@article {13449, title = {Short sleep and insomnia are associated with accelerated epigenetic age.}, journal = {Psychosom Med}, year = {Forthcoming}, abstract = {

OBJECTIVE: Short sleep and insomnia are each associated with greater risk for age-related disease, which suggests that insufficient sleep may accelerate biological aging. We examine whether short sleep and insomnia alone or together relate to epigenetic age among older adults.

METHODS: A total of 3,795 men (46.3\%) and women aged 56-100 years from the Health and Retirement Study were included. Insomnia was defined as reporting at least one insomnia symptom (difficulty falling asleep, waking up at night, or waking up too early in the morning) and feeling unrested when waking up most of the time. Those reporting <6 hours of bedtime were categorized as short sleepers. Three second- or third-generation epigenetic age acceleration clocks were derived from the 2016 HRS Venous Blood Study. The linear regression analysis was adjusted for age, sex, race/ethnicity, education, and obesity status.

RESULTS: Insomnia and short sleep were associated with an 0.49 (95\%CI:0.03-0.94; P:0.04) and 1.29 (95\%CI:0.52-2.07; P:0.002) years acceleration of GrimAge, respectively, as well as a faster pace of aging (DunedinPACE; 0.018 (95\%CI:0.004-0.033; P:0.02); 0.022(95\%CI:-0.004-0.048; P:0.11)). Compared to healthy sleepers, individuals with the combination of short sleep and insomnia had an accelerated GrimAge (0.97 years; 95\%CI:0.07-1.87; P:0.04) and a greater DunedinPACE (0.032; 95\%CI:0.003-0.060; P:0.04).

CONCLUSION: Our findings indicate short sleep, insomnia, and the combination of the two, are linked to epigenetic age acceleration, suggesting that these individuals have an older biological age that may contribute to risk for comorbidity and mortality.

}, keywords = {Epigenetic Age, insomnia, short sleep}, issn = {1534-7796}, doi = {10.1097/PSY.0000000000001243}, author = {Kusters, Cynthia D J and Klopack, Eric T and Crimmins, Eileen M and Seeman, Teresa E and Cole, Steve and Carroll, Judith E} } @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 {Ding2022, title = {Statistical Learning for Individualized Asset Allocation}, journal = {Journal of the American Statistical Association}, year = {Forthcoming}, abstract = {We establish a high-dimensional statistical learning framework for individualized asset allocation. Our proposed methodology addresses continuous-action decision-making with a large number of characteristics. We develop a discretization approach to model the effect of continuous actions and allow the discretization frequency to be large and diverge with the number of observations. We estimate the value function of continuous-action using penalized regression with our proposed generalized penalties that are imposed on linear transformations of the model coefficients. We show that our proposed Discretization and Regression with generalized fOlded concaVe penalty on Effect discontinuity (DROVE) approach enjoys desirable theoretical properties and allows for statistical inference of the optimal value associated with optimal decision-making. Empirically, the proposed framework is exercised with the Health and Retirement Study data in finding individualized optimal asset allocation. The results show that our individualized optimal strategy improves the financial well-being of the population. Supplementary materials for this article are available online. {\textcopyright} 2022 American Statistical Association.}, keywords = {Continuous-action decision-making, High-dimensional statistical learning, Individualization, Penalized regression}, doi = {10.1080/01621459.2022.2139265}, author = {Ding, Yi and Li, Yingying and Song, Rui} } @article {https://doi.org/10.1111/jomf.12946, title = {Stepfamily variation in parent{\textendash}child relationship quality in later life}, journal = {Journal of Marriage and Family}, year = {Forthcoming}, abstract = {Objective We use a family systems approach to examine how stepfamily structure is associated with both positive and negative parent{\textendash}child relationships while considering mothers{\textquoteright} and fathers{\textquoteright} discrepant reports. Background Two in five older couples with children are in stepfamilies. Past research on later-life stepfamily dynamics has focused mainly on positive aspects of relationships and compared reports of mothers and fathers from different families. Method Using the U.S. Health and Retirement Study, we estimated multilevel models with data from married couples in which both spouses reported living children and answered all questions about positive and negative parent{\textendash}child relationships (N = 2150). Results Couples in stepfamilies reported less positive and more negative relationships with their children than did couples in non-stepfamilies. Mothers reported more positive relationships than fathers, but there was no gender difference in reports of negative relationships. The patterns of perceived parent{\textendash}child relationships and divergent reports between mothers and fathers also varied by stepfamily structure. Structural complexity was not consistently related to positive or negative relationships. Conclusion This study underscores the importance of considering mothers{\textquoteright} and fathers{\textquoteright} different points of view in the same family and examining both positive and negative parent{\textendash}child interactions as negative relationships are not merely the reverse of positive relationships.}, keywords = {Aging, family structure, gender, parent{\textendash}child relationships, Remarriage, stepfamilies}, doi = {https://doi.org/10.1111/jomf.12946}, author = {Lin, I-Fen and Seltzer, Judith A.} } @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 {13139, title = {Sense of Purpose in Life and Beliefs and Knowledge of Alzheimer{\textquoteright}s Disease.}, journal = {Arch Clin Neuropsychol}, year = {2023}, month = {2023 Feb 04}, abstract = {

OBJECTIVE: A sense of purpose in life is associated with healthier cognitive outcomes, including lower risk of Alzheimer{\textquoteright}s Disease (ad). The present research examines whether purpose is also associated with beliefs and knowledge of ad.

METHOD: A random subsample (N = 1,187) of community-dwelling participants from the Health and Retirement Study completed a module on self-reported beliefs and knowledge of ad.

RESULTS: Purpose in life was associated with lower perceived threat of ad and greater belief that modifiable factors (e.g., physical activity) decrease risk. Associations were not moderated by experience with ad or depressive symptoms. Purpose was unrelated to beliefs that genetics or stress increase risk or knowledge of ad.

CONCLUSIONS: Individuals with a sense of purpose are less concerned about risk of developing ad and believe modifiable factors reduce risk. These beliefs may support engagement in behaviors that reduce risk and be one psychological pathway through which purpose protects against ad.

}, keywords = {Alzheimer{\textquoteright}s disease, beliefs, Knowledge}, issn = {1873-5843}, doi = {10.1093/arclin/acad014}, author = {Sutin, Angelina R and Stephan, Yannick and Luchetti, Martina and Aschwanden, Damaris and Sesker, Amanda A and Zhu, Xianghe and Terracciano, Antonio} } @article {Sutin2023, title = {Sense of purpose in life and work-life tension: Perceptions of interference and enhancement}, journal = {Aging and Health Research}, volume = {3}, year = {2023}, note = {Cited by: 0; All Open Access, Gold Open Access}, type = {Article}, doi = {10.1016/j.ahr.2023.100154}, url = {https://www.scopus.com/inward/record.uri?eid=2-s2.0-85166003472\&doi=10.1016\%2fj.ahr.2023.100154\&partnerID=40\&md5=61d5d1146dfd6872bbf04e77ab2d2232}, author = {Sutin, Angelina R. and Luchetti, Martina and Stephan, Yannick and Terracciano, Antonio} } @article {13437, title = {Sensory impairment and depressive symptoms among older adults before and during the COVID-19 pandemic.}, journal = {Aging Ment Health}, year = {2023}, month = {2023 Aug 07}, pages = {1-9}, abstract = {

OBJECTIVES: This study examined the associations between sensory impairment (SI), lack of social contact during the COVID-19 pandemic, and depressive symptoms among Americans aged 50 and above.

METHODS: We employed data from the 2018 and 2020 Health and Retirement Study ( = 13,460) to examine four SI groups: no SI, visual impairment (VI) only, hearing impairment (HI) only, and dual sensory impairment (DSI). First, multilevel models were employed to estimate the associations between SI and depressive symptoms before and during the pandemic using the full dataset ( = 13,460). Second, linear regression models were employed to estimate the moderation effect of lack of social contact during the pandemic using the 2020 wave data only ( = 4,133).

RESULTS: Among older adults, 15.60\% had VI only, 10.16\% had HI only, and 9.66\% had DSI. All SI groups reported significantly more depressive symptoms than the no SI group. The differences between older adults with VI and DSI and those without SI regarding depressive symptoms narrowed during the pandemic. There was no statistically significant moderation effect of lack of social contact for SI and depressive symptoms.

CONCLUSION: Older adults with SI faced mental health challenges and demonstrated psychological resilience during the pandemic. Future research should examine other risk factors that may modify the relationship between SI and mental health during public health crises.

}, keywords = {Emotional well-being; hearing impairment; public health crisis; social networks; visual impairment.}, issn = {1364-6915}, doi = {10.1080/13607863.2023.2242290}, author = {Xu, Shu and Wang, Haowei and Song, Qian and Burr, Jeffrey A} } @article {12699, title = {Shifting of Cognitive Assessments Between Face-to-Face and Telephone Administration: Measurement Considerations.}, journal = {The Journals of Gerontology, Series B}, volume = {78}, year = {2023}, pages = {191-200}, abstract = {

OBJECTIVES: Telephone-administered cognitive assessments are a cost-effective and sometimes necessary alternative to face-to-face assessments. There is limited information in large studies concerning mode effects, or differences in cognition attributable to assessment method, as a potential measurement threat. We evaluated mode effects on cognitive scores using a population-based sample of community-living older adults.

METHODS: We used data from participants aged 65-79 in the 2014 Health and Retirement Study for whom interview mode was randomized (n=6825). We assessed mode differences in test means, whether mode modifies associations of cognition with criterion variables, and formal measurement invariance testing.

RESULTS: Relative to face-to-face assessment, telephone assessment was associated with higher scores for memory and calculation (0.06 to 0.013 standard deviations (SD)) and lower scores for non-memory items (-0.09 to -0.01 SD). Cognition was significantly differentially related to IADL difficulty depending on assessment mode. Measurement invariance testing identified evidence of mode differences in certain tests as a function of mode: adjusting for underlying cognition, the largest mode differences in memory and attention: immediate noun recall, delayed word recall, and serial-7s scores were higher given telephone administration.

DISCUSSION: Differences by mode of administration are apparent in cognitive measurement in older adults albeit to a small degree in our study, and most pronounced for tests of memory and attention. The importance of accounting for mode differences ultimately depends on one{\textquoteright}s research question and study sample: not all associations may be affected by mode differences and such modification may only be apparent among those with lower cognitive functioning.

}, keywords = {Cognition, Mode effects, Psychometrics, Telephone}, issn = {1758-5368}, doi = {10.1093/geronb/gbac135}, author = {Smith, Jason R and Gibbons, Laura E and Crane, Paul K and Mungas, Dan M and Glymour, M Maria and Jennifer J Manly and Zahodne, Laura B and Mayeda, Elizabeth Rose and Richard N Jones and Gross, Alden L} } @article {13459, title = {A Simple Single Item Rated by an Interviewer Predicts Incident Dementia Over 15 Years.}, journal = {J Alzheimers Dis}, year = {2023}, abstract = {

Subjective memory is useful to detect cognitive deficits not apparent on objective tests. This research evaluates whether memory rated by an interviewer predicts incident dementia. Health and Retirement Study participants without cognitive impairment at baseline whose memory was rated by the interviewer were analyzed (N = 12,749). Worse interviewer-rated memory was associated with higher risk of incident dementia over 15 years (HR = 1.40, 95\% CI = 1.27-1.54). The association was evident even among participants in the top quartile of objective memory performance (HR = 1.71, 95\% CI = 1.26-2.32). Interviewer-rated memory may be a low-cost supplement to neuropsychological evaluation to predict dementia risk beyond self-reports and objective cognitive testing.

}, issn = {1875-8908}, doi = {10.3233/JAD-230417}, author = {Sutin, Angelina R and Aschwanden, Damaris and Luchetti, Martina and Stephan, Yannick and Terracciano, Antonio} } @article {13144, title = {Social Frailty Index: Development and validation of an index of social attributes predictive of mortality in older adults.}, journal = {Proc Natl Acad Sci U S A}, volume = {120}, year = {2023}, month = {2023 Feb 14}, pages = {e2209414120}, abstract = {

While social characteristics are well-known predictors of mortality, prediction models rely almost exclusively on demographics, medical comorbidities, and function. Lacking an efficient way to summarize the prognostic impact of social factor, many studies exclude social factors altogether. Our objective was to develop and validate a summary measure of social risk and determine its ability to risk-stratify beyond traditional risk models.~We examined participants in the Health and Retirement Study, a longitudinal, survey of US older adults. We developed the model from a comprehensive inventory of 183 social characteristics using least absolute shrinkage and selection operator, a penalized regression approach. Then, we assessed the predictive capacity of the model and its ability to improve on traditional prediction models.~We studied 8,250 adults aged~>=65 y. Within 4 y of the baseline interview, 22\% had died. Drawn from 183 possible predictors, the Social Frailty Index included age, gender, and eight social predictors: neighborhood cleanliness, perceived control over financial situation, meeting with children less than yearly, not working for pay, active with children, volunteering, feeling isolated, and being treated with less courtesy or respect. In the validation cohort, predicted and observed mortality were strongly correlated. Additionally, the Social Frailty Index meaningfully risk-stratified participants beyond the Charlson score (medical comorbidity index) and the Lee Index (comorbidity and function model).~The Social Frailty Index includes age, gender, and eight social characteristics and accurately risk-stratifies older adults. The model improves upon commonly used risk prediction tools and has application in clinical, population health, and research settings.

}, keywords = {Aged, Child, Frailty, Humans, Longitudinal Studies, Retirement, Sociological Factors}, issn = {1091-6490}, doi = {10.1073/pnas.2209414120}, author = {Shah, Sachin J and Oreper, Sandra and Jeon, Sun Young and Boscardin, W John and Fang, Margaret C and Covinsky, Kenneth E} } @mastersthesis {13302, title = {SOCIAL ISOLATION ACROSS THE ADULT LIFE SPAN: VARIATIONS BY GENDER}, volume = {Doctor of Philosophy}, year = {2023}, school = {University of Carolina at Chapel Hill}, address = {Chapel Hill, North Carolina}, abstract = {This dissertation uses two nationally representative surveys which span from young adulthood to late life to examine social isolation across the adult life course in the United States. In the first chapter of this dissertation, I examine patterns and trends of social isolation by age, period, cohort, and gender by conducting descriptive analyses using the National Survey of Midlife Development in the United States (MIDUS) and the Health and Retirement Study (HRS). I find that about 14 percent of U.S. adults aged 25 and older are socially isolated with this percentage growing with advancing age as well as across period-based time. Additionally, there are gender differences in social isolation which vary based on whether relationship status is included or excluded from the measure of social isolation. In the second chapter, I investigate the trajectory of social isolation across the adult life course and examine how social isolation varies by cohort and gender. This is done by testing five longitudinal models of social isolation: enduring, spontaneous, lagged effects, life course, and hybrid, using both MIDUS and HRS. This chapter shows that social isolation is relatively stable within people as they age through adulthood, which is due to both time-invariant factors and recent history. More recent birth cohorts have higher levels of social isolation. Additionally, iv while men are more isolated than women earlier in adulthood, these disparities converge before reversing at later ages. My third chapter examines the relationship between social isolation and self-rated health across adulthood and how this relationship differs by gender, again using MIDUS and HRS. This chapter demonstrates that social isolation and self-rated health influence each other in older adulthood, but not in early adulthood or midlife. There are few gender differences in the relationship between social isolation and self-rated health across adulthood, except that women in older adulthood may experience greater health risks to being socially isolated than men. In sum, this dissertation advances understanding of social isolation across the adult life course in the United States by evaluating trends within and between-individuals across time, examining connections between social isolation and health, and assessing gender differences.}, url = {https://www.proquest.com/docview/2816716148?pq-origsite=gscholar\&fromopenview=true}, author = {Kaitlin Shartle} } @article {13562, title = {Social relationships and epigenetic aging in older adulthood: Results from the Health and Retirement Study.}, journal = {Brain, behavior and immunity}, volume = {114}, year = {2023}, pages = {349-359}, abstract = {

Growing evidence suggests that social relationship quality can influence age-related health outcomes, although how the quality of one{\textquoteright}s relationships directly relates to the underlying aging process is less clear. We hypothesized that the absence of close relationships as well as lower support and higher strain within existing relationships would be associated with an accelerated epigenetic aging profile among older adults in the Health and Retirement Study. Adults (N~=~3,647) aged 50-100~years completed ratings of support and strain in relationships with their spouse, children, other family members, and friends. They also provided a blood sample that was used for DNA methylation profiling to calculate a priori-specified epigenetic aging measures: Horvath, Hannum, PhenoAge, GrimAge, and Dunedin Pace of Aging methylation (DunedinPoAm38). Generalized linear models that adjusted for chronological age, sex, and race/ethnicity and applied a false discovery rate correction revealed that the absence of marital and friend relationships related to an older GrimAge and faster DunedinPoAm38. Among those with existing relationships, lower support from a spouse, child, other family, and friends and higher strain with friends related to an older PhenoAge and GrimAge and faster DunedinPoAm38. In secondary analyses that further adjusted for socioeconomic and lifestyle factors, lower support from other family members and friends was associated with greater epigenetic aging. Findings suggest that the absence of close relationships and lower support within existing relationships-particularly with family members and friends-relate to accelerated epigenetic aging in older adulthood, offering one mechanism through which social relationships might influence risk for age-related declines and disease.

}, keywords = {biological aging, DNA Methylation, epigenetic clock, Social Relationships, Social strain, Social Support}, issn = {1090-2139}, doi = {10.1016/j.bbi.2023.09.001}, author = {Rentscher, Kelly E and Klopack, Eric T and Crimmins, Eileen M and Seeman, Teresa E and Cole, Steve W and Carroll, Judith E} } @article {13172, title = {Socioeconomic and Ethnic Inequalities in the Progress of Multimorbidity and the Role of Health Behaviors.}, journal = {J Am Med Dir Assoc}, year = {2023}, month = {2023 Feb 20}, abstract = {

OBJECTIVES: To assess socioeconomic and ethnic inequalities in the progress of multimorbidity and whether behavioral factors explain these inequalities among older Americans.

DESIGN: Health and Retirement Study, a longitudinal survey of older American adults.

SETTING AND PARTICIPANTS: Data pooled from 2006 to 2018 (waves 8-14), which include 38,061 participants.

METHODS: We used 7 waves of the survey from 2006 to 2018. Socioeconomic factors were indicated by education, total wealth, poverty-income ratio (income), and race/ethnicity. Multimorbidity was indicated by self-reported diagnoses of 5 chronic conditions: diabetes, heart conditions, lung diseases, cancer, and stroke. Behavioral factors were smoking, excessive alcohol consumption, physical activity, and body mass index (BMI). Multilevel mixed effects generalized linear models were constructed to assess socioeconomic and ethnic inequalities in the progress of multimorbidity and the role of behavior. All variables included in the analysis were time-varying except gender, race/ethnicity, and education.

RESULTS: African American individuals had higher rates of multimorbidity than White individuals; however, after adjusting for income and education, the association was reversed. There were clear income, wealth, and education gradients in the progress of multimorbidity. After adjusting for behavioral factors, the relationships were attenuated. The rate ratio (RR) of multimorbidity attenuated by 9\% among participants with the lowest level of education after accounting for behavior (RR 1.21; 95\% CI 1.18-1.23 and 1.11; 95\% CI 1.17-1.14) in the models unadjusted and adjusted for behaviors, respectively. Similarly, RR for multimorbidity among those in the lowest wealth quartile attenuated from 1.47 (95\% CI 1.44-1.51) and 1.31 (95\% CI 1.26-1.36) after accounting for behaviors.

CONCLUSION AND IMPLICATIONS: Ethnic inequalities in the progress of multimorbidity were explained by wealth, income, and education. Behavioral factors partially attenuated socioeconomic inequalities in multimorbidity. The findings are useful in identifying the behaviors that should be included in health promotion programs aiming at tackling inequalities in multimorbidity.

}, keywords = {ethnic inequalities, Health Behavior, socioeconomic}, issn = {1538-9375}, doi = {10.1016/j.jamda.2023.01.009}, author = {Mira, Rolla and Newton, Tim and Sabbah, Wael} } @article {12866, title = {Socioeconomic and race/ethnic differences in immunosenescence: Evidence from the Health and Retirement Study.}, journal = {Brain, Behavior, and Immunity}, volume = {107}, year = {2023}, pages = {361-368}, abstract = {

BACKGROUND: The COVID-19 pandemic has highlighted the urgent need to understand variation in immunosenescence at the population-level. Thus far, population patterns of immunosenescence have not well described.

METHODS: We characterized measures of immunosenescence from the 2016 Venous Blood Study from the nationally representative U.S Health and Retirement Study (HRS) of individuals ages 50~years and older.

RESULTS: Median values of the CD8+:CD4+, EMRA:Na{\"\i}ve CD4+ and EMRA:Na{\"\i}ve CD8+ ratios were higher among older participants and were lower in those with additional educational attainment. Generally, minoritized race and ethnic groups had immune markers suggestive of a more aged immune profile: Hispanics had a CD8+:CD4+ median value of 0.37 (95~\% CI: 0.35, 0.39) compared to 0.30 in non-Hispanic Whites (95~\% CI: 0.29, 0.31). Non-Hispanic Blacks had the highest median value of the EMRA:Na{\"\i}ve CD4+ ratio (0.08; 95~\% CI: 0.07, 0.09) compared to non-Hispanic Whites (0.03; 95~\% CI: 0.028, 0.033). In regression analyses, race/ethnicity and education were associated with large differences in the immune ratio measures after adjustment for age and sex.

CONCLUSIONS: Lower educational attainment and minoritized racial ethnic status were associated with higher levels of immunosenescence. This population variation may have important implications for both risk of age-related disease and vulnerability to emerging pathogens (e.g., SARS-CoV-2).

}, keywords = {Academic Success, COVID-19, Health Status, Pandemics, SARS-CoV-2}, issn = {1090-2139}, doi = {10.1016/j.bbi.2022.10.019}, author = {Noppert, Grace A and Stebbins, Rebecca C and Dowd, Jennifer Beam and Aiello, Allison E} } @article {12450, title = {Spending behavior and stimulus transfer use in response to income shocks among older Americans: evidence from the COVID-19 pandemic}, journal = {Applied Economics Letters}, volume = {30}, year = {2023}, pages = {1680-1684}, abstract = {This study examines household behavioural responses to the pandemic-induced income shocks regarding their overall spending and spending out of 2020 CARES stimulus payments. Using data from the 2020 Health and Retirement Study COVID-19 project and restricting our sample to older adults (51 years old and above), we show that the negative income shocks experienced during the COVID-19 pandemic put downward pressure on household spending. Results also reveal that, relative to those who did not experience an income shock, stimulus recipients who experienced income losses were more likely to use the stimulus transfer to increase spending, pay off debt, or for other purposes rather than to save.}, keywords = {COVID-19, Income shocks, Saving, Spending, stimulus checks}, doi = {10.1080/13504851.2022.2078774}, author = {Muna Sharma and Patryk Babiarz} } @article { WOS:001086538400001, title = {Stepfamily variation in parent-child relationship quality in later life}, journal = {JOURNAL OF MARRIAGE AND FAMILY}, year = {2023}, abstract = {Objective: We use a family systems approach to examine how stepfamily structure is associated with both positive and negative parent-child relationships while considering mothers{\textquoteright} and fathers{\textquoteright} discrepant reports.Background: Two in five older couples with children are in stepfamilies. Past research on later-life stepfamily dynamics has focused mainly on positive aspects of relationships and compared reports of mothers and fathers from different families.Method: Using the U.S. Health and Retirement Study, we estimated multilevel models with data from married couples in which both spouses reported living children and answered all questions about positive and negative parent-child relationships (N = 2150).Results: Couples in stepfamilies reported less positive and more negative relationships with their children than did couples in non-stepfamilies. Mothers reported more positive relationships than fathers, but there was no gender difference in reports of negative relationships. The patterns of perceived parent-child relationships and divergent reports between mothers and fathers also varied by stepfamily structure. Structural complexity was not consistently related to positive or negative relationships.Conclusion: This study underscores the importance of considering mothers{\textquoteright} and fathers{\textquoteright} different points of view in the same family and examining both positive and negative parent-child interactions as negative relationships are not merely the reverse of positive relationships.}, keywords = {Aging, family structure, gender, parent-child relationships, Remarriage, stepfamilies}, issn = {0022-2445}, doi = {10.1111/jomf.12946}, author = {Lin, I-Fen and Seltzer, Judith A.} } @article {12506, title = {Subjective Memory Decline Predicts Incident Cognitive Impairment among White-but Not Black or Hispanic-Older Adults.}, journal = {The Gerontologist}, year = {2023}, abstract = {

BACKGROUND AND OBJECTIVES: This study investigates whether subjective memory decline in a racially diverse sample of older adults without cognitive impairment at baseline is associated with incident cognitive impairment during a 12-year follow-up period.

RESEARCH DESIGN AND METHODS: With panel data from a national sample (N=9,244) of cognitively-intact Black, White, and Hispanic Americans 65 years or older in 2004, we examine if subjective memory decline is associated with the loss of normal cognition by 2016. Cognitive status was assessed every two years with a modified version of the Telephone Interview for Cognitive Status to identify the transition from normal cognition to cognitive impairment.

RESULTS: Estimates from Weibull accelerated failure-time models reveal that subjective memory decline is associated with earlier incident cognitive impairment (time ratio = 0.96, p<.05). In subsequent models stratified by race-ethnicity, this association was evident among White respondents (time ratio = 0.95, p<.01) but not among Black, US-born Hispanic, or foreign-born Hispanic respondents.

DISCUSSION AND IMPLICATIONS: Given that the prognostic validity of subjective memory decline differs by race and ethnicity, caution is warranted when using it as a screening or clinical tool in diverse populations.

}, keywords = {cognitive function, Disparities, Racial-ethnic differences, Self-reported memory}, issn = {1758-5341}, doi = {10.1093/geront/gnac086}, author = {Ferraro, Kenneth F and Sauerteig-Rolston, Madison R and Barnes, Lisa L and Friedman, Elliot and Sands, Laura P and Thomas, Patricia A} } @article {13611, title = {Sustaining Retirement during Lockdown: Annuitized Income and Older American{\textquoteright}s Financial Well-Being before and during the COVID-19 Pandemic}, journal = {Journal of Risk and Financial Management}, volume = {16}, year = {2023}, abstract = {The landscape of employer-sponsored retirement plans in the U.S. has changed dramatically during the past few decades as more and more private-sector employers have decided to freeze or terminate traditional pension plans. Defined contribution (DC) plans became the primary choice or the only choice for employees to participate in employer-sponsored retirement plans. In the next ten to twenty years, the income from pension plans will only count for a third of the total retirement income for GenXers when compared to their baby boomer counterparts. It is important for research to provide evidence on how the change in retirement income resources impacts retirees{\textquoteright} retirement security and financial wellness. Using Health and Retirement Study (HRS) data before and during the COVID-19 pandemic, this study examines the association between annuitized income and various measures of older Americans{\textquoteright} financial well-being over time, particularly during the pandemic. This study finds that receiving annuitized income has a statistically significant relationship with reduced subjective financial well-being for both measurements, while only one of the measures of objective well-being, having liquid assets greater than the median household income, has a statistically significant positive relationship with receiving annuitized income. {\textcopyright} 2023 by the authors.}, keywords = {annuitized income, defined contribution plans, Financial well-being, longevity risk}, issn = {19118074}, doi = {10.3390/jrfm16100432}, author = {Sun, Qi and Curnutt, Gary} } @article {13016, title = {A Satellite Account for Health in the United States.}, journal = {American Economic Review}, volume = {112}, year = {2022}, pages = {494-533}, abstract = {

This paper develops a satellite account for the US health sector and measures productivity growth in health care for the elderly population between 1999 and 2012. We measure the change in medical spending and health outcomes for a comprehensive set of 80 conditions. Medical care has positive productivity growth over the time period, with aggregate productivity growth of 1.5\% per year. However, there is significant heterogeneity in productivity growth. Care for cardiovascular disease has had very high productivity growth. In contrast, care for people with musculoskeletal conditions has been costly but has not led to improved outcomes.

}, keywords = {Health Care, health outcome, health spending}, issn = {0002-8282}, doi = {10.1257/aer.20201480}, author = {Cutler, David M and Ghosh, Kaushik and Messer, Kassandra L and Raghunathan, Trivellore and Rosen, Allison B and Stewart, Susan T} } @article {12356, title = {Scientists identify genetic variants linked to mobility changes in aging}, year = {2022}, publisher = {ScienceDaily}, keywords = {C. elegans, evolutionary biology, Genetics, Genomics}, url = {https://www.sciencedaily.com/releases/2022/04/220426101758.htm}, author = {ScienceDaily} } @article {12009, title = {Screening recall in older cancer survivors detects differences in balance and mobility.}, journal = {Supportive Care In Cancer}, volume = {30}, year = {2022}, pages = {2605-2612}, abstract = {

PURPOSE: Cognitive impairments have been reported by up to two-thirds of cancer survivors whose primary cancer did not occur in the central nervous system. Physical impairments as sequelae of cancer-related cognitive impairment (CRCI) have not been well described in previous studies. Furthermore, there is scarcity of literature describing differences among physical performance in those with and without CRCI. The purpose of this study is to examine the differences in physical function of older cancer survivors based on cognitive ability to determine if physical performance differs when different cognitive screening measures are employed.

METHODS: Adults age 65 + with a history of cancer from the 2010 Health and Retirement Study (n = 1,953) were assigned to groups according to their cognitive ability. Between-group demographic, mobility, and cognitive differences were analyzed using chi-squared and t tests. Recall and orientation were used as cognitive variables, and physical performance outcomes included gait speed, balance, and grip strength.

RESULTS: Respondents with Low Recall had more impaired balance (semi-tandem, tandem) (p < .05) and slower gait speeds (p < .05). Respondents that were Not-Oriented had slower gait speed (p < .05). Between-group differences in demographics were found by recall and orientation groups.

CONCLUSIONS: Impairments in balance and gait speed are able to be detected when recall is screened in a population of older cancer survivors. When assessing how physical mobility is related to fall risk, a screen of cognition should go beyond just orientation.

}, keywords = {Cognition, Memory, Neoplasms, Orientation, Postural Balance, Short-term, walking speed}, issn = {1433-7339}, doi = {10.1007/s00520-021-06705-9}, author = {Blackwood, Jennifer and Sweeney, Robert and Rybicki, Kateri} } @article {11943, title = {Self-perceptions of aging and depressive symptoms: the mediating role of loneliness.}, journal = {Aging \& Mental Health}, volume = {26}, year = {2022}, pages = {1495-1501}, abstract = {

Depression is a major health concern for both individuals and societies. Hence, understanding the risk factors for depression is of importance. As individuals grow older, the way in which they perceive the aging process may have a significant influence on their physical and mental health. More negative perceptions of aging could put individuals at risk for social withdrawal, causing loneliness and resulting in higher levels of depressive symptoms. We use the Health and Retirement Survey, a large and longitudinal dataset spanning over a period of 8 years, to examine a model in which loneliness mediates the relationship between self-perceptions of aging and depressive symptoms. Our findings suggest that loneliness indeed mediates the relationship between self-perceptions of aging and depressive symptoms. The results highlight to the importance of the way people view the aging process in shaping their social and mental well-being. Practitioners may want to address self-perceptions of aging when helping older adults cope with loneliness and depressive symptoms.

