@article {11186, title = {The Association Between Cancer and Spousal Rate of Memory Decline: A Negative Control Study to Evaluate (Unmeasured) Social Confounding of the Cancer-memory Relationship.}, journal = {Alzheimer Disease \& Associated Disorders}, volume = {35}, year = {2021}, pages = {271-274}, abstract = {

Cancer diagnoses are associated with better long-term memory in older adults, possibly reflecting a range of social confounders that increase cancer risk but improve memory. We used spouse{\textquoteright}s memory as a negative control outcome to evaluate this possible confounding, since spouses share social characteristics and environments, and individuals{\textquoteright} cancers are unlikely to cause better memory among their spouses. We estimated the association of an individual{\textquoteright}s incident cancer diagnosis (exposure) with their own (primary outcome) and their spouse{\textquoteright}s (negative control outcome) memory decline in 3601 couples from 1998 to 2014 in the Health and Retirement Study, using linear mixed-effects models. Incident cancer predicted better long-term memory for the diagnosed individual. We observed no association between an individual{\textquoteright}s cancer diagnosis and rate of spousal memory decline. This negative control study suggests that the inverse association between incident cancer and rate of memory decline is unlikely to be attributable to social/behavioral factors shared between spouses.

}, keywords = {Cancer, Cognition, Spouses}, issn = {1546-4156}, doi = {10.1097/WAD.0000000000000398}, author = {Ospina-Romero, Monica and Willa D Brenowitz and M. Maria Glymour and Elizabeth R Mayeda and Graff, Rebecca E and Witte, John S and Ackley, Sarah F and Lu, Kun Ping and Lindsay C Kobayashi} } @article {11720, title = {Proof of concept example for use of simulation to allow data pooling despite privacy restrictions.}, journal = {Epidemiology}, volume = {32}, year = {2021}, pages = {638-647}, abstract = {

BACKGROUND: Integrating results from multiple samples is often desirable, but privacy restrictions may preclude full data pooling, and most datasets do not include fully harmonized variable sets. We propose a simulation-based method leveraging partial information across datasets to guide creation of synthetic data, based on explicit assumptions about the underlying causal structure, that permits pooled analyses that adjust for all desired confounders in the context of privacy restrictions.

METHODS: This proof-of-concept project uses data from the Health and Retirement Study (HRS) and Atherosclerosis Risk in Communities (ARIC) study. We specified an estimand of interest and a directed acyclic graph (DAG) summarizing the presumed causal structure for the effect of glycated hemoglobin (HbA1c) on cognitive change. We derived publicly reportable statistics to describe the joint distribution of each variable in our DAG. These summary estimates were used as data-generating rules to create synthetic datasets. After pooling, we imputed missing covariates in the synthetic datasets and used the synthetic data to estimate the pooled effect of HbA1c on cognitive change, adjusting for all desired covariates.

RESULTS: Distributions of covariates, as well as model coefficients and associated standard errors for our model estimating the effect of HbA1c on cognitive change were similar across cohort-specific original and pre-imputation synthetic data. The estimate from the pooled synthetic incorporates control for confounders measured in either original dataset.

DISCUSSION: Our approach has advantages over meta-analysis or individual-level pooling/data harmonization when privacy concerns preclude data sharing and key confounders are not uniformly measured across datasets.

