTS: Adults aged 50 and older with diabetes mellitus in the United States (N=1,097, mean age 69.2).

MEASUREMENTS: Glycosylated hemoglobin (HbA1c) level; cognitive function, measured with the 35-point HRS cognitive scale (HRS-cog); sociodemographic variables; duration of diabetes mellitus; depressed mood; social support for diabetes mellitus care; self-reported knowledge of diabetes mellitus; treatments for diabetes mellitus; components of the Total Illness Burden Index related to diabetes mellitus; and functional limitations.

RESULTS: In an ordered logistic regression model for the three ordinal levels of HbA1c (<7.0, 7.0-7.9, >or=8.0 mg/dL), respondents with HRS-cog scores in the lowest quartile had significantly higher HbA1c levels than those in the highest cognitive quartile (adjusted odds ratio=1.80, 95\% confidence interval=1.11-2.92). A high level of social support for diabetes mellitus care modified this association; for respondents in the lowest cognitive quartile, those with high levels of support had significantly lower odds of having higher HbA1c than those with low levels of support (1.11 vs 2.87, P=.02).

CONCLUSION: Although cognitive impairment was associated with worse glycemic control, higher levels of social support for diabetes mellitus care ameliorated this negative relationship. Identifying the level of social support available to cognitively impaired adults with diabetes mellitus may help to target interventions for better glycemic control.

}, keywords = {Aged, Blood Glucose, Cognition, Cross-Sectional Studies, Diabetes Mellitus, Female, Humans, Male, Middle Aged, Social Support}, issn = {1532-5415}, doi = {10.1111/j.1532-5415.2009.02431.x}, author = {Okura, Toru and Michele M Heisler and Kenneth M. Langa} } @article {7340, title = {Cognitive decline among patients with chronic obstructive pulmonary disease.}, journal = {Am J Respir Crit Care Med}, volume = {180}, year = {2009}, note = {PMID: 19423714}, month = {2009 Jul 15}, pages = {134-7}, publisher = {180}, abstract = {

RATIONALE: Prior research has suggested an association between chronic obstructive pulmonary disease (COPD) and the development of cognitive decline; however, these studies have been cross-sectional or small case series.

OBJECTIVES: To determine whether COPD increases the risk of cognitive decline among older adults surveyed in a large, population-based longitudinal cohort.

METHODS: We included data from the 1996 to 2002 waves of the Health and Retirement Study, a biennial nationally representative survey. We studied respondents who completed cognitive testing in 1996 and at least one subsequent survey, and excluded those with unknown history of COPD. Clinical history of COPD was based on self-report; severity was categorized based on use of oxygen or disease-related activity limitations. Our primary outcome was cognitive performance, measured using a validated 35-point scale. We examined the effect of COPD on cognition using multivariable mixed linear models accounting for repeated measurements, adjusted for sociodemographic and clinical characteristics.

MEASUREMENTS AND MAIN RESULTS: A total of 4,150 adults were included in our study. Among them, 12\% reported a history of COPD (29\% severe, 71\% nonsevere disease). On repeated measurement, mean cognition scores of older adults with both severe and nonsevere COPD were significantly lower when compared with adults without COPD (2.6 points [P < 0.001] and 0.9 points [P < 0.001], respectively). After multivariable adjustment, mean scores of adults with severe COPD remained lower (0.9 point [P < 0.001]), whereas mean score of adults with nonsevere COPD was no longer different (P = 0.39) when compared with adults without COPD.

CONCLUSIONS: Severe COPD was associated with lower cognitive performance on standardized measurement over time.

}, keywords = {Aged, Case-Control Studies, Cognition Disorders, Female, Health Surveys, Humans, Longitudinal Studies, Male, Middle Aged, Pulmonary Disease, Chronic Obstructive, Pulmonary Ventilation, Risk Factors, Severity of Illness Index, Socioeconomic factors, United States}, issn = {1535-4970}, doi = {10.1164/rccm.200902-0276OC}, author = {William W. Hung and Juan P. Wisnivesky and Albert L Siu and Joseph S. Ross} } @article {7346, title = {Cognitive health among older adults in the United States and in England.}, journal = {BMC Geriatr}, volume = {9}, year = {2009}, note = {PMID: 19555494}, month = {2009 Jun 25}, pages = {23}, publisher = {9}, abstract = {

BACKGROUND: Cognitive function is a key determinant of independence and quality of life among older adults. Compared to adults in England, US adults have a greater prevalence of cardiovascular risk factors and disease that may lead to poorer cognitive function. We compared cognitive performance of older adults in the US and England, and sought to identify sociodemographic and medical factors associated with differences in cognitive function between the two countries.

METHODS: Data were from the 2002 waves of the US Health and Retirement Study (HRS) (n = 8,299) and the English Longitudinal Study of Ageing (ELSA) (n = 5,276), nationally representative population-based studies designed to facilitate direct comparisons of health, wealth, and well-being. There were differences in the administration of the HRS and ELSA surveys, including use of both telephone and in-person administration of the HRS compared to only in-person administration of the ELSA, and a significantly higher response rate for the HRS (87\% for the HRS vs. 67\% for the ELSA). In each country, we assessed cognitive performance in non-hispanic whites aged 65 and over using the same tests of memory and orientation (0 to 24 point scale).

RESULTS: US adults scored significantly better than English adults on the 24-point cognitive scale (unadjusted mean: 12.8 vs. 11.4, P < .001; age- and sex-adjusted: 13.2 vs. 11.7, P < .001). The US cognitive advantage was apparent even though US adults had a significantly higher prevalence of cardiovascular risk factors and disease. In a series of OLS regression analyses that controlled for a range of sociodemographic and medical factors, higher levels of education and wealth, and lower levels of depressive symptoms, accounted for some of the US cognitive advantage. US adults were also more likely to be taking medications for hypertension, and hypertension treatment was associated with significantly better cognitive function in the US, but not in England (P = .014 for treatment x country interaction).

CONCLUSION: Despite methodological differences in the administration of the surveys in the two countries, US adults aged >/= 65 appeared to be cognitively healthier than English adults, even though they had a higher burden of cardiovascular risk factors and disease. Given the growing number of older adults worldwide, future cross-national studies aimed at identifying the medical and social factors that might prevent or delay cognitive decline in older adults would make important and valuable contributions to public health.

}, keywords = {Aged, Aged, 80 and over, Aging, Cognition, Cognition Disorders, Cohort Studies, Cross-Sectional Studies, England, Female, Health Status, Humans, Longitudinal Studies, Male, Neuropsychological tests, United States}, issn = {1471-2318}, doi = {10.1186/1471-2318-9-23}, author = {Kenneth M. Langa and David J Llewellyn and Iain A Lang and David R Weir and Robert B Wallace and Mohammed U Kabeto and Felicia A Huppert} } @article {7291, title = {Compensatory Inter Vivos Gifts}, journal = {Journal of Applied Econometrics}, volume = {24}, year = {2009}, pages = {993-1023}, publisher = {24}, abstract = {Parents transfer motives are important for understanding, e.g., macroeconomics, income (re)distribution, savings, and public finance. Using data from six biennial waves of the Health and Retirement Study 1992 2002, we estimate censored regression models with nested multilevel error components. First, we interpret our findings that inter vivos transfers from parents to children are gifts, rather than temporary help to overcome liquidity constraints. Second, inter vivos gifts are compensatory in the sense that lifetime poorer children will receive higher transfers than their lifetime richer siblings. Third, inter vivos gifts do not, however, make up the entire difference in lifetime incomes.}, keywords = {Adult children}, doi = {https://doi.org/10.1002/jae.1071}, author = {Hochguertel, Stefan and Ohlsson, Henry} } @article {5753, title = {Determinants and Consequences of Moving Decisions for Older Homeowners}, number = {WP$\#$2009-16}, year = {2009}, institution = {Center for Retirement Research at Boston College}, address = {Boston}, abstract = {The lore on whether older Americans move is mixed. While the familiar stereotype is that retirees flock to Florida or Arizona, prior studies have found that their home equity rises modestly over time, suggesting that they tend to stay put. This paper examines moving trends, determinants, and consequences using the original cohort of the Health and Retirement Study (HRS). We find that a full 30 percent of homeowners in the HRS cohort move over the 1992-2004 period, but most moves occur close to home. Overall, two types of movers emerge from the analysis those who affirmatively plan to move and those who react to changing circumstances. As proxies for these two types, this study uses the presence or absence of a negative shock, such as death of a spouse or entry into a nursing home. Our results show that the factors that help determine a move are similar for both groups, while the consequences of a move vary. Homeowners with shocks are more likely to discontinue homeownership and reduce net equity, supporting the hypothesis that households may view housing wealth as insurance against catastrophic events. Finally, while movers in both groups of homeowners experience improvements in psychological well-being, movers with shocks are impacted most by the shocks themselves.}, keywords = {Demographics, Housing, Retirement Planning and Satisfaction}, url = {https://crr.bc.edu/working-papers/determinants-and-consequences-of-moving-decisions-for-older-homeowners/}, author = {Calvo, Esteban and Haverstick, Kelly and Natalia A. Zhivan} } @inbook {5233, title = {The Effect of Large Capital Gains or Losses on Retirement}, booktitle = {Developments in the economics of aging}, year = {2009}, pages = {127-172}, publisher = {University of Chicago Press}, organization = {University of Chicago Press}, chapter = {4}, address = {Chicago}, keywords = {Net Worth and Assets, Retirement Planning and Satisfaction}, isbn = {0-226-90335-4}, url = {https://www.nber.org/books-and-chapters/developments-economics-aging/effect-large-capital-gains-or-losses-retirement}, author = {Michael D Hurd and Reti, Monika and Susann Rohwedder}, editor = {David A Wise} } @mastersthesis {6348, title = {Effects of Health Status on the Decision to Retire with Corrections for Measurement Error}, volume = {Doctor of Philosophy}, year = {2009}, school = {City University of New York}, type = {Dissertation}, address = {New York}, abstract = {Many studies on the relationship between labor supply and health status generally do not illustrate a unanimous agreement on the usage of subjective and objective health due to the difficulty in employing the right measures to obtain the precise and up-to-date information on the health status of subjects in question. Thereby, to resolve this quandary, we propose two models; the first model addresses how a researcher could obtain more appropriate estimate in health measure with measurement error; the other model examines whether probabilities questions within and across waves could potentially result in another measurement error. In the first model allowing to justification bias, we found the health and financial compensation{\textquoteright} lower and upper bounds for labor force exit and in views of bounds concept, health status plays a larger role in labor force exit than financial compensation. In the second model, we found that measurement error from survey effect has an impact on the survival probability along with the measurement errors from an inherent errors-in-variable bias by using two methods: the former employing the averaged survival probabilities and the latter incorporating the instrumental variables.}, keywords = {Employment and Labor Force, Health Conditions and Status, Methodology}, author = {Hyun, Kyung-Rae} } @article {7295, title = {Expectations and Realization of Joint Retirement among Dual-Worker Couples.}, journal = {Res Aging}, volume = {31}, year = {2009}, month = {2009}, pages = {153-179}, publisher = {31}, abstract = {

Using data from the first seven waves of the Health and Retirement Study (1992 to 2004), the authors examined the extent to which joint retirement expectations were realized, the role of couple-level agreement in facilitating joint retirement, whether husbands{\textquoteright} or wives{\textquoteright} expectations were more likely to be realized in cases of disagreement, and factors associated with the realization of expectations. The results indicate that couples expecting joint retirement were over three times more likely to retire jointly than couples in which neither spouse expected to do so. However, the probability of joint retirement did not differ between couples in which both spouses expected to retire jointly and those in which only one spouse expected to do so. Wives{\textquoteright} and husbands{\textquoteright} expectations were equally strong predictors of joint retirement, and retirement age, health, spouses{\textquoteright} relative earnings, and discussions of retirement were related to the likelihood of realizing joint retirement expectations.

}, issn = {1552-7573}, doi = {10.1177/0164027508328308}, author = {Ho, Jeonghwa and James M Raymo} } @article {7380, title = {Financial status, employment, and insurance among older cancer survivors.}, journal = {J Gen Intern Med}, volume = {24 Suppl 2}, year = {2009}, month = {2009 Nov}, pages = {S438-45}, publisher = {24}, abstract = {

BACKGROUND: Few data are available about the socioeconomic impact of cancer for long-term cancer survivors.

OBJECTIVES: To investigate socioeconomic outcomes among older cancer survivors compared to non-cancer patients.

DATA SOURCE: 2002 Health and Retirement Study.

STUDY DESIGN: We studied 964 cancer survivors of > 4 years and 14,333 control patients who had never had cancer from a population-based sample of Americans ages >or= 55 years responding to the 2002 Health and Retirement Study.

MEASURES: We compared household income, housing assets, net worth, insurance, employment, and future work expectations.

ANALYSES: Propensity score methods were used to control for baseline differences between cancer survivors and controls.

RESULTS: Female cancer survivors did not differ from non-cancer patients in terms of income, housing assets, net worth, or likelihood of current employment (all P > 0.20); but more were self-employed (25.0\% vs. 17.7\%; P = 0.03), and fewer were confident that if they lost their job they would find an equally good job in the next few months (38.4\% vs. 45.9\%; P = 0.03). Among men, cancer survivors and noncancer patients had similar income and housing assets (both P >or= 0.10) but differed somewhat in net worth (P = 0.04). Male cancer survivors were less likely than other men to be currently employed (25.2\% vs. 29.7\%) and more likely to be retired (66.9\% vs. 62.2\%), although the P value did not reach statistical significance (P = 0.06). Men were also less optimistic about finding an equally good job in the next few months if they lost their current job (33.5\% vs. 46.9\%), although this result was not significant (P = 0.11).

CONCLUSIONS: Despite generally similar socioeconomic outcomes for cancer survivors and noncancer patients ages >or=55 years, a better understanding of employment experience and pessimism regarding work prospects may help to shape policies to benefit cancer survivors.

}, keywords = {Aged, Aged, 80 and over, Cohort Studies, Data collection, Employment, Female, Financing, Personal, Humans, Income, Insurance Coverage, Insurance, Health, Longitudinal Studies, Male, Middle Aged, Neoplasms, Socioeconomic factors, Survivors}, issn = {1525-1497}, doi = {10.1007/s11606-009-1034-5}, author = {Norredam, Marie and Meara, Ellen and Landrum, Mary Beth and Haiden A. Huskamp and Nancy L. Keating} } @article {7378, title = {Formal Home Health Care, Informal Care, and Family Decision Making}, journal = {International Economic Review}, volume = {50}, year = {2009}, pages = {1205-42}, publisher = {50}, abstract = {We use the 1993 wave of the Assets and Health Dynamics Among the Oldest Old (AHEAD) data set to estimate a game-theoretic model of families{\textquoteright} decisions concerning the provision of informal and formal care for elderly individuals. The outcome is the Nash equilibrium where each family member jointly determines her consumption, transfers for formal care, and allocation of time to informal care, market work, and leisure. We use the estimates to decompose the effects of adult children{\textquoteright}s opportunity costs, quality of care, and caregiving burden on their propensities to provide informal care. We also simulate the effects of a broad range of policies of current interest.}, keywords = {Healthcare}, doi = {10.1111/j.1468-2354.2009.00566.x}, url = {http://onlinelibrary.wiley.com/doi/10.1111/j.1468-2354.2009.00566.x/abstract}, author = {Byrne, David and Hiedemann, Bridget and Goeree, Michelle S. and Steven N. Stern} } @article {7321, title = {Gradual Retirement, Sense of Control, and Retirees{\textquoteright} Happiness}, journal = {Research on Aging}, volume = {31}, year = {2009}, pages = {112}, publisher = {31}, abstract = {The aim of this study was to explore the factors that affect an individual{\textquoteright}s happiness while transitioning into retirement. Recent studies have found that workers often view the idea of gradual retirement as a more attractive alternative than a cold turkey or abrupt retirement. However, there is very little evidence as to whether phasing or cold turkey makes for a happier retirement. Using longitudinal data from the Health and Retirement Study, the authors explored what shapes the change in happiness between the last wave of full employment and the first wave of full retirement. The results suggest that what matters is not the type of transition (gradual retirement or cold turkey) but whether people perceive the transition as chosen or forced.}, keywords = {Employment and Labor Force, Retirement Planning and Satisfaction}, doi = {https://doi.org/10.1177/0164027508324704}, author = {Calvo, Esteban and Haverstick, Kelly and Sass, Steven A.} } @article {7384, title = {The health impact of remarriage behavior on chronic obstructive pulmonary disease: findings from the US longitudinal survey.}, journal = {BMC Public Health}, volume = {9}, year = {2009}, month = {2009 Nov 14}, pages = {412}, publisher = {9}, abstract = {

BACKGROUND: Chronic obstructive pulmonary disease (COPD) is a major disease among adults, and its deterioration was reported to be associated with psychological imbalance. Meanwhile, bereavement and divorce have proven harmful to the health status of a surviving spouse. But few studies have been conducted to evaluate the remedial effect on survivors{\textquoteright} health outcome by remarriage after bereavement. The present study thus examined the associations between remarriage and the onset of COPD.

METHODS: Our cohort was drawn from Health and Retirement Study participants in the United States, and consisted of 2676 subjects who were divorced or bereaved from 1992 to 2002. We then followed them for up to 11 years and assessed the incidence rate of COPD using a Cox proportional hazard model after adjusting for marital status, age, gender, education and the number of cigarettes smoked.

RESULTS: Among all subjects, 224 who remarried after bereavement or divorce tended to be younger and more male dominated. Remarriage after bereavement/divorce was associated with significantly decreased risk of COPD onset for overall subjects [hazard ratio (HR): 0.51, 95\% confidence interval (95\% CI): 0.28-0.94], female subjects [HR: 0.36, 95\% CI: 0.13-0.98], and for those under 70 years old [HR: 0.36, 95\% CI: 0.17-0.79].

CONCLUSION: This study investigates the impact of remarriage on health outcome based on a large-scale population survey and indicates that remarriage significantly correlates with reduced risk of COPD incidence, even after adjusting smoking habit.

}, keywords = {Aged, Bereavement, Educational Status, Female, Follow-Up Studies, Health Status, Health Surveys, Humans, Lung Diseases, Obstructive, Male, Marriage, Middle Aged, Outcome Assessment, Health Care, Proportional Hazards Models, Smoking, United States}, issn = {1471-2458}, doi = {10.1186/1471-2458-9-412}, author = {Noda, Tatsuya and Ojima, Toshiyuki and Hayasaka, Shinya and Hagihara, Okihito and Takayanagi, Ryoichi and Nobutomo, Koichi} } @article {7368, title = {Intervivos Giving in the Older Population: Who Receives Financial Gifts from the Childless?}, journal = {Ageing Soc}, volume = {29}, year = {2009}, month = {2009 Nov 01}, pages = {1207-1225}, publisher = {29}, issn = {0144-686X}, doi = {10.1017/S0144686X08008362}, author = {Michael D Hurd} } @article {7353, title = {Marital biography and health at mid-life.}, journal = {J Health Soc Behav}, volume = {50}, year = {2009}, month = {2009 Sep}, pages = {344-58}, publisher = {50}, abstract = {

This article develops a series of hypotheses about the long-term effects of one{\textquoteright}s history of marriage, divorce, and widowhood on health, and it tests those hypotheses using data from the Health and Retirement Study. We examine four dimensions of health at mid-life: chronic conditions, mobility limitations, self-rated health, and depressive symptoms. We find that the experience of marital disruption damages health, with the effects still evident years later; among the currently married, those who have ever been divorced show worse health on all dimensions. Both the divorced and widowed who do not remarry show worse health than the currently married on all dimensions. Dimensions of health that seem to develop slowly, such as chronic conditions and mobility limitations, show strong effects of past marital disruption, whereas others, such as depressive symptoms, seem more sensitive to current marital status. Those who spent more years divorced or widowed show more chronic conditions and mobility limitations.

}, keywords = {Female, Health Status, Humans, Interviews as Topic, Longitudinal Studies, Male, Marital Status, Middle Aged, United States}, issn = {0022-1465}, doi = {10.1177/002214650905000307}, author = {Mary Elizabeth Hughes and Linda J. Waite} } @book {5282, title = {Markov Models with Covariate Dependence for Repeated Measures}, year = {2009}, publisher = {Nova Science Publishers}, organization = {Nova Science Publishers}, address = {New York}, abstract = {During the recent past, there has been a great deal of interst in solving problems of repeated measures data employing the Markov chain models. Most of the researchers and users of such techniques are only transition probabilities of various orders to show relationships among various states. However, in the recent past, there are attempts to include covariates in order to analyse the transition probabilities. Due to lack of a book on this topic, it is difficult for the researchers, students, and other users to have a thorough understanding in applying the methods based on sound knowledge. In addition, there is a lack of suitable software to handle repeated measures for Markov model applications. The main purpose of the book is to provide a theoretical base to the readers who will be willing to use these techniques for real life situations as well as for those who intend to continue advanced research in this field. This book provides a comprehensive discussion and theoretical details of the techniques in this field along with their estimation and test procedures, application of the techniques to real life problems, and the computer programs for using the techniques.}, keywords = {Methodology}, author = {M. Ataharul Islam and Rafiqul I Chowdhury and Huda, Shahariar} } @article {7396, title = {Memory and depressive symptoms are dynamically linked among married couples: longitudinal evidence from the AHEAD study.}, journal = {Dev Psychol}, volume = {45}, year = {2009}, note = {PMID: 19899917}, month = {2009 Nov}, pages = {1595-610}, publisher = {45}, abstract = {

This study examined dyadic interrelations between episodic memory and depressive symptom trajectories of change in old and advanced old age. The authors applied dynamic models to 10-year incomplete longitudinal data of initially 1,599 married couples from the study of Asset and Health Dynamics Among the Oldest Old (M(age) = 75 years at Time 1). The authors found domain-specific lead-lag associations (time lags of 2 years) among wives and husbands as well as between spouses. For memory, better performance among husbands protected against subsequent memory decline among wives, with no evidence of a directed effect in the other direction. For depressive symptoms, wives{\textquoteright} scores predicted subsequent depression increase and memory decline among husbands. Possible individual covariates (age, education, functional limitations) and spousal covariates (length of marriage, number of children, and whether the couple remained intact over the study period) did not account for differential lead-lag associations. The findings of antecedent-consequent relations between wives and husbands are consistent with life-span notions that individual development both influences and is influenced by contextual factors such as close social relationships.

}, keywords = {Adaptation, Psychological, Aged, Aged, 80 and over, Aging, Cognition, depression, Female, Health Status, Humans, Interpersonal Relations, Longitudinal Studies, Male, Marriage, Mental Recall, Models, Psychological, Quality of Life, Spouses}, issn = {1939-0599}, doi = {10.1037/a0016346}, author = {Denis Gerstorf and Christiane A Hoppmann and Kelly M Kadlec and John J McArdle} } @article {7401, title = {Methodological Innovations in Collecting Spending Data: The HRS Consumption and Activities Mail Survey.}, journal = {Fisc Stud}, volume = {30}, year = {2009}, note = {Journal Article}, month = {2009 Dec 01}, pages = {435-459}, publisher = {30}, abstract = {

It has traditionally been believed that collecting survey measures of total spending necessarily involved asking a large number of questions, too many for inclusion of a comprehensive spending measure in a general-purpose survey. In this paper we report on a supplemental survey to the Health and Retirement Study that took up this challenge. We discuss issues that arise designing a survey module to collect spending data with strict time constraints, describe how the implementation in the Consumption and Activities Mail Survey (CAMS) played out, and elicit anomalies that more detailed analysis of data quality revealed. We report how we addressed some of these anomalies in subsequent waves of CAMS. Other anomalies required conducting additional randomized experiments to find what explains the observed patterns. The results highlight the tension between asking about spending using a long time frame, which exacerbates recall bias, versus using a short time frame, which risks relying on an unrepresentative snapshot of a household{\textquoteright}s spending to proxy the total for the last 12 months. An important complicating factor in deciding which goods should be put into which time frames is that there is substantial heterogeneity in the frequency of spending across households even for the same category of spending.

}, issn = {0143-5671}, doi = {10.1111/j.1475-5890.2009.00103.x}, url = {URL:http://www.wiley.com/bw/journal.asp?ref=0143-5671 Publisher{\textquoteright}s URL}, author = {Michael D Hurd and Susann Rohwedder} } @article {7301, title = {Subjective Probabilities in Household Surveys.}, journal = {Annu Rev Econom}, volume = {1}, year = {2009}, month = {2009 Jun 01}, pages = {543-562}, publisher = {1}, abstract = {

Subjective probabilities are now collected on a number of large household surveys with the objective of providing data to better understand inter-temporal decision making. Comparison of subjective probabilities with actual outcomes shows that the probabilities have considerable predictive power in situations where individuals have considerable private information such as survival and retirement. In contrast the subjective probability of a stock market gain varies greatly across individuals even though no one has private information and the outcome is the same for everyone. An explanation is that there is considerable variation in accessing and processing information. Further, the subjective probability of a stock market gain is considerably lower than historical averages, providing an explanation for the relatively low frequency of stock holding. An important research objective will be to understand how individuals form their subjective probabilities.

}, issn = {1941-1383}, doi = {10.1146/annurev.economics.050708.142955}, url = {http://www.annualreviews.org/doi/abs/10.1146/annurev.economics.050708.142955}, author = {Michael D Hurd} } @article {COURTEMANCHE2009296, title = {Tax incentives and the decision to purchase long-term care insurance}, journal = {Journal of Public Economics}, volume = {93}, year = {2009}, pages = {296 - 310}, abstract = {This paper studies the impact of the tax incentive prescribed in the Health Insurance Portability and Accountability Act of 1996 (HIPAA) on individuals{\textquoteright} long-term care insurance purchasing behavior. Using data from the Health and Retirement Study, we find that the tax incentive in HIPAA increased the take-up rate of private LTC insurance by 3.3 percentage points, or 25\%, for those eligible. Despite this seemingly strong response, our results imply that even an above-the-line tax deduction would not increase the coverage rate of seniors beyond 13\%, indicating that tax incentives alone are unlikely to expand the market substantially. We also present, to our knowledge, the first estimate of the price elasticity of demand for LTC insurance of around -3.9, suggesting that demand is highly elastic at the current low ownership rate. Finally, we evaluate the net fiscal impact of the tax incentive and find that the tax deductibility of LTC insurance premiums leads to a net revenue loss for the government, as the reduced tax revenue from granting the tax incentive exceeds the savings in Medicaid{\textquoteright}s LTC expenditures.}, keywords = {Demand elasticity, Fiscal impact, HIPAA, Itemization, Long-term Care, Long-term care insurance, Medical Expenses, Tax incentive}, issn = {0047-2727}, doi = {https://doi.org/10.1016/j.jpubeco.2008.05.007}, author = {Charles Courtemanche and Daifeng He} } @mastersthesis {6332, title = {Three Essays on Long-Term Care and Life Insurance}, year = {2009}, month = {2009}, school = {Washington University}, address = {St. Louis, Missouri}, abstract = {This dissertation consists of three essays on long-term care and life insurance. Essay 1 examines the impact of the tax incentive prescribed in the Health Insurance Portability and Accountability Act of 1996 (HIPAA) on individuals{\textquoteright} long-term care (LTC) insurance purchasing behavior. 1 Using data from the Health and Retirement Study, we find that the tax incentive in HIPAA increased the take-up rate of private LTC insurance by 3.3 percentage points, or 25\%, for those eligible. Despite this seemingly strong response, our results imply that even an above-the-line tax deduction would not increase the coverage rate of seniors beyond 13\%, indicating that tax incentives alone are unlikely to expand the market substantially. We also present, to our knowledge, the first estimate of the price elasticity of demand for LTC insurance of around -3.9, suggesting that demand is highly elastic at the current low ownership rate. Finally, we evaluate the net fiscal impact of the tax incentive and find that the tax deductibility of LTC insurance premiums leads to a net revenue loss for the government, as the reduced tax revenue from granting the tax incentive exceeds the savings in Medicaid{\textquoteright}s LTC expenditures. Essay 2 finds evidence for the presence of adverse selection in the life insurance market, a conclusion contrasting with the existing literature. In particular, I find a significant and positive correlation between the decision to purchase life insurance and subsequent mortality, conditional on risk classification. Individuals who died within a 12-year time window after a base year were 19 percent more likely to have taken up life insurance in that base year than were those who survived the time window. Moreover, I find that individuals are most likely to obtain life insurance four to six years before death. Methodologically, I address sample-selection and omitted-variables issues overlooked in the previous literature. In Chapter 3, I examine whether dynamic adverse selection prevails in the life insurance market and finds little evidence of it. In particular, I find that individuals with lower mortality risk do not have a higher lapse rate than do otherwise equivalent individuals with higher mortality risk, nor do they lapse a higher amount conditional on a cancellation. The absence of dynamic selection in life insurance markets appears to imply that adequate premium front-loading may serve as an effective consumer lock-in mechanism in long-term insurance markets.}, keywords = {Healthcare, Insurance}, author = {Daifeng He} } @article {7222, title = {Actuation of mobility intentions among the young-old: an event-history analysis.}, journal = {Gerontologist}, volume = {48}, year = {2008}, month = {2008 Apr}, pages = {190-202}, publisher = {48}, abstract = {

PURPOSE: Although migration decision making is central to understanding later-life migration, the critical step between migration intentions and mobility outcomes has received only limited empirical attention. We address two questions: How often are intended moves actuated? What factors condition the likelihood that mobility intentions will be actuated?

DESIGN AND METHODS: We employ data from the 1994-2002 Health and Retirement Study, which is a nationally representative panel targeting households containing persons aged 53 to 63 years at baseline. Event-history techniques are used to examine the link between reported mobility intentions at baseline and mobility outcomes across the study period, net of relevant controls. We conduct separate household-level analyses for couple and noncouple households and recognize three types of moves: local, family oriented, and nonlocal.

RESULTS: Findings confirm the utility of mobility expectations as a predictor of future mobility. More importantly, results highlight the complex nature of later-life mobility. The actuation of mobility intentions appears to operate differently in couple than in noncouple households. Moreover, our findings suggest that the role of several key variables depends on the type of move under consideration.

IMPLICATIONS: The ability to identify potential "retirement migrants" may be of practical importance for state and local government officials as well as developers interested in recruiting or retaining young-old residents. Our study offers insight on the interpretation of stated mobility intentions. Moreover, consistent with early theoretical work in the field, our analysis suggests that empirical studies must account for heterogeneity among older movers in order to avoid misleading results.

}, keywords = {Aged, Databases as Topic, Emigration and Immigration, Humans, Intention, Middle Aged, Population Dynamics, Retirement, United States}, issn = {0016-9013}, doi = {10.1093/geront/48.2.190}, author = {Don E Bradley and Charles F Longino and Eleanor P. Stoller and William H Haas} } @article {5710, title = {Adequacy of Economic Resources in Retirement and Returns-to-scale in Consumption}, year = {2008}, institution = {The University of Michigan, Michigan Retirement Research Center}, abstract = {Most assessments of the adequacy of retirement resources are expressed as a comparison of preretirement income to immediate post-retirement income. Yet, among couples a substantial fraction of retirement years is eventually spent by the surviving spouse living alone. To the extent that singles need less than couples to maintain the same standard of living, assessments of the adequacy of economic resources that make no adjustment for widowing will systematically misstate economic preparation. We estimate returns-to-scale parameters in spending by older households, using data from the Consumption and Activities Mail Survey and apply these to assessments of adequacy of retirement resources.}, keywords = {Consumption and Savings, Health Conditions and Status, Net Worth and Assets}, url = {http://www.mrrc.isr.umich.edu/publications/papers}, author = {Michael D Hurd and Susann Rohwedder} } @article {7253, title = {Changes in weight among U.S. adults aged 70 and over, 1993 to 2002.}, journal = {Prev Med}, volume = {47}, year = {2008}, month = {2008 Nov}, pages = {489-93}, publisher = {47}, abstract = {

OBJECTIVE: To describe the patterns and predictors of weight change among U.S. adults aged 70 and over.

METHOD: The study is a retrospective cohort study of 7441 community-dwelling U.S. adults aged 70 years and over during 1993-2002. We examined changes in weight for men and women, and by race/ethnicity groups. We used multivariate linear regression analysis to determine predictors of weight change while controlling for key covariates at baseline.

RESULTS: The mean body weight decreased in both genders and all ethnic groups. Unadjusted average weight loss was 3.41 kg for men and 3.29 kg for women over nine years. Black women had higher mean body weight at baseline and were more likely to report weight gains of 5 kg or more. Multivariate analysis showed that age and baseline weight were major predictors of weight loss. Physical activity was associated with less weight loss among men.

CONCLUSION: The trends of weight change among U.S. adults aged 70 and over were more prone to weight loss than weight gain, with substantial variations. Public health messages regarding weight control should take into account the heterogeneity of this population and target weight loss as well as weight gain to meet diverse needs of the population.

}, keywords = {Aged, Aged, 80 and over, Aging, Female, Humans, Interviews as Topic, Linear Models, Male, Multivariate Analysis, Population Growth, Retrospective Studies, United States, Weight Gain, Weight Loss}, issn = {1096-0260}, doi = {10.1016/j.ypmed.2008.06.022}, author = {Xiaoxing He and Meng, Hongdao} } @article {5730, title = {The Characteristics of Social Security Beneficiaries Who Claim Benefits at the Early Entitlement Age}, year = {2008}, institution = {AARP Public Policy Institute}, keywords = {Retirement Planning and Satisfaction, Social Security}, url = {http://assets.aarp.org/rgcenter/econ/2008_19_beneficiaries.pdf}, author = {Xiaoyan Li and Michael D Hurd and Loughran, David} } @article {7226, title = {Circumstances of Women{\textquoteright}s First Birth May Be Linked to Their Health During Middle Age}, journal = {Perspectives on Sexual and Reproductive Health}, volume = {40}, year = {2008}, pages = {57}, publisher = {40}, abstract = {Once women reach late middle age, their mortality and disease risks may be related to their early childbearing history, according to analyses of data from the Health and Retirement Study (HRS), which conducts periodic surveys to track participants{\textquoteright} health, socioeconomic circumstances and family structure.1 Among U.S. women who were born in 1931-1941 and lived until at least the early 1990s, those who had first given birth as teenagers had elevated odds of dying between 1994 and 2002; they also were more likely than others to have had heart disease, lung disease or cancer by 1994. A series of logistic regression models controlling for background and midlife characteristics indicated that women who had given birth before age 20 were at increased risk of having had heart disease, lung disease or cancer by 1994 (coefficients, 0.3-0.4).}, keywords = {Adult children, Demographics, Health Conditions and Status}, author = {Hollander, Dore} } @inbook {5243, title = {Data sources, Later Life: Health and Retirement Study (HRS)}, booktitle = {Encyclopedia of the Life Course and Human Development}, volume = {3}, year = {2008}, publisher = {Gale}, organization = {Gale}, address = {Farmington Hills, MI}, abstract = {This reference is an entry in Volume 3 of the Encyclopedia of the Life Course and Human Development; it discusses the Health and Retirement Study as a data source for research on the Later Life stage of the life course.}, keywords = {Methodology}, isbn = {978-0-02-866162-9}, author = {Mary Beth Ofstedal}, editor = {Deborah Carr and Crosnoe, Robert and Mary Elizabeth Hughes and Pienta, Amy M.} } @article {7268, title = {Early Claiming of Social Security Benefits and Labor Supply Behavior of Older Americans.}, journal = {Appl Econ}, volume = {40}, year = {2008}, month = {2008 Dec 01}, pages = {2969-2985}, publisher = {40}, abstract = {

The labor supply incentives provided by the early retirement rules of the United States Social Security Old Age benefits program are of growing importance as the Normal Retirement Age (NRA) increases to 67, and the labor force participation of Older Americans starts to increase. These incentives allow individuals who claim benefits before the NRA but continue to work, or return to the labor force, to increase their future rate of benefit pay by having benefits withheld. Since the adjustment of the benefit rate takes place only after the NRA is reached, benefits received before the NRA can become actuarially unfair for those who continue to work after claiming. Consistent with these incentives, estimates from bivariate models of the monthly labor force exit and claiming hazards using data from the Health and Retirement Study indicate that early claimers who do not withdraw from the labor force around the time they claim are increasingly likely to stay in the labor force.

}, issn = {0003-6846}, doi = {10.1080/00036840600994054}, author = {Hugo Ben{\'\i}tez-Silva and Frank Heiland} } @article {7264, title = {Early motherhood and mental health in midlife: a study of British and American cohorts.}, journal = {Aging Ment Health}, volume = {12}, year = {2008}, note = {PMID: 18855176}, month = {2008 Sep}, pages = {605-14}, publisher = {12}, abstract = {

OBJECTIVES: Examine the relationship between early age at first birth and mental health among women in their fifties.

METHODS: Analysis of data on women from a British 1946 birth cohort study and the U.S. Health and Retirement Study birth cohort of 1931-1941.

RESULTS: In both samples a first birth before 21 years, compared to a later first birth, is associated with poorer mental health. The association between early first birth and poorer mental health persists in the British study even after controlling for early socioeconomic status, midlife socioeconomic status and midlife health. In the U.S. sample, the association becomes non-significant after controlling for educational attainment.

CONCLUSIONS: Early age at first birth is associated with poorer mental health among women in their fifties in both studies, though the pattern of associations differs.

}, keywords = {Adolescent, Birth Order, Cohort Studies, England, Female, Humans, Interviews as Topic, Maternal Age, Mental Health, Middle Aged, Mothers, Pregnancy, Pregnancy in Adolescence, United States}, issn = {1364-6915}, doi = {10.1080/13607860802343084}, author = {John C Henretta and Emily M D Grundy and Lucy C Okell and Michael E J Wadsworth} } @article {7277, title = {The Effect of Depressive Symptoms on Active Life Expectancy in the Presence or Absence of Chronic Conditions}, journal = {American Journal of Geriatric Psychiatry}, volume = {16}, year = {2008}, pages = {425-32}, publisher = {16}, abstract = {Objectives: The authors prospectively examined whether depressive symptoms (DS) in older adults negatively affected active live expectancy (ALE), or remaining years free of disability, and mortality, independently and in the presence of chronic diseases, and after stratification by gender. Design: Prospective cohort study, first three waves (1993-1998) of the Asset and Health Dynamics Among the Oldest Old. Setting: Data collection: University of Michigan; analysis: University of South Florida. Participants: Nationally representative sample of community-dwelling adults age 70 and older (N = 7,381). Measurements: DS (Center for Epidemiological Studies Depression, 8-item version), self-reported cancer, diabetes, heart disease, or stroke, difficulty with activities of daily living, death, and estimates of total, active, and disabled life expectancy. Results: DS reduced ALE by 6.5 years for young-old men (age 70), 3.2 years for old-old men (age 85), 4.2 years for young-old women, and 2.2 years for old-old women, and these effects remained significant at all ages and across gender even after controlling for chronic disease, the one exception being DS and cancer in old-old women. DS also reduced total life expectancy significantly, although controlling for some chronic diseases (particularly cancer and stroke) eliminated the effect of DS across age and gender groups. Conclusion: Depressive symptoms represent a serious and distinct threat to independent functioning in older adults. Whether experienced alone, or in combination with chronic diseases, depressive symptoms shorten ALE substantially. Timely diagnosis and treatment of depressive symptoms in older adults may delay the onset of disability and improve the quality of life.}, keywords = {Expectations, Health Conditions and Status}, author = {Sandra L Reynolds and William E. Haley and Nonna Kozlenko} } @article {10771, title = {An {\textquoteright}Elastic{\textquoteright} Earliest Eligibility Age for Social Security}, number = {IB$\#$8-2}, year = {2008}, institution = {Center for Retirement Research at Boston College}, abstract = {In the early 1980s, Congress responded to the Social Security program{\textquoteright}s long-term financing shortfall, in part, by raising the Full Retirement Age (FRA) from 65 to 67. When fully phased in, for those who turn 62 in 2022, workers will have to wait an additional two years to get the same monthly benefit. If they do not postpone claiming, the increase in the FRA will cut their benefits by about 13 percent. Congress did not change the earliest age at which workers can claim. This Earliest Eligibility Age (EEA) remains 62. When the increase in the FRA is fully phased in, workers who claim at 62 will get 70 percent, rather than 80 percent, of their FRA benefit. This has raised concerns that benefits claimed at the EEA will be too low, especially as retirees age and other sources of income decline. One response would be to raise the EEA from 62 to 64, in line with the two-year rise in the FRA. There are, however, two important objections to an increase in the EEA. The primary concern is that it would create hardship for those unable to work or find employment and who lack the resources to support themselves without working until age 64. A second objection is that raising the EEA is unfair to disadvantaged groups with low life expectancy. This brief addresses these concerns by considering an {\textquotedblleft}Elastic{\textquotedblright} EEA, which gives different workers different earliest eligibility ages.}, keywords = {Social Security, Social Security Eligibility}, url = {https://crr.bc.edu/briefs/an-qelasticq-earliest-eligibility-age-for-social-security/}, author = {Haverstick, Kelly and Margarita Sapozhnikov and Natalia A. Zhivan and Sass, Steven A.} } @mastersthesis {6343, title = {Evaluating the role of Social Security in providing annuity insurance}, volume = {Doctor of Philosophy}, year = {2008}, month = {2008}, school = {University of Minnesota}, type = {3318018}, address = {Minneapolis, MN}, abstract = {In this dissertation I study the usefulness of social security in providing annuity insurance when there is adverse selection in the annuity market. In Chapter 1 I study a two period economy where altruistic consumers have uncertain lifetime and are privately informed about their survival probabilities. Consumers buy insurance by participating in insurance pools. In this environment competitive equilibrium with life and annuity insurance exists despite the presence of adverse selection. This environment has three key features: (1) In any equilibrium there is at most one insurance market where trade occurs. (2) Increase in social security tax and benefits leads to increase in price of annuity and crowds out trade activities in annuity market. (3) In this environment efficient allocations are independent of private information and can be optimally implemented using simple tax-transfer instruments. Under optimal policy both annuity and life insurance markets are endogenously closed. I extend the model to a multi-period dynamic environment in Chapter 2. I calculate the welfare cost of adverse selection in the annuity market using a life cycle model in which individuals have private information about their mortality. I calibrate the model to the current U.S. social security replacement ratio, fraction of annuitized wealth and mortality heterogeneity in the Health and Retirement Study. My findings are as follows. First, in the absence of social security, individuals (on average) maintain about the same fraction of annuitized wealth as they do in the presence of social security, despite the fact that prices in the market are actuarially unfair. As a result, the welfare loss of abolishing social security is only 0.12 percent (in terms of consumption). Second, there is an ex ante gain of 0.51 percent from implementing the ex ante efficient allocations, which comes from redistributing resources from high mortality types to low mortality types. Individuals with high mortality (who will die soon and do not have demand for longevity insurance) incur large welfare losses from mandatory participation. These losses offset the benefits of providing insurance to low mortality types, leaving the overall ex ante welfare gain small.}, keywords = {Methodology}, author = {Hosseini, Roozbeh} } @article {5715, title = {Examining the Relationships between Excess Body Weight, Health and Disability}, year = {2008}, institution = {Office of the Assistant Secretary for Planning and Evaluation}, address = {Washington, D.C.}, abstract = {The recent rise in the prevalence of obesity and overweight in the overall United States population has raised many concerns about the future. In addition to concerns about the medical costs of treating obesity-related illness, an apparent correlation between obesity and disability has led to concern that the recent declines in rates of disability among the elderly may cease or reverse. In this report, we explore the relationship between excess weight and obesity in a series of cross-sectional and longitudinal analyses in an attempt to evaluate these concerns. Using data from the 1998-2004 waves of the Health and Retirement Study (HRS), we find evidence that the risks of developing difficulties with activities of daily living (ADLs) does increase with the prevalence of obesity, but the effects appear to be less dramatic than the effects on the limitations in physical functioning, which can be precursors of ADL disability. Further, we find only a weak relationship between excess weight and the onset of difficulties with instrumental activities of daily living (IADLs).}, keywords = {Health Conditions and Status}, url = {https://aspe.hhs.gov/basic-report/examining-relationships-between-excess-body-weight-health-and-disability}, author = {Timothy A Waidmann and Vicki A Freedman and Christine L Himes and Ahmad, Saad} } @article {7221, title = {Exploring the determinants of racial and ethnic disparities in total knee arthroplasty: health insurance, income, and assets.}, journal = {Med Care}, volume = {46}, year = {2008}, month = {2008 May}, pages = {481-8}, publisher = {46}, abstract = {

OBJECTIVE: To estimate national total knee arthroplasty (TKA) rates by economic factors, and the extent to which differences in insurance coverage, income, and assets contribute to racial and ethnic disparities in TKA use.

DATA SOURCE: US longitudinal Health and Retirement Study survey data for the elderly and near-elderly (biennial rounds 1994-2004) from the Institute of Social Research, University of Michigan.

STUDY DESIGN: The outcome is dichotomous, whether the respondent received first TKA in the previous 2 years. Longitudinal, random-effects logistic regression models are used to assess associations with lagged economic indicators.

SAMPLE: Sample was 55,469 person-year observations from 18,439 persons; 663, with first TKA.

RESULTS: Racial/ethnic disparities in TKA were more prominent among men than women. For example, relative to white women, odds ratios (ORs) were 0.94, 0.46, and 0.79, for white, black, and Hispanic men, respectively (P < 0.05 for black men). After adjusting for economic factors, racial/ethnic differences in TKA rates for women essentially disappeared, while the deficit for black men remained large. Among Medicare-enrolled elderly, those with supplemental insurance may be more likely to have first TKA compared with those without it, whether the supplemental coverage was private [OR: 1.27; 95\% confidence interval (CI): 0.82-1.96] or Medicaid (OR: 1.18; 95\% CI: 0.93-1.49). Among the near-elderly (age 47-64), compared with the privately insured, the uninsured were less likely (OR: 0.61; 95\% CI: 0.40-0.92) and those with Medicaid more likely (OR: 1.53; 95\% CI: 1.03-2.26) to have first TKA.

CONCLUSIONS: Limited insurance coverage and financial constraints explain some of the racial/ethnic disparities in TKA rates.

}, keywords = {Aged, Aged, 80 and over, Arthroplasty, Replacement, Knee, Comorbidity, ethnicity, Female, Healthcare Disparities, Humans, Income, Insurance, Health, Logistic Models, Longitudinal Studies, Male, Middle Aged, Sex Distribution, Socioeconomic factors, United States}, issn = {0025-7079}, doi = {10.1097/MLR.0b013e3181621e9c}, author = {Amresh D Hanchate and Zhang, Yuqing and David T Felson and Arlene S Ash} } @mastersthesis {6340, title = {Factors associated with purchase of long-term care insurance}, volume = {Doctor of Philosophy}, year = {2008}, school = {The Johns Hopkins University}, type = {3309675}, address = {Baltimore, MD}, abstract = {Spending on long-term care (LTC) is projected to increase from $194 billion in 2004 (with 49\% coming from Medicaid) to $540 billion in 2040. In response, efforts have been made to bolster the market for private long-term care insurance (LTCI) to reduce Medicaid spending. Private insurers want to understand what motivates people who purchase LTCI and how to expand the private market; consumers want to understand whether LTCI is an appropriate strategy for them to cover long-term care costs; and policymakers want to understand what the potential role of private LTCI is in terms of meeting future needs to fund LTC and what can be done to encourage purchase of LTCI. These papers aim to respond to these questions by reviewing sources of LTCI market failure and understanding the extent to which assets, income maintenance savings (savings that may set aside for 3 or more years), taste for insurance, and prior experience with a parent in nursing home care is associated with purchase of LTCI. Analysis of data from the 2004 Health and Retirement Study (HRS) shows that the most likely market of those for whom it might be worth purchasing LTCI is limited to approximately one-quarter of those over 50. Analyses were conducted within a target market of individuals (with $100,000 - $2 million in assets) who have medical insurance other than Medicaid, and are younger than 85. Logistic regression models were conducted with data from the HRS in 2000, 2002, and 2004. Data are weighted to represent the population of adults over 50 in the US as of 2004. Among those in the target market, individuals with a very high level of income maintenance savings (>/$100,000), who could presumably self-insure against all but the greatest risk of LTC; those with life insurance; and those with a parent who lived or lives in a nursing home, are associated with a greater likelihood of purchasing LTCI. However, with the exception of life insurance, none of these factors is independently associated with more than a forty percent higher likelihood of LTCI purchase, demonstrating that factors motivating purchase of LTCI are diffuse. The data presented suggest it important to re-evaluate expectations for the private market for LTCI based on individuals{\textquoteright} personal and financial circumstances, taste for insurance, and prior experience. Realistically assessing the factors that influence long-range planning for LTC among those capable of purchasing LTCI illustrates the largely separate roles of the public and private sector in terms of financing LTC.}, keywords = {Healthcare, Public Policy}, author = {Holve, Erin} } @inbook {5222, title = {Family Care and Assisted Living: An Uncertain Future?}, booktitle = {The Assisted Living Residence: A Vision for the Future}, year = {2008}, note = {ProCite field 6 : In ProCite field 8 : eds}, pages = {198-222}, publisher = {Johns Hopkins University Press}, organization = {Johns Hopkins University Press}, address = {Baltimore}, keywords = {Healthcare, Retirement Planning and Satisfaction}, author = {Douglas A. Wolf and Jenkins, Carol}, editor = {Golant, Steven M. and Hyde, Joan} } @article {5723, title = {Guide to Content of the HRS Psychosocial Leave-Behind Participant Lifestyle Questionnaires: 2004 and 2006}, year = {2008}, institution = {Ann Arbor, The University of Michigan}, abstract = {In 2004, HRS added a new feature for data collection in the form of self-administered questionnaires that were left with respondents upon the completion of an in-person Core Interview. These are referred to as Leave-Behind Questionnaires and electronic versions of the questionnaires are included in the 2004 Final release and 2006 Early Release. The purpose of the Leave-Behind Questionnaire is to collect additional information from respondents without adding to the interview length. Two separate questionnaires on different topics were included in HRS 2004: a) Participant Lifestyle Questionnaire, which measures psychosocial issues that are described in much more detail later in this report, and b) Participant questionnaire on Work and Health, which included a series of disability vignettes in which people with various levels of physical and mental health impairment were described and respondents were asked to indicate the extent to which they think the person described is limited in the kind or amount of work they can do. At the beginning of the vignettes, respondents were asked to rate their own degree of limitation in the kind or amount of work they can do.}, keywords = {Disabilities, Health Conditions and Status}, url = {http://hrsonline.isr.umich.edu/sitedocs/userg/HRS2006LBQscale.pdf}, author = {Philippa J Clarke and Gwenith G Fisher and House, Jim and Jacqui Smith and David R Weir} } @book {5287, title = {Handbook of cognitive aging: interdisciplinary perspectives}, year = {2008}, note = {Includes bibliographical references and indexes.}, publisher = {Sage Publications}, organization = {Sage Publications}, address = {Thousand Oaks, Calif}, keywords = {Health Conditions and Status}, doi = {10.4135/9781412976589}, author = {Scott M Hofer and Duane F. Alwin} } @article {7202, title = {Health insurance coverage as people approach and pass age-eligibility for Medicare.}, journal = {J Aging Soc Policy}, volume = {20}, year = {2008}, month = {2008}, pages = {29-44}, publisher = {20}, abstract = {

This study uses six waves of the Health and Retirement Study (HRS) to measure dynamics of health insurance coverage as people approach and pass age-eligibility for Medicare. Thirteen percent of 59- to 64-year-olds were uninsured and 13\% of 65- to 70-year-olds relied solely on Medicare. Those unmarried, in good health, and in poor health had an increased likelihood of being uninsured before age-eligibility for Medicare, while non-whites and those in good health had an increased likelihood of having Medicare-only coverage after age-eligibility for Medicare. Although only a small percentage was continually without coverage or with Medicare-only coverage, a substantial percentage had these coverage types at some point. Limitations and policy implications are included.