}, keywords = {Depressive symptoms, Loneliness, self-perceptions of aging}, issn = {1364-6915}, doi = {10.1080/13607863.2021.1991275}, author = {Dikla Segel-Karpas and Cohn-Schwartz, Ella and Liat Ayalon} } @article {article, title = {Self-reported hearing loss, hearing aid use, and cognitive function among U.S. older adults}, journal = {International Journal of Population Studies}, volume = {8}, year = {2022}, pages = {17-26}, abstract = { There has been increasing attention to the role of hearing loss as a potentially modifiable risk factor for Alzheimer{\textquoteright}s disease and related dementias. However, more nationally-representative studies are needed to understand the co-occurring changes in hearing loss and cognitive function in older adults over time, and how hearing aid use might influence this association. The purpose of this report is to examine how age-related changes in hearing loss and hearing aid use are associated with trajectories of cognitive function in a nationallyrepresentative sample of U.S. older adults. We used 11 waves of longitudinal data from the Health and Retirement Study (HRS) from 1998 to 2018 to examine changes in self-reported hearing loss, hearing aid use, and cognitive function in adults 65 and older by race and ethnicity. Results from mixed models showed that greater levels of hearing loss were associated with lower levels of cognitive function at age 65 in non-Hispanic White, non-Hispanic Black, and Hispanic older adults. We also found that the associations diminished across age in White and Black individuals; but remained persistent in Hispanic individuals. The use of hearing aids was not associated with cognitive function in Black older adults but appeared protective for White and Hispanic older adults. Overall, the findings from this report suggest that the timely identification of hearing loss and subsequent acquisition of hearing aids may be important considerations for reducing declines in cognitive function that manifests differently in U.S. population subgroups.}, keywords = {Cognitive decline, Dementia, Hearing loss, racial/ethnic disparities}, doi = {10.18063/ijps.v8i1.1308}, author = {West, Jessica and Smith, Sherri and Dupre, Matthew} } @article {11707, title = {Self-reported sense of purpose in life and proxy-reported behavioral and psychological symptoms of dementia in the last year of life.}, journal = {Aging and Mental Health}, volume = {26}, year = {2022}, pages = {1693-1698}, abstract = {

Behavioral and psychological symptoms of dementia (BPSD) are among the most challenging aspects of dementia for individuals living with dementia and their caregivers. Identifying factors associated with resilience to BPSD may inform interventions to reduce them. The present research examines whether purpose in life is associated with BPSD in the last year of life.Participants from the Health and Retirement Study were selected if they reported on their sense of purpose, had evidence of a memory impairment, died across the follow-up, and a proxy completed the End of Life survey that included BPSD ( = 2473). Self-reported sense of purpose was tested as a predictor of the sum of symptoms and each indivdual symptom in the last year of life.Purpose in life was associated with fewer BPSD overall. Of the individual symptoms, purpose was associated with less risk of psychological symptoms, specfiically less depression, periodic confusion, uncontrolled temper, but not with motor or perceptual symptoms. These results are consistent with growing evidence that purpose is associated with better cognitive outcomes. Purpose may be a useful target of intervention to improve outcomes across the spectrum of dementia.

}, keywords = {Behavioral Symptoms, BPSD, Dementia, end of life, Purpose in life}, issn = {1364-6915}, doi = {10.1080/13607863.2021.1937055}, author = {Angelina R Sutin and Martina Luchetti and Yannick Stephan and Antonio Terracciano} } @article {12332, title = {Sense of purpose in life and inflammation in healthy older adults: A longitudinal study.}, journal = {Psychoneuroendocrinology}, volume = {141}, year = {2022}, pages = {105746}, abstract = {

BACKGROUND: A higher sense of purpose in life has been linked with reduced risk of age-related chronic health conditions that share elevated inflammation as a key risk factor (e.g., neurodegenerative diseases, heart disease, and diabetes). While prior research has documented cross-sectional associations between higher sense of purpose and lower inflammation, few studies have examined the association between purpose and changes in inflammation over time.

OBJECTIVE: We tested if a higher sense of purpose was prospectively associated with lower likelihood of developing unhealthy C-reactive protein levels in older adults who initially had healthy CRP levels (i.e., <3~ug/mL).

METHODS: Participants were 6925 adults aged >~50 in the Health and Retirement Study who were followed for 8 years. Participants completed the purpose in life subscale of the Ryff Psychological Well-being Scales at study baseline in 2006/2008. CRP was obtained from blood spots collected at baseline and after 4 and 8 years of follow-up. Pooled logistic regression estimated discrete-time hazard ratios (HR) and 95\% confidence intervals (CI) for the association between baseline purpose and onset of unhealthy CRP levels (>3~ug/mL).

RESULTS: There was no strong evidence of an association between baseline continuous purpose scores and onset of unhealthy CRP levels over time in the overall analytic sample. In sex-stratified models, higher purpose was associated with lower hazards of developing unhealthy CRP levels among men, while associations were null in women (e.g., in sociodemographics-adjusted model, men: HR=0.89, 95\% CI: 0.79-0.99; women: HR=0.96, 95\% CI: 0.85-1.08; interaction between continuous purpose scores and sex p~=~0.15).

CONCLUSIONS: Findings suggest that a higher versus lower sense of purpose is associated with lower inflammation levels in older men. In specific populations, purpose may serve as a novel target for future interventions aimed at reducing inflammation.

}, keywords = {C-reactive protein, Epidemiology, Health psychology, Inflammation, Purpose in life}, issn = {1873-3360}, doi = {10.1016/j.psyneuen.2022.105746}, author = {Guimond, Anne-Josee and Shiba, Koichiro and Kim, Eric S and Kubzansky, Laura D} } @article {12227, title = {Sense of Purpose in Life and Markers of Hearing Function: Replicated Associations across Two Longitudinal Cohorts.}, journal = {Gerontology}, volume = {68}, year = {2022}, pages = {943-950}, abstract = {

INTRODUCTION: A sense of purpose in life is a psychological resource that is associated with healthier outcomes. The present research examines whether a greater sense of purpose in life is associated with subjective and objective markers of hearing health and whether hearing acuity contributes to the association between purpose and episodic memory. We sought to evaluate whether these associations were replicable across 2 independent samples.

METHODS: Participants in the Health and Retirement Study (N = 14,291) and the English Longitudinal Study of Ageing (N = 8,844) reported on their purpose in life and perceived hearing quality at baseline. Hearing acuity was measured using an audiometer 2-4 years later, and episodic memory was measured at baseline and 6-8 years later.

RESULTS: In both samples, higher purpose in life was associated with better hearing quality measured concurrently, lower risk of either subjective or objective hearing impairment, and hearing acuity accounted for some of the longitudinal relation between sense of purpose and better episodic memory.

DISCUSSION: Across samples, measures, and analytical approaches, the present research indicates replicable associations between sense of purpose in life and hearing health. It further indicates that hearing may be one factor that associates purpose with better episodic memory.

}, keywords = {Episodic Memory, hearing acuity, Hearing loss, Replication, Sense of purpose}, issn = {1423-0003}, doi = {10.1159/000521257}, author = {Angelina R Sutin and Martina Luchetti and Damaris Aschwanden and Yannick Stephan and Antonio Terracciano} } @article {12700, title = {Serum Cystatin-C is linked to increased prevalence of diabetes and higher risk of mortality in diverse middle-aged and older adults.}, journal = {PLoS One}, volume = {17}, year = {2022}, pages = {e0270289}, abstract = {

OBJECTIVE: Type 2 Diabetes Mellitus (henceforth diabetes) affects roughly 35 million individuals in the US and is a major risk factor for cardiovascular and kidney disease. Serum Cystatin-C is used to monitor renal function and detect kidney damage. Recent research has focused on linking Cystatin-C to cardiovascular risk and disease, but most findings focus on small sample sizes and generalize poorly to diverse populations, thus limiting epidemiological inferences. The aim of this manuscript is to study the association between Cystatin-C, diabetes, and mortality and test for possible sex or racial/ethnic background modifications in these relationships.

METHODS: We analyzed 8-years of biennial panel data from Health and Retirement Study participants 50-years and older who self-identified as White (unweighted N (uN) = 5,595), Black (uN = 867), or Latino (uN = 565) for a total of uN = 7,027 individuals. We modeled diabetes and death over 8-years as function of baseline Cystatin-C (log transformed) adjusting for covariates and tested modifications in associations by race/ethnic background and sex.

RESULTS: Mean log Cystatin-C at visit 1 was 0.03{\textpm}0.32 standard deviation. A 10\% increase in Cystatin-C levels was associated with 13\% increased relative risk of diabetes at baseline (11\% and 9\% by years 4 and 8). A 10\% increase in Cystatin-C was highly associated with increased relative risk of death (28\% and 31\% by years 4 and 8). These associations were present even after adjusting for possible confounders and were not modified by sex or racial/ethnic background.

CONCLUSION: Despite differential risks for diabetes and mortality by racial/ethnic groups, Cystatin-C was equally predictive of these outcomes across groups. Cystatin-C dysregulations could be used as a risk indicator for diabetes and as a warning sign for accelerated risk of mortality.

}, keywords = {Diabetes Mellitus, Hispanic or Latino, Kidney diseases, Prevalence, Risk Factors, Type 2}, issn = {1932-6203}, doi = {10.1371/journal.pone.0270289}, author = {Gonz{\'a}lez, Kevin A and Stickel, Ariana M and Kaur, Sonya S and Ramos, Alberto R and Gonz{\'a}lez, Hector M and Tarraf, Wassim} } @article {11918, title = {Sex Differences in the Association between Metabolic Dysregulation and Cognitive Aging: The Health and Retirement Study.}, journal = {The Journals of Gerontology, Series A }, volume = {77}, year = {2022}, pages = {1827-1835}, abstract = {

BACKGROUND: Dysregulation of some metabolic factors increases the risk of dementia. It remains unclear if overall metabolic dysregulation, or only certain components, contribute to cognitive aging and if these associations are sex-specific.

METHODS: Data from the 2006-2016 waves of the Health and Retirement Study (HRS) was used to analyze 7,103 participants aged 65+ at baseline (58\% women). We created a metabolic-dysregulation risk score (MDRS) composed of blood pressure/hypertension status, HbA1c/diabetes status, total cholesterol (TC), high-density lipoprotein cholesterol (HDL-C), and waist circumference, and assessed cognitive trajectories from repeated measures of the HRS-Telephone Interview for Cognitive Status (HRS-TICS) over 10 years of follow-up. Linear mixed-effects models estimated associations between MDRS or individual metabolic factors (biomarkers) with mean and change in HRS-TICS scores and assessed sex-modification of these associations.

RESULTS: Participants with higher MDRSs had lower mean HRS-TICS scores, but there were no statistically significant differences in rate of decline. Sex-stratification showed this association was present for women only. MDRS biomarkers revealed heterogeneity in the strength and direction of associations with HRS-TICS. Lower HRS-TICS levels were associated with hypertension, higher HbA1c/diabetes, and lower HDL-C and TC; while faster rate of cognitive decline was associated with hypertension, higher HbA1c/diabetes and higher TC. Participants with higher HbA1c/diabetes presented worse cognitive trajectories. Sex-differences indicated women with higher HbA1c/diabetes to have lower HRS-TICS levels while hypertensive males presented better cognitive trajectory.

CONCLUSIONS: Our results demonstrate that metabolic dysregulation is more strongly associated with cognition in women compared to men, though sex-differences vary by individual biomarker.

}, keywords = {Biomarkers, Brain Aging, Diabetes, Epidemiology}, issn = {1758-535X}, doi = {10.1093/gerona/glab285}, author = {Chanti-Ketterl, Marianne and Rebecca C Stebbins and Obhi, Hardeep K and Daniel W. Belsky and Brenda L Plassman and Yang, Yang Claire} } @article {12458, title = {Sleep Disorders as a Potential Risk Factor for Dementia in Elderly Adults}, journal = {Sleep}, volume = {45}, year = {2022}, pages = {A123}, abstract = {Introduction Sleep disorders such as insomnia are seen in the early onset of Alzheimer{\textquoteright}s disease, the most common form of dementia. Simultaneously, sleep disorders may indicate increased risk for the development of dementia. Due to the rate of comorbidity of these two conditions seen in the elderly population, the relationship between dementia and sleep disorders is a topic of interest for researchers. A bidirectional correlation between the two could have important implications in the clinical field exploring factors that lead to dementia Methods Data was assessed from 17,146 older adults from the 2018 Health and Retirement Survey. Participants were surveyed using questionnaires regarding both incident dementia or serious memory impairment in the past 2 years and the presence of a sleep disorder, as diagnosed by a doctor or health professional. Those who reported no dementia in the previous wave (N=16,547) were asked if they had been diagnosed since they were last asked. N=185 individuals reported incident dementia in the 2-years between assessments. Responses were coded to either {\textquotedblleft}Yes{\textquotedblright} or {\textquotedblleft}No{\textquotedblright}. A Poisson regression analysis was conducted to explore the relationship between incident dementia and sleep disorders. Results In a sample of older adults, unadjusted results indicate that having a sleep disorder was associated with a 0.6\% increased risk of new onset dementia (PRR=1.006; 95\%CI[1.001,1.012]; p=0.026). These results were sustained when adjusted for sex, age, race, ethnicity, and depression (PRR=1.006; 95\%CI[1.001,1.012]; p=0.013). Conclusion Chronic sleep disturbances may be a factor used to indicate increased risk for dementia and help with early detection of the disease. These results demonstrate the value of sleep disorders screening among those at risk for dementia. Further research is needed to clarify these findings (e.g., explore specific sleep disorders) and expand the follow-up window (i.e., beyond 2 years).}, keywords = {Alzheimer disease, Comorbidity, Dementia, depressive disorders, Early Diagnosis, ethnic group, Health Personnel, insomnia, memory impairment, sleep disorders}, doi = {10.1093/sleep/zsac079.271}, author = {Kuhler, Cassandra and Wills, Chloe and Tubbs, Andrew and Seixas, Azizi and Turner, Arlener and Jean-Louis, Girardin and Killgore, William and Grandner, Michael} } @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 {12448, title = {Social stressors associated with age-related T lymphocyte percentages in older US adults: Evidence from the US Health and Retirement Study.}, journal = {Proceedings of the National Academy of Sciences}, volume = {119}, year = {2022}, pages = {e2202780119}, abstract = {

Exposure to stress is a risk factor for poor health and accelerated aging. Immune aging, including declines in na{\"\i}ve and increases in terminally differentiated T cells, plays a role in immune health and tissue specific aging, and may contribute to elevated risk for poor health among those who experience high psychosocial stress. Past data have been limited in estimating the contribution of life stress to the development of accelerated immune aging and investigating mediators such as lifestyle and cytomegalovirus (CMV) infection. This study utilizes a national sample of 5,744 US adults over age 50 to assess the relationship of social stress (viz., everyday discrimination, stressful life events, lifetime discrimination, life trauma, and chronic stress) with flow cytometric estimates of immune aging, including na{\"\i}ve and terminally differentiated T cell percentages and the ratio of CD4 to CD8 cells. Experiencing life trauma and chronic stress was related to a lower percentage of CD4 na{\"\i}ve cells. Discrimination and chronic stress were each associated with a greater percentage of terminally differentiated CD4 cells. Stressful life events, high lifetime discrimination, and life trauma were related to a lower percentage of CD8 na{\"\i}ve cells. Stressful life events, high lifetime discrimination, and chronic stress were associated with a higher percentage of terminally differentiated CD8 cells. High lifetime discrimination and chronic stress were related to a lower CD4:CD8 ratio. Lifestyle factors and CMV seropositivity partially reduced these effects. Results identify psychosocial stress as a contributor to accelerating immune aging by decreasing na{\"\i}ve and increasing terminally differentiated T cells.

}, keywords = {Aging, Immunosenescence, socioeconomic status, Stress}, issn = {1091-6490}, doi = {10.1073/pnas.2202780119}, author = {Klopack, Eric T and Eileen M. Crimmins and Cole, Steve W and Seeman, Teresa E and Carroll, Judith E} } @article {12993, title = {SOCIODEMOGRAPHIC DIFFERENCES IN IMMUNOSENESCENCE IN OLDER AGE: EVIDENCE FROM THE HEALTH AND RETIREMENT STUDY}, journal = {Innovation in Aging}, volume = {6}, year = {2022}, pages = {447-448}, abstract = {Population patterns of immunosenescence are not well described. We characterized markers of immunosenescence and assessed sociodemographic differences in a population of individuals ages 56 years and older using newly released venous blood data from the nationally representative U.S. Health and Retirement Study (HRS) (n=8,400). Median values of the CD8+:CD4+, effector memory (em)RA:na{\"\i}ve CD4+ and emRA:na{\"\i}ve CD8+ T cell ratios were higher among older participants (more aged immune profile) and were lower among those with additional educational attainment (less aged immune profile). Racialized minority populations had immune markers suggestive of a more aged immune profile: Hispanics had a CD8+:CD4+ median value of 0.37 (95\% CI: 0.35, 0.39) compared to Whites (0.30, 95\% CI: 0.29, 0.31). Blacks had the highest median value of the emRA:naive CD4+ ratio (0.08; 95\% CI: 0.07, 0.09) compared to Whites (0.03; 95\% CI: 0.028, 0.033). Our regression analyses showed that race/ethnicity and education were associated with large differences in T-cell markers of aging, which were orders of magnitude greater than age. By standardizing regression coefficients to estimate years of immunological aging, we found that each additional level of education was associated with roughly an additional decade of immunological age, and racialized minorities had on average an immunological age two to four decades higher than Whites. As one of the first large-scale population-based investigations of immunosenescence, our study advances understanding of the immune mechanisms underlying age-related disease, with implications for risks such as vulnerability to novel pathogens (e.g., SARS-CoV-2).}, keywords = {Immunosenescence, sociodemographic differences}, doi = {10.1093/geroni/igac059.1749}, author = {Noppert, Grace and Stebbins, Rebecca and Dowd, Jennifer and Aiello, Allison E} } @article {11740, title = {The Socioeconomic Gradient in Epigenetic Ageing Clocks: Evidence from the Multi-Ethnic Study of Atherosclerosis and the Health and Retirement Study.}, journal = {Epigenetics}, volume = {17}, year = {2022}, pages = {589-611}, abstract = {

Epigenetic clocks have been widely used to predict disease risk in multiple tissues or cells. Their success as a measure of biological ageing has prompted research on the connection between epigenetic pathways of ageing and the socioeconomic gradient in health and mortality. However, studies examining social correlates of epigenetic ageing have yielded inconsistent results. We conducted a comprehensive, comparative analysis of associations between various dimensions of socioeconomic status (SES) (education, income, wealth, occupation, neighbourhood environment, and childhood SES) and eight epigenetic clocks in two well-powered US ageing studies: The Multi-Ethnic Study of Atherosclerosis (MESA) (n~=~1,211) and the Health and Retirement Study (HRS) (n~=~4,018). In both studies, we found robust associations between SES measures in adulthood and the GrimAge and DunedinPoAm clocks (Bonferroni-corrected -value < 0.01). In the HRS, significant associations with the Levine and Yang clocks were also evident. These associations were only partially mediated by smoking, alcohol consumption, and obesity, which suggests that differences in health behaviours alone cannot explain the SES gradient in epigenetic ageing in older adults. Further analyses revealed concurrent associations between polygenic risk for accelerated intrinsic epigenetic ageing, SES, and the Levine clock, indicating that genetic risk and social disadvantage may contribute additively to faster biological aging.

}, keywords = {DNA methylation age, epigenetic clock, polygenic score, socioeconomic status}, issn = {1559-2308}, doi = {10.1080/15592294.2021.1939479}, author = {Lauren L Schmitz and Zhao, Wei and Scott M Ratliff and Goodwin, Julia and Miao, Jiacheng and Lu, Qiongshi and Guo, Xiuqing and Kent D Taylor and Ding, Jingzhong and Liu, Yongmei and Morgan E. Levine and Smith, Jennifer A} } @article {AVILA2022107454, title = {Socioeconomic Status across the Life Course and Smoking Cessation among Older Adult Smokers in the U.S}, journal = {Addictive Behaviors}, volume = {135}, year = {2022}, pages = {107454}, abstract = {Socioeconomic status (SES) at different stages of the life course impacts late-life health. However, whether SES across the life course impacts smoking cessation in late-life is not known. Purpose: Assess how life course SES impacts smoking cessation among older smokers. Methods We identified 5,124 smokers, 50 years and older, from the 1998 to 2018 waves of the Health and Retirement Study. The outcome was self-reported smoking cessation. The main exposure was life course SES, defined as: low child and low adult SES (persistent low); low child, high adult SES (upward mobility); high child, low adult SES (downward mobility); and high child, high adult SES (persistent high). A multilevel mixed-effect logistic model was used to examine how life course SES predicts smoking cessation at age 65 and over time, adjusted for covariates. Results Compared to those with persistent high SES, those with persistent low SES, upward and downward SES were more likely to be Hispanic or non-Hispanic Black. The adjusted results showed that at age 65, compared to those with persistent high SES, those with persistent low SES (OR=0.69, 95\% CI= [0.51-0.92]), upward SES (OR=0.49, [0.32-0.75]), and downward SES (OR=0.55, [0.40-0.76]) were less likely to quit. However, as age increased, only those with downward or persistent low SES were significantly less likely to quit compared to those with persistent high SES. Conclusion: Social mobility of SES from childhood to adulthood significantly impacts smoking cessation. Both stages of the life course should be considered to understand smoking behaviors.}, keywords = {Smoking cessation, socioeconomic status, Tobacco}, issn = {0306-4603}, doi = {10.1016/j.addbeh.2022.107454}, author = {Jaqueline C. Avila and Sangah Lee and Ezinwa Osuoha and Dale Dagar Maglalang and Alexander Sokolovsky and Jasjit S. Ahluwalia} } @article {12652, title = {Socioeconomic Status, Biological Aging, and Memory in a Diverse National Sample of Older US Men and Women.}, journal = {Neurology}, volume = {99}, year = {2022}, pages = {e2114-e2124}, abstract = {

BACKGROUND AND OBJECTIVES: Exposure to socioeconomic disadvantage is associated with early-onset cognitive aging. Biological aging, the progressive loss of system integrity that occurs as we age is proposed as a modifiable process mediating this health inequality. We examined whether socioeconomic disparities in cognitive aging in mid-to late-life adults is explained by accelerated biological aging similarly across race, ethnicity and sex/gender.

METHODS: Data was from a prospective cohort study of the U.S. Health and Retirement Study DNA-methylation sub-study. Socioeconomic status (SES) was measured from years of education and household wealth at baseline. The extent and pace of biological aging were quantified using three DNA-methylation measures: PhenoAge, GrimAge, and DunedinPoAm. Cognitive aging was measured from repeated longitudinal assessments of immediate and delayed word recall. Latent growth curve modeling estimated participants{\textquoteright} level of memory performance and rate of decline over 2-11 follow-up assessments spanning 2-20 years. Multiple-group models were estimated to assess whether the relationship between SES and memory trajectories was mediated by biological aging across racial-ethnic by sex/gender subgroups.

RESULTS: Data from a total of 3,997 adults aged 50-100 were analyzed. Participants with lower SES had lower memory performance, faster decline and exhibited accelerated biological aging (SES effect size associations (β) ranged from .08 to .41). Accelerated biological aging was associated with decreased memory performance and faster memory decline (effect-size range .03 to .23). SES-biological aging associations were strongest for White men and women and weakest for Latinx women. The relationship between biological aging measures and memory was weaker for Black participants compared with White and Latinx people. In mediation analysis, biological aging accounted for 4-27\% of the SES-memory gradient in White participants. There was little evidence of mediation in Black or Latinx participants.

DISCUSSION: Among a national sample of mid-to late-life adults, DNA-methylation measures of biological aging were variably associated with memory trajectories and SES across White, Black, and Latinx mid-to late-life adults. These results challenge the assumption that DNA-methylation biomarkers of aging that were developed in primarily White people can equivalently quantify aging processes affecting cognition in Black and Latinx mid-to late-life adults.

}, keywords = {biological aging, Cognition, DNA Methylation, Race/ethnicity, sex/gender, socio-economic status}, issn = {1526-632X}, doi = {10.1212/WNL.0000000000201032}, author = {Avila-Rieger, Justina and Turney, Indira C and Vonk, Jet M J and Esie, Precious and Seblova, Dominika and Weir, Vanessa R and Belsky, Daniel W and Jennifer J Manly} } @article {12782, title = {Sons and parental cognition in mid-life and older adulthood.}, journal = {Journal of Psychiatric Research}, volume = {156}, year = {2022}, pages = {284-290}, abstract = {

Prior research suggests a relationship between number of sons and maternal long-term health outcomes, including dementia. We assessed the relationship between having sons and parental cognitive aging. Specifically, we investigated the relationship between having at least 1 son and parental baseline cognition level and rate of cognitive decline, accounting for life course sociodemographic characteristics in a cohort of 13~222 adults aged >=50 years from the US Health and Retirement Study. We included only participants with at least one child. We further explored whether this relationship varies by parental sex and whether the magnitude of the relationship increases with each additional son. Cognition was assessed biennially for a maximum of nine times as a sum of scores from immediate and delayed 10-noun free recall tests, a serial 7s subtraction test, and a backwards counting test. Associations were evaluated using linear mixed-effects models, stepwise adjusting for sociodemographic and health-related factors. In our analytic sample of parents, a total of 82.3\% of respondents had at least 1 son and 61.6\% of respondents were female. Parents of at least 1 son had a faster rate of cognitive decline in comparison to parents without any son. Our results also suggest that cognitive decline was faster among parents of multiple sons, compared to parents with only daughters. Thus, the results support the theory that having sons might have a long-term negative effect on parental cognition.

}, keywords = {cognitive aging, Dementia, offspring sex}, issn = {1879-1379}, doi = {10.1016/j.jpsychires.2022.10.026}, author = {Wolfova, Katrin and Wu, Di and Weiss, Jordan and Cermakova, Pavla and Kohler, Hans-Peter and Skirbekk, Vegard Fykse and Stern, Yaakov and Gemmill, Alison and Tom, Sarah E} } @article {10.1093/geroni/igac059.2108, title = {SPOUSAL ASSOCIATIONS BETWEEN GRANDPARENT CAREGIVING AND WELL-BEING: FINDINGS FROM THE HEALTH AND RETIREMENT STUDY}, journal = {Innovation in Aging}, volume = {6}, year = {2022}, pages = {558}, abstract = {Numerous studies document the impact of grandparent caregiving on the health and well-being of grandparents; however, there has been little dyadic research on how the caregiving and health-related outcomes of one grandparent influence partner couples The purpose of this study was to determine the interdependence of grandparents{\textquoteright} intensity of caregiving and well-being (i.e., depressive symptoms and self-rated health) over time. Participants were 7,133 dyads of American grandparents aged >= 50 who participated in the Health and Retirement Study, a population-based study of community-dwelling adults, in 2010 and 2012. Data on hours of grandparent caregiving in the past two years, depressive symptoms, and self-rated health were obtained via self-report. Two longitudinal, dyadic path analyses were conducted using the Actor-Partner Interdependence Model. Within individuals (actor effects), greater depressive symptoms and better self-rated health at baseline, predicted greater depressive symptoms and better self-rated health two years later. Between spouses (partner effects), an individuals{\textquoteright} greater depressive symptoms predicted the spouses{\textquoteright} greater depressive symptoms. However, grandfathers{\textquoteright} better self-rated health predicted subsequent better grandmothers{\textquoteright} self-rated health, but not vice versa. Further, greater depressive symptoms among grandmothers predicted lower subsequent caregiving intensity among both grandmothers and grandfathers. Additionally, better self-rated health among grandfathers predicted better self-rated health and lower subsequent self and spousal grandparenting caregiving intensity. Our findings demonstrate that depressive symptoms, self-rated health, and caregiving intensity are interrelated among grandparent couples. Interventions for improving well-being and caregiving outcomes that focus on couples may be more effective than those that focus on individuals.}, keywords = {Caregiving, grandparent, Spouses, Well-being}, issn = {2399-5300}, doi = {10.1093/geroni/igac059.2108}, author = {Chan, Athena Chung Yin and Sneed, Rodlescia} } @article {12938, title = {State-level metabolic comorbidity prevalence and control among adults age 50-plus with diabetes: estimates from electronic health records and survey data in five states.}, journal = {Population Health Metrics}, volume = {20}, year = {2022}, pages = {22}, abstract = {

BACKGROUND: Although treatment and control of diabetes can prevent complications and reduce morbidity, few data sources exist at the state level for surveillance of diabetes comorbidities and control. Surveys and electronic health records (EHRs) offer different strengths and weaknesses for surveillance of diabetes and major metabolic comorbidities. Data from self-report surveys suffer from cognitive and recall biases, and generally cannot be used for surveillance of undiagnosed cases. EHR data are becoming more readily available, but pose particular challenges for population estimation since patients are not randomly selected, not everyone has the relevant biomarker measurements, and those included tend to cluster geographically.

METHODS: We analyzed data from the National Health and Nutritional Examination Survey, the Health and Retirement Study, and EHR data from the DARTNet Institute to create state-level adjusted estimates of the prevalence and control of diabetes, and the prevalence and control of hypertension and high cholesterol in the diabetes population, age 50 and over for five states: Alabama, California, Florida, Louisiana, and Massachusetts.

RESULTS: The estimates from the two surveys generally aligned well. The EHR data were consistent with the surveys for many measures, but yielded consistently lower estimates of undiagnosed diabetes prevalence, and identified somewhat fewer comorbidities in most states.

CONCLUSIONS: Despite these limitations, EHRs may be a promising source for diabetes surveillance and assessment of control as the datasets are large and created during the routine delivery of health care.

TRIAL REGISTRATION: Not applicable.

}, keywords = {Comorbidity, Diabetes Mellitus, Electronic Health Records, Prevalence, Self Report}, issn = {1478-7954}, doi = {10.1186/s12963-022-00298-z}, author = {Mardon, Russell and Campione, Joanne and Nooney, Jennifer and Merrill, Lori and Johnson, Maurice and Marker, David and Jenkins, Frank and Saydah, Sharon and Rolka, Deborah and Zhang, Xuanping and Shrestha, Sundar and Gregg, Edward} } @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 {12220, title = {Subjective Aging and Objectively Assessed Hearing Function: A Prospective Study of Older Adults.}, journal = {The Journals of Gerontology, Series B }, volume = {77}, year = {2022}, pages = {1637-1644}, abstract = {

OBJECTIVES: Subjective aging is consistently related to a range of health-related outcomes, but little is known about its relationship with sensory functioning. The present prospective study tested whether subjective age and self-perceptions of aging (SPA) are associated with objective hearing function.

METHOD: Participants were 7,085 individuals aged 50 to 93 years (60\% women, Mean= 65.15, SD= 8.71) from the Health and Retirement Study (HRS). Measures of subjective age, SPA, and information on demographic factors were obtained in 2008/2010. Objective hearing function was assessed eight years later in 2016/2018. Furthermore, potential mediating variables (c-reactive protein, body mass index, physical inactivity, and chronic conditions) were assessed in 2012/2014.

RESULTS: In regression analyses that accounted for demographic factors, older subjective age and negative SPA were associated with lower hearing acuity eight years later. In addition, 1 SD older subjective age and negative SPA were related to a 9\% and 7\% higher likelihood of hearing impairment. Mediation analyses revealed that physical inactivity and chronic conditions partially mediated subjective age and SPA associations with hearing acuity. There was little evidence that the link between subjective aging and hearing was moderated by hearing aids and partial support for a moderating role of age.

CONCLUSION: This study provides new evidence that subjective aging is prospectively related to hearing function. Individuals with older subjective age or negative SPA have unfavorable behavioral and clinical profiles that explain part of their lower hearing function. Individuals{\textquoteright} experience with their aging process is a marker of risk for impaired hearing.

}, keywords = {hearing acuity, self-perceptions of aging, Subjective age}, issn = {1758-5368}, doi = {10.1093/geronb/gbac018}, author = {Yannick Stephan and Angelina R Sutin and Antonio Terracciano} } @article {12682, title = {Subjective Cognitive Decline: Is a Resilient Personality Protective Against Progression to Objective Cognitive Impairment? Findings from Two Community-Based Cohort Studies.}, journal = {Journal of Alzheimer{\textquoteright}s Disease}, volume = {89}, year = {2022}, pages = {87-105}, abstract = {

BACKGROUND: Subjective cognitive decline (SCD) is related to personality functioning and risk of subsequent objective cognitive impairment.