}, keywords = {data pooling, Methodology, privacy restrictions}, issn = {1531-5487}, doi = {10.1097/EDE.0000000000001373}, author = {Teresa Filshtein and Li, Xiang and Zimmerman, Scott C and Ackley, Sarah F and M. Maria Glymour and Melinda C Power} } @article {9337, title = {Alzheimer{\textquoteright}s disease genetic risk variants beyond APOE ε4 predict mortality}, journal = {Alzheimer{\textquoteright}s \& Dementia: Diagnosis, Assessment \& Disease Monitoring}, volume = {8}, year = {2017}, pages = {188-195}, abstract = {We hypothesized that, like apolipoprotein E (APOE), other late-onset Alzheimer{\textquoteright}s disease (LOAD) genetic susceptibility loci predict mortality. Methods We used a weighted genetic risk score (GRS) from 21 non-APOE LOAD risk variants to predict survival in the Adult Changes in Thought and the Health and Retirement Studies. We meta-analyzed hazard ratios and examined models adjusted for cognitive performance or limited to participants with dementia. For replication, we assessed the GRS-longevity association in the Cohorts for Heart and Aging Research in Genomic Epidemiology, comparing cases surviving to age >=90 years with controls who died between ages 55 and 80 years. Results Higher GRS predicted mortality (hazard ratio = 1.05; 95\% confidence interval: 1.00{\textendash}1.10, P =.04). After adjusting for cognitive performance or restricting to participants with dementia, the relationship was attenuated and no longer significant. In case-control analysis, the GRS was associated with reduced longevity (odds ratio = 0.64; 95\% confidence interval: 0.41{\textendash}1.00, P =.05). Discussion Non-APOE LOAD susceptibility loci confer risk for mortality, likely through effects on dementia incidence.}, keywords = {Alzheimer{\textquoteright}s disease, APoE4, Cognitive Ability, Genetics, Mortality, Risk Factors}, issn = {23528729}, doi = {10.1016/j.dadm.2017.07.002}, url = {http://linkinghub.elsevier.com/retrieve/pii/S2352872917300416http://api.elsevier.com/content/article/PII:S2352872917300416?httpAccept=text/xmlhttp://api.elsevier.com/content/article/PII:S2352872917300416?httpAccept=text/plain}, author = {Mez, Jesse and Jessica R Marden and Mukherjee, Shubhabrata and Stefan Walter and Laura E Gibbons and Alden L Gross and Laura B Zahodne and Paola Gilsanz and Brewster, Paul and Nho, Kwangsik and Paul K Crane and Eric B Larson and M. Maria Glymour} } @article {9002, title = {Physical activity, but not body mass index, predicts less disability before and after stroke.}, journal = {Neurology}, volume = {88}, year = {2017}, month = {05/2017}, pages = {1718-1726}, abstract = {

OBJECTIVE: To determine whether physical activity and body mass index (BMI) predict instrumental or basic activities of daily living (I/ADL) trajectories before or after stroke compared to individuals who remained stroke-free.

METHODS: Using a prospective cohort, the Health and Retirement Study, we followed adults without a history of stroke in 1998 (n = 18,117) for up to 14 years. We estimated linear regression models of I/ADL trajectories comparing individuals who remained stroke-free throughout follow-up (n = 16,264), those who survived stroke (n = 1,374), and those who died after stroke and before the next interview wave (n = 479). We evaluated whether I/ADL trajectories differed by physical activity or BMI at baseline (before stroke), adjusting for demographic and socioeconomic covariates.

RESULTS: Compared to those who were physically active, stroke survivors who were physically inactive at baseline had a lower probability of independence in ADLs and IADLs 3 years after stroke (risk difference = -0.18 and -0.16 for ADLs and IADLs, respectively). However, a similar difference in the probability of independence was also present 3 years before stroke, and we observed no evidence that physical activity slowed the rate of decline in independence before or after stroke. Unlike the results for physical activity, we did not observe a consistent pattern for the probability of independence in ADLs or IADLs comparing obese stroke survivors to normal-weight or to overweight stroke survivors 3 years before stroke or 3 years after stroke.

CONCLUSIONS: Physical inactivity predicts a higher risk of being dependent both before and after stroke.

}, keywords = {BMI, Disabilities, Older Adults, Physical activity, Stroke}, issn = {1526-632X}, doi = {10.1212/WNL.0000000000003888}, author = {Pamela M. Rist and Benjamin D Capistrant and Elizabeth R Mayeda and Sze Y Liu and M. Maria Glymour} } @article {8512, title = {Association of a Genetic Risk Score With Body Mass Index Across Different Birth Cohorts.}, journal = {JAMA}, volume = {316}, year = {2016}, month = {2016 Jul 05}, pages = {63-9}, chapter = {63}, abstract = {

IMPORTANCE: Many genetic variants are associated with body mass index (BMI). Associations may have changed with the 20th century obesity epidemic and may differ for black vs white individuals.

OBJECTIVE: Using birth cohort as an indicator for exposure to obesogenic environment, to evaluate whether genetic predisposition to higher BMI has a larger magnitude of association among adults from more recent birth cohorts, who were exposed to the obesity epidemic at younger ages.

DESIGN, SETTING, AND PARTICIPANTS: Observational study of 8788 adults in the US national Health and Retirement Study who were aged 50 years and older, born between 1900 and 1958, with as many as 12 BMI assessments from 1992 to 2014.