}, keywords = {Aged, Eligibility Determination, Female, Humans, Insurance Coverage, Insurance, Health, Male, Medicare, Middle Aged, United States}, issn = {0895-9420}, doi = {10.1300/j031v20n01_02}, author = {Caffrey, Christine and Christine L Himes} } @article {5725, title = {How Much Do Respondents in the Health and Retirement Study Know About Their Tax-deferred Contribution Plans? A Crosscohort Comparison}, number = {WP 2008-201}, year = {2008}, institution = {Michigan Retirement Research Center, University of Michigan}, address = {Ann Arbor, MI}, abstract = {We use information from Social Security earnings records to examine the accuracy of survey responses regarding participation in tax-deferred pension plans. As employer-provided defined benefit pensions are replaced by voluntary contribution plans, employees understanding of the link between their annual contribution decisions and their post-retirement wealth is becoming increasingly important. We examine the extent to which wage-earners in the Health and Retirement Study correctly report their inclusion in tax-deferred contribution plans and, conditional on inclusion, their annual contributions. We use two samples representing different cohorts in two different periods: the original HRS cohort interviewed in 1992 at ages 51-61, and a combination of the War Babies and Early Baby Boomer cohorts at the same ages interviewed twelve years later. Our findings indicate that while respondents interviewed in 2004 were more likely to report correctly whether they were included in DC plans, they were no more accurate in reporting whether they contributed to their plans than respondents interviewed in 1992. Respondents in both cohorts, moreover, overestimated their annual contributions. In both 1992 and in 2004, the mean absolute difference between respondent-reported and Social Security earnings record contributions was 1.5 times larger than the mean earnings record contribution.}, keywords = {Pensions, Social Security}, url = {https://deepblue.lib.umich.edu/bitstream/handle/2027.42/64473/wp201.pdf?sequence=1\&isAllowed=y}, author = {Irena Dushi and Honig, Marjorie} } @article {5748, title = {How Well Do Individuals Predict the Selling Prices of Their Homes?}, number = {No. 571}, year = {2008}, institution = {The Levy Economics Institute}, address = {New York, New York}, abstract = {Self-reported home values are widely used as a measure of housing wealth by researchers employing a variety of data sets and studying a number of different individual and household level decisions. The accuracy of this measure is an open empirical question, and requires some type of market assessment of the values reported. In this research, we study the predictive power of self-reported housing wealth when estimating sales prices utilizing the Health and Retirement Study. We find that homeowners, on average, overestimate the value of their properties by between 5 and 10 . We also find a strong correlation between accuracy and the economic conditions (measured by the prevalent interest rate, the growth of household income, and the growth of median housing prices) at the time of the purchase of the property. While most individuals overestimate the value of their properties, those who bought during more difficult economic times tend to be more accurate, and in some cases even underestimate the value of their house. This cyclicality of the overestimation of house prices can provide some clues regarding the reasons for the difficulties currently faced by many homeowners.}, keywords = {Housing, Net Worth and Assets}, doi = {http://dx.doi.org/10.2139/ssrn.1107165}, author = {Hugo Ben{\'\i}tez-Silva and Sel{\c c}uk Eren and Frank Heiland and Jimenez-Martin, Sergi} } @article {9046, title = {HRS Design History}, year = {2008}, month = {12/2008}, institution = {Survey Research Center, Institute for Social Research, University of Michigan}, address = {Ann Arbor, MI}, author = {HRS Staff} } @article {9047, title = {HRS Sample Evolution: 1992-1998 }, year = {2008}, month = {12/2008}, institution = {Survey Research Center, Institute for Social Research, University of Michigan}, address = {Ann Arbor, MI}, author = {HRS Staff} } @article {7217, title = {Impact of functional limitations and medical comorbidity on subsequent weight changes and increased depressive symptoms in older adults.}, journal = {J Aging Health}, volume = {20}, year = {2008}, month = {2008 Jun}, pages = {367-84}, publisher = {20}, abstract = {

OBJECTIVE: The primary goal of this study was to determine the effect of the onset of major medical comorbidity and functional decline on subsequent weight change and increased depressive symptoms.

METHODS: The sample included a prospective cohort of 53 to 63 year olds (n = 10,150) enrolled in the Health and Retirement Study. Separate lagged covariate models for men and women were used to study the impact of functional decline and medical comorbidity on subsequent increases in depressive symptoms and weight change 2 years later.

RESULTS: Functional decline and medical comorbidity were individual predictors of subsequent weight changes but not increased depressive symptoms. Most specific incident medical comorbidities or subtypes of functional decline predicted weight changes in both directions.

DISCUSSION: The elevated risk of weight gain subsequent to functional decline or onset of medical comorbidities may require the receipt of preventive measures to reduce further weight-related complications.

}, keywords = {Activities of Daily Living, Age Factors, Arthritis, Comorbidity, depression, Depressive Disorder, Diabetes Complications, Diabetes Mellitus, Disabled Persons, Female, Health Surveys, Heart Diseases, Humans, Hypertension, Lung Diseases, Male, Mental Disorders, Middle Aged, Neoplasms, Obesity, Risk Factors, Sex Factors, Stroke, United States, Weight Gain}, issn = {0898-2643}, doi = {10.1177/0898264308315851}, author = {Valerie L Forman-Hoffman and Kelly K Richardson and Jon W. Yankey and Stephen L Hillis and Robert B Wallace and Frederic D Wolinsky} } @article {7282, title = {Life with and without heart disease among women and men over 50.}, journal = {J Women Aging}, volume = {20}, year = {2008}, month = {2008}, pages = {5-19}, publisher = {20}, abstract = {

This article uses a demographic approach and data from the Health and Retirement Survey, a nationally representative sample of the U.S. population, to investigate sex differences in the length of life lived with heart disease and after a heart attack for persons in the United States age 50 and older. On average, women live longer than men with heart disease. At age 50 women can expect to live 7.9 years and men 6.7 years with heart disease. The average woman experiences heart disease onset three years older and heart attacks 4.4 years older than men.

}, keywords = {Activities of Daily Living, Aged, Female, Health Status, Heart Diseases, Humans, Life Expectancy, Male, Middle Aged, Myocardial Infarction, Patient Education as Topic, Prejudice, Risk Factors, United States, Women{\textquoteright}s Health, Women{\textquoteright}s Health Services}, issn = {0895-2841}, doi = {10.1300/j074v20n01_02}, author = {Eileen M. Crimmins and Mark D Hayward and Ueda, Hiroshi and Saito, Yasuhiko and Jung K Kim} } @article {7260, title = {Lifecourse social conditions and racial disparities in incidence of first stroke.}, journal = {Ann Epidemiol}, volume = {18}, year = {2008}, month = {2008 Dec}, pages = {904-12}, publisher = {18}, abstract = {

PURPOSE: Some previous studies found excess stroke rates among black subjects persisted after adjustment for socioeconomic status (SES), fueling speculation regarding racially patterned genetic predispositions to stroke. Previous research was hampered by incomplete SES assessments, without measures of childhood conditions or adult wealth. We assess the role of lifecourse SES in explaining stroke risk and stroke disparities.

METHODS: Health and Retirement Study participants age 50+ (n = 20,661) were followed on average 9.9 years for self- or proxy-reported first stroke (2175 events). Childhood social conditions (southern state of birth, parental SES, self-reported fair/poor childhood health, and attained height), adult SES (education, income, wealth, and occupational status) and traditional cardiovascular risk factors were used to predict first stroke onset using Cox proportional hazards models.

RESULTS: Black subjects had a 48\% greater risk of first stroke incidence than whites (95\% confidence interval, 1.33-1.65). Childhood conditions predicted stroke risk in both blacks and whites, independently of adult SES. Adjustment for both childhood social conditions and adult SES measures attenuated racial differences to marginal significance (hazard ratio, 1.13; 95\% CI, 1.00-1.28).

CONCLUSIONS: Childhood social conditions predict stroke risk in black and White American adults. Additional adjustment for adult SES, in particular wealth, nearly eliminated the disparity in stroke risk between black and white subjects.

}, keywords = {Aged, Aged, 80 and over, Black or African American, Cardiovascular Diseases, ethnicity, Female, Health Status Disparities, Humans, Incidence, Interviews as Topic, Life Style, Longitudinal Studies, Male, Middle Aged, Models, Statistical, Risk Factors, Social Environment, Socioeconomic factors, Stroke, United States, White People}, issn = {1873-2585}, doi = {10.1016/j.annepidem.2008.09.010}, author = {M. Maria Glymour and Mauricio Avendano and Steven A Haas and Lisa F Berkman} } @mastersthesis {6328, title = {Modeling aging processes: Social activities, partner influence, and individual well-being}, year = {2008}, month = {2008}, pages = {Ph.D.}, school = {The University of Chicago}, type = {3322590}, address = {United States -- Illinois}, abstract = {The past decade has witnessed a growing interest in longitudinal studies of aging. The perspective of cumulative advantage/adversity was employed to explain health disparities in later life. In terms of methodology, recent advances in the statistical theory of growth curve models have enabled important breakthroughs in the study of correlates of change. Moreover, moving beyond single-trajectory growth curve analysis, a combination of the longitudinal model for individual change and the cross-sectional model for matched pairs makes it possible to estimate dual aging trajectories of marital dyads. Hence, this dissertation focuses on effects from social activities and partner influences that affect aging. Using the Health and Retirement Study (HRS) and the Asset and Health Dynamics among the Oldest Old (AHEAD) data, I conduct three studies in this dissertation. In first two studies, I perform growth curve analyses to examine how activities such as volunteering, helping and late-life employment influence aging trajectories for mid-old aged and older adults. In the third study, I extend growth curve models into family and marriage research to estimate dual aging trajectories for marital dyads and to examine cross-partner interactive processes. The results suggest that social activity and marital context do influence aging processes after midlife. Findings also confirm the existence of selection mechanisms that may drive healthy individuals into activity and similar individuals into a marital relationship. In total, causal relations between activities and partner influence and the effects on later aging trajectories are established. Moreover, these studies predict that, to the extent that the changes accumulate, the above mechanisms will keep shaping older adults{\textquoteright} health trajectories over time. This suggests a mutually reinforcing cumulative process of selection and causal mechanisms.}, keywords = {Healthcare, Methodology}, author = {Hao, Yanni} } @book {5285, title = {Older and out of work: jobs and social insurance for a changing economy}, year = {2008}, note = {Includes bibliographical references and index.}, publisher = {W.E. Upjohn Institute for Employment Research}, organization = {W.E. Upjohn Institute for Employment Research}, address = {Kalamazoo, Mich.}, keywords = {Demographics, Employment and Labor Force}, url = {https://www.nasi.org/research/2008/older-out-work-jobs-social-insurance-changing-economy}, author = {Eberts, Randall W. and Hobbie, Richard} } @inbook {5241, title = {Pathways to Disability: Predicting Health Trajectories}, booktitle = {Health at Older Ages: The Causes and Consequences of Declining Disability}, year = {2008}, pages = {105-150}, chapter = {4}, keywords = {Disabilities, Healthcare}, isbn = {0-226-13231-5}, url = {https://www.nber.org/books-and-chapters/health-older-ages-causes-and-consequences-declining-disability-among-elderly/pathways-disability-predicting-health-trajectories}, author = {Florian Heiss and Axel Borsch-Supan and Michael D Hurd and David A Wise}, editor = {David M Cutler and David A Wise} } @article {7241, title = {Place of death among older Americans: does state spending on home- and community-based services promote home death?}, journal = {Med Care}, volume = {46}, year = {2008}, month = {2008 Aug}, pages = {829-38}, publisher = {46}, abstract = {

BACKGROUND: The majority of Americans die in institutions although most prefer to die at home. States vary greatly in their proportion of home deaths. Although individuals{\textquoteright} circumstances largely determine where they die, health policies may affect the range of options available to them.

OBJECTIVE: To examine whether states{\textquoteright} spending on home- and community-based services (HCBS) affects place of death, taking into consideration county health care resources and individuals{\textquoteright} family, sociodemographic, and health factors.

METHODS: Using exit interview data from respondents in the Health and Retirement Study born in 1923 or earlier who died between 1993 and 2002 (N = 3362), we conducted discrete-time survival analysis of the risk of end-of-life nursing home relocation to examine whether states{\textquoteright} HCBS spending would delay or prevent end-of-life nursing home admission. Then we ran logistic regression analysis to investigate the HCBS effects on place of death separately for those who relocated to a nursing home and those who remained in the community.

RESULTS: Living in a state with higher HCBS spending was associated with lower risk of end-of-life nursing home relocation, especially among people who had Medicaid. However, state HCBS support was not directly associated with place of death.

CONCLUSIONS: States{\textquoteright} generosity for HCBS increases the chance of dying at home via lowering the risk of end-of-life nursing home relocation. State-to-state variation in HCBS spending may partly explain variation in home deaths. Our findings add to the emerging encouraging evidence for continued efforts to enhance support for HCBS.

}, keywords = {Aged, Aged, 80 and over, Community Health Services, Death, Humans, Logistic Models, Nursing homes, Residence Characteristics, Terminal Care}, issn = {1537-1948}, doi = {10.1097/MLR.0b013e3181791a79}, author = {Muramatsu, Naoko and Ruby L Hoyem and yin, Hongjun and Richard T. Campbell} } @article {7229, title = {Predictors of non-local moves among older adults: a prospective study.}, journal = {J Gerontol B Psychol Sci Soc Sci}, volume = {63}, year = {2008}, month = {2008 Jan}, pages = {S7-14}, publisher = {63B}, abstract = {

OBJECTIVES: The goal of this article was to test a series of established predictors of the hazard of moving for persons primarily in their 50s and 60s. We tested demographic covariates, resources, travel experience, and community and person ties using a prospective design.

METHODS: We employed data from the Health and Retirement Study, 1994 to 2002, based on a representative sample of households containing at least one member aged 51 to 61 in 1992. We employed measures available in the Health and Retirement Study to construct a series of Cox proportional hazards models that examined the causes of non-local moves.

RESULTS: Community and person ties emerged as important predictors of non-local moves.

DISCUSSION: Travel experience, when measured by regular vacationing and second homes, may increase community ties to a destination. The life-course model must be modified in its explanation of the importance of community and person ties, and of life transitions, as motivators of migration.

}, keywords = {Aged, Emigration and Immigration, Female, Humans, Interpersonal Relations, Life Change Events, Male, Prospective Studies, Socioeconomic factors, Surveys and Questionnaires, Travel}, issn = {1079-5014}, doi = {10.1093/geronb/63.1.s7}, author = {Charles F Longino and Don E Bradley and Eleanor P. Stoller and William H Haas} } @article {7201, title = {Prevalence of cognitive impairment without dementia in the United States.}, journal = {Ann Intern Med}, volume = {148}, year = {2008}, month = {2008 Mar 18}, pages = {427-34}, publisher = {148}, abstract = {

BACKGROUND: Cognitive impairment without dementia is associated with increased risk for disability, increased health care costs, and progression to dementia. There are no population-based prevalence estimates of this condition in the United States.

OBJECTIVE: To estimate the prevalence of cognitive impairment without dementia in the United States and determine longitudinal cognitive and mortality outcomes.

DESIGN: Longitudinal study from July 2001 to March 2005.

SETTING: In-home assessment for cognitive impairment.

PARTICIPANTS: Participants in ADAMS (Aging, Demographics, and Memory Study) who were age 71 years or older drawn from the nationally representative HRS (Health and Retirement Study). Of 1770 selected individuals, 856 completed initial assessment, and of 241 selected individuals, 180 completed 16- to 18-month follow-up assessment.

MEASUREMENTS: Assessments, including neuropsychological testing, neurologic examination, and clinical and medical history, were used to assign a diagnosis of normal cognition, cognitive impairment without dementia, or dementia. National prevalence rates were estimated by using a population-weighted sample.

RESULTS: In 2002, an estimated 5.4 million people (22.2\%) in the United States age 71 years or older had cognitive impairment without dementia. Prominent subtypes included prodromal Alzheimer disease (8.2\%) and cerebrovascular disease (5.7\%). Among participants who completed follow-up assessments, 11.7\% with cognitive impairment without dementia progressed to dementia annually, whereas those with subtypes of prodromal Alzheimer disease and stroke progressed at annual rates of 17\% to 20\%. The annual death rate was 8\% among those with cognitive impairment without dementia and almost 15\% among those with cognitive impairment due to medical conditions.

LIMITATIONS: Only 56\% of the nondeceased target sample completed the initial assessment. Population sampling weights were derived to adjust for at least some of the potential bias due to nonresponse and attrition.

CONCLUSION: Cognitive impairment without dementia is more prevalent in the United States than dementia, and its subtypes vary in prevalence and outcomes.

}, keywords = {Aged, Aged, 80 and over, Cognition Disorders, Dementia, disease progression, Humans, Longitudinal Studies, Prevalence, United States}, issn = {1539-3704}, doi = {10.7326/0003-4819-148-6-200803180-00005}, author = {Brenda L Plassman and Kenneth M. Langa and Gwenith G Fisher and Steven G Heeringa and David R Weir and Mary Beth Ofstedal and James R Burke and Michael D Hurd and Guy G Potter and Willard L Rodgers and David C Steffens and John J McArdle and Robert J. Willis and Robert B Wallace} } @article {7223, title = {Productive activities and psychological well-being among older adults.}, journal = {J Gerontol B Psychol Sci Soc Sci}, volume = {63}, year = {2008}, month = {2008 Mar}, pages = {S64-72}, publisher = {63B}, abstract = {

OBJECTIVES: The purpose of this study was to test whether paid work and formal volunteering reduce the rate of mental health decline in later life.

METHODS: Using four waves of Health and Retirement Study data collected from a sample of 7,830 individuals aged 55 to 66, I estimated growth curve models to assess the effects of productive activities on mental health trajectories. The analytical strategy took into account selection processes when examining the beneficial effects of activities. The analyses also formally attended to the sample attrition problem inherent in longitudinal studies.

RESULTS: The results indicated that activity participants generally had better mental health at the beginning of the study. Full-time employment and low-level volunteering had independent protective effects against decline in psychological well-being. Joint participants of both productive activities enjoyed a slower rate of mental health decline than single-activity participants.

DISCUSSION: The results are consistent with activity theory and further confirm the role accumulation perspective. The finding that full-time work combined with low-level volunteering is protective of mental health reveals the complementary effect of volunteering to formal employment. Methodological and theoretical implications are discussed.

}, keywords = {Activities of Daily Living, Aged, Cohort Studies, depression, Employment, Female, Health Status, Humans, Male, Mental Health, Middle Aged, Models, Psychological, Psychological Theory, Psychomotor Performance, Quality of Life, Social Environment, Volunteers}, issn = {1079-5014}, doi = {10.1093/geronb/63.2.s64}, author = {Hao, Yanni} } @article {7239, title = {Retirement and weight changes among men and women in the health and retirement study.}, journal = {J Gerontol B Psychol Sci Soc Sci}, volume = {63}, year = {2008}, month = {2008 May}, pages = {S146-53}, publisher = {63B}, abstract = {

OBJECTIVES: Older adults may experience weight changes upon retirement for a number of reasons, such as being less physically active; having less structured meal times; and consuming food in response to losing personal identity, the potential for social interactions, or the sense of accomplishment derived from working. The purpose of this study was to determine whether retirement was associated with either weight gain or weight loss.

METHODS: We used the 1994-2002 Health and Retirement Study to determine whether retirement between biennial interviews was associated with weight change, separately for men (n = 1,966) and women (n = 1,759). We defined weight change as a 5\% increase or decrease in body mass index between interviews.

RESULT: . We did not find a significant association between retirement and weight change among men. Women who retired were more likely to gain weight than women who continued to work at least 20 hr per week (odds ratio [OR] = 1.24, 95\% confidence interval [CI] = 1.04-1.48). We found a significant relationship between retirement and weight gain only for women who were normal weight upon retiring (OR = 1.30, 95\% CI = 1.01-1.69) and who retired from blue-collar jobs (OR = 1.58, 95\% CI = 1.13-2.21).

DISCUSSION: Public health interventions may be indicated for women, particularly those working in blue-collar occupations, in order to prevent weight gain upon retirement.

}, keywords = {Aged, Aging, Body Mass Index, Body Weight, Demography, depression, Female, Health Behavior, Health Status, Humans, Interviews as Topic, Male, Middle Aged, Obesity, Retirement}, issn = {1079-5014}, doi = {10.1093/geronb/63.3.s146}, author = {Valerie L Forman-Hoffman and Kelly K Richardson and Jon W. Yankey and Stephen L Hillis and Robert B Wallace and Frederic D Wolinsky} } @article {5733, title = {The Retirement Consumption Puzzle: Actual Spending Change in Panel Data}, number = {13929}, year = {2008}, institution = {National Bureau of Economic Research}, address = {Cambridge, MA}, abstract = {The simple one-good model of life-cycle consumption requires that consumption be continuous over retirement; yet prior research based on partial measures of consumption or on synthetic panels indicates that spending drops at retirement, a result that has been called the retirement-consumption puzzle. Using panel data on total spending, nondurable spending and food spending, we find that spending declines at small rates over retirement, at rates that could be explained by mechanisms such as the cessation of work-related expenses, unexpected retirement due to a health shock or by the substitution of time for spending. In the low-wealth population where spending did decline at higher rates, the main explanation for the decline appears to be a high rate of early retirement due to poor health. We conclude that at the population level there is no retirement consumption puzzle in our data, and that in subpopulations where there were substantial declines, conventional economic theory can provide the main explanation.}, keywords = {Event History/Life Cycle, Health Conditions and Status, Retirement Planning and Satisfaction}, doi = {10.3386/w13929}, author = {Michael D Hurd and Susann Rohwedder} } @book {5280, title = {Socioeconomic Differences in Old Age Mortality}, series = {The Springer series on Demographic Methods and Population Analysis}, volume = {25}, year = {2008}, publisher = {Springer}, organization = {Springer}, address = {Dordrecht}, abstract = {Social differences in health and mortality constitute a persistent finding in epidemiological, demographic, and sociological research. This topic is increasingly discussed in the political debate and is among the most urgent public health issues. However, it is still unknown if socioeconomic mortality differences increase or decrease with age. This book provides a comprehensive, thoughtful and critical discussion of all aspects involved in the relationship between socioeconomic status, health and mortality. In a well-written language, it synthesizes the sociological theory of social inequality and an empirical study of mortality differences that has been performed at the Max Planck Institute for Demographic Research (Rostock, Germany). The best available datasets from Denmark and the USA, as two very different countries, are used to analyze the age pattern of social mortality differences, the Danish register data covering the whole Danish population between 1980 and 2002. This study is the most comprehensive analysis of socioeconomic mortality differences in the literature, in terms of data quantity, quality, and the statistical method of event-history modeling. It makes important new theoretical and empirical contributions. With a new method it also addresses the question whether the measurement of social mortality differences in old age so far has been biased by mortality selection due to unobserved heterogeneity.}, keywords = {Demographics, Health Conditions and Status}, isbn = {978-1-4020-8692-2}, url = {https://www.springer.com/gp/book/9781402086915}, author = {Rasmus Hoffmann} } @article {7210, title = {Trajectories of functional health: the {\textquoteright}long arm{\textquoteright} of childhood health and socioeconomic factors.}, journal = {Soc Sci Med}, volume = {66}, year = {2008}, month = {2008 Feb}, pages = {849-61}, publisher = {66}, abstract = {

Few studies have specifically examined trajectories of functional health status or estimated the extent to which they are influenced by childhood health and socioeconomic conditions. This study examines how circumstances associated with early life may shape the level and progression of functional limitations among adults at or near retirement. Employing data from the US Health and Retirement Study (HRS), it estimates latent growth curve models (LGM) of functional limitation. The results demonstrate that functional health trajectories in old age continue to be shaped by childhood health and socioeconomic circumstances. Poor childhood health and disadvantaged social origins are associated with both more functional limitations at baseline and higher rates of increase over time. This association is net of baseline adult chronic disease and socioeconomic status. While both childhood and adult factors influence the baseline level of functional limitation, only childhood health and socioeconomic status are associated with the rate of change in limitations over time.

}, keywords = {Aged, Child, Female, Health Behavior, Health Status Disparities, Humans, Male, Middle Aged, Social Class, Socioeconomic factors}, issn = {0277-9536}, doi = {10.1016/j.socscimed.2007.11.004}, author = {Steven A Haas} } @mastersthesis {6345, title = {Understanding health inequality through the study of living arrangements}, year = {2008}, month = {2008}, pages = {M.A.}, school = {Mississippi State University}, type = {1454242}, address = {United States -- Mississippi}, abstract = {Promoting population health is an essential task for sustainable development. This study explores the association between socioeconomic status and perceived health in the United States, with special attention on the influence of living arrangements. It also improves the existing explanations of causal mechanisms underlying the impact of SES on health among Americans over 50. Using the first and seventh waves of Health and Retirement Study to run ordered logistic regression, this research addresses the importance of living arrangements and social capital on self-reported health. Income and education are both important predictors of self-reported health. In addition, living arrangements and household social capital also affects self-reported health after controlling individuals{\textquoteright} characteristics and SES indicators. These effects do not appear to mediate the socioeconomic effects on self-reported health. Future research should highlight better measures of living arrangements and social capital, as well as explore longitudinal analyses.}, keywords = {Demographics, Public Policy}, author = {Hsu, Tze-Li} } @article {7219, title = {VALUING LOST HOME PRODUCTION OF DUAL EARNER COUPLES.}, journal = {Int Econ Rev (Philadelphia)}, volume = {49}, year = {2008}, month = {2008 May 01}, pages = {701-736}, publisher = {49}, abstract = {

Using a life-cycle model in which women divide their time between home and market work, we establish a link between retirement wealth and the value of forgone home production. We use data from the Health and Retirement Study to estimate the model{\textquoteright}s parameters and adjust the growth rate of GDP to reflect reductions in non-market output. We find that the value of forgone home production is modest - about 25 percent of women{\textquoteright}s measured earnings.

}, issn = {0020-6598}, doi = {10.1111/j.1468-2354.2008.00495.x}, author = {Christopher L House and John Laitner and Stolyarov, Dmitriy} } @article {5732, title = {Wealth Change and Active Saving at Older Ages}, year = {2008}, institution = {RAND and Netspar}, abstract = {According to the simple lifecycle model single persons are predicted to decumulate assets at advanced age, when mortality risk is high to reduce the risk of dying with substantial wealth. Empirically it has been difficult to show this prediction in micro data. In this paper we discuss the most common limitations in existing data. We provide empirical evidence of dissaving at older ages by single persons using the unusually rich data from the Health and Retirement Study. We present lifecycle patterns of dissaving based on three very different kinds of data: those that are derived from wealth change, those derived from measures of active saving defined as disposable income minus consumption and those that are derived from model simulation. Based on wealth change we find evidence of dissaving for singles and limited evidence for couples: couples preserve wealth longer to provide for the surviving spouse. However, rates of active saving imply much smaller wealth decumulation for singles and no decumulation at all for couples. Decumulation based on model simulation lies between the two. We suspect that the discrepancies are partly due to the treatment of taxes and partly due to consumption being under measured.}, keywords = {Consumption and Savings, Event History/Life Cycle, Net Worth and Assets}, author = {Michael D Hurd and Susann Rohwedder} } @article {7142, title = {All in the family: the impact of caring for grandchildren on grandparents{\textquoteright} health.}, journal = {J Gerontol B Psychol Sci Soc Sci}, volume = {62}, year = {2007}, month = {2007 Mar}, pages = {S108-19}, publisher = {62}, abstract = {

OBJECTIVES: The purpose of this study was to examine the effects of caring for grandchildren on health behaviors and mental and physical health among older adults.

METHODS: Using a sample of 12,872 grandparents aged 50 through 80 from the Health and Retirement Study, we examined the relationship between stability and change in various types of grandchild care and subsequent health, controlling for covariates and earlier health.

RESULTS: We found no evidence to suggest that caring for grandchildren has dramatic and widespread negative effects on grandparents{\textquoteright} health and health behavior. We found limited evidence that grandmothers caring for grandchildren in skipped-generation households are more likely to experience negative changes in health behavior, depression, and self-rated health. We also found some evidence of benefits to grandmothers who babysit.

DISCUSSION: Our findings suggest that the health disadvantages found previously among grandparent caregivers arise from grandparents{\textquoteright} prior characteristics, not as a consequence of providing care. Health declines as a consequence of grandchild care appear to be the exception rather than the rule. These findings are important given continuing reliance on grandparents for day care and increasing reliance on grandparents for custodial care. However, the findings should be tempered by the recognition that for a minority of grandparents, coresidential grandchild care may compromise health.

}, keywords = {Adaptation, Psychological, Aged, Aged, 80 and over, Aging, Caregivers, Child Care, Child, Preschool, Family Relations, Female, Health Status, Humans, Intergenerational Relations, Male, Middle Aged, Parenting, Risk Assessment, Stress, Psychological}, issn = {1079-5014}, doi = {10.1093/geronb/62.2.s108}, author = {Mary Elizabeth Hughes and Linda J. Waite and Tracey A. LaPierre and Ye Luo} } @article {5696, title = {Are 401(k) Saving Rates Changing? Cohort/Period Evidence from the Health and Retirement Study}, number = {WP 2007-160}, year = {2007}, institution = {Michigan Retirement and Disability Research Center, University of Michigan}, address = {Ann Arbor, MI}, abstract = {This research examines the determinants of eligibility and participation in 401(k) plans using two cross-sections of data from the Health and Retirement Study. Our sample consists of workers ages 51-56 representing two cohorts: the original HRS cohort born 1931-41, first interviewed in 1992, and the Early Baby Boomer (EBB) cohort born 1948-53, interviewed in 2004. Participation in 401(k) pensions in the EBB cohort is nearly 50 percent greater than that of the earlier cohort. This substantial growth in 401(k) plan participation over a relatively brief period may reflect intrinsic differences in tastes between the two cohorts, changes over this period in the external environment regarding retirement saving, or the joint effects of both influences.}, keywords = {Pensions, Retirement Planning and Satisfaction}, url = {https://mrdrc.isr.umich.edu/pubs/are-401k-saving-rates-changing-cohort-period-evidence-from-the-health-and-retirement-study/}, author = {Irena Dushi and Honig, Marjorie} } @article {7173, title = {Beyond comorbidity counts: how do comorbidity type and severity influence diabetes patients{\textquoteright} treatment priorities and self-management?}, journal = {J Gen Intern Med}, volume = {22}, year = {2007}, month = {2007 Dec}, pages = {1635-40}, publisher = {22}, abstract = {

BACKGROUND: The majority of older adults have 2 or more chronic conditions and among patients with diabetes, 40\% have at least three.

OBJECTIVE: We sought to understand how the number, type, and severity of comorbidities influence diabetes patients{\textquoteright} self-management and treatment priorities.

DESIGN: Cross-sectional observation study.

PATIENTS: A total of 1,901 diabetes patients who responded to the 2003 Health and Retirement Study (HRS) diabetes survey.

MEASUREMENTS: We constructed multivariate models to assess the association between presence of comorbidities and each of 2 self-reported outcomes, diabetes prioritization and self-management ability, controlling for patient demographics. Comorbidity was characterized first by a count of all comorbid conditions, then by the presence of specific comorbidity subtypes (microvascular, macrovascular, and non-diabetes related), and finally by severity of 1 serious comorbidity: heart failure (HF).

RESULTS: 40\% of respondents had at least 1 microvascular comorbidity, 79\% at least 1 macrovascular comorbidity, and 61\% at least 1 non-diabetes-related comorbidity. Patients with a greater overall number of comorbidities placed lower priority on diabetes and had worse diabetes self-management ability scores. However, only macrovascular and non-diabetes-related comorbidities, but not microvascular comorbidities, were associated with lower diabetes prioritization, whereas higher numbers of microvascular, macrovascular, and non-diabetes-related conditions were all associated with lower diabetes self-management ability scores. Severe, but not mild, HF was associated with lower diabetes prioritization and self-management scores.

CONCLUSIONS: The type and severity of comorbid conditions, and not just the comorbidity count, influence diabetes patients{\textquoteright} self-management. Patients with severely symptomatic comorbidities and those with conditions they consider to be unrelated to diabetes may need additional support in making decisions about care priorities and self-management activities.

}, keywords = {Aged, Attitude to Health, Cohort Studies, Comorbidity, Cross-Sectional Studies, Diabetes Mellitus, Female, Health Priorities, Heart Failure, Humans, Male, Middle Aged, Self Care, Severity of Illness Index, United States}, issn = {1525-1497}, doi = {10.1007/s11606-007-0313-2}, author = {Eve A Kerr and Michele M Heisler and Sarah L. Krein and Mohammed U Kabeto and Kenneth M. Langa and David R Weir and John D Piette} } @article {7162, title = {Black Women: Truly disadvantaged in the transition from employment to retirement income}, journal = {Social Science Research}, volume = {36}, year = {2007}, pages = {1184}, publisher = {36}, abstract = {We combine labor market and class theory to explain how racial and gender income inequality endures in the transition from employment to retirement. Using data from Health and Retirement Study primary respondents who were not retired in 1992 (wave 1) but were retired in 2000 (wave 5), OLS regression and Heckman{\textquoteright}s two step analysis indicate that: (1) black and white women earn less from employment, even after controlling for employment and marital status, educational credentials, and work experience; (2) black and white women are less likely to retire, even after controlling for employment, age, insurance, assets, and spousal employment/retirement status; and (3) after controlling for these gender differences in employment earnings and in retirement decisions, white women actually receive more total (Social Security, pension, and asset) income in retirement than comparable white men. Black men continue to exhibit no significant (net effect) differences (compared to white men), while black women continue to earn the least.}, keywords = {Demographics, Employment and Labor Force, Income}, doi = {https://doi.org/10.1016/j.ssresearch.2006.07.002}, author = {Hogan, Richard and Perrucci, Carolyn C.} } @article {7183, title = {Disease prevalence and survey design effects: A response to Weir and Smith}, journal = {Social Science and Medicine}, volume = {65}, year = {2007}, pages = {1078}, publisher = {65}, abstract = {Evidence provided by Weir and Smith, particularly the findings from the National Health and Nutrition Examination Survey (NHANES), leads us to conclude that an increase in arthritis prevalence during the 1990s in the United States is probable, but the trend is likely overstated in the Health and Retirement Study (HRS). We show that a mistake in our earlier method does not change substantively our previous conclusion that survey duration effects are occurring in the HRS, a finding that is also supported by a variety of regression models (including that of Weir and Smith). Furthermore, very little evidence exists for an upward trend among self-reporters in the National Health Interview Survey (NHIS), and less than 25 of the increase in the HRS over the 1990s can be attributed to increases in obesity.}, keywords = {Health Conditions and Status, Methodology}, doi = {https://doi.org/10.1016/j.socscimed.2007.04.039}, author = {Sven E. Wilson and Benjamin L. Howell} } @article {7178, title = {Does physician communication influence older patients{\textquoteright} diabetes self-management and glycemic control? Results from the Health and Retirement Study (HRS).}, journal = {J Gerontol A Biol Sci Med Sci}, volume = {62}, year = {2007}, month = {2007 Dec}, pages = {1435-42}, publisher = {62A}, abstract = {

BACKGROUND: Effective chronic disease self-management among older adults is crucial for improved clinical outcomes. We assessed the relative importance of two dimensions of physician communication-provision of information (PCOM) and participatory decision-making (PDM)-for older patients{\textquoteright} diabetes self-management and glycemic control.

METHODS: We conducted a national cross-sectional survey among 1588 older community-dwelling adults with diabetes (response rate: 81\%). Independent associations were examined between patients{\textquoteright} ratings of their physician{\textquoteright}s PCOM and PDM with patients{\textquoteright} reported diabetes self-management (medication adherence, diet, exercise, blood glucose monitoring, and foot care), adjusting for patient sociodemographics, illness severity, and comorbidities. Among respondents for whom hemoglobin A1c (HbA1c) values were available (n=1233), the relationship was assessed between patient self-management and HbA1c values.

RESULTS: In separate multivariate regressions, PCOM and PDM were each associated with overall diabetes self-management (p<.001) and with all self-management domains (p<.001 in all models), with the exception of PDM not being associated with medication adherence. In models with both PCOM and PDM, PCOM alone predicted medication adherence (p=.001) and foot care (p=.002). PDM alone was associated with exercise and blood glucose monitoring (both p<.001) and was a stronger independent predictor than PCOM of diet. Better patient ratings of their diabetes self-management were associated with lower HbA1c values (B= -.10, p=.005).

CONCLUSION: Among these older adults, both their diabetes providers{\textquoteright} provision of information and efforts to actively involve them in treatment decision-making were associated with better overall diabetes self-management. Involving older patients in setting chronic disease goals and decision-making, however, appears to be especially important for self-care areas that demand more behaviorally complex lifestyle adjustments such as exercise, diet, and blood glucose monitoring.

}, keywords = {Aged, Blood Glucose, Communication, Cross-Sectional Studies, Diabetes Mellitus, Female, Glycated Hemoglobin, Humans, Male, Multivariate Analysis, Physician-Patient Relations, Self Care}, issn = {1079-5006}, doi = {10.1093/gerona/62.12.1435}, author = {Michele M Heisler and Cole, Ian and David R Weir and Eve A Kerr and Rodney A. Hayward} } @article {7169, title = {Early childbearing, marital status, and women{\textquoteright}s health and mortality after age 50.}, journal = {J Health Soc Behav}, volume = {48}, year = {2007}, month = {2007 Sep}, pages = {254-66}, publisher = {48}, abstract = {

This article examines the relationship between a woman{\textquoteright}s childbearing history and her later health and mortality, with primary focus on whether the association between them is due to early and later socioeconomic status. Data are drawn from the Health and Retirement Study birth cohort of 1931-1941. Results indicate that, conditional on reaching midlife and controlling for early and later socioeconomic status, a first birth before age 20 is associated with a higher hazard of dying. In addition, having an early birth is associated with a higher prevalence of reported heart disease, lung disease, and cancer in 1994. Being unmarried at the time of the first birth is associated with earlier mortality, but this association disappears when midlife socioeconomic status is controlled. The number of children ever born does not significantly affect mortality but is associated with prevalence of diabetes.

}, keywords = {Adolescent, Cohort Studies, Female, Humans, Marital Status, Maternal Age, Middle Aged, Mortality, Parity, Pregnancy, Pregnancy in Adolescence, Prevalence, Proportional Hazards Models, Social Class, United States, Women{\textquoteright}s Health}, issn = {0022-1465}, doi = {10.1177/002214650704800304}, author = {John C Henretta} } @article {5679, title = {Enhancing the Quality of Data on the Measurement of Income and Wealth}, number = {WP 2007-151}, year = {2007}, institution = {Michigan Retirement and Disability Research Center, University of Michigan}, address = {Ann Arbor, MI}, abstract = {Over the last decade or so, a substantial effort has gone into the design of a series of methodological investigations aimed at enhancing the quality of survey data on income and wealth. These investigations have largely been conducted at the Survey Research Center at the University of Michigan, and have mainly involved two longitudinal surveys: the Health and Retirement Study (HRS), with a first wave beginning in 1992 and continued thereafter every other year through 2004; and the Assets and Health Dynamics Among the Oldest Old (AHEAD) Study, begun in 1993 and continued in 1995 and 1998, then in every other year through 2004. Surveys for the year 2006 are currently in the field. This paper provides an overview of the main studies and summarizes what has been learned so far. The studies include; a paper by Juster and Smith (Improving the Quality of Economic Data: Lessons from the HRS and AHEAD, JASA, 1997); a paper by Juster, Cao, Perry and Couper (The Effect of Unfolding Brackets on the Quality of Wealth Data in HRS, MRRC Working Paper, WP 2006-113, January 2006); a paper by Hurd, Juster and Smith (Enhancing the Quality of Data on Income: Recent Innovations from the HRS, Journal of Human Resources, Summer 2003); a paper by Juster, Lupton and Cao (Ensuring Time-Series Consistency in Estimates of Income and Wealth, MRRC Working Paper, WP 2002-030, July 2002); a paper by Cao and Juster (Correcting Second-Home Equity in HRS/AHEAD: MRRC Working Paper WP 2004-081, June 2004); and a paper by Rohwedder, Haider and Hurd (RAND Working Paper, 2004).}, keywords = {Income, Methodology, Net Worth and Assets}, url = {https://papers.ssrn.com/sol3/papers.cfm?abstract_id=1095815}, author = {Juster, F. Thomas and Cao, Honggao and Mick P. Couper and Daniel H. Hill and Michael D Hurd and Joseph P. Lupton and Michael M. Perry and James P Smith} } @article {7137, title = {Gender differences in the link between childhood socioeconomic conditions and heart attack risk in adulthood.}, journal = {Demography}, volume = {44}, year = {2007}, month = {2007 Feb}, pages = {137-58}, publisher = {44}, abstract = {

A growing body of evidence shows that childhood socioeconomic status (SES) is predictive of disease risk in later life, with those from the most disadvantaged backgrounds more likely to experience poor adult-health outcomes. Most of these studies, however are based on middle-aged male populations and pay insufficient attention to the pathways between childhood risks and specific adult disorders. This article examines gender differences in the link between childhood SES and heart attack risk trajectories and the mechanisms by which early environments affect future disease risk. By using methods that model both latent and path-specific influences, we identify heterogeneity in early life conditions and human, social, and health capital in adulthood that contribute to diverse heart attack risk trajectories between and among men and women as they age into their 60s and 70s. We find that key risk factors for heart attack operate differently for men and women. For men, childhood SES does not differentiate those at low, increasing, and high risk for heart attack. In contrast, women who grew up without a father and/or under adverse economic conditions are the most likely to experience elevated risk for heart attack, even after we adjust for the unequal distribution of working and living conditions, social relationships, access to health care, and adult lifestyle behaviors that influence health outcomes.

}, keywords = {Adult, Age Factors, Child, Child Welfare, Health Status, Humans, Middle Aged, Myocardial Infarction, North Carolina, Poverty, Risk Assessment, Risk Factors, Sex Factors, Social Class, Socioeconomic factors, Time}, issn = {0070-3370}, doi = {10.1353/dem.2007.0004}, author = {Jenifer Hamil-Luker and Angela M O{\textquoteright}Rand} } @article {5686, title = {A Gradual Exit May Not Make for a Happier Retirement}, number = {IB$\#$7-16}, year = {2007}, institution = {Center for Retirement Research at Boston College}, address = {Boston}, abstract = {Workers often say they want to retire gradually. As retirement is a sharp break with life as they know it, it{\textquoteright}s not surprising that many prefer to negotiate the transition a step at a time. Many policymakers also view gradual retirement favorably. They see it as a way to extend careers, shorten retirements, and thereby improve retirement income security. Expanding opportunities for gradual or {\textquotedblleft}phased{\textquotedblright} retirement has thus gained a prominent place on the policy agenda. Workers who say they want to retire gradually, however, are clearly not basing their preference on personal experience. These workers have not retired both ways, concluding that retiring in stages is better. To shed light on this issue, this brief summarizes a new study comparing individuals who retired gradually with those who retired {\textquotedblleft}cold turkey{\textquotedblright} and asks which are happier in retirement. The study uses happiness as the yardstick because it measures realized quality of life; other criteria {\textemdash} such as income, wealth, social status, or health {\textemdash} measure potential quality of life. Greater happiness in retirement is also what workers seem to expect if they exit the labor force gradually{\textellipsis}}, keywords = {Retirement Planning and Satisfaction}, url = {https://crr.bc.edu/briefs/a-gradual-exit-may-not-make-for-a-happier-retirement/}, author = {Calvo, Esteban and Haverstick, Kelly and Sass, Steven A.} } @article {7123, title = {The long-term effects of poor childhood health: an assessment and application of retrospective reports.}, journal = {Demography}, volume = {44}, year = {2007}, month = {2007 Feb}, pages = {113-35}, publisher = {44}, abstract = {

This study assesses retrospective childhood health reports and examines childhood health as a predictor of adult health. The results suggest that such reports are of reasonable reliability as to warrant their judicious use in population research. They also demonstrate a large positive relationship between childhood and adult health. Compared with excellent, very good, or good childhood health, poor childhood health is associated with more than three times greater odds of having poor adult self-rated health and twice the risk of a work-limiting disability or a chronic health condition. These associations are independent of childhood and current socioeconomic position and health-related risk behaviors.

}, keywords = {Adolescent, Adult, Age Factors, Aged, Child, Child Welfare, Child, Preschool, Chronic disease, Disabled Persons, Female, Health Status, Humans, Infant, Infant, Newborn, Male, Middle Aged, Reproducibility of Results, Retrospective Studies, Risk Assessment, Risk Factors, Socioeconomic factors, Time, United States}, issn = {0070-3370}, doi = {10.1353/dem.2007.0003}, author = {Steven A Haas} } @article {7168, title = {Mechanisms for racial and ethnic disparities in glycemic control in middle-aged and older Americans in the health and retirement study.}, journal = {Arch Intern Med}, volume = {167}, year = {2007}, month = {2007 Sep 24}, pages = {1853-60}, publisher = {167}, abstract = {

BACKGROUND: Mechanisms for racial/ethnic disparities in glycemic control are poorly understood.

METHODS: A nationally representative sample of 1901 respondents 55 years or older with diabetes mellitus completed a mailed survey in 2003; 1233 respondents completed valid at-home hemoglobin A(1c) (HbA(1c)) kits. We constructed multivariate regression models with survey weights to examine racial/ethnic differences in HbA(1c) control and to explore the association of HbA(1c) level with sociodemographic and clinical factors, access to and quality of diabetes health care, and self-management behaviors and attitudes.

RESULTS: There were no significant racial/ethnic differences in HbA(1c) levels in respondents not taking antihyperglycemic medications. In 1034 respondents taking medications, the mean HbA(1c) value (expressed as percentage of total hemoglobin) was 8.07\% in black respondents and 8.14\% in Latino respondents compared with 7.22\% in white respondents (P < .001). Black respondents had worse medication adherence than white respondents, and Latino respondents had more diabetes-specific emotional distress (P < .001). Adjusting for hypothesized mechanisms accounted for 14.0\% of the higher HbA(1c) levels in black respondents and 19.0\% in Latinos, with the full model explaining 22.0\% of the variance. Besides black and Latino ethnicity, only insulin use (P < .001), age younger than 65 years (P = .007), longer diabetes duration (P = .004), and lower self-reported medication adherence (P = .04) were independently associated with higher HbA(1c) levels.

CONCLUSIONS: Latino and African American respondents had worse glycemic control than white respondents. Socioeconomic, clinical, health care, and self-management measures explained approximately a fifth of the HbA(1c) differences. One potentially modifiable factor for which there were racial disparities--medication adherence--was among the most significant independent predictors of glycemic control.

}, keywords = {Aged, Aged, 80 and over, Black People, Diabetes Mellitus, Female, Glycated Hemoglobin, Health Services Accessibility, Hispanic or Latino, Humans, Longitudinal Studies, Male, Middle Aged, Patient Compliance, Socioeconomic factors, Treatment Refusal, United States, White People}, issn = {0003-9926}, doi = {10.1001/archinte.167.17.1853}, author = {Michele M Heisler and Jessica Faul and Rodney A. Hayward and Kenneth M. Langa and Caroline S Blaum and David R Weir} } @article {5695, title = {A Multistage Model for Analyzing Repeated Observations on Depression in Elderly}, year = {2007}, abstract = {The problem of depression in elderly, in terms of short and long-term health and economic consequence, needs to be assessed more critically. This study uses the longitudinal data from the six waves of the Health and Retirement Survey to examine the transition to depression, reverse transition from depression to no depression and also repeated transition from no depression to depression after experiencing a reverse transition during a study period. Covariate-dependent Markov models are proposed using the logistic link function based on the Chapman-Kolmogorov equation. A simplified and more flexible approach of constructing the likelihood function is demonstrated in this paper to deal with the branching of a number of transition types starting from a group of subjects with no depression at the beginning of the study.}, keywords = {Demographics, Health Conditions and Status}, author = {M. Ataharul Islam and Rafiqul I Chowdhury and Huda, Shahariar} } @article {10770, title = {A New Approach to Raising Social Security{\textquoteright}s Earliest Eligibility Age.}, number = {WP$\#$2007-19}, year = {2007}, institution = {Center for Retirement Research at Boston College}, address = {Boston}, abstract = {While Social Security{\textquoteright}s Normal Retirement Age (NRA) is increasing to 67, the Earliest Eligibility Age (EEA) remains at 62. Similar plans to increase the EEA raise concerns that they would create excessive hardship on workers that are worn-out or in bad health. One simple rule to increase the EEA is to tie an increase to the number of quarters of covered earnings. Such a provision would allow those with long worklives {\textemdash} presumably the less educated and lower paid {\textemdash} to quit earlier. We provide evidence that this simple rule would not satisfy the goal of preventing undue hardship on certain workers. Thus, this paper considers an alternative policy that ties an increase in the EEA to individuals{\textquoteright} Average Indexed Monthly Earnings (AIME). We show that allowing workers with low AIME to continue to be eligible to receive benefits at age 62 has promise as a policy to protect workers who have low earnings and are in poor health from hardship associated with an increase in the EEA.}, keywords = {Social Security, Social Security Eligibility}, url = {https://crr.bc.edu/working-papers/a-new-approach-to-raising-social-securitys-earliest-eligibility-age/}, author = {Triest, Robert K. and Haverstick, Kelly and Margarita Sapozhnikov and Natalia A. Zhivan} } @article {7164, title = {Prevalence of dementia in the United States: the aging, demographics, and memory study.}, journal = {Neuroepidemiology}, volume = {29}, year = {2007}, month = {2007}, pages = {125-32}, publisher = {29}, abstract = {

AIM: To estimate the prevalence of Alzheimer{\textquoteright}s disease (AD) and other dementias in the USA using a nationally representative sample.