OBJECTIVE: The aim of this study was to examine whether lower neuroticism and higher conscientiousness-resilient personality traits-protect against conversion from SCD to objective cognitive impairment in two longitudinal community-based cohorts.

METHODS: Data from the Health and Retirement Study (N = 1,741, Mean age = 68.64 years, Follow-up mean = 7.34 years) and the National Health and Aging Trends Survey (N = 258, Mean age = 79.34 years, Follow-up mean = 4.31 years) were analyzed using Cox regression analysis, controlling for sociodemographic covariates, symptoms of anxiety and depression, and apolipoprotein ɛ4.

RESULTS: The pooled results showed that lower neuroticism and higher conscientiousness were associated with decreased risk of conversion from SCD to objective cognitive impairment.

CONCLUSION: Among individuals with SCD, those with a resilient personality may have more cognitive and psychological reserve to maintain cognitive functioning and delay conversion to objective cognitive impairment. The findings further contribute to a better understanding of personality along the cognitive continuum: The observed effect sizes were smaller than those reported in cognitively normal individuals but larger than in individuals with mild cognitive impairment. Personality could provide useful information to identify individuals with SCD who may develop objective cognitive impairment-namely those who hold a vulnerable personality (higher neuroticism, lower conscientiousness).

}, keywords = {Apolipoprotein E4, Cognitive Dysfunction, Personality, Personality Disorders}, issn = {1875-8908}, doi = {10.3233/JAD-220319}, author = {Aschwanden, Damaris and Sutin, Angelina R and Ledermann, Thomas and Luchetti, Martina and Stephan, Yannick and Sesker, Amanda A and Zhu, Xianghe and Terracciano, Antonio} } @article {11693, title = {Self-Rated Health and Incident Dementia over Two Decades: Replication Across Two Cohorts}, journal = {Journal of Psychiatric Research}, volume = {143}, year = {2021}, pages = {462-466}, abstract = {This prospective study examined the association between self-rated health and incident dementia in two large cohorts of middle-aged and older adults. Participants were drawn from the Health and Retirement Study (HRS, N= 13,839, Mean Age= 64.32, SD= 9.04) and the English Longitudinal Study of Ageing (ELSA, N=4649, Mean Age = 64.44, SD= 9.97). Self-rated health and covariates were assessed at baseline in 1998 and 2002, and cognitive status was tracked for up to 21 years in HRS and 17 years in ELSA, respectively. Controlling for demographic factors, poorer self-rated health was associated with higher risk of incident dementia in HRS (HR: 1.18, 95\%CI: 1.12-1.24, p<.001) and ELSA (HR: 1.38, 95\%CI: 1.23-1.55, p<.001). These associations remained significant when diabetes, hypertension, smoking, physical inactivity, depressive symptoms, personality, and polygenic risk for Alzheimer{\textquoteright}s Disease were included as additional covariates or when cases occurring within the first ten years of follow-up were excluded from the analyses. There was no replicable evidence that age, sex, education, race or ethnicity moderated the association. Self-rated health is a long-term, replicable predictor of incident dementia that is independent of genetic, clinical, and behavioral risk factors.}, keywords = {Dementia, longitudinal, Risk Factors, Self-rated health}, isbn = {0022-3956}, doi = {10.1016/j.jpsychires.2021.06.036}, author = {Yannick Stephan and Angelina R Sutin and Martina Luchetti and Damaris Aschwanden and Antonio Terracciano} } @article {11648, title = {Self-Reported Dementia-Related Diagnosis Underestimates the Prevalence of Older Americans Living with Possible Dementia.}, journal = {Journal of Alzheimer{\textquoteright}s Disease}, volume = {82}, year = {2021}, pages = {373-380}, abstract = {

BACKGROUND: Dementia screening is an important step for appropriate dementia-related referrals to diagnosis and treat possible dementia.

OBJECTIVE: We 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).

METHODS: The weighted analytical sample included 6,036,224 Americans aged at least 65 years old 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 Health and Retirement Study. The adapted Telephone Interview of Cognitive Status assessed cognitive functioning. Those with scores<=6 were considered as having a CICD. Healthcare provider dementia-related diagnosis was self-reported. Age, sex, educational achievement, and race and ethnicity were also self-reported.

RESULTS: The overall estimated prevalence of no reported dementia-related diagnosis for older Americans with a CICD was 91.4\%(95\%confidence interval (CI): 87.7\%-94.1\%). Persons with a CICD who identified as non-Hispanic black had a high prevalence of no reported dementia-related diagnosis (93.3\%; CI: 89.8\%-95.6\%). The estimated prevalence of no reported dementia-related diagnosis was greater in males with a CICD (99.7\%; CI: 99.6\%-99.8\%) than females (90.2\%; CI: 85.6\%-93.4\%). Moreover, the estimated prevalence of no reported dementia-related diagnosis for non-high school graduates with a CICD was 93.5\%(CI: 89.3\%-96.1\%), but 90.9\%(CI: 84.7\%-94.7\%) for those with at least a high school education.

CONCLUSION: Dementia screening should be encouraged during routine geriatric health assessments. Continued research that evaluates the utility of self-reported dementia-related measures is also warranted.

}, keywords = {Aging, Cognitive Dysfunction, Geriatric Assessment, Geriatrics, Healthcare Disparities}, issn = {1875-8908}, doi = {10.3233/JAD-201212}, author = {Ryan P McGrath and Sheria G Robinson-Lane and Brian C Clark and Suhr, Julie A and Bruno J Giordani and Brenda Vincent} } @article {11753, title = {Semiparametric methods for incomplete longitudinal count data with an application to Health and Retirement Study}, journal = {Journal of Applied Statistics}, volume = {49}, year = {2021}, pages = {3513-3535}, abstract = {In this paper, we propose and explore a novel semiparametric approach to analyzing longitudinal count data. We address the issue of missingness in longitudinal data and propose a weighted generalized estimations equations approach to fitting marginal mean response models for count responses with dropouts. Also, we investigate a spline regression approach to approximating the curvilinear relationship between the mean response and covariates. The asymptotic properties of the proposed estimators are studied in some detail. The empirical properties of the estimators are investigated using Monte Carlo simulations. An application is also provided using actual survey data obtained from the Health and Retirement Study (HRS).}, keywords = {Generalized estimating equation, inverse probability weight, Missing response, Monte Carlo Method, semiparametric method, spline regression}, isbn = {0266-4763}, doi = {10.1080/02664763.2021.1951684}, author = {Zubair, Seema and Sinha, Sanjoy K.} } @article {11674, title = {Sex, age, BMI, and C-Reactive Protein impact the odds of developing hypertension - findings based on data from the Health and Retirement Study (HRS).}, journal = {American Journal of Hypertension}, volume = {34}, year = {2021}, pages = {1057-1063}, abstract = {

BACKGROUND: Hypertension is a major contributor to cardiovascular diseases and premature death. Despite widespread use of antihypertensive medication, it remains a concern, therefore determining factors that contribute to such a high burden of disease is critically important. This study examined anthropometric and physical measurements, as well as blood and saliva biomarkers, as predictors for hypertension using datasets from the 2008 Health and Retirement Study.

METHODS: A total of 2924 participants (aged 74.84 {\textpm} 6.45 years) were included. Binary logistic regression was performed to ascertain the effects of sex, age, telomere length, C-reactive protein (CRP), BMI, and additional markers on the odds of developing hypertension.

RESULTS: Males had 2.3 times the odds (OR = 2.313 CI 95\% (1.391, 3.845); p = 0.001) of being hypertensive if they were obese, females had 1.7 times the odds (OR = 1.788 CI 95\% (1.260,2.536); p = 0.001) if overweight, and 2.4 times (OR = 2.479 CI 95\% (1.693, 3.630); p < 0.001) if obese. Age in females was an independent predictor where every one-year increase in age was tied to a 5.1\% increase in being hypertensive (OR = 1.051 CI 95\% (1.027, 1.075); p <0.001) and, CRP (>3mg/L) had 1.4 times the odds (OR = 1.447 CI 95\% (1.079, 1.942); p = 0.014).

CONCLUSIONS: This study provides verification for BMI as a predictor for hypertension and proposes age and CRP as predictors for females. Specific sex differences and life stage should be considered when evaluating hypertension risk to improve clinical outcomes and promote healthy aging.

}, keywords = {BMI, C-reactive protein, Hypertension, Inflammation, Telomere length}, issn = {1941-7225}, doi = {10.1093/ajh/hpab088}, author = {Speer, H and D{\textquoteright}Cunha, N M and Naumovski, N and McKune, A J} } @conference {12003, title = {Sex and racial/ethnic associations with post-stroke cognitive decline: longitudinal analyses from the health and retirement study}, booktitle = {World Stroke Congress}, year = {2021}, abstract = {Background and Aims Evidence on sex and race/ethnic disparities in post-stroke cognitive decline have largely been inconclusive. We investigate these disparities using a series of quasi-experimental models. Methods Using the Health and Retirement Study (HRS), a biennial survey of a nationally representative sample of community dwellers in the US aged 51 years and older, we applied the two-way fixed effects model, event study design, and Bacon{\textquoteright}s weighted difference-in-differences (DiD) estimation for survey panel data (1996 - 2016), to evaluate the differences in the modified Telephone Interview for Cognitive Status (TICS-m) score (lower scores representing lower cognitive functioning) between patients with and without self-reported incident stroke, while controlling for observed and unobserved time-invariant baseline participant characteristics such as age and education, as well as time-specific confounders. Results Of the 35,451 HRS participants that met the inclusion criteria (Figure.1), 4,620 (13.03\%) had incident stroke. The mean (SD) TICS-m score post vs pre incident stroke was 12.8 (0.02) vs. 15.5 (0.07). The two-way fixed effects estimator for the relationship between incident stroke and cognitive decline was -1.21(95\% CI:-1.32,-1.10), which was similar to the weighted DiD estimate of -1.25(95\% CI:-1.38,-1.13). Event study revealed a continuous decline in TICS-m score, up to 10 years after stroke incidence in the overall sample, as well as among females and white non-Hispanics (Figure.1). However, the decline in TICS-m score plateaued from the third wave post-stroke for males and second wave post-stroke for black non-Hispanics. Conclusions Sex and race differences may illuminate variations in cognitive decline associated with stroke.}, keywords = {Cognitive decline, post-stroke, Racial/ethnic differences, sex}, url = {https://www.researchgate.net/publication/356069921_Sex_and_racialethnic_associations_with_post-stroke_cognitive_decline_longitudinal_analyses_from_the_health_and_retirement_study}, author = {Bako, Abdulaziz and Potter, Thomas and Pan, Alan and Smith, M.} } @article {BLOOMBERG2021, title = {Sex differences in functional limitations and the role of socioeconomic factors: a multi-cohort analysis}, journal = {The Lancet Healthy Longevity}, volume = {2}, year = {2021}, pages = {e780-e790}, abstract = {Summary Background Women are more likely to have functional limitations than are men, partly because of greater socioeconomic disadvantage. However, how sex differences vary by severity of functional limitations remains unclear. We examined sex differences in functional limitations, with attention to socioeconomic factors and severity of limitations. Methods Longitudinal data on limitations in basic activities of daily living (ADL) and instrumental activities of daily living (IADL) and mobility activities were drawn from 62 375 participants from 14 countries. For ADL, IADL, and mobility, participants were categorised based on number of limited activities (0, 1, 2, or >=3). Sex differences in limitations in four birth cohorts (1895{\textendash}1929, 1930{\textendash}38, 1939{\textendash}45, and 1946{\textendash}60) were analysed before and after adjustment for socioeconomic factors (education and labour force status). Findings The prevalence of IADL and ADL limitations was higher in women than in men. After adjustment for socioeconomic factors, this sex difference was attenuated. The sex difference in IADL limitations at age 75 years (in the 1895{\textendash}1929 cohort) was 3{\textperiodcentered}7\% before adjustment for socioeconomic factors (95\% CI 2{\textperiodcentered}6{\textendash}4{\textperiodcentered}7) and 1{\textperiodcentered}7\% (1{\textperiodcentered}1{\textendash}2{\textperiodcentered}2) after adjustment. For ADL, the sex difference in limitations at age 75 years (in the 1895{\textendash}1929 cohort) was 3{\textperiodcentered}2\% (2{\textperiodcentered}3{\textendash}4{\textperiodcentered}1) before adjustment for socioeconomic factors and 1{\textperiodcentered}4\% (0{\textperiodcentered}9{\textendash}1{\textperiodcentered}8) after adjustment. Sex differences in mobility limitations (16{\textperiodcentered}1\%, 95\% CI 14{\textperiodcentered}4{\textendash}17{\textperiodcentered}7) remained after adjustment for socioeconomic factors (14{\textperiodcentered}3\%, 12{\textperiodcentered}7{\textendash}15{\textperiodcentered}9). After age 85 years, women were more likely to have three or more IADL or mobility limitations and men were more likely to have one or two limitations. Interpretation Socioeconomic factors largely explain sex differences in IADL and ADL limitations but not mobility. Sex differences in mobility limitations in midlife are important targets for future research and interventions. Funding National Institute on Aging, UK National Institute for Health Research, European Commission, and US Social Security Administration.}, keywords = {Activities of Daily Living, ELSA, Functional limitations, Sex differences, SHARE, Sister studies, Socioeconomic factors, TILDA}, issn = {2666-7568}, doi = {https://doi.org/10.1016/S2666-7568(21)00249-X}, author = {Mikaela Bloomberg and Aline Dugravot and Benjamin Landr{\'e} and Annie Britton and Andrew Steptoe and Archana Singh-Manoux and S{\'e}verine Sabia} } @article {WuE361, title = {Sex differences in mortality: results from a population-based study of 12 longitudinal cohorts}, journal = {CMAJ}, volume = {193}, year = {2021}, pages = {E361{\textendash}E370}, abstract = {BACKGROUND: Women generally have longer life expectancy than men but have higher levels of disability and morbidity. Few studies have identified factors that explain higher mortality in men. The aim of this study was to identify potential factors contributing to sex differences in mortality at older age and to investigate variation across countries.METHODS: This study included participants age >= 50 yr from 28 countries in 12 cohort studies of the Ageing Trajectories of Health: Longitudinal Opportunities and Synergies (ATHLOS) consortium. Using a 2-step individual participant data meta-analysis framework, we applied Cox proportional hazards modelling to investigate the association between sex and mortality across different countries. We included socioeconomic (education, wealth), lifestyle (smoking, alcohol consumption), social (marital status, living alone) and health factors (cardiovascular disease, diabetes, mental disorders) as covariates or interaction terms with sex to test whether these factors contributed to the mortality gap between men and women.RESULTS: The study included 179 044 individuals. Men had 60\% higher mortality risk than women after adjustment for age (pooled hazard ratio [HR] 1.6; 95\% confidence interval 1.5{\textendash}1.7), yet the effect sizes varied across countries (I2 = 71.5\%, HR range 1.1{\textendash}2.4). Only smoking and cardiovascular diseases substantially attenuated the effect size (by about 22\%).INTERPRETATION: Lifestyle and health factors may partially account for excess mortality in men compared with women, but residual variation remains unaccounted for. Variation in the effect sizes across countries may indicate contextual factors contributing to gender inequality in specific settings.}, keywords = {CHARLS, ELSA, JSTAR, KLoSA, Men, Mortality, SHARE, women}, issn = {0820-3946}, doi = {10.1503/cmaj.200484}, author = {Wu, Yu-Tzu and Niubo, Albert Sanchez and Daskalopoulou, Christina and Moreno-Agostino, Dario and Stefler, Denes and Bobak, Martin and Oram, Sian and Prince, Martin and Matthew Prina} } @mastersthesis {11933, title = {Should I Stay or Should I Go? Mexican Return Migration across the Life Course }, year = {2021}, school = {The City University of New York}, address = {New York, NY}, abstract = {Foreign-born individuals make up a growing share of older adults in the US. Older immigrants offer an important vantage point from which to investigate integration because outcomes at older ages can be considered {\textquotedblleft}final{\textquotedblright} measures providing empirical evidence for theoretical understandings of the forces impacting immigrant trajectories. However, considering the non-negligible portion of immigrants that ultimately return to their country of origin it is impossible to get the full range of immigrant outcomes without considering returnees. Further, patterns of return may differ across the life course with distinct economic, social, and health considerations at older ages. However, the impact of selective return migration, including considerations of heterogeneity by life stage, on immigrant outcomes at older ages remains understudied. }, keywords = {life course, Mexico, MHAS, Migration}, url = {https://academicworks.cuny.edu/cgi/viewcontent.cgi?article=5622\&context=gc_etds}, author = {Mara Getz Sheftel} } @article {11261, title = {Social Media Communication and Loneliness Among Older Adults: The Mediating Roles of Social Support and Social Contact.}, journal = {Gerontologist}, volume = {61}, year = {2021}, pages = {888-896}, abstract = {

BACKGROUND AND OBJECTIVES: Social media communication offers a medium for helping older people stay socially and emotionally connected with others. This study investigated the association between social media communication with close social ties and loneliness among community-dwelling older adults. The study also examined the mediating roles of social support and social contact.

RESEARCH DESIGN AND METHODS: Four waves of data from the Health and Retirement Study (2010/2012 and 2014/2016) were used to address the research questions (N = 7,524). A path model was estimated to examine the association between social media communication and older adults{\textquoteright} loneliness. We also examined whether the association between social media communication and loneliness was mediated by perceived social support from close social ties (children, other family members, and friends) and frequency of contact with social network members (phone, in-person contact, and writing letters/email).

RESULTS: The results showed that frequent social media communication was associated with lower levels of loneliness, adjusting for previous levels of loneliness. The relationship between social media communication and loneliness was mediated by perceived social support and social contact. Thus, social media communication was associated with higher levels of perceived social support and social contact, which were related to lower levels of loneliness among older adults.

DISCUSSION AND IMPLICATIONS: These findings suggested that social media communication may be considered an intervention to reduce loneliness among older people by increasing levels of social support and social contact.

}, keywords = {Directed communication, Emotional Health, Internet use, Social Networking Sites}, issn = {1758-5341}, doi = {10.1093/geront/gnaa197}, author = {Zhang, Kunyu and Kim, Kyungmin and Nina M Silverstein and Song, Qian and Jeffrey A Burr} } @article {ABELIANSKY2021100924, title = {Social vulnerability and aging of elderly people in the United States}, journal = {SSM - Population Health}, volume = {16}, year = {2021}, pages = {100924}, abstract = {We use 7 waves of the Health and Retirement Study and construct a social vulnerability index (SVI) for elderly U.S. Americans (born 1913{\textendash}1966). We show that the SVI is mildly larger for men than for women and increases in age from above age 60 onwards for both genders. Social vulnerability of men (but not of women) is lower in the West and Midwest than in other regions and higher income mildly reduces the SVI for men (but not for women). In cohort analysis we find an increase of the SVI for individuals born in the late 1940s or later, which is, however, statistically significant only for women. In order to investigate the nexus between social vulnerability and aging, we construct a frailty index from the same data. We find that socially vulnerable persons display more health deficits at any age. Using the initial SVI (at first interview) we find that social vulnerability exerts a significant impact on subsequent accumulation of health deficits, which is of about the same size for men and women. A one standard deviation increase in the initial SVI leads to a 20 percent increase of the frailty index at any age.}, keywords = {frailty index, health, Social capital, Social vulnerability}, issn = {2352-8273}, doi = {10.1016/j.ssmph.2021.100924}, author = {Ana Lucia Abeliansky and Devin Erel and Holger Strulik} } @article {10999, title = {Subjective age and informant-rated cognition and function: A prospective study.}, journal = {Psychology and Aging}, volume = {36}, year = {2021}, pages = {338-343}, abstract = {

The present study examined whether subjective age is related to informant-rated cognition. Participants were adults ( = 2,337, mean age = 69.84 years, = 7.45) from the Health and Retirement Study who provided subjective age and demographic factors in 2008/2010 and informant-rated cognition in 2016 as part of the Harmonized Cognitive Assessment Protocol. An older subjective age was associated with informant reports of steeper cognitive decline, worse cognitive function, lower ability, and loss of ability to do everyday activities. The present study indicates that subjective age predicts cognitive function in everyday life as observed by knowledgeable informants. (PsycInfo Database Record (c) 2020 APA, all rights reserved).

}, keywords = {Cognition, HCAP, Subjective age}, issn = {1939-1498}, doi = {10.1037/pag0000566}, author = {Yannick Stephan and Angelina R Sutin and Martina Luchetti and Antonio Terracciano} } @article {STEPHAN2021110616, title = {Subjective age and multiple cognitive domains in two longitudinal samples}, journal = {Journal of Psychosomatic Research}, volume = {150}, year = {2021}, pages = {110616}, abstract = {Objective Subjective age is consistently related to memory performance and global cognitive function among older adults. The present study examines whether subjective age is prospectively related to specific domains of cognitive function. Method Participants were drawn from the Health and Retirement Study (HRS, N{\^A} ={\^A} 2549, Mean Age{\^A} ={\^A} 69.66, SD{\^A} ={\^A} 7.36) and the Midlife in the United States Survey (MIDUS, N{\^A} ={\^A} 2499, Mean Age{\^A} ={\^A} 46.24, SD{\^A} ={\^A} 11.25). In both samples, subjective age, depressive symptoms, chronic conditions, and demographic factors were assessed at baseline. Four domains of cognition were assessed 8{\^A} years later in the HRS and almost 20{\^A} years later in the MIDUS: episodic memory, speed-attention-executive, verbal fluency, and numeric reasoning. HRS also assessed visuospatial ability. Results Regression analysis revealed that an older subjective age was related to worse performance in the domains of episodic memory and speed-attention-executive in both samples. The effect size for the difference between a younger and an older subjective age was d{\^A} ={\^A} 0.14 (MIDUS) and d{\^A} ={\^A} 0.24 (HRS) for episodic memory and d{\^A} ={\^A} 0.25 (MIDUS) and d{\^A} ={\^A} 0.33 (HRS) for speed-attention-executive. Feeling older was related to lower verbal fluency in HRS (d{\^A} ={\^A} 0.30) but not in MIDUS, whereas no association was found with numeric reasoning in either sample. An older subjective age was related to lower visuospatial ability in HRS (d{\^A} ={\^A} 0.25). Conclusion Subjective age is prospectively related to performance in different cognitive domains. The associations between subjective age and both episodic memory and speed-attention-executive functions were replicable and robust over up to 20{\^A} years of follow-up.}, keywords = {Adulthood, Cognition, Executive function, Memory, numeric reasoning, Subjective age, verbal fluency, Visuospatial ability}, issn = {0022-3999}, doi = {10.1016/j.jpsychores.2021.110616}, author = {Yannick Stephan and Angelina R Sutin and Martina Luchetti and Damaris Aschwanden and Antonio Terracciano} } @article {STEPHAN2021104527, title = {Subjective Age and Verbal Fluency among Middle Aged and Older Adults: A Meta-Analysis of Five Cohorts}, journal = {Archives of Gerontology and Geriatrics}, volume = {97}, year = {2021}, pages = {104527}, abstract = {Objectives This study aimed to examine the relation between subjective age and verbal fluency in five large samples of older adults to advance knowledge on the role of subjective age in a complex cognitive function that is an intermediate marker of cognitive impairment and dementia risk. Methods Participants (N > 27,000), aged 32 to 99 years old, predominantly white, were from the Wisconsin Longitudinal Study Graduate (WLSG) and Siblings (WLSS) samples, the Health and Retirement Study (HRS), the Midlife in the United States Study (MIDUS), and the English Longitudinal Study of Ageing (ELSA). They provided complete data on subjective age, demographic factors and verbal fluency. Estimates from each sample were combined in a meta-analysis. Results Across each of the five samples and in the meta-analysis, an older subjective age was related to lower performance on the verbal fluency task. This association was independent of chronological age and was not moderated by age, sex, nor education. The difference in fluency between individuals with an older and younger subjective age ranged from d= .09 to d= .37 across the five samples. Conclusions This study found replicable evidence for an association between an older subjective age and lower verbal fluency, extending knowledge about an intermediate marker of cognitive function.}, keywords = {Adulthood, ELSA, Sister studies, Subjective age, verbal fluency}, issn = {0167-4943}, doi = {10.1016/j.archger.2021.104527}, author = {Yannick Stephan and Angelina R Sutin and Martina Luchetti and Damaris Aschwanden and Antonio Terracciano} } @article {11640, title = {Subjective age, depressive symptoms, and cognitive functioning across five domains.}, journal = {Journal of Clinical and Experimental Neuropsychology}, volume = {43}, year = {2021}, pages = {310-323}, abstract = {

: Younger subjective age predicts better episodic memory and executive functioning performance independent of chronological age. This study examined whether subjective age is associated with performance in five cognitive domains, quantified the extent to which these relationships are mediated by depressive symptoms, and tested whether these associations are moderated by chronological age. Participants in this cross-sectional study included 993 adults aged 65 and older from the Health and Retirement Study{\textquoteright}s 2016 Harmonized Cognitive Assessment Protocol. Moderated mediation models estimated direct and indirect effects of subjective age on factor scores representing episodic memory, executive functioning, language, visuoconstruction, and speed through depressive symptoms and tested whether associations differed according to chronological age. Depressive symptoms explained 21-32\% of the associations between subjective age and language, speed, episodic memory, and executive functioning. Chronological age moderated the indirect effect involving language, such that depressive symptoms were more strongly related to worse language performance at older chronological ages. After accounting for indirect effects, direct effects of younger subjective age remained for language and speed domains. This study extends research on the cognitive correlates of subjective age and demonstrates that depressive symptoms partly mediate these relationships. Subjective age may bemost strongly associated with language among individuals at older chronological ages not because they are more sensitive to the negative mental health impact of feeling older than they are but because they may be particularly vulnerable to the negative effects of depressive symptoms on language ability. Additional longitudinal research is needed to determine whether links between subjective age and cognition are causal versus predictive.

}, keywords = {Cognition, cognitive aging, Depressive symptoms, HCAP, Subjective age}, issn = {1744-411X}, doi = {10.1080/13803395.2021.1926436}, author = {Morris, Emily P and Afsara B. Zaheed and Sharifian, Neika and Sol, Ketlyne and A Zarina Kraal and Laura B Zahodne} } @article {11018, title = {Subjective Aging and Incident Cardiovascular Disease.}, journal = {The Journals of Gerontology: Series B}, volume = {76}, year = {2021}, pages = {910-919}, abstract = {

OBJECTIVES: Subjective aging, including subjective age and self-perceptions of aging (SPA), predicts health-related outcomes in older adults. Despite its association with cardiovascular risk factors, little is known about the association between subjective aging and the incidence of cardiovascular disease. Therefore, the present study examined whether subjective age and SPA are related to the incidence of heart conditions and stroke.

METHODS: The sample comprises 10,695 participants aged 50-100 years from the Health and Retirement Study. Subjective age, SPA, demographic factors, and health-related behaviors, body mass index (BMI), hypertension, diabetes, and depressive symptoms were assessed at baseline. Self-reported physician diagnosis of heart conditions and stroke were assessed biennially over up to 9 years of follow-up.

RESULTS: Controlling for demographic factors, an older subjective age and more negative SPA were related to a higher risk of incident heart conditions and stroke. Feeling older and holding negative SPA were associated with around 40\% higher risk of experiencing heart conditions over time. An older subjective age and negative SPA were related to almost twofold and 30\% higher risk of incident stroke, respectively. Health risk behaviors, BMI, hypertension, diabetes, and depressive symptoms accounted for part of the associations between subjective aging and heart diseases and stroke.

CONCLUSIONS: Consistent with the literature on subjective aging and cardiovascular risk factors, this large prospective study indicates that an older subjective age and negative SPA increase the risk of incident stroke and other cardiovascular diseases.