EXPOSURES: A multilocus genetic risk score for BMI (GRS-BMI), calculated as the weighted sum of alleles of 29 single nucleotide polymorphisms associated with BMI, with weights equal to the published per-allele effects. The GRS-BMI represents how much each person{\textquoteright}s BMI is expected to differ, based on genetic background (with respect to these 29 loci), from the BMI of a sample member with median genetic risk. The median-centered GRS-BMI ranged from -1.68 to 2.01.

MAIN OUTCOMES AND MEASURES: BMI based on self-reported height and weight.

RESULTS: GRS-BMI was significantly associated with BMI among white participants (n = 7482; mean age at first assessment, 59 years; 3373 [45\%] were men; P <.001) and among black participants (n = 1306; mean age at first assessment, 57 years; 505 [39\%] were men; P <.001) but accounted for 0.99\% of variation in BMI among white participants and 1.37\% among black participants. In multilevel models accounting for age, the magnitude of associations of GRS-BMI with BMI were larger for more recent birth cohorts. For example, among white participants, each unit higher GRS-BMI was associated with a difference in BMI of 1.37 (95\% CI, 0.93 to 1.80) if born after 1943, and 0.17 (95\% CI, -0.55 to 0.89) if born before 1924 (P = .006). For black participants, each unit higher GRS-BMI was associated with a difference in BMI of 3.70 (95\% CI, 2.42 to 4.97) if born after 1943, and 1.44 (95\% CI, -1.40 to 4.29) if born before 1924.

CONCLUSIONS AND RELEVANCE: For participants born between 1900 and 1958, the magnitude of association between BMI and a genetic risk score for BMI was larger among persons born in later cohorts. This suggests that associations of known genetic variants with BMI may be modified by obesogenic environments.

}, keywords = {African Continental Ancestry Group, Age Factors, Aged, Aged, 80 and over, Alleles, Body Mass Index, Cohort Studies, European Continental Ancestry Group, Female, Genetic Predisposition to Disease, Genetic Variation, Genome-Wide Association Study, Humans, Male, Middle Aged, Multilocus Sequence Typing, Obesity, Polymorphism, Single Nucleotide, Risk Factors, United States}, issn = {1538-3598}, doi = {10.1001/jama.2016.8729}, url = {http://www.ncbi.nlm.nih.gov/pubmed/27380344}, author = {Stefan Walter and Mej{\'\i}a-Guevara, Iv{\'a}n and Estrada, Karol and Sze Y Liu and M. Maria Glymour} } @article {6496, title = {Families and Disability Onset: Are Spousal Resources Less Important for Individuals at High Risk of Dementia?}, journal = {The American Journal of Geriatric Psychiatry}, volume = {24}, year = {2016}, pages = {585-594}, chapter = {585}, abstract = {Objective To determine whether social contacts and spousal characteristics predict incident instrumental or basic activities of daily living (I/ADL) limitations and whether effects differ for individuals with high risk of dementia. Design Cohort study. Setting Biennial interviews of Health and Retirement Study participants over up to 12 years. Participants 4,125 participants aged 65 years and older without baseline I/ADL limitations. Measurements Participants{\textquoteright} family characteristics (living arrangements, proximity to children, contacts with friends, marital status, and spouse{\textquoteright}s depression, employment, and education) and dementia probability (high versus low risk of dementia based on direct and proxy cognitive assessments) were characterized at baseline. Family characteristics and their interactions with dementia probability were used to predict incident I/ADL limitations in pooled logistic regressions. Results ADL limitation incidence was higher among the unmarried (odds ratio OR versus married: 1.14; 95 CI: 1.01 1.30); those married to a depressed spouse (OR versus nondepressed spouse: 1.56, 95 CI: 1.21 2.00); or whose spouse had less than high school education (OR versus spouse with high school or more: 1.29, 95 CI: 1.06 1.57). Living with someone other than a spouse compared with living with a spouse predicted higher risk of both incident ADL (OR: 1.35; 95 CI: 1.11 1.65), and IADL (OR: 1.30; 95 CI: 1.06 1.61) limitations. Effects were similar for respondents with high and low dementia probability. Conclusions Regardless of dementia risk, older adults may receive important marriage benefits, which help delay disability. The salience of spouse{\textquoteright}s education and depression status implicate modifiable mechanisms, such as information and instrumental support, which may be amenable to interventions.}, keywords = {Demographics, Disabilities, Health Conditions and Status, Healthcare}, doi = {10.1016/j.jagp.2016.02.003}, url = {http://www.sciencedirect.com/science/article/pii/S1064748116001561}, author = {Pamela M. Rist and Sze Y Liu and M. Maria Glymour} } @article {8342, title = {Instrumental variable approaches to identifying the causal effect of educational attainment on dementia risk.}, journal = {Ann Epidemiol}, volume = {26}, year = {2016}, note = {Times Cited: 0 0}, month = {2016 Jan}, pages = {71-6.e1-3}, publisher = {26}, abstract = {