METHODS: The Aging, Demographics, and Memory Study sample was composed of 856 individuals aged 71 years and older from the nationally representative Health and Retirement Study (HRS) who were evaluated for dementia using a comprehensive in-home assessment. An expert consensus panel used this information to assign a diagnosis of normal cognition, cognitive impairment but not demented, or dementia (and dementia subtype). Using sampling weights derived from the HRS, we estimated the national prevalence of dementia, AD and vascular dementia by age and gender.

RESULTS: The prevalence of dementia among individuals aged 71 and older was 13.9\%, comprising about 3.4 million individuals in the USA in 2002. The corresponding values for AD were 9.7\% and 2.4 million individuals. Dementia prevalence increased with age, from 5.0\% of those aged 71-79 years to 37.4\% of those aged 90 and older.

CONCLUSIONS: Dementia prevalence estimates from this first nationally representative population-based study of dementia in the USA to include subjects from all regions of the country can provide essential information for effective planning for the impending healthcare needs of the large and increasing number of individuals at risk for dementia as our population ages.

}, keywords = {Age Distribution, Aged, Aged, 80 and over, Cohort Studies, Dementia, Female, Geriatric Assessment, Health Surveys, Humans, Logistic Models, Male, Prevalence, Sex Distribution, United States}, issn = {1423-0208}, doi = {10.1159/000109998}, author = {Brenda L Plassman and Kenneth M. Langa and Gwenith G Fisher and Steven G Heeringa and David R Weir and Mary Beth Ofstedal and James R Burke and Michael D Hurd and Guy G Potter and Willard L Rodgers and David C Steffens and Robert J. Willis and Robert B Wallace} } @article {7138, title = {Risk of nursing home admission among older americans: does states{\textquoteright} spending on home- and community-based services matter?}, journal = {J Gerontol B Psychol Sci Soc Sci}, volume = {62}, year = {2007}, month = {2007 May}, pages = {S169-78}, publisher = {62B}, abstract = {

OBJECTIVE: States vary greatly in their support for home- and community-based services (HCBS) that are intended to help disabled seniors live in the community. This article examines how states{\textquoteright} generosity in providing HCBS affects the risk of nursing home admission among older Americans and how family availability moderates such effects.

METHODS: We conducted discrete time survival analysis of first long-term (90 or more days) nursing home admissions that occurred between 1995 and 2002, using Health and Retirement Study panel data from respondents born in 1923 or earlier.

RESULT: State HCBS effects were conditional on child availability among older Americans. Living in a state with higher HCBS expenditures was associated with lower risk of nursing home admission among childless seniors (p <.001). However, the association was not statistically significant among seniors with living children. Doubling state HCBS expenditures per person aged 65 or older would reduce the risk of nursing home admission among childless seniors by 35\%.

DISCUSSION: Results provided modest but important evidence supportive of increasing state investment in HCBS. Within-state allocation of HCBS resources, however, requires further research and careful consideration about fairness for individual seniors and their families as well as cost effectiveness.

}, keywords = {Aged, Aged, 80 and over, Caregivers, Cohort Studies, Cost Savings, Cost-Benefit Analysis, Female, Financing, Government, Health Expenditures, Home Care Services, Homes for the Aged, Humans, Insurance Coverage, Long-term Care, Male, Medicaid, Medicare, Nursing homes, Patient Admission, Patient Readmission, Risk Assessment, Risk Factors, State Health Plans, United States}, issn = {1079-5014}, doi = {10.1093/geronb/62.3.s169}, author = {Muramatsu, Naoko and yin, Hongjun and Richard T. Campbell and Ruby L Hoyem and Martha A. Jacob and Christopher Ross} } @article {7145, title = {The Social Security Earnings Test and Work Incentives}, journal = {Journal of Policy Analysis and Management}, volume = {26}, year = {2007}, pages = {527}, publisher = {26}, abstract = {The labor supply and benefit claiming incentives provided by the early retirement rules of the Social Security Old Age benefits program are of growing importance as the Normal Retirement Age (NRA) increases to 67, the labor force participation of Older Americans rises, and a variety of reforms to the Social Security system are considered. Any reform needs to take into account the effects and rationale of the Social Security Earnings Test and the Actuarial Adjustment Factor, which are likely to be widely misunderstood due to the relatively little attention paid by policymakers and researchers to the fact that Americans are willing to work while receiving benefits. We describe these incentives and emphasize that individuals who claim benefits before the NRA but continue to work, or return to the labor force, can reduce the early retirement penalty by suspending the collection of monthly benefits if they earn above the Earnings Test limit. We then argue that the Earnings Test can be distortionary and is costly to administer, and that these characteristics are inflated by the lack of information given to Older Americans regarding the consequences of working while receiving retirement benefits. We present results from statistical models of labor force exit behavior using data from the Health and Retirement Study showing the relevance of these incentives, and investigate the importance of informational asymmetries among beneficiaries regarding benefit withholding using a dynamic life-cycle model of labor supply and benefit claiming. We then use the latter framework to compare the behavioral and welfare implications of a removal of the Earnings Test to the policy of providing more information regarding the Earnings Test and the adjustment of the rate of benefit pay to Older Americans. 2007 by the Association for Public Policy Analysis and Management.}, keywords = {Employment and Labor Force, Retirement Planning and Satisfaction, Social Security}, url = {https://www.jstor.org/stable/30163415}, author = {Hugo Ben{\'\i}tez-Silva and Frank Heiland} } @inbook {5210, title = {The Sufficiency of Retirement Savings: Comparing Cohorts at the Time of Retirement}, booktitle = {Redefining Retirement: How Will Boomers Fare?}, year = {2007}, note = {ProCite field 6 : In ProCite field 8 : eds}, publisher = {Oxford University Press}, organization = {Oxford University Press}, address = {New York, NY}, abstract = {Assessing savings sufficiency requires detailed information on both potential retirement benefits and the characteristics of a national sample of older citizens. This chapter uses the Health and Retirement Survey and the New Beneficiary Survey linked to administrative records to assess and compare the saving adequacy of two different cohorts. Specifically we compare the two groups in terms of their annuitized net wealth (ANW) and ANW relative to the poverty line, as well as the near-poverty line. We find that the mean wealth levels of both new retiree cohorts rose over time (by about two-thirds for wealth and by half for ANW), but the chance of meeting social adequacy targets has also risen. This shortfall we believe is concentrated increasingly among nonmarried persons, and those with low human capital and labor force attachment. In other words, vulnerability during the working life appears to persist into retirement. }, keywords = {Consumption and Savings, Income, Other}, url = {https://repository.upenn.edu/cgi/viewcontent.cgi?article=1363\&context=prc_papers}, author = {Haveman, Robert and Karen C. Holden and Barbara Wolfe and Romanov, Andrei} } @article {7170, title = {Is There a Retirement-Consumption Puzzle? Evidence Using Subjective Retirement Expectations}, journal = {Review of Economics and Statistics}, volume = {89}, year = {2007}, pages = {247-264}, publisher = {89}, abstract = {Abstract Previous research finds a systematic decrease in consumption at retirement, a finding that is inconsistent with the life cycle/permanent income hypothesis if retirement is an expected event. In this paper, we use workers subjective beliefs about their retirement dates as an instrument for retirement. After demonstrating that subjective retirement expectations are strong predictors of subsequent retirement decisions, we still find a consumption decline at retirement for workers who retire when expected. However, our estimates of this consumption fall are about a third less than those found when we instead rely on the instrumental variables strategy used in prior studies.}, keywords = {Consumption and Savings, End of life decisions, Expectations}, doi = {https://doi.org/10.1162/rest.89.2.247}, author = {Steven Haider and Melvin Stephens Jr.} } @inbook {5216, title = {Trends in Pension Values Around Retirement}, booktitle = {Redefining Retirement: How Will Boomers Fare?}, year = {2007}, note = {ProCite field 6 : In ProCite field 8 : eds}, publisher = {Oxford University Press}, organization = {Oxford University Press}, address = {New York, NY}, keywords = {Net Worth and Assets}, doi = {10.1093/acprof:oso/9780199230778.003.0011}, author = {Michael D Hurd and Susann Rohwedder} } @article {5689, title = {Trends in the Labor Force Participation of Married Women}, number = {WP 2007-171}, year = {2007}, institution = {Michigan Retirement Research Center, University of Michigan}, address = {Ann Arbor, MI}, abstract = {This study seeks to quantify determinants, and costs, of the labor force participation of married women. We use demographic and earnings data from the Health and Retirement Study. The earnings data constitute an unusually long panel but have the defect of lacking corresponding reports on work hours. By using a highly structured model and concentrating on the participation margin, we nevertheless feel that we can make substantial progress. Our preliminary regression results imply that married women s market work disrupts their household consumption slightly less than one half as much as men s work (relative to complete household retirement). We lay out a course of additional steps that can, we believe, clarify these results even more precisely in the near future.}, keywords = {Adult children, Consumption and Savings, Employment and Labor Force, Women and Minorities}, url = {https://mrdrc.isr.umich.edu/pubs/trends-in-the-labor-force-participation-of-married-women-2/}, author = {Christopher L House and John Laitner and Stolyarov, Dmitriy} } @article {7131, title = {Weight and depressive symptoms in older adults: direction of influence?}, journal = {J Gerontol B Psychol Sci Soc Sci}, volume = {62}, year = {2007}, month = {2007 Jan}, pages = {S43-51}, publisher = {62}, abstract = {

OBJECTIVE: . The purpose of this study was to clarify the direction of the relationship between changes in depressive symptoms and changes in weight in older adults. Methods. The sample included a prospective cohort of individuals aged 53-63 (n = 9,130) enrolled in the Health and Retirement Study. We used separate cross-lagged models for men and women in order to study the impact of weight change on subsequent increases in depressive symptoms 2 years later and vice versa.

RESULT: . Weight gain did not lead to increased depressive symptoms, and weight loss preceded increased depressive symptoms only in unadjusted models among men (odds ratio [OR] = 1.26, 95\% confidence interval [CI] = 1.04-1.53). Increased depressive symptoms were not predictive of subsequent weight loss, but they were predictive of subsequent weight gain in unadjusted models only (men: OR = 1.24, 95\% CI = 1.00-1.54; women: OR = 1.12, 95\% CI = 1.00-1.26). In adjusted models, baseline depressive symptoms predicted both weight loss and weight gain among both men and women. Increase in functional limitations and medical conditions were significant predictors of both weight loss and weight gain. Baseline functional limitations also predicted increased depressive symptoms. Discussion. Based on our findings, it is apparent that researchers need to examine the pathways between changes in weight and increases in depressive symptoms in the context of functional limitations and medical comorbidity.

}, keywords = {Activities of Daily Living, Age Factors, Aged, Aged, 80 and over, Body Mass Index, Cohort Studies, Comorbidity, Depressive Disorder, Female, Health Status Indicators, Health Surveys, Humans, Longitudinal Studies, Male, Middle Aged, Models, Statistical, Odds Ratio, Prospective Studies, Sex Factors, Statistics as Topic, United States, Weight Gain, Weight Loss}, issn = {1079-5014}, doi = {10.1093/geronb/62.1.s43}, author = {Valerie L Forman-Hoffman and Jon W. Yankey and Stephen L Hillis and Robert B Wallace} } @article {5685, title = {What Makes Retirees Happier: A Gradual or {\textquoteright}Cold Turkey{\textquoteright} Retirement?}, year = {2007}, institution = {Chestnut Hill, MA, Center for Retirement Research at Boston College}, abstract = {This study explores the factors that affect an individual s happiness while transitioning into retirement. Recent studies highlight gradual retirement as an attractive option to older workers as they approach full retirement. However, it is not clear whether phasing or cold turkey makes for a happier retirement. Using longitudinal data from the Health and Retirement Study, this study explores what shapes the change in happiness between the last wave of full employment and the first wave of full retirement. Results suggest that what really matters is not the type of transition (gradual retirement or cold turkey), but whether people perceive the transition as chosen or forced.}, keywords = {Retirement Planning and Satisfaction}, url = {http://crr.bc.edu/}, author = {Calvo, Esteban and Haverstick, Kelly and Sass, Steven A.} } @article {5671, title = {Alternative Measures of Replacement Rates}, number = {UM06-03}, year = {2006}, institution = {Michigan Retirement Research Center, University of Michigan}, address = {Ann Arbor, MI}, abstract = {This study finds that on average those just past the usual retirement age are adequately prepared for retirement in that they will be able to follow a path of consumption that begins at their current level of consumption and then follows an age-pattern similar to that of current retirees. That pattern is similar to what would be found from a theoretically derived and estimated life-cycle model. Thus we do not find inadequate preparation for retirement on average or even at the median. This is not true, however, for all groups in the population. In particular, singles lacking a high school education are likely to be forced to reduce consumption: some 62 would have died with negative wealth had they followed the consumption path given by our data. Future research will show the extent to which this percentage is over-estimated because we did not account for differential mortality.}, keywords = {Consumption and Savings, Income}, url = {https://mrdrc.isr.umich.edu/projects/alternative-measures-of-replacement-rates/}, author = {Michael D Hurd and Susann Rohwedder} } @article {7074, title = {Analysis of poststroke sleep abnormality from health and retirement study survey, 2002}, journal = {Stroke}, volume = {37}, year = {2006}, pages = {687 -688}, publisher = {37}, keywords = {Health Conditions and Status}, author = {Afshin A Divani and Amardeep Hoonjan and Jarrett Hesselbirg and Luboslav Halik and Siatta Dunbar and Sana Khan} } @inbook {5183, title = {Consequences of Educational Change for the Burden of Chronic Health Problems in the Population}, booktitle = {Allocating Public and Private Resources across Generations}, number = {3}, year = {2006}, note = {ProCite field 8 : eds.}, pages = {227-242}, publisher = {Oxford University Press}, organization = {Oxford University Press}, address = {Oxford, UK}, abstract = {Changes in the public and individual burden of chronic health problems have significant implications for the allocation of public and private resources across generations. Preston (1984) noted almost two decades ago that population ageing in the United States was accompanied by the rapid expansion of public programs benefiting the health of elderswhile public programs benefiting children{\textquoteright}s education contracted. Health care is the principal public service provided to the elderly while education is the counterpart for children. Within a historical time period, political choices about the funding of age-targeted service programs have an urgency that oftentimes sweeps aside the fact that investments in children{\textquoteright}s well-being pay substantial dividends decades later when children become the elders of a population. In large part, this reflects a lack of attention both by policy makers and by demographers of these long-run associations. Here, we provide new insights into the longrun consequences of investments in children for the burden of chronic health problems by conducting a thought experiment in which we simulate how sweeping historical changes in a population{\textquoteright}s educational achievement potentially alters active life expectancy and the prevalence of functioning problems in the population.}, keywords = {Educational attainment, Educational Change, Functional Limitation, Functional Problem, Life Table}, isbn = {978-1-4020-4480-9}, doi = {https://doi.org/10.1007/978-1-4020-4481-6_9}, author = {Mark D Hayward and Eileen M. Crimmins and Zhang, Zhenmei}, editor = {Gauthier, Anne H. and Chu, Cyrus and Tuljapurkar, Shripad} } @article {5645, title = {Consumption and Economic Well-Being at Older Ages: Income- and Consumption-Based Poverty Measures in the HRS}, number = {WR-410}, year = {2006}, institution = {RAND Corporation}, address = {Santa Monica, CA}, abstract = {According to economic theory, well-being or utility depends on consumption. However, at the household level, total consumption is rarely well measured because its collection requires a great deal of survey time. As a result income has been widely used to assess well-being and poverty rates. Yet, because households can use wealth to consume more than income, so an income-based measure of well-being could yield misleading results for many households. We use data from the Health and Retirement Study to find income-based poverty rates which we compare with poverty rates as measured in the Current Population Survey. We use HRS consumption data to calculate a consumption-based poverty rate and study the relationship between income-based and consumption-based poverty measures. We find that a poverty rate based on consumption is lower than an income-based poverty rate. Particularly noteworthy is the much lower rate among the oldest single persons such as widows. The explanation for the difference is the ability to consume out of wealth.}, keywords = {Consumption and Savings, Health Conditions and Status, Income, Methodology}, doi = {https://doi.org/10.7249/WR410}, author = {Michael D Hurd and Susann Rohwedder} } @article {7064, title = {Crediting care or marriage? Reforming Social Security family benefits.}, journal = {J Gerontol B Psychol Sci Soc Sci}, volume = {61}, year = {2006}, month = {2006 Jan}, pages = {S24-34}, publisher = {61}, abstract = {

OBJECTIVE: For more than 20 years policy advocates and policymakers have argued that Social Security should reward women for raising children. Current family benefits, which only benefit women who marry, are thought to be outdated and unable to protect the neediest women. Thus, would Black and poor women fare better if family benefits were linked to parenthood, as opposed to marriage? I examined three care credit proposals that reflect the most common proposals put forth in the United States and the most common designs in other countries.

METHODS: I used the 1992 Health and Retirement Study and the Current Population Survey to create a policy simulation that estimates how women reaching age 62 from 2020 to 2030 would be affected by care credits.

RESULT: Black and poor women fared best with benefits linked to parenthood. The specific proposal allowed parents, from the 35 earnings years used to calculate their benefit, to substitute $15,000 for up to 9 earnings{\textquoteright} years that fell below this level.

DISCUSSION: The poorest women fare better with family benefits linked to parenthood instead of marital status. Moreover, they fare best when working women can benefit from care credits, but the care credit{\textquoteright}s value is not linked to earnings.

}, keywords = {Family, Female, Humans, Insurance Benefits, Marital Status, Mothers, Social Security, United States}, issn = {1079-5014}, doi = {10.1093/geronb/61.1.s24}, author = {Herd, Pamela} } @article {7113, title = {Development and validation of an index to predict activity of daily living dependence in community-dwelling elders}, journal = {Medical Care}, volume = {44}, year = {2006}, pages = {149-157}, publisher = {44}, abstract = {BACKGROUND: Maintaining independence in daily functioning is an important health outcome in older adults. A key measure of functional independence in elders is the ability to do activities of daily living (ADL) without the assistance of another person. However, few prognostic indices have been developed that stratify elders into groups at variable risk for developing ADL dependence. OBJECTIVE: We sought to develop and validate a prognostic index that distinguishes between elders at different risk of ADL dependence. RESEARCH DESIGN, SUBJECTS, AND MEASURES: We studied subjects enrolled in Asset and Health Dynamics Among the Oldest Old (AHEAD), a nationally representative cohort of elders older than the age of 70. We included 5239 subjects (mean age, 77) reporting that they could do each of 5 ADL (bathing, dressing, toileting, transferring, and eating) without the assistance of another person at baseline. Subjects were divided into development (n = 3245) and validation (n = 1994) samples based on region of the United States. Our primary outcome was the need for help (dependence) with at least one ADL at 2 years. We used logistic regression to select among predictor variables encompassing several domains: demographic characteristics, comorbid conditions, functional status, cognitive status, and general health indicators. RESULTS: The 9 independent predictors of 2-year ADL dependence were age older than 80, diabetes, difficulty walking several blocks, difficulty bathing or dressing, need for help with personal finances, difficulty lifting 10 pounds, inability to name the Vice President, history of falling, and low body mass index. We created a risk score by assigning 1 point to each risk factor. In the development sample, rates of 2-year ADL dependence in subjects with 0, 1, 2, 3, 4, and 5 or more risk factors were 1.3 , 2.8 , 3.8 , 10 , 22 , and 33 , respectively (P 0.001, roc area = 0.79). In the validation sample, the rates were 0.7 , 4.3 , 8.7 , 11 , 18 , and 40 (P 0.001, roc area = 0.77). The risk score also discriminated between subjects at variable risk for a combined outcome of either ADL decline or death (4.3 , 7.6 , 15 , 21 , 30 , and 47 ). CONCLUSION: Using data available from patient reports, we validated a simple risk index that distinguished between elders at variable risk of ADL dependence. This index may be useful for identifying elders at high risk of poor outcomes or for risk adjustment.}, keywords = {Health Conditions and Status, Healthcare, Risk Taking}, author = {Kenneth E Covinsky and Hilton, Joan and Lindquist, Karla and Dudley, R. A.} } @mastersthesis {6341, title = {The Effects of Defined Contribution Plans on the Retirement Decision}, volume = {Doctor of Philosophy}, year = {2006}, month = {2006}, school = {Georgia State University}, address = {Atlanta, GA}, abstract = {This study examines the effects of pensions on the retirement decision, focusing on the differences between defined benefit (DB) plans and defined contribution (DC) plans. I find that DC plans have different effects on the accumulation of retirement wealth, the incentives for retirement and the risk of retirement benefits than DB plans. Thereby, DC plans have different effects from DB plans on the decision to retire. This paper is the first empirical study to investigate the effect of longevity risk in pension plans on retirement. It is an important addition to the literature on retirement behavior since longevity risk will become more important as individuals have longer life expectancies and bear more longevity risk due to increasing likelihood of coverage by DC plans or Social Security personal accounts. Previous research has found that DB plans have an age-incentive effect on retirement. That is, the structure of DB plans may induce individuals to retire at a specific age. By contrast, the structure of DC plans does not have age-incentive effects. Thereby, individuals with DC plans may retire either earlier or later on average than individuals with DB plans because of the absence of age-related incentives in DC plans. To shed further light on these issues, this study introduces risk factors, and particularly longevity risk, to an option value model of the retirement decision. Longevity risk is important to DC participants since DC plans usually offer a lump-sum benefit at retirement. Since payouts are not guaranteed over life expectancy, retirees with DC plans bear a greater risk of outliving their resources, i.e., longevity risk. The additional risks in DC plans may make workers save more, and retire later. This paper extends a standard intertemporal model of consumption and retirement by incorporating risk factors for different pension types into the retirement decision problem. Comparative statics from the optimal solution show that increases in risk factors (i.e. longevity risk) during retirement induce workers with DC plans to retire later than workers with defined benefit (DB) plans. This study then tests the predictions of this model empirically, using the data from the Health and Retirement Study (HRS). Empirical results confirm the predictions of the theoretical model. First, workers with DC plans expect to retire later than workers with DB plans. Next, increase in pension option value, measured as the difference between the maximum pension value and the pension value of 1992, decreases the probability of retirement, thereby increasing the expected retirement wage. By contrast, greater pension wealth increases the probability of retirement, reducing the expected retirement age. Considering that pension wealth in DC plans is about half of pension wealth in DB plans, it is reasonable to conclude that workers with DC plans retire later than workers with DB plans. Finally, longevity risk, as measured by the Annuity Equivalent Wealth (AEW), decreases probability of retirement, increasing the expected retirement age.}, keywords = {Pensions, Retirement Planning and Satisfaction}, url = {https://scholarworks.gsu.edu/rmi_diss/19/}, author = {Hong, Wonku} } @inbook {5206, title = {Gender Differences Among Custodial Grandparents}, booktitle = {Custodial Grandparenting: Individual, Cultural, and Ethnic Diversity}, year = {2006}, note = {ProCite field 6 : In ProCite field 8 : eds}, publisher = {Springer Publishing Company}, organization = {Springer Publishing Company}, keywords = {Adult children, Demographics}, author = {Hayslip, B. and Kaminski, P.L. and Earnheart, K.L.}, editor = {Hayslip, Bert and Hicks Patrick, Julie} } @article {7101, title = {Gender, the Marital Life Course, and Cardiovascular Disease in Late Midlife}, journal = {Journal of Marriage and Family}, volume = {68}, year = {2006}, pages = {639}, publisher = {68}, abstract = {Drawing on 5 waves of the Health and Retirement Study, we examine the influence of the marital life course on the prevalence and incidence of cardiovascular disease among 9,434 middle-aged individuals. Results show that compared to continuously married persons, both men and women with a marital loss have significantly higher prevalence of cardiovascular disease at baseline. Men and women, however, differ in the effects of marital loss on the incidence of cardiovascular disease over the course of the study. Women with a marital loss have a higher risk of cardiovascular disease in late midlife compared to continuously married women, whereas marital loss is not associated with men{\textquoteright}s risk of cardiovascular disease. Emotional distress and socioeconomic status account for the higher risk of cardiovascular disease among divorced women.}, keywords = {Adult children, Health Conditions and Status}, author = {Zhang, Zhenmei and Mark D Hayward} } @article {7077, title = {Health Insurance and Health at Age 65: Implications for medical care spending on new Medicare beneficiaries}, journal = {Health Services Research}, volume = {41}, year = {2006}, note = {Article English}, pages = {429 -451}, publisher = {41}, abstract = {Objectives. To investigate the consequences of endogeneity bias on the estimated effect of having health insurance on health at age 63 or 64, just before most people qualify for Medicare, and to simulate the implications for total and public insurance (Medicare and Medicaid) spending on newly enrolled beneficiaries in their first years of Medicare coverage. . Data. The longitudinal Health and Retirement Survey of people who were 55-61 years old in 1992, followed through biannual surveys to age 63-64 or until 2000 (whichever came first), and those who were 66-70 years olds from the Medicare Current Beneficiary Surveys, 1992-1998. . Study Design. Instrumental variable (IV) estimation of a simultaneous equation model of insurance choice and health at age 63-64 as a function of baseline health and sociodemographic characteristics in 1992 and endogenous insurance coverage over the observation period. . Findings. Continuous insurance coverage is associated with significantly fewer deaths prior to age 65 and, among those who survive, a significant upward shift in the distribution of health states from fair and poor health with disabilities to good to excellent health. Treating insurance coverage as endogenous increases the magnitude of the estimated effect of having insurance on improved health prior to age 65. The medical spending simulations suggest that if the near-elderly had continuous insurance coverage, average annual medical spending per capita for new Medicare beneficiaries in their first few years of coverage would be slightly lower because of the improvement in health status. In addition, total Medicare and Medicaid spending for new beneficiaries over their first few years of coverage would be about the same or slightly lower, even though more people survive to age 65. Conclusions. Extending insurance coverage to all Americans between the ages of 55 and 64 would improve health (increase survival and shift people from good-fair-poor health to excellent-very good health) at age 65, and possibly reduce total short-term spending by Medicare and Medicaid for newly eligible Medicare beneficiaries, even though more people would enter the program because of increased survival.}, keywords = {End of life decisions, Healthcare, Insurance, Medicare/Medicaid/Health Insurance, Other}, author = {Hadley, J. and Timothy A Waidmann} } @article {5663, title = {Home Production by Dual Earner Couples and Consumption During Retirement}, year = {2006}, institution = {The University of Michigan, Michigan Retirement Research Center}, abstract = {To study the role of home production in life cycle behavior, this paper creates a theoretical model in which both spouses in a couple allocate their time between market and home work. It then derives a pair of regression equations for estimating the parameters of the model, and it carries out the estimation using panel data on household net worth and lifetime earnings from the Health and Retirement Study and pseudo panel data on household consumption expenditures from the Consumer Expenditure Survey. We estimate that the value of forgone home production is roughly 10-15 cents for every dollar that a married man earns, but 30-35 cents per dollar of married women s market earnings. Our findings imply male labor supply elasticities that are very near zero and female elasticities in the range of 0.50. Our model predicts a substantial decline in measured consumption expenditure at a household s retirement, and it shows that Euler equation models of consumption behavior should include terms reflecting home production.}, keywords = {Consumption and Savings, Event History/Life Cycle, Net Worth and Assets}, url = {http://www.mrrc.isr.umich.edu/publications/papers/}, author = {Christopher L House and John Laitner and Stolyarov, Dmitriy} } @article {5673, title = {How Accurate are Expected Retirement Savings?}, year = {2006}, institution = {The University of Michigan, Michigan Retirement Research Center}, abstract = {This paper examines the ability of workers nearing retirement to report their expected retirement savings, where retirement savings refers to funds held in savings, checking, and investment-type accounts. Responding to such a question is likely to be difficult, even for those who are near retirement, because it requires respondents to assess when they will retire, their likely income stream between the survey date and retirement, and what portfolio choices will be made at retirement. Based on two nationally representative surveys collected two decades apart, we find that most individuals provide some response to the question, particularly when they are allowed to provide a range. Moreover, the responses that are given have substantial predictive power for actual retirement savings, even when compared to the savings in the initial wave. Despite this predictive power, there is evidence that responses do not satisfy the more stringent requirements of the rational expectations hypothesis.}, keywords = {Consumption and Savings, Expectations}, url = {http://www.mrrc.isr.umich.edu/publications/papers}, author = {Steven Haider and Melvin Stephens Jr.} } @article {7075, title = {Incidence and Frequency of Falling Accidents among Persons With and Without Stroke: Health and Retirement Study survey 2002}, journal = {Stroke}, volume = {37}, year = {2006}, pages = {631}, publisher = {37}, keywords = {Health Conditions and Status}, author = {A. A. Divani and Hoonjan, A. and Nasar, A. and Dunbar, S. and Hesselbrig, J.} } @article {7078, title = {Life-Cycle Variation in the Association between Current and Lifetime Earnings}, journal = {American Economic Review}, volume = {96}, year = {2006}, pages = {1308}, publisher = {96}, abstract = {Researchers in a variety of important economic literatures have assumed that current income variables as proxies for lifetime income variables follow the textbook errors-in-variables model. In our analysis of Social Security records containing nearly career-long earnings histories for the Health and Retirement Study sample, we find that the relationship between current and lifetime earnings departs substantially from the textbook model in ways that vary systematically over the life cycle. Our results can enable more appropriate analysis of, and correction for, errors-in-variables bias in any research that uses current earnings to proxy for lifetime earnings.}, keywords = {Employment and Labor Force, Other}, url = {http://www.nber.org/papers/w11943.pdf}, author = {Steven Haider and Solon, Gary} } @article {7117, title = {Loneliness as a specific risk factor for depressive symptoms: cross-sectional and longitudinal analyses.}, journal = {Psychol Aging}, volume = {21}, year = {2006}, month = {2006 Mar}, pages = {140-51}, publisher = {21}, abstract = {

The extent to which loneliness is a unique risk factor for depressive symptoms was determined in 2 population-based studies of middle-aged to older adults, and the possible causal influences between loneliness and depressive symptoms were examined longitudinally in the 2nd study. In Study 1, a nationally representative sample of persons aged 54 and older completed a telephone interview as part of a study of health and aging. Higher levels of loneliness were associated with more depressive symptoms, net of the effects of age, gender, ethnicity, education, income, marital status, social support, and perceived stress. In Study 2, detailed measures of loneliness, social support, perceived stress, hostility, and demographic characteristics were collected over a 3-year period from a population-based sample of adults ages 50-67 years from Cook County, Illinois. Loneliness was again associated with more depressive symptoms, net of demographic covariates, marital status, social support, hostility, and perceived stress. Latent variable growth models revealed reciprocal influences over time between loneliness and depressive symptomatology. These data suggest that loneliness and depressive symptomatology can act in a synergistic effect to diminish well-being in middle-aged and older adults.

}, keywords = {Aged, Cross-Sectional Studies, depression, Female, Follow-Up Studies, Health Status, Hostility, Humans, Loneliness, Male, Middle Aged, Risk Factors, Severity of Illness Index, Social Support, Stress, Psychological, Surveys and Questionnaires}, issn = {0882-7974}, doi = {10.1037/0882-7974.21.1.140}, author = {John T. Cacioppo and Mary Elizabeth Hughes and Linda J. Waite and Louise C Hawkley and Ronald A. Thisted} } @article {5661, title = {Moral Hazard, Adverse Selection and Health Expenditures: A semiparametric analysis}, year = {2006}, institution = {Cambridge, MA, National Bureau of Economic Research}, abstract = {Theoretical models predict asymmetric information in health insurance markets may generate inefficient outcomes due to adverse selection and moral hazard. However, previous empirical research has found it difficult to disentangle adverse selection from moral hazard in health care. We empirically study this question by using data from the Health and Retirement Study to estimate a structural model of the demand for health insurance and medical care. Using a two-step semi-parametric estimation strategy we find significant evidence of moral hazard, but not of adverse selection.}, keywords = {Medicare/Medicaid/Health Insurance, Methodology}, author = {Bajari, Patrick and Hong, Han and Ahmed Khwaja} } @article {7447, title = {Postretirement earnings relative to preretirement earnings: gender and racial differences.}, journal = {J Gerontol Soc Work}, volume = {47}, year = {2006}, note = {Using Smart Source Parsing pp. May Sage Publications, Thousand Oaks CA}, month = {2006}, pages = {63-82}, publisher = {32}, abstract = {

As the social security program comes under increasing financial pressure in the coming decades, the federal government will encourage elderly people to continue to work. Data from the Social Security Administration indicate that earnings are already a sizable component of retirement income. But there is public concern about how women and minorities will fare economically in this changing policy environment. To what extent can women and minorities keep earning money after they reach retirement age? This article presents the results of a study that investigated the postretirement earnings, relative to the preretirement earnings, of women and minorities, and compared the results with those for men and whites. The major finding, based on regression analyses, was that women{\textquoteright}s postretirement earnings, relative to their preretirement earnings, were greater than those of men. Furthermore, the regression results indicate that nonwhites{\textquoteright} postretirement earnings could not be predicted by their preretirement earnings or by any of the independent variables used in the study, including age, gender, education, marital status, number of children, occupation, and preretirement earnings.

}, keywords = {Age Factors, Aged, Aged, 80 and over, Data collection, Employment, Female, Humans, Income, Male, Men, Minority Groups, Pensions, Retirement, Salaries and Fringe Benefits, Sex Factors, Social Security, Time Factors, United States, White People, women}, issn = {0163-4372}, doi = {10.1300/J083v47n03_05}, author = {Martha N. Ozawa and Hong, Baeg-Eui} } @article {7002, title = {The Aging, Demographics and Memory Study: Study Design and Methods}, journal = {Neuroepidemiology}, volume = {25}, year = {2005}, pages = {181-191}, publisher = {25}, abstract = {Objective: We describe the design and methods of the Aging, Demographics, and Memory Study (ADAMS), a new national study that will provide data on the antecedents, prevalence, outcomes, and costs of dementia and cognitive impairment, not demented (CIND) using a unique study design based on the nationally representative Health and Retirement Study (HRS). We also illustrate potential uses of the ADAMS data and provide information to interested researchers on obtaining ADAMS and HRS data. Methods: The ADAMS is the first population-based study of dementia in the United States to include subjects from all regions of the country, while at the same time using a single standardized diagnostic protocol in a community-based sample. A sample of 856 individuals aged 70 or older who were participants in the on-going HRS received an extensive in-home clinical and neuropsychological assessment to determine a diagnosis of normal, CIND, or dementia. Within the CIND and dementia categories, subcategories (e.g., Alzheimer disease, vascular dementia) were assigned to denote the etiology of cognitive impairment. Conclusion: Linking the ADAMS dementia clinical assessment data to the wealth of available longitudinal HRS data on health, health care utilization, informal care, and economic resources and behavior, will provide a unique opportunity to study the onset of CIND and dementia in a nationally-representative population-based sample, as well as the risk factors, prevalence, outcomes, and costs of CIND and dementia.}, keywords = {Health Conditions and Status, Healthcare}, author = {Kenneth M. Langa and Brenda L Plassman and Robert B Wallace and A. Regula Herzog and Steven G Heeringa and Mary Beth Ofstedal and James F. Burke and Gwenith G Fisher and Fultz, Nancy H. and Michael D Hurd and Guy G Potter and Willard L Rodgers and David C Steffens and David R Weir} } @article {5639, title = {Changes in Consumption and Activities in Retirement}, year = {2005}, institution = {The University of Michigan, Michigan Retirement Research Center}, abstract = {The simple one-good model of life-cycle consumption requires consumption smoothing. According to previous results based on partial spending and on synthetic panels, British and U.S. households apparently reduce consumption at retirement. The reduction cannot be explained by the simple one-good life-cycle model, so it has been referred to as the retirement-consumption puzzle. An interpretation is that at retirement individuals discover they have fewer economic resources than they had anticipated prior to retirement, and as a consequence reduce consumption. This interpretation challenges the life-cycle model where consumers are assumed to be forward looking. Using panel data on anticipated consumption changes at retirement and on recollected consumption changes following retirement, we find that the median recollected change in spending at retirement is zero and that the recollections are broadly consistent with anticipations. Based on a measure of total spending in true panel we find that the actual mean and median changes are slightly positive. Therefore, we find no retirement-consumption puzzle.}, keywords = {Consumption and Savings, Event History/Life Cycle, Retirement Planning and Satisfaction}, url = {http://www.mrrc.isr.umich.edu/publications/papers/}, author = {Michael D Hurd and Susann Rohwedder} } @article {8754, title = {Differences in leisure-time, household, and work-related physical activity by race, ethnicity, and education}, journal = {Journal of General Internal Medicine}, volume = {20}, year = {2005}, month = {Jan-03-2005}, pages = {259 - 266}, abstract = {Background: Racial and ethnic minority groups have lower levels of leisure-time physical activity (LTPA) than whites, but it is unclear how much of this is explained by differences in socioeconomic status and health. Objective: To examine differences in LTPA, work-related physical activity (WRPA; heavy household chores and strenuous job activities), and total physical activity (TPA) by race, ethnicity, and education. Design, Setting, and Participants: Cross-sectional analyses of data from the 1992 Health and Retirement Study for a nationally representative cohort of 9,621 community-dwelling adults aged 51{\textendash}61 years. Measurements: Physical activity scores for LTPA, WRPA, and TPA based upon self-reported frequency of light or vigorous recreational activities, heavy household chores, and strenuous job-related physical activities. Main Results: LTPA was lower for blacks and Hispanics compared to whites, and LTPA steadily declined with lower levels of education. WRPA showed the reverse pattern, being lowest for whites and persons with greater education. Education was far more important than race/ethnicity as a determinant of LTPA and WRPA in multivariate analyses. After adjusting for differences in overall health and physical functioning, mean TPA scores were similar across racial/ethnic and education categories; blacks (β=1.0; 95\% confidence interval [CI], 0.5 to 1.5) and Spanish-speaking Hispanics (β=1.1; 95\% CI, 0.3 to 1.9) had slightly higher levels of TPA than whites (P<.01 and P=.01, respectively). Conclusions: Differences in educational attainment and health status accounted for virtually all of the racial and ethnic differences in LTPA. After accounting for WRPA, TPA was similar across race, ethnicity, and education subgroups.}, keywords = {Education, Leisure activities, Mortality, Older Adults, Physical activity, Racial/ethnic differences}, issn = {0884-8734}, doi = {10.1111/j.1525-1497.2005.40198.x}, url = {http://link.springer.com/10.1111/j.1525-1497.2005.40198.xhttp://www.springerlink.com/index/pdf/10.1111/j.1525-1497.2005.40198.x}, author = {Xiaoxing He and David W. Baker} } @article {7009, title = {Do Panel Surveys Make People Sick? U.S. Arthritis Trends in the Health and Retirement Study}, journal = {Social Science and Medicine}, volume = {60}, year = {2005}, pages = {2623-7}, publisher = {60}, abstract = {Researchers have long viewed large, longitudinal studies as essential for understanding chronic illness and generally superior to cross-sectional studies. In this study, we show that (1) age-specific arthritis prevalence in the longitudinal Health and Retirement Study (HRS) from the United States has risen sharply since its inception in 1992, and (2) this rise is almost surely spurious. In periods for which the data sets are comparable, we find no such increase in the crosssectional National Health Interview Survey (NHIS), the primary source for prevalence data of chronic conditions in the US. More important, the upward trend in the HRS is not internally consistent: even though prevalence in the HRS rises sharply between 1992 and 1996 for 55 56 year-olds, the prevalence for that age group plummets to its 1992 level among the new cohort added in 1998 and then rises rapidly again between 1998 and 2002. We discuss possible reasons for these discrepancies and demonstrate that they are not due to sample attrition in the HRS.}, keywords = {Health Conditions and Status, Methodology}, author = {Sven E. Wilson and Benjamin L. Howell} } @article {7034, title = {Do Socioeconomic Mortality Differences Decrease with Rising Age?}, journal = {Demographic Research}, volume = {13}, year = {2005}, pages = {35-62}, publisher = {13}, abstract = {The impact of SES on mortality is an established finding in mortality research. I examine, whether this impact decreases with age. Most research finds evidence for this decrease but it is unknown whether the decline is due to mortality selection. My data come from the US-Health and Retirement Study (HRS) and includes 9376 persons aged 59 , which are followed over 8 years. The variables allow a time varying measurement of SES, health and behavior. Event-history-analysis is applied to analyze mortality differentials. My results show that socioeconomic mortality differences are stable across ages whereas they decline clearly with decreasing health. The first finding that health rather than age is the equalizer combined with the second finding of unequally distributed health leads to the conclusion that in old age, the impact of SES is transferred to health and is stable across ages.}, keywords = {Demographics, Health Conditions and Status}, author = {Rasmus Hoffmann} } @article {5620, title = {Documentation of Cognitive Functioning Measures in the Health and Retirement Study}, year = {2005}, institution = {Institute for Social Research, University of Michigan}, address = {Ann Arbor, Michigan}, keywords = {Health Conditions and Status, Methodology}, url = {http://hrsonline.isr.umich.edu/sitedocs/userg/dr-006.pdf}, author = {Mary Beth Ofstedal and Gwenith G Fisher and A. Regula Herzog} } @article {5617, title = {Does the Socioeconomic Mortality Gradient Interact with Age? Evidence from U.S. Survey Data and Danish Register Data}, year = {2005}, institution = {Rostock, Germany, Max Planck Institute for Demographic Research}, abstract = {The aim of our paper is to provide an answer to the questions if and why social differences in health and mortality decrease with age. Most research confirms this decrease but the reasons for it and the role of unobserved heterogeneity are unknown. The data used for our analysis come from the US Health and Retirement Study (n=9376) and from the Danish Demographic Database (Denmark s population above age 58). They offer detailed information about SES and health information. The technique of event-history-analysis is used, and frailty models address mortality selection. A new method is developed to consider systematic difference in the change of average frailty over age between social groups. SES differentials in mortality converge with age in Denmark but not in the US. In both countries, they converge strongly with decreasing health. When controlled for health, the differences are stable across age in both countries. This means that worsening health levels social mortality differences and not increasing age. Controlling for mortality selection removes the converging pattern over age.}, keywords = {Demographics, Health Conditions and Status}, author = {Rasmus Hoffmann} } @article {7037, title = {Effect of Physical Activity on Functional Status among Older Middle-Age Adults with Arthritis}, journal = {Arthritis Care and Research}, volume = {53}, year = {2005}, pages = {879-85}, publisher = {53}, abstract = {Objective. To determine the effect of leisure time and work-related physical activity on changes in physical functioning among 3,554 nationally representative survey respondents, ages 53 63 years in 1994, with arthritis and joint symptoms, interviewed in the Health and Retirement Study (HRS). Methods. In 1992 1994, light and vigorous exercise items were empirically categorized into recommended, insufficient, and inactive leisure time physical activity levels using data from the HRS. Leisure and work-related physical activity levels in 1994 were used to predict 1996 functional decline or improvement, controlling for baseline functional difficulties, health status, sociodemographic characteristics, and behavioral risk factors. Results. Whereas 29.7 of respondents reported functional declines in 1996, 38.6 of those with baseline difficulties in 1994 reported improvement. Compared with inactive respondents, recommended and insufficient leisure time physical activity were equally protective against functional decline (odds ratio OR 0.59 and 0.62, respectively; P 0.0001). Higher levels of physical activity were also modestly associated with functional improvement among respondents with baseline functional difficulties (OR 1.47, P 0.05 and OR 1.45, P 0.01, respectively). Work-related physical activity was not a significant predictor of decline or improvement. Conclusion. Given the high prevalence of arthritis, even modest increases in rates of lifestyle physical activity among older adults could make a substantial contribution to disability-free life expectancy.}, keywords = {Health Conditions and Status}, url = {http://www.rheumatology.org/publications/acr/index.asp}, author = {Joseph Feinglass and Jason A. Thompson and Xiaoxing He and Whitney P. Witt and Rowland W Chang and David W. Baker} } @article {5635, title = {Enhancing the Quality of Data on Income and Wealth}, year = {2005}, institution = {The University of Michigan, Michigan Retirement Research Center}, abstract = {Over the last decade or so, a substantial effort has gone into the design of a series of methodological investigations aimed at enhancing the quality of survey data on income and wealth. These investigations have largely been conducted at the Survey Research Center at the University of Michigan, and have mainly involved two longitudinal surveys: the Health and Retirement Study (HRS), with a first wave beginning in 1992 and continued thereafter every other year through 2004; and the Assets and Health Dynamics Among the Oldest Old (AHEAD) Study, begun in 1993 and continued in 1995 and 1998, then in every other year through 2004. This provides and overview of the main studies and summarizes what has been learned about correcting longitudinal inconsistencies that arise.}, keywords = {Income, Methodology, Net Worth and Assets}, url = {http://www.mrrc.isr.umich.edu/publications/papers/}, author = {Cao, Honggao and Daniel H. Hill and Juster, F. Thomas and Michael M. Perry} } @article {7001, title = {Ensuring a Minimum: Social Security Reform and Women}, journal = {The Gerontologist}, volume = {45}, year = {2005}, pages = {12-25}, publisher = {45}, abstract = {Purpose: The potential effects of implementing three different minimum benefits in Social Security, which have accompanied proposals to privatize the program and reform family benefits, are examined in relation to the adequacy of benefits for women reaching age 62 between 2020 and 2030. Design and Methods: The 1992 Health and Retirement Study is used to conduct a simplified microsimulation. Results: The minimum benefit proposal accompanying privatization proposals, which requires 40 earnings years for a poverty level benefit, fails to cover significant numbers of vulnerable women. The elimination of spousal benefits, criticized for being outdated and regressive, helps offset the costs of more generous minimum benefits, such as those that require residency or 10 earnings years for eligibility. Implications: Noncontributory benefits distributed based on marital status are not as effective at protecting poorer women, as well as a new generation of women that is less likely to be married, than are minimum benefits where eligibility is tied to U.S. residency or simply Social Security eligibility.}, keywords = {Social Security, Women and Minorities}, url = {http://gerontologist.gerontologyjournals.org/content/vol45/issue1/}, author = {Herd, Pamela} } @article {7004, title = {Female Labor Force Intermittency and Current Earnings: A Switching Regression Model with Unknown Sample Selection}, journal = {Applied Economics}, volume = {37}, year = {2005}, pages = {545-560}, publisher = {37}, abstract = {Using the Health and Retirement Survey, this paper finds a 16 percent selectivity-corrected wage penalty among women who engage in intermittent labor market activity. This penalty is experienced at a low level of intermittent activity but appears not to play an important role in a woman{\textquoteright}s decision to undertake such activity. In addition, employer preferences appear to play a larger role than human capital atrophy in the determination of the wage penalty.}, keywords = {Employment and Labor Force, Income, Women and Minorities}, doi = {https://doi.org/10.1080/0003684042000307003}, author = {Hotchkiss, Julie L. and Pitts, M. Melinda} } @inbook {5186, title = {Healthy, Wealthy, and Knowing Where to Live: Trajectories of Health, Wealth, and Living Arrangements among the Oldest Old}, booktitle = {Analyses in the Economics of Aging}, year = {2005}, note = {ProCite field 6 : In ProCite field 8 : ed.}, pages = {241-275}, publisher = {University of Chicago Press}, organization = {University of Chicago Press}, address = {Chicago}, abstract = {There are many mechanisms that suggest that living arrangements and well-being derived from health and economic status are closely related. This paper investigates the joint evolution of the three conditions, using a microeconometric approach similar to what is known as vector autoregressions (VAR) in the macroeconomics literature.}, keywords = {Consumption and Savings, Health Conditions and Status, Net Worth and Assets}, doi = {10.3386/w9897}, author = {Florian Heiss and Michael D Hurd and Axel Borsch-Supan}, editor = {David A Wise} } @article {5643, title = {HRS 2001 HUMS College Tuition Imputations}, year = {2005}, institution = {Institute for Social Research, University of Michigan}, address = {Ann Arbor, Michigan}, abstract = {HRS 2001 Off-Year Mail Survey on Human Capital Investment (HRS 2001 HUMS) collected important information on the education of HRS respondents children. Among other things, the survey asked a selected set of HRS respondents to provide information about whether a child attended a two- or four-year undergraduate college, the total number of years in college(s), his or her age when he or she last attended college, and the name of the college that he or she last attended. One way to use the information is to produce college tuition data associated with each child, which can then be linked in an integrated analysis of family transfer with other family transfer information collected in the HRS core survey. In this document we describe what we have done in imputing HRS 2001 HUMS college tuitions. The general idea is to link the children college attendance information in HRS 2001 HUMS with a college tuition database (CASPAR) created and administered by the National Science Foundation. For 2000 and 2001, college cost data are also taken from the NCES IPEDS online database.}, keywords = {Consumption and Savings, Methodology, Net Worth and Assets}, author = {Cao, Honggao and John C Henretta and Norgard, T.M. and Beth J Soldo and David R Weir} } @inbook {5181, title = {Individual Subjective Survival Curves}, booktitle = {Analyses in the Economics of Aging}, year = {2005}, note = {RDA ProCite field 6 : In ProCite field 8 : ed.}, pages = {337-412}, publisher = {University of Chicago Press}, organization = {University of Chicago Press}, chapter = {12}, address = {Chicago}, abstract = {Testing life-cycle models and other economic models of saving and consumption at micro level requires knowledge of individuals{\textquoteright} subjective believes of their mortality risk. Previous studies have shown that individual responses on subjective survival probabilities are generally consistent with life tables. However, survey responses suffer serious problems caused by focal responses of zero and one. This paper suggests using a Bayesian update model that accounts for the problems encountered in focal responses. We also propose models that help us to identify how much each individual deviates from life table in her subjective belief. The resulting individual subjective survival curves have considerable variations and are readily applicable in testing economic models that require individual subjective life expectancies.}, keywords = {Expectations}, url = {https://www.nber.org/chapters/c10367}, author = {Gan, Li and Michael D Hurd and Daniel McFadden}, editor = {David A Wise} } @article {5636, title = {Knowledge and Preference in Reporting Financial Information}, year = {2005}, institution = {Michigan Retirement Research Center, University of Michigan}, address = {Ann Arbor, MI}, abstract = {This article models respondent behavior in a financial survey with a framework explicitly integrating a respondent s knowledge of and willingness to reveal his or her financial status. Whether a respondent provides a valid answer, a don t know , or a refusal to a financial question depends on the interaction of his or her financial knowledge and preferences regarding revealing the knowledge. Using asset response and nonresponse data from the Health and Retirement Study (2000), we found that knowledge and preferences play interrelated roles in reporting financial information, that a respondent s age, gender, education, and race and ethnicity are important predictors of respondent behavior, and that race and ethnicity affect a respondent behavior only via their influence on preferences, while gender only via its influence on knowledge. We also found strong heterogeneity in respondents financial knowledge and their willingness to reveal the knowledge.}, keywords = {Methodology}, url = {https://mrdrc.isr.umich.edu/pubs/knowledge-and-preference-in-reporting-financial-information/}, author = {Cao, Honggao and Daniel H. Hill} } @article {7058, title = {Life course pathways to adult-onset diabetes.}, journal = {Soc Biol}, volume = {52}, year = {2005}, month = {2005 Fall-Winter}, pages = {94-111}, publisher = {52}, abstract = {

Early life conditions, such as socioeconomic status (SES) and health, have the potential to set in motion multiple and reinforcing pathways that shape both the prevalence and onset of diabetes among older adults. Using data from the Health and Retirement Study (1998-2002) for persons age 51 years and older, we investigated the core mediating mechanisms linking early life conditions with diabetes prevalence in 1998 and onset over a 4-year follow-up period, focusing on adult achievement processes and obesity as key mechanisms. We found that father{\textquoteright}s education is negatively associated with diabetes prevalence for older men and women. However, no markers of early life SES are directly associated with older men{\textquoteright}s and women{\textquoteright}s onset of diabetes, and the negative effects of adult SES on diabetes onset pertain only to women. Early life health affects the onset of diabetes among women--but not the prevalence--and no evidence of this association was found for men. We found no evidence that obesity is an important mechanism connecting either early life or adult SES with diabetes development in men or women. We speculate that early life SES may accelerate the development of diabetes at younger ages, and that the pathways linking life course SES, early life health, and diabetes are partly gender-specific and biological in nature.