}, keywords = {ardiovascular disease, self-perceptions of aging, Stroke, Subjective age}, issn = {1758-5368}, doi = {10.1093/geronb/gbaa106}, author = {Yannick Stephan and Angelina R Sutin and Wurm, Susanne and Antonio Terracciano} } @article {https://doi.org/10.1002/dad2.12252, title = {Subtle mistakes in self-report surveys predict future transition to dementia}, journal = {Alzheimer{\textquoteright}s \& Dementia: Diagnosis, Assessment \& Disease Monitoring}, volume = {13}, year = {2021}, pages = {e12252}, abstract = {Introduction We investigate whether indices of subtle reporting mistakes derived from responses in self-report surveys are associated with dementia risk. Methods We examined 13,831 participants without dementia from the prospective, population-based Health and Retirement Study (mean age 69 {\textpm} 10 years, 59\% women). Participants{\textquoteright} response patterns in 21 questionnaires were analyzed to identify implausible responses (multivariate outliers), incompatible responses (Guttman errors), acquiescent responses, random errors, and the proportion of skipped questions. Subsequent incident dementia was determined over up to 10 years of follow-up. Results During follow-up, 2074 participants developed dementia and 3717 died. Each of the survey response indices was associated with future dementia risk controlling for confounders and accounting for death as a competing risk. Stronger associations were evident for participants who were younger and cognitively normal at baseline. Discussion Mistakes in the completion of self-report surveys in longitudinal studies may be early indicators of dementia among middle-aged and older adults.}, keywords = {cognitive impairment, Dementia, early detection, Epidemiology, functional abilities, self-report surveys}, doi = {https://doi.org/10.1002/dad2.12252}, author = {Stefan Schneider and Junghaenel, Doerte U. and Elizabeth Zelinski and Erik Meijer and Arthur A. Stone and Kenneth M. Langa and Arie Kapteyn} } @article { ISI:000545748200001, title = {Sarcopenia Definition \& Outcomes Consortium Defined Low Grip Strength in Two Cross-Sectional, Population-Based Cohorts}, journal = {JOURNAL OF THE AMERICAN GERIATRICS SOCIETY}, volume = {68}, year = {2020}, month = {JUL}, pages = {1438-1444}, type = {Article}, abstract = {BACKGROUND/OBJECTIVES The extent to which the prevalence of muscle weakness in the US population varies by different putative grip strength constructs developed by the Sarcopenia Definitions and Outcomes Consortium (SDOC) has not been described. DESIGN Cross-sectional analysis. SETTING Two nationally representative cohorts-2010 and 2012 waves of the Health and Retirement Survey and round 1 (2011) of the National Health and Aging Trends Survey. PARTICIPANTS Adults aged 65 years and older (n = 12,984) were included in these analyses. MEASUREMENTS We analyzed three constructs of muscle weakness developed by the SDOC, and found to be associated with mobility disability for men and women, respectively: absolute grip strength (<35.5 kg and 20 kg); grip strength standardized to body mass index (<1.05 kg/kg/m(2) and 0.79 kg/kg/m(2)); and grip strength standardized to weight (<0.45 kg/kg and 0.337 kg/kg). We estimated the prevalence of muscle weakness defined by each of these constructs in the overall older US population, and by age, sex, race, and ethnicity. We also estimated the sensitivity and specificity of each of the grip strength constructs to discriminate slowness (gait speed <0.8 m/s) in these samples. RESULTS The prevalence of muscle weakness ranged from 23\% to 61\% for men and from 30\% to 66\% for women, depending on the construct used. There was substantial variation in the prevalence of muscle weakness by race and ethnicity. The sensitivity and specificity of these measures for discriminating slowness varied widely, ranging from 0.30 to 0.92 (sensitivity) and from 0.17 to 0.88 (specificity). CONCLUSIONS The prevalence of muscle weakness, defined by the putative SDOC grip strength constructs, depends on the construct of weakness used.}, keywords = {Gait, muscle, Physical performance, sarcopenia}, issn = {0002-8614}, doi = {10.1111/jgs.16419}, author = {Patel, Sheena M. and Kate A Duchowny and Douglas P Kiel and Correa-de-Araujo, Rosaly and Fielding, Roger A. and Travison, Thomas and Magaziner, Jay and Manini, Todd and Xue, Qian-Li and Anne B Newman and Pencina, Karol M. and Santanasto, Adam J. and Bhasin, Shalender and Peggy M Cawthon} } @article {11338, title = {Self-Related Views of Aging After Age 50: The Long-Term Effects of Poor Health in Childhood}, journal = {Innovation in Aging}, volume = {4}, year = {2020}, pages = {326}, abstract = {Age stereotypes and expectations about one{\textquoteright}s own aging commence in childhood but most research focuses on predictive associations with midlife health behaviors, later-life chronic conditions, and longevity. Surprisingly little is known about the role of poor childhood health in these associations. This study aims to fill this gap. Using data from the Health and Retirement Study (HRS: N = 5807; aged 50-98), we investigated whether diagnosed chronic illness before age 16 and self-rated childhood health predict late-life self-perceptions of aging (SPA) and subjective age discrepancy (AD). We conducted multivariate multiple regressions to determine the joint and unique effects of childhood health. Models included controls for current health (functional limitations), memory status, and demographic covariates (age, gender, race/ethnicity, marital status, and education). Multivariate tests (Pillai{\textquoteright}s trace) revealed that both childhood health indicators were significant predictors. Over and above all covariates and the covariation of the two views of one{\textquoteright}s own aging, univariate models showed that the number of childhood diagnoses was significant predictor of AD (p < .007) but not for SPA. In contrast, self-rated childhood health was a significant predictor of SPA (p < .001) but not for AD. This study provides new insight into precursors of self-evaluations of aging. Whereas childhood diagnoses of chronic illness attenuated the extent that individuals felt younger than their actual age, ratings of poor childhood health enhanced negative SPA. The non-normative experience of poor health in early life is a lifelong foundation for both late life beliefs and health.}, keywords = {Childhood, health, Self-Assessment}, isbn = {2399-5300}, doi = {10.1093/geroni/igaa057.1045}, author = {Jacqui Smith and Larkina, Marina} } @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 {10917, title = {Sense of purpose in life and five health behaviors in older adults}, journal = {Preventive Medicine}, volume = {139}, year = {2020}, abstract = {Accumulating evidence shows that a higher sense of purpose in life is associated with lower risk of chronic conditions and premature mortality. Health behaviors might partially explain these findings, however, the prospective association between sense of purpose and health behaviors is understudied. We tested whether a higher sense of purpose at baseline was associated with lower likelihood of developing unhealthy behaviors over time. Prospective data were from the Health and Retirement Study, a national sample of U.S. older adults. Our sample included 13,770 adults assessed up to five times across eight years. Among people who met recommended guidelines for a given health behavior outcome at baseline, those in the top versus lowest quartile of purpose in life had 24\% lower likelihood of becoming physically inactive (95\% CI: 0.68{\textendash}0.85), 33\% lower likelihood of developing sleep problems (95\% CI: 0.58{\textendash}0.79), and 22\% lower likelihood of developing unhealthy body mass index (BMI) (95\% CI: 0.69{\textendash}0.87) in sociodemographic-adjusted models. Further there was a marginal reduction in smoking relapse (HR = 0.65, 95\% CI: 0.41{\textendash}1.03) and no association with heavy alcohol use (HR = 1.02, 95\% CI: 0.81{\textendash}1.29). Findings for physical inactivity, sleep problems, and unhealthy BMI remained evident after further adjusting for baseline health status and depression. Our results, suggest that a sense of purpose in life might emerge (with further research) as a valuable target to consider for interventions aimed at helping older adults maintain some health behaviors.}, keywords = {Alcohol Consumption, Body Weight, Epidemiology, Health behaviors, Health psychology, Physical activity, psychological well-being, Purpose in life, Sleep, Smoking}, isbn = {0091-7435}, doi = {10.1016/j.ypmed.2020.106172}, author = {Eric S Kim and Shiba, Koichiro and Boehm, Julia K. and Laura D Kubzansky} } @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 {10879, title = {Sleep Difficulties and Cognition over a 10-Year Period in a National Sample of U.S. Older Adults}, journal = {Innovation in Aging}, year = {2020}, abstract = {Sleep difficulties are common among older adults and are associated with cognitive decline. We used data from a large, nationally representative longitudinal survey of adults over the age of 50 in the U.S. to examine the relationship between specific sleep difficulties and cognitive function over time.Longitudinal data from the 2004-2014 waves of the Health and Retirement Study were used in the current study. We examined sleep difficulties and cognitive function within participants and across time (n=16,201). Sleep difficulty measures included difficulty initiating sleep, nocturnal awakenings, early morning awakenings, and waking feeling rested from rarely/never (1) to most nights (3). The modified Telephone Interview for Cognitive Status (TICS-m) was used to measure cognitive function. Generalized Linear Mixed Models (GLMM) were used with time varying covariates to examine the relationship between sleep difficulties and cognitive function over time.In covariate-adjusted models, compared to {\textquotedblleft}never{\textquotedblright} reporting sleep difficulty, difficulty initiating sleep {\textquotedblleft}most nights{\textquotedblright} was associated with worse cognitive function over time (Year 2014: b=-0.40, 95\%CI: -0.63 to -0.16, p\<.01) as was difficulty waking up too early {\textquotedblleft}most nights{\textquotedblright} (Year 2014: b=-0.31, 95\%CI: -0.56 to -0.07, p\<.05). In covariate-adjusted analyses, compared to {\textquotedblleft}never{\textquotedblright} reporting waking up feeling rested, cognitive function was higher among those who reported waking up feeling rested {\textquotedblleft}some nights{\textquotedblright} (Year 2010: b=0.21, 95\%CI: 0.02 to 0.40, p\<.05).Our findings highlight an association between early morning awakenings and worse cognitive function, but also an association between waking feeling rested and better cognitive function over time.Sleep difficulties are common among older adults yet reduce quality of life and also contribute to the development of and potentially accelerate cognitive decline. This study examines specific sleep difficulties (e.g., difficulty falling asleep) and their unique relationship to cognition over time among older adults in the U.S. The primary aim of this work is to illuminate the specific sleep difficulties that are most concerning from the standpoint of cognitive impairment so as to inform the design of future tailored sleep improvement programs for older adults.}, keywords = {cognitive function, Gerontology, healthy aging, Sleep, Translational medicine}, isbn = {2399-5300}, doi = {10.1093/geroni/igaa025}, author = {Robbins, Rebecca and Amanda Sonnega and Robert W. Turner and Jean-Louis, Girardin and Butler, Mark and Osorio, Ricardo M and Kenneth M. Langa} } @article {Whibleye036219, title = {Sleep disturbance as a moderator of the association between physical activity and later pain onset among American adults aged 50 and over: evidence from the Health and Retirement Study}, journal = {BMJ Open}, volume = {10}, year = {2020}, pages = {e036219}, abstract = {Objective To examine whether sleep disturbance modifies the association between physical activity and incident pain.Design Prospective population-based study.Setting Health and Retirement Study.Participants American adults aged >=50 years who reported no troublesome pain in 2014 were re-assessed for pain in 2016. Of 9828 eligible baseline respondents, 8036 (82\%) had complete follow-up data for adjusted analyses (weighted analysis population N=42 407 222).Exposures Physical activity was assessed via interview with questions about time spent in moderate and vigorous physical activity. Sleep disturbance, assessed using a modified form of the Jenkins Sleep Scale, was examined as a potential moderator.Main outcome measure Troublesome pain.Results In weighted analyses, 37.9\% of the 2014 baseline pain-free sample participated in moderate or vigorous physical activity once a week or less, with an overall mean Physical Activity Index Score of 9.0 (SE=0.12). 18.6\% went on to report troublesome pain in 2016. Each one-point higher on the Physical Activity Index Score was associated with a reduced odds ratio (OR) of incident pain for those who endorsed sleep disturbance never/rarely (OR=0.97, 95\% CI 0.94 to 0.99), but not for those who endorsed sleep disturbance sometimes (OR=0.99, 95\% CI 0.97 to 1.01) or most of the time (OR=1.01, 95\% CI 0.99 to 1.03). The analysis of possible interaction demonstrated that frequency of sleep disturbance moderated the physical activity and incident pain association (Wald test: p=0.02).Conclusions The beneficial association of physical activity on reduced likelihood of later pain was only observed in persons who endorsed low levels of sleep disturbance.}, keywords = {pain, Physical activity, sleep disorders}, issn = {2044-6055}, doi = {10.1136/bmjopen-2019-036219}, author = {Whibley, Daniel and Heidi M Guyer and Swanson, Leslie M and Braley, Tiffany J and Kratz, Anna L and Galit L Dunietz} } @article {11313, title = {Social Media Communication and Loneliness Among Older Adults: The Mediating Roles of Social Support and Social Contact}, journal = {The Gerontologist}, year = {2020}, pages = {gnaa197}, abstract = {Social media communication offers a medium for helping older people stay socially and emotionally connected with others. This study investigated the association between social media communication with close social ties and loneliness among community-dwelling older adults. The study also examined the mediating roles of social support and social contact.Four waves of data from the Health and Retirement Study (2010/2012 and 2014/2016) were used to address the research questions (N = 7,524). A path model was estimated to examine the association between social media communication and older adults{\textquoteright} loneliness. We also examined whether the association between social media communication and loneliness was mediated by perceived social support from close social ties (children, other family members, and friends) and frequency of contact with social network members (phone, in-person contact, and writing letters/email).The results showed that frequent social media communication was associated with lower levels of loneliness, adjusting for previous levels of loneliness. The relationship between social media communication and loneliness was mediated by perceived social support and social contact. Thus, social media communication was associated with higher levels of perceived social support and social contact, which were related to lower levels of loneliness among older adults.These findings suggested that social media communication may be considered an intervention to reduce loneliness among older people by increasing levels of social support and social contact.}, keywords = {Directed communication, Emotional Health, Internet use, Social Networking Sites}, isbn = {0016-9013}, doi = {https://doi.org/10.1093/geront/gnaa197}, author = {Zhang, Kunyu and Kim, Kyungmin and Nina M Silverstein and Song, Qian and Jeffrey A Burr} } @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 {11468, title = {Social Security Wealth, Inequality, and Life-cycle Saving: An Update}, number = {MRDRC WP 2020-416}, year = {2020}, institution = {University of Michigan Retirement and Disability Research Center}, address = {Ann Arbor, MI}, abstract = {Social Security wealth (SSW) is the present value of future benefits an individual will receive less the present value of future taxes they will pay. When an individual enters the labor force, they generally face a lifetime of taxes to pay before they will receive any benefits and, thus, their initial SSW is generally low or negative. As an individual works and pays into the system their SSW grows and generally peaks somewhere around typical Social Security benefit claiming ages. The accrual of SSW over the working life is most important for lower income workers because the progressive Social Security benefit formula means that taxes paid while working are associated with proportionally higher benefits in retirement. We estimate SSW for individuals in the Survey of Consumer Finances (SCF) for 1995 through 2019 using detailed labor force history and expectations modules. We use a pseudo-panel approach to empirically demonstrate life-cycle patterns of SSW accumulation and drawdown. We also show that including SSW in a comprehensive wealth measure generally reduces estimated levels of U.S. wealth inequality, but does not reverse the upward trend in top wealth shares.}, keywords = {Inequality, life-cycle saving, social security wealth}, url = {https://mrdrc.isr.umich.edu/pubs/social-security-wealth-inequality-and-life-cycle-saving-an-update/}, author = {Sabelhaus, J. and Alice Henriques Volz} } @article {Parnia248, title = {Socioeconomic disparities in smoking are partially explained by chronic financial stress: marginal structural model of older US adults}, journal = {Journal of Epidemiology \& Community Health}, volume = {74}, year = {2020}, pages = {248{\textendash}254}, abstract = {Background A persistent socioeconomic gradient in smoking has been observed in a variety of populations. While stress is hypothesised to play a mediating role, the extent of this mediation is unclear. We used marginal structural models (MSMs) to estimate the proportion of the effect of socioeconomic status (SES) on smoking, which can be explained by an indicator of stress related to SES, experiences of chronic financial stress.Methods Using the Health and Retirement Study (waves 7{\textendash}12, 2004{\textendash}2014), a survey of older adults in the USA, we analysed a total sample of 15 260 people. A latent variable corresponding to adult SES was created using several indicators of socioeconomic position (wealth, income, education, occupation and labour force status). The main analysis was adjusted for other factors that influence the pathway from adult SES to stress and smoking, including personal coping resources, health-related factors, early-life SES indicators and other demographic variables to estimate the proportion of the effect explained by these pathways.Results Compared with those in the top SES quartile, those in the bottom quartile were more than four times as likely to be current smokers (rate ratio 4.37, 95\% CI 3.35 to 5.68). The estimate for the MSM attenuated the effect size to 3.34 (95\% CI 2.47 to 4.52). Chronic financial stress explained 30.4\% of the association between adult SES and current smoking (95\% CI 13 to 48).Conclusion While chronic financial stress accounts for part of the socioeconomic gradient in smoking, much remains unexplained.}, issn = {0143-005X}, doi = {10.1136/jech-2019-213357}, url = {https://jech.bmj.com/content/74/3/248}, author = {Parnia, Abtin and Siddiqi, Arjumand} } @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 {11191, title = {Socioeconomic Status and the Experience of Pain: An Example from Knees}, number = {27974}, year = {2020}, institution = {The National Bureau of Economic Research}, address = {Cambridge, MA}, abstract = {Reports of pain differ markedly across socioeconomic groups and are correlated with outcomes such as functional limitations and disability insurance receipt. This paper examines the differential experience of pain by education. We focus on knee pain, the most common musculoskeletal complaint. Comparing clinical interpretation of knee x-rays of people with and without pain, there are few differences in presence or clinical severity of arthritis across education groups. In contrast, less educated people report more pain for any given objective measure of arthritis. After confirming that reported pain maps to objective measures like walking speed and range of motion, we test four theories for differential experience of pain: differences in obesity, physically demanding occupations, psychological factors, and medical treatment differences. We find that physical demands on the job and obesity each explain about one-third of the education gradient in knee pain. There is an interaction between the two; physical requirements on the job are associated with knee pain primarily in those who are obese. In contrast, psychological traits and access to medical care explain little of the difference in reported pain by education level. These findings imply that educational gradients in pain are likely to persist or even widen as the need for physically demanding occupations{\textemdash}like home health aides and personal service workers{\textemdash}grows in importance with the aging population, and the working population continues to be obese.}, keywords = {pain, socioeconomic status}, doi = {10.3386/w27974}, author = {David M Cutler and Meara, Ellen and Stewart, Susan} } @article {10907, title = {Spending in retirement: How you just might find what you want and what you need}, year = {2020}, institution = {PGIM}, address = {Atlanta}, abstract = {As the defined contribution (DC) industry recognizes the need to shift its focus from accumulation to more holistic strategies designed to provide lifetime income, the challenge of portfolio decumulation and providing sustainable income through retirement needs to be thoughtfully addressed. In doing so, having a strong understanding of the retirement spending objectives for workers is the critical component. Historically, most investment solutions have been designed under the assumption that retirement spending is the same for all individuals, but the reality is the characteristics of retiree expenses vary greatly. For solutions to be successful in providing retirement income, they will need to better address the different types of spending workers will experience after they leave the workforce. We believe plan sponsors should evolve their DC plans to be more supportive of lifetime income, including more outcome-focused asset allocation, technology customized to the individual, institutional investments including non-guaranteed liability-driven investments, and guaranteed income solutions. In this paper, we focus onbetter understanding expenses in retirement and discuss the idea of using a {\textquotedblleft}Needs and Wants{\textquotedblright} framework for designing income-oriented investment solutions. It is our view that this type of approach to how spending in retirement is viewed may be able to provide better solutions and outcomes for workers.}, url = {https://www.pgim.com/piservices/pidocs/v1/RepositoryEntries/08EFE583F7C14C57ABFEC49D62BF0E97/File}, author = {Perna, Matthew and Stempien, Jeremy} } @article {10765, title = {Still shortchanged: An update on women{\textquoteright}s retirement preparedness}, year = {2020}, institution = {National Institute on Retirement Security }, address = {Washington, D.C.}, abstract = {Most Americans struggle to adequately save for retirement, but women face unique challenges in saving, largely stemming from a gender pay gap that persists into a retirement wealth gap. This update of previous research from the National Institute on Retirement Security (NIRS) takes a fresh look at the data on women{\textquoteright}s retirement preparedness. Relying on data from the 2014 Survey of Income and Program Participation (SIPP), this research finds that older women receive approximately 80 percent of the retirement income that older men receive - nearly identical to the gender pay gap for American women. The data also reveals that different groups of women have very different retirement experiences, with older women in a first marriage faring better than the rest, and widows, especially those age 80 and older, seeing a marked decline in income. The report{\textquoteright}s key findings are as follows: {\textbullet} In 2016, women age 65 and older had a median household retirement income of $47,244 or 83 percent of median household income for men ($57,144). {\textbullet} Women earn less than men over the course of their career. Men with savings in a defined contribution (DC) plan far surpass the earnings trajectory of women with savings in a DC plan, and earn significantly more than women without DC savings. {\textbullet} Women experience a steep decline in income past age 80. Women age 80 and older are much more likely to be widows and widowhood presents challenges on both the income and cost side of retirement. {\textbullet} There are stark differences in the sources of income for women in the top and bottom income quintiles. Women with less than $20,000 of income in retirement are much more dependent on Social Security income, whereas women with income above $80,000 receive much more from earnings and property income. {\textbullet} Divorce presents a complex set of issues relating to retirement preparedness. The timing of divorce seems to matter, as does the division of assets following a divorce. {\textbullet} Caregiving, especially spousal caregiving, has a strong effect on retirement preparedness, and this particularly impacts women as they remain much more likely to provide caregiving than men.}, keywords = {Caregiving, Divorce, Retirement Planning, women}, url = {https://www.nirsonline.org/wp-content/uploads/2020/04/Still-Shortchanged-Final.pdf}, author = {Bond, Tyler and Saad-Lessler, Joelle and Christian Weller} } @article {13276, title = {Study Protocol: Social Capital as a Resource for the Planning and Design of Socially Sustainable and Health Promoting Neighborhoods- A Mixed Method Study.}, journal = {Front Public Health}, volume = {8}, year = {2020}, pages = {581078}, abstract = {

Promoting inclusive, safe, resilient, and sustainable communities is one of the 17 Sustainable Development Goals ratified in 2015 by 193 UN member states, not least in Sweden. Social sustainability involves preserving particular societal values (e.g., local identity) as well as developing values (e.g., social cohesion) that are perceived as needed. Socially sustainable development also implies promoting integration and preventing segregation. Social capital is one important indicator to measure how socially sustainable an area is. This project aims to explore how social capital can be used as a conceptual tool in developing housing policy for social sustainability in Ume{\r a} Municipality. The three sub-studies in this project combine quantitative and qualitative methods. We will conduct a review of the municipality{\textquoteright}s documents to understand how the ideas of social sustainability have influenced political declarations and implemented social and housing policies and interventions during the period 2006-2020. The quantitative study includes a longitudinal follow-up to the 2006 survey{\textquoteright}s respondents to assess the longitudinal impacts of neighborhood social capital on health and well-being; as well as a new repeated cross-sectional survey to investigate how social capital has changed in local neighborhoods from 2006 to 2020. The qualitative study includes case studies in neighborhoods with different social capital dynamics to understand how different resident sub-groups perceive their neighborhoods and how implemented social and housing policies have influenced the social capital dynamics and responded to the needs of different sub-groups. The project is run in close collaboration with the Commission for a Socially Sustainable Ume{\r a}. This project will create new and unique perspectives on long-term structural changes of relevance for a socially sustainable housing policy; knowledge that is highly valuable for continuous municipal planning; and will outline recommendations to guide local housing policies for social sustainable neighborhoods in Ume{\r a} Municipality. This study has been assessed and approved by the Swedish Ethics Review Authority (Dnr: 2019-04395; Dnr: 2020-00160; Dnr 2020-02757). The dissemination goals of this project are (1) sustained engagement of key stakeholders throughout the project and (2) dissemination of the research findings through popular science, conferences, and scientific papers.

}, keywords = {Cross-Sectional Studies, Housing, Residence Characteristics, Review Literature as Topic, Social capital, Sweden}, issn = {2296-2565}, doi = {10.3389/fpubh.2020.581078}, author = {Santosa, Ailiana and Ng, Nawi and Zetterberg, Liv and Eriksson, Malin} } @article {11210, title = {Subjective well-being among male veterans in later life: The enduring effects of early life adversity.}, journal = {Aging \& Mental Health}, year = {2020}, abstract = {

OBJECTIVES: This study investigated the association between childhood and young adult adversities and later-life subjective well-being among older male veterans. We also explored whether early-life parent-child relationships and later-life social engagement served as moderators and mediators, respectively.

METHODS: Data were from the 2008 to 2012 waves of the Health and Retirement Study for male veterans ( = 2026). Subjective well-being measures included depressive symptoms, self-rated health, and life satisfaction. Linear regression with the macro was employed to estimate the relationships.

RESULTS: Adverse childhood experiences (ACEs) were positively associated with number of depressive symptoms and negatively related to life satisfaction. Combat exposure, a young adulthood adversity experience, was positively associated with depressive symptoms, but not with self-rated health or life satisfaction. Later-life social engagement mediated the relationship between ACEs and subjective well-being indices. Parent-child relationship quality did not moderate the association between the measures of adversity and any measure of subjective well-being.

DISCUSSION: Childhood adversity and combat exposure were related to worse later life subjective well-being. Also, later-life social engagement mediated the association of two early life adversity measures and subjective well-being. Future research should examine subjective well-being and early life adversity for female veterans and should employ more detailed information about combat exposure.

}, keywords = {Adversity, depression, Life Satisfaction, Military service, Self-rated health}, issn = {1364-6915}, doi = {10.1080/13607863.2020.1842999}, author = {Mai See Yang and Lien Quach and Lee, Lewina O and Avron Spiro III and Jeffrey A Burr} } @article {10229, title = {SeaTE: Subjective ex ante Treatment Effect of Health on Retirement}, journal = {National Bureau of Economic Research Working Paper Series}, volume = {No. 26087}, year = {2019}, note = {Author contact info:Pamela GiustinelliDepartment of EconomicsBocconi UniversityMilan, ItalyE-Mail: pamela.giustinelli@gmail.comMatthew D. ShapiroDepartment of EconomicsUniversity of Michigan611 Tappan StAnn Arbor, MI 48109-1220Tel: 734/764-5419Fax: 734 764-2769E-Mail: shapiro@umich.edu}, month = {2019}, abstract = {The Subjective ex ante Treatment Effect is the difference between the probabilities of an outcome conditional on a treatment. The SeaTE yields ex ante causal effects at the individual level. The paper gives an interpretation in two workhorse econometric frameworks: potential outcomes and dynamic programming. It finds large effect heterogeneity of health on work in two surveys of older workers, the VRI and the HRS. It shows how reduced-form estimates of health on work are biased when there is unobserved heterogeneity in taste for work. Using the VRI{\textquoteright}s panel structure, it validates the elicited conditional probabilities of work given health.}, keywords = {health, Retirement, SeaTE}, doi = {10.3386/w26087}, url = {http://www.nber.org/papers/w26087}, author = {Giustinelli, Pamela and Matthew D. Shapiro} } @mastersthesis {10253, title = {Self-Perceptions of Aging and Health: The Embodiment of Age Stereotypes.}, volume = {Ph.D. Psychology}, year = {2019}, month = {10/2019}, pages = {181}, school = {University of Michigan}, address = {Ann Arbor, MI}, abstract = {Age stereotypes are pervasive in contemporary American society. A growing body of research has shown that the internalization of societal age stereotypes can affect older adults{\textquoteright} self-perceptions of aging (SPA), or attitudes towards their own aging process, in ways that can have significant implications for health and well-being. Based on Levy{\textquoteright}s stereotype embodiment theory, this dissertation used data from the Health and Retirement Study to examine the behavioral, biological, and psychological processes that potentially underlie the relationship between SPA and health among older US adults. On a behavioral level, Study 1 found that, over a 1-year follow-up, individuals with negative SPA were more likely to delay necessary medical care and report more barriers to care, such as limited access to transportation and disliking going to the doctor. On a biological level, Study 2 considered the association between SPA, perceived discrimination, and changes in cystatin c (a biomarker of kidney function). Over the 4-year follow-up, having more negative SPA was associated with larger increases in cystatin c (e.g., worse kidney functioning) among those who reported being the target of discrimination. On a psychological level, Study 3 investigated the relationship between two different perceptions of the self, self-perceptions of grip strength and SPA, in predicting 4-year change in mobility limitations among adults over age 65. Individuals with more positive SPA had fewer mobility limitations four years later, even after adjusting for measured/perceived grip strength and other risk factors. Having more positive SPA, however, was only predictive of fewer mobility problems among respondents who also perceived their grip strength to be strong, highlighting the importance of considering both domain-specific and domain-general self-perceptions when designing interventions to improve functional health. Together, these studies extend the literature linking SPA and health by investigating proposals about three underlying processes. The final chapter discusses the implications of study findings, with a special focus on the design of interventions to promote more positive attitudes toward aging and the need to change age-related attitudes among health care professionals.}, keywords = {Aging, health, Self-perception, Stereotypes}, url = {https://deepblue.lib.umich.edu/handle/2027.42/151399?show=full}, author = {Jennifer K Sun} } @article {Sutin2019181, title = {Self-Reported Personality Traits and Informant-Rated Cognition: A 10-Year Prospective Study}, journal = {Journal of Alzheimer{\textquoteright}s Disease}, volume = {72}, year = {2019}, note = {cited By 0}, pages = {181-190}, abstract = {Personality traits, such as higher Neuroticism and lower Conscientiousness, are associated with risk of Alzheimer{\textquoteright}s disease and other dementias. A diagnosis of dementia relies, in part, on informant ratings of the individual{\textquoteright}s cognitive status. Here we examine whether self-reported personality traits are associated with four measures of informant-rated cognition up to a decade later. Participants from the Health and Retirement Study (N = 2,536) completed a five-factor model measure of personality in 2006 or 2008. Informants completed the 2016 Harmonized Cognitive Assessment Protocol (HCAP), which included ratings of the participant{\textquoteright}s current cognitive functioning and change in cognitive function over the last decade assessed with the IQCODE, Blessed, 1066, and CSID. Controlling for characteristics of the participant, informant, and their relationship, higher Neuroticism and lower Conscientiousness were associated consistently with worse informant-rated cognition. The association between Openness and better informant-rated cognition was due primarily to higher baseline cognitive function. Extraversion and Agreeableness were associated with better informant-rated cognition only among participants who were cognitively intact at follow-up. The present research suggests that knowledgeable informants are able to detect cognitive deficits associated with personality. {\textcopyright} 2019 - IOS Press and the authors. All rights reserved.}, keywords = {Aged, agreeableness, Article, Cognition, Conscientiousness, extraversion, Female, follow up, human, major clinical study, Male, neurosis, openness, Personality, priority journal, prospective study, Self Report}, issn = {13872877}, doi = {10.3233/JAD-190555}, url = {https://www.ncbi.nlm.nih.gov/pubmed/31561364}, author = {Angelina R Sutin and Yannick Stephan and Antonio Terracciano} } @article {10115, title = {Sex differences in the association between salivary telomere length and multimorbidity within the US Health \& Retirement Study}, journal = {Age and Ageing}, volume = {48}, year = {2019}, pages = { 703{\textendash}710}, type = {Journal}, abstract = {Background Telomere length is associated with several physical and mental health conditions, but whether it is a marker of multimorbidity is unclear. We investigated associations between telomere length and multimorbidity by sex. Methods Data from adults (N = 5,495) aged >=50 years were taken from the US Health and Retirement Study (2008{\textendash}14). Telomere length was measured in 2008 from salivary samples. The cross-sectional associations between telomere length and eight chronic health conditions were explored using logistic regression, adjusting for confounders and stratified by sex. Logistic, ordinal and multinomial regression models were calculated to explore relationships between telomere length and multimorbidity (using a binary variable and a sum of the number of health conditions) and the type of multimorbidity (no multimorbidity, physical multimorbidity, or multimorbidity including psychiatric problems). Using multilevel logistic regression, prospective relationships between telomere length and incident multimorbidity were also explored. Results In cross-sectional analyses, longer telomeres were associated with reduced likelihood of lung disease and psychiatric problems among men, but not women. Longer telomeres were associated with lower risk of multimorbidity that included psychiatric problems among men (OR=0.521, 95\% CI: 0.284 to 0.957), but not women (OR=1.188, 95\% CI: 0.771 to 1.831). Prospective analyses suggested little association between telomere length and the onset of multimorbidity in men (OR=1.378, 95\% CI: 0.931 to 2.038) nor women (OR=1.224, 95\% CI: 0.825 to 1.815). Conclusions Although telomere length does not appear to be a biomarker of overall multimorbidity, further exploration of the relationships is merited particularly for multimorbidity including psychiatric conditions among men.}, keywords = {Comorbidity, Genetics, Telomeres, Women and Minorities}, issn = {0002-0729}, doi = {10.1093/ageing/afz071}, url = {https://academic.oup.com/ageing/article/48/5/703/5511442}, author = {Niedzwiedz, Claire L. and Katikireddi, Srinivasa Vittal and Pell, Jill P. and Smith, Daniel J.} } @article {10153, title = {Social relations and age-related change in memory.}, journal = {Psychology and Aging}, volume = {34}, year = {2019}, pages = {751-765}, abstract = {Previous research suggests that social relations are associated with age-related memory change. However, social relations are complex and multidimensional, and it is not yet clear which aspects (structure, quality) may be beneficial over time. Further, the strength and direction of associations may differ depending on relationship type (partner, children, other family, friends). Using longitudinal data from the Health and Retirement Study (n = 10,390; Mage = 69, SD = 9.53 at baseline), latent growth curve models tested which aspects of social relations predicted 6-year episodic memory trajectories. Both structure and quality of social relations were associated with initial memory level, such that being married/partnered, reporting more frequent contact with children and friends, reporting less support from family members other than partners and children, and reporting less strain across relationship types were each independently associated with better initial memory. In contrast, only structure was associated with subsequent memory decline. Specifically, being married/partnered and reporting more frequent contact with friends were each independently associated with slower memory decline. No evidence of bidirectionality was found, as baseline memory did not predict subsequent changes in social relations. This longitudinal study helps to clarify which aspects of social relations are most likely to influence late-life episodic memory trajectories. Future intervention studies may focus on increasing social interactions with nonfamily members to minimize memory decline with age. (PsycINFO Database Record (c) 2019 APA, all rights reserved).}, keywords = {Cognitive Ability, Family Roles/Relationships, Memory, Social Support}, issn = {1939-1498}, doi = {10.1037/pag0000369}, author = {Laura B Zahodne and Kristine J. Ajrouch and Sharifian, Neika and Toni C Antonucci} } @article {10385, title = {Social Status Perception and Individual Social Capital: Evidence from the US}, journal = {The B.E. Journal of Economic Analysis \& Policy}, year = {2019}, month = {10/2019}, abstract = {This paper provides evidence that individual social capital contributes to our understanding of where individuals locate themselves in the social ladder, also when their objective location within society (measured in terms of income, wealth, education and job) is considered. Using large-scale longitudinal data from the US Health and Retirement Study, we assess individual social capital by means of a multidimensional approach and consider (number, intensity and quality of) respondents{\textquoteright} friendships, prosocial behavior, social engagement and neighborhood cohesion. Our findings indicate that individual social capital plays a role in affecting subjective status, as self-perceived status correlates positively with neighborhood cohesion and negatively with negative support from friends, after controlling for objectively measured social status.}, keywords = {Perception, Social capital, Social status}, isbn = {19351682}, doi = {https://doi.org/10.1515/bejeap-2019-0071}, url = {https://www.degruyter.com/view/j/bejeap.ahead-of-print/bejeap-2019-0071/bejeap-2019-0071.xml}, author = {Alessandro Bucciol and Cicognani Simona and Zarri Luca} } @article {9244, title = {Spousal breadwinning across 30 years of marriage and husbands{\textquoteright} health: A gendered life course stress approach.}, journal = {Journal of Aging and Health}, volume = {31}, year = {2019}, pages = {37-66}, abstract = {

OBJECTIVE: Wives increasingly outearn their husbands, and gender relations theory suggests this arrangement may undermine men{\textquoteright}s well-being. We explore how long-term histories of spousal breadwinning may be associated with older men{\textquoteright}s self-rated mental and physical health, and risk of nine health diagnoses.