PURPOSE: Education is an established correlate of cognitive status in older adulthood, but whether expanding educational opportunities would improve cognitive functioning remains unclear given limitations of prior studies for causal inference. Therefore, we conducted instrumental variable (IV) analyses of the association between education and dementia risk, using for the first time in this area, genetic variants as instruments as well as state-level school policies.

METHODS: IV analyses in the Health and Retirement Study cohort (1998-2010) used two sets of instruments: (1) a genetic risk score constructed from three single-nucleotide polymorphisms (SNPs; n = 7981); and (2) compulsory schooling laws (CSLs) and state school characteristics (term length, student teacher ratios, and expenditures; n = 10,955).

RESULTS: Using the genetic risk score as an IV, there was a 1.1\% reduction in dementia risk per year of schooling (95\% confidence interval, -2.4 to 0.02). Leveraging compulsory schooling laws and state school characteristics as IVs, there was a substantially larger protective effect (-9.5\%; 95\% confidence interval, -14.8 to -4.2). Analyses evaluating the plausibility of the IV assumptions indicated estimates derived from analyses relying on CSLs provide the best estimates of the causal effect of education.

CONCLUSIONS: IV analyses suggest education is protective against risk of dementia in older adulthood.

}, keywords = {Aged, Aged, 80 and over, Dementia, Education, Nonprofessional, Educational Status, Female, Genetic Predisposition to Disease, Health Surveys, Humans, Longitudinal Studies, Male, Middle Aged, Polymorphism, Single Nucleotide, Protective factors, Risk Factors, Schools, United States}, issn = {1873-2585}, doi = {10.1016/j.annepidem.2015.10.006}, author = {Thu T Nguyen and Eric J. Tchetgen Tchetgen and Ichiro Kawachi and Stephen E. Gilman and Stefan Walter and Sze Y Liu and Jennifer J Manly and M. Maria Glymour} } @article {8542, title = {Lagged Associations of Metropolitan Statistical Area- and State-Level Income Inequality with Cognitive Function: The Health and Retirement Study.}, journal = {PLoS One}, volume = {11}, year = {2016}, month = {2016}, pages = {e0157327}, abstract = {

PURPOSE: Much variation in individual-level cognitive function in late life remains unexplained, with little exploration of area-level/contextual factors to date. Income inequality is a contextual factor that may plausibly influence cognitive function.

METHODS: In a nationally-representative cohort of older Americans from the Health and Retirement Study, we examined state- and metropolitan statistical area (MSA)-level income inequality as predictors of individual-level cognitive function measured by the 27-point Telephone Interview for Cognitive Status (TICS-m) scale. We modeled latency periods of 8-20 years, and controlled for state-/metropolitan statistical area (MSA)-level and individual-level factors.

RESULTS: Higher MSA-level income inequality predicted lower cognitive function 16-18 years later. Using a 16-year lag, living in a MSA in the highest income inequality quartile predicted a 0.9-point lower TICS-m score (β = -0.86; 95\% CI = -1.41, -0.31), roughly equivalent to the magnitude associated with five years of aging. We observed no associations for state-level income inequality. The findings were robust to sensitivity analyses using propensity score methods.

CONCLUSIONS: Among older Americans, MSA-level income inequality appears to influence cognitive function nearly two decades later. Policies reducing income inequality levels within cities may help address the growing burden of declining cognitive function among older populations within the United States.