}, keywords = {Aged, Child, Diabetes Mellitus, Type 2, Family Health, Female, Follow-Up Studies, Humans, Life Style, Likelihood Functions, Logistic Models, Male, Middle Aged, Obesity, Poverty, Risk Factors, Social Class, United States}, issn = {0037-766X}, doi = {https://doi.org/10.1080/19485565.2005.9989104}, author = {Best, Latrica E. and Mark D Hayward and Mira M Hidajat} } @article {7044, title = {Physical and mental health status of older long-term cancer survivors.}, journal = {J Am Geriatr Soc}, volume = {53}, year = {2005}, month = {2005 Dec}, pages = {2145-52}, publisher = {53}, abstract = {

OBJECTIVES: To assess the physical and mental health status of older long-term cancer survivors.

DESIGN: Cohort study using propensity score methods to control for baseline differences between cancer survivors and controls.

SETTING: General community population in the United States.

PARTICIPANTS: Nine hundred sixty-four cancer patients who had survived for more than 4 years and 14,333 control patients who had never had cancer from a population-based sample of Americans aged 55 and older responding to the 2002 Health and Retirement Study.

MEASUREMENTS: Medical conditions, symptoms, health behaviors, health status, mobility, activities of daily living, mental health diagnoses, self-rated memory, depressive symptoms, cognitive function, and self-reported life expectancy.

RESULTS: Cancer survivors reported higher rates of lung disease (13.9\% vs 9.6\%; P=.001), heart condition (29.3\% vs 22.9\%; P<.001), arthritis (69.4\% vs 59.4\%; P<.001), incontinence (26.6\% vs 19.7\%; P=.001), frequent pain (36.4\% vs 29.4\%; P=.005), and obesity (27.0\% vs 24.2\%; P=.001) than individuals without cancer but lower rates of smoking (12.0\% vs 14.8\%; P=.03). Cancer survivors were less likely than persons without cancer to report excellent or very good health status (37.2\% vs 44.6\%; P<.001) and had more mobility (P<.001) and activity of daily living (P=.01) limitations. Cancer survivors did not differ from persons without cancer in rates of depression or cognitive function (both P>.2) but were less optimistic about their life expectancy (P=.004).

CONCLUSION: The physical health status of older long-term cancer survivors is somewhat worse than that of comparable persons who have never had cancer, but they have surprisingly similar mental health status. Future research is needed to understand factors contributing to poorer health status and identify patients at highest risk of long-term cancer-related problems.

}, keywords = {Aged, Aged, 80 and over, Case-Control Studies, Chronic disease, Cohort Studies, Female, Health Behavior, Health Status, Humans, Logistic Models, Male, Mental Health, Middle Aged, Neoplasms, Survivors, United States}, issn = {0002-8614}, doi = {10.1111/j.1532-5415.2005.00507.x}, author = {Nancy L. Keating and Norredam, Marie and Landrum, Mary Beth and Haiden A. Huskamp and Meara, Ellen} } @article {7041, title = {Processes of cumulative adversity: childhood disadvantage and increased risk of heart attack across the life course.}, journal = {J Gerontol B Psychol Sci Soc Sci}, volume = {60 Spec No 2}, year = {2005}, month = {2005 Oct}, pages = {117-24}, publisher = {60B}, abstract = {

OBJECTIVES: This article examines how processes of cumulative adversity shape heart attack risk trajectories across the life course.

METHODS: Our sample includes 9,760 Health and Retirement Study respondents born between 1931 and 1941. Using self-reported retrospective measures of respondents{\textquoteright} early background, we first identify three latent classes with differential exposure to childhood disadvantage. Intervening covariates associated with educational attainment, employment status, income attainment, marital history, and health behaviors are added to capture sequential processes of adversity. Final latent-class cluster models estimate the cumulative impact of these covariates on three different heart attack risk trajectories between 1992 and 2002: high, increasing, and low.

RESULTS: Early disadvantage and childhood illness have severe enduring effects and increase the risk for heart attack. Adult pathways, however, differentially influence trajectories of heart attack risk and mediate the effects of early disadvantage.

DISCUSSION: Findings suggest that future research should consider how processes of cumulative adversity initiated in childhood influence health outcomes in older ages.

}, keywords = {Child, Cluster Analysis, Family Characteristics, Female, Human Development, Humans, Likelihood Functions, Male, Middle Aged, Myocardial Infarction, Psychosocial Deprivation, Regression Analysis, Risk Factors, Social Environment, Socioeconomic factors, United States}, issn = {1079-5014}, doi = {10.1093/geronb/60.special_issue_2.s117}, author = {Angela M O{\textquoteright}Rand and Jenifer Hamil-Luker} } @inbook {5201, title = {Survey Design and Methodology in the Health and Retirement Study and the Wisconsin Longitudinal Study}, booktitle = {Aging, Health and Public Policy: Demographic and Economic Perspectives}, series = {Population and Development Review}, volume = {30}, year = {2005}, pages = {209-235}, publisher = {Population Council}, organization = {Population Council}, address = {New York}, abstract = {Large-scale data collection has become the kernel of the growth of knowledge in the social sciences. Nowhere is this more evident than in research in the demography of aging and the life course, where scientific progress has been stimulated and sustained by complementary longitudinal studies of aging populations. In this chapter, we review the history, organization, and design of two of these public resources, the Wisconsin Longitudinal Study (WLS) and the Health and Retirement Study (HRS). Recent innovations in each of these studies hold promise for major advances in knowledge about the demography, economics, sociology, and epidemiology of aging. The stories of the WLS and HRS highlight important clues about the creation of systems of continuing surveys to inform science and public policy.}, keywords = {Methodology}, doi = {10.7826/isr-um.06.585031.001.05.0012.2005}, author = {Hauser, Robert M. and Robert J. Willis}, editor = {Linda J. Waite} } @article {5638, title = {Valuing Lost Home Production in Dual-Earner Couples}, year = {2005}, institution = {The University of Michigan, Michigan Retirement Research Center}, address = {Ann Arbor, MI}, abstract = {Economists principal tool for studying household behavioral responses to changes in tax and other government policies, and the magnitude and determinants of private saving, is the life cycle model. The purpose of this paper is to attempt to incorporate into that model one of the most conspicuous changes in the U.S. economy in the last 50 years, the rise in labor market participation for married women. The increased presence of married women in the labor force has obvious benefits: women now earn much more income than they did in the past. On the other hand, working women presumably spend less time doing housework and other types of home production, and the forgone value of time at home reduces the net benefit of their work in the market. Conventional accounts do not provide measurements of the costs of lost home production, but we attempt to use comparisons of household net worth at retirement to deduce valuations indirectly. This paper modifies a standard life cycle model to include women s labor supply decisions, estimates key parameters of the new specification, and attempts to assess the significance of rising female labor market participation for aggregate national saving in the U.S. Using panel data from the Health and Retirement Study, we find that the difference between measured labor market earnings for married women and earnings net of the value of lost home production seems moderately small about 30 percent and that the corresponding long run effect on the overall rate of private saving is minor.}, keywords = {Employment and Labor Force, Net Worth and Assets, Women and Minorities}, url = {https://mrdrc.isr.umich.edu/pubs/valuing-lost-home-production-in-dual-earner-couples/}, author = {John Laitner and Christopher L House and Stolyarov, Dmitriy} } @article {5601, title = {All in the Family: Providing support to grandchildren and health in midlife}, year = {2004}, institution = {Duke University}, abstract = {The purpose of this study was to examine the effects of caring for grandchildren on health behaviors and mental and physical health among older adults. METHODS: Using a sample of 12,872 grandparents aged 50 through 80 from the Health and Retirement Study, we examined the relationship between stability and change in various types of grandchild care and subsequent health, controlling for covariates and earlier health. RESULTS: We found no evidence to suggest that caring for grandchildren has dramatic and widespread negative effects on grandparents{\textquoteright} health and health behavior. We found limited evidence that grandmothers caring for grandchildren in skipped-generation households are more likely to experience negative changes in health behavior, depression, and self-rated health. We also found some evidence of benefits to grandmothers who babysit. DISCUSSION: Our findings suggest that the health disadvantages found previously among grandparent caregivers arise from grandparents{\textquoteright} prior characteristics, not as a consequence of providing care. Health declines as a consequence of grandchild care appear to be the exception rather than the rule. These findings are important given continuing reliance on grandparents for day care and increasing reliance on grandparents for custodial care. However, the findings should be tempered by the recognition that for a minority of grandparents, coresidential grandchild care may compromise health.}, keywords = {Adult children, Demographics, Health Conditions and Status}, author = {Mary Elizabeth Hughes and Tracey A. LaPierre and Linda J. Waite and Ye Luo} } @inbook {5180, title = {The American Family as a Context for Healthy Aging}, booktitle = {Families in Ageing Societies: A multi-disciplinary approach}, year = {2004}, note = {ProCite field 6 : Chapter 10 in ProCite field 8 : ed.}, publisher = {Oxford University Press}, organization = {Oxford University Press}, address = {Oxford}, keywords = {Adult children}, author = {Mary Elizabeth Hughes and Linda J. Waite}, editor = {Harper, Sarah} } @article {6963, title = {Body mass index, physical activity, and the risk of decline in overall health and physical functioning in late middle age.}, journal = {Am J Public Health}, volume = {94}, year = {2004}, month = {2004 Sep}, pages = {1567-73}, publisher = {94}, abstract = {

OBJECTIVES: We examined the relation between body mass index, exercise, overall health, and physical functioning.

METHODS: We studied 7867 adults aged 51 to 61 years in 1992 to 1996. Adjusted relative risks for health decline and new physical difficulties were determined with logistic regression.

RESULTS: Overweight and obesity were independently associated with health decline (adjusted relative risk [ARR] = 1.29 and 1.36) and development of a new physical difficulty (ARR = 1.27 and 1.45). Regular exercise significantly reduced the risk of health decline and development of a new physical difficulty, even among obese individuals.

CONCLUSIONS: Maintaining ideal body weight is important in preventing decline in overall health and physical functioning. However, regular exercise can reduce the risk of health decline even among individuals who cannot achieve ideal weight.

}, keywords = {Attitude to Health, Body Mass Index, Female, Health Status, Humans, Logistic Models, Male, Middle Aged, Motor Activity, Obesity, Quality of Life, Risk Assessment, Risk Factors, Risk Reduction Behavior, Self Care, United States}, issn = {0090-0036}, doi = {10.2105/ajph.94.9.1567}, author = {Xiaoxing He and David W. Baker} } @article {6962, title = {Changes in weight among a nationally representative cohort of adults aged 51 to 61, 1992 to 2000.}, journal = {Am J Prev Med}, volume = {27}, year = {2004}, month = {2004 Jul}, pages = {8-15}, publisher = {27}, abstract = {

BACKGROUND: Few studies have examined patterns and predictors of changes in body weight among adults in late middle age.

METHODS: Prospective cohort study of 7391 community-dwelling U.S. adults aged 51 to 61 years at baseline (1992), using publicly available data files from the 1992, 1994, 1996, 1998, and 2000 Health and Retirement Survey interviews. Changes in weight and body mass index (BMI) were examined for different racial/ethnic groups of men and women. The predictors of changes in body weight and BMI were determined using gender-specific linear regression.

RESULTS: Mean body weight and BMI increased in both genders and all ethnic groups. The mean weight gain was higher for women (1.67 kg, 95\% confidence interval [CI]=1.34-1.99) than for men (1.43 kg, 95\% CI=1.17-1.68). White men and women had the lowest baseline BMI but tended to gain more weight than other racial/ethnic groups. In multivariate analyses, individuals who were older or had higher baseline weight showed less weight gain. Men were less likely to gain weight if their self-reported overall health at baseline was poor compared to those in excellent health. Regular light or vigorous recreational activities and work-related activities were not associated with less weight gain. Race, education, and income were not associated with weight gain in multivariate analyses.

CONCLUSIONS: All population subgroups are at risk for weight gain. Public health messages should target diverse populations. The current levels of physical activity attained by this population do not appear to protect against weight gain.

}, keywords = {Body Mass Index, Body Weight, Female, Health Surveys, Humans, Linear Models, Longitudinal Studies, Male, Middle Aged, Motor Activity, Multivariate Analysis, Prospective Studies, Racial Groups, Sex Factors, United States}, issn = {0749-3797}, doi = {10.1016/j.amepre.2004.03.016}, author = {Xiaoxing He and David W. Baker} } @article {6939, title = {Diabetes Diagnosis and Weight Loss in Middle-Aged Adults}, journal = {Research on Aging}, volume = {26}, year = {2004}, pages = {62-81}, publisher = {26}, abstract = {Using three waves of Health and Retirement Study data, this study investigated whether (a) self-reported physician-diagnosed diabetes prior to 1994 predicted weight loss between 1994 and 1996 in adults who were aged 51 to 61 and relatively healthy but overweight in 1992 (n = 2,642) and (b) socioeconomic status influenced that relationship. The authors found that these overweight middle-aged adults were at least 50 more likely to report that they lost at least 10 pounds of excess body weight if they had been diagnosed with diabetes than if they had not. Furthermore, the authors found that neither education nor net worth predicted weight loss in these adults. Identifying the social, psychological, and physiological mechanisms linking chronic conditions and health behaviors can inform policy makers and health care providers and enhance the development of effective interventions to prevent or reduce health risks in middle-aged and older adults.}, keywords = {Demographics, Health Conditions and Status, Healthcare}, doi = {10.1177/0164027503258741}, url = {http://roa.sagepub.com/content/26/1/62.abstract}, author = {Linda A. Wray and Caroline S Blaum and Mary Beth Ofstedal and A. Regula Herzog} } @article {5605, title = {The Division of Bequests}, year = {2004}, institution = {RAND}, keywords = {Adult children}, author = {Michael D Hurd and James P Smith} } @article {5607, title = {Documentation of Physical Functioning Measures in the Health and Retirement Study and the Asset and Health Dynamics Among the Oldest Old Study}, year = {2004}, institution = {The University of Michigan}, abstract = {This document is part of a series of working papers on health-related measures in the Health and Retirement Study (HRS) and the Asset and Health Dynamics Among the Oldest-Old (AHEAD) study. The series currently contains papers on cognitive function, affective function, and physical function, the latter of which is the focus of this document. The purpose of this document is to aid prospective analysts in the appropriate use of the physical functioning data. To do so, this document provides an inventory of the physical functioning measures included in the survey interviews, describes the formats and origins of these measures, discusses their reliability, validity, and change over time and several options for working with the evolution of the questions, and provides SAS code for recoding the variables and creating simple summary measures.}, keywords = {Health Conditions and Status, Healthcare, Methodology}, author = {Stephanie J. Fonda and A. Regula Herzog} } @article {6941, title = {The effect of equipment usage and residual task difficulty on use of personal assistance, days in bed, and nursing home placement.}, journal = {J Am Geriatr Soc}, volume = {52}, year = {2004}, month = {2004 Jan}, pages = {72-9}, publisher = {52}, abstract = {

OBJECTIVES: To determine whether residual difficulty in functioning in spite of equipment use is linked with increased use of personal assistance.

DESIGN: Longitudinal. Two waves of the Asset and Health Dynamics Among the Oldest Old (AHEAD) database were used to test the effect of residual difficulty on hours of personal assistance and bed days at Wave 1 on hours of personal assistance, bed days, and nursing home placement at Waves 1 and 2.

SETTING: A nationally representative setting of community-dwelling persons aged 70 and older and their spouses, regardless of age at Wave 1 AHEAD. There was movement of some respondents into nursing homes by the Wave 2 interview.

PARTICIPANTS: Respondents to the AHEAD survey, N=8,222 at Wave 1.

MEASUREMENTS: The dependent variables were hours of personal assistance in the month before the AHEAD survey (Waves 1 and 2), number of days in month before the survey in which the person did not get out of bed (Waves 1 and 2), and residence in a nursing home at Wave 2. The key explanatory variable was a mutually exclusive (four category) variable that specified whether there was residual difficulty (yes/no) in indoor mobility in spite of using equipment to aid specifically with indoor mobility. The four-category variable was defined by the four categories created by a cross-tabulation of equipment use (yes/no) and difficulty with indoor mobility (yes/no). A similar four-category variable was also defined for transferring in the home.

RESULTS: In cross section, equipment users with residual difficulty reported more hours of personal assistance in the case of indoor mobility impairment and were more likely to have some hours of personal assistance than those without residual difficulty with indoor mobility and transferring. Longitudinally, those with residual difficulty at Wave 1 were more likely to need some personal assistance hours at Wave 2 (odds ratio=1.67, 95\% confidence interval= 1.23-2.26 for indoor mobility). For transferring, those with residual difficulty had 43 more hours of personal assistance per month (P=.001) than those for whom equipment resolved their disability. Residual disability was linked to more bed days for users of indoor mobility and transferring equipment, but it was not predictive of nursing home placement by Wave 2.

CONCLUSION: Equipment for indoor mobility or transfers apparently resolves difficulty for some users of the equipment but not for others. Residual task difficulty in spite of equipment for indoor mobility and transferring is linked with worse outcomes, including increased dependency on personal assistance and more days in bed. This shows that more attention is needed to determine whether equipment prescribed is appropriate for a patient{\textquoteright}s difficulty and that follow-up assessment is crucial after equipment is prescribed.

}, keywords = {Activities of Daily Living, Aged, Aged, 80 and over, Bed Rest, Cross-Sectional Studies, Disability Evaluation, Female, Homemaker Services, Humans, Least-Squares Analysis, Logistic Models, Longitudinal Studies, Male, Nursing homes, Risk Factors, Self-Help Devices}, issn = {0002-8614}, doi = {10.1111/j.1532-5415.2004.52013.x}, author = {Donald H. Taylor Jr. and Hoenig, H.} } @mastersthesis {6336, title = {Essays on Elderly Labor Force Participation, Pension Structure, and Partial Retirement}, volume = {Doctor of Philosophy}, year = {2004}, month = {2004}, school = {University of Notre Dame}, abstract = {Increasingly, older Americans are postponing retirement or re-entering the workforce after retirement. This research examines the effect of pension structure changes and the different ways older workers partially retire by transitioning from full time work to part-time work, by changing jobs, or by returning to work from full retirement. Defined contribution pension growth makes retirement income increasingly tied to financial markets, implying that older workers need to postpone retirement in recessions, precisely when jobs are scarce. Using data from the Health and Retirement Study, a difference-in-differences analysis comparing older workers with defined benefit and defined contribution pensions before and after the stock market crash in 2000 reveals that the probability of retirement for people aged 63-64 with only defined contribution pensions fell by over 34 percentage points from 1998 to 2002. As men and women work longer, partial retirement has become an important option for older workers. Studies suggest that workers in the private sector cannot work fewer hours as they age on their career job because defined benefit pensions restrict inservice distributions prior to the plan{\textquoteright}s normal retirement age. Using an instrumental variables regression, I find little evidence ERISA regulated defined benefit pensions cause partial retirees to change employers prior to attaining the normal retirement age. However, many older workers not affected by ERISA also change jobs in partial retirement, which suggests the presence of constraints not identified in the model or that changing employers is in itself desirable as people age. Although partial retirement usually refers to workers voluntarily transitioning from full-time work to complete retirement, health or financial problems may be causing these changes. I find partial retirees are less healthy than similar full-time workers and report their health constrains work ability. In addition, over 26\% of partial retirees return to work after retirement and hourly wages of partial retirees (previously retired) fall substantially more than hourly wages of partial retirees who transitioned directly from full-time work. Regression analysis indicates retirees with defined benefit pensions rarely return to work. Women, though return to work if their spouse{\textquoteright}s health deteriorates, while men re-enter the workforce if their spouse works.}, keywords = {Employment and Labor Force, Healthcare, Net Worth and Assets}, url = {https://curate.nd.edu/show/2z10wq0045w}, author = {Sharon Lynn Hermes} } @article {5603, title = {Family Care, Nursing Home Transitions, and States{\textquoteright} Long-Term Care Policies}, year = {2004}, note = {RDA}, institution = {University of Illinois-Chicago}, keywords = {Healthcare}, author = {Muramatsu, Naoko and Richard T. Campbell and Ruby L Hoyem and Martha A. Jacob and Chris Ross and yin, Hongjun} } @article {6920, title = {The health effects of restricting prescription medication use because of cost.}, journal = {Med Care}, volume = {42}, year = {2004}, note = {Comment in: Med Care. 2004 Jul;42(7):623-5 AN=15213485}, month = {2004 Jul}, pages = {626-34}, publisher = {42}, abstract = {

BACKGROUND: High out-of-pocket expenditures for prescription medications could lead people with chronic illnesses to restrict their use of these medications. Whether adults experience adverse health outcomes after having restricted medication use because of cost is not known.

METHODS: We analyzed data from 2 prospective cohort studies of adults who reported regularly taking prescription medications using 2 waves of the Health and Retirement Study (HRS), a national survey of adults aged 51 to 61 in 1992, and the Asset and Health Dynamics Among the Oldest Old (AHEAD) Study, a national survey of adults aged 70 or older in 1993 (n = 7991). We used multivariable logistic and Poisson regression models to assess the independent effect on health outcomes over 2 to 3 years of follow up of reporting in 1995-1996 having taken less medicine than prescribed because of cost during the prior 2 years. After adjusting for differences in sociodemographic characteristics, health status, smoking, alcohol consumption, body mass index (BMI), and comorbid chronic conditions, we determined the risk of a significant decline in overall health among respondents in good to excellent health at baseline and of developing new disease-related adverse outcomes among respondents with cardiovascular disease, diabetes, arthritis, and depression.

RESULTS: In adjusted analyses, 32.1\% of those who had restricted medications because of cost reported a significant decline in their health status compared with 21.2\% of those who had not (adjusted odds ratio [AOR], 1.76; confidence interval [CI], 1.27-2.44). Respondents with cardiovascular disease who restricted medications reported higher rates of angina (11.9\% vs. 8.2\%; AOR, 1.50; CI, 1.09-2.07) and experienced higher rates of nonfatal heart attacks or strokes (7.8\% vs. 5.3\%; AOR, 1.51; CI, 1.02-2.25). After adjusting for potential confounders, we found no differences in disease-specific complications among respondents with arthritis and diabetes, and increased rates of depression only among the older cohort.

CONCLUSIONS: Cost-related medication restriction among middle-aged and elderly Americans is associated with an increased risk of a subsequent decline in their self-reported health status, and among those with preexisting cardiovascular disease with higher rates of angina and nonfatal heart attacks or strokes. Such cost-related medication restriction could be a mechanism for worse health outcomes among low-income and other vulnerable populations who lack adequate insurance coverage.

}, keywords = {Aged, Chronic disease, Female, Financing, Personal, Health Services Accessibility, Health Status, Humans, Male, Middle Aged, Multivariate Analysis, Patient Compliance, Prospective Studies, Risk, United States}, issn = {0025-7079}, doi = {10.1097/01.mlr.0000129352.36733.cc}, author = {Michele M Heisler and Kenneth M. Langa and Eby, Elizabeth L. and A. Mark Fendrick and Mohammed U Kabeto and John D Piette} } @article {6912, title = {The impact of diabetes on workforce participation: results from a national household sample.}, journal = {Health Serv Res}, volume = {39}, year = {2004}, note = {Social Security Administration/Michigan Retirement Research Center Grant UM01-11}, month = {2004 Dec}, pages = {1653-69}, publisher = {39}, abstract = {

OBJECTIVE: Diabetes is a highly prevalent condition that results in substantial morbidity and premature mortality. We investigated how diabetes-associated mortality, disability, early retirement, and work absenteeism impacts workforce participation.

DATA SOURCE: We used the Health and Retirement Study (HRS), a national household sample of adults aged 51-61 in 1992, as a data source.

STUDY DESIGN: We conducted cross-sectional analyses on the baseline HRS data, and longitudinal analyses using data from eight years of follow-up. We used two-part regression models to estimate the adjusted impact of diabetes on workforce participation, and then estimated the economic impact of diabetes-related losses in productivity.

PRINCIPAL FINDINGS: Diabetes is a significant predictor of lost productivity. The incremental lost income due to diabetes by 1992 was 60.0 billion US dollars over an average diabetes duration of 9.7 years. From 1992 to 2000, diabetes was responsible for 4.4 billion US dollars in lost income due to early retirement, 0.5 billion US dollars due to increased sick days, 31.7 billion US dollars due to disability, and 22.0 US dollars billion in lost income due to premature mortality, for a total of 58.6 billion dollars in lost productivity, or 7.3 billion US dollars per year.

CONCLUSIONS: In the U.S. population of adults born between 1931 and 1941, diabetes is associated with a profound negative impact on economic productivity. By 1992, an estimated 60 billion US dollars in lost productivity was associated with diabetes; additional annual losses averaged 7.3 billion US dollars over the next eight years, totaling about 120 billion US dollars by the year 2000. Given the rising prevalence of diabetes, these costs are likely to increase substantially unless countered by better public health or medical interventions.

}, keywords = {Chronic disease, Cohort Studies, Cost of Illness, Cross-Sectional Studies, Diabetes Mellitus, Disabled Persons, Efficiency, Employment, Female, Health Services Research, Health Status Indicators, Humans, Longitudinal Studies, Male, Middle Aged, United States}, issn = {0017-9124}, doi = {10.1111/j.1475-6773.2004.00311.x}, author = {Sandeep Vijan and Rodney A. Hayward and Kenneth M. Langa} } @article {5598, title = {Increases in Wealth Among the Elderly in the Early 1990s: How Much is Due to Survey Design?}, number = {10862}, year = {2004}, institution = {The National Bureau of Economic Research}, address = {Cambridge, MA}, abstract = {The Asset and Health Dynamics Among the Oldest Old (AHEAD) study shows a large increase in reported total wealth between 1993 and 1995. Such an increase is not found in other US household surveys around that period. This paper examines one source of this difference. We find that in AHEAD 1993 ownership rates of stocks, CDs, bonds, and checking and saving accounts were underreported, resulting in under-measurement of wealth in 1993, and a substantial increase in wealth from 1993 to 1995. The explanation for the under-reporting is a combination of question sequence and wording in the AHEAD survey instrument.}, keywords = {Methodology, Net Worth and Assets}, doi = {10.3386/w10862}, author = {Susann Rohwedder and Steven Haider and Michael D Hurd} } @article {6921, title = {Out-of-pocket health care expenditures among older Americans with dementia.}, journal = {Alzheimer Dis Assoc Disord}, volume = {18}, year = {2004}, month = {2004 Apr-Jun}, pages = {90-8}, publisher = {18}, abstract = {

The number of older individuals with dementia will likely increase significantly in the next decades, but there is currently limited information regarding the out-of-pocket expenditures (OOPE) for medical care made by cognitively impaired individuals and their families. We used data from the 1993 and 1995 Asset and Health Dynamics Study, a nationally representative longitudinal survey of older Americans, to determine the OOPE for individuals with and without dementia. Dementia was identified in 1993 using a modified version of the Telephone Interview for Cognitive Status for self-respondents, and proxy assessment of memory and judgment for proxy respondents. In 1995, respondents reported OOPE over the prior 2 years for: 1) hospital and nursing home stays, 2) outpatient services, 3) home care, and 4) prescription medications. The adjusted mean annual OOPE was 1,350 US dollars for those without dementia, 2,150 US dollars for those with mild/moderate dementia, and 3,010 US dollars for those with severe dementia (p < 0.01). Expenditures for hospital/nursing home care (1,770 per year US dollars) and prescription medications (800 per year US dollars) were the largest OOPE components for those with severe dementia. We conclude that dementia is independently associated with significantly higher OOPE for medical care compared with those with normal cognitive function. Severe dementia is associated with a doubling of OOPE, mainly due to higher payments for long-term care. Given that the number of older Americans with dementia will likely increase significantly in the coming decades, changes in public funding aimed at reducing OOPE for both long-term care and prescription medications would have considerable impact on individuals with dementia and their families.

}, keywords = {Aged, Aged, 80 and over, Alzheimer disease, Costs and Cost Analysis, Data Interpretation, Statistical, Female, Financing, Personal, Health Care Costs, Health Expenditures, Health Surveys, Humans, Insurance Coverage, Longitudinal Studies, Male}, issn = {0893-0341}, doi = {10.1097/01.wad.0000126620.73791.3e}, author = {Kenneth M. Langa and Eric B Larson and Robert B Wallace and A. Mark Fendrick and Norman L Foster and Mohammed U Kabeto and David R Weir and Robert J. Willis and A. Regula Herzog} } @article {6914, title = {Out-of-pocket health-care expenditures among older Americans with cancer.}, journal = {Value Health}, volume = {7}, year = {2004}, month = {2004 Mar-Apr}, pages = {186-94}, publisher = {7}, abstract = {

OBJECTIVE: There is currently limited information regarding the out-of-pocket expenditures (OOPE) for medical care made by elderly individuals with cancer. We sought to quantify OOPE for community-dwelling individuals age 70 or older with: 1) no cancer (No CA), 2) a history of cancer, not undergoing current treatment (CA/No Tx), and 3) a history of cancer, undergoing current treatment (CA/Tx).

METHODS: We used data from the 1995 Asset and Health Dynamics Study, a nationally representative survey of community-dwelling elderly individuals. Respondents identified their cancer status and reported OOPE for the prior 2 years for: 1) hospital and nursing home stays, 2) outpatient services, 3) home care, and 4) prescription medications. Using a multivariable two-part regression model to control for differences in sociodemographics, living situation, functional limitations, comorbid chronic conditions, and insurance coverage, the additional cancer-related OOPE were estimated.

RESULTS: Of the 6370 respondents, 5382 (84\%) reported No CA, 812 (13\%) reported CA/No Tx, and 176 (3\%) reported CA/Tx. The adjusted mean annual OOPE for the No CA, CA/No Tx, and CA/Tx groups were 1210 dollars, 1450 dollars, and 1880 dollars, respectively (P < .01). Prescription medications (1120 dollars per year) and home care services (250 dollars) accounted for most of the additional OOPE associated with cancer treatment. Low-income individuals undergoing cancer treatment spent about 27\% of their yearly income on OOPE compared to only 5\% of yearly income for high-income individuals with no cancer history (P < .01).

CONCLUSIONS: Cancer treatment in older individuals results in significant OOPE, mainly for prescription medications and home care services. Economic evaluations and public policies aimed at cancer prevention and treatment should take note of the significant OOPE made by older Americans with cancer.

}, keywords = {Aged, Aged, 80 and over, Cost of Illness, Family Characteristics, Female, Financing, Personal, Health Expenditures, Health Services Research, Humans, Insurance, Health, Longitudinal Studies, Male, Medicaid, Medicare, Michigan, Neoplasms}, issn = {1098-3015}, doi = {10.1111/j.1524-4733.2004.72334.x}, author = {Kenneth M. Langa and A. Mark Fendrick and M.E. Chernew and Mohammed U Kabeto and Paisley, Kerry L. and Hayman, James A.} } @article {6938, title = {Physical activity and mortality across cardiovascular disease risk groups.}, journal = {Med Sci Sports Exerc}, volume = {36}, year = {2004}, month = {2004 Nov}, pages = {1923-9}, abstract = {

PURPOSE: Several cohort studies suggest that sedentary individuals have an increased risk of death compared with individuals who are physically active. Most of these studies have been conducted in highly selected patient populations who tend to be healthier and are from higher socioeconomic status (SES) groups. We examined the impact of a sedentary lifestyle on mortality by cardiovascular disease (CVD) risk group in a national sample of U.S. adults who represent a wide range of activity levels, health conditions, and SES groups.

METHODS: Using data from the HRS, a nationally representative, observational study of 9824 U.S. adults aged 51-61 yr in 1992, we estimated the relative risk of death comparing sedentary individuals with those who are physically active by CVD risk group in a multivariate logistic regression model.

RESULTS: Even after adjusting for confounders, regular moderate to vigorous physical activity was associated with substantially lower overall mortality (odds ratio (OR) = 0.62 (95\% CI 0.44-0.86)) compared with sedentary individuals. High CVD risk individuals (21\% of the population) accounted for 64\% of deaths attributable to a sedentary lifestyle. Those with high CVD risk had the most significant benefit from being active (regular moderate to vigorous exercisers OR = 0.55 (95\% CI 0.31-0.97) and occasional or light exercisers OR 0.55 (95\% CI 0.41-0.74)) compared with high CVD risk individuals who were sedentary.

CONCLUSION: A sedentary lifestyle is associated with a higher risk of death in preretirement-aged U.S. adults. Individuals with high CVD risk appear to get the largest benefit from being physically active. Physical activity interventions targeting high CVD risk individuals should be a medical and public health priority.

}, keywords = {Cardiovascular Diseases, Cohort Studies, Female, Follow-Up Studies, Humans, Life Style, Logistic Models, Male, Middle Aged, Motor Activity, Multivariate Analysis, Odds Ratio, Prospective Studies, Risk Assessment, Risk Factors, Socioeconomic factors, Survival Analysis, United States}, issn = {0195-9131}, doi = {10.1249/01.mss.0000145443.02568.7a}, author = {Richardson, Caroline R. and Kriska, Andrea M. and Lantz, Paula M. and Rodney A. Hayward} } @article {6919, title = {Predicting Nursing Home Admission: Estimates from a seven-year follow-up of a nationally representative sample of older Americans}, journal = {Alzheimer Disease and Associated Disorders}, volume = {18}, year = {2004}, pages = {83-89}, publisher = {18}, abstract = {This study determines whether prevalence and predictors of nursing home admission changed in the 1990s, during a period of dramatic changes in the service provision for and medical care of chronic impairments. Data from the 1993-2000 surveys of the Asset and Health Dynamics Among the Oldest Old (AHEAD) Study, a longitudinal and nationally representative sample, were used. Proportional hazard models were used to determine the effects of dementia, physical functioning, clinical conditions, and sociodemographics on the likelihood of nursing home admission. Of the 6,676 respondents, 17 were admitted to a nursing home. Models excluding functional impairment demonstrated significant effects of chronic medical conditions and dementia on the risk of institutionalization. After controlling for functional impairment, dementia still had significant and strong effects on institutionalization but clinical conditions did not, suggesting that the impact of dementia goes beyond its effect on physical functioning. Nursing home admissions did not decrease during the study period, and the impact of dementia on the risk of nursing home admission did not decrease. Interventions for individuals with dementia should impact the behavioral aspects of the condition and slow disease progression in addition to improving physical functioning.}, keywords = {Demographics, Health Conditions and Status, Healthcare, Methodology}, author = {Banaszak-Holl, Jane and A. Mark Fendrick and Norman L Foster and A. Regula Herzog and Mohammed U Kabeto and Kent, David and Walter L. Straus and Kenneth M. Langa} } @inbook {5228, title = {Race/Ethnicity, Socioeconomic Status, and Health}, booktitle = {Critical Perspectives on Race and Ethnic Differences in Health in Later Life}, year = {2004}, pages = {310-352}, publisher = {National Academy of Sciences}, organization = {National Academy of Sciences}, chapter = {9}, abstract = {Mounting evidence indicates that racial/ethnic differences in morbidity and mortality are tied to socioeconomic resources (Hayward, Crimmins, Miles, and Yu, 2000; Williams and Collins, 1995). Largely because of data availability, most of this evidence is based on the health experiences of blacks and whites, with much less evidence on the role of socioeconomic factors in understanding racial/ethnic disparities when Americans of Asian or Pacific Island descent, Hispanics, and Native Americans are part of the picture. The potential power of the socioeconomic status (SES) paradigm in understanding health disparities{\textemdash}including racial/ethnic disparities{\textemdash}is evident in the fact that socioeconomic differences in health outcomes have been widely documented for most health conditions in most countries. People who are poorer and who have less education are more likely to suffer from diseases, to experience loss of functioning, to be cognitively and physically impaired, and to experience higher mortality rates (Adler, Boyce, Chesney, Folkman, and Syme, 1993; Adler et al., 1994; Marmot, Kogevinas, and Elston, 1987; Marmot, Ryff, Bumpass, Shipley, and Marks, 1997; Preston and Taubman, 1994; Williams, 1990). In the United States, few health problems are more likely to occur among those who are better off, and some health conditions are particularly sensitive to SES. In recent years socioeconomic differences in health also appear to be increasing in the United States and in other developed countries (Crimmins and Saito, 2001; Feldman, Makuc, Kleinman, and Coroni-Huntley, 1989; Manton, 1997; Marmot, 1994; Pappas, Queen, Hadden, and Fisher, 1993; Preston and Elo, 1995).}, keywords = {Demographics, Health Conditions and Status, Healthcare, Women and Minorities}, url = {https://www.ncbi.nlm.nih.gov/books/NBK25526/$\#$:~:text=Socioeconomic\%20status\%20is\%20obviously\%20related,health\%20outcomes\%20relative\%20to\%20whites.}, author = {Eileen M. Crimmins and Mark D Hayward and Teresa Seeman}, editor = {Norman B. Anderson and Randy A. Bulatao and Barney Cohen} } @article {6980, title = {Review of: The smoking puzzle: Information, risk perception, and choice}, journal = {Journal of Economic Literature}, volume = {42}, year = {2004}, note = {ProCite field 3 : Clemson University}, pages = {1126-27}, publisher = {42}, keywords = {Consumption and Savings, Health Conditions and Status, Healthcare, Methodology, Public Policy}, author = {Jahn K. Hakes} } @article {9045, title = {Sample Weights and Sample Selection Indicator for the Physical Measures in HRS 2004}, year = {2004}, institution = {Survey Research Center, Institute for Social Research, University of Michigan}, address = {Ann Arbor, MI}, author = {HRS Staff} } @article {6954, title = {A Short Scale for Measuring Loneliness in Large Surveys: Results From Two Population-Based Studies.}, journal = {Res Aging}, volume = {26}, year = {2004}, month = {2004}, pages = {655-672}, publisher = {26}, abstract = {

Most studies of social relationships in later life focus on the amount of social contact, not on individuals{\textquoteright} perceptions of social isolation. However, loneliness is likely to be an important aspect of aging. A major limiting factor in studying loneliness has been the lack of a measure suitable for large-scale social surveys. This article describes a short loneliness scale developed specifically for use on a telephone survey. The scale has three items and a simplified set of response categories but appears to measure overall loneliness quite well. The authors also document the relationship between loneliness and several commonly used measures of objective social isolation. As expected, they find that objective and subjective isolation are related. However, the relationship is relatively modest, indicating that the quantitative and qualitative aspects of social relationships are distinct. This result suggests the importance of studying both dimensions of social relationships in the aging process.

}, issn = {1552-7573}, doi = {10.1177/0164027504268574}, author = {Mary Elizabeth Hughes and Linda J. Waite and Louise C Hawkley and John T. Cacioppo} } @article {6905, title = {Social Interaction and Stock Market Participation}, journal = {Journal of Finance}, volume = {59}, year = {2004}, pages = {137-163}, publisher = {59}, abstract = {We propose that stock-market participation is influenced by social interaction. In our model, any given social investor finds the market more attractive when more of his peers participate. We test this theory using data from the Health and Retirement Study, and find that social households those who interact with their neighbors, or attend church are substantially more likely to invest in the market than non-social households, controlling for wealth, race, education, and risk tolerance. Moreover, consistent with a peer-effects story, the impact of sociability is stronger in states where stock-market participation rates are higher.}, keywords = {Health Conditions and Status, Net Worth and Assets}, doi = {10.3386/w8358}, author = {Hong, Harrison and Kubik, Jeffrey D. and Stein, Jeremy C.} } @article {6929, title = {Urinary incontinence and its association with death, nursing home admission, and functional decline.}, journal = {J Am Geriatr Soc}, volume = {52}, year = {2004}, month = {2004 May}, pages = {712-8}, publisher = {52}, abstract = {

OBJECTIVES: To determine whether urinary incontinence (UI) is an independent predictor of death, nursing home admission, decline in activities of daily living (ADLs), or decline in instrumental activities of daily living (IADLs).

DESIGN: A population-based prospective cohort study from 1993 to 1995.

SETTING: Community-dwelling within the United States.

PARTICIPANTS: Six thousand five hundred six of the 7,447 subjects aged 70 and older in the Asset and Health Dynamics Among the Oldest Old study who had complete information on continence status and did not require a proxy interview at baseline.

MEASUREMENTS: The predictor was UI, and the outcomes were death, nursing home admission, ADL decline, and IADL decline. Potential confounders considered were comorbid conditions, baseline function, sensory impairment, cognition, depressive symptoms, body mass index, smoking and alcohol, demographics, and socioeconomic status.

RESULTS: The prevalence of UI was 14.8\% (18.5\% in women; 8.5\% in men). At 2-year follow-up, subjects incontinent at baseline were more likely to have died (10.9\% vs 8.7\%; unadjusted odds ratio (OR)=1.29, 95\% confidence interval (CI)=1.02-1.64), be admitted to a nursing home (4.4\% vs 2.6\%, OR=1.77; 95\% CI=1.18-2.63), and to have declined in ADL function (13.6\% vs 8.1\%; OR=1.78, 95\% CI=1.36-2.33) and IADL function (21.2\% vs 13.8\%; OR 1.69, 95\% CI 1.39-2.05). However, after adjusting for confounders, UI was not an independent predictor of death (adjusted OR (AOR)= 0.90, 95\% CI=0.67-1.21), nursing home admission (AOR=1.33, 95\% CI=0.86-2.04), or ADL decline (AOR=1.24, 95\% CI=0.92-1.68). Incontinence remained a predictor of IADL decline (AOR=1.31; 95\% CI=1.05-1.63), although adjustment markedly reduced the strength of this association.

CONCLUSION: Higher levels of baseline illness severity and functional impairment appear to mediate the relationship between UI and adverse outcomes. The results suggest that, although UI appears to be a marker of frailty in community-dwelling elderly, it is not a strong independent risk factor for death, nursing home admission, or functional decline.

}, keywords = {Activities of Daily Living, Aged, Aged, 80 and over, Body Mass Index, Female, Follow-Up Studies, Frail Elderly, Health Status, Humans, Male, Nursing homes, Outcome Assessment, Health Care, Risk Factors, Smoking, Socioeconomic factors, Time Factors, Urinary incontinence}, issn = {0002-8614}, doi = {10.1111/j.1532-5415.2004.52207.x}, author = {Holroyd-Leduc, Jayna M. and Kala M. Mehta and Kenneth E Covinsky} } @article {6989, title = {Workplace characteristics and work disability onset for men and women.}, journal = {Soz Praventivmed}, volume = {49}, year = {2004}, month = {2004}, pages = {122-31}, publisher = {49}, abstract = {

OBJECTIVES: This paper investigates the association between job characteristics and work disability among men and women in older working ages in the United States. We examine whether the association persists when controlling for major chronic disease experience. We also address whether job characteristics are ultimately associated with the receipt of disability benefits.

METHODS: Data are from the Health and Retirement Survey and are nationally representative of noninstitutionalized persons 51-61 in 1992. Disability onset is estimated using a hazard modeling approach for those working at wave 1 (N = 5,999). A logistic regression analysis of disability benefits is based on a risk set of 525 persons who become work-disabled before the second interview.

RESULTS: Women{\textquoteright}s disability onset and health problems appear less related to job characteristics than men{\textquoteright}s. For men, work disability is associated with stressful jobs, lack of job control, and environmentally hazardous conditions but is not associated with physical demands. Participation in disability benefit programs among those with work disability is unrelated to most job characteristics or health conditions.

CONCLUSIONS: Understanding of the differing process to work disability for men and women and the relationship between work and health by gender is important for current policy development.

}, keywords = {Disabled Persons, Female, Humans, Logistic Models, Male, Middle Aged, Occupational Diseases, Proportional Hazards Models, Retirement, Risk, Sex Factors, Sick Leave, Stress, Psychological, United States, Workers{\textquoteright} compensation, Workload, Workplace}, issn = {0303-8408}, doi = {10.1007/s00038-004-3105-z}, author = {Eileen M. Crimmins and Mark D Hayward} } @article {6863, title = {Additive and interactive effects of comorbid physical and mental conditions on functional health.}, journal = {J Aging Health}, volume = {15}, year = {2003}, month = {2003 Aug}, pages = {465-81}, publisher = {15}, abstract = {

OBJECTIVE: To understand the role of cognitive impairment and depressive symptoms on functional outcomes of stroke and diabetes. Evaluation approaches to functional outcomes have rarely focused on the presence of specific comorbidities, particularly those involving mental health disorders.

METHODS: Data are from the AHEAD cohort of the Health and Retirement Study (HRS), a nationally representative panel of persons 70+ years of age in 1993. Analyses are limited to 5,646 self-respondents for whom functional outcome data are available in 1995. Additive and interactive multiple regression models are compared for each outcome and focal condition combination.

RESULTS: The additive model is sufficient for the majority of outcome and focal condition combinations. The interaction term is significant in 4 of 12 comparisons.

DISCUSSION: Stroke, diabetes, cognitive impairment, and depressive symptoms exhibit strong independent effects on physical functioning. Support for the hypothesis that cognitive impairment and depression exacerbate the impact of stroke and diabetes is more limited.