METHOD: Using 30 years of couple-level income data from the Health and Retirement Study ( n = 1,095 couples), we use latent class analyses to identify six classes that differ with respect to the timing and level of wife breadwinning. We link these classes to older husbands{\textquoteright} later-life health.

RESULTS: Classes that transitioned from husband breadwinning to wife breadwinning in early or later adulthood were associated with husbands{\textquoteright} poorer overall physical health and risk of cardiometabolic and stress-related diseases. Patterns persist net of sociodemographics, depressive symptoms, health behaviors, and adolescent health.

DISCUSSION: Violating cultural expectations, such as the masculinity ideal of male breadwinning, is associated with older men{\textquoteright}s poorer health.

}, keywords = {Gender Differences, Income, Marriage, Women and Minorities}, issn = {1552-6887}, doi = {10.1177/0898264317721824}, author = {Kristen W Springer and Lee, Chioun and Deborah Carr} } @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 {10011, title = {Stress and salivary telomere length in the second half of life: A comparison of life-course models}, journal = {Advances in Life Course Research}, volume = {39}, year = {2019}, pages = {34-41}, keywords = {Biomarkers, Depressive symptoms, Telomeres}, issn = {10402608}, doi = {10.1016/j.alcr.2019.02.001}, author = {Willis, Margaret and Ursula M. Staudinger and Factor-Litvak, Pam and Calvo, Esteban} } @article {9346, title = {Subjective Age and Cystatin C Among Older Adults.}, journal = {Journals of Gerontology, Series B: Psychological Sciences \& Social Sciences}, volume = {74}, year = {2019}, pages = {382-388}, abstract = {

Objective: Cystatin C (CysC) is a marker of kidney function that is relevant for the health and cognition of older adults. Little is known about the link between psychological factors and CysC. Therefore, the present study examined whether subjective age is related to CysC level and changes in CysC over time.

Method: Participants were 5,066 individuals drawn from the Health and Retirement Study aged from 50 to 107 years (60\% women, mean age = 69.36 years, SD = 9.54). They provided data on subjective age, demographic covariates, and CysC at baseline. CysC was assessed again 4 years later.

Results: Analysis revealed that an older subjective age was related to higher level of CysC at baseline and to an increase in CysC over 4 years, controlling for demographic factors. An older subjective age was also related to higher risk of exceeding the clinical threshold of CysC at baseline and 4 years later. Additional analysis revealed that disease burden, depressive symptoms, physical inactivity, and BMI partly mediated these associations.

Conclusion: The present study provides new evidence on the role of subjective age as a psychological factor associated with individuals{\textquoteright} risk of kidney dysfunction, an association beyond chronological age.

}, keywords = {Cystatin C, Health Conditions and Status, Subjective age}, issn = {1758-5368}, doi = {10.1093/geronb/gbx124}, author = {Yannick Stephan and Angelina R Sutin and Antonio Terracciano and Shevaun Neupert} } @article {10007, title = {Systematic mortality improvement trends and mortality heterogeneity: Insights from individual-level HRS data}, journal = {North American Actuarial Journal}, volume = {23}, year = {2019}, type = {Journal}, abstract = {Providers of life annuities and pensions need to consider both systematic mortality improvement trends and mortality heterogeneity. Although how mortality improvement varies with age and gender at the population level is well studied, how trends vary with risk factors remains relatively unexplored. This article assesses how systematic mortality improvement trends vary with individual risk characteristics using individual-level longitudinal data from the U.S. Health and Retirement Study between 1994 and 2009. Initially a Lee-Carter model is used to assess mortality improvement trends by grouping individuals with similar risk characteristics of gender, education, and race. We then fit a longitudinal mortality model to individual-level data allowing for heterogeneity and time trends in individual-level risk factors. Our results show how survey data can provide valuable insights into both mortality heterogeneity and improvement trends more effectively than commonly used aggregate models. We show how mortality improvement differs across individuals with different risk factors. Significantly, at an individual level, mortality improvement trends have been driven by changes in health history such as high blood pressure, cancer, and heart problems rather than risk factors such as education, marital status, body mass index, and smoker status.}, keywords = {Mortality}, issn = {1092-0277}, doi = {10.1080/10920277.2018.1513369}, url = {https://www.tandfonline.com/doi/full/10.1080/10920277.2018.1513369}, author = {Xu, Mengyi and Sherris, Michael and Meyricke, Ramona} } @article {9391, title = {Secular Trends in Dementia and Cognitive Impairment of U.S. Rural and Urban Older Adults}, journal = {American Journal of Preventive Medicine}, volume = {54}, year = {2018}, pages = {164-172}, abstract = {Introduction This is a nationally representative study of rural-urban disparities in the prevalence of probable dementia and cognitive impairment without dementia (CIND). Methods Data on non-institutionalized U.S. adults from the 2000 (n=16,386) and 2010 (n=16,311) cross-sections of the Health and Retirement Study were linked to respective Census assessments of the urban composition of residential census tracts. Relative risk ratios (RRR) for rural-urban differentials in dementia and CIND respective to normal cognitive status were assessed using multinomial logistic regression. Analyses were conducted in 2016. Results Unadjusted prevalence of dementia and CIND in rural and urban tracts converged so that rural disadvantages in the relative risk of dementia (RRR=1.42, 95\% CI=1.10, 1.83) and CIND (RRR=1.35, 95\% CI=1.13, 1.61) in 2000 no longer reached statistical significance in 2010. Adjustment for the strong protective role of educational attainment reduced rural disadvantages in 2000 to statistical nonsignificance, whereas adjustment for race/ethnicity resulted in a statistically significant increase in RRRs in 2010. Full adjustment for sociodemographic and health factors revealed persisting rural disadvantages for dementia and CIND in both periods with RRR in 2010 for dementia of 1.79 (95\% CI=1.31, 2.43) and for CIND of 1.38 (95\% CI=1.14, 1.68). Conclusions Larger gains in rural adults{\textquoteright} cognitive functioning between 2000 and 2010 that are linked with increased educational attainment demonstrate long-term public health benefits of investment in secondary education. Persistent disadvantages in cognitive functioning among rural adults compared with sociodemographically similar urban peers highlight the importance of public health planning for more rapidly aging rural communities.}, keywords = {Cognitive Ability, Dementia, Religion, Rural Settings, urban life}, issn = {07493797}, doi = {10.1016/j.amepre.2017.10.021}, url = {http://linkinghub.elsevier.com/retrieve/pii/S074937971730644Xhttp://api.elsevier.com/content/article/PII:S074937971730644X?httpAccept=text/xmlhttp://api.elsevier.com/content/article/PII:S074937971730644X?httpAccept=text/plain}, author = {Margaret M Weden and Regina A Shih and Mohammed U Kabeto and Kenneth M. Langa} } @article {9296, title = {Self-reported personality traits are prospectively associated with proxy-reported behavioral and psychological symptoms of dementia at the end of life.}, journal = {International Journal of Geriatric Psychiatry}, volume = {33}, year = {2018}, pages = {489-494}, abstract = {

OBJECTIVE: Behavioral and psychological symptoms of dementia (BPSD) are among the most challenging aspects of Alzheimer disease for patients and their families. Previous studies have found associations between informant-reported retrospective personality and BPSD; we test whether prospective, self-reported personality predicts who will experience these symptoms.

METHODS: Deceased participants from the Health and Retirement Study who had evidence of cognitive impairment at the end of life (N~=~1988) were selected to examine whether self-reported five-factor model personality traits, measured up to 8~years before death, were associated with proxy-reported BPSD.

RESULTS: Neuroticism was associated with increased risk of the 7 BPSD: got lost in familiar places, wandered off, were not able to be left alone, experienced hallucinations, suffered from depression, had periodic confusion, and an uncontrolled temper. These associations were not moderated by age, gender, race, or education. Conscientiousness was associated with fewer symptoms overall and especially with lower risk of getting lost in familiar places and not being able to be left alone.

CONCLUSIONS: The present research indicates that self-reported personality, particularly Neuroticism, is associated prospectively with risk for a wide range of behavioral symptoms for individuals who had cognitive impairment at the end of life. The use of self-reported personality traits can help aid in identifying who is most at risk for behavioral symptoms. Such information may be useful for nonpharmacological interventions tailored to the individual{\textquoteright}s personality to reduce the prevalence and burden of these BPSD.

}, keywords = {Cognitive Ability, Dementia, Personality, Self-reported health}, issn = {1099-1166}, doi = {10.1002/gps.4782}, author = {Angelina R Sutin and Yannick Stephan and Martina Luchetti and Antonio Terracciano} } @article {9632, title = {Semi-parametric methods of handling missing data in mortal cohorts under non-ignorable missingness.}, journal = {Biometrics}, volume = {74}, year = {2018}, pages = {1427-1437}, abstract = {We propose semi-parametric methods to model cohort data where repeated outcomes may be missing due to death and non-ignorable dropout. Our focus is to obtain inference about the cohort composed of those who are still alive at any time point (partly conditional inference). We propose: i) an inverse probability weighted method that upweights observed subjects to represent subjects who are still alive but are not observed; ii) an outcome regression method that replaces missing outcomes of subjects who are alive with their conditional mean outcomes given past observed data; and iii) an augmented inverse probability method that combines the previous two methods and is double robust against model misspecification. These methods are described for both monotone and non-monotone missing data patterns, and are applied to a cohort of elderly adults from the Health and Retirement Study. Sensitivity analysis to departures from the assumption that missingness at some visit t is independent of the outcome at visit t given past observed data and time of death is used in the data application.}, keywords = {Data collection, Datasets, Survey Methodology}, issn = {1541-0420}, doi = {10.1111/biom.12891}, author = {Wen, Lan and Shaun R Seaman} } @article {8509, title = {Smoking Cessation and Changes in Body Mass Index Among Middle Aged and Older Adults.}, journal = {J Appl Gerontol}, volume = {37}, year = {2018}, month = {2018 08}, pages = {1012-1036}, abstract = {

OBJECTIVE: This study contributes to the body of literature examining smoking cessation and body mass index (BMI) for adults aged 50 and older.

METHOD: Utilizing the 2004 and 2010 waves of the RAND Health and Retirement Study, this analysis utilized Fixed Effects (FE) regression on a sample of 1,316 adults aged 50 and older.

RESULTS: Older adults undergo a small change in BMI after a transition from smoking to nonsmoking during a 6-year period, and this occurs after accounting for individual-level unobserved heterogeneity. More specifically, men experience a BMI gain of 1.24 ( p< .01) and women experience a BMI gain of 1.58 ( p< .01).

DISCUSSION: Gerontologists/health professionals can use these results to inform older adults about the potential for a small increase in BMI and, in the process, assuage any apprehensions about excessive weight gain. This insight may encourage a greater number of older adults to cease smoking.

}, keywords = {Aged, Aged, 80 and over, Body Mass Index, Female, Humans, Male, Middle Aged, Models, Statistical, Smoking cessation, Weight Gain}, issn = {1552-4523}, doi = {10.1177/0733464816655438}, url = {http://www.ncbi.nlm.nih.gov/pubmed/27353834}, author = {Sharma, Andy} } @article {Arpino2018SmokingEA, title = {Smoking, education and the ability to predict own survival probabilities}, journal = {Advances in Life Course Research}, volume = {37}, year = {2018}, pages = {23-30}, abstract = {Abstract Subjective survival probabilities (SSPs) are a good predictor of mortality, go beyond the aggregate description of survival defined by life tables, and are important for individuals{\textquoteright} decision-making in later life. However, despite the well-known mortality differentials by education as well as by characteristics such as smoking, little investigation has focused on SSPs by population sub-groups defined as a combination of these two characteristics. We use data on individuals aged 50{\textendash}89 from the Health and Retirement Study (HRS) carried out in the USA between 2000 and 2012 (N = 23,895). Respondents were asked to assess the probability to survive to a given target age according to their age at the time of the survey. We assess how individuals{\textquoteright} SSPs and estimated objective survival probabilities (OSPs) vary by education and smoking and calculate, for each respondent, the gap between them. Consistently with real mortality patterns, smokers report the lowest SSPs in each of the three considered education groups. When comparing SSPs and OSPs we find that all groups tend to underestimate survival. Within each education group, past smokers better predict their survival probability. Current smokers with low education show the highest probability to overestimate their survival. Smokers are aware of their lower life expectancy. Still, a considerable proportion of them overestimate their survival probabilities, independently of their level of education.}, keywords = {Education, Life Expectancy, Smoking}, doi = {10.1016/J.ALCR.2018.06.001}, author = {Bruno Arpino and Valeria Bordone and Sergei Scherbov} } @article {9869, title = {Smoking, education and the ability to predict own survival probabilities}, journal = {Advances in Life Course Research}, volume = {37}, year = {2018}, month = {Jan-09-2018}, pages = {23 - 30}, abstract = {Subjective survival probabilities (SSPs) are a good predictor of mortality, go beyond the aggregate description of survival defined by life tables, and are important for individuals{\textquoteright} decision-making in later life. However, despite the well-known mortality differentials by education as well as by characteristics such as smoking, little investigation has focused on SSPs by population sub-groups defined as a combination of these two characteristics. We use data on individuals aged 50-89 from the Health and Retirement Study (HRS) carried out in the USA between 2000 and 2012 (N = 23,895). Respondents were asked to assess the probability to survive to a given target age according to their age at the time of the survey. We assess how individuals{\textquoteright} SSPs and estimated objective survival probabilities (OSPs) vary by education and smoking and calculate, for each respondent, the gap between them. Consistently with real mortality patterns, smokers report the lowest SSPs in each of the three considered education groups. When comparing SSPs and OSPs we find that all groups tend to underestimate survival. Within each education group, past smokers better predict their survival probability. Current smokers with low education show the highest probability to overestimate their survival. Smokers are aware of their lower life expectancy. Still, a considerable proportion of them overestimate their survival probabilities, independently of their level of education.}, keywords = {Decision making, Education, Mortality, Probability, Smoking}, issn = {10402608}, doi = {10.1016/j.alcr.2018.06.001}, url = {https://linkinghub.elsevier.com/retrieve/pii/S1040260818300650https://api.elsevier.com/content/article/PII:S1040260818300650?httpAccept=text/xmlhttps://api.elsevier.com/content/article/PII:S1040260818300650?httpAccept=text/plain}, author = {Bruno Arpino and Valeria Bordone and Sergei Scherbov} } @article {9541, title = {Socioeconomic status, non-communicable disease risk factors, and walking speed in older adults: multi-cohort population based study}, journal = {BMJ}, volume = {360}, year = {2018}, pages = {k1046}, abstract = {Objective To assess the association of low socioeconomic status and risk factors for non-communicable diseases (diabetes, high alcohol intake, high blood pressure, obesity, physical inactivity, smoking) with loss of physical functioning at older ages. Design Multi-cohort population based study. Setting 37 cohort studies from 24 countries in Europe, the United States, Latin America, Africa, and Asia, 1990-2017. Participants 109 107 men and women aged 45-90 years. Main outcome measure Physical functioning assessed using the walking speed test, a valid index of overall functional capacity. Years of functioning lost was computed as a metric to quantify the difference in walking speed between those exposed and unexposed to low socioeconomic status and risk factors. Results According to mixed model estimations, men aged 60 and of low socioeconomic status had the same walking speed as men aged 66.6 of high socioeconomic status (years of functioning lost 6.6 years, 95\% confidence interval 5.0 to 9.4). The years of functioning lost for women were 4.6 (3.6 to 6.2). In men and women, respectively, 5.7 (4.4 to 8.1) and 5.4 (4.3 to 7.3) years of functioning were lost by age 60 due to insufficient physical activity, 5.1 (3.9 to 7.0) and 7.5 (6.1 to 9.5) due to obesity, 2.3 (1.6 to 3.4) and 3.0 (2.3 to 4.0) due to hypertension, 5.6 (4.2 to 8.0) and 6.3 (4.9 to 8.4) due to diabetes, and 3.0 (2.2 to 4.3) and 0.7 (0.1 to 1.5) due to tobacco use. In analyses restricted to high income countries, the number of years of functioning lost attributable to low socioeconomic status by age 60 was 8.0 (5.7 to 13.1) for men and 5.4 (4.0 to 8.0) for women, whereas in low and middle income countries it was 2.6 (0.2 to 6.8) for men and 2.7 (1.0 to 5.5) for women. Within high income countries, the number of years of functioning lost attributable to low socioeconomic status by age 60 was greater in the United States than in Europe. Physical functioning continued to decline as a function of unfavourable risk factors between ages 60 and 85. Years of functioning lost were greater than years of life lost due to low socioeconomic status and non-communicable disease risk factors. Conclusions The independent association between socioeconomic status and physical functioning in old age is comparable in strength and consistency with those for established non-communicable disease risk factors. The results of this study suggest that tackling all these risk factors might substantially increase life years spent in good physical functioning.}, keywords = {Cross-National, Gait speed, Risk Factors, Socioeconomic factors}, issn = {0959-8138}, doi = {10.1136/bmj.k1046}, url = {http://www.bmj.com/lookup/doi/10.1136/bmj.k1046https://syndication.highwire.org/content/doi/10.1136/bmj.k1046http://data.bmj.org/tdm/10.1136/bmj.k1046}, author = {Stringhini, Silvia and Carmeli, Cristian and Markus Jokela and Mauricio Avendano and McCrory, Cathal and d{\textquoteright}Errico, Angelo and Bochud, Murielle and Barros, Henrique and Costa, Giuseppe and Chadeau-Hyam, Marc and Delpierre, Cyrille and Gandini, Martina and Fraga, Silvia and Goldberg, Marcel and Giles, Graham G and Lassale, Camille and Kenny, Rose Anne and Kelly-Irving, Michelle and Paccaud, Fred and Layte, Richard and Muennig, Peter and Michael Marmot and Ribeiro, Ana Isabel and Severi, Gianluca and Andrew Steptoe and Shipley, Martin J and Zins, Marie and Johan P Mackenbach and Vineis, Paolo and Mika Kivim{\"a}ki} } @article {11264, title = {State-level estimation of diabetes and prediabetes prevalence: Combining national and local survey data and clinical data.}, journal = {Statistics in Medicine}, volume = {37}, year = {2018}, pages = {3975-3990}, abstract = {

Many statisticians and policy researchers are interested in using data generated through the normal delivery of health care services, rather than carefully designed and implemented population-representative surveys, to estimate disease prevalence. These larger databases allow for the estimation of smaller geographies, for example, states, at potentially lower expense. However, these health care records frequently do not cover all of the population of interest and may not collect some covariates that are important for accurate estimation. In a recent paper, the authors have described how to adjust for the incomplete coverage of administrative claims data and electronic health records at the state or local level. This article illustrates how to adjust and combine multiple data sets, namely, national surveys, state-level surveys, claims data, and electronic health record data, to improve estimates of diabetes and prediabetes prevalence, along with the estimates of the method{\textquoteright}s accuracy. We demonstrate and validate the method using data from three jurisdictions (Alabama, California, and New York City). This method can be applied more generally to other areas and other data sources.

}, keywords = {Bias, California, Diabetes Mellitus, Electronic Health Records, Health Surveys, Humans, Insurance Claim Review, New York City, Nutrition Surveys, Prediabetic State, Prevalence, Statistics as Topic, United States}, issn = {1097-0258}, doi = {10.1002/sim.7848}, author = {David A Marker and Mardon, Russ and Jenkins, Frank and Campione, Joanne and Nooney, Jennifer and Li, Jane and Saydeh, Sharon and Zhang, Xuanping and Shrestha, Sundar and Deborah B. Rolka} } @article {9515, title = {Step-grandparenthood in the United States.}, journal = {Journals of Gerontology Series B: Psychological Sciences \& Social Sciences}, volume = {73}, year = {2018}, month = {08/2018}, abstract = {

Objectives: This study provides new information about the demography of step-grandparenthood in the United States. Specifically, we examine the prevalence of step-grandparenthood across birth cohorts and for socioeconomic and racial/ethnic groups. We also examine lifetime exposure to the step-grandparent role.

Methods: Using data from the Panel Study of Income Dynamics and the Health and Retirement Study, we use percentages to provide first estimates of step-grandparenthood and to describe demographic and socioeconomic variation in who is a step-grandparent. We use life tables to estimate the exposure to step-grandparenthood.

Results: The share of step-grandparents is increasing across birth cohorts. However, individuals without a college education and non-Whites are more likely to become step-grandparents. Exposure to the step-grandparent role accounts for approximately 15\% of total grandparent years at age 65 for women and men.

Discussion: A growing body of research finds that grandparents are increasingly instrumental in the lives of younger generations. However, the majority of this work assumes that these ties are biological, with little attention paid to the role of family complexity across three generations. Understanding the demographics of step-grandparenthood sheds light on the family experiences of an overlooked, but growing segment of the older adult population in the United States.

}, keywords = {Adult children, Family Roles/Relationships, Grandparents}, issn = {1758-5368}, doi = {10.1093/geronb/gbx164}, author = {Jenjira J Yahirun and Sung S Park and Judith A Seltzer} } @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 {9768, title = {Subjective Age and Mortality in Three Longitudinal Samples.}, journal = {Psychosomatic Medicine}, volume = {80}, year = {2018}, pages = {659-664}, abstract = {

OBJECTIVE: Subjective age has been implicated in a range of health outcomes. The present study extends existing research by providing new data on the relation between subjective age and mortality in three large national samples.

METHODS: Participants (total N > 17,000) were drawn from the Health and Retirement Study (HRS, 2008-2014), the Midlife in the United State Survey (MIDUS, 1995-2014), and the National Health and Aging Trends Study (NHATS, 2011-2014). Subjective age, demographic factors, disease burden, functional limitations, depressive symptoms, and physical inactivity were assessed at baseline and mortality data were tracked for up to 20 years. Cognition was also included as a covariate in the HRS and the NHATS.

RESULTS: Individuals felt on average 15\% to 16\% younger relative to their chronological age. Feeling approximately 8, 11, and 13 years older in the MIDUS, HRS, and NHATS, was related to an 18\%, 29\% and 25\% higher risk of mortality, respectively. This pattern was confirmed by a meta-analysis of the three samples (HR = 1.24; 95\%CI = 1.17-1.31, p<.001). Multivariate analyses showed that disease burden, physical inactivity, functional limitations, and cognitive problems, but not depressive symptoms, accounted for the associations between subjective age and mortality.

CONCLUSIONS: The present study provides robust evidence for an association between an older subjective age and a higher risk of mortality across adulthood. These findings support the role of subjective age as a biopsychosocial marker of aging.

}, keywords = {Mortality, Subjective age, Subjective Expectations}, issn = {1534-7796}, doi = {10.1097/PSY.0000000000000613}, author = {Yannick Stephan and Angelina R Sutin and Antonio Terracciano} } @article {9740, title = {Subjective Social Status Predicts Late-Life Memory Trajectories through Both Mental and Physical Health Pathways}, journal = {Gerontology}, volume = {64}, year = {2018}, month = {03/2018}, pages = {466-474}, abstract = {Background: Subjective social status (SSS) is associated with mental and physical health, independent of objective socioeconomic status (SES), but its association with late-life cognitive decline is unknown. Objective: This study characterizes the association between SSS and late-life memory trajectories in a large, nationally representative sample of older adults in the United States. Methods: Using data from 8,530 participants aged 65 years and older in the Health and Retirement Study, structural equation models tested associations between SSS, objective SES (i.e., educational attainment, occupation, income, and wealth), physical and mental health, and 6-year memory trajectories, controlling for sociodemographic characteristics. Results: Independent of objective SES, lower SSS was associated with worse initial memory but not subsequent memory decline. The association between SSS and initial memory was separately mediated by chronic diseases, stroke, and depressive symptoms. Conclusion: Results provide preliminary behavioral evidence for the deleterious effects of social stress on cognitive aging. These results may help inform the development of policies and interventions to reduce cognitive morbidity among older adults who perceive a low position on the social hierarchy.}, keywords = {Cognitive Ability, Depressive symptoms, Health Conditions and Status, Late-life Health, Memory}, issn = {0304-324X}, doi = {10.1159/000487304}, url = {https://www.karger.com/Article/FullText/487304https://www.karger.com/Article/Pdf/487304https://www.karger.com/Article/Pdf/487304}, author = {Laura B Zahodne and A Zarina Kraal and Afsara B. Zaheed and Sol, Ketlyne} } @article {9231, title = {Self-perceptions of aging and perceived barriers to care: Reasons for health care delay}, journal = {The Gerontologist}, volume = {57}, year = {2017}, month = {Jul-06-2018}, pages = {S216 - S226}, abstract = {Abstract Background and Objectives: Self-perceptions of aging (SPA), or attitudes toward one{\textquoteright}s aging experience, have been linked to health through multiple pathways. Few studies, however, have investigated how older adults{\textquoteright} views on aging influence their care-seeking behaviors. Research Design and Methods: Using two independent subsamples from the Health and Retirement Study (2011 Health Care Mail Survey: N = 2,866; 2013 Health Care and Nutrition Study: N = 2,474), logistic regression and negative binomial regression were used to examine the association between SPA and health care delay over the next 12 months. Subsequently, we used latent class analysis to identify subgroups reporting different reasons for delay. With multinomial logistic regression, we then examined if, compared with the no delay group, SPA differentiated membership in the delay subgroups. Results: In both samples, more negative aging self-perceptions were associated with a higher likelihood of health care delay and more perceived barriers to care, after adjusting for predisposing, enabling, and need factors. Latent class analysis revealed three subgroups characterized by different reasons for delay: (a) limited health care access, (b) too busy to go to the doctor, and (c) dislike of going to the doctor. In fully adjusted models, individuals with more negative SPA were more likely to belong to {\textquotedblleft}limited-access{\textquotedblright} and {\textquotedblleft}dislike{\textquotedblright} subgroups compared with the no delay group. Discussion and Implications: SPA may affect decision-making processes regarding whether to seek care for worrisome symptoms. Efforts to promote more positive SPA may encourage older adults to be more proactive in addressing their health care needs.}, keywords = {Accessibility, Perception, Self-reported health}, issn = {0016-9013}, doi = {10.1093/geront/gnx014}, url = {https://academic.oup.com/gerontologist/article-lookup/doi/10.1093/geront/gnx014}, author = {Jennifer K Sun and Jacqui Smith} } @article {8958, title = {Sensory functioning and personality development among older adults.}, journal = {Psychology and Aging}, volume = {32}, year = {2017}, month = {03/2017}, pages = {139-147}, abstract = {Deficits in sensory functioning, such as poor vision and hearing, take a significant toll on quality of life. Little is known, however, about their relation with personality development across adulthood. This study examined whether baseline and change in vision and hearing were associated with personality change over a 4-year period. Participants (N = 7,471; Mage = 66.89; 59\% women) were drawn from the Health and Retirement Study. They provided data on vision, hearing, and personality both at baseline and 4 years later. Poor vision and hearing at baseline and declines in vision and hearing over time were independently related to steeper declines in extraversion, agreeableness, openness, and conscientiousness, and less decline in neuroticism, controlling for demographic factors, disease burden, and depressive symptoms. Sensory functioning was generally a stronger predictor of personality change than disease burden or depressive symptoms. Consistent with evidence that poor and worsening sensory functions compromise individuals{\textquoteright} interactions with the social and physical environment, this study found deficits in hearing and vision were also associated with maladaptive personality trajectories in older adults. }, keywords = {Older Adults, Personality}, issn = {1939-1498}, doi = {10.1037/pag0000159}, author = {Yannick Stephan and Angelina R Sutin and Bosselut, Gr{\'e}goire and Antonio Terracciano} } @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 {11438, title = {Smoking, Education and the Ability to Predict Own Survival Probabilities: An Observational Study on US Data}, number = {WP-17-012}, year = {2017}, institution = {International Institute for Applied Systems Analysis }, address = {Laxenburg, Austria}, abstract = {Background: Subjective survival probabilities (SSPs) are a good predictor of mortality, go beyond the aggregate description of survival defined by life tables, and are important for individuals{\textquoteright} decision-making in later life. Despite the well-known mortality differentials by education as well as by characteristics such as smoking, little investigation has focused on SSPs by population sub-groups. Methods: We use data on individuals aged 50-89 from the Health and Retirement Study(HRS) carried out in the USA between 2000 and 2012 (N=23,895). Each respondent was asked to assess the probability to survive to a given target age according to their age at the time of the survey. We assess how individuals{\textquoteright} SSPs and estimated objective survival probabilities (OSPs) vary by education and smoking and calculate, for each respondent, the gap between them. Results: Consistently with real mortality patterns, smokers report the lowest SSPs, both among lower and higher educated people. When comparing SSPs and OSPs we find that, irrespectively of the smoking status, higher educated people are more likely to correctly predict their survival probabilities than their lower educated counterparts. Within both education groups, past smokers better predict their survival probability. Current smokers with low education show the highest probability to overestimate their survival probability. Conclusions: Lower educated people and smokers are aware of their lower life expectancy. Still, they overestimate their survival probabilities more than the higher educated and non-smokers. Our findings emphasize the need for policy makers to disseminate information about the risks of smoking, targeting people with lower education.}, keywords = {Education, Life Expectancy, Smoking}, url = {http://pure.iiasa.ac.at/id/eprint/14692/}, author = {Bruno Arpino and Valeria Bordone and Sergei Scherbov} } @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 {8750, title = {Social determinants, multimorbidity, and patterns of end-of-life care in older adults dying from cancer.}, journal = {J Geriatr Oncol}, volume = {8}, year = {2017}, month = {2017 03}, pages = {117-124}, abstract = {

OBJECTIVE: Most prior studies on aggressive end-of-life care in older patients with cancer have accounted for social determinants of health (e.g., race, income, and education), but rarely for multimoribidity (MM). In this study, we examine the association between end-of-life care and each of the social determinants of health and MM, hypothesizing that higher MM is associated with less aggressive care.

METHODS: From the linked 1991-2008 Health and Retirement Study, Medicare data, and the National Death Index, we identified fee-for-service patients age >=66years who died from cancer (n=835). MM was defined as the occurrence or co-occurrence of chronic conditions, functional limitations, and/or geriatric syndromes. Aggressive care was based on claims-derived measures of receipt of cancer-directed treatment in the last two weeks of life; admission to the hospital and/or emergency department (ED) within the last month; and in-hospital death. We also identified patients enrolled in hospice. In multivariable logistic regression models, we analyzed the associations of interest, adjusting for potential confounders.

RESULTS: While 61.2\% of the patients enrolled in hospice, 24.6\% underwent cancer-directed treatment; 55.1\% were admitted to the hospital and/or ED; and 21.7\% died in the hospital. We observed a U-shaped distribution between income and in-hospital death. Chronic conditions and geriatric syndromes were associated with some outcomes, but not with others.