}, keywords = {Cities, Cognition, Female, health, Humans, Income, Interviews as Topic, Linear Models, Male, Middle Aged, Multivariate Analysis, Residence Characteristics, Retirement, Socioeconomic factors, Statistics as Topic, Telephone, United States}, issn = {1932-6203}, doi = {10.1371/journal.pone.0157327}, url = {http://dx.doi.org/10.1371/journal.pone.0157327}, author = {Kim, Daniel and Griffin, Beth Ann and Mohammed U Kabeto and Jos{\'e} J Escarce and Kenneth M. Langa and Regina A Shih}, editor = {M. Maria Glymour} } @article {8612, title = {Genetic vulnerability to diabetes and obesity: does education offset the risk?}, journal = {Soc Sci Med}, volume = {127}, year = {2015}, month = {2015 Feb}, pages = {150-8}, abstract = {

The prevalence of type 2 diabetes (T2D) and obesity has recently increased dramatically. These common diseases are likely to arise from the interaction of multiple genetic, socio-demographic and environmental risk factors. While previous research has found genetic risk and education to be strong predictors of these diseases, few studies to date have examined their joint effects. This study investigates whether education modifies the association between genetic background and risk for type 2 diabetes (T2D) and obesity. Using data from non-Hispanic Whites in the Health and Retirement Study (HRS, n~=~8398), we tested whether education modifies genetic risk for obesity and T2D, offsetting genetic effects; whether this effect is larger for individuals who have high risk for other (unobserved) reasons, i.e., at higher quantiles of HbA1c and BMI; and whether effects differ by gender. We measured T2D risk using Hemoglobin A1c (HbA1c) level, and obesity risk using body-mass index (BMI). We constructed separate genetic risk scores (GRS) for obesity and diabetes respectively based on the most current available information on the single nucleotide polymorphism (SNPs) confirmed as genome-wide significant predictors for BMI (29 SNPs) and diabetes risk (39 SNPs). Linear regression models with years of schooling indicate that the effect of genetic risk on HbA1c is smaller among people with more years of schooling and larger among those with less than a high school (HS) degree compared to HS degree-holders. Quantile regression models show that the GRS~{\texttimes}~education effect systematically increased along the HbA1c outcome distribution; for example the GRS~{\texttimes}~years of education interaction coefficient was~-0.01 (95\% CI~=~-0.03, 0.00) at the 10th percentile compared to~-0.03 (95\% CI~=~-0.07, 0.00) at the 90th percentile. These results suggest that education may be an important socioeconomic source of heterogeneity in responses to genetic vulnerability to T2D.

}, keywords = {Aged, Body Mass Index, Diabetes Mellitus, Type 2, Educational Status, European Continental Ancestry Group, Female, Genetic Predisposition to Disease, Genotype, Glycated Hemoglobin A, Health Status Disparities, Humans, Male, Middle Aged, Obesity, Risk Factors, Social determinants of health}, issn = {1873-5347}, doi = {10.1016/j.socscimed.2014.09.009}, url = {http://www.sciencedirect.com/science/article/pii/S0277953614005760}, author = {Sze Y Liu and Stefan Walter and Jessica R Marden and David Rehkopf and Laura D Kubzansky and Thu T Nguyen and M. Maria Glymour} } @article {10640, title = {Genetically predicted body mass index and Alzheimer{\textquoteright}s disease-related phenotypes in three large samples: Mendelian randomization analyses.}, journal = {Alzheimers Dement}, volume = {11}, year = {2015}, month = {2015 Dec}, pages = {1439-1451}, abstract = {

Observational research shows that higher body mass index (BMI) increases Alzheimer{\textquoteright}s disease (AD) risk, but it is unclear whether this association is causal. We applied genetic variants that predict BMI in Mendelian randomization analyses, an approach that is not biased by reverse causation or confounding, to evaluate whether higher BMI increases AD risk. We evaluated individual-level data from the AD Genetics Consortium (ADGC: 10,079 AD cases and 9613 controls), the Health and Retirement Study (HRS: 8403 participants with algorithm-predicted dementia status), and published associations from the Genetic and Environmental Risk for AD consortium (GERAD1: 3177 AD cases and 7277 controls). No evidence from individual single-nucleotide polymorphisms or polygenic scores indicated BMI increased AD risk. Mendelian randomization effect estimates per BMI point (95\% confidence intervals) were as follows: ADGC, odds ratio (OR) = 0.95 (0.90-1.01); HRS, OR = 1.00 (0.75-1.32); GERAD1, OR = 0.96 (0.87-1.07). One subscore (cellular processes not otherwise specified) unexpectedly predicted lower AD risk.