}, keywords = {Activities of Daily Living, Aged, Aging, Black or African American, Cognition Disorders, depression, Diabetes Complications, Educational Status, Health Surveys, Hispanic or Latino, Humans, Stroke, United States, White People}, issn = {0898-2643}, doi = {10.1177/0898264303253502}, author = {Fultz, Nancy H. and Mary Beth Ofstedal and A. Regula Herzog and Robert B Wallace} } @article {6874, title = {Assistance to Aging Parents and Parents-in-Law: Does lineage affect family allocation decisions?}, journal = {Journal of Marriage and the Family}, volume = {65}, year = {2003}, pages = {418-431}, publisher = {65}, abstract = {In this analysis we used data from the Health and Retirement Study to examine how, couples organize transfers of assistance to aging parents and whether the flow of assistance is structured by family lineage. We found evidence of a tradeoff between types of assistance and a unilineal pattern of assistance. Few couples provided both time and money, and few assisted parents and parents-in-law. The determinants of assistance varied by type of care, recipient, and patterns of parental survival. Couples were more responsive to the needs of the wife{\textquoteright}s parent(s) and were less likely to exclude her parents from care even tinder circumstances of competition. Controlling for resources, African American and Hispanic couples were consistently more likely to provide assistance.}, keywords = {Adult children, Health Conditions and Status, Healthcare}, doi = {10.2307/3600087}, author = {Kim Shuey and Melissa A. Hardy} } @article {6895, title = {At What Level of Labor Market Intermittency Are Women Penalized?}, journal = {American Economic Review}, volume = {93}, year = {2003}, note = {RDA 2001-001 Pitts}, pages = {233-237}, publisher = {93}, abstract = {A common explanation offered for the observed wage differential between men and women is that women are less attached to the labor market; they exhibit a greater degree of labor-market intermittency than do men. There are several theories that explain this link between intermittency and lower wages, including differences in human-capital attainment, atrophy of skills during absences, and preferences of employers (see e.g., Solomon W. Polachek and W. Stanley Siebert, 1993; Joyce P. Jacobsen and Laurence M. Levin, 1995; James W. Albrecht et al., 2000). The goal of this paper is to explore in greater depth the role past labormarket intermittency plays in the determination of a woman{\textquoteright}s current wage and at what level of intermittent activity women can expect to have that activity affect her wage}, keywords = {Employment and Labor Force, Women and Minorities}, doi = {10.1257/000282803321947100}, author = {Hotchkiss, Julie L. and Pitts, M. Melinda} } @article {5555, title = {Can Unexpected Retirement Explain the Retirement-Consumption Puzzle? Evidence from Subjective Retirement Expectations}, number = {WP$\#$2003-15}, year = {2003}, institution = {Center for Retirement Research at Boston College}, address = {Boston}, abstract = {Previous research finds a systematic fall in consumption at retirement, even when these retirements are expected, which implies households do not behave as predicted by the lifecycle/ permanent income hypothesis. However, the worker s expected date of retirement is typically predicted using an instrument - age - that we show to be correlated with unexpected retirements and will therefore lead to biased estimates. In this paper, we use an alternative instrument for expected retirement: workers own subjective beliefs of their expected retirement dates. We find that subjective retirement expectations provide strong predictive power for subsequent retirements above and beyond the impact of age on retirement probabilities. We still find, however, that consumption falls for workers who retire when expected although the estimated impact is 50 percent smaller when using retirement expectations as an instrument instead of age.}, keywords = {Consumption and Savings, Expectations, Retirement Planning and Satisfaction}, url = {https://crr.bc.edu/working-papers/can-unexpected-retirement-explain-the-retirement-consumption-puzzle-evidence-for-subjective-retirement-expectations/}, author = {Melvin Stephens Jr. and Steven Haider} } @article {6847, title = {Enhancing the Quality of Data on Income: Recent Innovations from the HRS}, journal = {Journal of Human Resources}, volume = {38}, year = {2003}, pages = {758-772}, publisher = {38}, abstract = {This paper evaluates two survey innovations introduced in the HRS that aimed to improve income measurement. The innovations are (1) the integration of questions for income and wealth and (2) matching the periodicity over which income questions are asked to the typical way such income is received. Both innovations had significant impacts in improving the quality of income reports. For example, the integration of income questions into the asset module produced in HRS an across-wave 63 percent increase in the amount of income derived from financial assets, real estate investments and farm and business equity. Similarly, asking respondents to answer using a time interval consistent with how income is received substantially improved the quality of reports on social security income. Fortunately, we also suggest ways that these innovations can be introduced into other major social science surveys.}, keywords = {Income, Methodology}, author = {Michael D Hurd and Juster, F. Thomas and James P Smith} } @article {10963, title = {Food Stamps and the Elderly: Why is Participation So Low? }, number = {03-2}, year = {2003}, institution = {National Poverty Center, University of Michigan}, address = {Ann Arbor, MI}, abstract = {Estimates imply that only one-third of elderly persons who are eligible for food stamps actually participate in the program, which is half the rate that exists among younger people. This study investigates potential reasons for the relatively low take-up rate among the elderly. Analyzing new data, we conclude that the low take-up rate is not explained by measurement error and little is explained by various behavioral factors. Despite this much lower take-up rate, elderly who are eligible for assistance but not enrolled in the program do not appear to be especially needy. }, keywords = {Households, pension eligibility, Public Assistance}, url = {http://www.npc.umich.edu/publications/working_papers/paper2/03-02.pdf}, author = {Steven Haider and Robert F. Schoeni and Jacknowitz, Alison} } @article {6854, title = {Food Stamps and the Elderly: Why is Participation So Low?}, journal = {Journal of Human Resources}, volume = {38}, year = {2003}, note = {National Institute on Aging}, pages = {1080-1111}, publisher = {38}, abstract = {Estimates imply that only one-third of elderly persons who are eligible for food stamps actually participate in the program, which is half the rate that exists among younger people. This study investigates potential reasons for the relatively low take-up rate among the elderly. Analyzing new data, we conclude that the low take-up rate is not explained by measurement error and little is explained by various behavioral factors. Despite this much lower take-up rate, elderly who are eligible for assistance but not enrolled in the program do not appear to be especially needy.}, keywords = {Households, pension eligibility, Public Assistance}, doi = {10.2307/3558982}, author = {Steven Haider and Robert F. Schoeni and Jacknowitz, Alison} } @article {6852, title = {Health, Wealth, and the Role of Institutions}, journal = {Journal of Human Resources}, volume = {38}, year = {2003}, pages = {386-415}, publisher = {38}, abstract = {A positive relationship between socioeconomic status and health has been observed over many populations and many time periods. One of the factors mediating this relation is the institutional environment in which people function. We consider longitudinal data from two countries with very different institutional environments. the United States and The Netherlands. To structure the empirical analysis. we develop a theoretical model relating changes in health status to income and changes in income to health status. We show that income or wealth inequality is closely connected with health inequality. We empirically estimate counterparts to the theoretical relationships with generally corroborative results.}, keywords = {Demographics, Health Conditions and Status}, url = {http://www.nber.org/ confer/2001/si2001/hurd.pdf}, author = {Michael D Hurd and Arie Kapteyn} } @article {6853, title = {Healthy, wealthy, and wise? Tests for direct casual paths between health and socioeconomic status}, journal = {Journal of Econometrics}, volume = {112}, year = {2003}, note = {RDA; National Institute on Aging through a grant to the NBER Program Project on the Economics of Aging (P01-AG 05842)}, pages = {3-56}, publisher = {112}, abstract = {This paper provides statistical methods that permit the association of socioeconomic status and health to be partially unraveled in panel data by excluding some postulated causal paths, or delimiting their range of action. These methods are applied to the Asset and Health Dynamics of the Oldest Old (AHEAD) Panel to test for the absence of causal links from socioeconomic status (SES) to health innovations and mortality, and from health conditions to innovations in wealth. We conclude that in this elderly American population, where Medicare covers most acute care and pension income is not affected by ability to work, the evidence supports the hypothesis of no direct causal link from SES to mortality and to incidence of most sudden onset health conditions (accidents and some acute conditions), once initial health conditions are controlled, but there is an association of SES with incidence of gradual onset health conditions (mental conditions, and some degenerative and chronic conditions), due either to causal links or to persistent unobserved behavioral or genetic factors that have a common influence on both SES and innovations in health. There is little evidence to support a broad association of health conditions and wealth changes. The death of a spouse appears to have a negative effect on the wealth of the survivor; this is plausibly a direct causal effect. There is evidence for some association of health conditions with increased dissaving from liquid wealth for intact couples and singles. From these findings, we conclude that there is no evidence that SES-linked therapies for acute diseases induce mortality differentials. The question of whether SES linked preventative care influences onset of chronic and mental diseases remains open.}, keywords = {Demographics, Health Conditions and Status, Socioeconomic factors}, url = {http://emlab.berkeley.edu/users/mjansson/Courses/ECON242_SPRING02/McFadden.pdf}, author = {Adams, Peter and Michael D Hurd and Daniel McFadden and Merrill, Angela and Ribeiro, Tiago} } @article {8753, title = {The Impact of Poor Health Behaviors on Workforce Disability }, number = {WP 2003-057 }, year = {2003}, month = {06/2003}, pages = {1-22}, institution = {University of Michigan Retirement Research Center}, address = {Ann Arbor}, abstract = {The effects of poor health habits on mortality have been studied extensively. However, few studies have examined the impact of these health behaviors on workforce disability. In the Health and Retirement Study, a nationally representative cohort of 6044 Americans who were between the ages of 51 and 61 and who were working in 1992, we found that both baseline smoking status and a sedentary lifestyle predict workforce disability six years later. If this relationship is causal, cost-benefit analyses of health behavior intervention that neglect workforce disability may substantially underestimate the benefits of such interventions. }, keywords = {Disabilities, Health Behavior, Labor force participation, Older Adults}, url = {https://core.ac.uk/download/pdf/7189096.pdf}, author = {Richardson, Caroline R. and Jennifer T. Hanlon and Hillary J. Mull and Sandeep Vijan and Rodney A. Hayward and Linda A. Wray and Kenneth M. Langa} } @inbook {5205, title = {Leaving Bequests: By Accident or by Design?}, booktitle = {Death and Dollars: The role of gifts and bequests in America}, year = {2003}, note = {ProCite field 8 : eds}, pages = {93-129}, publisher = {The Brookings Institution Press}, organization = {The Brookings Institution Press}, chapter = {4}, address = {Washington, DC}, abstract = {The life-cycle model of consumption is the standard model for the analysis of consumption and saving over the life cycle.{\textonesuperior} The model specifies that people save during their working lives, and then consume their savings in retirement. The claim that a large fraction of household wealth is the result of inheritances has stimulated substantial interest in a bequest motive for saving. While large bequests are not necessarily at odds with simple life-cycle saving, they could also indicate that people are actively saving in order to make such transfers.}, keywords = {Adult children}, doi = {https://www.jstor.org/stable/10.7864/j.ctvb9380x}, author = {Michael D Hurd}, editor = {Alicia H. Munnell and Sund{\'e}n, Annika} } @article {5538, title = {The Retirement-Consumption Puzzle: Anticipated and Actual Declines in Spending at Retirement}, number = {9586}, year = {2003}, institution = {The National Bureau of Economic Research}, address = {Cambridge, MA}, abstract = {The simple one-good model of life-cycle consumption requires consumption smoothing. However, British and U.S. households apparently reduce consumption at retirement and the reduction cannot be explained by the life-cycle model. An interpretation is that retirees are surprised by the inadequacy of resources. This interpretation challenges the life-cycle model where consumers are forward looking. However, data on anticipated consumption changes at retirement and on realized consumption changes following retirement show that the reductions are fully anticipated. Apparently the decline is due to the cessation of work-related expenses and the substitution of home production for market-purchased goods and services.}, keywords = {Consumption and Savings, Retirement Planning and Satisfaction}, doi = {10.3386/w9586}, author = {Michael D Hurd and Susann Rohwedder} } @article {6872, title = {Risk Ratings that Do Not Measure Probabilities}, journal = {Journal of Risk Research}, volume = {6}, year = {2003}, pages = {23-43}, publisher = {6}, abstract = {Survey questions regarding assessed survival chances are an often-used example of a risk rating scale for eliciting a probability assessment. The responses to such questions do exhibit several properties of probabilities, but differ in some key respects, resulting in relationships which are not only inconsistent with accurate beliefs, but also in which precision is sacrificed for ease of use. The Health and Retirement Study, for example, uses a 0 to 10 scale to measure self-assessed survival probabilities to a particular age. Transformation of these responses for use as a probability results in some patterns that are consistent with a model of imperfect information, or a monotonic transformation of imperfectly perceived risks, but more subtle analysis reveals inconsistencies with either of these theories, suggesting the scale is inappropriate for use as a probability measure. The age-related effects for female respondents are the most salient results that are inconsistent with use of the survey{\textquoteright}s response scale as representing a probability.}, keywords = {Expectations, Health Conditions and Status, Retirement Planning and Satisfaction}, doi = {https://doi.org/10.1080/1366987032000047789}, author = {Viscusi, W.K. and Jahn K. Hakes} } @inbook {5204, title = {Socioeconomic Status and Health over the Life Course: Capital as a Unifying Concept}, booktitle = {Handbook of the Life Course}, series = {Handbooks of Sociology and Social Research}, year = {2003}, note = {ProCite field 6 : Chapter 28 in ProCite field 8 : eds.}, pages = {623-643}, publisher = {Kluwer Academic/Plenum Publishers}, organization = {Kluwer Academic/Plenum Publishers}, address = {New York}, abstract = {On average, individuals of lower socioeconomic status (SES){\textemdash}based on education, income, or occupation{\textemdash}have worse health than their higher SES counterparts (Adler, Boyce, Chesney, Folkman, \& Syme, 1993; Antonovsky, 1967; Feinstein, 1993; Feldman, Makuc, Kleinman, \& Cornoni-Huntley, 1989; House, Kessler, \& Herzog, 1990; Kitagawa \& Hauser, 1973; Marmot, Shipley, \& Rose, 1984; Pappas, Queen, Hadden, \& Fisher, 1993; Preston \& Taubman, 1994; Townsend \& Davidson, 1982). This relationship is best depicted as a gradient in health with a fairly linear trend in better health associated with increasing levels of SES, rather than a threshold effect. Furthermore, this relationship is stratified by age; lower SES individuals begin to experience health problems shortly after adolescence, while higher SES individuals experience little health decline until around retirement age (House et al, 1990, 1994). This life course patterning of SES and health is intriguing since it suggests substantial variation in the ability of each group to sustain good health over the life course.}, keywords = {Demographics, Event History/Life Cycle, Health Conditions and Status, Net Worth and Assets}, doi = {10.1007/978-0-306-48247-2_28}, author = {Frytak, Jennifer R. and Harley, Carolyn R. and Finch, Michael D.}, editor = {Mortimer, Jeylan T and Shanahan, Michael J.} } @article {6858, title = {Trends in Scores on Tests of Cognitive Ability in the Elderly U.S. Population, 1993-2000}, journal = {The Journals of Gerontology: Social Sciences}, volume = {58B}, year = {2003}, pages = {S338-S346}, publisher = {58B}, abstract = {Objective. This study investigates cohort differences in cognitive functioning among Americans aged 70 or older in 1993, 1995, 1998, and 2000. Methods. The study draws on self-respondent data from four waves of the Asset and Health Dynamics Among the Oldest Old Study and the Health and Retirement Study surveys collected between 1993 and 2000. Cognitive performance scores for each of four components (immediate recall, delayed recall, serial 7s, and mental status) and their sum are compared across cohorts, unadjusted and with adjustments for survey design features and demographic characteristics. Results. Unadjusted scores suggest cohort improvements in several components of cognitive functioning between 1993 and 1998, and little change between 1998 and 2000. However, these improvements largely disappear after confounding features of the survey design (changes in age distribution of the sample across waves and prior exposure to the cognitive tests) and changes in the demographic composition of the sample (race, ethnicity, and gender) are adjusted for. Discussion. There appears to have been little improvement of cognitive functioning across recent cohorts of older Americans. However, the study points out the complexities of using panel data to study cohort differences, particularly when the measures of interest are likely influenced by prior wave participation. Future studies based on other data sources are needed.}, keywords = {Health Conditions and Status}, doi = {https://doi.org/10.1093/geronb/58.6.S338}, author = {Willard L Rodgers and Mary Beth Ofstedal and A. Regula Herzog} } @article {6870, title = {Wealth, Race, and Mortality}, journal = {Social Science Quarterly}, volume = {84}, year = {2003}, pages = {667-684}, publisher = {84}, abstract = {Objective. We explore, first, whether wealth relates to mortality risk independent of income and education, and second, whether wealth closes the black-white gap in U.S. adult mortality while controlling for other socioeconomic and sociodemographic factors. Methods. We employ the Cox proportional hazards models on data from the 1992 wave of the Health and Retirement Study linked to deaths through 1998, to analyze pre-retirement adult mortality in the United States. Results. The findings suggest that broader measures of SES, including wealth, are significant for understanding adult mortality. Further, vastly lower asset holdings among blacks, compared to whites, not only affects their financial wellbeing but also their survival prospects. Conclusions. Research and social policies that aim to understand and close health disparities in the United States may be poorly conceived if they ignore the impact of wealth on premature adult mortality.}, keywords = {Demographics, Health Conditions and Status, Net Worth and Assets}, doi = {https://doi.org/10.1111/1540-6237.8403011}, author = {S.A. Bond and Patrick M. Krueger and Rebecca G Rogers and Robert A Hummer} } @article {5566, title = {Work Disability Among Non-Elderly Adult Males: The United States, 1893-2001}, year = {2003}, institution = {Brigham Young University}, keywords = {Disabilities}, author = {Sven E. Wilson and Burton, Joseph and Benjamin L. Howell} } @inbook {5188, title = {Aging and Housing Equity}, booktitle = {Innovations in Retirement Financing}, year = {2002}, note = {ProCite field 6 : In ProCite field 8 : eds.}, publisher = {University of Pennsylvania Press/Pension Research Council}, organization = {University of Pennsylvania Press/Pension Research Council}, address = {Philadephia, PA}, keywords = {Housing}, url = {http://www.nber.org/papers/w7882}, author = {Steven F Venti and David A Wise}, editor = {Zvi Bodie and P. Brett Hammond and Olivia S. Mitchell and Stephen P. Zeldes} } @mastersthesis {6335, title = {Crediting Care, Citizenship or Marriage? Gender, Race, Class, and Social Security Reform}, year = {2002}, month = {2002}, school = {Syracuse University}, abstract = {This project addresses welfare state theoretical debates as to how benefits should be distributed to reduce gender, race, and class inequities. Should benefit eligibility be based on citizenship, care or marital status? Scholars concerned about class-based inequities are supportive of minimum benefits that reward citizenship, while scholars concerned with gender-based inequities are supportive of policies that either reward unpaid care through care credits or policies that soften the economic ramifications of marital dissolution such as improving benefits for divorced women. The reform debate over social security in the United States provides a useful case study of how benefit distribution impacts inequality. Over 20 years have passed since policy analysts first argued that social security benefits needed to be altered to better protect women. These benefits contain two flaws. First, they no longer represent the American family due to the rise in divorce rates, single parent families, and mothers working. Second, family benefits undermine the program{\textquoteright}s redistributive goals. But no project has attempted to quantitatively evaluate the impact of the three most popular sets of reforms proposed to improve family}, keywords = {Adult children, Methodology, Public Policy, Women and Minorities}, url = {Database ID: DAI-A 63/03, p. 1136, Sep 2002}, author = {Herd, Pamela} } @article {5489, title = {Crediting Care? Gender, Race, Class and Social Security Reform}, year = {2002}, note = {RDA 2002-007}, institution = {Syracuse University}, keywords = {Demographics, Methodology, Net Worth and Assets}, author = {Herd, Pamela} } @article {6837, title = {Death of a Parent and Risk-Taking: Midlife Assessment}, journal = {The Gerontologist}, volume = {42}, year = {2002}, publisher = {42}, keywords = {Risk Taking}, author = {Karen C. Swallen and Schwartzman, Luisa and Steven A Haas} } @article {6839, title = {Driving life expectancy of persons aged 70 years and older in the United States.}, journal = {Am J Public Health}, volume = {92}, year = {2002}, month = {2002 Aug}, pages = {1284-9}, publisher = {92}, abstract = {

OBJECTIVES: We estimated total life expectancy and driving life expectancy of US drivers aged 70 years and older.

METHODS: Life table methods were applied to 4699 elderly persons who were driving in 1993 and reassessed in a 1995 survey.

RESULTS: Drivers aged 70 to 74 years had a driving life expectancy of approximately 11 years. A higher risk of mortality among men as a cause of driving cessation offset a higher risk of driving cessation not related to mortality among women that resulted in similar driving life expectancies.

CONCLUSIONS: Nationwide, many elderly drivers quit driving each year and must seek alternative sources of transportation. Because of differences in life expectancy, women require more years of support for transportation, on average, than men after age 70.

}, keywords = {Accidents, Traffic, Activities of Daily Living, Aged, Aged, 80 and over, Automobile Driving, Decision making, Family Characteristics, Female, Frail Elderly, Humans, Interviews as Topic, Licensure, Life Expectancy, Logistic Models, Male, Risk Factors, Transportation, United States}, issn = {0090-0036}, doi = {10.2105/ajph.92.8.1284}, author = {Foley, Daniel J. and Heimovitz, Harley K. and Jack M. Guralnik and Brock, Dwight B.} } @article {5504, title = {The Effects of Changing Social Security Administation{\textquoteright}s Early Entitlement Age and the Normal Retirement Age}, year = {2002}, note = {RDA 2000-010}, institution = {Washington, DC, RAND Labor and Population Program; Prepared for the Social Security Administration}, abstract = {The Old-Age and Survivors Insurance (OASI) program is projected to be unable to meet its obligations by approximately the year 2041. Many proposals that aim to restore solvency include provisions to accelerate the already legislated increase of the normal retirement age (NRA) or to increase it beyond the current target of 67 years; some proposals also suggest raising the early entitlement age (EEA) beyond 62 years. This document sheds light on the implications of EEA and/or NRA increases on the solvency of the OASI and DI programs. It does not discuss private accounts. The report starts with a characterization of workers who claim benefits at age 62 and a discussion of retirement planning. We then estimate formal models of retirement and DI application and simulate the financial consequences of EEA and/or NRA increases and other policy proposals. We conclude with an assessment of likely responses of employers to changes in Social Security policy. Most analyses in this report are based on the Health and Retirement Study (HRS), a survey of individuals in their 50s and 60s with very extensive information about work, financial resources including Social security and private pensions, and health. }, keywords = {Methodology, Retirement Planning and Satisfaction, Test}, url = {https://www.ssa.gov/policy/docs/contractreports/agereport.pdf}, author = {Panis, Constantijn and Michael D Hurd and Loughran, David and Julie M Zissimopoulos and Steven Haider and Patricia A St Clair} } @article {5516, title = {Expected Bequests and their Distribution}, year = {2002}, note = {National Institute on Aging}, institution = {National Bureau of Economic Research}, abstract = {Based on a sample of actual bequests that is population-representative and on the subjective probability of bequests, we estimate the distribution of bequests that the older population will make. We find that the distribution is highly skewed, so that the typical baby-boom person will receive a very modest inheritance. This is partly due to the skewed distribution of wealth and partly due to the tendency of the wealthy to have fewer children. But it is also due to anticipated dissaving: we estimate that households in the age band 70-74 will bequeath just 39 of their wealth, consuming the rest before they die.}, keywords = {Adult children, Consumption and Savings}, url = {http://papers.nber.org/papers/w9142}, author = {Michael D Hurd and James P Smith} } @article {6821, title = {Florida Migration in the AHEAD Study, 1993-1995: A note on the flight of the oldest retirees}, journal = {Research on Aging}, volume = {24}, year = {2002}, pages = {473-83}, publisher = {24}, abstract = {Explores the migration patterns of people older than age 70. If the life course perspective on retirement migration is correct, then this older category should be somewhat less inclined to enter the key national destination states and more likely to be moving toward the usual sending states, unlike younger retirees. The Asset and Health Dynamics Among the Oldest Old (AHEAD) Study is critical to this study goal because it contains an oversample of Florida residents older than age 70. Respondents were interviewed in 1993 and again in 1995. The older movers who were identified tend to move locally, or within the state, but those who migrate across state lines are more often leaving Florida than entering it, as suggested by the life course theory.}, keywords = {Demographics, Health Conditions and Status}, url = {http://roa.sagepub.com/archive/}, author = {Hays, Judith C. and Charles F Longino} } @article {6788, title = {Health in household context: living arrangements and health in late middle age.}, journal = {J Health Soc Behav}, volume = {43}, year = {2002}, month = {2002 Mar}, pages = {1-21}, publisher = {43}, abstract = {

People living in some arrangements show better health than persons in other living arrangements. Recent prospective studies document higher mortality among persons living in particular types of households. We extend this research by examining the influence of household structure on health using longitudinal data. We theorize that individuals experience role-based household relations as sets of resources and demands. In certain household structures, individuals are more likely to perceive that the demands made on them outweigh the resources available to them. This perceived imbalance poses a risk to individual health. We test our expectations by analyzing the relationship between living arrangements and health using data from waves 1 and 2 of the Health and Retirement Study. We focus on persons ages 51-61 and explore gender differences. We find prospective links between household structure and self-rated health, mobility limitation, and depressive symptoms. Married couples living alone or with children only are the most advantaged; single women living with children appear disadvantaged on all health outcomes. Men and women in other household types are disadvantaged on some health outcomes. Our results suggest that the social context formed by the household may be important to the social etiology of health. In addition, they qualify the well-known link between marital status and health: The effect of marital status on health depends on household context.

}, keywords = {Activities of Daily Living, Depressive Disorder, Family Characteristics, Family Health, Female, Health Status Indicators, Humans, Longitudinal Studies, Male, Marital Status, Middle Aged, Self Efficacy, United States}, issn = {0022-1465}, doi = {10.2307/3090242}, author = {Mary Elizabeth Hughes and Linda J. Waite} } @article {6831, title = {Health Insurance and Mammography: Would a Medicare buy-in take us to universal screening?}, journal = {Health Services Research}, volume = {37}, year = {2002}, pages = {1469-1486}, publisher = {37}, abstract = {Objective. To determine whether health insurance expansioins via a Medicare buy-in might Plausibly increase mammography screening rates among women aged 50-64.Data Sources. Two waves of the Health and Retirement Study (HRS) (1994, 1996).Study Design. A longitudinal study with most explanatory variables measured at the second wave of HRS (1994); receipt of mammography, number of physician visits, and breast self exam (BSE) were measured at the third wave (1996).Data Extraction. Our sample included women aged 50-62 in 1994 who answered the second and third HRS interview (n=4,583).Principal Findings. From 1994 to 199,6, 72.7 percent of women received a mammogram. Being insured increased mammography in both unadjusted and adjusted analyses. A simulation of universal insurance coverage in,this age group increased mammography rates only to 75-79 percent from the observed 72.7 percent. When we accounted for potential endogeneity of physician visits and BSE to mammo graphy, physician visits remained a strong predictor of mammography but BSE did not.Conclusion. Even in the presence of universal coverage and very optimistic scenarios regarding the effect of insurance on mammography for, newly insured women, mammography rates would only increase a small amount and gaps in screening would remain. Thus, a Medicare buy-in could be expected to have a small impact on mammography screening rates.}, keywords = {Health Conditions and Status, Medicare/Medicaid/Health Insurance, Women and Minorities}, author = {Donald H. Taylor Jr. and Lynn Van Scoyoc and Hawley, Sarah T.} } @article {6803, title = {Individual consequences of volunteer and paid work in old age: health and mortality.}, journal = {J Health Soc Behav}, volume = {43}, year = {2002}, month = {2002 Dec}, pages = {490-509}, publisher = {43}, abstract = {

The impacts of the productive social activities of volunteer and paid work on health have rarely been investigated among the oldest Americans despite a recent claim for their beneficial effect (Rowe and Kahn 1998). This paper used data from Waves 3 and 4 of the Asset and Health Dynamics among the Oldest Old (AHEAD) Study to (1) investigate the impact of these activities on health measured as self-reported health and activities of daily living (ADL) functioning limitations and to (2) explore possible causal mechanisms. Using multinomial logistic regression analysis, amounts of volunteer and paid work over a minimum of 100 annual hours self-reported at Wave 3 were related to poor health and death as competing risks measured at Wave 4, controlling for health measured at Wave 2 and for other predictors of poor health and death. Findings suggest that performing more than 100 annual hours of volunteer work and of paid work have independent and significant protective effects against subsequent poor health and death. Additional analyses suggest that the quantity of volunteer and paid work beyond 100 annual hours is not related to health outcomes and that physical exercise and mental health measured as cognitive functioning and depressive symptoms explain not entirely overlapping parts of the relationship between productive activities and health.

}, keywords = {Activities of Daily Living, Aged, Aged, 80 and over, Employment, Female, Health Status, Humans, Male, Mortality, Multivariate Analysis, Prospective Studies, United States, Volunteers}, issn = {0022-1465}, doi = {10.2307/3090239}, author = {Luoh, M. and A. Regula Herzog} } @article {6790, title = {Informal caregiving for diabetes and diabetic complications among elderly americans.}, journal = {J Gerontol B Psychol Sci Soc Sci}, volume = {57}, year = {2002}, month = {2002 May}, pages = {S177-86}, publisher = {57B}, abstract = {

OBJECTIVES: Little is known regarding the amount of time spent by unpaid caregivers providing help to elderly individuals for disabilities associated with diabetes mellitus (DM). We sought to obtain nationally representative estimates of the time, and associated cost, of informal caregiving provided to elderly individuals with diabetes, and to determine the complications of DM that contribute most significantly to the subsequent need for informal care.

METHODS: We estimated multivariable regression models using data from the 1993 Asset and Health Dynamics Among the Oldest Old Study, a nationally representative survey of people aged 70 or older (N = 7,443), to determine the weekly hours of informal caregiving and imputed cost of caregiver time for community-dwelling elderly individuals with and without a diagnosis of DM.

RESULTS: Those without DM received an average of 6.1 hr per week of informal care, those with DM taking no medications received 10.5 hr, those with DM taking oral medications received 10.1 hr, and those with DM taking insulin received 14.4 hr of care (p <.01). Disabilities related to heart disease, stroke, and visual impairment were important predictors of diabetes-related informal care. The total cost of informal caregiving for elderly individuals with diabetes in the United States was between $3 and $6 billion per year, similar to previous estimates of the annual paid long-term care costs attributable to DM.

DISCUSSION: Diabetes imposes a substantial burden on elderly individuals, their families, and society, both through increased rates of disability and the significant time that informal caregivers must spend helping address the associated functional limitations. Future evaluations of the costs of diabetes, and the cost-effectiveness of diabetes interventions, should consider the significant informal caregiving costs associated with the disease.

}, keywords = {Aged, Aged, 80 and over, Caregivers, Cost of Illness, Costs and Cost Analysis, Diabetes Complications, Diabetes Mellitus, Disabled Persons, Female, Health Surveys, Humans, Hypoglycemic Agents, Insulin, Male, Time Factors}, issn = {1079-5014}, doi = {10.1093/geronb/57.3.s177}, author = {Kenneth M. Langa and Sandeep Vijan and Rodney A. Hayward and M.E. Chernew and Caroline S Blaum and Mohammed U Kabeto and David R Weir and Steven J. Katz and Robert J. Willis and A. Mark Fendrick} } @article {6791, title = {Informal caregiving time and costs for urinary incontinence in older individuals in the United States.}, journal = {J Am Geriatr Soc}, volume = {50}, year = {2002}, month = {2002 Apr}, pages = {733-7}, publisher = {50}, abstract = {

OBJECTIVES: To obtain nationally representative estimates of the additional time, and related cost, of informal caregiving associated with urinary incontinence in older individuals.

DESIGN: Multivariate regression models using data from the 1993 Asset and Health Dynamics Study, a nationally representative survey of people aged 70 and older (N = 7,443).

SETTING: Community-dwelling older people.

PARTICIPANTS: National population-based sample of community-dwelling older people.

MEASUREMENTS: Weekly hours of informal caregiving, and imputed cost of caregiver time, for community-dwelling older people who reported (1) no unintended urine loss, (2) incontinence that did not require the use of absorbent pads, and (3) incontinence that required the use of absorbent pads.

RESULTS: Thirteen percent of men and 24\% of women reported incontinence. After adjusting for sociodemographics, living situation, and comorbidities, continent men received 7.4 hours per week of care, incontinent men who did not use pads received 11.3 hours, and incontinent men who used pads received 16.6 hours (P <.001). Women in these groups received 5.9, 7.6, and 10.7 hours (P <.001), respectively. The additional yearly cost of informal care associated with incontinence was $1,700 and $4,000 for incontinent men who did not and did use pads, respectively, whereas, for women in these groups, the additional yearly cost was $700 and $2,000. Overall, this represents a national annual cost of more than $6 billion for incontinence-related informal care.

CONCLUSIONS: The quantity of informal caregiving for older people with incontinence and its associated economic cost are substantial. Future analyses of the costs of incontinence, and the cost-effectiveness of interventions to prevent or treat incontinence, should consider the significant informal caregiving costs associated with this condition.

}, keywords = {Aged, Caregivers, Comorbidity, Confounding Factors, Epidemiologic, Female, Humans, Incontinence Pads, Male, Regression Analysis, Time Factors, United States, Urinary incontinence}, issn = {0002-8614}, doi = {10.1046/j.1532-5415.2002.50170.x}, author = {Kenneth M. Langa and Fultz, Nancy H. and Sanjay Saint and Mohammed U Kabeto and A. Regula Herzog} } @book {5272, title = {Innovations in Retirement Financing}, year = {2002}, note = {ProCite field 8 : eds.}, publisher = {University of Pennsylvania Press}, organization = {University of Pennsylvania Press}, address = {Philadelphia, PA}, keywords = {Consumption and Savings}, url = {https://pensionresearchcouncil.wharton.upenn.edu/publications/books/innovations-in-retirement-financing/}, author = {Zvi Bodie and P. Brett Hammond and Olivia S. Mitchell and Stephen P. Zeldes} } @article {5502, title = {Liquidity Constraints, Wealth Accumulation and Entrepreneurship}, year = {2002}, institution = {Chicago Business School}, abstract = {There exist many government programs in the U.S. aimed to foster entrepreneurship and, in particular, to relax credit restrictions new entrepreneurs may face. However, many leading empirical works have found that there exists a positive correlation between wealth and starting a business and argued that binding liquidity constraints prevent many household from becoming business owners. In this paper, we examine closely the relationship between weath accumulation and entrepreneurship. We argue that, if liquidity constraints are binding, the incremental effect of a dollar of wealth on the probability to start a business should decrease as welath increases. Using data from several surveys, we can reject the hypothesis that liquidity constraints are the cause of the observed wealth-business start-up correlation. We find that only a small group of extremely wealthy households (top 3 of the wealth distribution) drives the correlation between wealth and becoming a business owner. Additionally, we find that there is no correlation between initial wealth (and wealth changes) and the propensity to become a business owner among businesses that require high starting capital and among groups that are ex-ante more likely to be liquidity constrained, such as young, black, or female households. Furthermore, when using a more appropriate measure of liquidity and accessibility of funds, such as receiving insurance settlements or capital gains on home equity, we find that the positive correlation between wealth and starting a business vanishes. Finally, we examine the importance of family wealth in affecting the child{\textquoteright}s propensity to start a business as well as business survival. We again show that it is mainly those families at the very top of the wealth distribution that are responsible for driving the positive relationship between wealth and business start-up and wealth and business survival. Taken together, our evidence casts severe doubts that the mechanism at play in explaining the positive relationship between wealth and business start-up had much to do with the existence of liquidity constraints.}, keywords = {Employment and Labor Force, Net Worth and Assets}, doi = {10.1086/381478}, author = {Hurst, Erik and Annamaria Lusardi} } @article {5485, title = {Long-Term Care, Formal Home Health Care, and Informal Care}, year = {2002}, note = {RDA 1998-005}, institution = {University of Virginia, Dept. of Economics}, address = {Charlottesville, VA}, keywords = {Health Conditions and Status, Healthcare}, url = {https://pdfs.semanticscholar.org/ae6a/0d50ea5ea07818288b478c8fdecbfa3f0fc4.pdf?_ga=2.124059916.720161521.1595010693-1957489956.1593535391}, author = {Byrne, David and Goeree, Michelle S. and Hiedemann, Bridget and Steven N. Stern} } @article {6793, title = {A national study of the quantity and cost of informal caregiving for the elderly with stroke.}, journal = {Neurology}, volume = {58}, year = {2002}, month = {2002 Jun 25}, pages = {1754-9}, publisher = {58}, abstract = {

BACKGROUND: As the US population ages, increased stroke incidence will result in higher stroke-associated costs. Although estimates of direct costs exist, little information is available regarding informal caregiving costs for stroke patients.

OBJECTIVE: To determine a nationally representative estimate of the quantity and cost of informal caregiving for stroke.

METHODS: The authors used data from the first wave of the Asset and Health Dynamics (AHEAD) Study, a longitudinal study of people over 70, to determine average weekly hours of informal caregiving. Two-part multivariable regression analyses were used to determine the likelihood of receiving informal care and the quantity of caregiving hours for those with stroke, after adjusting for important covariates. Average annual cost for informal caregiving was calculated.

RESULTS: Of 7,443 respondents, 656 (8.8\%) reported a history of stroke. Of those, 375 (57\%) reported stroke-related health problems (SRHP). After adjusting for cormorbid conditions, potential caregiver networks, and sociodemographics, the proportion of persons receiving informal care increased with stroke severity, and there was an association of weekly caregiving hours with stroke +/- SRHP (p < 0.01). Using the median 1999 home health aide wage (8.20 dollars/hour) as the value for family caregiver time, the expected yearly caregiving cost per stroke ranged from 3,500 dollars to 8,200 dollars. Using conservative prevalence estimates from the AHEAD sample (750,000 US elderly patients with stroke but no SRHP and 1 million with stroke and SRHP), this would result in an annual cost of up to 6.1 billion dollars for stroke-related informal caregiving in the United States.

CONCLUSIONS: Informal caregiving-associated costs are substantial and should be considered when estimating the cost of stroke treatment.

}, keywords = {Aged, Aged, 80 and over, Caregivers, Confidence Intervals, Female, Humans, Longitudinal Studies, Male, Multivariate Analysis, Stroke, United States}, issn = {0028-3878}, doi = {10.1212/wnl.58.12.1754}, author = {Hickenbottom, S.L. and A. Mark Fendrick and Kutcher, J.S. and Mohammed U Kabeto and Steven J. Katz and Kenneth M. Langa} } @article {6798, title = {The Predictive Validity of Subjective Probabilities of Survival}, journal = {The Economic Journal}, volume = {112}, year = {2002}, note = {ProCite field 19 : NBER}, publisher = {112}, abstract = {Although expectations, or more precisely subjective probability distributions, play a prominent role in models of decision making under uncertainty, we have had very little data on them. Based on panel data from the Health and Retirement Study, we study the evolution of subjective survival probabilities and their ability to predict actual mortality. In panel, respondents modify their survival probabilities in response to new information such as the onset of a new disease condition. Subjective survival probabilities predict actual survival: those who survived in the panel reported survival probabilities approximately 50 greater at baseline than those who died.}, keywords = {Expectations, Methodology}, url = {https://www.jstor.org/stable/798539}, author = {Michael D Hurd and Kathleen McGarry} } @article {6835, title = {Prevalence and correlates of depressive symptoms in a community sample of people suffering from heart failure.}, journal = {J Am Geriatr Soc}, volume = {50}, year = {2002}, month = {2002 Dec}, pages = {2003-8}, publisher = {50}, abstract = {

OBJECTIVES: To examine the rates and correlates of depressive symptoms and syndromal depression in people with self-reported heart failure participating in a community study of people aged 70 and older.

DESIGN: Cross-sectional.

SETTING: Community-based epidemiological study of older people from the continental United States.

PARTICIPANTS: Six thousand one hundred twenty-five older people participating in the longitudinal study of Assets and Health Dynamics. Participants had to be born in 1923 or earlier.

MEASUREMENTS: The short-form Composite International Diagnostic Interview assessed syndromal depression, and a revised version of the Center for Epidemiologic Studies-Depression scale assessed depressive symptoms. Medical illness was based on self-report. The authors compared the rates of syndromal depression and individual depressive symptoms in people with self-reported heart failure (n = 199) with those in people with other heart conditions (n = 1,856) and with no heart conditions (n = 4,070).

RESULTS: Eleven percent of those with heart failure met criteria for syndromal depression, compared with 4.8\% of people with other heart conditions and 3.2\% of those with no heart conditions. The association between heart failure and depression held even after controlling for disability, reported fatigue and breathlessness, and number of comorbid chronic illnesses.

CONCLUSION: Community-living older people with self-reported heart failure were at approximately twice the risk for syndromal depression of the rest of the community. Although fatigue and functional disability were also related to depression in this sample, these variables did not account for the association between syndromal depression and self-reported heart failure.

}, keywords = {Aged, depression, Female, Heart Failure, Humans, Longitudinal Studies, Male, Prevalence, United States}, issn = {0002-8614}, doi = {10.1046/j.1532-5415.2002.50612.x}, author = {Carolyn L. Turvey and Schultz, K. and Arndt, Stephan and Robert B Wallace and A. Regula Herzog} } @article {5494, title = {Saving for Retirement: Wage Growth and Unexpected Events}, number = {UM02-05}, year = {2002}, institution = {Michigan Retirement and Disability Research Center, University of Michigan}, address = {Ann Arbor, MI}, abstract = {We found that there is a perception of {\textquoteleft}under-saving{\textquoteright} for retirement among many individuals. Individuals who perceive they have saved inadequately attribute this mainly to having insufficient income. Under a lifecycle model of consumption with a known income path this is not a reasonable answer. Those with low income today who fail to save will have even lower consumption levels in the future and could increase lifetime utility by reallocating consumption from pre-retirement to post-retirement. Unexpected outcomes in earnings, however, may cause households that planned to reach retirement with adequate savings, not to realize their plans. The decline in real wages that began in 1973 suggests a compelling explanation for low wealth levels: individuals were surprised by low earnings growth and thus under-saved relative to their lifetime incomes. We find that the hypothesis fits the data for those with extreme outcomes but does not explain large wealth differences for individuals on average.}, keywords = {Consumption and Savings}, url = {https://mrdrc.isr.umich.edu/projects/saving-for-retirement-wage-growth-and-unexpected-events/}, author = {Michael D Hurd and Julie M Zissimopoulos} } @article {6804, title = {The socio-economic and Health Differences in Parents{\textquoteright} Provision of Help to Adult Children: A British-USA Comparison}, journal = {Ageing and Society}, volume = {22}, year = {2002}, pages = {441-458}, publisher = {22}, abstract = {Transfers of assistance from older to younger family members are an important, though often ignored, component of intergenerational exchanges. The ability to help younger family members, either financially or practically, may be influenced by the health and socio-economic status of older parents, but very little is known about these patterns. This article examines the effects of socio-economic and health status on the help that late mid-life parents in Britain and the United States give their children with money, domestic tasks, and grandchild care. Results for the different types of family support yield three main findings. First, there are relatively few differences between Britain and the USA in the factors affecting the provision of support. Secondly, socio-economic factors appear to be more important among married respondents while health is more important among the unmarried. Thirdly, children{\textquoteright}s co-residence has greater effects on the provision of domestic task help in Britain than in the United States.}, keywords = {Adult children, Demographics, Health Conditions and Status}, doi = {10.1017/S0144686X02008735}, author = {John C Henretta and Emily M D Grundy and Harris, Susan} } @article {12179, title = {Using the Health and Retirement Survey to Investigate Health Disparities}, year = {2002}, publisher = {National Institute on Aging}, address = {Bethesda, MD}, keywords = {Health Disparities, Physical Health, socio-economic issues}, author = {Mark D Hayward} } @article {6797, title = {Who Expects to Continue Working After Age 62? The retirement plans of couples}, journal = {The Journals of Gerontology: Social Sciences}, volume = {57B}, year = {2002}, pages = {S199-208}, publisher = {57B}, abstract = {OBJECTIVES: This study examines the individual, spousal, and household characteristics associated with the retirement expectations of husbands and wives. METHODS: Using data from the 1992 Health and Retirement Study, subjective probabilities of working full-time after reaching age 62 and age 65 are used to measure retirement expectations. The retirement expectations of husbands and wives are modeled simultaneously using a joint-generalized least-squares approach. RESULTS: Within a marriage, retirement expectations are shaped by individual, spousal, and household characteristics. We observe some gender differences in cross-spousal influence with wives{\textquoteright} retirement expectations being more influenced by husbands{\textquoteright} resources and constraints than vice versa. Nonetheless, individual and household factors associated with retirement expectations are widely shared by husbands and wives. DISCUSSION: Husbands and wives both respond to individual and joint constraints and opportunities when planning for retirement. Findings support that there is considerable overlap in retirement planning of husbands and wives during early parts of the retirement decision-making process. However, inequity in cross-spousal influences is a defining characteristic of retirement decision making. Implications for both policy makers and practitioners are briefly discussed.}, keywords = {Adult children, Demographics, Employment and Labor Force, Expectations, Health Conditions and Status, Healthcare, Methodology, Retirement Planning and Satisfaction, Risk Taking}, doi = {10.1093/geronb/57.4.S199}, author = {Pienta, Amy M. and Mark D Hayward} } @article {6795, title = {Workers{\textquoteright} Ignorance of Retirement Benefits}, journal = {The Gerontologist}, volume = {42}, year = {2002}, pages = {543-51}, publisher = {42}, abstract = {PURPOSE: This study considered the extent of workers{\textquoteright} unfamiliarity with retirement benefits, a problem that could compromise informed retirement planning. DESIGN AND METHODS: Among workers in the 1992 Health and Retirement Study, we examined the frequency of don{\textquoteright}t know responses to question series about employer pensions, health insurance, and Social Security. RESULTS: Eligible workers readily offered responses about the shared, public details of pension plans, but knowledge about personal pension wealth was lacking for one third of persons in defined benefit plans and for one fifth of those in defined contribution plans. Among household financial respondents, 14 did not know about health insurance continuation after retirement, and 52 could not offer an expected Social Security amount. Such nonresponse was patterned by proximity to retirement and by social and occupational factors. IMPLICATIONS: More than a problem of missing data, these findings argue for a theoretical reconsideration of the role of financial knowledge in retirement behavior. Ignorance of benefits is probably less a problem of disclosure than of workers{\textquoteright} inattention to available information.}, keywords = {Demographics, Education, Medicare/Medicaid/Health Insurance, Methodology, Other, Pensions, Social Security}, doi = {10.1093/geront/42.4.543}, author = {David J Ekerdt and Kyle J Hackney} } @article {5500, title = {Workers Who Take Early Social Security Retirement Benefits}, year = {2002}, note = {RDA 2000-010}, institution = {Washington, DC, RAND Labor and Population Program; Prepared for the Social Security Administration}, abstract = {The objectives of this analysis are to shed light on the differences between workers who take early Social Security retirement benefits and those that postpone claiming, and to identify the types of individuals that would be particularly vulnerable to an increase in the Early Entitlement Age (EEA) above its current level of age 62. Generally speaking, we find workers who accept early retirement benefits are less likely to be college educated, less likely to be in management positions or to be professionals and more likely to have left the labor force before age 62. There are no large differences in financial wealth between Takers and Postponers, except for in pension wealth. Takers are much less likely to be covered by a pension plan and have lower pension wealth than Postponers. Moreover, while quite healthy on average, Takers are more likely to be in poorer health than workers who postpone benefits. This difference is particularly important for understanding the impact of raising the EEA. Individuals with a limited ability to continue working past age 62 due to health problems may experience substantial welfare losses in case of an increase in the EEA. Among a particularly vulnerable group of Takers, those in poor health and without pension entitlement, we find that more than half have a physically demanding job. These workers are particularly likely to apply for DI benefits in case of an increase of the EEA, which would add to rather than reduce total Social Security outlays.}, keywords = {Retirement Planning and Satisfaction, Social Security}, author = {Julie M Zissimopoulos and Panis, Constantijn and Michael D Hurd} } @inbook {5134, title = {Worklife Determinants of Retirement Income Differentials Between Men and Women}, booktitle = {Innovations in Financing Retirement}, year = {2002}, note = {RDA ProCite field 6 : In ProCite field 8 : eds.}, pages = {50-76}, publisher = {University of Pennsylvania Press}, organization = {University of Pennsylvania Press}, address = {Philadelphia, PA}, abstract = {Women enter retirement having spent fewer years in market, earned less over their lifetimes, and work in different jobs than men of the same age. This study examines whether these differences in work life experiences help explain why many women end with lower level of retirement income in old age. We use Health and Retirement Study (HRS), which provide information on labor market histories along with the ability to predict retirement income from employer pensions, social security benefits, and investment returns. We document differences in anticipated retirement income by sex that exist largely between non-married men and women. Multivariate models show that 85 percent of this retirement income gap can be attributed to differences in lifetime labor market earnings, years worked, and occupational segregation by sex. Our results suggest that as women{\textquoteright}s work life experiences become more congruent with men{\textquoteright}s over time, the gap in retirement income between men and women may shrink.}, keywords = {Income, Methodology, Retirement Planning and Satisfaction, Women and Minorities}, url = {http://www.nber.org/papers/w7243}, author = {Phillip B. Levine and Olivia S. Mitchell and John W R Phillips}, editor = {Z. Bodie and Hammond, B. and Olivia S. Mitchell} } @inbook {5133, title = {Anticipated and Actual Bequests}, booktitle = {Themes in the Economics of Aging}, year = {2001}, note = {ProCite field 6 : In ProCite field 8 : ed.}, publisher = {University of Chicago Press}, organization = {University of Chicago Press}, address = {Chicago, IL}, abstract = {This paper uses data on anticipated bequests from two waves of the Health and Retirement Study and the Asset and Health Dynamics of the Oldest Old (AHEAD), and on actual bequests from AHEAD. Actual bequests were measured in exit interviews given by proxy respondents for 774 AHEAD respondents who died between waves 1 and 2. Because the exit interview is representative of the elderly population, the distribution of estate values is quite different from that obtained from estate records, which represent just a wealthy subset of the population. Anticipated bequests were measured by the subjective probability of leaving bequests. Between waves 1 and 2, increases in bequest probabilities were associated with increases in the subjective probability of surviving, increments in household wealth, and widowing while out-of-pocket medical expenses reduced the likelihood of a bequest. By comparing bequest probabilities with baseline wealth we were able to test a main prediction of the life-cycle model, that individuals will dissave at advanced old-age. The AHEAD respondents anticipate substantial dissaving before they die.}, keywords = {Adult children, Consumption and Savings, Demographics, Event History/Life Cycle, Health Conditions and Status}, url = {http://www.nber.org}, author = {Michael D Hurd and James P Smith}, editor = {David A Wise} } @inbook {5199, title = {Are Smokers Too Optimistic?}, booktitle = {The Economic Analysis of Substance Use and Abuse: The Experience of Developed Countries and Lessons for Developing Countries}, year = {2001}, note = {ProCite field 6 : In ProCite field 8 : eds.}, pages = {103-33}, publisher = {Edward Elgar Publishing Limited}, organization = {Edward Elgar Publishing Limited}, address = {Cheltenham, UK}, keywords = {Consumption and Savings, Health Conditions and Status}, url = {https://www.e-elgar.com/shop/usd/the-economic-analysis-of-substance-use-and-abuse-9781840646252.html}, author = {Frank A Sloan and Donald H. Taylor Jr.}, editor = {Michael Grossman and Chee-Ruey Hsieh} } @article {5431, title = {Are There Unhealthy Cities? The Impact of Metropolitan Context on Health in Late Middle Age}, year = {2001}, institution = {Southern Sociological Society}, abstract = {Recently, several authors have argued that individual health is shaped in part by the characteristics of the cities in which individuals live. Particular attention has been devoted to metropolitan income distribution, residential segregation, and employment conditions. While these ideas are compelling, they have yet to be adequately tested. I expand on previous research in four ways. First, I use multilevel data that includes characteristics of both individuals and the cities in which they live. Second, my data are longitudinal, tracing the health impact of metropolitan context over a 4-year period. Third, I examine several dimensions of health. Finally, I focus on a narrow age range. Data for my analysis are drawn from waves 1-3 of the Health and Retirement Study, an ongoing longitudinal survey of persons born between 1931 and 1941. I limit my analysis to respondents living in metropolitan areas, yielding an effective sample size of approximately 6,900 persons. I appended data characterizing respondents{\textquoteright} metropolitan areas, drawn from a variety of sources, to their individual data records. I use hierarchical linear modeling to examine the impact of metropolitan characteristics on self-rated health, presence of a mobility limitation, depressive symptoms, and presence of a chronic disease.}, keywords = {Demographics, Health Conditions and Status, Healthcare}, author = {Mary Elizabeth Hughes} } @article {6783, title = {Caregiver report of hallucinations and paranoid delusions in elders aged 70 or older.}, journal = {Int Psychogeriatr}, volume = {13}, year = {2001}, month = {2001 Jun}, pages = {241-9}, publisher = {13}, abstract = {

This study examined the demographic, medical, and psychiatric correlates of hallucinations and paranoid delusions reported by proxy informants for 822 elders aged 70 or older. This sample comprised people who were deemed unable to complete a direct interview in a large nationwide study of aging. Marital status, trouble with vision, and cognitive impairment were associated with report of both paranoid delusions and hallucinations. Depressive symptoms and stroke were associated with hallucinations only. These results suggest that inadequate external stimulation in the elderly leads to psychotic experiences.