CONCLUSIONS: To improve quality end-of-life care and curtail costs incurred by dying patients, relevant interventions need to account for social determinants of health and MM in a nuanced fashion.

}, keywords = {Age Factors, Aged, Aged, 80 and over, Emergency Service, Hospital, Female, Health Surveys, Hospices, Hospital Mortality, Humans, Logistic Models, Male, multimorbidity, Neoplasms, Population Surveillance, Quality of Health Care, Risk Factors, Socioeconomic factors, Terminal Care}, issn = {1879-4076}, doi = {10.1016/j.jgo.2016.10.001}, url = {http://linkinghub.elsevier.com/retrieve/pii/S1879406816301229http://api.elsevier.com/content/article/PII:S1879406816301229?httpAccept=text/xmlhttp://api.elsevier.com/content/article/PII:S1879406816301229?httpAccept=text/plain}, author = {Siran M Koroukian and Nicholas K Schiltz and David F Warner and Charles W Given and Mark Schluchter and Owusu, Cynthia and Nathan A. Berger} } @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$768 (p <.001). Increased spending concentrated in inpatient and nursing home (skilled nursing facilities [SNFs]) care; despite more health care, objectively isolated beneficiaries had 31\% (p <.001) greater risk of death. Loneliness did not predict SNF use or mortality, but predicted slightly less inpatient and outpatient care. Discussion: Objectively isolated seniors have higher Medicare spending, driven by increased hospitalization and institutionalization, and face greater mortality. Policies supporting social connectedness could reap significant savings. }, keywords = {Depressive symptoms, Isolation, Loneliness, Medicare expenditures, Medicare linkage, Medicare/Medicaid/Health Insurance, Social Support}, issn = {0898-2643}, doi = {10.1177/0898264317703559}, url = {http://journals.sagepub.com/doi/10.1177/0898264317703559http://journals.sagepub.com/doi/pdf/10.1177/0898264317703559}, author = {Jonathan G Shaw and Farid, Monica and Claire No{\"e}l-Miller and Joseph, Neesha and Houser, Ari and Steven Asch and Bhattacharya, Jay and Flowers, Lynda} } @article {9140, title = {Social Security and Total Replacement Rates in Disability and Retirement}, number = {WP$\#$2017-6}, year = {2017}, month = {05/2017}, institution = {Center for Retirement Research at Boston College}, address = {Chestnut Hill, MA}, abstract = {Social Security provides higher replacement rates to disability insurance beneficiaries than retired beneficiaries. This fact reflects two factors: 1) Disability Insurance (SSDI) beneficiaries have lower career earnings, and Social Security benefits are progressive; and 2) SSDI benefits are not reduced for claiming early. This project uses the 1992-2010 waves of the Health and Retirement Study (HRS) linked to Social Security Administration earnings records to decompose the differences between the Social Security replacement rates for retired worker and SSDI beneficiaries into these two factors. The project also examines how the total replacement rate {\textendash} which accounts for other sources of income in addition to Social Security {\textendash} differs between retirees and SSDI beneficiaries to capture the difference in overall retirement security between the two groups. The results indicate that about half of the 10-percentage-point advantage in Social Security replacement rates for SSDI beneficiaries is due to the actuarial adjustment applied to retirement benefits, implying that career earnings are not that different between retired workers and SSDI beneficiaries. But total replacement rates are substantially lower for SSDI beneficiaries, which indicates that, despite Social Security{\textquoteright}s vital role in providing a reliable income source, SSDI beneficiaries have much lower post-career well-being than retired workers.}, keywords = {Consumption and Savings, Disabilities, Retirement Planning and Satisfaction, Social Security}, url = {http://crr.bc.edu/working-papers/social-security-and-total-replacement-rates-in-disability-and-retirement/}, author = {Khan, Mashfiqur R. and Matthew S. Rutledge and Geoffrey T. Sanzenbacher} } @article {210951, title = {Social Security Claiming and the Annuity Puzzle}, year = {2017}, institution = {Harvard University}, abstract = {Life cycle theory predicts that individuals facing uncertain mortality will annuitize all or most of their retirement wealth. Researchers seeking to explain why retirees rarely purchase annuities have focused on imperfections in commercial annuities {\textendash} including actuarially unfair pricing, lack of bequest protection, and illiquidity in the case of risky events like medical shocks. I study the annuity choice implicit in the timing of Social Security claiming and show that none of these can explain why most retirees claim benefits as early as possible, effectively choosing the minimum annuity. Most early claimers in the Health and Retirement Study had sufficient liquidity to delay Social Security longer than they actually did and could have increased lifetime consumption by delaying. Because the marginal annuity obtained through delay is better than actuarially fair, standard bequest motives cannot explain the puzzle. Nor can the risk of out-of-pocket nursing home costs, since these are concentrated at older ages past the break-even point for delayed claiming. Social Security claiming patterns, therefore, add to the evidence that behavioral explanations may be needed to explain the annuity puzzle.}, keywords = {Social Security}, url = {https://scholar.harvard.edu/mshepard/publications/social-security-claiming-and-life-cycle-model}, author = {Shepard, Mark} } @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 {9393, title = {Staying mentally fit by helping others}, journal = {The Herald-Palladium}, year = {2017}, month = {12/13/2017}, address = {Saint Joseph, MI}, keywords = {Meta-analyses, News, Volunteerism}, url = {http://www.heraldpalladium.com/features/staying-mentally-fit-by-helping-others/article_2d4bd273-41af-5327-8008-879c1a4d91f2.html}, author = {Steinke, Andy} } @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 {9079, title = {Subjective age and sleep in middle-aged and older adults.}, journal = {Psychology \& Health}, volume = {32}, year = {2017}, pages = {1140-1151}, abstract = {

OBJECTIVE: Chronological age is commonly used to explain change in sleep. The present study examines whether subjective age is associated with change in sleep difficulties across middle adulthood and old age.

DESIGN: Participants were drawn from the second (2004-2005) and third (2013-2014) waves of the Midlife in the United States Survey (MIDUS, N~=~2350; Mean Age: 55.54~years), the 2008 and 2014 waves of the Health and Retirement Study (HRS, N~=~4066; Mean Age: 67.59~years) and the first (2011) and fourth (2014) waves of the National Health and Aging Trends Survey (NHATS, N~=~3541; Mean Age: 76.46). In each sample, subjective age, sleep difficulties, depressive symptoms, anxiety and chronic conditions were assessed at baseline. Sleep difficulties was assessed again at follow-up.

MAIN OUTCOME MEASURES: Sleep difficulties.

RESULTS: An older subjective age at baseline was related to an increase in sleep difficulties over time in the three samples, and was mediated, in part, through more depressive symptoms, anxiety and chronic conditions. Feeling older was associated with an increased likelihood of major sleeping difficulties at follow-up in the three samples.

CONCLUSION: Subjective age is a salient marker of individuals{\textquoteright} at risk for poor sleep quality, beyond chronological age.

}, keywords = {Anxiety, Depressive symptoms, Sleep}, issn = {1476-8321}, doi = {10.1080/08870446.2017.1324971}, author = {Yannick Stephan and Angelina R Sutin and Bayard, Sophie and Antonio Terracciano} } @article {8856, title = {Successful Aging as the Intersection of Individual Resources, Age, Environment, and Experiences of Well-being in Daily Activities.}, journal = {J Gerontol B Psychol Sci Soc Sci}, volume = {72}, year = {2017}, month = {2017 Mar 01}, pages = {279-289}, abstract = {

Objective: We conceptualize successful aging as a cumulative index of individual resources (the absence of disease and disability, high cognitive and physical functioning, social embeddedness) in the service of successful aging outcomes (global well-being, experienced well-being, and vital status), and conditioned by age, social structure, and environment.

Method: The study used baseline and follow-up data from the 2008-2014 waves of the Health and Retirement Study (N = 17,230; age = 51-101). Linear, multilevel, and logistic models compared individual resources at baseline as independent, cumulative, and binary predictors of outcomes 4 years later.

Results: Individual resources were unequally distributed across age group and social structures (education, wealth, race, gender) and had a cumulative effect on all successful aging outcomes. For experienced well-being, individual resources were most important at midlife and for groups with lower education. Person-environment congruence (social cohesion, city satisfaction) was associated with all successful aging outcomes and conditioned the effect of individual resources on experienced well-being.

Discussion: A cumulative index allows for gradations in resources that can be compensated for by external factors such as person-environment congruence. This index could guide policy and interventions to enhance resources in vulnerable subgroups and diminish inequalities in successful aging outcomes.

}, keywords = {Activities of Daily Living, Adult, Aged, Aged, 80 and over, Aging, environment, Female, Follow-Up Studies, Health Status, Humans, Male, Middle Aged, Personal Satisfaction, Social Support, United States}, issn = {1758-5368}, doi = {10.1093/geronb/gbw148}, url = {http://psychsocgerontology.oxfordjournals.org/cgi/pmidlookup?view=long\&pmid=28077430}, author = {Shannon T. Mejia and Lindsay H Ryan and Gonzalez, Richard and Jacqui Smith} } @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 {8408, title = {Spousal Characteristics and Older Adults{\textquoteright} Hospice Use: Understanding Disparities in End-of-Life Care.}, journal = {J Palliat Med}, volume = {19}, year = {2016}, month = {2016 05}, pages = {509-15}, publisher = {19}, abstract = {

BACKGROUND: Hospice use has been shown to benefit quality of life for patients with terminal illness and their families, with further evidence of cost savings for Medicare and other payers. While disparities in hospice use by patient diagnosis, race, and region are well documented and attention to the role of family members in end-of-life decision-making is increasing, the influence of spousal characteristics on the decision to use hospice is unknown.

OBJECTIVES: To determine the association between spousal characteristics and hospice use.

DESIGN: We used data from the Health and Retirement Study (HRS), a prospective cohort study, linked to the Dartmouth Atlas of Health Care and Medicare claims.

SETTING: National study of 1567 decedents who were married or partnered at the time of death (2000-2011).

MEASURES: Hospice use at least 1 day in the last year of life as measured via Medicare claims data. Spousal factors (e.g., education and health status) measured via survey.

RESULTS: In multivariate models controlling for patient factors and regional variation, spouses with lower educational attainment than their deceased spouse had decreased likelihood of hospice use (odds ratio [OR] = 0.58; 95\% confidence interval [CI] = 0.40-0.82). Health of the spouse was not significantly associated with likelihood of decedent hospice use in adjusted models.

IMPLICATIONS: Although the health of the surviving spouse was not associated with hospice use, their educational level was a predictor of hospice use. Spousal and family characteristics, including educational attainment, should be examined further in relation to disparities in hospice use. Efforts to increase access to high-quality end-of-life care for individuals with serious illness must also address the needs and concerns of caregivers and family.

}, keywords = {Hospice Care, Hospices, Humans, Medicare, Prospective Studies, Quality of Life, Terminal Care, United States}, issn = {1557-7740}, doi = {10.1089/jpm.2015.0399}, url = {http://dx.doi.org/10.1089/jpm.2015.0399}, author = {Katherine A Ornstein and Melissa D. Aldridge and Christine A Mair and Rebecca Jean Gorges and Albert L Siu and Amy Kelley} } @article {6445, title = {Subjective Age and Changes in Memory in Older Adults}, journal = {The Journals of Gerontology Series B: Psychological Sciences and Social Sciences}, volume = {71}, year = {2016}, pages = {675-683}, chapter = {675}, abstract = {Objective. The subjective experience of aging, indexed by how old or young an individual feels, has been related to well-being and health-related outcomes among older adults. The present study examined whether subjective age is associated with memory level and changes, as indexed by measures of immediate and delayed recall. A complementary purpose was to test the mediating role of depressive symptoms and physical activity in the relation between subjective age and memory changes. Method. Participants were drawn from three waves of the Health and Retirement Study. Subjective age, baseline memory measures, and covariates were assessed during the 2008 wave (N = 5809), depressive symptoms and physical activity were assessed again in the 2010 wave, and the follow-up memory measures were assessed in the 2012 wave. Results. Regression analyses that included demographic, metabolic, and vascular covariates revealed that a younger subjective age at baseline was associated with better concurrent performance and with slower decline in immediate and delayed recall. Bootstrap procedures indicated that fewer depressive symptoms mediated these associations. Additional analyses revealed that memory level and change were unrelated to changes in subjective age. Conclusion. Beyond chronological age, the subjective experience of age is associated with cognitive aging.}, keywords = {Expectations, Health Conditions and Status}, doi = {10.1093/geronb/gbv010}, url = {http://psychsocgerontology.oxfordjournals.org/content/early/2015/03/05/geronb.gbv010.abstract}, author = {Yannick Stephan and Angelina R Sutin and Caudroit, Johan and Antonio Terracciano} } @conference {8762, title = {Subjective Life Expectancy: Differences by Smoking, Education and Gender}, booktitle = {European Population Conference 2016}, year = {2016}, abstract = {Despite the well-known higher mortality rates among smokers than non-smokers, little investigation has focused on subjective survival probabilities (SSP) by smoking behaviour. We give attention to sub-group differences in subjective survival probabilities, comparing subjective predictions to objective ones (SP) and accounting for the role of education. We use biannual data from the Health and Retirement Study (HRS) from 2000 to 2012 carried out in the USA. Based on a sample of 23,895 respondents aged 50-89, we calculate, for each respondent, the {\textquotedblleft}gap{\textquotedblright} between SSP and the estimated survival probability (SP) from the HRS data. We find that people currently smoking report lower survival probabilities especially if they are low educated. This is consistent with real mortality data that show higher mortality among these groups. When comparing subjective and objective survival probabilities we find that irrespectively of the smoking status, high educated people are more likely to correctly predict their survival probabilities than their low educated counterparts. Within education groups, people who smoked in the past are the best at predicting their mortality. Interestingly, those who currently smoke show the highest probability to incorrectly overestimate their survival probability (i.e., to underestimate the negative effect of smoking on mortality).}, keywords = {Education, Gender Differences, Longevity, Mortality, Older Adults, Smoking}, url = {http://epc2016.princeton.edu/uploads/160554}, author = {Sergei Scherbov and Bruno Arpino and Valeria Bordone} } @article {8221, title = {Sequential Patterns of Health Conditions and Financial Outcomes in Late Life: Evidence From the Health and Retirement Study}, journal = {The International Journal of Aging and Human Development}, volume = {81}, year = {2015}, pages = {54-82}, publisher = {81}, abstract = {The cost and prevalence of chronic health conditions increase in late life and can negatively impact accumulated wealth. Based on the financial challenges midaged and older adults face, we sought to understand the evolution of distinctive sequences of chronic health conditions and how these sequences affect retirement savings. We used 10 waves of the Health and Retirement Study and tracked the health states and changes in wealth of 5,540 individuals. We identified five typical sequences of chronic health conditions, which are defined as follows: Multimorbidity, Comorbidity, Mild Disease, Late Event, and No Disease. Wealth accumulation differed across the five sequences. Multimorbidity and Comorbidity were the most costly sequences. Individuals with these health patterns, respectively, had 91,205 and 95,140, less net worth than respondents identified with No Disease. Our findings suggest policy makers consider sequential disease patterns when planning for the health-care needs and expenditures of older Americans.}, keywords = {Demographics, Net Worth and Assets, Public Policy}, doi = {10.1177/0091415015614948}, url = {http://ahd.sagepub.com/content/81/1-2/54.abstract}, author = {Hyungsoo Kim and Shin, Serah and Karen A. Zurlo} } @mastersthesis {6121, title = {Social Resource Factors that Influence Cognitive Functioning of Aging Black Adults}, volume = {3705749}, year = {2015}, note = {Copyright - Copyright ProQuest Dissertations Publishing 2015 Last updated - 2015-08-28 First page - n/a}, month = {2015}, pages = {185}, school = {The Catholic University of America}, type = {Ph.D.}, address = {Washington, DC}, abstract = {Social workers have found that aging adults are often challenged by reduced cognitive functioning, which impacts their health and mental health. Recent advances in knowledge indicate that social resources such as quality of emotional support and social integration can slow cognitive decline. Aging Black persons are twice more likely to have cognitive impairment than aging White persons. However, the majority of studies investigating associations or predictors of cognitive health are comprised of primarily White samples, and little is known regarding the effect of social resource factors on cognition in aging Black adults. Data for the study came from the 2010 wave of the Health and Retirement Study (HRS), an ongoing, longitudinal, population-based cohort study of adults ages 50 to 98. The analyzed sample was comprised of 338 men and 699 women who self-identified as African American/Black. Controlling for factors known to influence cognitive functioning, a multiple regression analysis of four categories of social resources was conducted, by gender, to determine their effect on global cognitive functioning: quality of social supports, social networks, social integration, and social influence. For Black men, emotional support from family and frequency of contact with their children were predictive of global cognition. For Black women, emotional support from friends was positively predictive of global cognition. Further, locus of control perceived constraints was inversely related with global cognition in men, while education was positively predictive of global cognition across gender. The findings demonstrate that the evaluative aspects of social relationships (perceptions of support) are important in predicting cognitive functioning for both genders, and the structural components (types of relationships or frequency of contacts) are important in predicting cognitive functioning for men. Additionally, this study validated the role of gender as a moderator between quality of social supports and global cognition, and as a moderator between social networks and global cognition in aging Black persons. Research grounded in intersectionality theory yielded unique information for Black men and women that is applicable for evidence-based practice interventions. Practices targeting the reduction of constraints and strengthening family, friend, and children networks in men, and practices assisting women in strengthening their friendship networks, may mitigate their cognitive decline and increase their global cognition as they age.}, keywords = {Demographics, Event History/Life Cycle, Gerontology, Health Conditions and Status, Healthcare, Methodology, Other, Women and Minorities}, url = {http://proxy.lib.umich.edu/login?url=http://search.proquest.com/docview/1705880418?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+Full+Text\&rft_val_fmt=info:ofi/}, author = {Swett, Laura} } @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 {8302, title = {Spouses and depressive symptoms in older adulthood.}, journal = {Sci Rep}, volume = {5}, year = {2015}, note = {Times Cited: 0 0}, month = {2015 Feb 26}, pages = {8594}, publisher = {5}, abstract = {

Depressive symptoms may co-occur within couples and follow similar trajectories, but relatively little is known about this process in old age. This study thus examined the association between some spousal characteristics (spouse{\textquoteright}s depressive symptoms, age difference between spouses) and the trajectory of depressive symptoms in older adults. Participants >= 65 years old were drawn from the Health and Retirement Study (N = 12,010; Mean age = 70.60 and 69.16 for target husbands and wives, respectively). Depressive symptoms were measured with a short form of the Center for Epidemiological Studies Depression (CES-D) scale. Hierarchical Linear Modeling was used to model up to 9 assessments of depressive symptoms of target spouses (Mean number of CESD assessments per target spouse = 3, range 1-9). Depressive symptoms between spouses were correlated; convergence over time was modest. For both husbands and wives, having a younger spouse was associated with more depressive symptoms at age 65. These results suggest that there is concordance between spouses{\textquoteright} depressive symptoms and that the age difference between spouses contribute to depressive symptoms as couples enter old age. The association between spouses{\textquoteright} depressive symptoms is nearly as strong as the effect of each decade increase in age.

}, keywords = {Aged, depression, Female, Humans, Longitudinal Studies, Male, Sex Distribution, Spouses}, issn = {2045-2322}, doi = {10.1038/srep08594}, author = {Pradeep, Neeti and Angelina R Sutin} } @article {11440, title = {Subjective life horizon and portfolio choice}, journal = {Journal of Economic Behavior \& Organization}, volume = {116}, year = {2015}, pages = {94-106}, abstract = {Using data from a U.S. household survey, we examine the empirical relation between subjective life horizon (i.e., the self-reported expectation of remaining life span) and portfolio choice. We find that equity portfolio shares are higher for investors with longer horizons, controlling for gender-specific age effects, socio-economic characteristics, health, and optimism. Our result is robust to accounting for the endogeneity of equity market participation or instrumenting subjective life horizon with parental survival. Finally, we show that the effect of a shortening horizon on portfolio allocation is stronger for households without bequest motives.}, keywords = {Bequests, Investment horizon, Life Expectancy, Portfolio choice, Subjective Expectations}, isbn = {0167-2681}, doi = {https://doi.org/10.1016/j.jebo.2015.04.006}, author = {Spaenjers, Christophe and Spira, Sven Michael} } @article {8239, title = {Substance-use coping and self-rated health among US middle-aged and older adults.}, journal = {Addict Behav}, volume = {42}, year = {2015}, note = {Export Date: 20 January 2015}, month = {2015 Mar}, pages = {96-100}, publisher = {42}, abstract = {

The prevalence of alcohol, drug, and tobacco use among US middle-aged and older adults is increasing. A subset of this population uses substances to cope with stress, but the characteristics of these individuals, and the association between substance-use coping and health outcomes remain unclear. We identified correlates of substance-use coping and measured its association with self-rated health in a community-based sample of adults aged 54-99 in the Health and Retirement Study (HRS). In the 2008 HRS, 1351 participants reported their frequency of prescription/other drug-, alcohol-, and cigarette-use coping with stress and reported self-rated health (excellent/very good, good, or fair/poor); 1201 of these participants also reported self-rated health in 2010. One in six participants frequently used substances to cope. The oldest participants were least likely to engage in frequent alcohol-use coping. Those with elevated depressive symptoms were more likely to frequently engage in cigarette- and prescription/other drug-use coping. In multivariable-adjusted analyses, participants who frequently used cigarettes (compared to participants who infrequently used cigarettes) to cope had 2.7 times (95\% CI=1.1-6.7) the odds of poor (vs. excellent) self-rated health. Relative to participants who infrequently used prescription/other drugs to cope, participants who frequently used prescription/other drugs to cope had 2.4 times (95\% CI=1.1-5.1) the odds of reporting poor self-rated health. The association between prescription/other drug-use coping in 2008 and self-rated health in 2010 was statistically significant (relative OR=3.5, 95\% CI=1.7-7.2). Participants engaging in substance-use coping likely have particular demographic and clinical characteristics. Interventions to reduce substance-use coping may prevent adverse health outcomes.

}, keywords = {Adaptation, Psychological, Aged, Aged, 80 and over, Alcohol Drinking, depression, Female, Health Status, Humans, Male, Middle Aged, Smoking, Substance-Related Disorders, United States}, issn = {1873-6327}, doi = {10.1016/j.addbeh.2014.10.031}, author = {Pia M Mauro and Sarah L. Canham and Silvia S Martins and Adam P Spira} } @article {8300, title = {Symptom Trends in the Last Year of Life From 1998 to 2010 A Cohort Study}, journal = {Annals of Internal Medicine}, volume = {162}, year = {2015}, note = {Times Cited: 1 0 1}, pages = {175-U58}, publisher = {162}, abstract = {Background: Calls for improvement in end-of-life care have focused attention on the management of pain and other troubling symptoms at the end of life. Objective: To describe changes in pain intensity and symptom prevalence during the last year of life from 1998 to 2010. Design: Observational study. Setting: The HRS (Health and Retirement Study), a nationally representative longitudinal survey of community-dwelling U. S. residents aged 51 years or older. Participants: 7204 HRS participants who died while enrolled in the study and their family respondents. Measurements: Proxy-reported pain during the last year of life and other symptoms for at least 1 month during the last year of life. Trends in pain intensity and symptom prevalence were analyzed for all decedents and within the categories of sudden death, cancer, congestive heart failure or chronic lung disease, and frailty. Results: Between 1998 and 2010, proxy reports of the prevalence of any pain increased for all decedents from 54.3 (95 CI, 51.6 to 57.1 ) to 60.8 (CI, 58.2 to 63.4 ), an increase of 11.9 (CI, 3.1 to 21.4 ). Reported prevalences of depression and periodic confusion also increased for all decedents by 26.6 (CI, 14.5 to 40.1 ) and 31.3 (CI, 18.6 to 45.1 ), respectively. Individual symptoms increased in prevalence among specific decedent categories, except in cancer, which showed no significant changes. The prevalence of moderate or severe pain did not change among all decedents or in any specific decedent category. Limitation: Use of proxy reports and limited information about some patient and surrogate variables. Conclusion: Despite national efforts to improve end-of-life care, proxy reports of pain and other alarming symptoms in the last year of life increased from 1998 to 2010.}, keywords = {Health Conditions and Status, Methodology, Retirement Planning and Satisfaction}, doi = {10.7326/m13-1609}, author = {Adam E Singer and Meeker, Daniella and Joan M Teno and Lynn, Joanne and June R Lunney and Karl A Lorenz} } @article {8016, title = {Satisfaction with aging and use of preventive health services.}, journal = {Prev Med}, volume = {69}, year = {2014}, note = {Times Cited: 0 0}, month = {2014 Dec}, pages = {176-80}, publisher = {69}, abstract = {

OBJECTIVE: Preventive health service use is relatively low among older age groups. We hypothesized that aging satisfaction would be associated with increased use of preventive health services four years later.

METHOD: We conducted multiple logistic regression analyses on a sample of 6177 people from the Health and Retirement Study, a nationally representative study of U.S. adults over the age of 50 (M age=70.6; women n=3648; men n=2529).

RESULTS: Aging satisfaction was not associated with obtaining flu shots. However, in fully-adjusted models, each standard deviation increase in aging satisfaction was associated with higher odds of reporting service use for cholesterol tests (OR=1.10, 95\% CI=1.00-1.20). Further, women with higher aging satisfaction were more likely to obtain a mammogram/x-ray (OR=1.17, 95\% CI=1.06-1.29) or Pap smear (OR=1.10, 95\% CI=1.00-1.21). Among men, the odds of obtaining a prostate exam increased with higher aging satisfaction (OR=1.20 95\% CI=1.09-1.34).

CONCLUSION: These results suggest that aging satisfaction potentially influences preventive health service use after age 50.

}, keywords = {Aged, Aged, 80 and over, Aging, Chronic disease, Female, Health Behavior, Health Knowledge, Attitudes, Practice, Humans, Influenza Vaccines, Logistic Models, Male, Mammography, Middle Aged, Patient Acceptance of Health Care, Patient Satisfaction, Personal Satisfaction, Preventive Health Services, Prostatic Neoplasms, Surveys and Questionnaires, United States, Vaginal Smears}, issn = {1096-0260}, doi = {10.1016/j.ypmed.2014.09.008}, author = {Eric S Kim and Kyle D Moored and Hannah L. Giasson and Jacqui Smith} } @article {8118, title = {Self-rated health in the last 12 years of life compared to matched surviving controls: the Health and Retirement Study.}, journal = {PLoS One}, volume = {9}, year = {2014}, note = {Times Cited: 0 0}, month = {2014}, pages = {e107879}, publisher = {9}, abstract = {

Self-rated health (SRH) is a valid measure of health status and associated with mortality. Based on individual-level biannual repeat data on SRH we sought to characterize the natural history of poor SRH during the 12 years prior to death in men and women in different age groups. We conducted a retrospective analysis of the Health and Retirement Study participants who died between 1998 and 2010 and had at least two SRH measurements in the 12 years prior to death. We used a nested case-control design to compare SRH trajectories of deceased men and women aged 30-64, 65-79 and 80 years versus surviving participants. The cases comprised 3,350 deceased participants who were matched to surviving controls (n = 8,127). SRH was dichotomized into good vs. poor health. Men and women dying at age 65-79 and >= 80 years had 1.5 to 3 times higher prevalence of poor SRH already 11-12 years prior to death compared to surviving controls. The risk estimates remained statistically significant even after adjusting for life-style related risk factors and diagnosed diseases. Prevalence of poor SRH before death was lowest among those aged >= 80 years and highest in 30-64 year-olds. In conclusion, men and women who subsequently die perceive their health worse already 11-12 years prior to death compared to their surviving controls.

}, keywords = {Adult, Aged, Aged, 80 and over, Diagnostic Self Evaluation, Female, health, Health Status, Humans, Life Style, Male, Middle Aged, Mortality, Retirement, Retrospective Studies}, issn = {1932-6203}, doi = {10.1371/journal.pone.0107879}, author = {Stenholm, Sari and Pentti, Jaana and Ichiro Kawachi and Westerlund, Hugo and Mika Kivim{\"a}ki and Vahtera, Jussi} } @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 {8048, title = {Snapshots of Mixtures of Affective Experiences in a Day: Findings from the Health and Retirement Study}, journal = {Journal of Population Ageing}, volume = {7}, year = {2014}, pages = {55-79}, publisher = {7}, abstract = {In 2009, a representative subsample of participants in the Health and Retirement Study (HRS: N = 5333; Age 50 101) responded to a short day reconstruction self-administered questionnaire that asked about their time and experiences on seven activities the previous day. We evaluate the quality and reliability of responses to this 10-min measure of experienced well-being and compare the properties and correlates of three intensity-based composites reflecting mixtures of activity-linked affective experiences (Activity-Positive Affect, Activity-Negative Affect, and Net Affect), and a frequency-based index, Activity Affective Complexity, that summarizes the proportion of activities that include a mixture of positive and negative affective experiences regardless of intensity. On average, older adults reported that 36 of the activities in their day provided some mixture of feelings (e.g., interested and frustrated). Regression models revealed differential associations for the four constructs of affective well-being with socio-demographic factors, physical and mental health, and proximal indicators of the day s context. We conclude that the HRS short day reconstruction measure is reliable and discuss the conceptual issues in assessing, summarizing, and interpreting the complexity of emotional experience in older adults.}, keywords = {Demographics, Expectations, Health Conditions and Status, Methodology}, doi = {10.1007/s12062-014-9093-8}, url = {http://dx.doi.org/10.1007/s12062-014-9093-8}, author = {Jacqui Smith and Lindsay H Ryan and Tara L Queen and Sandra E Becker and Gonzalez, Richard} } @article {8012, title = {The Social Security Windfall Elimination and Government Pension Offset Provisions for Public Employees in the Health and Retirement Study}, journal = {Social Security Bulletin}, volume = {74}, year = {2014}, note = {Date revised - 2015-04-01 Availability - URL:http://www.ssa.gov/policy/docs/ssb/ Publisher{\textquoteright}s URL}, pages = {55-69}, publisher = {74}, abstract = {This article uses Health and Retirement Study data to investigate the effects of Social Security{\textquoteright}s Windfall Elimination Provision (WEP) and Government Pension Offset (GPO) on Social Security benefits received by households. The provisions reduce benefits for individuals or the dependents of individuals whose work histories include jobs for which they were entitled to a pension and were not subject to Social Security payroll taxes ( noncovered employment). We find that about 3.5 percent of households are subject to either the WEP or the GPO, and that the provisions reduce the present value of their Social Security benefits by roughly one-fifth. Households affected by both provisions experience benefit reductions of about one-third. Under the WEP, the Social Security benefit reduction is capped at one-half of the amount of the pension from noncovered employment, which substantially reduces the WEP penalty and prevents the WEP adjustment from falling disproportionately on households in the lowest earnings category.}, keywords = {Employment and Labor Force, Income, Pensions, Public Policy, Retirement Planning and Satisfaction, Social Security}, author = {Alan L Gustman and Thomas L. Steinmeier and N. Tabatabai} } @article {8050, title = {Socioeconomic inequalities in health after age 50: Are health risk behaviors to blame?}, journal = {Social Science and Medicine}, volume = {101}, year = {2014}, note = {Times Cited: 0}, pages = {52-60}, publisher = {101}, abstract = {Recent studies indicate that socioeconomic inequalities in health extend into the elderly population, even within the most highly developed welfare states. One potential explanation for socioeconomic inequalities in health focuses on the role of health behaviors, but little is known about the degree to which health behaviors account for health inequalities among older adults, in particular. Using data from the Health and Retirement Study (N = 19,245), this study examined the degree to which four behavioral risk factors smoking, obesity, physical inactivity, and heavy drinking are associated with socioeconomic position among adults aged 51 and older, and whether these behaviors mediate socioeconomic differences in mortality, and the onset of disability among those who were disability-free at baseline, over a 10-year period from 1998 to 2008. Results indicate that the odds of both smoking and physical inactivity are higher among persons with lower wealth, with similar stratification in obesity, but primarily among women. The odds of heavy drinking decrease at lower levels of wealth. Significant socioeconomic inequalities in mortality and disability onset are apparent among older men and women; however, the role that health behaviors play in accounting for these inequalities differs by age and gender. For example, these health behaviors account for between 23 and 45 of the mortality disparities among men and middle aged women, but only about 5 of the disparities found among women over 65 years. Meanwhile, these health behaviors appear to account for about 33 of the disparities in disability onset found among women survivors, and about 9-14 among men survivors. These findings suggest that within the U.S. elderly population, behavioral risks such as smoking and physical inactivity contribute moderately to maintaining socioeconomic inequalities in health. As such, promoting healthier lifestyles among the socioeconomically disadvantaged older adults should help to reduce later life health inequalities. (C) 2013 Elsevier Ltd. All rights reserved.}, keywords = {Demographics, Disabilities, Health Conditions and Status, Other}, doi = {10.1016/j.socscimed.2013.10.040}, author = {Benjamin A Shaw and McGeever, Kelly and Elizabeth Vasquez and Agahi, Neda and Fors, Stefan} } @article {8114, title = {Socio-economic status over the lifecourse and internet use in older adulthood}, journal = {Ageing and Society}, volume = {34}, year = {2014}, note = {Times Cited: 0}, pages = {1019-1034}, publisher = {34}, abstract = {This study explored associations between socio-economic status (SES) at different phases in the lifecourse and regular internet use among older adults. A sample (N=11,035) from the 2010 wave of the United States Health and Retirement Study was used. Odds ratios were estimated to explore the relationship between regular internet use in older adulthood and measures of SES in childhood and in adulthood, and cumulative SES. Findings provided support for the lifecourse perspective, suggesting that variations observed among older adults are reflective of cumulative experiences. Three main themes emerged: higher SES in childhood increased the odds of being an internet user in older adulthood; SES advantages tended to accumulate, so that having at least one period of high SES in the lifecourse increased the odds of being an internet user in older adulthood; age did not appear to modify the positive relationship between cumulative SES and internet use.}, keywords = {Demographics, Other}, doi = {10.1017/s0144686x12001420}, author = {Silver, Michelle Pannor} } @article {8913, title = {Spousal social support and strain: impacts on health in older couples.}, journal = {Journal of Behavioral Medicine}, volume = {37}, year = {2014}, month = {2014 Dec}, pages = {1108-17}, abstract = {

Using a nationally representative sample of couples aged 51+ in the United States (N~=~1,923 couples), the current study investigated whether both partners{\textquoteright} perceptions of relationship support and strain are associated with an individual{\textquoteright}s self-rated health and functional limitations. The sample had an average age of 67.17~years (SD~=~9.0; range 50-97). Actor-Partner Interdependence Models adjusting for couple interdependencies were applied using multilevel models. After accounting for age, education, gender, race, and couple differences in length of marriage, results indicate that individual perceptions of support were significantly associated with higher self-rated health and fewer functional limitations. These individual-level benefits increased if the spouse also perceived positive support and low strain. Finally, the negative association of an individual{\textquoteright}s perceived support on functional limitations was greater in those with a spouse reporting low levels of perceived strain. Findings are discussed relative to theory on behavioral and psychological pathways between partners{\textquoteright} perceptions of support and health.