}, keywords = {Aged, Aged, 80 and over, Alzheimer disease, Body Mass Index, Female, Genotype, Humans, Linear Models, Male, Mendelian Randomization Analysis, Obesity, Phenotype, Polymorphism, Single Nucleotide, Risk Factors}, issn = {1552-5279}, doi = {10.1016/j.jalz.2015.05.015}, author = {Mukherjee, Shubhabrata and Stefan Walter and Kauwe, John S K and Andrew J Saykin and David A Bennett and Eric B Larson and Paul K Crane and M. Maria Glymour} } @article {8230, title = {Role of Place in Explaining Racial Heterogeneity in Cognitive Outcomes among Older Adults}, journal = {Journal of the International Neuropsychological Society}, volume = {21}, year = {2015}, note = {Times Cited: 0 Si 0}, pages = {677-687}, publisher = {21}, abstract = {Racially patterned disadvantage in Southern states, especially during the formative years of primary school, may contribute to enduring disparities in adult cognitive outcomes. Drawing on a lifecourse perspective, we examine whether state of school attendance affects cognitive outcomes in older adults and partially contributes to persistent racial disparities. Using data from older African American and white participants in the national Health and Retirement Study (HRS) and the New York based Washington Heights Inwood Cognitive Aging Project (WHICAP), we estimated age-and gender-adjusted multilevel models with random effects for states predicting years of education and cognitive outcomes (e.g., memory and vocabulary). We summarized the proportion of variation in outcomes attributable to state of school attendance and compared the magnitude of racial disparities across states. Among WHICAP African Americans, state of school attendance accounted for 9 of the variance in years of schooling, 6 of memory, and 12 of language. Among HRS African Americans, state of school attendance accounted for 13 of the variance in years of schooling and also contributed to variance in cognitive function (7 ), memory (2 ), and vocabulary (12 ). Random slope models indicated state-level African American and white disparities in every Census region, with the largest racial differences in the South. State of school attendance may contribute to racial disparities in cognitive outcomes among older Americans. Despite tremendous within-state heterogeneity, state of school attendance also accounted for some variability in cognitive outcomes. Racial disparities in older Americans may reflect historical patterns of segregation and differential access to resources such as education.}, keywords = {Health Conditions and Status, Healthcare, Women and Minorities}, doi = {10.1017/s1355617715000806}, author = {Sze Y Liu and M. Maria Glymour and Laura B Zahodne and Weiss, Christopher and Jennifer J Manly} } @article {7995, title = {The disability burden associated with stroke emerges before stroke onset and differentially affects blacks: results from the health and retirement study cohort.}, journal = {J Gerontol A Biol Sci Med Sci}, volume = {69}, year = {2014}, month = {2014 Jul}, pages = {860-70}, publisher = {69}, abstract = {

BACKGROUND: Few longitudinal studies compare changes in instrumental activities of daily living (IADLs) among stroke-free adults to prospectively document IADL changes among adults who experience stroke. We contrast annual declines in IADL independence for older individuals who remain stroke free to those for individuals who experienced stroke. We also assess whether these patterns differ by sex, race, or Southern birthplace.

METHODS: Health and Retirement Study participants who were stroke free in 1998 (n = 17,741) were followed through 2010 (average follow-up = 8.9 years) for self- or proxy-reported stroke. We used logistic regressions to compare annual changes in odds of self-reported independence in six IADLs among those who remained stroke free throughout follow-up (n = 15,888), those who survived a stroke (n = 1,412), and those who had a stroke and did not survive to participate in another interview (n = 442). We present models adjusted for demographic and socioeconomic covariates and also stratified on sex, race, and Southern birthplace.

RESULTS: Compared with similar cohort members who remained stroke free, participants who developed stroke had faster declines in IADL independence and lower probability of IADL independence prior to stroke. After stroke, independence declined at an annual rate similar to those who did not have stroke. The black-white disparity in IADL independence narrowed poststroke.

CONCLUSION: Racial differences in IADL independence are apparent long before stroke onset. Poststroke differences in IADL independence largely reflect prestroke disparities.

}, keywords = {Activities of Daily Living, Aged, Aged, 80 and over, Aging, Black or African American, Cohort Studies, Disabled Persons, Female, Humans, Male, Prospective Studies, Stroke, United States, White People}, issn = {1758-535X}, doi = {10.1093/gerona/glt191}, url = {http://biomedgerontology.oxfordjournals.org/content/early/2014/01/19/gerona.glt191.abstract}, author = {Benjamin D Capistrant and Nicte I Mejia and Sze Y Liu and Qianyi Wang and M. Maria Glymour} } @article {8029, title = {Short- and long-term associations between widowhood and mortality in the United States: longitudinal analyses.}, journal = {J Public Health (Oxf)}, volume = {36}, year = {2014}, month = {2014 Sep}, pages = {382-9}, publisher = {36}, abstract = {

BACKGROUND: Past research shows that spousal death results in elevated mortality risk for the surviving spouse. However, most prior studies have inadequately controlled for socioeconomic status (SES), and it is unclear whether this {\textquoteright}widowhood effect{\textquoteright} persists over time.