}, keywords = {Aged, Aged, 80 and over, Aging, Caregivers, Cognition Disorders, Cohort Studies, Delusions, depression, Female, Follow-Up Studies, Hallucinations, Humans, Male, Marital Status, Paranoid Disorders, Risk Factors, Stroke, Surveys and Questionnaires, United States, Vision Disorders}, issn = {1041-6102}, doi = {10.1017/s1041610201007621}, author = {Carolyn L. Turvey and Schultz, Susan K. and Arndt, Stephan and Ellingrod, Vicki and Robert B Wallace and A. Regula Herzog} } @article {6764, title = {Changes in driving patterns and worsening depressive symptoms among older adults.}, journal = {J Gerontol B Psychol Sci Soc Sci}, volume = {56}, year = {2001}, month = {2001 Nov}, pages = {S343-51}, publisher = {56B}, abstract = {

OBJECTIVES: This study examined whether changes in driving patterns-driving cessation and reduction-have negative consequences for the depressive symptoms of older Americans and whether these consequences are mitigated for people with a spouse who drives.

METHODS: The project used data from 3 waves of the Asset and Health Dynamics Among the Oldest Old (AHEAD) study. Depressive symptoms were assessed with an abbreviated Center for Epidemiologic Studies-Depression scale. Using 2 models, the project examined how driving cessation and reduction that occurred between Waves 1 and 2 contributed to increases in depressive symptoms between Waves 2 and 3. The first model included the entire sample (N = 5,239), and the second model focused on drivers only (n = 3,543). A third model added interaction terms to the analysis to consider whether respondents who stopped driving but had a spouse who drove were less at risk of worsening depressive symptoms.

RESULTS: Respondents who stopped driving had greater risk of worsening depressive symptoms. Drivers who restricted their driving distances before the study began also had greater risk of worsening depressive symptoms, but seemingly less so than the respondents who stopped driving altogether. For respondents who stopped driving, having a spouse available to drive them did not mitigate the risk of worsening symptoms.

DISCUSSION: Changes in driving patterns can be deleterious for older people{\textquoteright}s depressive symptoms. Initiatives for assisting older people should focus on strategies that help them retain driving skills, that prepare them for the possible transition from driver to ex-driver, and that ensure that they have access to mental health therapies if driving changes are imminent.

}, keywords = {Activities of Daily Living, Adaptation, Psychological, Aged, Aged, 80 and over, Automobile Driving, depression, Female, Humans, Male, Quality of Life, Risk Factors, Social Environment}, issn = {1079-5014}, doi = {10.1093/geronb/56.6.s343}, author = {Stephanie J. Fonda and Robert B Wallace and A. Regula Herzog} } @article {6748, title = {Childlessness and the psychological well-being of older persons.}, journal = {J Gerontol B Psychol Sci Soc Sci}, volume = {56}, year = {2001}, month = {2001 Sep}, pages = {S311-20}, publisher = {56B}, abstract = {

OBJECTIVES: Rapid growth in the size of the childless elderly population has prompted concerns about the negative effects of childlessness on psychological well-being. This study adds to this line of inquiry by examining the effects of childlessness on two important dimensions of elderly persons{\textquoteright} psychological well-being: loneliness and depression.

METHODS: Using the 1993 Asset and Health Dynamics Among the Oldest Old data set, the authors estimated logistic and ordinary least squares regression models of psychological well-being for a nationally representative sample of people aged 70 and older (N = 6,517).

RESULTS: Childlessness per se did not significantly increase the prevalence of loneliness and depression at advanced ages, net of other factors. There also was no statistical evidence for the hypothesis that childlessness increases loneliness and depression for divorced, widowed, and never married elderly persons. Sex, however, altered how childlessness and marital status influenced psychological well-being. Divorced, widowed, and never married men who were childless had significantly higher rates of loneliness compared with women in comparable circumstances; divorced and widowed men who were childless also had significantly higher rates of depression than divorced and widowed women.

DISCUSSION: The findings suggest that it is important to understand the consequences of childlessness in the context of marital status and sex.

}, keywords = {Aged, Aged, 80 and over, depression, Family Planning Services, Female, Geriatric Assessment, Humans, Loneliness, Male, Marital Status, Risk Factors, Sex Factors}, issn = {1079-5014}, doi = {10.1093/geronb/56.5.s311}, author = {Zhang, Zhenmei and Mark D Hayward} } @article {6758, title = {Demography of Risk Aversion}, journal = {Journal of Risk and Insurance}, volume = {68}, year = {2001}, pages = {1-24}, publisher = {68}, abstract = {This paper uses HRS data to empirically estimate the model of risk aversion and examines attitudes to both pure and speculative risks across various segments of the population. Results show that those individuals that had already engaged in the risk-taking behavior of migrating across national borders (i.e.- non-natives) are significantly more inclined than natives to both pure and speculative risks. Similarly, those who are currently employed exhibit a significantly greater willingness to gamble their current income for a chance to double it. These findings, along with the fact that women seem to be significantly more risk adverse than men, are in agreement with earlier studies and were expected. Other results, that were not as expected, show that the self-employed are significantly more adverse to pure risks than those employed by others, yet the two groups are not significantly different in their attitudes toward speculative risks. Similarly, education seems to increase aversion to pure risks but also increases the willingness to accept speculative risks. In terms of the causal relationship between risk aversion and personal characteristics, it is clear that purely demographic variables affect an individual s degree of risk aversion and that differences in religious beliefs affect attitudes toward risk-taking. Other variables produced statistically significant relationships, but causality cannot be determined.}, keywords = {Demographics, Insurance, Net Worth and Assets, Risk Taking}, doi = {10.2307/2678130}, author = {Halek, Martin and Eisenhauer, Joseph G.} } @article {6735, title = {Does Childhood Health Affect Chronic Morbidity in Later Life?}, journal = {Social Science and Medicine}, volume = {52}, year = {2001}, pages = {1269-1284}, publisher = {52}, abstract = {Examines whether childhood health has long-term and enduring consequences for chronic morbidity, and addresses two methodological issues of concern in the literature: (1) Is adult height a surrogate for childhood health experiences in modeling chronic disease in later life? and (2) Are the effects of adult socioeconomic status on chronic disease overestimated when childhood health is not accounted for? The analysis is based on a topical module to the third wave of the Health and Retirement Study, a representative survey of US adults, ages 55 -65, in 1996. Our results support the hypothesis that poor childhood health increases morbidity in later life. This association is found for cancer, lung disease, cardiovascular conditions, and arthritis/rheumatism. The associations were highly persistent in the face of statistical controls for both adult and childhood socioeconomic status. No support was found for using adult height as a proxy for the effects of childhood health experiences. Further, the effects of adult socioeconomic status were not overestimated when childhood health was excluded from the explanatory models. Results point to the importance of an integrated health care policy based on the premise of maximizing health over the entire life cycle. 6 Tables, 43 References. Adapted from the source document}, keywords = {Adult children, Demographics, Health Conditions and Status}, author = {Blackwell, Debra L. and Mark D Hayward and Eileen M. Crimmins} } @article {6750, title = {Eddies in the Stream: The Prevalence of Uncertain Plans for Retirement}, journal = {The Journals of Gerontology: Social Sciences}, volume = {56B}, year = {2001}, pages = {S162-70}, publisher = {56B}, abstract = {OBJECTIVE: This study examined an assumption of retirement theory that typifies older workers as preretirees who are planfully engaged in paths toward retirement. METHODS: Using survey responses among workers in the 1992 and 1994 waves of the Health and Retirement Study, we described the prevalence of nonsubstantive answers to questions about the expected form and timing of retirement (e.g., don{\textquoteright}t know, haven{\textquoteright}t thought about it ). We tested explanations for this uncertainty as an artifact of the survey process, but also as an outcome of the opportunity structure for retirement planning. RESULTS: Survey procedure did generate some of these noncommittal responses. Depending on question type, approximately 10 to 40 of workers did not state when or how they would retire, and such responses were less prevalent across age and time. In addition, categorical uncertainty about form and timing was theoretically predictable in a framework that supposed that workers less subject to a socially attended life--at work or away--would be more undecided about the future. DISCUSSION: Uncertainty is an authentic, meaningful stance toward retirement that theory and research design should not ignore. Just as actual transitions to retirement can be ambiguous or blurred, the expectation of retirement, as well, can be untidy.}, keywords = {Demographics, Employment and Labor Force, End of life decisions, Health Conditions and Status, Healthcare, Methodology, Other, Retirement Planning and Satisfaction, Time Use}, url = {http://psychsoc.gerontologyjournals.org/}, author = {David J Ekerdt and Kyle J Hackney and Karl Kosloski and S. DeViney} } @inbook {5174, title = {The Effects of Job Loss on Older Workers}, booktitle = {Ensuring Health and Income Security for an Aging Workforce}, year = {2001}, note = {ProCite field 6 : In ProCite field 8 : eds.}, publisher = {W.E. Upjohn Institute}, organization = {W.E. Upjohn Institute}, address = {Kalamazoo}, keywords = {Employment and Labor Force}, author = {Sewin Chan and Ann H. Stevens}, editor = {Peter P. Budetti and R.V. Burkhauser and Janice M. Gregory and H. Allan Hunt} } @article {5450, title = {Elderly Labor Supply: Work or Play?}, year = {2001}, institution = {Boston College}, abstract = {As the labor force has begun to retire at earlier ages and the population of the U.S. continues to age, people over the age of 65 that are still working have become a very important part of the economy. This study creates many questions that will allow the researchers to find out why some people over the age of 65 continue to work. Those elderly people that work past normal retirement age, somewhat surprisingly, are the ones that are most educated, wealthiest, and healthiest. At the same time these elder workers receive less compensation than younger workers and less compensation then they had in the past. Health was found to be the deciding factor in whether or not these elderly people stay in the workforce.}, keywords = {Employment and Labor Force, Health Conditions and Status, Other, Retirement Planning and Satisfaction}, author = {Steven Haider and Loughran, David} } @article {5473, title = {Estate Taxes, Labor Supply, and Economic Efficiency}, year = {2001}, institution = {American Council for Capital Formation Center for}, abstract = {The key conclusions of the paper are that the federal estate tax reduces the labor supply and personal saving and increases the cost of capital (the hurdle rate) for new investment. In addition, entrepreneurs are particularly hard hit by the estate tax as they face higher average estate tax rates and higher capital costs for new investment than do other individuals. Finally, the federal estate tax causes distortions in household decision-making about work effort, saving, and investment (and thus loss of economic efficiency) that are even greater in size than those from other taxes on income from capital.}, keywords = {Adult children, Employment and Labor Force, Public Policy}, url = {http://www.accf.org/tax/estate-tax.html}, author = {Holtz-Eakin, Douglas and Donald Marples} } @article {RePEc:tpr:restat:v:83:y:2001:i:1:p:52-63, title = {Estate Taxes, Life Insurance, And Small Business}, journal = {The Review of Economics and Statistics}, volume = {83}, year = {2001}, pages = {52-63}, abstract = {Critics argue that the estate tax prevents the owners of family businesses from passing their enterprises to heirs because it is difficult to pay estate taxes without liquidating the business. Why don{\textquoteright}t owners purchase enough life insurance to meet their estate tax liabilities? We examine whether and how people use life insurance to deal with the estate tax. We find that, ceteris paribus, business owners purchase more life insurance than do other individuals. However, on the margin, their insurance purchases are less responsive to estate tax considerations, and they are less likely to have the wherewithal to meet estate tax liabilities out of liquid assets plus insurance. 2000 by the President and Fellows of Harvard College and the Massachusetts Institute of Technology}, keywords = {Estate tax, Life insurance, Small business owners}, url = {https://ideas.repec.org/a/tpr/restat/v83y2001i1p52-63.html}, author = {Holtz-Eakin, Douglas and John W R Phillips and Rosen, Harvey S.} } @article {6742, title = {Estimating the cost of informal caregiving for elderly patients with cancer.}, journal = {J Clin Oncol}, volume = {19}, year = {2001}, month = {2001 Jul 01}, pages = {3219-25}, publisher = {19}, abstract = {

PURPOSE: As the United States population ages, the increasing prevalence of cancer is likely to result in higher direct medical and nonmedical costs. Although estimates of the associated direct medical costs exist, very little information is available regarding the prevalence, time, and cost associated with informal caregiving for elderly cancer patients.

MATERIALS AND METHODS: To estimate these costs, we used data from the first wave (1993) of the Asset and Health Dynamics (AHEAD) Study, a nationally representative longitudinal survey of people aged 70 or older. Using a multivariable, two-part regression model to control for differences in health and functional status, social support, and sociodemographics, we estimated the probability of receiving informal care, the average weekly number of caregiving hours, and the average annual caregiving cost per case (assuming an average hourly wage of $8.17) for subjects who reported no history of cancer (NC), having a diagnosis of cancer but not receiving treatment for their cancer in the last year (CNT), and having a diagnosis of cancer and receiving treatment in the last year (CT).

RESULTS: Of the 7,443 subjects surveyed, 6,422 (86\%) reported NC, 718 (10\%) reported CNT, and 303 (4\%) reported CT. Whereas the adjusted probability of informal caregiving for those respondents reporting NC and CNT was 26\%, it was 34\% for those reporting CT (P <.05). Those subjects reporting CT received an average of 10.0 hours of informal caregiving per week, as compared with 6.9 and 6.8 hours for those who reported NC and CNT, respectively (P <.05). Accordingly, cancer treatment was associated with an incremental increase of 3.1 hours per week, which translates into an additional average yearly cost of $1,200 per patient and just over $1 billion nationally.

CONCLUSION: Informal caregiving costs are substantial and should be considered when estimating the cost of cancer treatment in the elderly.

}, keywords = {Activities of Daily Living, Aged, Aged, 80 and over, Caregivers, Cost of Illness, Family, Female, Home Nursing, Humans, Male, Multivariate Analysis, Neoplasms, Regression Analysis, United States}, issn = {0732-183X}, doi = {10.1200/JCO.2001.19.13.3219}, author = {Hayman, James A. and Kenneth M. Langa and Mohammed U Kabeto and Steven J. Katz and DeMonner, Sonya M. and M.E. Chernew and Slavin, Mitchell B. and A. Mark Fendrick} } @article {6770, title = {Giving Incentives of Adult Children Who Care for Disabled Parents}, journal = {Journal of Consumer Affairs}, volume = {35}, year = {2001}, pages = {364-389}, publisher = {35}, abstract = {What motivates adult children in the United States to care for their disabled parents? This paper examines whether altruism and bequest motives influence adult childrens decisions about giving time to care for a disabled parent, giving financial resources, and giving future financial resources. Further, the paper examines the ways these different forms of giving affect caregivers{\textquoteright} overall well-being, financial, family life, and life satisfaction. Using data from the 1992 Health and Retirement Study, we find that bequest incentives, noneconomicllly motivated altruism, the type of disability faced by the parent, and considerations of opportunity cost are key factors. They influence adult childrens decisions about employment, giving time, and giving money to support disabled parents. General well-being, financial and family life satisfaction are lower when adult children risk long term income resources by decreasing labor market participation. Giving money increases family life satisfaction for adult children who care for parents who have cognitive limitations. While giving time to care for disabled parents increases financial satisfaction among adult children, it decreases their family life satisfaction.}, keywords = {Adult children, Demographics, Employment and Labor Force, Health Conditions and Status, Net Worth and Assets}, doi = {10.1111/j.1745-6606.2001.tb00119.x}, author = {Shelley I. White-Means and Gong-Soog Hong} } @article {6782, title = {The Impact of Age, Gender, and Race on the Relationship Between Depression and Self-Rated Health in Community-Dwelling Older Adults: A longitudinal study}, journal = {Home Health Care Services Quarterly}, volume = {20}, year = {2001}, pages = {27-43}, publisher = {20}, abstract = {Objective: To examine whether the prediction of baseline depression for subsequent changes in self-rated health is consistent across different age cohorts, gender, and racial groups. Data Sources and Study Setting: A total of 6,714 participants who were 65 years old or older and took part in both the first and the second wave of Assets and Health Dynamics among the Oldest-Old (AHEAD) national survey of community-dwelling older adults were examined. Study Design: A two-year prospective cohort study. Principle Findings: Baseline depression was an independent risk factor, which not only decreased the odds of having substantial improvement in self-rated health but also increased the possibility of having substantial decline in self-rated health in older men and women, and in Blacks and Whites of all age groups. Conclusions: Early prevention and treatment of depression among community-dwelling older adults may not only reduce their health decline but also promote their health.}, keywords = {Demographics, Health Conditions and Status}, url = {http://www.haworthpressinc.com/web/HHC/}, author = {Beth Han} } @article {5428, title = {Impact of Displacement on Older Workers}, year = {2001}, institution = {Santa Monica, CA, RAND Corp}, abstract = {We examine the impact of job displacement on older workers. Whereas previous studies focus on the earnings losses associated with displacement, we examine compensation losses more generally. Using the Health and Retirement Study, we measure the impact of a job loss on earnings, pension wealth, and health insurance. When pension and health insurance losses are incorporated to measure the overall impact of a displacement, the estimated total compensation loss increases by nearly 100 percent relative to the standard analysis that only examines earnings losses.}, keywords = {Employment and Labor Force, Health Conditions and Status, Income, Insurance, Other, Retirement Planning and Satisfaction}, author = {Steven Haider} } @article {5463, title = {Modeling Retirement Behavior: A Test of the Option-Value Model Using the Health and Retirement Study}, year = {2001}, note = {RDA 1998-003}, institution = {Congressional Budget Office}, abstract = {This study outlines a latent variable model for consistently estimating the effects of health and other characteristics on the labor force transitions of older, working-aged adults. This model deals explicitly with both the potential endogeneity of global self-reported health measures and with the measurement error inherent in quantifying health status. We estimate the model using the longitudinal Health and Retirement Study and evaluate its properties by testing its underlying assumptions. We intend our results to inform work that uses the kinds of latent variable models we have been using in our own research as well as other research using the health variables available on the HRS.}, keywords = {Pensions, Retirement Planning and Satisfaction, Social Security}, author = {Harris, Amy Rehder} } @article {6738, title = {National estimates of the quantity and cost of informal caregiving for the elderly with dementia.}, journal = {J Gen Intern Med}, volume = {16}, year = {2001}, month = {2001 Nov}, pages = {770-8}, publisher = {16}, abstract = {

OBJECTIVE: Caring for the elderly with dementia imposes a substantial burden on family members and likely accounts for more than half of the total cost of dementia for those living in the community. However, most past estimates of this cost were derived from small, nonrepresentative samples. We sought to obtain nationally representative estimates of the time and associated cost of informal caregiving for the elderly with mild, moderate, and severe dementia.

DESIGN: Multivariable regression models using data from the 1993 Asset and Health Dynamics Study, a nationally representative survey of people age 70 years or older (N = 7,443).

SETTING: National population-based sample of the community-dwelling elderly.

MAIN OUTCOME MEASURES: Incremental weekly hours of informal caregiving and incremental cost of caregiver time for those with mild dementia, moderate dementia, and severe dementia, as compared to elderly individuals with normal cognition. Dementia severity was defined using the Telephone Interview for Cognitive Status.

RESULTS: After adjusting for sociodemographics, comorbidities, and potential caregiving network, those with normal cognition received an average of 4.6 hours per week of informal care. Those with mild dementia received an additional 8.5 hours per week of informal care compared to those with normal cognition (P < .001), while those with moderate and severe dementia received an additional 17.4 and 41.5 hours (P < .001), respectively. The associated additional yearly cost of informal care per case was 3,630 dollars for mild dementia, 7,420 dollars for moderate dementia, and 17,700 dollars for severe dementia. This represents a national annual cost of more than 18 billion dollars.

CONCLUSION: The quantity and associated economic cost of informal caregiving for the elderly with dementia are substantial and increase sharply as cognitive impairment worsens. Physicians caring for elderly individuals with dementia should be mindful of the importance of informal care for the well-being of their patients, as well as the potential for significant burden on those (often elderly) individuals providing the care.

}, keywords = {Aged, Aged, 80 and over, Caregivers, Cost of Illness, Dementia, Female, Health Care Costs, Humans, Male, Multivariate Analysis, Regression Analysis, Severity of Illness Index, Time Factors, United States}, issn = {0884-8734}, doi = {10.1111/j.1525-1497.2001.10123.x}, author = {Kenneth M. Langa and M.E. Chernew and Mohammed U Kabeto and A. Regula Herzog and Mary Beth Ofstedal and Robert J. Willis and Robert B Wallace and Mucha, L.M. and Walter L. Straus and A. Mark Fendrick} } @article {6751, title = {Patterns and risk factors of change in somatic and mood symptoms among older adults.}, journal = {Ann Epidemiol}, volume = {11}, year = {2001}, month = {2001 Aug}, pages = {361-8}, publisher = {11}, abstract = {

PURPOSE: This paper was concerned with patterns of individual-level, longitudinal change in depressive symptoms and factors related to those patterns among Americans 70+ years of age. Two types of depressive symptoms were considered, somatic and mood symptoms. The paper focused on whether the patterns of change and the risk factors for these two types of symptoms differed, as we might expect among old and oldest-old adults.

METHODS: The analytic sample included self-respondents of the 1993--1995 Asset and Health Dynamics among the Oldest Old (AHEAD) study who were born in 1923 or earlier. Depressive symptoms were assessed using an abbreviated Center for Epidemiologic Studies-Depression (CES-D) Scale. The analyses involved examination of respondents{\textquoteright} change scores in depressive symptoms and multivariate models using ordinary least squares (OLS) and seemingly unrelated regressions (SUR).

RESULTS: In aggregate, somatic symptoms were more common than mood symptoms initially and over time. Despite differences in aggregate rates, AHEAD respondents{\textquoteright} individual-level patterns of change for the two types of symptoms were similar; i.e., stability was the principal trend (53--60\%), followed by improvement (21--26\%). A number of factors related to change in one aspect of depressive symptoms and not the other, or had greater effects on one aspect of depressive symptoms than the other; e.g., physical health had greater effects on somatic than mood symptoms.

CONCLUSIONS: This study suggests that, in investigations of the course and risk factors for depressive symptoms among people 70+ years of age, it is important to separate somatic symptoms from mood symptoms; their etiology may differ. In general, factors reflecting respondents{\textquoteright} social milieu (e.g., bereavement, residential relocation) may have greater effects on mood than somatic symptoms, whereas certain factors representing physical health may have greater effects on somatic symptoms.

}, keywords = {Age Factors, Aged, Depressive Disorder, Female, Follow-Up Studies, Geriatric Assessment, Humans, Least-Squares Analysis, Longitudinal Studies, Male, Mood Disorders, Regression Analysis, Risk Factors, Severity of Illness Index, Somatoform Disorders, United States}, issn = {1047-2797}, doi = {10.1016/s1047-2797(00)00219-2}, author = {Stephanie J. Fonda and A. Regula Herzog} } @inbook {5173, title = {Predictors of Mortality among the Elderly}, booktitle = {Themes in the Economics of Aging}, year = {2001}, note = {ProCite field 8 : ed.}, publisher = {Univ. of Chicago Press}, organization = {Univ. of Chicago Press}, address = {Chicago}, abstract = {This paper examines the quantitative importance of some predictors of mortality among the population aged 70 and over. As expected, this research confirms that socioeconomic status is related to mortality. This relationship is strong at younger ages and appears to weaken as the cohort gets older. The 13 health indicators are also strong predictors of mortality. Results also show that subjective probabilities of survival predict mortality and remain strong predictors even after controlling for socioeconomic indicators and health conditions.}, keywords = {Demographics, Expectations, Health Conditions and Status, Net Worth and Assets}, url = {https://www.nber.org/papers/w7440}, author = {Michael D Hurd and Daniel McFadden and Merrill, Angela}, editor = {David A Wise} } @article {6766, title = {Racial, Ethnic, and Sociodemographic Differences in the level of Psychosocial Distress Among Older Americans}, journal = {Research on Aging}, volume = {23}, year = {2001}, pages = {131-152}, publisher = {23}, abstract = {This paper explores the reasons for the observed differences in the level of self-reported depressive symptoms between older African Americans, Hispanic-English speaking, Hispanic-Spanish speaking, and Whites. For all groups in the sample, being male, married, having a high level of education, and good health are strong indicators of lower levels of depressive symptoms. Comparing the levels of self-reported depressive symptoms among the different racial/ethnic groups demonstrated that there are large differences, with the Hispanic-Spanish speaking individuals reporting the highest scores. Results show that language acculturation, the number of years of education, and the number of years of U.S. residency are significant factors that help to explain these differences.}, keywords = {Demographics, Health Conditions and Status, Net Worth and Assets, Women and Minorities}, doi = {10.1177/0164027501232001}, author = {Mills, Terry L. and John C Henretta} } @article {6730, title = {Reducing Panel Attrition: A Search for Effective Policy Instruments}, journal = {Journal of Human Resources}, volume = {36}, year = {2001}, note = {ProCite field 3 : Survey Research Center, Institute for Social Research, U MI; Survey Research Center, Institute for Social Research, U MI}, pages = {416-38}, publisher = {36}, abstract = {In this paper we develop a theory of the survey response decision process and apply it to the analysis of field office policy measures in an attempt to see which of these are effective in reducing panel attrition. We use data from the Health and Retirement Study (HRS) to assess the effectiveness of 1) reducing the length of the interview and 2) assigning the same initial interviewer wave after wave. There is virtually no evidence in the data that interview length affects subsequent wave response. Assigning the same interviewer wave after wave, however, has a strong positive effect on response rates.}, keywords = {Methodology}, doi = {10.2307/3069625}, author = {Daniel H. Hill and Robert J. Willis} } @article {5474, title = {Social Security Expectations and Retirement Savings Decisions}, number = {8718}, year = {2001}, note = {National Institute on Aging Grant 2 P01 AG10179-04A1 and National Science Foundation grant SES-0001436.}, institution = {The National Bureau of Economic Research}, address = {Cambridge, MA}, abstract = {Retirement savings decisions should depend on expectations of Social Security retirement income. Persons may be uncertain of their future Social Security benefits for several reasons, including uncertainty about their future labor earnings, the formula now determining social security benefits, and the future structure of the Social Security system. To learn how Americans perceive their benefits, we have elicited Social Security expectations from respondents to the Survey of Economic Expectations. We have also performed a more intensive face-to-face survey on a small sample of respondents. This paper presents the empirical findings. It also illustrates how data on expectations may help predict how Social Security policy affects retirement savings.}, keywords = {Consumption and Savings, Social Security}, doi = {https://www.nber.org/papers/w8718}, author = {Dominitz, Jeff and Charles F Manski and Heinz, Jordan} } @article {6769, title = {Socioeconomic Differences in Having Living Parents and Children: A U.S.-British Comparison of Middle-Aged Women}, journal = {Journal of Marriage and the Family}, volume = {63}, year = {2001}, pages = {852-867}, publisher = {63}, abstract = {The authors observe the differences in socioeconomic status among women in Britain and the U.S. who have living parents as well as children in the middle-aged cohort. Those people in the middle generation are likely to encounter many demands, both from their parents and their children. What is the magnitude of the socioeconomic effects in these two countries? What is the pattern of socioeconomic differences in parent survival when inspecting the socioeconomic status of the middle-aged children? Data from the 1988 Office of National Statistics Retirement and Retirement Plans Survey was gathered for the British population and compared to Wave 1 (1992) and Wave 2 (1994) of the Health and Retirement Study. Findings from this study are that: (1) the U.S. has much greater levels of kin availability; (2) the pattern of socioeconomic effects is rather similar between the two countries; (3) socioeconomic status is negatively correlated with the number of children one has; and (4) people with greater socioeconomic status are more likely to have a living parent and children. Policies that change the amount of responsibility a person has with regard to other generations of the family will have differing consequences depending on the country, status, and whom the policy is concerning (elderly or young).}, keywords = {Adult children, Demographics}, doi = {10.1111/j.1741-3737.2001.00852.x}, author = {John C Henretta and Emily M D Grundy and Harris, Susan} } @article {5445, title = {Surveys of the Life Course and Aging: Some Comparisons}, number = {2001-06}, year = {2001}, institution = {University of Wisconsin-Madison}, address = {Madison, WI}, abstract = {In this paper, we introduce, compare, and evaluate the design and content of five major longitudinal studies of aging: the Wisconsin Longitudinal Study (WLS), Health and Retirement Survey (HRS), National Survey of Families and Households (NSFH), Americans{\textquoteright} Changing Lives (ACL), and Midlife in the United States (MIDUS). We first compare population coverage, sampling design, response rate, observational duration, sources of relational and multi-level data, and links to public records. Overall, WLS, HRS, and NSFH excel in many respects. We also evaluate questions and measures in each study. In topical coverage, WLS and NSFH are the most complete. In question quality, WLS, HRS, and NSFH excel in several areas, while MIDUS and ACL stand out mainly in life event inventories, psychological measures and some health measures.}, keywords = {Methodology}, url = {https://www.ssc.wisc.edu/wlsresearch/publications/files/public/Kuo-Park-HauserT-Hauser-Marks_Surveys.Life.C.A_CDE_01-06.pdf}, author = {Kuo, Hsiang-Hui Daphne and Park, Hyunjoon and Hauser, Taissa S. and Hauser, Robert M. and Marks, Nadine F.} } @article {6784, title = {Valuation of life: a concept and a scale.}, journal = {J Aging Health}, volume = {13}, year = {2001}, month = {2001 Feb}, pages = {3-31}, publisher = {13}, abstract = {

OBJECTIVES: The objective was to derive and test the psychometric characteristics of a scale to measure Valuation of Life (VOL).

METHODS: Four samples were used in successive phases of exploratory factor analysis, confirmatory factor analysis, reliability and validity testing, and exploration of response-error effects. Estimates of Years of Desired Life were obtained under a variety of hypothetical quality-of-life (QOL)-compromising conditions of poor health.

RESULTS: Confirmed 13-item (Positive VOL) and 6-item (Negative VOL) factors were obtained. A significant relationship between VOL and most Years of Desired Life estimates remained when demographic, health, quality of life, and mental health measures were controlled. Analysis of Negative VOL revealed that some respondents misunderstand the meaning of an agree response to negatively phrased items.

DISCUSSION: VOL is a cognitive-affective schema whose function as a mediator and moderator between health and end-of-life decisions deserves further research.

}, keywords = {Factor Analysis, Statistical, Humans, Psychometrics, Quality of Life, United States}, issn = {0898-2643}, doi = {10.1177/089826430101300101}, author = {Lawton, M. Powell and Moss, Miriam and Hoffman, Christine and Kleban, Morton H. and Ruckdeschel, Katy and Winter, Laraine} } @article {8444, title = {Will the Aid You Need Be There for You?}, journal = {Orlando Sentinel}, year = {2001}, month = {March 15, 2001}, pages = {J2}, publisher = {Orlando Sentinel}, address = {Orlando, FL}, keywords = {Healthcare, Retirement Planning and Satisfaction}, author = {Hughes, Mona} } @article {5421, title = {Association between Body Size and Mortality in Later Life}, number = {21}, year = {2000}, institution = {Syracuse University, Center for Policy Research}, address = {Syracuse, NY}, abstract = {The rising prevalence of obesity in the United States has focused attention on the health consequences of excess weight. Obesity is linked to many of the major causes of death in the United States, including heart disease, some types of cancer, strokes, diabetes, and atherosclerosis. However, the effects of body size on mortality and health among the elderly are much less clear. This paper extends our current understanding of the relationship between body size and mortality by using two nationally representative, longitudinal datasets of individuals at older ages. These analyses indicate that obesity may not contribute greatly to increased mortality risks after age 70. In fact, obesity may be somewhat protective and lower the risk of death. At younger ages, however, the effects of obesity tend to operate in the opposite direction. Women especially appear to be at greater risk of death in their 50s and 60s if they are overweight. }, keywords = {Health Conditions and Status}, url = {https://www.researchgate.net/profile/Christine_Himes/publication/237523551_Association_between_Body_Size_and_Mortality_in_Later_Life/links/0f3175321bcd2bb348000000.pdf}, author = {Christine L Himes} } @article {5412, title = {Black and White Differences in Health and Functional Status Dimensions: How Many and What Type Among Older Americans}, year = {2000}, institution = {North Carolina State University}, keywords = {Health Conditions and Status}, author = {Alvin E. Headen Jr. and Kenneth G. Manton and Woodbury, Max A.} } @inbook {5168, title = {Early Retirement Windows}, booktitle = {Forecasting Retirement Needs and Retirement Wealth}, year = {2000}, note = {ProCite field 8 : eds}, pages = {253-273}, publisher = {Univ. of Pennsylvania Press}, organization = {Univ. of Pennsylvania Press}, chapter = {9}, address = {Philadelphia}, keywords = {Net Worth and Assets, Retirement Planning and Satisfaction}, url = {https://pensionresearchcouncil.wharton.upenn.edu/publications/books/forecasting-retirement-needs-and-retirement-wealth/}, author = {Charles Brown}, editor = {Olivia S. Mitchell and Hammond, B. and Rappaport, A.} } @article {6686, title = {Economic, Cultural, and Social Origins of Emotional Well-Being: Comparisons of Immigrants and Natives at Midlife}, journal = {Research on Aging}, volume = {22}, year = {2000}, pages = {599-629}, publisher = {22}, abstract = {Linking theories of social stratification, ethnicity, and mental health with theories of human and social capital, the authors examine the impact of economic, cultural, and social factors on five different dimensions of emotional well-being for immigrants and natives at midlife. Based on data from the 1992 wave of the Health and Retirement Study, the authors found that economic factors and human capital variables are the most important determinants of emotional health for both immigrants and natives. The results indicate that cultural factors can enhance emotional well-being. Religious affiliation and participation are important for both immigrants and natives, but religious participation appears to be more beneficial for immigrants. Being part of a couple was also associated with better emotional health, especially for immigrants. The effects of several determinants of emotional health differed across immigrant groups. It was found that marriage, education, and the presence of economically stable kin are particularly important for Cubans. 6 Tables, 36 References. Adapted from the source document}, keywords = {Demographics, Health Conditions and Status, Other}, doi = {10.1177/0164027500226002}, author = {Hao, Lingxin and Richard W. Johnson} } @article {5417, title = {Elderly Asset Management and Health: An Empirical Analysis}, number = {7814}, year = {2000}, institution = {The National Bureau of Economic Research}, address = {Cambridge, MA}, abstract = {We present models of asset management by the elderly. We focus on saving, spend-down of assets, and gift-giving, and the influence of health on these precesses. We also study the evolution of elderly health and the impact of economic variables on health outcomes. We present results from estimating our models using data from waves one and two of the AHEAD dataset. Our model of asset management links elderly decisions about saving, spend-down of assets, and gift-giving in a system of equations. We divide households for which head and partner (if present) are in poor health and those for which head and partner are in good health; our specification allows for differences in health to affect both the average level of economic outcomes and the marginal effects of income and wealth on the outcomes. We also include in our model a set of sociodemographic control variables. Our model of health outcomes links health in the preceding period to health in the current period, allowing for three outcomes good health, poor health, or death. In our models of health outcomes we include variables measuring health in the previous period, wealth, age, education, and control variables. Our main results are the following. First, results for gift-giving suggest that at least some elderly do plan their estate transfer - those that have established trust funds or for which households assets exceed the estate tax filling threshold have a significantly greater propensity to give gifts. Second, the average level of gift-giving is lower for those in poor health, but the marginal effect of increasing wealth on gift-giving is much greater. This result is important in showing the ways in which health can interact with economic variables in influencing economic decision-making. Third, income is an important determinant of saving and spend-down. Fourth, other things equal, households that save are also more likely to give gifts. Fifth, sudden changes in family structure and health are associated with changing patters of economic behavior - most especially, becoming a widow or widower is associated with a significant increase in the likelihood both of spending out of assets and of making gifts. Finally, variables related to children have less effect on propensity to give gifts than expected - the only variable that has a significant effect is the number of children for which parents cannot provide income information, suggesting that the quality of the relationship between parents and children is important for gift-giving.}, keywords = {Adult children, Demographics, Health Conditions and Status, Net Worth and Assets}, url = {https://www.nber.org/papers/w7814}, author = {Feinstein, Jonathan S. and Ho, Chih-Chin} } @article {5405, title = {Employment Income Inequality among Older U.S. Workers: Gender, Race, and Class Comparisons}, year = {2000}, abstract = {As the elderly segment of the US population continues to grow in size and voice, the economic status of older workers and retirees, particularly women and racial minorities, is of growing social and political interest and concern. While sociologists have analyzed occupational and industrial segmentation and racial and gender inequality in retirement, most studies have narrowly focused on either race or gender and on either pension or Social Security earnings. This research examines effects of gender, race, class, occupation, work, and marital status characteristics on older workers{\textquoteright} preretirement income. This research is based on the preretired respondents who are currently working for pay (N = 4,959) in the 1992 Health and Retirement Study, a nationally representative survey of individuals ages 51-61 and their spouses. Ordinary least squares regressions were used to estimate the effects of ascribed characteristics (race and gender) as well as work and family history on employment income prior to retirement. Race and gender were found to interact to produce preretirement employment income advantages/disadvantages. Similarly, occupation, class, and the interaction of these variables created considerable differences in income, especially along race and gender lines. The findings suggest status inequality is produced and sustained throughout the life course.}, keywords = {Demographics, Employment and Labor Force, Income, Other}, author = {Behringer, Autumn and Janet M Wilmoth and Hogan, Richard and Perrucci, Carolyn C.} } @inbook {5144, title = {Evaluating Pension Entitlements}, booktitle = {Forecasting Retirement Needs and Retirement Wealth}, year = {2000}, note = {RDA 1996-005; Revision of Pension Research Council Working Paper 98-20 ProCite field 8 : eds.}, pages = {309-326}, publisher = {University of Pennsylvania Press}, organization = {University of Pennsylvania Press}, chapter = {12}, address = {Philadelphia}, keywords = {Net Worth and Assets, Pensions, Public Policy}, url = {https://pensionresearchcouncil.wharton.upenn.edu/publications/books/forecasting-retirement-needs-and-retirement-wealth/}, author = {Alan L Gustman and Olivia S. Mitchell and Andrew A. Samwick and Thomas L. Steinmeier}, editor = {Olivia S. Mitchell and Hammond, B. and Rappaport, A.} } @article {6723, title = {Expectations among the elderly about nursing home entry.}, journal = {Health Serv Res}, volume = {35}, year = {2000}, month = {2000 Dec}, pages = {1181-202}, publisher = {35}, abstract = {

OBJECTIVE: To assess whether the covariates that explain expectations of nursing home entry are consistent with the characteristics of those who enter nursing homes.

DATA SOURCES: Waves 1 and 2 of the Assets and Health Dynamics Among the Oldest Old (AHEAD) survey.

STUDY DESIGN: We model expectations about nursing home entry as a function of expectations about leaving a bequest, living at least ten years, health condition, and other observed characteristics. We use an instrumental variables and generalized least squares (IV-GLS) method based on Hausman and Taylor (1981) to obtain more efficient estimates than fixed effects, without the restrictive assumptions of random effects.

PRINCIPAL FINDINGS: Expectations about nursing home entry are reasonably close to the actual probability of nursing home entry. Most of the variables that affect actual entry also have significant effects on expectations about entry. Medicaid subsidies for nursing home care may have little effect on expectations about nursing home entry; individuals in the lowest asset quartile, who are most likely to receive these subsidies, report probabilities not significantly different from those in other quartiles. Application of the IV-GLS approach is supported by a series of specification tests.

CONCLUSIONS: We find that expectations about future nursing home entry are consistent with the characteristics of actual entrants. Underestimation of risk of nursing home entry as a reason for low levels of long-term care insurance is not supported by this analysis.

}, keywords = {Activities of Daily Living, Aged, Attitude to Health, Data Interpretation, Statistical, Effect Modifier, Epidemiologic, Female, Geriatric Assessment, Health Care Surveys, Health Services Research, Health Status, Homes for the Aged, Humans, Least-Squares Analysis, Longevity, Male, Medicaid, Nursing homes, Patient Admission, Probability, Risk Factors, Surveys and Questionnaires, United States}, issn = {0017-9124}, author = {Richard C Lindrooth and Hoerger, Thomas J. and Edward C Norton} } @inbook {5147, title = {Explaining Retirement Saving Shortfalls}, booktitle = {Forecasting Retirement Needs and Retirement Wealth}, year = {2000}, note = {RDA 1996-002; Revision of Pension Research Council Working Paper 98-13 ProCite field 6 : In ProCite field 8 : eds.}, pages = {139-63}, publisher = {University of Pennsylvania Press}, organization = {University of Pennsylvania Press}, chapter = {5}, address = {Philadelphia}, keywords = {consumption, Savings}, url = {https://pensionresearchcouncil.wharton.upenn.edu/publications/books/forecasting-retirement-needs-and-retirement-wealth/}, author = {Olivia S. Mitchell and James Moore and John W R Phillips}, editor = {Olivia S. Mitchell and Hammond, B. and Rappaport, A.} } @book {5268, title = {Forecasting Retirement Needs and Retirement Wealth}, year = {2000}, note = {RDA 1996-002 ProCite field 8 : eds.}, publisher = {University of Pennsylvania Press}, organization = {University of Pennsylvania Press}, address = {Philadelphia, PA}, abstract = {Thirteen papers draw on data from the Health and Retirement Study and from other sources to explore people{\textquoteright}s preparation for and the financial challenges of retirement in the United States. Papers discuss new paths to retirement; how prepared Americans are for retirement; projected retirement wealth and saving adequacy; individual savings and investment choices associated with 401(k) plans; factors explaining retirement savings shortfalls; women{\textquoteright}s economic well -being at the end of their work lives and the factors that appear to be associated with the poorer economic status of older women relative to older men; the prospects for widow poverty; minorities facing retirement; early retirement windows; the relationship between people{\textquoteright}s expectations about their retirement, their realizations of retirement, and the role of health shocks in this process; planning for health care needs in retirement; the evaluation of pension entitlements; social security earnings and projected benefits. Mitchell is at the Wharton School, University of Pennsylvania. Hammond is with the Teachers Insurance Annuity Association-College Retirement Equities Fund (TIAA -CREF). Rappaport is at William M. Mercer, Inc. Index.}, keywords = {Consumption and Savings, Health Conditions and Status, Healthcare, Pensions, Retirement Planning and Satisfaction, Women and Minorities}, url = {https://pensionresearchcouncil.wharton.upenn.edu/publications/books/forecasting-retirement-needs-and-retirement-wealth/}, author = {Olivia S. Mitchell and P. Brett Hammond and Anna M. Rappaport} } @article {8430, title = {Forecasting Retirement Needs and Retirement Wealth (Book Review)}, journal = {The Actuary}, year = {2000}, month = {2000}, pages = {16}, keywords = {Retirement Planning and Satisfaction}, author = {Hardcastle, Peter and Pryor, Bob} } @article {6706, title = {The Future of Age Integration in Unemployment}, journal = {The Gerontologist}, volume = {40}, year = {2000}, pages = {286-92}, publisher = {40}, abstract = {This article discusses the direction and implications of current and possible future trends in workplace age integration. The study used HRS respondents{\textquoteright} attitudes towards work as a way of examining the possible supply of older workers. Overall, there are a number of underlying trends that will combine in the near future that will likely result in an increase of older persons remaining in the work force for longer. The shifting population age composition and the high education and ability levels of the cohorts born around 1950 are some of the trends that contribute to the increased demand for older workers. Other trends, such as changes in Social Security eligibility ages, the shift to DC pension plans, and the improving health of older cohorts, contribute to the increase in the supply of older workers. HRS data indicate that an overwhelming majority, 77 of men and 71 of women, say that they would like to continue some paid work when they retire. Evidence also suggests that since job flexibility among this cohort is limited, that either significant job changing from pre-retirement to postretirement jobs will be required, or significant job redesign must occur.}, keywords = {Adult children, Demographics, Employment and Labor Force, Methodology, Other, Retirement Planning and Satisfaction, Social Security}, doi = {10.1093/geront/40.3.286}, author = {John C Henretta} } @article {6711, title = {Health Consequences of Marriage for the Retirement Years}, journal = {Journal of Family Issues}, volume = {21}, year = {2000}, pages = {559-586}, publisher = {21}, abstract = {Over the last few decades there has been an increasing trend toward divorce, postponed marriage, never marrying, and cohabitation. It is also known that marriage increases ones health, mainly because of the ability to gain from the help of a spouse or other relatives that transfer finances and time to the married person. How will changes in marriage trends effect the health of people as they reach retirement ages? What aspects of health are linked to marriage? Married persons from this data were the least likely to be afflicted by any of the diseases or limitations studied. Widowed and divorced persons were found to have the worst overall health of any two groups. However, cohabiting people were not much better off then the widowed or divorced persons. The authors also break down the data further and compare genders and races. Exiting marriage, surprisingly, was worse then never having been married.}, keywords = {Adult children, Demographics, Health Conditions and Status, Retirement Planning and Satisfaction}, doi = {10.1177/019251300021005003}, author = {Pienta, Amy M. and Mark D Hayward and Kristi Rahrig Jenkins} } @article {6701, title = {Memory complaint in a community sample aged 70 and older.}, journal = {J Am Geriatr Soc}, volume = {48}, year = {2000}, month = {2000 Nov}, pages = {1435-41}, publisher = {48}, abstract = {

OBJECTIVES: The ability of older people to estimate their own memory, often referred to as "metamemory," has been evaluated in previous studies with conflicting reports regarding accuracy. Some studies have suggested that an older person{\textquoteright}s metamemory is mostly accurate, whereas others have demonstrated little relationship between memory complaint and actual impairment. This study examines memory complaint in a large national sample of older people aged > or = 70.

DESIGN: A longitudinal cohort study with two waves of data collection spaced 2 years apart.

SETTING: A nationwide random sample of community-dwelling older persons.

PARTICIPANTS: A total of 5,444 community-dwelling persons aged > or = 70 and their spouses.

MEASUREMENTS: Participants were asked if they believed their memory was excellent, very good, good, fair, or poor. They were then administered a cognitive assessment derived from the Mini-Mental Status Exam.

RESULTS: In general, people{\textquoteright}s assessment of their memory corresponded with their actual performance on cognitive measures. However, large portions of the sample inaccurately assessed their memory skills. People who reported depressive symptoms and had impairment in activities of daily living were more likely to state that their memory was impaired, although they performed very well on cognitive measures.

CONCLUSIONS: The conditions that skew people{\textquoteright}s self-assessment are the ones most likely to bring them into contact with healthcare professionals. This may give clinicians the general impression that older people cannot assess their own cognitive skills. However, poor metamemory appears to be a characteristic of a specific subgroup of older persons, not necessarily characteristic of the general population.