}, keywords = {Health Conditions and Status, Marriage, Older Adults, Social Support, Stress}, issn = {1573-3521}, doi = {10.1007/s10865-014-9561-x}, author = {Lindsay H Ryan and Wylie H Wan and Jacqui Smith} } @article {7828, title = {Is Self-Rated Health Comparable Between Non-Hispanic Whites and Hispanics? Evidence From the Health and Retirement Study}, journal = {The Journals of Gerontology}, volume = {68}, year = {2013}, note = {Copyright - Copyright Oxford University Press, UK Jul 2013 Last updated - 2013-06-21 SubjectsTermNotLitGenreText - United States--US}, pages = {622}, publisher = {68}, abstract = {Using subsequent all-cause mortality as a yardstick for retrospective health, this study assessed the comparability of self-rated health (SRH) between non-Hispanic whites and Hispanics. Based on longitudinal data from 6,870 white and 886 Hispanic respondents aged between 51 and 61 in the 1992 Health and Retirement Study, we related SRH in 1992 to risk of mortality in the 1992-2008 period. Logit models were used to predict white-Hispanic differences in reporting fair or poor SRH. Survival curves and cox proportional hazard models were estimated to assess whether and the extent to which the SRH-mortality association differs between non-Hispanic whites and Hispanics. Hispanic respondents reported worse SRH than whites at the baseline, yet they had similar risk of mortality as whites in the 1992-2008 period. Overall, Hispanics rated their health more pessimistically than whites. This was especially the case for Hispanics who rated their health fair or poor at the baseline, whereas their presumed health conditions, as reflected by subsequent risk of mortality, should be considerably better than their white counterparts. Health disparities between whites and Hispanics aged between 51 and 61 will be overestimated if the assessment has been solely based on differences in SRH between the two groups. Findings from this study call for caution in relying on SRH to quantify and explain health disparities between non-Hispanic whites and Hispanics in the United States.}, keywords = {Demographics, Health Conditions and Status, Methodology, Retirement Planning and Satisfaction, Women and Minorities}, author = {Su, Dejun and Wen, Ming and Kyriakos S Markides} } @article {5960, title = {The Social Security Windfall Elimination and Government Pension Offset Provisions for Public Employees in the Health and Retirement Study}, year = {2013}, institution = {Ann Arbor, The University of Michigan}, abstract = {This paper uses data from the Health and Retirement Study to investigate the effects of Social Security s Windfall Elimination Provision (WEP) and Government Pension Offset (GPO) provision on Social Security benefits received by individuals and households. WEP reduces the benefits of individuals who worked in jobs covered by Social Security and also worked in uncovered jobs where a pension was earned. WEP also reduces spouse benefits. GPO reduces spouse and survivor benefits for persons who worked in uncovered government employment where they also earned a pension. Unlike previous studies, we take explicit account of pensions earned on jobs not covered by Social Security, a key determinant of the size of WEP and GPO adjustments. Also unlike previous studies, we focus on the household. This allows us to incorporate the full effects of WEP and GPO on spouse and survivor benefits, and to evaluate the effects of WEP and GPO on the assets accumulated by affected families. Among our specific findings: About 3.5 percent of households are subject to either WEP or to GPO. The present value of their Social Security benefits is reduced by roughly one fifth. This amounts to five to six percent of the total wealth they accumulate before retirement. Households affected by both WEP and GPO lose about one third of their benefit. Limiting the Social Security benefit to half the size of the pension from uncovered employment reduces the penalty from WEP for members of the original HRS cohort by about 60 percent.}, keywords = {Public Policy, Retirement Planning and Satisfaction, Social Security}, url = {http://www.mrrc.isr.umich.edu/publications/papers/pdf/wp288.pdf}, author = {Alan L Gustman and Thomas L. Steinmeier and N. Tabatabai} } @article {7715, title = {Self- and other-oriented potential lifetime traumatic events as predictors of loneliness in the second half of life.}, journal = {Aging Ment Health}, volume = {16}, year = {2012}, month = {2012}, pages = {423-30}, publisher = {16}, abstract = {

OBJECTIVES: This study examined the relationship between self- and other-oriented potential lifetime traumatic events (PLTE) and loneliness at the second half of life.

METHOD: The sample was comprised of 7446 respondents who completed the Health and Retirement Study (HRS) 2006 psychosocial questionnaire. PLTE were classified into self-oriented PLTE, defined as traumatic events that primarily inflict the self (e.g., being abused by parents) and other-oriented PLTE, defined as events that affect the self by primarily targeting others (e.g., death of one{\textquoteright}s child). We evaluated the role of self- and other-oriented PLTE as predictors of loneliness, as evaluated by the short R-UCLA. Analyses were stratified by age at which trauma happened categorized into four life periods (0-17, 18-30, 31-49, 50+).

RESULTS: The results showed that PLTE is positively related to loneliness. Moreover, the number of other-oriented PLTE, and even more pronouncedly self-oriented PLTE, that happened up until adulthood were the strongest predictors of loneliness at the second half of life.

CONCLUSION: The study suggests that self- and other-oriented PLTE reported to have occurred early in life are associated with perceived loneliness in the second half of life.

}, keywords = {Age Factors, Aged, Aged, 80 and over, Child, Child Abuse, Cross-Sectional Studies, depression, Female, Forecasting, Humans, Life Change Events, Loneliness, Male, Middle Aged, Self Psychology, Wounds and Injuries}, issn = {1364-6915}, doi = {10.1080/13607863.2011.638903}, author = {Yuval Palgi and Amit Shrira and Menachem Ben-Ezra and Sharon Shiovitz-Ezra and Liat Ayalon} } @article {7632, title = {Self-care and health outcomes of diabetes mellitus.}, journal = {Clin Nurs Res}, volume = {21}, year = {2012}, month = {2012 Aug}, pages = {309-26}, abstract = {

Studies show that self-care improves diabetes mellitus (DM) outcomes; however, previous studies have focused on self-care maintenance, and little is known about self-care management. The objective of this study is to examine the influence of DM self-care maintenance and management on number of hospitalizations and hospitalization days. A cohort design with secondary analysis of data from the Health and Retirement Study 2002-2004 was used. Data from 726 adults with DM were analyzed with logistic regression and negative binomial regression adjusting for covariates. Self-care maintenance and management were significant determinants of hospitalization outcomes. Establishing a goal for HbA1c (self-care management) and eating >=2 snacks or desserts per day (self-care maintenance) were associated with a decrease in hospitalizations (IRR = 0.860, p = .001; IRR = 0.914, p = .043, respectively). DM self-care maintenance and management influence health outcomes but in different ways. These data provide evidence that both elements are needed in the education of patients about DM.

}, keywords = {Adult, Aged, Aged, 80 and over, Clinical Nursing Research, Diabetes Mellitus, Female, Follow-Up Studies, Hospitalization, Humans, Length of Stay, Male, Middle Aged, Self Care, Treatment Outcome}, issn = {1552-3799}, doi = {10.1177/1054773811422604}, author = {MinKyoung Song and Sarah J Ratcliffe and Nancy C Tkacs and Barbara Riegel} } @article {7770, title = {A simple measure with complex determinants: investigation of the correlates of self-rated health in older men and women from three continents}, journal = {Bmc Public Health}, volume = {12}, year = {2012}, note = {Times Cited: 0 French, Davina J. Browning, Colette Kendig, Hal Luszcz, Mary A. Saito, Yasuhiko Sargent-Cox, Kerry Anstey, Kaarin J.}, publisher = {12}, abstract = {Background: Self-rated health is commonly employed in research studies that seek to assess the health status of older individuals. Perceptions of health are, however, influenced by individual and societal level factors that may differ within and between countries. This study investigates levels of self-rated health (SRH) and correlates of SRH among older adults in Australia, United States of America (USA), Japan and South Korea. Methods: Cross-sectional data were drawn from large surveys of older respondents ( = 65 years) in Australia (n = 7,355), USA (n = 10,358), Japan (n = 3,541) and South Korea (n = 3,971), collected between 2000 and 2006. Harmonized variables were developed to represent socioeconomic, lifestyle and health indicators. We then assessed whether these variables, and their potentially different impact in different countries, could account for cross-national differences in levels of SRH. Results: SRH differed significantly between countries, with older Koreans reporting much poorer health than those in the other three nations. This was not the result of biases in response patterns (for example central versus extreme tendency). Health-related correlates of SRH were similar across countries; those with more medical conditions, functional limitations or poor mental health gave poorer ratings. After accounting for the differential impact of determinants in different national contexts, Australians reported better SRH than other nations. Conclusions: We conclude that when examining correlates of SRH, the similarities are greater than the differences between countries. There are however differences in levels of SRH which are not fully accounted for by the health correlates. Broad generalizations about styles of responding are not helpful for understanding these differences, which appear to be country, and possibly cohort specific. When using SRH to characterize the health status of older people, it is important to consider earlier life experiences of cohorts as well as national and individual factors in later life. Further research is required to understand the complex societal influences on perceptions of health.}, keywords = {Cross-National, Health Conditions and Status, KLoSA, Methodology}, doi = {10.1186/1471-2458-12-649}, author = {D. J. French and Chris Browning and Kendig, H. and Luszcz, M. A. and Saito, Yasuhiko and K. A. Sargent-Cox and Kaarin J. Anstey} } @article {7732, title = {Spurring enrollment in Medicare savings programs through a substitute for the asset test focused on investment income.}, journal = {Health Aff (Millwood)}, volume = {31}, year = {2012}, note = {Copyright - Copyright The People to People Health Foundation, Inc., Project HOPE Feb 2012 Language of summary - English Location - United States--US Pages - 367-75 ProQuest ID - 921992803 Document feature - Tables; References SubjectsTermNotLitGenreText - United States--US Last updated - 2012-06-05 Place of publication - Chevy Chase Corporate institution author - Dorn, Stan; Shang, Baoping DOI - 2588825981; 67448192; 15986; HAF; 22323167; INNNHAF0000865869}, month = {2012 Feb}, pages = {367-75}, publisher = {31}, abstract = {

Fewer than one-third of eligible Medicare beneficiaries enroll in Medicare savings programs, which pay premiums and, in some cases, eliminate out-of-pocket cost sharing for poor and near-poor enrollees. Many beneficiaries don{\textquoteright}t participate in savings programs because they must complete a cumbersome application process, including a burdensome asset test. We demonstrate that a streamlined alternative to the asset test-allowing seniors to qualify for Medicare savings programs by providing evidence of limited assets or showing a lack of investment income-would permit 78 percent of currently eligible seniors to bypass the asset test entirely. This simplified approach would increase the number of beneficiaries who qualify for Medicare savings programs from the current 3.6 million seniors to 4.6 million. Such an alternative would keep benefits targeted to people with low assets, eliminate costly administrative expenses and obstacles to enrollment associated with the asset test, and avoid the much larger influx of seniors that would occur if the asset test were eliminated entirely.

}, keywords = {Cost Savings, Eligibility Determination, Financing, Personal, Humans, Medicare, Poverty, United States}, issn = {1544-5208}, doi = {10.1377/hlthaff.2011.0443}, author = {Dorn, Stan and Shang, Baoping} } @article {7780, title = {Stability and change in financial transfers from adult children to older parents.}, journal = {Can J Aging}, volume = {31}, year = {2012}, month = {2012 Dec}, pages = {367-78}, publisher = {31}, abstract = {

We sought to identify the extent and predictors of longitudinal changes in adult children{\textquoteright}s financial assistance to parents and in transfer networks over a two-year period. Analyses rely on pooled data from 1994 to 2000 of the Health and Retirement Study, using families in which adult children with no more than four siblings financially supported parents over two years. Change in the help network occurred in about 40 per cent of these families over the two-year period. When change occurred, it most commonly involved cessation of support by a child, followed by addition of another child to the network, whereas exchange of supporting children was relatively rare. Change reflected children{\textquoteright}s ability to provide care and the burden created by parents{\textquoteright} needs. However, the size and composition of the adult-child network and of the initial support group also played an important role. Results highlight the dynamic and systemic nature of intergenerational financial networks.

}, keywords = {Adult children, Aged, Female, Financial Support, Humans, Male, Middle Aged, Parent-Child Relations, Parents}, issn = {1710-1107}, doi = {10.1017/S0714980812000372}, author = {Maximiliane E Szinovacz and Adam Davey} } @article {7745, title = {Stroke incidence in older US Hispanics: is foreign birth protective?}, journal = {Stroke}, volume = {43}, year = {2012}, note = {Moon, J Robin Capistrant, Benjamin D Kawachi, Ichiro Avendano, Mauricio Subramanian, S V Bates, Lisa M Glymour, M Maria T32-HL098048-01/HL/NHLBI NIH HHS/United States Research Support, N.I.H., Extramural Research Support, Non-U.S. Gov{\textquoteright}t United States Stroke. 2012 May;43(5):1224-9. Epub 2012 Feb 21.}, month = {2012 May}, pages = {1224-9}, publisher = {43}, abstract = {

BACKGROUND AND PURPOSE: Although Hispanics are the fastest growing ethnic group in the United States, relatively little is known about stroke risk in US Hispanics. We compare stroke incidence and socioeconomic predictors in US- and foreign-born Hispanics with patterns among non-Hispanic whites.

METHODS: Health and Retirement Study participants aged 50+ years free of stroke in 1998 (mean baseline age, 66.3 years) were followed through 2008 for self- or proxy-reported first stroke (n=15 784; 1388 events). We used discrete-time survival analysis to compare stroke incidence among US-born (including those who immigrated before age 7 years) and foreign-born Hispanics with incidence in non-Hispanic whites. We also examined childhood and adult socioeconomic characteristics as predictors of stroke among Hispanics, comparing effect estimates with those for non-Hispanic whites.

RESULTS: In age- and sex-adjusted models, US-born Hispanics had higher odds of stroke onset than non-Hispanic whites (OR, 1.44; 95\% CI, 1.08-1.90), but these differences were attenuated and nonsignificant in models that controlled for childhood and adulthood socioeconomic factors (OR, 1.07; 95\% CI, 0.80-1.42). In contrast, in models adjusted for all demographic and socioeconomic factors, foreign-born Hispanics had significantly lower stroke risk than non-Hispanic whites (OR, 0.58; 95\% CI, 0.41-0.81). The impact of socioeconomic predictors on stroke did not differ between Hispanics and whites.

CONCLUSIONS: In this longitudinal national cohort, foreign-born Hispanics had lower incidence of stroke incidence than non-Hispanic whites and US-born Hispanics. Findings suggest that foreign-born Hispanics may have a risk factor profile that protects them from stroke as compared with other Americans.

}, keywords = {Age Factors, Aged, Cohort Studies, Emigration and Immigration, Female, Hispanic or Latino, Humans, Incidence, Longitudinal Studies, Male, Middle Aged, Retrospective Studies, Risk Factors, Socioeconomic factors, Stroke, United States, White People}, issn = {1524-4628}, doi = {10.1161/STROKEAHA.111.643700}, author = {J Robin Moon and Benjamin D Capistrant and Ichiro Kawachi and Mauricio Avendano and Subramanian, S V and Lisa M. Bates and M. Maria Glymour} } @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 {7467, title = {Situational versus chronic loneliness as risk factors for all-cause mortality.}, journal = {Int Psychogeriatr}, volume = {22}, year = {2010}, month = {2010 May}, pages = {455-62}, publisher = {22}, abstract = {

BACKGROUND: Several international studies have substantiated the role of loneliness as a risk factor for mortality. Although both theoretical and empirical research has supported the classification of loneliness as either situational or chronic, research to date has not evaluated whether this classification has a differential impact upon mortality.

METHODS: To establish the definition of situational vs. chronic loneliness, we used three waves of the Health and Retirement Study (HRS), a nationally representative sample of Americans over the age of 50 years. Baseline data for the present study were collected in the years 1996, 1998, and 2000. The present study concerns the 7,638 individuals who completed all three waves; their loneliness was classified as either not lonely, situational loneliness or chronic loneliness. Mortality data were available through to the year 2004.

RESULTS: Those identified as "situationally lonely" (HR = 1.56; 95\% CI: 1.52-1.62) as well as those identified as "chronically lonely" (HR = 1.83; 95\% CI: 1.71-1.87) had a greater risk for all cause mortality net of the effect of possible demographic and health confounders. Nonetheless, relative to those classified as "situationally lonely," individuals classified as "chronically lonely" had a slightly greater mortality risk.

CONCLUSIONS: The current study emphasizes the important role loneliness plays in older adults{\textquoteright} health. The study further supports current division into situational vs. chronic loneliness, yet suggests that both types serve as substantial mortality risks.

}, keywords = {Age Factors, Aged, Aged, 80 and over, Aging, Cause of Death, Female, Geriatric Assessment, Health Surveys, Humans, Israel, Life Change Events, Loneliness, Male, Middle Aged, Risk Factors, social isolation, Surveys and Questionnaires, Time Factors}, issn = {1741-203X}, doi = {10.1017/S1041610209991426}, author = {Sharon Shiovitz-Ezra and Liat Ayalon} } @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 {7508, title = {Subjective Mortality Expectations and Consumption and Saving Behaviours among the Elderly}, journal = {Canadian Journal of Economics}, volume = {43}, year = {2010}, note = {Using Smart Source Parsing August pp}, pages = {1040-1057}, publisher = {43}, abstract = {Life expectancy is an important factor that individuals have to take into account for saving and consumption choices. The life-cycle model of consumption and saving behaviour predicts that consumption growth should decrease with higher mortality rates. The aim of this study is to test this hypothesis based on data about subjective longevity expectations from the Health and Retirement Study merged with detailed consumption data from two waves of the Consumption and Activities Mail Survey. This study finds that an increase in subjective mortality by 1 corresponds to an annual decrease in consumption of non-durable goods of around 1.8 .}, keywords = {Consumption and Savings, Employment and Labor Force, Event History/Life Cycle, Health Conditions and Status, Women and Minorities}, url = {https://www.jstor.org/stable/40800727}, author = {Salm, Martin} } @article {7433, title = {Surgery as a teachable moment for smoking cessation.}, journal = {Anesthesiology}, volume = {112}, year = {2010}, month = {2010 Jan}, pages = {102-7}, publisher = {112}, abstract = {

BACKGROUND: A "teachable moment" is an event that motivates spontaneous behavior change. Some evidence suggests that major surgery for a smoking-related illness can serve as a teachable moment for smoking cessation. This study tested the hypotheses that surgery increases the likelihood of smoking cessation and that cessation is more likely after major surgical procedures compared with outpatient surgery.

METHODS: Secondary analyses were performed of longitudinal biennial survey data (1992-2004) from the nationally representative Health and Retirement Study of U.S. adults older than 50 yr, determining the relationship between the incidence of smoking cessation and the occurrence of surgery.

RESULTS: Five thousand four hundred ninety-eight individuals reported current smoking at enrollment, and 2,444 of them (44.5\%) quit smoking during the period of examination. The incidence of quitting in smokers undergoing major surgery was 20.6/100 person-years of follow-up and 10.2/100 person-years in those undergoing outpatient surgery. In a multivariate negative binomial regression model, the incidence rate ratio of quitting associated with major surgery was 2.02 (95\% CI: 1.67-2.44) and that of those associated with outpatient surgery was 1.28 (95\% CI: 1.09-1.50). Estimates derived from national surgical utilization data show that approximately 8\% of all quit events in the United States annually can be attributed to the surgical procedures analyzed.

CONCLUSIONS: Undergoing surgery is associated with an increased likelihood of smoking cessation in the older U.S. population. Cessation is more likely in association with major procedures compared with outpatient surgery. These data support the concept that surgery is a teachable moment for smoking cessation.

}, keywords = {Aged, Aged, 80 and over, Ambulatory Surgical Procedures, Analysis of Variance, Cohort Studies, Female, Follow-Up Studies, General Surgery, Humans, Longitudinal Studies, Male, Middle Aged, Patient Education as Topic, Regression Analysis, Smoking cessation, Treatment Outcome, United States}, issn = {1528-1175}, doi = {10.1097/ALN.0b013e3181c61cf9}, author = {Yu Shi and David O. Warner} } @article {7319, title = {Selection Bias in Web Surveys and the Use of Propensity Scores}, journal = {Sociological Methods and Research}, volume = {37}, year = {2009}, pages = {291-318}, publisher = {37}, abstract = {Web surveys have several advantages compared to more traditional surveys with in-person interviews, telephone interviews, or mail surveys. Their most obvious potential drawback is that they may not be representative of the population of interest because the sub-population with access to Internet is quite specific. This paper investigates propensity scores as a method for dealing with selection bias in web surveys. The authors{\textquoteright} main example has an unusually rich sampling design, where the Internet sample is drawn from an existing much larger probability sample that is representative of the US 50 population and their spouses (the Health and Retirement Study). They use this to estimate propensity scores and to construct weights based on the propensity scores to correct for selectivity. They investigate whether propensity weights constructed on the basis of a relatively small set of variables are sufficient to correct the distribution of other variables so that these distributions become representative of the population. If this is the case, information about these other variables could be collected over the Internet only. Using a backward stepwise regression they find that at a minimum all demographic variables are needed to construct the weights. The propensity adjustment works well for many but not all variables investigated. For example, they find that correcting on the basis of socio-economic status by using education level and personal income is not enough to get a representative estimate of stock ownership. This casts some doubt on the common procedure to use a few basic variables to blindly correct for selectivity in convenience samples drawn over the Internet. Alternatives include providing non-Internet users with access to the Web or conducting web surveys in the context of mixed mode surveys.}, keywords = {Methodology}, doi = {https://doi.org/10.1177/0049124108327128}, author = {Matthias Schonlau and Arthur H.O. vanSoest and Arie Kapteyn and Mick P. Couper} } @inbook {5235, title = {The SES Health Gradient On Both Sides Of The Atlantic}, booktitle = {Developments in the economics of aging}, series = {A National Bureau of Economic Research conference report}, year = {2009}, pages = {359-406}, publisher = {University of Chicago Press}, organization = {University of Chicago Press}, chapter = {10}, address = {Chicago}, abstract = {Looking across many diseases, average health among mature men is much worse in America compared to England. Second, there exists a steep negative health gradient for men in both countries where men at the bottom of the economic hierarchy are in much worse health than those at the top. This health gradient exists whether education, income, or financial wealth is used as the marker of one{\textquoteright}s SES status. These conclusions are maintained even after controlling for a standard set of behavioral risk factors such as smoking, drinking, and obesity and are equally true using either biological measures of disease or individual self-reports. In contrast to these disease based measures, health of American men appears to be superior to the health of English men when self-reported general health status is used. The contradiction most likely stems instead from different thresholds used by Americans and English when evaluating health status on subjective scales. For the same objective health status, Americans are much more likely to say that their health is good than are the English. Finally, feedbacks from new health events to household income are one of the reasons that underlie the strength of the income gradient with health in England.}, keywords = {Cross-National, Healthcare, Risk Taking}, url = {https://ssrn.com/abstract=942969}, author = {James Banks and Michael Marmot and Oldfield, Zo{\"e} and James P Smith}, editor = {David A Wise} } @article {5765, title = {Sin Taxes: Do Heterogeneous Responses Undercut Their Value?}, number = {15124}, year = {2009}, institution = {The National Bureau of Economic Research}, address = {Cambridge, MA}, abstract = {This paper estimates the price elasticity of demand for alcohol using Health and Retirement Survey data. To account for unobserved heterogeneity in price responsiveness, we use finite mixture models. We recover two latent groups, one is significantly responsive to price but the other is unresponsive. Differences between these two groups can be explained in part by the behavioral factors of risk aversion, financial planning horizon, forward looking and locus of control. These results have policy implications. Only a subgroup responds significantly to price. Importantly, the unresponsive group drinks more heavily, suggesting that a higher price could fail to curb drinking by those most likely to cause negative externalities. In contrast, those least likely to impose costs on others are more responsive, thus suffering greater deadweight loss yet with less prevention of negative externalities.}, keywords = {Health Conditions and Status, Methodology, Public Policy}, doi = {10.3386/w15124}, author = {Padmaja Ayyagari and Deb, Partha and Jason M. Fletcher and William T Gallo and Jody L Sindelar} } @article {8629, title = {Social Security Research at the Michigan Retirement Research Center}, journal = {Social Security Bulletin}, volume = {69}, year = {2009}, pages = {51-64}, chapter = {51}, abstract = {Social Security has been a topic of widespread discussion in the last decade. Rising longevity and falling fertility have led to an aging population, which increases solvency challenges for the Social Security system. Public concerns over low national saving have led to an extensive dialog on the merits of reform that might change the U.S. system into one with fully or partially funded personal accounts. Meanwhile, pensions in the private sector have been evolving from predominantly defined benefit (DB) to predominantly defined contribution (DC), raising concerns that workers preparing for retirement have more personal responsibility, with more complex financial challenges, than ever before.}, keywords = {Meta-analyses, Older Adults, Research, Social Security}, url = {https://www.ssa.gov/policy/docs/ssb/v69n4/v69n4p51.pdf}, author = {R.V. Burkhauser and Alan L Gustman and John Laitner and Olivia S. Mitchell and Amanda Sonnega} } @article {10725, title = {Social Security Research at the Michigan Retirement Research Center}, journal = {Social Security Bulletin}, volume = {69}, year = {2009}, type = {Journal}, abstract = {Social Security has been a topic of widespread discussion in the last decade. Rising longevity and falling fertility have led to an aging population, which increases solvency challenges for the Social Security system. Public concerns over low national saving have led to an extensive dialog on the merits of reform that might change the U.S. system into one with fully or partially funded personal accounts. Meanwhile, pensions in the private sector have been evolving from predominantly defined benefit (DB) to predominantly defined contribution (DC), raising concerns that workers preparing for retirement have more personal responsibility, with more complex financial challenges, than ever before.}, keywords = {Pension, Retirement, Social Security}, url = {https://www.ssa.gov/policy/docs/ssb/v69n4/v69n4p51.html}, author = {R.V. Burkhauser and Alan L Gustman and John Laitner and Olivia S. Mitchell and Amanda Sonnega} } @mastersthesis {6245, title = {Socioeconomic status and health redux: New evidence from England in a comparative context}, volume = {Ph.D}, year = {2009}, pages = {166}, school = {The American University}, type = {Dissertation}, address = {Washington, D.C.}, abstract = {People with higher socioeconomic status (SES) enjoy superior health. For the US, it is especially difficult to identify pathways underpinning this relationship, as it likely reflects differences in access to health care in addition to other factors correlated with SES. In England, however, access to care is universal, so that if SES is positively correlated with health, its main effects must come via alternative pathways other than access to care. This dissertation investigates the effects of SES on health outcomes, and vice versa, using the English Longitudinal Study of Ageing (ELSA). As the ELSA is similar to the US Health and Retirement Study, I compare the SES-health relation between countries. I find that the effect of SES on health is significant in England, with wealth the most important in guarding against negative health outcomes. However, for lower SES individuals, there are important differences between countries, suggesting that access to care has its largest effect among the least advantaged. Furthermore, new health events affect the economic resources of English individuals less than their US counterparts. Finally, there is evidence among married couples that wives respond to their husbands{\textquoteright} new health conditions by increasing market labor hours--i.e., an {\textquoteright}added worker effect.{\textquoteright}}, keywords = {Cross-National, Demographics, Health Conditions and Status, Healthcare, Net Worth and Assets, Other, Public Policy}, author = {Caswell, Kyle J.} } @article {7370, title = {Statistical design and estimation for the national social life, health, and aging project.}, journal = {J Gerontol B Psychol Sci Soc Sci}, volume = {64 Suppl 1}, year = {2009}, month = {2009 Nov}, pages = {i12-9}, publisher = {64B}, abstract = {

OBJECTIVES: The paper discusses the sample design of the National Social Life, Health, and Aging Project (NSHAP) and how the design affects how estimates should be calculated from the survey data. The NSHAP study allows researchers to study the links between sexuality and health in older adults. The goal of the design was to represent adults aged 57-85 years in six demographic domains.

METHODS: The sample design begins with a national area probability sample of households, carried out jointly with the 2004 round of the Health and Retirement Study. Selection of respondents for NSHAP balanced age and gender subgroups and oversampled African Americans and Latinos. Data collection was carried out from July 2005 to March 2006.

RESULTS: The survey obtained an overall response rate of 75.5\%.

DISCUSSION: The complex sample design requires that the selection probabilities and the field implementation be accounted for in estimating population parameters. The data set contains weights to compensate for differential probabilities of selection and response rates among demographic groups. Analysts should use weights in constructing estimates from the survey and account for the complex sample design in estimating standard errors for survey estimates.