METHODS: Health and Retirement Study participants aged 50+ years and married in 1998 (n = 12 316) were followed through 2008 for widowhood status and mortality (2912 deaths). Discrete-time survival analysis was used to compare mortality for the widowed versus the married.

RESULTS: Odds of mortality during the first 3 months post-widowhood were significantly higher than in the continuously married (odds ratio (OR) for men = 1.87, 95\% CI: 1.27, 2.75; OR for women = 1.47, 95\% CI: 0.96, 2.24) in models adjusted for age, gender, race and baseline SES (education, household wealth and household income), behavioral risk factors and co-morbidities. Twelve months following bereavement, men experienced borderline elevated mortality (OR = 1.16, 95\% CI: 1.00, 1.35), whereas women did not (OR = 1.07, 95\% CI: 0.90, 1.28), though the gender difference was non-significant.

CONCLUSION: The {\textquoteright}widowhood effect{\textquoteright} was not fully explained by adjusting for pre-widowhood SES and particularly elevated within the first few months after widowhood. These associations did not differ by sex.

}, keywords = {Bereavement, Female, Humans, Longitudinal Studies, Male, Middle Aged, Mortality, Risk Factors, Sex Factors, Socioeconomic factors, Time Factors, United States, Widowhood}, issn = {1741-3850}, doi = {10.1093/pubmed/fdt101}, url = {http://jpubhealth.oxfordjournals.org/content/early/2013/10/27/pubmed.fdt101.abstract}, author = {J Robin Moon and M. Maria Glymour and Anusha M Vable and Sze Y Liu and S. V. Subramanian} } @article {7814, title = {Stroke-associated differences in rates of activity of daily living loss emerge years before stroke onset.}, journal = {J Am Geriatr Soc}, volume = {61}, year = {2013}, month = {2013 Jun}, pages = {931-938}, publisher = {61}, abstract = {

OBJECTIVES: To compare typical age-related changes in activities of daily living (ADLs) independence in stroke-free adults with long-term ADL trajectories before and after stroke.

DESIGN: Prospective, observational study.

SETTING: Community-dwelling Health and Retirement Study (HRS) cohort.

PARTICIPANTS: HRS participants who were stroke free in 1998 and were followed through 2008 (average follow-up 7.9 years) (N = 18,441).

MEASUREMENTS: Strokes were assessed using self- or proxy-report of a doctor{\textquoteright}s diagnosis and month and year of event. Logistic regression was used to compare within-person changes in odds of self-reported independence in five ADLs in those who remained stroke free throughout follow-up (n = 16,816), those who survived a stroke (n = 1,208), and those who had a stroke and did not survive to participate in another interview (n = 417). Models were adjusted for demographic and socioeconomic covariates.

RESULTS: Even before stroke, those who later developed stroke had significantly lower ADL independence and were experiencing faster independence losses than similar-aged individuals who remained stroke free. Of those who developed a stroke, survivors experienced slower pre-stroke loss of ADL independence than those who died. ADL independence declined at the time of stroke and decline continued afterwards.

CONCLUSION: In adults at risk of stroke, disproportionate ADL limitations emerge well before stroke onset. Excess disability in stroke survivors should not be entirely attributed to effects of acute stroke or quality of acute stroke care. Although there are many possible causal pathways between ADL and stroke, the association may be noncausal. For example, ADL limitations may be a consequence of stroke risk factors (e.g., diabetes mellitus) or early cerebrovascular ischemia.