}, keywords = {Activities of Daily Living, Aged, Aged, 80 and over, Cognition, Depressive Disorder, Educational Status, Female, Geriatric Assessment, Humans, Longitudinal Studies, Male, Marital Status, Memory, Self-Assessment}, issn = {0002-8614}, doi = {10.1111/j.1532-5415.2000.tb02634.x}, author = {Carolyn L. Turvey and Schultz, Susan K. and Arndt, Stephan and Robert B Wallace and A. Regula Herzog} } @inbook {5120, title = {Minorities Face Retirement: Worklife Disparities Repeated?}, booktitle = {Forecasting Retirement Needs and Retirement Wealth}, year = {2000}, note = {ProCite field[3]: CUNYProCite field[6]: InProCite field[8]: eds.}, pages = {235-52}, publisher = {University of Pennsylvania Press}, organization = {University of Pennsylvania Press}, chapter = {8}, address = {Philadelphia}, keywords = {Consumption and Savings, Retirement Planning and Satisfaction, Women and Minorities}, url = {https://pensionresearchcouncil.wharton.upenn.edu/publications/books/forecasting-retirement-needs-and-retirement-wealth/}, author = {Honig, Marjorie}, editor = {Olivia S. Mitchell and P. Brett Hammond and Anna M. Rappaport} } @inbook {5167, title = {New Paths to Retirement}, booktitle = {Forecasting Retirement Needs and Retirement Wealth}, year = {2000}, note = {ProCite field 8 : eds.}, pages = {13-32}, publisher = {Univ. of Pennsylvania Press}, organization = {Univ. of Pennsylvania Press}, address = {Philadelphia}, keywords = {Consumption and Savings, Employment and Labor Force, Net Worth and Assets, Retirement Planning and Satisfaction}, url = {https://pensionresearchcouncil.wharton.upenn.edu/publications/books/forecasting-retirement-needs-and-retirement-wealth/}, author = {Joseph F. Quinn}, editor = {Olivia S. Mitchell and Hammond, B. and Rappaport, A.} } @article {5400, title = {Nonrandom Selection in the HRS Social Security Earnings Sample.}, year = {2000}, institution = {Santa Monica, CA, RAND Corp.}, abstract = {The Health and Retirement Study (HRS), administered by the Institute for Social Research (ISR) at the University of Michigan, is a longitudinal survey of the population of U.S. households with at least one adult between the ages of 51 and 61 in 1992 (individuals born between 1931 and 1941). Wave 1 of the survey was carried out in 1992 with subsequent waves to be conducted every two years. In Wave 1, the HRS collected data on 12,652 respondents from 7,702 households. In accordance with an agreement with the Social Security Administration, HRS respondents were asked to grant ISR permission to obtain the respondents{\textquoteright} earnings histories as reported to the Social Security Administration. Such data are extremely valuable because they provide unusually accurate administrative earnings histories over an unusually long period, 1951- 1991, and these data can be used in conjunction with the wealth of survey information collected in the HRS itself. Because of the highly confidential nature of the data, the earnings histories are not part of the FIRS public release data sets; rather, the Social Security earnings data are provided only through special permission from the HRS.}, keywords = {Methodology, Social Security}, url = {https://www.rand.org/pubs/drafts/DRU2254.html}, author = {Steven Haider and Solon, Gary} } @article {6692, title = {Obesity, Disease, and Functional Limitation in Later Life}, journal = {Demography}, volume = {37}, year = {2000}, pages = {73-82.}, publisher = {37}, abstract = {Little is known about the effects of obesity late in life. Using data from the Longitudinal Study of Aging and the Assets and Health Dynamics of the Oldest Old Survey, this study finds an increased prevalence of obesity, over time, among those 70 and older. Obesity is related most strongly to limitations in activities of daily living (ADLs) for women and to activities related to mobility. One ADL, eating, has a negative association to obesity. Obesity is associated with an increased prevalence of arthritis, diabetes, and hypertension. These results are cross-sectional and are based on self-reports of height and weight; they must be interpreted cautiously.}, keywords = {Demographics, Health Conditions and Status, Methodology, Other}, doi = {10.2307/2648097}, author = {Christine L Himes} } @article {5427, title = {Patterns of Dissaving in Retirement}, number = {2000-10}, year = {2000}, institution = { AARP Public Policy Institute}, address = {Washington, D.C.}, abstract = {Abstract: Examined patterns of dissaving among households with at least one older adult. Data were obtained from the Social Security Administration{\textquoteright}s New Beneficiary Data System (NBDS) on older adults (mainly those aged 62-65) who received Social Security benefits for the first time in 1980-1981 and who were interviewed in 1982 and 1991. Data were also obtained from the 1993 and 1995 waves of the National Institute on Aging{\textquoteright}s Asset and Health Dynamics Among the Oldest Old (AHEAD) survey of adults aged 70 and older. Multivariate analyses indicated that changes in wealth were fairly flat in the 1980s (based on NBDS data), with mean wealth growing just under one percent per year for the 9 years of the sample period, while median wealth declined by about one-quarter of a percentage point per year. The AHEAD data from the 1990s suggest that most adults aged 70 and older enjoyed wealth increases, which in large part were due to the dramatic rise in stock prices over the 2 years of the survey period. Overall, there was increasing wealth inequality, with less well off households dissaving more rapidly than better off households. Households in which health declined between the waves studied were more likely to dissave. Savings patterns of households with and without children were fairly similar. Two appendixes provide information on the study methodology and additional data tables}, keywords = {Consumption and Savings, Net Worth and Assets, Retirement Planning and Satisfaction}, url = {https://assets.aarp.org/rgcenter/econ/2000_10_dissaving.pdf}, author = {Steven Haider and Michael D Hurd and Reardon, Elaine and Williamson, Stephanie} } @article {6704, title = {Pension decisions in a changing economy: gender, structure, and choice.}, journal = {J Gerontol B Psychol Sci Soc Sci}, volume = {55}, year = {2000}, month = {2000 Sep}, pages = {S271-7}, publisher = {55B}, abstract = {

OBJECTIVES: As responsibility for financial security in retirement becomes more individualized, understanding the distribution and determinants of savings behavior grows in importance. Employed men and women often gain access to their pension assets when they change jobs. In this study gender differences in pre-retirement access to and disposition of accumulated pension assets are examined.

METHODS: The authors used data from the Health and Retirement Study to model pension participation, disposition of pension assets, and use of cash settlements derived from a pension plan in a previous job. Logit models provided estimates of gender differences in access to pensions and the preservation of pension funds for retirement.

RESULTS: Women were less likely to have participated in employer-sponsored pension plans; more likely to cash out accumulated pension assets when they changed jobs; and, when job changes occurred at relatively young ages, equally likely to spend the settlement. However, by their late 40s, women were more likely to save the settlement, a net gender difference that increased with age at which the settlement was received.

DISCUSSION: The structure of employment compensation continues to place women at a disadvantage. Gender differences in earnings and fringe benefits not only affect current financial status, but also cast a shadow over future financial security. Although the gender gap in pension coverage has been reduced, women with pensions have access to lower benefits and less in accumulated assets. As these continuing deficits are addressed, enhancing women{\textquoteright}s tendency to save pension assets for retirement can help them build financial security.

}, keywords = {Age Factors, Choice Behavior, Decision making, Female, Humans, Male, Middle Aged, Models, Economic, Pensions, United States}, issn = {1079-5014}, doi = {10.1093/geronb/55.5.s271}, author = {Melissa A. Hardy and Kim Shuey} } @article {6693, title = {Preferences for surrogate decision makers, informal communication, and advance directives among community-dwelling elders: results from a national study.}, journal = {Gerontologist}, volume = {40}, year = {2000}, month = {2000 Aug}, pages = {449-57}, publisher = {40}, abstract = {

This study, drawing on a nationally representative sample of community-dwelling adults aged 70 and older from the second wave of the Asset and Health Dynamics Among the Oldest Old (AHEAD) survey, addresses the need for greater information on advance care planning among older adults. Older persons expect to draw on a diverse array of persons to make health care decisions for them when they are unable to do so, including spouses, when available, as well as younger generation members such as children and grandchildren. Completion of advance directives such as living wills and durable powers of attorney for health care was more common among White respondents than among African American respondents, and among high school- and college-educated respondents compared with those with less than a high school education. The results suggest the need to develop interventions aimed at strengthening knowledge and understanding of advance directives, particularly for African Americans and persons with lower levels of educational attainment. They further suggest the need for more research on the factors related to informal communication between older adults and their family members on issues related to advance care planning.

}, keywords = {Advance directives, Aged, Aged, 80 and over, Black or African American, Choice Behavior, Communication, Educational Status, Family, Female, Health education, Health Status, Humans, Logistic Models, Male, Needs Assessment, Surveys and Questionnaires, United States, White People}, issn = {0016-9013}, doi = {10.1093/geront/40.4.449}, author = {Faith P. Hopp} } @inbook {5148, title = {Projected Retirement Wealth and Saving Adequacy in the Health and Retirement Study}, booktitle = {Forecasting Retirement Needs and Retirement Wealth}, year = {2000}, note = {RDA 1996-002; Revision of NBER Working Paper No. 6240 ProCite field 8 : eds.}, pages = {68-94}, publisher = {Univ. of Pennsylvania Press}, organization = {Univ. of Pennsylvania Press}, chapter = {3}, address = {Philadelphia}, abstract = {In the future it is likely that retirees will have to take on more of the burden of ensuring their own well-being then is now the case. This is because of the growing population over the age of 65 that is causing the social security surplus to wither away and the ongoing trend toward defined contribution retirement plans rather then defined benefit plans. However, household savings rates have plunged over the last half-century and this causes one to wonder how people will maintain their current consumption levels when retired. The authors use the first wave (1992) of the Health and Retirement Study in order to illustrate a life cycle model of savings. These researchers also look at initial and projected wealth, savings needs, replacement rates, and income. They find that the median current wealth of older households is 325,000, including retirement plans and assets, and they feel that at retirement the median wealth will be 380,000. At the same time though the median older household will need a savings rate of 16 in order to maintain current consumption levels in retirement.}, keywords = {Consumption and Savings, Net Worth and Assets}, url = {https://pensionresearchcouncil.wharton.upenn.edu/publications/books/forecasting-retirement-needs-and-retirement-wealth/}, author = {James Moore and Olivia S. Mitchell}, editor = {Olivia S. Mitchell and Hammond, B. and Rappaport, A.} } @inbook {5128, title = {Prospects for Widow Poverty}, booktitle = {Forecasting retirement needs and retirement wealth.}, series = {Pension Research Council Publications.:}, year = {2000}, note = {ProCite field[8]: eds.}, pages = {208 -34}, publisher = {University of Pennsylvania Press}, organization = {University of Pennsylvania Press}, address = {Philadelphia}, keywords = {Consumption and Savings, Methodology, Net Worth and Assets, Retirement Planning and Satisfaction}, author = {David R Weir and Robert J. Willis}, editor = {Olivia S. Mitchell and P. Brett Hammond and Anna M. Rappaport} } @article {6694, title = {Racial variations in end-of-life care.}, journal = {J Am Geriatr Soc}, volume = {48}, year = {2000}, month = {2000 Jun}, pages = {658-63}, publisher = {48}, abstract = {

OBJECTIVES: To identify differences in advanced care planning and end-of-life decision-making between whites and blacks aged 70 and older.

DESIGN: The Asset and Health Dynamics Among the Oldest Old (AHEAD) study is a nationally representative survey of adults who were aged 70 and older in 1993. Relatives (proxy respondents) for 540 persons who died between the first (1993) and second (1995) waves of the study were surveyed about advanced care planning and end-of-life decisions that were made for their family member who died.

SETTING: Respondents were interviewed at home by telephone (n = 444) or in person (n = 95).

PARTICIPANTS: The 540 proxy respondents included 454 whites and 86 blacks.

MEASUREMENTS: Questions were asked about advance care planning and end-of-life decisions.

RESULTS: Whites were significantly more likely than blacks to discuss treatment preferences before death (P = .002), to complete a living will (P = .001), and to designate a Durable Power of Attorney for Health Care (DPAHC) (P = .032). The treatment decisions for whites were more likely to involve limiting care in certain situations (P = .007) and withholding treatment before death (P = .034). In contrast, the treatment decisions for blacks were more likely to be based on the desire to provide all care possible in order to prolong life (P = .013). Logistic regression models revealed that race continued to be a significant predictor of advance care planning and treatment decisions even after controlling for sociodemographic factors.

CONCLUSIONS: These findings suggest that there are important differences between blacks and whites regarding advanced care planning and end-of-life decision-making. Health professionals need to understand the diverse array of end-of-life preferences among various racial and ethnic groups and to develop greater awareness and sensitivity to these preferences when helping patients with end-of-life decision-making.

}, keywords = {Advance care planning, Advance directives, Aged, Aged, 80 and over, Attitude to Health, Black or African American, Cross-Cultural Comparison, Decision making, Female, Follow-Up Studies, Humans, Logistic Models, Male, Patient Care Planning, Terminal Care, United States, White People}, issn = {0002-8614}, doi = {10.1111/j.1532-5415.2000.tb04724.x}, author = {Faith P. Hopp and Sonia A. Duffy} } @inbook {5169, title = {Retirement Expectations and Realizations: The Role of Health Shocks and Economic Factors}, booktitle = {Forecasting Retirement Needs and Retirement Wealth}, year = {2000}, note = {ProCite field 8 : eds.}, pages = {274-287}, publisher = {Univ. of Pennsylvania Press}, organization = {Univ. of Pennsylvania Press}, address = {Philadelphia}, abstract = {This chapter explores the relationship between peoples{\textquoteright} expectations about retirement, their realizations of retirement, and the role of health shocks in this process. We look at how accurately people predict retirement and we examine the determinants of changes in retirement expectations. Expectations are made under uncertainty about future health, labor force status, household characteristics, and economic variables; therefore plans must frequently be updated with new information. While many factors influence the decision to retire, we are specifically interested in the role of health shocks in peoples{\textquoteright} decisions to alter their plans to retire. Research to date has recognized the importance of understanding the relationship between health and retirement; however, until now, information about health, work, and economic well-being was difficult to obtain in a single survey. The Health and Retirement Study (HRS) is the first national survey to combine comprehensive data on all of these areas. Nevertheless much of the early HRS research has used only the first wave of data, at which time many in the cohort were too young to retire. In this chapter we use new information on this group of people from wave 2, enabling us to observe this cohort moving into retirement. In what follows we first offer a brief discussion of the literature, and then discuss empirical models, data used in the analysis, results and conclusions.}, keywords = {Expectations, Health Conditions and Status, Retirement Planning and Satisfaction}, url = {https://www.researchgate.net/publication/23739676_Retirement_Expectations_and_Realizations_The_Role_of_Health_Shocks_and_Economic_Factors}, author = {Debra S. Dwyer and Hu, Jianting}, editor = {Olivia S. Mitchell and Hammond, B. and Rappaport, A.} } @article {6720, title = {Risk Tolerance and Asset Allocation for Investors Nearing Retirement}, journal = {Financial Services Review}, volume = {9}, year = {2000}, pages = {159-170}, publisher = {9}, abstract = {This paper uses a large individual-level data set to isolate the effects of risk tolerance on portfolio composition. We test and confirm two predictions of the Capital Asset Pricing Model: (1) increased risk tolerance reduces an individual{\textquoteright}s propensity to purchase risk-free assets; and (2) higher risk tolerance does not affect the composition of an individual{\textquoteright}s portfolio of risky assets. More specifically, we find that risk tolerant investors nearing retirement do not reduce their bond allocations in order to buy more stock.}, keywords = {Net Worth and Assets, Risk Taking}, doi = {10.1016/S1057-0810(00)00063-9}, author = {Hariharan, Govind and Chapman, Kenneth S. and Domian, Dale L.} } @article {6688, title = {Scaling the Semantics of Satisfaction}, journal = {Social Indicators Research}, volume = {49}, year = {2000}, pages = {147-180}, publisher = {49}, abstract = {Self-assessed satisfaction is typically measured on an ordinal scale of verbal categories. Here, data from the 1992 Wave 1 of the US Health and Retirement Study (N = 12,654 respondents) are used to investigate whether the boundaries that persons implicitly set between contiguous categories are uniformly set across persons and/or across domains of satisfaction, or are variably sensitive to status characteristics and/or to domain. Analysis demonstrates systematic variations and sensitivities in the semantics of satisfaction. This semantic elasticity affects other estimates in models of self-assessed satisfaction. 3 Tables, 3 Figures, 43 References. Adapted from the source document}, keywords = {Methodology, Retirement Planning and Satisfaction}, url = {https://www.jstor.org/stable/27522430}, author = {Hazelrigg, Lawrence E. and Melissa A. Hardy} } @article {5420, title = {Self-employment and Labor Market Transitions at Older Ages}, number = {2000-13}, year = {2000}, institution = {Boston College}, address = {Boston}, abstract = {Self-employment is an important aspect of the labor market activity of older workers and many wage and salary workers choose a period of self-employment before complete labor force withdrawal. Our analysis of the HRS data indicates that the determinants of self-employment transitions among these workers reflect those of younger workers. In particular, there appears to be an important effect of credit market imperfections, but little impact of employer-provided health insurance. In light of the demographic shift toward a relatively elderly population, these results suggest that the degree to which older workers utilize self-employment as a bridge to complete retirement will be more influenced by the distribution of wealth than by the private sector promise of medical insurance. Viewed from a research perspective, these results suggest the need for explicit modeling of joint life-cycle evolution of asset accumulation and the choice of working in the salaried and self-employed sectors. In addition, our results emphasize the importance of viewing retirement as a process. In addition to transitions from wage and salary work to self-employment (and vice versa), there are interesting patterns of re-entry to the labor force, and to self-employment in particular, that merit further attention.}, keywords = {Employment and Labor Force}, url = {https://crr.bc.edu/working-papers/self-employment-and-labor-market-transitions-at-older-ages/}, author = {Bruce, Donald and Holtz-Eakin, Douglas and Joseph F. Quinn} } @article {6712, title = {The Significance of Socioeconomic Status in Explaining the Racial Gap in Chronic Health Conditions}, journal = {American Sociological Review}, volume = {65}, year = {2000}, pages = {910-930}, publisher = {65}, abstract = {Using Wave 1 (1992) and Wave 2 (1994) of the Health and Retirement Study the researchers try to detect the differences in life without health problems between different races so as to understand disparities in mortality rate and quality of life. Do Blacks have a higher risk of acquiring chronic health impairments of all types? How do differences in social conditions produce differences in the prevalence of fatal chronic diseases among races? The researchers notice that Blacks have a lower chance of surviving to middle age then do Whites. Blacks have a far greater level of morbidity in middle age, as well as, chances in having multiple fatal disease conditions. The author s give possible reasons for their findings, with much of it based on social status and life events.}, keywords = {Health Conditions and Status, Net Worth and Assets}, doi = {10.2307/2657519}, author = {Mark D Hayward and Eileen M. Crimmins and Toni Miles and Yang, Yu} } @inbook {5170, title = {Social Security Earnings and Projected Benefits}, booktitle = {Forecasting Retirement Needs and Retirement Wealth}, year = {2000}, pages = {327-359}, publisher = {Univ. of Pennsylvania Press}, organization = {Univ. of Pennsylvania Press}, address = {Philadelphia}, keywords = {Pensions, Social Security}, author = {Olivia S. Mitchell and Olson, Jan and Thomas L. Steinmeier}, editor = {Olivia S. Mitchell and Hammond, B. and Rappaport, A.} } @mastersthesis {6330, title = {Studies on the Relationship Between the Elderly and Public Policies}, year = {2000}, month = {2000}, school = {University of Maryland, College Park}, abstract = {A number of important demographic phenomena--rising life expectancy, the post-war baby boom, and the subsequent baby bust--will have dramatic effects on the age distribution of the U.S. population well into the next century. In particular, the American population is aging. This dissertation looks at the relationships between two very different public policies and the aging population. The first relationship is a possible intergenerational conflict over public education spending at the local level. Previous research by Poterba (1997) shows a negative effect from aging on public education spending at the state level. Using school district data, the second chapter shows that at the local level the elderly also have a negative and statistically significant effect on per-pupil education spending; however, the district-level results are much smaller than previous state-level results. Several pieces of evidence are then presented to bolster my results which indicate that the elderly are much less likely to support increased spending at the state level than at the local level. The second relationship is the interaction between elderly retirement behavior and the largest federal public spending program, Social Security. To project the aging population{\textquoteright}s future claims for Social Security benefits, it is crucial to have a reliable model of retirement behavior which incorporates the incentives of the Social Security system. A promising model of retirement is the Stock and Wise (1990a) option-value model. Their structural retirement model predicts retirement behavior based on the forward-looking incentives created by social security and pensions. However, they estimated their model using an unrepresentative sample of 1,500 salesmen working for one large firm. The third chapter tests whether the Stock and Wise option-value model can be applied to a more representative sample of males from the Health and Retirement Study. When the option-value model is applied to the HRS sample, the model fails to yield economically meaningful parameters. My results suggest that additional work is needed to accurately model and project future retirement behavior of the growing elderly population.}, keywords = {Demographics, Employment and Labor Force, Methodology, Other, Public Policy, Retirement Planning and Satisfaction}, author = {Harris, Amy Lenae} } @inbook {5146, title = {Women on the Verge of Retirement: Predictors of Retiree Well-Being}, booktitle = {Forecasting Retirement Needs and Retirement Wealth}, year = {2000}, note = {RDA 1996-002; Revision of Pension Research Council Working Paper 97-2 ProCite field 6 : In ProCite field 8 : eds.}, pages = {167-207}, publisher = {University of Pennsylvania Press}, organization = {University of Pennsylvania Press}, address = {Philadelphia}, keywords = {Retirement Planning and Satisfaction, Women and Minorities}, url = {https://www.researchgate.net/publication/23739651_Women_on_the_Verge_of_Retirement_Predictors_of_Retiree_Well-being}, author = {Phillip B. Levine and Olivia S. Mitchell and James Moore}, editor = {Olivia S. Mitchell and Hammond, B. and Rappaport, A.} } @article {6627, title = {Anchoring and Acquiescence Bias in Measuring Assets in Household Surveys}, journal = {Journal of Risk and Uncertainty}, volume = {19}, year = {1999}, note = {ProCite field 3 : RAND, SUNY, Stony Brook, and NBER}, pages = {111-36}, publisher = {19}, abstract = {Cognitive psychology has identified and studied extensively a number of cognitive anomalies that may be important for the assessment of the economic status of individuals and households. In particular the use of brackets to elicit information about income and assets in surveys of households can interact with acquiescence bias and anchoring to cause bias in the estimates of the distributions of income and assets. This paper uses data from the Health and Retirement Study and the Asset and Health Dynamics Study to find that, as predicted by psychology, bracketing can produce bias in population estimates of assets.}, keywords = {Methodology}, doi = {10.1023/A:1007819225602}, author = {Michael D Hurd} } @inbook {5127, title = {The Association of Influenza Vaccine Receipt with Health and Economic Expectations among Elders: The AHEAD Study}, booktitle = {Wealth, work, and health: Innovations in measurement in the social sciences: Essays in honor of F. Thomas Juster}, year = {1999}, note = {ProCite field[8]: eds.}, pages = {326-34.}, publisher = {University of Michigan Press}, organization = {University of Michigan Press}, address = {Ann Arbor, MI}, keywords = {Consumption and Savings, Expectations, Health Conditions and Status, Methodology}, author = {Robert B Wallace and Nichols, Sara and Michael D Hurd}, editor = {James P Smith and Robert J. Willis} } @article {6641, title = {At risk on the cusp of old age: living arrangements and functional status among black, white and Hispanic adults.}, journal = {J Gerontol B Psychol Sci Soc Sci}, volume = {54}, year = {1999}, month = {1999 May}, pages = {S136-44}, publisher = {54B}, abstract = {

OBJECTIVES: We examine the relationship between living arrangements and multiple measures of physical, cognitive, and emotional functioning in late midlife.

METHODS: Using cross-sectional data from the Health and Retirement Study, we first assess the bivariate relationship between living arrangements and functioning; we then take into account demographic characteristics and measures of household resources and demands.

RESULTS: We find evidence of differential functioning among individuals in various living arrangements. Married couples living alone or with children show the highest levels of functioning, whereas single adults living in complex households show the lowest levels. Functional deficits for those in complex households are reduced but not eliminated when we take demographic characteristics and household resources and demands into account. We find few differences by gender and race/ethnicity in the relationship between living arrangements and functioning.

DISCUSSION: We show a pattern of poorer functioning among those in arguably the most demanding and least supportive household environments. This points to a vulnerable and risk-filled transition from middle to old age for these persons. Because Blacks and Hispanics show lower levels of functioning than Whites and are more likely to live in complex households, they may be particularly disadvantaged.

}, keywords = {Activities of Daily Living, Aging, Black or African American, Cultural Characteristics, Family Relations, Female, Hispanic or Latino, Housing, Humans, Male, Middle Aged, Quality of Life, Retirement, Risk Factors, White People}, issn = {1079-5014}, doi = {10.1093/geronb/54b.3.s136}, url = {http://www.ncbi.nlm.nih.gov/pubmed/10363044?dopt=Abstract}, author = {Linda J. Waite and Mary Elizabeth Hughes} } @inbook {5165, title = {Cognitive Performance Measures in Survey Research on Older Adults}, booktitle = {Cognition, Aging, and Self Reports}, year = {1999}, note = {ProCite field 6 : In ProCite field 8 : eds.}, publisher = {Psychology Press}, organization = {Psychology Press}, chapter = {16}, address = {Philadelphia}, abstract = {Many researchers wonder whether cognitive ability decreases in the elderly and surveys of the elderly tend to include tests of cognitive ability that allow survey administrators to reject certain peoples responses or adjust the weight given to responses based on the respondents cognitive ability. The author s discuss cognitive tests used in the AHEAD Study, methodological issues of such tests, and the validity of cognitive measures in these tests. After a great deal of testing they conclude that the survey measures for cognition in the two studies are valid. They also present a number of methodological problems within cognitive tests and ways to resolve such problems.}, keywords = {Health Conditions and Status, Methodology}, doi = {10.4324/9780203345115}, author = {A. Regula Herzog and Willard L Rodgers}, editor = {Schwarz, Norbert and Denise C. Park and Barbel Knauper and Seymour Sudman} } @article {6646, title = {Conjugal loss and syndromal depression in a sample of elders aged 70 years or older.}, journal = {Am J Psychiatry}, volume = {156}, year = {1999}, month = {1999 Oct}, pages = {1596-601}, publisher = {156}, abstract = {

OBJECTIVE: The goal of this study was to describe the association between conjugal loss and both syndromal depression and depressive symptoms in a prospective cohort study of people aged 70 years or older.

METHOD: A measure of syndromal depression, the shortform Composite International Diagnostic Interview (CIDI), and a revised version of the Center for Epidemiologic Studies--Depression Scale (CES-D Scale) were administered to a group of 5,449 elders in a longitudinal cohort study. The authors compared the rates of syndromal depression (CIDI diagnosis) and depressive symptoms (six CES-D Scale symptoms) in married participants and those who lost spouses between the first and second waves of assessment.

RESULTS: The rate of syndromal depression in the newly bereaved was nearly nine times as high as the rate for married individuals, and the rate of depressive symptoms was nearly four times as high. The percentage of the bereaved respondents who had scores above threshold on the revised CES-D Scale was higher for those interviewed up to 2 years after loss of a spouse than for married respondents. Age, sex, prior psychiatric history, and the expectedness of the death did not differ between depressed and nondepressed newly bereaved subjects.

CONCLUSIONS: Recent bereavement is a significant risk factor for syndromal depression in the elderly. Some widows and widowers experienced high levels of depressive symptoms up to 2 years after the loss of their spouses. Neither demographic variables nor variables concerning the nature of the spouse{\textquoteright}s death predicted bereavement-related depression.

}, keywords = {Age Factors, Aged, Aged, 80 and over, Bereavement, Cohort Studies, depression, Depressive Disorder, Female, Humans, Logistic Models, Longitudinal Studies, Male, Marital Status, Odds Ratio, Psychiatric Status Rating Scales, Risk Factors, Sex Factors, Widowhood}, issn = {0002-953X}, doi = {10.1176/ajp.156.10.1596}, author = {Carolyn L. Turvey and Carney, C. and Arndt, Stephan and Robert B Wallace and A. Regula Herzog} } @article {6629, title = {Consumer Preferences for Health Care Reform Options}, journal = {Journal of Consumer Affairs}, volume = {33}, year = {1999}, note = {ProCite field 3 : Purdue U; U Memphis}, pages = {237-53}, publisher = {33}, abstract = {This study uses the 1992 Health and Retirement Study to examine consumer preferences for four health care reform options: tax-financed national health insurance, personally subsidized Medicare extensions, publicly subsidized nursing home insurance, and tax credits for health insurance purchases. Males, non-Caucasians, the self-employed, those in excellent health, and those who reside in the Northeast favor national health insurance, while those with high levels of liquid and non-liquid assets tend to disfavor it. Males and those with higher expectations of living in nursing homes tend to favor personally subsidized Medicare extensions to cover nursing homes and home health care. Those with higher expectations of living in nursing homes also favor publicly subsidized nursing home insurance. Relatively little support for subsidized nursing home insurance is found among males and those with high levels of liquid and non-liquid assets. The self-employed tend to support tax credits for health insurance premiums.}, keywords = {Consumption and Savings, Health Conditions and Status, Healthcare, Net Worth and Assets, Public Policy}, url = {https://www.jstor.org/stable/23859957?seq=1$\#$page_scan_tab_contents}, author = {Gong-Soog Hong and Shelley I. White-Means} } @article {10761, title = {ESTATE TAXES, LIFE INSURANCE, AND SMALL BUSINESS}, number = { 7360}, year = {1999}, institution = {National Bureau of Economic Research}, address = {Cambridge}, abstract = {One criticism of the estate tax is that it prevents the owners of family businesses from passing their enterprises to their children. The problem is that it may be difficult to pay estate taxes without liquidating the business. A natural question is why individuals with such concerns do not purchase enough life insurance to meet their estate tax liabilities. This paper examines whether and how people use life insurance to deal with the estate tax. We find that, other things being the same, business owners purchase more life insurance than other individuals. However, on the margin, their insurance purchases are less responsive to estate tax considerations and they are less likely to have the wherewithal to meet estate tax liabilities out of liquid assets plus insurance.}, keywords = {Estate tax, Life insurance, Small business owners}, url = {https://www.nber.org/papers/w7360}, author = {Holtz-Eakin, Douglas and John W R Phillips and Rosen, Harvey S.} } @inbook {5125, title = {Intergenerational Transfers: Blood, Marriage, and Gender Effects on Household Decisions}, booktitle = {Wealth, work, and health: Innovations in measurement in the social sciences: Essays in honor of F. Thomas Juster.}, year = {1999}, note = {ProCite field[3]: Georgetown U; Center for Policy Research, Syracuse U; U FLProCite field[8]: eds.}, pages = {335-55}, publisher = {University of Michigan Press}, organization = {University of Michigan Press}, address = {Ann Arbor, MI}, keywords = {Adult children, Consumption and Savings, Demographics, Event History/Life Cycle, Methodology}, author = {Beth J Soldo and Douglas A. Wolf and John C Henretta}, editor = {James P Smith and Robert J. Willis} } @inbook {5155, title = {Labor Market Transitions in the HRS: Effects of the Subjective Probability of Retirement and of Pension Eligibility}, booktitle = {Wealth, Work and Health: Innovations in Measurement in the Social Sciences}, year = {1999}, note = {ProCite field 8 : eds.}, pages = {267-90}, publisher = {University of Michigan Press}, organization = {University of Michigan Press}, address = {Ann Arbor, MI}, keywords = {Employment and Labor Force, Expectations, Pensions}, author = {Michael D Hurd}, editor = {James P Smith and Robert J. Willis} } @article {6660, title = {Multiple roles and well-being among midlife women: testing role strain and role enhancement theories.}, journal = {J Gerontol B Psychol Sci Soc Sci}, volume = {54}, year = {1999}, month = {1999 Nov}, pages = {S329-38}, publisher = {54B}, abstract = {

OBJECTIVE: Research on women{\textquoteright}s multiple roles frequently adopts one of two perspectives: role strain, which argues that assuming multiple roles is detrimental to mental well-being, or role enhancement, which argues that engaging in multiple roles enhances mental well-being. We argue that the relationship between role occupancy and well-being is manifested through multiple dimensions of role experiences. We investigate the association between depressive symptomatology and various dimensions of the roles of wife, mother, paid worker, and informal caregiver to aging parents.

METHODS: Data are from the 1992 wave of the Health and Retirement Study. Depressive symptomatology, measured by a subset of the CES-D scale, is the dependent variable. To assess the robustness of findings relative to different functional forms of the dependent variable, we estimate multiple regression, log-linear regression, and multinomial logit models. Independent variables include demographic characteristics, measures of role occupancy, role demands, and role satisfaction.

RESULTS: Although the number of roles women assume affects their reports of depressive symptoms, once the demand and satisfaction associated with these roles is controlled, number has no effect; that is, the effect of the number of roles is indirect.

DISCUSSION: Our results highlight the importance of women{\textquoteright}s perceptions of the quality of their roles in relation to their overall well-being. Future investigations of women{\textquoteright}s multiple roles should examine how roles may provide rewards, impose constraints, or generate conflict, as well as the extent to which the willingness to assume multiple roles and the reported levels of role satisfaction and mental well-being may be jointly endogenous.

}, keywords = {Caregivers, depression, Employment, Female, Humans, Marriage, Middle Aged, Personal Satisfaction, Psychological Theory, Role, Women{\textquoteright}s Health}, issn = {1079-5014}, doi = {10.1093/geronb/54b.6.s329}, url = {https://pubmed.ncbi.nlm.nih.gov/10625968/}, author = {Reid, Jennifer and Melissa A. Hardy} } @article {5395, title = {Panel Attrition Bias in Health-Event Models}, year = {1999}, institution = {University of Michigan Institute for Social Resear}, keywords = {Methodology}, author = {Daniel H. Hill} } @article {9101, title = {Perspectives on the household saving rate}, number = {1}, year = {1999}, pages = {181-224}, institution = {The Brookings Institution}, address = {Washington, DC}, abstract = {IN SEPTEMBER AND OCTOBER 1998, the personal saving rate as measured in the national income and product accounts (NIPAs) dipped below zero for the first time since the Great Depression. For the entire year, personal saving totaled just 0.5 percent of personal disposable income, the lowest rate since 1933. And in the advance estimate for the first quarter of 1999, the personal saving rate fell to {\textendash}0.5 percent. These results are just the latest steps in the decline of the NIPA personal saving rate, which, after averaging 7.6 percent in the 1960s, 8.2 percent in the 1970s, 6.7 percent in the 1980s, and 4.8 percent in 1990{\textendash}94, fell to 3.0 percent in 1996 and 2.2 percent in 1997. Although both academic publications and the popular press have repeatedly warned of a saving crisis over the last twenty years, the virtual disappearance of personal saving since 1998 has brought the issue back into the limelight.}, keywords = {Restricted data, Retirement Planning and Satisfaction, Saving}, url = {https://www.brookings.edu/bpea-articles/perspectives-on-the-household-saving-rate/}, author = {William G. Gale and Sabelhaus, J. and Hall, R. E.} } @article {6649, title = {Prevalence and severity of urinary incontinence in older African American and Caucasian women.}, journal = {J Gerontol A Biol Sci Med Sci}, volume = {54}, year = {1999}, month = {1999 Jun}, pages = {M299-303}, publisher = {54A}, abstract = {

BACKGROUND: Few studies have investigated the prevalence and severity of urinary incontinence in older African American women. Comparisons of findings with those for older Caucasian women could provide important clues to the etiology of urinary incontinence and be used in planning screening programs and treatment services.

METHODS: Data are from the first wave of the Asset and Health Dynamics Among the Oldest Old (AHEAD) study. A nationally representative sample of noninstitutionalized adults 70 years of age and older was interviewed. African Americans were oversampled to ensure that there would be enough minority respondents to compare findings across racial groups.

RESULTS: A statistically significant relationship was found between race and urinary incontinence in the previous year: 23.02\% of the Caucasian women reported incontinence, compared with 16.17\% of the African American women. Other factors that appear to increase the likelihood of incontinence include education, age, functional impairment, sensory impairment, stroke, body mass, and reporting by a proxy. Race was not related to the severity (as measured by frequency) of urine loss among incontinent older women.

CONCLUSION: This study identifies or confirms important risk factors for self-reported urinary incontinence in a national context, and suggests factors leading to protection from incontinence. Race is found to relate to incontinence, with older African American women reporting a lower prevalence.

}, keywords = {Aged, Aged, 80 and over, Black or African American, Female, Humans, Prevalence, Risk Factors, United States, Urinary incontinence, White People}, issn = {1079-5006}, doi = {10.1093/gerona/54.6.m299}, author = {Fultz, Nancy H. and A. Regula Herzog and Trivellore E. Raghunathan and Robert B Wallace and Diokno, A.C.} } @article {6653, title = {Prudence, Risk Aversion, and the Demand for Life Insurance}, journal = {Applied Economics Letters}, volume = {6}, year = {1999}, pages = {239-242}, publisher = {Vol. 6}, abstract = {Prudence is the idea of taking precautionary measures when one encounters a situation of risk, whereas risk aversion is a dislike and avoidance of risk. The goal of this article is to create a ratio of prudence to risk aversion. This was done by using survey data from Wave 1 (1992) of the Health and Retirement Study and applying it to a model of the expected utility of life insurance. It is found that as people near retirement the amount of coverage they receive by insurers decreases. Households that have term insurance on the head of the household tend to have greater risk aversion then those households that do not have such insurance.}, keywords = {Insurance, Risk Taking}, doi = {10.1080/135048599353429}, author = {Eisenhauer, Joseph G. and Halek, Martin} } @article {6640, title = {Racial differences in education, obesity, and health in later life.}, journal = {Ann N Y Acad Sci}, volume = {896}, year = {1999}, month = {1999}, pages = {370-2}, publisher = {896}, keywords = {Age Distribution, Aged, Arthritis, Black or African American, Diabetes Mellitus, Educational Status, Female, Health Status, Health Surveys, Humans, Logistic Models, Male, Obesity, Prevalence, Social Class, United States, White People}, issn = {0077-8923}, doi = {10.1111/j.1749-6632.1999.tb08144.x}, author = {Christine L Himes} } @article {6647, title = {A revised CES-D measure of depressive symptoms and a DSM-based measure of major depressive episodes in the elderly.}, journal = {Int Psychogeriatr}, volume = {11}, year = {1999}, month = {1999 Jun}, pages = {139-48}, publisher = {11}, abstract = {

This study examines the psychometric properties of two new abbreviated versions of standard measures of depression, a revised eight-item Center for Epidemiological Studies-Depression Scale (CES-D) and a short-form Composite International Diagnostic Interview (short-form CIDI). A sample of 6,133 elders, age 70 years or older, completed both measures as part of the Asset and Health Dynamics Study of the Oldest Old. The revised CES-D had an internal consistency and factor structure comparable to that of prior versions of the CES-D. The sources of discordance between the two measures were examined and the two measures were compared on self-report of four clinical variables: medical illness, physician diagnosis, psychiatric treatment, and antidepressant or tranquilizer use. Both measures were associated with self-report of physician diagnosis and psychiatric treatment. Respondents positive for depression on the CES-D reported higher rates of antidepressant use. Respondents positive on the short-form CIDI only did not report more antidepressant use than nondepressed respondents.

}, keywords = {Aged, Antidepressive Agents, depression, Depressive Disorder, Major, Diagnosis, Differential, Female, Humans, Male, Prospective Studies, Psychiatric Status Rating Scales, Psychometrics, Severity of Illness Index, Surveys and Questionnaires}, issn = {1041-6102}, doi = {10.1017/s1041610299005694}, url = {https://pubmed.ncbi.nlm.nih.gov/11475428/}, author = {Carolyn L. Turvey and Robert B Wallace and A. Regula Herzog} } @article {6664, title = {Scale Simplification of Expectations for Survival: Cognitive Ability and the Quality of Survey Responses}, journal = {Cognitive Technology}, volume = {4}, year = {1999}, pages = {29-38}, publisher = {4}, abstract = {This paper examines how data quality (specifically data that uses response scales designed to measure event probability) is affected by the cognitive ability of respondents and whether or not respondents provide a simplification process. Cognitive ability does have an affect on how respondents answer survey questions that use a high number of response options. Evidence of satisficing and providing simplification responses does show up in respondents with lower cognitive abilities, but the bunching phenomenon (due to satisficing) appears to have only limited effects on the data quality. Regardless of this limited effect, the results suggest ways of improving the quality of survey questions that use many response options. Better data quality will result when questioning leads respondents with higher cognitive abilities to maximize the number of response options while leading lower able respondents to deal with a reduced set of response options. The unfolded bracket technique is an example of such a method.}, keywords = {Expectations, Health Conditions and Status, Methodology}, author = {Robert F. Belli and A. Regula Herzog and Van Hoewyk, John} } @article {5392, title = {Self-employment and Wealth Disparities between Black and White Households Approaching Retirement}, year = {1999}, institution = {The Pennsylvania State University, Population Research Institute WP 99-17}, abstract = {This article examines the role that self-employment and wage/salary employment play in determining racial disparities in wealth among persons approaching retirement. Findings indicate that black households exclusively linked to the labor market via selfemployment are the worst prepared financially for retirement. White self-employed households also suffer from a lack of liquid assets, although they have accumulated the most wealth when housing equity and real assets are taken into consideration. Inheritances do not constitute the principal basis of the wealth advantages they enjoy but do reinforce wealth inequality. The results suggest that choice in terms of retirement timing and labor supply decisions is much more a characteristic of white self-employed persons than of their black counterparts. Self-employed blacks will also heavily depend on Social Security during retirement and on the pension wealth of a wage/salary spouse, if married.}, keywords = {Demographics, Employment and Labor Force}, author = {Daeumer, Roland and Mark D Hayward} } @article {6659, title = {The Transfer of Resources from Middle-Aged Children to Functionally Limited Elderly Parents: Providing Time, Giving Money, Sharing Space}, journal = {The Gerontologist}, volume = {39}, year = {1999}, pages = {648-657}, publisher = {39}, abstract = {This article investigates the interdependence among all three major modes of trasfer (giving time, money, and sharing space), given the parents{\textquoteright} specific needs for resources and the children{\textquoteright}s ability to provide them. While only reported in 17 of the households, the provision of caregiving time is the primary mode of resource transfer from children to their parents. When the other modes of transfers are added, money and space, the percentage of households transfering resources to their parents rose to 29 . It is significant to consider all modes of transfer in order to understand how families accomodate the needs of elderly/disabeled parents. These transfer modes appear to be dependent upon the needs and situations of the parents as well as the types of resources available to the household that is giving.}, keywords = {Adult children, Employment and Labor Force, Health Conditions and Status, Net Worth and Assets}, doi = {10.1093/geront/39.6.648}, author = {Boaz, Rachel F. and Hu, Jason and Ye, Yongjia} } @inbook {5119, title = {Unfolding Bracket Method in the Measurement of Expenditures and Wealth}, booktitle = {Wealth, Work, and Health: Innovations in Measurement in the Social Sciences: Essays in honor of F. Thomas Juster.}, year = {1999}, note = {ProCite field[8]: eds.}, pages = {64-86}, publisher = {University of Michigan Press}, organization = {University of Michigan Press}, address = {Ann Arbor, MI}, keywords = {Consumption and Savings, Methodology, Net Worth and Assets}, url = {https://books.google.com/books?id=lKvp4D1HuH8C\&pg=PA64\&lpg=PA64\&dq=Unfolding+Bracket+Method+in+the+Measurement+of+Expenditures+and+Wealth\&source=bl\&ots=hFIAdSfSt6\&sig=ACfU3U2f2HvZoq6nQLadPt_pPaidMEBcyQ\&hl=en\&sa=X\&ved=2ahUKEwjAruG52p3qAhWIZM0KHTMiBpAQ6AEwA}, author = {Daniel H. Hill}, editor = {James P Smith and Robert J. Willis} } @article {5367, title = {An Analysis of the Choice to Cash-Out, Maintain, or Annuitize Pension Rights at Job Change or Retirement}, year = {1998}, institution = {RAND}, keywords = {Pensions, Retirement Planning and Satisfaction}, url = {https://www.rand.org/content/dam/rand/pubs/drafts/2008/DRU1979.pdf}, author = {Michael D Hurd and Lee A. Lillard and Panis, Constantijn} } @article {5349, title = {Anchoring Effects in the HRS: Experimental and Nonexperimental Evidence}, number = {219}, year = {1998}, note = {ProCite field 8 : RAND Corporation and NBER}, institution = {National Bureau of Economic Research }, address = {Cambridge}, abstract = {The Health and Retirement Study (HRS) and a number of other major household surveys use unfolding brackets to reduce item nonresponse. However, the initial entry point into a bracketing sequence is likely to act as an anchor or point of reference to the respondent. For example, when the initial entry point is high the distribution will be shifted to the right, leading one to believe that holdings of the particular asset are greater than they truly are. This paper analyzes some experimental data on housing value from HRS wave 3 for anchoring effects. The paper also compares the distributions of assets in HRS waves 1 and 2 for evidence about any anchoring effects that may have been caused by changes in the entry points between the waves. Both the experimental data on housing values and the nonexperimental data from HRS waves 1 and 2 on assets show anchoring effects.}, keywords = {Health Conditions and Status, Healthcare, Methodology, Retirement Planning and Satisfaction}, url = {https://www.nber.org/papers/t0219}, author = {Michael D Hurd} } @mastersthesis {6331, title = {The Availability and Utilization of Assistance by Childless Elderly and Elderly Parents: A Comparative Study}, volume = {Master of Arts}, year = {1998}, school = {University of Nebraska}, abstract = {Using data from the Survey of Asset and Health Dynamics Among the Oldest-Old, Wave 1, 1993, the differences between elderly parents and childless elderly in the sources of assistance that are available to them and utilized by them are examined. Parental status is examined for its effect on sources of assistance with activities of daily living (ADLs), instrumental activities of daily living (LADLs), expected sources of future support with ADLs/LADLs, residence in a building or community which provides personal care services and with financial management. The effect is controlled for covariates of marital status, age, sex, and household income using regression models. The examination found that the lack of or presence of children does affect who assists an elderly person. Overall, the childless respondents used more non-family sources of assistance with a broad spectrum of care needs. Implications of the findings are discussed and recommendations for future research are detailed.}, keywords = {Health Conditions and Status, Healthcare}, url = {https://digitalcommons.unomaha.edu/studentwork/2081/}, author = {Hayes, Melanie} } @inbook {5163, title = {Consumption and Saving Balances of the Elderly: Experimental Evidence on Survey Response Bias}, booktitle = {Frontiers in the Economics of Aging}, year = {1998}, note = {ProCite field 8 : ed.}, pages = {353-387}, publisher = {Univ. of Chicago Press}, organization = {Univ. of Chicago Press}, address = {Chicago}, abstract = {A prerequisite for understanding the economic behavior of the elderly, and the impacts of public policy on their health and well-being, is accurate data on key economic variables such as income, consumption, and assets, as well as on expectations regarding future economic and demographic events such as major health costs, disabilities, and death. Standard practice is to elicit such information in economic surveys, relying on respondents{\textquoteright} statements regarding the variables in question. Economists are generally aware that stated responses are noisy. Item nonresponse is a common problem, and carefully done surveys are designed to minimize it. Well-designed analyses of economic survey data are careful about detecting implausible outliers, imputing missing values, and correcting for selection caused by dropping missing observations. Circumstances are recognized that tend to produce systematic biases in response, such as telescoping in recall of past events that arises from the psychophysical perception of time intervals, or overstatement of charitable contributions that arises from the incentive to project a positive self-image. Nevertheless, economic studies are often too sanguine about the reliability of subjects{\textquoteright} statements regarding objective economic data.}, keywords = {Consumption and Savings, Methodology}, url = {https://www.nber.org/chapters/c7306}, author = {Michael D Hurd and Daniel McFadden and Chand, Harish and Gan, Li and Merrill, Angela and Michael Ewing Roberts}, editor = {David A Wise} } @article {5364, title = {The Effects of Bracketing and Anchoring on Measurement in the Health and Retirement Study}, year = {1998}, institution = {University of Michigan, Institute for Social Research}, keywords = {Methodology}, author = {Michael D Hurd and Willard L Rodgers} } @article {5370, title = {The Empirical Validity of the HRS Medical Expenditure Data: A Model to Account for Different Reference Periods}, year = {1998}, institution = {University of Michigan Institute for Social Research}, keywords = {Medicare/Medicaid/Health Insurance, Methodology}, author = {Daniel H. Hill and Mathiowetz, Nancy A.} } @article {5360, title = {Estate Taxes, Life Insurance, and Small Business}, year = {1998}, institution = {Syracuse University}, keywords = {Adult children, Insurance}, author = {Holtz-Eakin, Douglas and John W R Phillips and Rosen, Harvey S.} } @inbook {5121, title = {Household Wealth of the Elderly under Alternative Imputation Procedures}, booktitle = {Inquiries in the economics of aging}, year = {1998}, note = {ProCite field[3]: U CA, Berkeley and NBER; SUNY, Stony Brook, RAND, and NBER; U CA, Berkeley}, pages = {229 -54}, publisher = {University of Chicago Press}, organization = {University of Chicago Press}, address = {Chicago and London}, abstract = {Although many reach retirement with few resources except housing equity and a claim to social security and Medicare, financial wealth, nonetheless, makes an important contribution to the economic status of many of the elderly. Most of our up-to-date information about the wealth of the elderly is based on the Survey of Income and Program Participation (SIPP), which sometimes adds an asset module to its core survey. As in many surveys of assets, the rate of missing data on individual asset items is high, about 30 to 40 percent among those with the asset. This raises the issue of the reliability of SIPP wealth measures because respondents who refuse or are unable to give a value to an asset item may not be representative of the population. Indeed, in the Health and Retirement Survey (HRS) it is clear that asset data are not missing at random. Through the use of bracketing methods, which we will discuss below, the HRS was able to reduce the rate of missing asset data substantially, and the data that were added in this way increased mean wealth in the HRS by about 40 percent (Smith 1995). Furthermore, because the additional data increased the mean so much, they undoubtedly increased measures of wealth inequality. }, keywords = {Consumption and Savings, Demographics, Income, Net Worth and Assets, Retirement Planning and Satisfaction}, url = {https://www.nber.org/chapters/c7088}, author = {Hoynes, Hilary and Michael D Hurd and Chand, Harish}, editor = {David A Wise} } @article {6609, title = {The Impact of Education and Heart Attack on Smoking Cessation Among Middle-aged Adults}, journal = {Journal of Health and Social Behavior}, volume = {39}, year = {1998}, pages = {271-94}, publisher = {39}, abstract = {Considerable evidence supports the premise that higher levels of education lead to enhanced health, including protective health behaviors. This paper focuses on how education affects one health behavior known to lead to enhanced health: the cessation of smoking. In particular, the authors examine the extent to which education influences the decision by middle-aged adults to quit smoking following a heart attack, a potentially life-threatening health event. We first hypothesize that middle-aged adults with more formal education will stop smoking more readily than people with less formal education following the experience of a heart attack. Second, we ask what other factors might underlie and explain that hypothesized effect. Using longitudinal data, the authors track changes in individual smoking behaviors after a heart attack among preretirement-age Americans. We control for documented correlates of smoking and heart attack plus other factors associated with education, heart attack, and smoking that may also influence whether a person quits smoking. In addition to confirming evidence on the education-health association as well as the documented connection between heart attack and smoking cessation, this study provides a surprising twist on those links: Our results show that the move to quit smoking following the experience of a heart attack among middle-aged adults is significantly and dramatically moderated by their level of educational attainment.}, keywords = {Demographics, Health Conditions and Status, Methodology}, author = {Linda A. Wray and A. Regula Herzog and Robert J. Willis and Robert B Wallace} } @article {6600, title = {Married Women{\textquoteright}s Retirement Expectations: Do Pensions and Social Security Matter?}, journal = {American Economic Review}, volume = {88}, year = {1998}, note = {ProCite field 3 : Hunter College and Graduate School, CUNY}, pages = {202-206}, publisher = {88}, keywords = {Methodology, Pensions, Retirement Planning and Satisfaction, Social Security, Women and Minorities}, url = {https://ideas.repec.org/a/aea/aecrev/v88y1998i2p202-06.html}, author = {Honig, Marjorie} } @article {6613, title = {Occupational injuries among older workers with disabilities: a prospective cohort study of the Health and Retirement Survey, 1992 to 1994.}, journal = {Am J Public Health}, volume = {88}, year = {1998}, month = {1998 Nov}, pages = {1691-5}, publisher = {88}, abstract = {

OBJECTIVES: We tested the hypothesis that among older workers, disabilities in general, and hearing and visual impairments in particular, are risk factors for occupational injuries.

METHODS: Using the first 2 interviews of the Health and Retirement Study, a nationally representative survey of Americans aged 51 to 61 years, we conducted a prospective cohort study of 5600 employed nonfarmers.