}, keywords = {Aged, Aged, 80 and over, Aging, Bias, Data collection, Data Interpretation, Statistical, Female, Health Status, Health Surveys, Humans, Longitudinal Studies, Male, Mass Screening, Middle Aged, Research Design, Sampling Studies, Sexual Behavior, Social Behavior, United States}, issn = {1758-5368}, doi = {10.1093/geronb/gbp045}, author = {O{\textquoteright}Muircheartaigh, Colm and Eckman, Stephanie and Smith, Stephen} } @article {7280, title = {Screening mammography in older women. Effect of wealth and prognosis.}, journal = {Arch Intern Med}, volume = {168}, year = {2008}, month = {2008 Mar 10}, pages = {514-20}, publisher = {168}, abstract = {

BACKGROUND: Wealthy women have higher rates of screening mammography than poor women do. Screening mammography is beneficial for women with substantial life expectancies, but women with limited life expectancies are unlikely to benefit. It is unknown whether higher screening rates in wealthy women are due to increased screening in women with substantial life expectancies, limited life expectancies, or both. This study examines the relationship between wealth and screening mammography use in older women according to life expectancy.

METHODS: A cohort study was performed of 4222 women 65 years or older with Medicare participating in the 2002 and 2004 Health and Retirement Survey. Women were categorized according to wealth and life expectancy (based on 5-year prognosis from a validated prognostic index). The outcome was self-reported receipt of screening mammography within 2 years.

RESULTS: Overall, within 2 years, 68\% of women (2871 of 4222) received a screening mammogram. Screening was associated with wealth (net worth, > $100 000) and good prognosis (< or = 10\% probability of dying in 5 years). Screening mammography was more common among wealthy women than among poor women (net worth, < $10 000) both for women with good prognosis (82\% vs 68\%; P < .001) and for women with limited prognoses (> or = 50\% probability of dying in 5 years) (48\% vs 32\%; P = .02). These associations remained after multivariate analysis accounting for age, race, education, proxy report, and rural residence.

CONCLUSIONS: Poorer older women with favorable prognoses are at risk of not receiving screening mammography when they are likely to benefit. Wealthier older women with limited prognoses are often screened when they are unlikely to benefit.

}, keywords = {Aged, Breast Neoplasms, Chi-Square Distribution, Female, Humans, Longitudinal Studies, Mammography, Mass Screening, Prognosis, Risk Factors, Social Class}, issn = {0003-9926}, doi = {10.1001/archinternmed.2007.103}, author = {Brie A Williams and Lindquist, Karla and Rebecca L. Sudore and Kenneth E Covinsky and Louise C Walter} } @article {7240, title = {Self-Reported Vision, Upper/Lower Limb Disability, and Fall Risk in Older Adults}, journal = {Journal of Applied Gerontology}, volume = {27}, year = {2008}, pages = {406}, publisher = {27}, abstract = {The purpose of this study was to examine independent and interactive roles of self-reported vision status and upper and lower limb disability as predictors of falls in people 65 and older. Data from the 2002 and 2004 panels of the Health and Retirement Study were analyzed using binary logistic regression. Results indicated a reduced or eliminated role of vision status after upper and lower limb disabilities were controlled. Gender differences were found with respect to health conditions that predicted falls; however, vision status was not found to have a moderating influence on upper and lower limb disability in predicting falls for men or women. Implications for exercise programs designed for older people with visual impairments are discussed.}, keywords = {Health Conditions and Status}, doi = {https://doi.org/10.1177/0733464807312176}, author = {Bernard A Steinman} } @article {7250, title = {Sources of Advantageous Selection: Evidence from the Medigap Insurance Market}, journal = {Journal of Political Economy}, volume = {116}, year = {2008}, pages = {303-350}, publisher = {116}, abstract = {We provide evidence of advantageous selection in the Medigap insurance market and analyze its sources. Conditional on controls for Medigap prices, those with Medigap spend, on average, 4,000 less on medical care than those without. But if we condition on health, those with Medigap spend 2,000 more. The sources of this advantageous selection include income, education, longevity expectations, and financial planning horizons, as well as cognitive ability. Conditional on all these factors, those with higher expected medical expenditures are more likely to purchase Medigap. Risk preferences do not appear as a source of advantageous selection; cognitive ability is particularly important.}, keywords = {Medicare/Medicaid/Health Insurance}, doi = {https://doi.org/10.1086/587623}, author = {Fang, Hanming and Keane, Michael P. and Daniel S. Silverman} } @article {7204, title = {Spousal concordance in health behavior change.}, journal = {Health Serv Res}, volume = {43}, year = {2008}, month = {2008 Feb}, pages = {96-116}, publisher = {43}, abstract = {

OBJECTIVE: This study examines the degree to which a married individual{\textquoteright}s health habits and use of preventive medical care are influenced by his or her spouse{\textquoteright}s behaviors.

STUDY DESIGN: Using longitudinal data on individuals and their spouses, we examine changes over time in the health habits of each person as a function of changes in his or her spouse{\textquoteright}s health habits. Specifically, we analyze changes in smoking, drinking, exercising, cholesterol screening, and obtaining a flu shot.

DATA SOURCE: This study uses data from the Health and Retirement Study (HRS), a nationally representative sample of individuals born between 1931 and 1941 and their spouses. Beginning in 1992, 12,652 persons (age-eligible individuals as well as their spouses) from 7,702 households were surveyed about many aspects of their life, including health behaviors, use of preventive services, and disease diagnosis.

SAMPLE: The analytic sample includes 6,072 individuals who are married at the time of the initial HRS survey and who remain married and in the sample at the time of the 1996 and 2000 waves.

PRINCIPAL FINDINGS: We consistently find that when one spouse improves his or her behavior, the other spouse is likely to do so as well. This is found across all the behaviors analyzed, and persists despite controlling for many other factors.

CONCLUSIONS: Simultaneous changes occur in a number of health behaviors. This conclusion has prescriptive implications for developing interventions, treatments, and policies to improve health habits and for evaluating the impact of such measures.

}, keywords = {Attitude to Health, Cross-Sectional Studies, Exercise, Family Characteristics, Female, Health Behavior, Health Care Surveys, Health Promotion, Health Status, Humans, Interpersonal Relations, Life Style, Male, Marriage, Middle Aged, Preventive Health Services, Prospective Studies, Risk-Taking, Smoking, Spouses, United States}, issn = {0017-9124}, doi = {10.1111/j.1475-6773.2007.00754.x}, author = {Tracy Falba and Jody L Sindelar} } @inbook {5208, title = {Saving Between Cohorts: The Role of Planning}, 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 = {We compare the saving behavior of two cohorts: the Early Baby Boomers (EBB, age 51- 56 in 2004) and the HRS cohort (age 51-56 in 1992). We find that EBB have accumulated more wealth than the previous cohort but they benefited from a large increase in house prices, which lifted the wealth of many home-owners. In fact, there are many families among EBB, particularly those headed by respondents with low education, low income, and minorities, which have less wealth than the previous cohort. Lack of wealth can be traced to lack of retirement planning. Notwithstanding the many initiatives aimed at fostering planning in the 1990s, a large portion of EBB still do not plan for retirement even though most respondents are close to it. The effect of planning is remarkably similar between the two cohorts; those who do not plan accumulate much lower amounts of wealth from 20 to 45 percent depending on the location in the wealth distribution- than those who do plan. Thus, for both the EBB and the HRS cohort, lack of planning is tantamount to lack of saving irrespective of the many changes in the economy between 1992 and 2004.}, keywords = {adequacy, Baby Boomer, Education, Housing, Income, minorities, Retirement Planning, Saving}, url = {https://oxford.universitypressscholarship.com/view/10.1093/acprof:oso/9780199230778.001.0001/acprof-9780199230778-chapter-13}, author = {Annamaria Lusardi and Beeler, Jason}, editor = {Brigitte C. Madrian and Olivia S. Mitchell and Beth J Soldo} } @article {5652, title = {The Size and Characteristics of the Residential Care Population: Evidence from Three National Surveys}, year = {2006}, institution = {U.S. Department of Health and Human Services Assistant Secretary for Planning and Evaluation Office of Disability, Aging and Long-Term Care Policy}, address = {Washington, D.C.}, abstract = {This report is the second of two prepared as part of a project to better understand the size and characteristics of the long-term care population in all settings. Identified were three recently federally supported surveys — the 2002 Health and Retirement Survey, the 2002 Medicare Current Beneficiary Survey Cost and Use file, and the National Long-Term Care Survey — as being best suited for the purpose because of their focus on the older population and data elements that allow identification of residential care alternatives by name, services available, or both. In this report, the authors report on their analysis of these surveys and discuss the implications of our findings for improving collection of data on residential settings. }, keywords = {Healthcare, Housing}, url = {https://aspe.hhs.gov/pdf-report/size-and-characteristics-residential-care-population-evidence-three-national-surveys}, author = {Brenda C Spillman and Black, Kirsten J.} } @article {7076, title = {State Fiscal Institutions and Empty-Nest Migration: Are Tiebout voters hobbled?}, journal = {Journal of Public Economics}, volume = {90}, year = {2006}, note = {Article English}, pages = {407 -427}, publisher = {90}, abstract = {Using the Health and Retirement Study and a national panel of local fiscal data, we test a lifecycle model of Tiebout sorting. On average, cross-state, empty-nest movers-presumed to be out of fiscal equilibrium-experience large fiscal gains in the form of reduced exposure to local school spending and property taxes, while local empty-nest movers experience no fiscal adjustment. We find evidence that within-state fiscal adjustment is constrained by state institutions that limit local discretion. Empty-nest households moving within states with school finance equalization do not engage in Tiebout-consistent fiscal adjustment, while those moving within states lacking school finance equalization adjust substantially. (c) 2005 Elsevier B.V. All rights reserved.}, keywords = {Demographics, Methodology, Public Policy}, doi = {https://doi.org/10.1016/j.jpubeco.2005.07.005}, author = {Martin P. Farnham and Purvi Sevak} } @article {5658, title = {Social Security and Retirement Dynamics}, number = {UM05-05}, year = {2005}, institution = {The University of Michigan, Michigan Retirement Research Center}, address = {Ann Arbor, MI}, abstract = {This paper is based on a structural model of retirement and saving, estimated with data for a sample of married men in the Health and Retirement Study. It explains the relation of specific features of Social Security -- the benefit amount, the early entitlement age, the normal retirement age, earnings test parameters, and the delayed retirement credit -- to the full range of retirement outcomes -- continued work on the main job, full time work outside the main job after a period of partial or full retirement, as well as partial retirement and full retirement. The project also estimates the relation of Social Security to the flows among these states. We consider not only the effect of Social Security on movement from states of greater to lesser work, the probability of either moving from full time work to partial retirement or directly to full retirement, or from partial retirement to full retirement, but the reverse flows from states of lesser work to states of greater work. The largest effects of the policies examined are from increasing the early entitlement age from 62 to 64 and reducing benefits to 75 percent of their promised levels, the approximate amount benefits would have to be reduced when the trust fund runs out if there are no changes in funding. With the older early entitlement age, about 5 percent more of the population continues to work full time at their main job at 62 and 63 than would otherwise. In addition, another 4.5 percent of the male population works full time after having retired, as does another 4 percent at age 63. Partial retirement is reduced at ages 62 and 63 by about 3 percentage points when the early entitlement age is 64. Overall, complete retirements are about 6 percentage points lower at 62 and 63 when the early retirement age is higher. From age 64 on, the percent completely retired is about two percentage points lower in each year when the early entitlement age is 64 rather than 62. The effects of reducing promised Social Security benefits by about a quarter are also large. The probability of remaining on the main job is higher for those in their sixties, with the difference ranging from 3 to 5 percentage points for those ages 62 and older. At each year of age, an additional 1 percentage point will be in full time work after having retired. There is little difference in the fraction partially retired, so the probability of being fully retired is reduced by 4 to 6 percentage points when benefits are reduced by a quarter.}, keywords = {Consumption and Savings, Social Security}, url = {https://mrdrc.isr.umich.edu/projects/social-security-and-retirement-dynamics/}, author = {Alan L Gustman and Thomas L. Steinmeier} } @article {6990, title = {The Social Security Early Entitlement Age In A Structural Model of Retirement and Wealth}, journal = {Journal of Public Economics}, volume = {89}, year = {2005}, note = {RDA 1996-005}, pages = {441-463}, publisher = {89}, abstract = {A structural life cycle model of retirement and wealth attributes retirement peaks at both ages 62 and 65 to Social Security rules and wide heterogeneity in time preferences. Those with high discount rates often retire at 62. They have few assets and heavily value lost benefits from working after 62, largely ignoring potential increases in later benefits. Declining actuarial adjustments beginning at 65 induce those with low discount rates to retire at 65. Raising the Social Security early entitlement age to 64 induces 5 of the population to delay retiring, shifting the retirement spike from 62 to 64.}, keywords = {Methodology, Net Worth and Assets}, doi = {https://doi.org/10.1016/j.jpubeco.2004.03.007}, author = {Alan L Gustman and Thomas L. Steinmeier} } @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 {6906, title = {Social Security, Pensions and Retirement Behaviour Within the Family}, journal = {Journal of Applied Econometrics}, volume = {19}, year = {2004}, note = {RDA 1996-005; HRS 1992}, pages = {723-737}, publisher = {19}, abstract = {This paper estimates a structural model of family retirement using US data from the Health and Retirement Study (HRS). It provides further insight into household retirement decision making and the reasons for interdependence in the retirement decisions of each spouse. Improvements in HRS data and matched employer provided pension histories allow more precise identification of key parameters governing interdependent behaviour within the household. In an earlier study we found that interdependence was due to preferences rather than coordination of retirement incentives in the budget, and in particular that it is not a correlation in preferences, but the appearance of the spouse{\textquoteright}s retirement status in the husband{\textquoteright}s and wife{\textquoteright}s utility function that is largely responsible for coordination of retirement between spouses. We now find that a measure of how much each spouse values being able to spend time in retirement with the other accounts for a good portion of that apparent interdependence. For the wife, the husband{\textquoteright}s retirement status influences her retirement decision only if she values spending time in retirement with her husband. For husbands, the effect of having the wife already retired on his retirement decision is roughly doubled if he enjoys spending time in retirement with his wife, but there is some effect even if he does not. This is consistent with our earlier findings that the husband is more influenced by having a retired spouse than the wife is. The increase in the extent of the dependence of the wife{\textquoteright}s labour supply on the husband{\textquoteright}s retirement from our past work probably is traceable to better measurement of the opportunity set facing the husband in HRS data. Once estimated, we use the model to investigate the labour supply effects of alternative social security policies, examining the effect of dividing credit for earnings evenly between spouses, or of basing social security benefits on the amounts accumulated in private accounts. Both policies change the relative importance of spouse and survivor social security benefits within the household and both raise the relative reward to work later in the life cycle. The incentives created are modest, and retirement responds accordingly. Nevertheless, at some ages, such as 65, there may be as much as a 6 increase in the old age work force under privatized accounts. Copyright 2004 John Wiley and Sons, Ltd.}, keywords = {Adult children, Pensions, Retirement Planning and Satisfaction, Social Security}, doi = {https://doi.org/10.1002/jae.753}, author = {Alan L Gustman and Thomas L. Steinmeier} } @inbook {5187, title = {Saving, Public Policy, and Late-Life Inequality}, booktitle = {Focus on Economic Outcomes in Later Life: Public Policy, Health, and Cummulative Advantage}, series = {Annual Review of Gerontology and Geriatrics}, volume = {22}, year = {2003}, note = {RDA 1998-006 (Lusardi) ProCite field 6 : Chapter 10 in ProCite field 8 : eds.}, pages = {207-238}, publisher = {Springer Publishing Company}, organization = {Springer Publishing Company}, chapter = {10}, address = {New York, NY}, keywords = {Consumption and Savings, Public Policy}, doi = {10.1891/0198-8794.22.1.207}, author = {Annamaria Lusardi and Jonathan S Skinner and Steven F Venti}, editor = {Crystal, Stephen and Dennis G. Shea} } @article {5572, title = {Searching for Better Prospects: Endogenizing Falling Job Tenure and Private Pension Coverage}, number = {2003-038E}, year = {2003}, institution = {Federal Reserve Bank of St. Louis}, address = {St. Louis}, abstract = {Recent declines in job tenure have coincided with a shift away from traditional defined benefit (DB) pensions, which reward long tenure. New evidence also points to an increase in job-to-job movements by workers, and we document gains in relative wages of job-to-job movers over a similar period. We develop a search model in which firms may offer tenure-based contracts like DB pensions to reduce the incidence of costly on-the-job search by workers. Either reduced search costs or an increase in the probability of job matches can, under fairly general conditions, lower the value of deterring search and the use of DB pensions.}, keywords = {Contracts, Job tenure, Pensions}, doi = {http://dx.doi.org/10.2139/ssrn.896546}, author = {Friedberg, Leora and Owyang, Michael T. and Sinclair, T.} } @article {6873, title = {Self-rated life expectancy as a predictor of mortality: evidence from the HRS and AHEAD surveys.}, journal = {Gerontology}, volume = {49}, year = {2003}, month = {2003 Jul-Aug}, pages = {265-71}, publisher = {49}, abstract = {

BACKGROUND: An extensive literature has demonstrated that self-ratings of health predict mortality, even after controlling for more objective measures of health, health habits and sociodemographic characteristics. We examine the role of a related concept, self-rated life expectancy, in predicting mortality.

OBJECTIVE: To assess whether self-rated life expectancy predicts mortality after controlling for measures of health, self-rated health, and sociodemographic characteristics.

METHODS: Using data from the 1992 Health and Retirement Survey (HRS), the 1993 Asset and Health Dynamics Among the Oldest Old (AHEAD) survey, and the second Tracker file (2.0), Cox proportional hazard models were estimated to assess whether self-rated life expectancy predicts mortality, after adjusting for self-rated health and several potential confounders that might otherwise explain this relationship. The AHEAD sample included 2,102 men and 3,160 women. During the 2 years of follow-up, 9\% (n = 185) of the men died and 5\% (n = 166) of the women died. The HRS sample was comprised of 4,090 men and 4,885 women. Four percent (n = 164) of the men died and 2\% (n = 99) of the women died in the 3 years of follow-up.

RESULTS: In the older, AHEAD sample, both self-rated life expectancy (p < 0.01) and self-rated health (p < 0.05) predicted mortality for both men and women, even when the two measures were included in the model together. In the younger, HRS sample, self-rated life expectancy was not significantly associated with mortality when self-rated health was included in the model.

CONCLUSION: Our findings suggest that, although self-rated life expectancy and self-rated health may be conceptually related, they have independent empirical effects on mortality.

}, keywords = {Aged, Female, Health Status, Health Surveys, Humans, Life Expectancy, Male, Mortality, Prognosis, Proportional Hazards Models, Self Concept, Sex Distribution, Survival Analysis}, issn = {0304-324X}, doi = {10.1159/000070409}, author = {Michele J. Siegel and Elizabeth H Bradley and Stanislav V Kasl} } @inbook {5197, title = {Smoking Cessation and Lifestyle Changes}, booktitle = {Frontiers in Health Policy Research}, volume = {6}, year = {2003}, note = {ProCite field 6 : In ProCite field 8 : eds}, pages = {115-42}, publisher = {MIT Press}, organization = {MIT Press}, chapter = {5}, address = {Cambridge, MA}, keywords = {Health Conditions and Status}, isbn = { 0-262-03309-7}, doi = {10.2202/1558-9544.1048 }, author = {Gabriel A. Picone and Frank A Sloan}, editor = {Garber, David Cutler and Alan M.} } @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 {6859, title = {Special Issue on Cross-National Comparative Research Using Panel Surveys (Introduction)}, journal = {Journal of Human Resources}, volume = {38}, year = {2003}, pages = {231-240}, publisher = {38}, abstract = {Until recently, international comparative research had a poor reputation, especially in economics. Panel surveys comparable to those in the United States either did not exist or were viewed as being of low quality. However, the number and quantity of international panels surveys are improving rapidly and in many dimensions will soon exceed those of their U.S. counterparts, particularly as foreign-born academics trained in the United States use data from their home countries in their research. This article introduces a series of papers presented at a conference on comparative international research using panel surveys, which took place in Ann Arbor, Michigan in October 2000. Its goal was to encourage researchers in the social sciences to use panel surveys to address critical scientific and policy issues that would be better informed by international comparisons and the variation in policy environments across countries. Five of the seven papers explicitly or implicitly examine international differences in savings behavior and wealth accumulation; the two remaining papers use international comparisons to assess the status of young children. }, keywords = {Households, retirement savings, Wealth, Workforce}, doi = {10.2307/1558744}, author = {James P Smith and Stafford, Frank and Walker, James R.} } @article {NBERw8237, title = {Saving Puzzles and Saving Policies in the United States}, year = {2001}, institution = {NBER}, abstract = {In the past two decades the widely reported personal saving rate in the United States has dropped from double digits to below zero. First, we attempt to account for the decline in the National Income and Product Accounts (NIPA) saving rate. The macroeconomic literature suggests that about half of the drop since 1988 can be attributed to households spending stock market capital gains. Another thirty percent is accounting transfers from personal saving into government and corporate saving because of the way pensions and capital gains taxes are treated in the NIPA. Second, while NIPA saving measures are well suited for measuring the supply of new funds for investment and capital accumulation, it is not clear that they should be the target of government saving policies. Finally, we emphasize that the NIPA saving rate is not useful in judging whether households are preparing for retirement or other contingencies. Many households have accumulated significant wealth, primarily through retirement saving vehicles and capital gains, even as the saving rate slid. There remains a segment of the population, however, who save little and whose behavior appears untouched either by the stock market boom or the slide in personal saving. We explore reasons and policy options for their puzzlingly low saving rate.}, keywords = {Saving, Saving behavior, Wealth, wealth accumulation}, doi = {10.3386/w8237}, url = {http://www.nber.org/papers/w8237}, author = {Annamaria Lusardi and Jonathan S Skinner and Steven F Venti} } @article {6741, title = {Self-restriction of medications due to cost in seniors without prescription coverage.}, journal = {J Gen Intern Med}, volume = {16}, year = {2001}, month = {2001 Dec}, pages = {793-9}, publisher = {16}, abstract = {

OBJECTIVE: Little is known about patients who skip doses or otherwise avoid using their medications because of cost. We sought to identify which elderly patients are at highest risk of restricting their medications because of cost, and how prescription coverage modifies this risk.

DESIGN AND PARTICIPANTS: Cross-sectional study from the 1995-1996 wave of the Survey of Asset and Health Dynamics Among the Oldest Old, a population-based survey of Americans age 70 years and older.

MEASUREMENTS: Subjects were asked the extent of their prescription coverage, and whether they had taken less medicine than prescribed for them because of cost over the prior 2 years. We used bivariate and multivariate analyses to identify risk factors for medication restriction in subjects who lacked prescription coverage. Among these high-risk groups, we then examined the effect of prescription coverage on rates of medication restriction.

MAIN RESULTS: Of 4,896 seniors who regularly used prescription medications, medication restriction because of cost was reported by 8\% of subjects with no prescription coverage, 3\% with partial coverage, and 2\% with full coverage (P <.01 for trend). Among subjects with no prescription coverage, the strongest independent predictors of medication restriction were minority ethnicity (odds ratio [OR], 2.9 compared with white ethnicity; 95\% confidence interval [95\% CI], 2.0 to 4.2), annual income <$10,000 (OR, 3.8 compared with income > or =$20,000; 95\% CI, 2.4 to 6.1), and out-of-pocket prescription drug costs >$100 per month (OR, 3.3 compared to costs < or =$20; 95\% CI, 1.5 to 7.2). The prevalence of medication restriction in members of these 3 risk groups was 21\%, 16\%, and 13\%, respectively. Almost half (43\%) of subjects with all 3 risk factors and no prescription coverage reported restricting their use of medications. After multivariable adjustment, high-risk subjects with no coverage had 3 to 15 times higher odds of medication restriction than subjects with partial or full coverage (P <.01).

CONCLUSIONS: Medication restriction is common in seniors who lack prescription coverage, particularly among certain vulnerable groups. Seniors in these high-risk groups who have prescription coverage are much less likely to restrict their use of medications.

}, keywords = {Aged, Aged, 80 and over, Cohort Studies, Cross-Sectional Studies, Female, Humans, Insurance, Pharmaceutical Services, Male, Prescription Fees, Risk Factors, Socioeconomic factors, Treatment Refusal, United States}, issn = {0884-8734}, doi = {10.1111/j.1525-1497.2001.10412.x}, author = {Michael A Steinman and Laura Sands and Kenneth E Covinsky} } @inbook {5156, title = {Social Security Benefits of Immigrants and U.S. Born}, booktitle = {Issues in the Economics of Immigration}, year = {2000}, note = {RDA 1996-005 ProCite field 8 : ed.}, pages = {309-350}, publisher = {University of Chicago Press}, organization = {University of Chicago Press}, abstract = {Immigrants realize higher Social Security benefits per year worked in the U.S. then U.S. born, even when earnings are identical in all years the immigrant has been in the U.S. The benefit formula favors those with low lifetime covered earnings, and the years prior to immigration are treated as years of zero earnings. If instead earnings were averaged only over years of residence in the U.S., and benefits were prorated based on the share of a 35 or 40 year base period spent in residence, immigrants would receive the same return on their social security taxes as U.S. born. For a sample from the Health and Retirement Study, a group born between 1931 and 1941, prorating reduces immigrants{\textquoteright} social security benefits by 7 to 15 percent. For immigrants who entered in the 1980{\textquoteright}s, the reductions would be over 30 percent. Prorating would reduce the present value of benefit payments to immigrants born from 1932 to 1941 by 7.5 billion to 15 billion. Most immigrants will still pay slightly more in taxes than they will receive in benefits. Taxes received from immigrants who subsequently emigrate without collecting benefits tip the balance in favor of including immigrants.}, keywords = {Consumption and Savings, Demographics, Employment and Labor Force, Pensions, Public Policy, Retirement Planning and Satisfaction, Social Security}, doi = {10.3386/w6478}, author = {Alan L Gustman and Thomas L. Steinmeier}, editor = {Borjas, George} } @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.} } @inbook {5151, title = {The Several Cultures of Research on Subjective Expectations}, booktitle = {Wealth, Work and Health: Innovations in Measurement in the Social Sciences}, year = {1999}, note = {ProCite field 8 : eds.}, pages = {15-33}, publisher = {University of Michigan Press}, organization = {University of Michigan Press}, address = {Ann Arbor, MI}, keywords = {Expectations, Methodology}, isbn = {0472110268}, url = {https://books.google.com/books?id=lKvp4D1HuH8C\&pg=PA209\&lpg=PA209\&dq=The+Size+Distribution+of+Wealth+in+the+United+States:+A+Comparison+Among+Recent+Household+Surveys\&source=bl\&ots=hFIAdSeWob\&sig=ACfU3U2nIQ6QSOJ4wEBUDcbZOo-x7n8b7g\&hl=en\&sa=X\&ved=2ahUKEwjQ}, author = {Dominitz, Jeff and Charles F Manski}, editor = {James P Smith and Robert J. Willis} } @inbook {5153, title = {The Size Distribution of Wealth in the United States: A Comparison Among Recent Household Surveys}, booktitle = {Wealth, Work and Health: Innovations in Measurement in the Social Sciences}, year = {1999}, note = {ProCite field 8 : eds.}, pages = {209-32}, publisher = {University of Michigan Press}, organization = {University of Michigan Press}, address = {Ann Arbor, MI}, keywords = {Income, Methodology}, url = {https://books.google.com/books?id=lKvp4D1HuH8C\&pg=PA209\&lpg=PA209\&dq=The+Size+Distribution+of+Wealth+in+the+United+States:+A+Comparison+Among+Recent+Household+Surveys\&source=bl\&ots=hFIAdSeWob\&sig=ACfU3U2nIQ6QSOJ4wEBUDcbZOo-x7n8b7g\&hl=en\&sa=X\&ved=2ahUKEwjQ}, author = {Wolff, Edward}, editor = {James P Smith and Robert J. Willis} } @article {6603, title = {Socioeconomic Status and Health}, journal = {American Economic Review}, volume = {88}, year = {1998}, note = {ProCite field 3 : RAND}, pages = {192-96}, publisher = {88}, keywords = {Consumption and Savings, Demographics, Health Conditions and Status}, author = {James P Smith} } @article {6604, title = {Symposium on Work, Retirement and Wealth: Current Data and Future Needs: An International Perspective}, journal = {Australasian Journal on Ageing}, volume = {17}, year = {1998}, pages = {supplement, 11-13}, publisher = {17}, abstract = {Discusses a cross-national symposium on elderly work, retirement, and wealth that drew on the US Health and Retirement Study and Panel Study of Income Dynamics, the Netherlands Household Panel Study, the German Socioeconomic Panel, and several East and Southeast Asian datasets.}, keywords = {Demographics, Employment and Labor Force, Net Worth and Assets, Retirement Planning and Satisfaction}, author = {R.V. Burkhauser and Robert Clark and Richard M. Suzman} } @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 {6578, title = {Socioeconomic Status and Racial and Ethnic Differences in Functional Status Associated with Chronic Diseases}, journal = {American Journal of Public Health}, volume = {87}, year = {1997}, pages = {805-10}, publisher = {87}, abstract = {OBJECTIVES: This study examined the relationships between wealth and income and selected racial and ethnic differences in health. METHODS: Cross-sectional data on a national sample of 9744 men and women aged 51 through 61 from the 1992 Health and Retirement Survey were analyzed to examine the association between socioeconomic status and racial and ethnic differences in functional status among those with hypertension, diabetes, a heart condition, and arthritis. RESULTS: Compared with Whites, African Americans report higher rates of hypertension, diabetes, and arthritis, while Hispanics report higher rates of hypertension and diabetes and a lower rate of heart conditions. Accounting for differences in education, income, and wealth had little effect on these prevalence differences. In general, among those with chronic diseases, African Americans and Hispanics reported worse function than Whites. This disadvantage was eliminated in every case by controlling for socioeconomic status. CONCLUSIONS: While socioeconomic status, including wealth, accounts for much of the difference in functional status associated with these chronic diseases. It plays a relatively small role in explaining differences in the prevalence of chronic disease, possibly reflecting different causal pathways.}, keywords = {Demographics, Health Conditions and Status, Income, Methodology, Other, Retirement Planning and Satisfaction, Women and Minorities}, author = {Raynard Kington and James P Smith} } @article {6574, title = {The Structure of Health Status among Hispanic, African American, and White Older Adults}, journal = {The Journals of Gerontology, Series B: Psychological Sciences and Social Sciences}, volume = {52B}, year = {1997}, pages = {49-60}, publisher = {52B}, abstract = {Activities of daily living (ADLs), instrumental ADLs, and disability markers have traditionally been the most common indicators of functional status. The study on Asset and Health Dynamics Among the Oldest Old (AHEAD) is used to replicate a five-dimensional measurement model composed of these observable indicators among the older adult self-respondents. The items available to measure upper body disability were found wanting, but the lower body disability, and the basic, household, and advanced ADL constructs were confirmed. Analyses of the measurement model separately among subgroups of women, men, Hispanics, Mexican Americans, African Americans, and Whites found no meaningful differences. Two structural models linking the lower body disability, and the basic, household, and advanced ADL constructs to perceived health and depression were also replicated among the older adult self-respondents, as well as separately among African Americans and among Whites. These models reaffirmed the dominant role of lower body disability on the everyday activities of older adults, and on their perceived health and depression.}, keywords = {Demographics, Disabilities, Health Conditions and Status, Methodology, Women and Minorities}, author = {Timothy E. Stump and Daniel O. Clark and Johnson, R.J. and Frederic D Wolinsky} }