}, keywords = {Activities of Daily Living, Age of Onset, Aged, Aged, 80 and over, Bayes Theorem, Disability Evaluation, Disabled Persons, Female, Follow-Up Studies, Geriatric Assessment, Humans, Male, Middle Aged, Morbidity, Prospective Studies, Risk Assessment, Risk Factors, Socioeconomic factors, Stroke, Stroke Rehabilitation, Survival Rate, Survivors, Time Factors, United States}, issn = {1532-5415}, doi = {10.1111/jgs.12270}, author = {Benjamin D Capistrant and Qianyi Wang and Sze Y Liu and M. Maria Glymour} } @article {7865, title = {Type of high-school credentials and older age ADL and IADL limitations: is the GED credential equivalent to a diploma?}, journal = {Gerontologist}, volume = {53}, year = {2013}, month = {2013 Apr}, pages = {326-33}, publisher = {53}, abstract = {

PURPOSE: Educational attainment is a robust predictor of disability in elderly Americans: older adults with high-school (HS) diplomas have substantially lower disability than individuals who did not complete HS. General Educational Development (GED) diplomas now comprise almost 20\% of new HS credentials issued annually in the United States but it is unknown whether the apparent health advantages of HS diplomas extend to GED credentials. This study examines whether adults older than 50 years with GEDs have higher odds of incident instrumental or basic activities of daily living (IADLs) limitations compared with HS degree holders.

METHODS: We compared odds of incident IADL limitations by HS credential type using discrete-time survival models among 9,426 Health and Retirement Study participants followed from 1998 through 2008.

RESULTS: HS degree holders had lower odds of incident IADLs than GED holders (OR = 0.72, 95\% CI = 0.58, 0.90 and OR = 0.69, 95\% CI = 0.56, 0.86 for ADLs and IADLs, respectively). There was no significant difference in odds of incident IADL limitations between GED holders and respondents without HS credentials (OR = 0.89, 95\% CI = 0.71, 1.11 for ADLs; OR = 0.88, 95\% CI = 0.70, 1.12 for IADLs).

IMPLICATIONS: Although GEDs are widely accepted as equivalent to high school diplomas, they are not associated with comparable health advantages for physical limitations in older age.

}, keywords = {Activities of Daily Living, Adult, Aged, Aged, 80 and over, Aging, Disabled Persons, Educational Status, Female, Follow-Up Studies, Humans, Kaplan-Meier Estimate, Logistic Models, Male, Socioeconomic factors, United States}, issn = {1758-5341}, doi = {10.1093/geront/gns077}, author = {Sze Y Liu and Chavan, Niraj R. and M. Maria Glymour} } @article {7725, title = {Self-reported and measured hypertension among older US- and foreign-born adults.}, journal = {J Immigr Minor Health}, volume = {14}, year = {2012}, note = {Copyright - Springer Science Business Media, LLC 2012 Language of summary - English Location - United States--US Pages - 721-6 ProQuest ID - 1022672464 Document feature - References SubjectsTermNotLitGenreText - United States--US Last updated - 2012-07-11 Place of publication - New York Corporate institution author - White, Kellee; Avenda o, Mauricio; Capistrant, Benjamin D; Robin Moon, J; Liu, Sze Y; Maria Glymour, M DOI - 2699707771; 70149852; 53471; JIMH; 22109587; SPVLJIMH109031449549}, month = {2012 Aug}, pages = {721-6}, publisher = {14}, abstract = {

Self-reported hypertension is frequently used for health surveillance. However, little is known about the validity of self-reported hypertension among older Americans by nativity status. This study compared self-reported and measured hypertension among older black, white, and Hispanic Americans by nativity using the 2006 and 2008 Health and Retirement Study (n~=~13,451). Sensitivity and specificity of self-reported hypertension were calculated using the Seventh report of the Joint National Committee on Prevention, Detection, Evaluation, and Treatment of High Blood Pressure definition. Sensitivity was high among older blacks (88.9\%), whites (82.8\%), and Hispanics (84.0\%), and both foreign-born (83.2\%) and US-born (84.0\%). Specificity was above 90\% for both US-born and foreign-born, but higher for whites (92.8\%) than blacks (86.0\%). Despite the potential vulnerability of older foreign-born Americans, self-reported hypertension may be considered a reasonable estimate of hypertension status. Future research should confirm these findings in samples with a larger and more ethnically diverse foreign-born population.

}, keywords = {Aged, Black or African American, Blood Pressure Determination, Emigrants and Immigrants, Female, Hispanic or Latino, Humans, Hypertension, Male, Middle Aged, Nutrition Surveys, Reproducibility of Results, Self Report, United States, White People}, issn = {1557-1920}, doi = {10.1007/s10903-011-9549-3}, url = {http://search.proquest.com.proxy.lib.umich.edu/docview/1022672464?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 = {White, Kellee and Mauricio Avendano and Benjamin D Capistrant and J Robin Moon and Sze Y Liu and M. Maria Glymour} }