RESULTS: Testing a logistic regression model developed in a previous cross-sectional study, we found that the following occupations and risk factors were associated with occupational injury as estimated by odds ratios: service personnel, odds ratio = 1.71 (95\% confidence interval = 1.13, 2.57); mechanics and repairers, 3.47 (1.98, 6.10); operators and assemblers, 2.33 (1.51, 3.61); laborers, 3.16 (1.67, 5.98); jobs requiring heavy lifting, 2.05 (1.55, 2.70); self-employment, 0.50 (0.34, 0.73); and self-reported disability, 1.58 (1.14, 2.19). Replacing the general disability variable with specific hearing and visual impairment variables, we found that poor hearing (1.35 [0.95, 1.93]) and poor sight (1.45 [0.94, 2.22]) both had elevated odds ratios.

CONCLUSIONS: Poor sight and poor hearing, as well as work disabilities in general, are associated with occupational injuries among older workers.

}, keywords = {Accidents, Occupational, Age Distribution, Aged, Aged, 80 and over, Analysis of Variance, Cross-Sectional Studies, Disabled Persons, Female, Health Surveys, Humans, Logistic Models, Male, Middle Aged, Odds Ratio, Prospective Studies, Retirement, Risk Factors, United States}, issn = {0090-0036}, doi = {10.2105/ajph.88.11.1691}, url = {https://pubmed.ncbi.nlm.nih.gov/9807538/}, author = {Zwerling, Craig and Nancy L. Sprince and Charles S. Davis and Paul S. Whitten and Robert B Wallace and Steven G Heeringa} } @article {6624, title = {Predictors of Mobility and Basic ADL Difficulty Among Adults Aged 70 Years and Older}, journal = {Journal of Aging and Health}, volume = {10}, year = {1998}, pages = {422-40}, publisher = {10}, abstract = {We use data from the 1993-1995 Assets and Health Dynamics of the Oldest-Old survey to estimate predictors of onset of mobility difficulty, onset of basic activity of daily living (ADL) difficulty, and improvement to no mobility difficulty. Onset of mobility difficulty occurred among 20 of those with no difficulty at baseline (n = 2,857) and was most likely among those 85 years of age or over, women, those with a body-mass index of 30 or over, and those who reported lung disease, arthritis, frequent pain, and poor memory. For those with mobility difficulty at baseline (n = 1,871), improvement occurred among 24 and onset of basic ADL difficulty occurred among 25 . Improvement was more likely among those with difficulty in just one mobility item at baseline, and onset of ADL difficulty was most common among those with difficulty in three or more mobility items at baseline.}, keywords = {Health Conditions and Status}, author = {Daniel O. Clark and Timothy E. Stump and Hui, S.L. and Frederic D Wolinsky} } @inbook {5122, title = {Subjective Survival Curves and Life Cycle Behavior}, booktitle = {Inquiries in the Economics of Aging}, series = {NBER Project Reports}, year = {1998}, note = {ProCite field[3]: SUNY, Stony Brook, RAND, and NBER; U CA, Berkeley and NBER; U CA, BerkeleyProCite field[6]: InProCite field[8]: ed.}, pages = {259 -305}, publisher = {University of Chicago Press}, organization = {University of Chicago Press}, address = {Chicago and London}, keywords = {Consumption and Savings, Event History/Life Cycle, Health Conditions and Status}, author = {Michael D Hurd and Daniel McFadden and Gan, Li}, editor = {David A Wise} } @article {5352, title = {Why There Are Differences in Retirement Income by Race in America}, year = {1998}, institution = {Watson Wyatt Worldwide}, keywords = {Income, Retirement Planning and Satisfaction}, author = {Hill, Tomeka} } @article {6614, title = {Women, marital status, and symptoms of depression in a midlife national sample.}, journal = {J Women Aging}, volume = {10}, year = {1998}, month = {1998}, pages = {41-57}, publisher = {10}, abstract = {

Previous studies of the correlates of depression among women have not generally been based on adequate midlife samples or precision in the specification of marital status categories. The present analysis is designed to address these deficiencies and is based on data from the Health and Retirement Survey-Wave 1 (i.e., respondents 51 to 61 years old). Results indicate that married women are less likely to report symptoms of depression than their unmarried counterparts. The mental health benefits of marriage are greater for men than for women. Moreover, other variables, such as marital satisfaction, self-rated health, and employment status are more powerful predictors of emotional well-being in midlife than marital status per se. The quality of marriage affects depressive symptoms more strongly for women than men.

}, keywords = {Age Factors, Depressive Disorder, Female, Humans, Male, Marital Status, Marriage, Middle Aged, Surveys and Questionnaires}, issn = {0895-2841}, doi = {10.1300/j074v10n01_04}, url = {https://www.ncbi.nlm.nih.gov/pubmed/9870051}, author = {J R Earle and M H Smith and C.T. Harris and Charles F Longino} } @article {8782, title = {Alcohol Consumption and Mortality among Middle-Aged and Elderly U.S. Adults}, journal = {New England Journal of Medicine}, volume = {337}, year = {1997}, month = {Nov-12-1997}, pages = {1705 - 1714}, abstract = {BACKGROUND Alcohol consumption has both adverse and beneficial effects on survival. We examined the balance of these in a large prospective study of mortality among U.S. adults. METHODS Of 490,000 men and women (mean age, 56 years; range, 30 to 104) who reported their alcohol and tobacco use in 1982, 46,000 died during nine years of follow-up. We compared cause-specific death rates and rates of death from all causes across categories of base-line alcohol consumption, adjusting for other risk factors, and related drinking and smoking habits to the cumulative probability of dying between the ages of 35 and 69 years. RESULTS Causes of death associated with drinking were cirrhosis and alcoholism; cancers of the mouth, esophagus, pharynx, larynx, and liver combined; breast cancer in women; and injuries and other external causes in men. The mortality from breast cancer was 30 percent higher among women reporting at least one drink daily than among nondrinkers (relative risk, 1.3; 95 percent confidence interval, 1.1 to 1.6). The rates of death from all cardiovascular diseases were 30 to 40 percent lower among men (relative risk, 0.7; 95 percent confidence interval, 0.7 to 0.8) and women (relative risk, 0.6; 95 percent confidence interval, 0.6 to 0.7) reporting at least one drink daily than among nondrinkers, with little relation to the level of consumption. The overall death rates were lowest among men and women reporting about one drink daily. Mortality from all causes increased with heavier drinking, particularly among adults under age 60 with lower risk of cardiovascular disease. Alcohol consumption was associated with a small reduction in the overall risk of death in middle age (ages 35 to 69), whereas smoking approximately doubled this risk. CONCLUSIONS In this middle-aged and elderly population, moderate alcohol consumption slightly reduced overall mortality. The benefit depended in part on age and background cardiovascular risk and was far smaller than the large increase in risk produced by tobacco. }, keywords = {Alcohol Consumption, Health Conditions and Status, Mortality, Older Adults, Smoking}, issn = {0028-4793}, doi = {10.1056/NEJM199712113372401}, author = {Michael J Thun and Peto, Richard and Lopez, Alan D. and Monaco, Jane H. and Henley, S. Jane and Heath, Clark W. and Doll, Richard} } @article {6573, title = {Asset and Health Dynamics Among the Oldest Old: An overview of the AHEAD Study}, journal = {The Journals of Gerontology, Series B: Psychological Sciences and Social Sciences}, volume = {52B}, year = {1997}, pages = {1-20}, publisher = {52B}, abstract = {This article contains background information on the study of Asset and Health Dynamics Among the Oldest Old (AHEAD), a prospective panel survey of persons born in 1923 or earlier who were residing in the community at the time of the 1993 baseline. Interviews were sought with both spouses in married households, and an overall total of 8,222 were completed. We review the interdisciplinary scientific issues that motivated the study, describe the fundamental design decisions that structured AHEAD, and summarize the content in the core and experimental modules. The study provides unusually detailed data on cognition, family structure and transfers, and assets. Data are presented on sample selections, response rates, and oversamples of minority groups. Basic descriptive data on the demographic, health, and socioeconomic attributes of respondents also are presented. Plans for future waves of AHEAD are described, including a next-of-kin interview for decreased respondents.}, keywords = {Adult children, Demographics, Health Conditions and Status, Healthcare, Income, Methodology, Net Worth and Assets}, author = {Beth J Soldo and Michael D Hurd and Willard L Rodgers and Robert B Wallace} } @article {6587, title = {Expectations of nursing home use in the Health and Retirement Study: the role of gender, health, and family characteristics.}, journal = {J Gerontol B Psychol Sci Soc Sci}, volume = {52}, year = {1997}, month = {1997 Sep}, pages = {S240-51}, publisher = {52B}, abstract = {

Economic models of life cycle behavior suggest that expectations about future events may affect savings, insurance, and retirement planning. This article uses data from the first wave of the Health and Retirement Survey (HRS) to examine how personal characteristics and health conditions influence expectations of nursing home use. Subjective expectations of nursing home use are quite close to known probabilities of lifetime use. There are marked differences in the determinants of expectations for women and men that also conform to actual behavior. There is strong evidence that women and men incorporate what is known about nursing home risk into their own expectations, even many years prior to the time when they are most likely to need long-term care.

}, keywords = {Aged, Black or African American, Female, Humans, Male, Middle Aged, Nursing homes, Patient Satisfaction, Retirement, Sex Characteristics, White People}, issn = {1079-5014}, doi = {10.1093/geronb/52b.5.s240}, url = {https://www.ncbi.nlm.nih.gov/pubmed/9310096}, author = {Karen C. Holden and Timothy D McBride and Maria Perozek} } @inbook {5161, title = {The Impact of Demographics on Housing and Nonhousing Wealth in the United States}, booktitle = {The Economic Effects of Aging in the United States and Japan}, year = {1997}, note = {ProCite field 8 : eds.}, pages = {153-194}, publisher = {University of Chicago Press}, organization = {University of Chicago Press}, address = {Chicago, IL}, keywords = {Demographics, Housing, Net Worth and Assets}, author = {Daniel McFadden and Hoynes, Hilary}, editor = {Naohiro Yashiro and Michael D Hurd} } @article {6597, title = {Imputation of Multivariate Data on Household Net Worth}, journal = {Proceedings of the American Statistical Association}, volume = {Section on Survey Research Methods}, year = {1997}, pages = {135-140}, publisher = {Section on Survey Research Methods}, abstract = {This paper analyzes the various methods involved in the imputation of multivariate data. The paper investigates methods of imputing amounts for bracketed net worth variables; empirically compares the distributional properties of data imputed by the alternative methods; and estimates the imputation variance that each method adds to the completed data set.}, keywords = {Methodology, Net Worth and Assets}, url = {http://www.asasrms.org/Proceedings/papers/1997_020.pdf}, author = {Steven G Heeringa and Roderick J.A. Little and Trivellore E. Raghunathan} } @article {6584, title = {Measures of cognitive functioning in the AHEAD Study.}, journal = {J Gerontol B Psychol Sci Soc Sci}, volume = {52 Spec No}, year = {1997}, month = {1997 May}, pages = {37-48}, publisher = {52B}, abstract = {

Decline in cognitive functioning and onset of cognitive impairment are potentially important predictors of elderly persons needing informal assistance and formal health care. This article describes the measures of cognitive functioning that were developed for the Asset and Health Dynamics Among the Oldest Old (AHEAD) study of some 6,500 Americans aged 70 years and older. The study was designed to investigate the impact of health on disbursement of family and economic resources. Evaluation of the cognitive measures in terms of psychometric properties and missing data, telephone administration, and formation of an aggregate index is encouraging. Their construct validity is evidenced by their correlations with sociodemographic characteristics and health indicators that replicate existing findings as well as by their prediction of IADL and ADL functioning that are consistent with theory.

}, keywords = {Aged, Aged, 80 and over, Cognition, Geriatric Assessment, Health Status, Health Surveys, Humans, Longitudinal Studies, Memory, Mental Status Schedule, Psychological Tests, Socioeconomic factors, United States}, issn = {1079-5014}, doi = {10.1093/geronb/52b.special_issue.37}, url = {https://www.ncbi.nlm.nih.gov/pubmed/9215356}, author = {A. Regula Herzog and Robert B Wallace} } @article {6588, title = {Medical insurance and the use of health care services by the elderly.}, journal = {J Health Econ}, volume = {16}, year = {1997}, month = {1997 Apr}, pages = {129-54}, publisher = {16}, abstract = {

The objective of this paper is to find how health insurance influences the use of health care services by the elderly. On the basis of the first wave of the Asset and Health Dynamics Survey, we find that those who are the most heavily insured use the most health care services. Because our data show little relationship between observable health measures and either the propensity to hold or to purchase private insurance, we interpret this as an effect of the incentives embodied in the insurance, rather than as the result of adverse selection in the purchase of insurance.

}, keywords = {Activities of Daily Living, Aged, Health Care Surveys, Health Services for the Aged, Health Status Indicators, Hospitalization, Humans, Insurance, Health, Medicare, Office Visits, Patient Acceptance of Health Care, Private Sector, Probability, United States}, issn = {0167-6296}, doi = {10.1016/s0167-6296(96)00515-2}, url = {https://www.ncbi.nlm.nih.gov/pubmed/10169091}, author = {Michael D Hurd and Kathleen McGarry} } @article {6591, title = {Question Difficulty and Respondents{\textquoteright} Cognitive Ability: The Impact on Data Quality}, journal = {Journal of Official Statistics}, volume = {13}, year = {1997}, pages = {181-199}, publisher = {13}, abstract = {Older respondents lower in cognitive ability are more affected by question difficulty than older respondents higher in cognitive ability. Respondents lower in cognitive ability gave more DK responses to difficult than to easy questions, while the differences between the difficult and easy questions were not as apparent for respondents with higher cognitive abilities. This effect may result in biased survey findings because responses to difficult questions from respondents with lower cognitive ability would be underrepresented.}, keywords = {Health Conditions and Status, Medicare/Medicaid/Health Insurance, Methodology}, url = {https://www.psc.isr.umich.edu/pubs/abs/1046}, author = {Barbel Knauper and Robert F. Belli and Daniel H. Hill and A. Regula Herzog} } @article {6579, title = {Selection of Children to Provide Care: The effect of earlier parental transfers}, journal = {The Journals of Gerontology, Series B: Psychological Sciences and Social Sciences}, volume = {52B}, year = {1997}, publisher = {52B}, abstract = {We use the first wave of data from the Asset and Health Dynamics Among the Oldest Old (AHEAD) study to examine the effects of past parent-to-child financial transfers on selection of a child to provide assistance with basic personal care for unmarried parents. We estimate a fixed-effects conditional logit model and find a positive and significant association between past financial transfers and a child{\textquoteright}s current helping behavior. The coefficient of past financial transfers is in the direction hypothesized, and its magnitude is 80 as large as that of gender, a well-documented powerful predictor of parental caregiving. There appears to be substantial evidence that earlier parent-to-child financial gifts play a role in determining which child in the family will provide assistance.}, keywords = {Adult children, Demographics, Health Conditions and Status, Healthcare, Income, Methodology, Other}, author = {John C Henretta and Martha S. Hill and Li, Wei and Beth J Soldo and Douglas A. Wolf} } @article {5327, title = {401(k) Pension plans: Many take advantage of opportunity to ensure adequate retirement income}, year = {1996}, institution = {United States General Accounting Office}, abstract = {This paper provides an in-depth look into 401(k) pension plans. Almost half of all workers and nearly two-thirds of workers nearing retirement age are covered by a pension plan. One in four workers who have pension coverage participates in a 401(k) pension plan. Male, white, highly educated, and higher-income workers are more likely to have pension coverage than are other workers. On average, workers covered by a 401(k) plan contribute 7 of their salary to their account; 80 also receive a matching contribution from their employer, averaging about 5 of their salary. Workers with higher income, college education, defined benefit plan coverage, or a spouse with pension coverage tend to contribute a higher proportion of their of their salary to their 401(k) pension account. About 25 of 401(k) participants invest their 401(k) funds in conservative investments, such as bonds; another 25 invest primarily in stocks; and the rest split their investments between stocks and bonds. Women are more likely to invest in bonds while highly educated workers and higher-income workers are more likely to invest in stocks.}, keywords = {Employment and Labor Force, Income, Net Worth and Assets, Pensions}, url = {http://www.gao.gov}, author = {Hungerford, Thomas L.} } @article {6553, title = {Alcohol and Occupational Injuries among Older Workers}, journal = {Accident Analysis and Prevention}, volume = {28}, year = {1996}, pages = {371-6.}, publisher = {28}, keywords = {Demographics, Employment and Labor Force, Health Conditions and Status, Methodology, Risk Taking}, author = {Zwerling, Craig and Nancy L. Sprince and Robert B Wallace and Charles S. Davis and Paul S. Whitten and Steven G Heeringa} } @article {5322, title = {Changes Over Time in Subjective Retirement Probabilities}, year = {1996}, institution = {University of Michigan}, abstract = {Reliable forecasts of future retirement patterns are of obvious importance in formulating public policy. The predictive value of workers{\textquoteright} expectations regarding retirement depends, however, on whether expectations are reliable indicators of future retirement, conditional on the information available at the time that expectations are formed. Using workers{\textquoteright} responses in the U.S. Health and Retirement Survey about the chances of working after age 62, this paper provides some tentative answers to two important questions regarding retirement expectations: Does there appear to be a high random component to expectations regarding future retirement and, if not, does the same behavioral model that generates retirement realizations seem to generate retirement expectations as well? Findings on changes in reported expectations between Waves 1 and 2 of the HRS suggest that expectations may well provide useful information about future retirement.}, keywords = {Expectations, Retirement Planning and Satisfaction}, url = {http://www.psc.isr.umich.edu/pubs/series.html hr}, author = {Honig, Marjorie} } @article {6546, title = {Complex marital histories and economic well-being: the continuing legacy of divorce and widowhood as the HRS cohort approaches retirement.}, journal = {Gerontologist}, volume = {36}, year = {1996}, month = {1996 Jun}, pages = {383-90}, publisher = {36}, abstract = {

We use data from the first wave of the Health and Retirement Survey (HRS) to examine the marital histories of this cohort of women and men on the verge of retirement. The legacy of past increases in divorce rates is evident in the complex marital histories of HRS households and the relationship between those histories and current economic status. Couples in a first marriage now make up only one-quarter of black households and fewer than half of all white and Hispanic households. In over one-third of all married-couple households, at least one spouse had a previous marriage that ended in divorce or widowhood. These couples have significantly lower incomes and assets than couples in first marriages. Contrary to the popular notion that private and public insurance better provide for the security of widows than divorced persons, currently widowed households and couples in which the prior marriage of one spouse had ended in widowhood are no better off than are their divorced peers. This holds true for both black and white households. From a single cross-section, one cannot tell what caused these differences in income and wealth across marital status groups although it is clear that women and blacks spend a higher percentage of their lifetime outside of marriage than do men and whites. We also speculate from estimates of widowhood expectations for a subset of married respondents that underestimating the chances of widowhood--because both men and women overestimate their chances of joint survival--may be a factor in the relatively low economic status of widows. Because couples in life-long marriages have been the traditional standard upon which marital property reform and the survivorship rules of private and public programs are based, their diminishing importance among all households raises concern about the protection provided by these institutions against the long-term economic consequences of past and future marital dissolution.

}, keywords = {Cross-Sectional Studies, Divorce, Female, Humans, Life Tables, Male, Middle Aged, Poverty, Retirement, United States, Widowhood}, issn = {0016-9013}, doi = {10.1093/geront/36.3.383}, author = {Karen C. Holden and Kuo, H.H.} } @article {5320, title = {Family Structure and Intergenerational Transfers: A Comparison of 55-63 Year Olds in the U.S. and Britain}, year = {1996}, institution = {University of Michigan}, abstract = {This study uses data from wave two of the HRS (1994/95) and the broadly comparable British Retirement and Retirement Plans Survey (1988) to compare two middle generation cohorts in order to examine the impact of differing demographic histories on the potential demographic and expectation {\textquoteright}burdens{\textquoteright} experienced by those in late middle-age. There are a number of reasons for supposing that the family responsibilities of those in their late fifties may vary between the US and Britain. In the cohorts under consideration achieved fertility was higher in the US. Moreover, much higher proportions of young adults attend college in the US and state support is much lower than in Britain. As a result adult children may remain economically dependent for longer in the US and this, combined with fertility differences, places a higher burden on adults in later mid life. An added factor of importance is that more of the US respondents will have experienced marital disruption, making the ratio of supported to dependants possibly even less favourable. In addition, Americans in later middle age may more often have responsibilities for their own ageing parents than their British peers as the life expectancy of individuals over 65 is higher in the US than in Britain. The study{\textquoteright}s findings show that middle generation adults in the US have more surviving children than in Britain and that a higher proportion of parents of middle generation individuals are alive in the US than in Britain. Although differences in question wording between the two surveys are substantial and therefore caution must be exercised in the interpretation of results, as expected a higher proportion of American respondents provide financial assistance to children, whereas it appears that British respondents are more likely to provide time transfers to children than their American counterparts. With respect to the older generation, British respondents also appear more likely to provide assistance to their parents and are more likely to coreside with an elderly parent when compared to the Americans. Thus it is important not only to look at demographic factors, but it also becomes necessary to examine the expectation burden, that is differences in policy and attitudes that affect time transfers to parents/children, and the financial assistance required by adult children and elderly parents.}, keywords = {Adult children}, url = {http://www.psc.isr.umich.edu/pubs/series.html hr}, author = {Glaser, Karen and Emily M D Grundy and John C Henretta and Murphy, Michael J.} } @article {5325, title = {The Florida AHEAD Respondents: Characteristics of Florida{\textquoteright}s Elderly Population Aged Seventy and Over}, year = {1996}, institution = {University of Michigan}, abstract = {This paper uses the first wave of data from the Asset and HEAlth Dynamics (AHEAD) Among the Oldest Old survey to compare the characteristics of the Florida oversample to the U.S. elderly population aged seventy and older. The goal of the AHEAD survey is to understand the interrelationship among changes and transitions in three major domains health, income and assets, and family transfers. Based on interviews of 8,223 respondents (1,088 Florida, 7,134 non-Florida), our comparison of Florida and non-Florida elderly indicates: Florida elderly are generally healthier, less impaired, and have greater financial resources than non-Florida elderly. Particularly among the unmarried, Floridians have lower levels of physical and cognitive impairment and higher income and asset levels. Floridians expect to live longer and to give an inheritance, and not to need nursing care or receive financial help in the future. Impaired Floridians are more likely to be married and equally likely to receive some help in dealing with impairment. That help is more likely to come from a spouse rather than a child. Even among the impaired, Floridians have greater assets than non-Floridians. The finding that unmarried Floridians are healthier and have more financial resources may suggest that the combination of widowhood, depletion of assets, absence of nearby children, and impairment triggers migration of elderly out of Florida or institutionalization. By following the migration patterns of respondents over time, future waves of AHEAD will provide the panel data needed to discern how important return migration and institutionalization are in shaping the characteristics of the Florida elderly population.}, keywords = {Demographics}, url = {http://www.psc.isr.umich.edu/pubs/series.html hr}, author = {Berry, Brent M. and John C Henretta} } @article {6549, title = {The health-wealth connection: racial differences.}, journal = {Gerontologist}, volume = {36}, year = {1996}, month = {1996 Jun}, pages = {342-9}, publisher = {36}, abstract = {

This article examines the theoretical connection between health capital and financial capital in an economic life-cycle model, exploring possible explanations for racial differences in capital accumulation behavior. Using data from the Health and Retirement Survey, detailed descriptive analysis and a comparison of regression models for health and financial capital are presented. The results, although preliminary and based on cross-section data, suggest possible racial differences in the connection between health and wealth and deserve further study.

}, keywords = {Black or African American, Cross-Sectional Studies, Female, Health Status, Humans, Income, Male, Middle Aged, Models, Theoretical, Regression Analysis, United States, White People}, issn = {0016-9013}, doi = {10.1093/geront/36.3.342}, author = {Dennis G. Shea and Toni Miles and Mark D Hayward} } @inbook {5135, title = {Income and Wealth of Older American Households: Modeling Issues for Public Policy Analysis}, booktitle = {Assessing Knowledge of Retirement Behavior}, year = {1996}, note = {ProCite field 6 : In ProCite field 8 : eds.}, pages = {11-60}, publisher = {National Academy Press}, organization = {National Academy Press}, address = {Washington, DC}, abstract = {This paper evaluates the extent to which current knowledge of retirement, savings, pension and related behavior is sufficient for determining the effects of major policy initiatives on the incomes and wealth of the aged population of the United States. Data are presented from two new surveys, the Health and Retirement Study and the Asset and Health Dynamics Among the Oldest Old Survey, describing the distributions of the major components of income and wealth to be explained by these behavioral models. The data suggest that the amount of wealth had by the older population has been severely understated in earlier surveys. Disagreements and inconsistencies in models of savings indicate that there is no agreed upon behavioral model upon which to base policy analysis. Similar problems characterize the pension literature. Most strikingly, central features of these three major branches of behavioral analysis are mutually inconsistent. Although there are important linkages among the behaviors determining retirement, savings and pension outcomes, research in each area ignores or misspecifies the related behavior from other areas. Consequently, significant advances are required before we can confidently predict the effects of contemplated changes in policies on income and wealth in retirement.}, keywords = {Consumption and Savings, Pensions, Retirement Planning and Satisfaction}, author = {Alan L Gustman and Juster, F. Thomas}, editor = {Eric A. Hanushek and Nancy L. Maritato} } @article {6547, title = {Retirement expectations: differences by race, ethnicity, and gender.}, journal = {Gerontologist}, volume = {36}, year = {1996}, month = {1996 Jun}, pages = {373-82}, publisher = {36}, abstract = {

Analyses by race and ethnicity of several important dimensions of labor market behavior have been constrained in the past by limited samples of the African American and Hispanic populations. This article uses data from the first wave of the Health and Retirement Survey, which oversamples these populations, to compare the retirement plans of African American, Hispanic, and white married men and women. Findings suggest that retirement expectations may accurately forecast retirement behavior and that the differences by race and ethnicity, as well as by gender, that are evident in retirement plans are likely to be reflected in retirement outcomes.

}, keywords = {ethnicity, Female, Health Knowledge, Attitudes, Practice, Humans, Male, Middle Aged, Models, Theoretical, Pensions, Retirement, Sex Factors, Social Security, United States}, issn = {0016-9013}, doi = {10.1093/geront/36.3.373}, author = {Honig, Marjorie} } @article {6552, title = {Risk factors for occupational injuries among older workers: an analysis of the health and retirement study.}, journal = {Am J Public Health}, volume = {86}, year = {1996}, month = {1996 Sep}, pages = {1306-9}, publisher = {86}, abstract = {

OBJECTIVES: This study examined risk factors for occupational injury among older workers.

METHODS: We analyzed data on 6854 employed nonfarmers from the Health and Retirement Study (HRS), a population-based sample of Americans 51 through 61 years old.

RESULTS: Occupational injuries were associated with the following: the occupations of mechanics and repairers (odds ratio [OR] = 2.27), service personnel (OR = 1.68), and laborers (OR = 2.18); jobs requiring heavy lifting (OR = 2.75); workers{\textquoteright} impaired hearing (OR = 1.60) and impaired vision (OR = 1.53); and jobs requiring good vision (OR = 1.43). Self-employment was associated with fewer injuries (OR = 0.47).

CONCLUSIONS: These results emphasize the importance of a good match between job demands and worker capabilities.

}, keywords = {Accidents, Occupational, Cross-Sectional Studies, Educational Status, Female, Health Status, Humans, Male, Middle Aged, Occupational Diseases, Regression Analysis, Retirement, Risk Factors, Sex Factors, United States, Wounds and Injuries}, issn = {0090-0036}, doi = {10.2105/ajph.86.9.1306}, author = {Zwerling, Craig and Nancy L. Sprince and Robert B Wallace and Charles S. Davis and Paul S. Whitten and Steven G Heeringa} } @article {6534, title = {Effect of recall period on the reporting of occupational injuries among older workers in the Health and Retirement Study.}, journal = {Am J Ind Med}, volume = {28}, year = {1995}, month = {1995 Nov}, pages = {583-90}, publisher = {28}, abstract = {

Studies of injury morbidity often rely on self-reported survey data. In designing these surveys, researchers must chose between a shorter recall period to minimize recall bias and a longer period to maximize the precision of rate estimates. Using data from the Health and Retirement Study, which employed a recall period of 1 year, we examined the effect of the recall period on rates of occupational injuries among older workers as well as upon rate ratios of these injuries for nine risk factors. We fit a stochastic model to the occupational injury rates as a function of time before the interview and used this model to estimate what the injury rates would have been had we used a 4-week recall period. The adjusted occupational injury rate of 5.9 injuries per 100 workers per year was 36\% higher than the rate based on a 1-year recall period. Adjustment for recall period had much less effect on rate ratios, which typically varied by < 10\%. Our work suggests that self-reported surveys with longer recall periods may be used to estimate occupational injury rates and also may be useful in studying the associations between occupational injuries and a variety of risk factors.

}, keywords = {Accidents, Occupational, Adult, Aged, Bias, Cross-Sectional Studies, Data collection, Female, Humans, Incidence, Linear Models, Male, Mental Recall, Middle Aged, Models, Statistical, Reproducibility of Results, Retirement, Risk Factors, Time Factors, United States}, issn = {0271-3586}, doi = {10.1002/ajim.4700280503}, author = {Zwerling, Craig and Nancy L. Sprince and Robert B Wallace and Charles S. Davis and Paul S. Whitten and Steven G Heeringa} } @article {6527, title = {Evaluation of the Subjective Probabilities of Survival in the Health and Retirement Study}, journal = {Journal of Human Resources}, volume = {30}, year = {1995}, note = {ProCite field 3 : SUNY and NBER; UCLA and NBER}, pages = {S268-92}, publisher = {30}, abstract = {In the Health and Retirement Study respondents were asked about the chances they would live to 75 or to 85. We analyze these responses to determine if they behave like probabilities of survival, if their averages are close to average probabilities in the population, and if they have correlations with other variables that are similar to correlations with actual mortality outcomes. We find that generally they do behave like probabilities and that they do aggregate to population probabilities. most remarkable, however, is that they covary with other variables in the same way actual outcomes vary with the variables. For example, respondents with higher socioeconomic status give higher probabilities of survival, whereas respondents who smoke give lower probabilities. We conclude that these measures of subjective probabilities have great potential use in models of intertemporal decision-making under uncertainty.}, keywords = {Consumption and Savings, Disabilities, Health Conditions and Status}, doi = {10.2307/146285}, author = {Michael D Hurd and Kathleen McGarry} } @article {6530, title = {Family Structure and Transfer Measures in the Health and Retirement Study: Background and Overview}, journal = {Journal of Human Resources}, volume = {30}, year = {1995}, note = {ProCite field 3 : Georgetown U; Institute for Social Research, U MI}, pages = {S108-37}, publisher = {30}, abstract = {This paper describes the rationale for and the measures of family structure and inter-vivos giving in the Health and Retirement Study (HRS). Of particular interest to the HRS is the extent to which transfers affect the labor supply of donors, especially women. Because all children and parents are individually profiled, HRS data can be used to examine the joint allocation of space, time, and money among competing kin. Data on siblings of respondents with living parents provide further opportunities to consider how adult children distribute the burden of parent care among themselves. Using the baseline HRS, we describe the quality of data on kin attributes and the correlations among family structures, transfers, and work.}, keywords = {Adult children, Demographics, Net Worth and Assets}, doi = {10.2307/146280}, author = {Beth J Soldo and Martha S. Hill} } @article {6538, title = {Occupational Injuries Among Agricultural Workers 51 to 61 Years Old: A National Study}, journal = {Journal of Agricultural Safety and Health}, volume = {1}, year = {1995}, pages = {273-281}, publisher = {1}, abstract = {This paper examines risk factors for occupational injuries among agricultural workers and compares them with the risk factors for injury among other older workers. The findings suggest that the risks for occupational injuries among agricultural workers differ from those that affect workers in all other occupations. While heavy lifting and poor eye sight were risk factors for both agricultural and other workers, self-employment- - which acted as a protective factor for other workers- - proved to be a risk factor for agricultural workers. Other variables - depressive symptoms and dissatisfaction with marriage, job, family life, the way problems are handled, and life overall - tended to be more strongly associated with occupational injuries in agricultural workers than among other workers.}, keywords = {Demographics, Employment and Labor Force, Health Conditions and Status, Net Worth and Assets}, doi = {10.13031/2013.19469}, url = {https://elibrary.asabe.org/abstract.asp?search=1\&JID=3\&AID=19469\&CID=j1995\&v=1\&i=4\&T=1\&urlRedirect=[anywhere=\&keyword=\&abstract=\&title=on\&author=\&references=\&docnumber=\&journals=All\&searchstring=Occupational\%20Injuries\%20among\%20Agricultural\%20Workers\&pg=}, author = {Zwerling, Craig and Nancy L. Sprince and Robert B Wallace and Charles S. Davis and Paul S. Whitten and Steven G Heeringa} } @article {6536, title = {Overview of the Health Measures in the Health and Retirement Survey}, journal = {The Journal of Human Resources}, volume = {30}, year = {1995}, pages = {S84-S107}, publisher = {30}, abstract = {This report discusses the conceptual and logistical issues that lead to the items and instruments used to measure health and function status in Wave 1 of the Health and Retirement Study (HRS). Health status was conceptualized as multidimensional, and included selected major symptoms, diseases and conditions, global self-assessment of health, physical and cognitive functional status, the utilization of health services and selected elements of emotional health. In addition, two physiologic measures were obtained on a sample basis: grip strength and pulmonary maximum expiratory flow rate. Prevalence rates for major conditions and functional states are presented. Correlational analyses generally demonstrated a high rate of convergent, discriminant and construct validity. These findings should assist those intending to analyze HRS data in terms of the focus and utility of the measures employed.}, keywords = {Consumption and Savings, Health Conditions and Status, Healthcare, Methodology}, author = {Robert B Wallace and A. Regula Herzog} } @article {5312, title = {Prevalence and Incidence of Health Problems in the First Two Waves of the Health and Retirement Study}, year = {1995}, keywords = {Health Conditions and Status}, author = {Eileen M. Crimmins and Mark D Hayward and Linda A. Wray and Lu, Ranyan} } @article {5311, title = {Technical Description of the Asset and Health Dynamics Among the Oldest Old (AHEAD) Study Sample Design}, year = {1995}, institution = {Institute for Social Research, University of Michigan}, address = {Ann Arbor, Michigan}, abstract = {Describes the sample design, sampling procedures, and sample outcomes for Wave 1 of the Study of Aging and Health Dynamics (AHEAD). The document is divided into eight sections. The introduction describes the purpose and organization of the AHEAD study. Sections 2, 3, and 4 provide an overview and a detailed description of the AHEAD dual-frame probability sample design. The fifth and sixth sections describe the AHEAD Wave 1 sample control procedures and sample outcomes. Sections 7 and 8 contain descriptions of the construction and use of the analysis weights and the codes and procedures for computation of sampling errors for the AHEAD Wave 1 data.}, keywords = {Methodology}, author = {Steven G Heeringa} } @article {5310, title = {Technical Description of the Health and Retirement Study Sample Design}, year = {1995}, institution = {Institute for Social Research, University of Michigan}, address = {Ann Arbor, Michigan}, abstract = {This technical memorandum describes the sample design, sampling procedures, and sample outcomes for Wave 1 of the Health and Retirement Study (HRS). This document is divided into six sections. The introduction describes the purpose and organization of the HRS. Sections 2 and 3 provide an overview and a detailed description of the multi-stage area probability sample design. The fourth section reports the HRS Wave 1 sample outcomes -- a comparison of the expected versus observed occupancy, eligibility, and response rates. Sections 5 and 6 contain descriptions of the construction and use of the analysis weights and the codes and procedures for computation of sampling errors for the HRS data.}, keywords = {Methodology}, author = {Steven G Heeringa and Connor, Judith} } @article {5313, title = {Unfolding Brackets for Reducing Item Non-Response in Economic Surveys}, year = {1995}, institution = {University of Michigan}, abstract = {This paper describes and analyzes a new survey methodology for reducing item non-response on financial measures. This unfolding bracket method is systematic and applicable in both face-to-face and telephone surveys. The proportion of missing observations for financial variables in national surveys is often in the 20-25 range and in some cases is as high as a third. With the unfolding bracket method the proportion of completely missing data can be cut by two-thirds. Furthermore, with appropriately chosen bracket breakpoints, the amount of the variance in the underlying measure recovered is quite high. We propose and demonstrate one method for choosing the breakpoints which employs the Downhill Simplex algorithm to maximize their exploratory value. Additionally, use of a Box-Cox transform of the actual data in conjunction with this algorithm, can result in breakpoints which are effective in explaining most of the underlying variance in both actual values and their log transforms. Since each of these metrics is appropriate for some uses this compromise is quite useful in meeting the needs of a wide variety of potential users. Finally, we investigate the effects of bracketing on the empirical validity of survey data. While we do find lower empirical validity for data from individuals exposed to brackets early in the survey instrument, this appears to be the result of self-selection rather than a direct effect of exposure to the methodology.}, keywords = {Methodology}, url = {http://www.psc.isr.umich.edu/pubs/series.html}, author = {Steven G Heeringa and Daniel H. Hill and Howell, David A.} } @article {10985, title = {Unfolding brackets for reducing item nonresponse in economic surveys}, year = {1995}, institution = {Survey Research Center, Institute for Social Research, University of Michigan}, address = {Ann Arbor, MI}, abstract = {This paper describes and analyzes a new survey methodology for reducing item non-response on financial measures. This "unfolding bracket" method is systematic and applicable in both face-to-face and telephone surveys. The proportion of missing observations for financial variables in national surveys is often in the 20-25\% range and in some cases is as high as a third, With the unfolding bracket method the proportion of completely missing data can be cut by two-thirds. Furthermore, with appropriately chosen bracket breakpoints, the amount of the variance in the underlying measure recovered is quite high. We propose and demonstrate on method for choosing the breakpoints which employs the Downhill Simplex algorithm to maximize their explanatory value. Additionally, use of a Box-Cox transform of the actual data in conjunction with this algorithm, can result in breakpoints which are effective in explaining most of the underlying variance in both actual values and their log transforms. Since each of these metrics is appropriate for some uses this compromise is quite useful in meeting the needs of a wide variety of potential users. Finally, we investigate the effect of bracketing on the empirical validity of survey data. While we do find lower empirical validity for data from individuals exposed to brackets early in the survey instrument, this appears to be the result of self-selection rather than a direct effect of exposure to the methodology. }, keywords = {economic survey, item nonreponse, Missing data}, author = {Steven G Heeringa and Daniel H. Hill and Howell, David A.} } @article {10497, title = {Unfolding Brackets for Reducing Item Nonresponse in Economic Surveys}, year = {1995}, abstract = {This paper describes and analyzes a new survey methodology for reducing item non-response on financial measures. This unfolding bracket method is systematic and applicable in both face-to-face and telephone surveys. The proportion of missing observations for financial variables in national surveys is often in the 20-25 range and in some cases is as high as a third. With the unfolding bracket method the proportion of completely missing data can be cut by two-thirds. Furthermore, with appropriately chosen bracket breakpoints, the amount of the variance in the underlying measure recovered is quite high. We propose and demonstrate one method for choosing the breakpoints which employs the Downhill Simplex algorithm to maximize their exploratory value. Additionally, use of a Box-Cox transform of the actual data in conjunction with this algorithm, can result in breakpoints which are effective in explaining most of the underlying variance in both actual values and their log transforms. Since each of these metrics is appropriate for some uses this compromise is quite useful in meeting the needs of a wide variety of potential users. Finally, we investigate the effects of bracketing on the empirical validity of survey data. While we do find lower empirical validity for data from individuals exposed to brackets early in the survey instrument, this appears to be the result of self-selection rather than a direct effect of exposure to the methodology.}, keywords = {Methodology}, author = {Steven G Heeringa}, editor = {Daniel H. Hill} } @article {5305, title = {The Impact of Demographics on Housing and Non-Housing Wealth in the United States}, number = {4666}, year = {1994}, note = {ProCite field 8 : U CA, Berkeley and NBER; U CA, Berkeley and NBER}, institution = {The National Bureau of Economic Research}, address = {Cambridge}, abstract = {Equity in housing is a major component of household wealth in the United States. Steady gains in housing prices over the last several decades have generated large potential gains in household wealth among homeowners. Mankiw and Weil (1989) and McFadden (1993b) have argued that the aging of the U.S. population is likely to induce substantial declines in housing prices, resulting in capital losses for future elderly generations. However, if households can anticipate changes in housing prices, and if they adjust their non-housing savings accordingly, then welfare losses in retirement could be mitigated. This paper focuses on two questions: (1) Are housing prices forecastable from current information on demographics and housing prices?; and (2) How are household savings decisions affected by capital gains in housing? We use metropolitan statistical area (MSA) level data on housing prices and demographic trends during the 1980{\textquoteright}s and find mixed evidence on the forecastability of housing prices. Further, we use data on five-year savings rates from the Panel Study of Income Dynamics and find no evidence that households engage in changing their non-housing savings in response to expectations about capital gains in housing. Thus, the projected decline in housing prices could result in large welfare losses to current homeowners and large intergenerational equity differences.}, keywords = {Adult children, Consumption and Savings, Demographics, Net Worth and Assets, Public Policy}, url = {https://www.nber.org/papers/w4666}, author = {Hoynes, Hilary and Daniel McFadden} } @article {5295, title = {Evaluation of Subjective Probability Distributions in the HRS}, year = {1993}, note = {ProCite field 8 : SUNY-Stony Brook and NBER; UCLA and NBER}, institution = {National Bureau of Economic Research}, abstract = {In the Health and Retirement Survey respondents were asked about the chances they would live to 75 or to 85, and the chances they would work after age 62 or 65. We analyze the responses to determine if they behave like probabilities, if their averages are close to average probabilities in the population, and if they have correlations with other variables that are similar to correlations with actual outcomes. We find that generally they do behave like probabilities and they do aggregate. Most remarkable, however, is that they covary with other variables in the same way actual outcomes vary with the variables. For example, smokers give lower probabilities of living to 75 than nonsmokers. We conclude that these measures of subjective probabilities have great potential use in models of intertemporal decision making under uncertainty.}, keywords = {Consumption and Savings, Health Conditions and Status, Methodology}, doi = {10.3386/w4560}, url = {https://www.nber.org/papers/w4560}, author = {Michael D Hurd and Kathleen McGarry} } @article {5299, title = {Intergenerational Transfers and Labor Supply: Preliminary Evidence from the HRS}, year = {1993}, institution = {University of Michigan}, abstract = {The HRS data permit more expansive examination of ties between market work and family than heretofore possible. This research focuses on inter-vivos transfers to adult children and how they relate to the labor supply of middle-age married women. The data show a notable and complex association in which the direction of the association varies by type of transfer. The results of our reduced-form, bivariate TOBIT analysis also indicate that the value of correlations between labor supply and transfers imputed for the underlying latent variables tend to be twice the value of the simple correlations. Overall results of the analysis are supportive of the theoretical framework we develop that depicts unanticipated luck and orientation toward giving as important forces in transfers to children.}, keywords = {Adult children, Employment and Labor Force}, url = {http://www.psc.isr.umich.edu/pubs/series.html}, author = {Martha S. Hill and Beth J Soldo and Li, Wei} } @inbook {5157, title = {Intergenerational Transfers: Economic, Demographic, and Social Perspectives}, booktitle = {Annual Review of Gerontology and Geriatrics: Focus on Kinship, Aging, and Social Change}, volume = {Vol. 13}, year = {1993}, note = {ProCite field 8 : eds.}, pages = {187-216}, publisher = {Springer Publishing Company}, organization = {Springer Publishing Company}, address = {New York}, abstract = {Intergenerational transfers can be studied from an economic, social gerontological, or social-psychological perspective. This chapter describes a variety of the social science theories and reviews related empirical research relevant to the major types of intergenerational transfers: a) flows of assistance from parents to children and grandchildren, b) flows of assistance from middle-aged children to elderly parents, c) coresidence of parents and children. While there seems to be remarkable consensus about the factors affecting the probability of exchange, because the various disciplines have focused on different aspects of exchange behavior at different points in the life cycle, the evidence in support of competing theories is not consistent. The chapter then focuses on the upcoming availability of the HRS and AHEAD studies as potentially providing the data necessary to capturing all of the relevant dimensions of transfer behaviors that have been missing for all disciplines.}, keywords = {Adult children, Healthcare, Methodology}, author = {Beth J Soldo and Martha S. Hill}, editor = {Maddox, George L. and Lawton, M. Powell} } @article {5296, title = {The Relationship Between Job Characteristics and Retirement}, year = {1993}, note = {ProCite field 8 : SUNY-Stony Brook and NBER; UCLA and National Bureau of Econ}, institution = {National Bureau of Economic Research}, abstract = {We study the influence of job characteristics on prospective retirement as measured by the probability of working past age 62 or 65. The characteristics fall into three broad classes: physical and mental requirements, job flexibility including employer accommodation to older workers, and financial aspects such as pensions and health care insurance. Using data from the Health and Retirement Survey, we find that physical and mental job requirements have a rather small influence on prospective retirement, whereas measures of job flexibility and financial aspects of the job are important determinants.}, keywords = {Consumption and Savings, Employment and Labor Force, Pensions, Time Use}, doi = {10.3386/w4558}, url = {https://www.nber.org/papers/w4558}, author = {Michael D Hurd and Kathleen McGarry} } @article {5301, title = {The Relationship Between Occupational Characteristics and Cognitive Performance in Adulthood}, year = {1993}, institution = {University of Michigan}, abstract = {The predictive relationships among individual in occupational characteristics and cognitive performance were examined. A sample of 4,039 men and women aged 25 to 78 years completed immediate and delayed word recall tasks and a reasoning measure. Hierarchical regression was used to predict performance on these tasks from occupational characteristic measures. Results indicated that occupational characteristics related to physical demands, cognitive demands, stressfulness, and repetitiousness predicted significant portions of variance in immediate recall, delayed recall, and reasoning, independent of the potentially confounding variables of age, education, gender, race, length of tenure, and health status.}, keywords = {Employment and Labor Force, Health Conditions and Status}, url = {http://www.psc.isr.umich.edu/pubs/series.html}, author = {Brent J. Small and Hultsch, David} } @article {5297, title = {Respondent Rules and the Quality of Net Worth Data in the HRS}, year = {1993}, institution = {University of Michigan}, abstract = {The HRS uses an informed selection procedure in choosing with spouse to ask about the household{\textquoteright}s assets and debts. This is more expensive than presumptive selection which has been commonly employed in past surveys. This paper evaluates the quality of the resulting net worth data in terms of the exactness of the reports. A trivariate ordered probit model is developed and estimated. This model controls for the self-selectivity of both the gender and proxy interview status of the net-worth respondent. The results suggest that the informed selection procedure does indeed result in lower item non-response and less reliance on approximation strategies than would a presumptive husband R1 respondent rule.}, keywords = {Methodology, Net Worth and Assets}, url = {http://www.psc.isr.umich.edu/pubs/series.html}, author = {Daniel H. Hill} } @article {5298, title = {The Subjective Probabilities of Retirement of White, Black, and Hispanic Married Women}, year = {1993}, institution = {University of Michigan}, abstract = {Analyses by race and ethnicity of several important dimensions of labor market behavior have been constrained in the past by limited samples of black and especially of Hispanic populations in nationally representative data sets. This paper uses a partial sample from the new Health and Retirement Survey, and provides the first comparative picture of the current labor force status, accumulated labor force experience, and pension and health insurance coverage of pre-retirement non-Hispanic white, non-Hispanic black, and Hispanic married women, as well as the first insights into the factors influencing retirement decisions of black and Hispanic married women. A model of the subjective probability that married women currently working full-time will continue to work full-time after age 62 is estimated for each population. The analysis focuses on the extent to which married women, in forming retirement expectations, take account of their own economic opportunities as well as factors related to the value of their time to the family. The results provide evidence that important aspects of current compensation such as health and disability insurance, as well as expected deferred compensation in the form of pension and Social Security benefits, are significant determinants of the likelihood of continued work for each of the three populations.}, keywords = {Expectations, Retirement Planning and Satisfaction, Women and Minorities}, url = {http://www.psc.isr.umich.edu/pubs/series.html}, author = {Honig, Marjorie} } @article {13587, title = {State-level desegregation in the U.S. South and mid-life cognitive function among Black and White adults.}, journal = {Social Science \& Medicine (1983)}, volume = {338}, pages = {116319}, abstract = {

RATIONALE: Black adults experience worse cognitive function than their White peers. Although educational attainment is an important predictor of cognitive function, other aspects of education, including school desegregation, may also shape this relationship. For Black adults who grew up in the U.S. South in the 1950s-1970s, exposure to school desegregation may have altered life course pathways critical for later cognitive function.

OBJECTIVE: We determined if state variation in exposure to school desegregation in the U.S. South was associated with cognitive function at mid-life, if the association varied by race, and if the association remained after adjustment for state-level education quality and respondents{\textquoteright} educational attainment.

METHODS: We linked historical data on state-level school desegregation to the Health and Retirement Study, a nationally representative sample of U.S. adults aged 50 and older. We restricted our sample to Black (n~=~1443) and White (n~=~1507) adults born between 1948 and 1963 who resided in the U.S. South during primary school. We assessed three cognition outcomes: total cognitive function, episodic memory, and mental status. We estimated race-stratified linear regression models with cluster adjustment and a final model using state fixed effects.

RESULTS: Greater exposure to desegregated primary schooling was associated with higher cognitive function and episodic memory among Black but not White adults. Among Black adults, the association between school desegregation and cognitive function and episodic memory remained after adjustment for state-level education quality and educational attainment.

CONCLUSIONS: Our findings suggest that state-level school desegregation efforts played a consequential role in shaping the cognitive function of Black adults who grew up in the U.S. South.

}, keywords = {Education, historical data, life course, school segregation}, issn = {1873-5347}, doi = {10.1016/j.socscimed.2023.116319}, author = {Walsemann, Katrina M and Hair, Nicole L and Farina, Mateo P and Tyagi, Pallavi and Jackson, Heide and Jennifer A Ailshire} }