@conference {11822, title = {Associations of Long-term Air Pollution Exposure and Incident Late-Life Disability in Older U.S. Adults: The Health Retirement Study}, booktitle = {ISEE Conference Abstracts}, volume = {2021}, year = {2021}, abstract = {Late-life disability is of critical concern to older adults and can reflect the cumulative burden of chronic disease over the lifespan. Although air pollution has been associated with many common chronic conditions, associations with disability are understudied. We aimed to quantify associations between long-term exposures to air pollution and late-life disability. METHODS: We used biennial data between 2000 and 2016 on self-reported Activities of Daily Living (ADL) from participants 65 years from the nationally representative Health and Retirement Study. Using a spatiotemporal prediction model, we estimated 10-year PM2.5, PM10-2.5, NO2, and O3 concentrations at participant residences. We then estimated the risk of incident ADL disability as a function of time-varying air pollution, adjusting for individual and area-level confounders and sampling weights in a Cox model. We fitted single- and two-pollutant models. RESULTS:Our study population of 16,927 adults (70+6.4 years) was predominantly non-Hispanic White (76\%), Non-Hispanic Black (14\%), and Hispanic White (8\%) and 32\% reported a new disability during follow-up. Overall, we found some evidence that air pollution was associated with an increased risk of ADL disability. After adjustment for place and PM2.5, we found that interquartile increases in PM10-2.5 and NO2 were associated with 8\% (HR: 1.08 per 5 {\textmu}g/m3, 95\% CI: 1.01, 1.17) and 9\% (HR: 1.09 per 6 ppb, 95\% CI: 1.00, 1.19) greater hazards of ADL, respectively, with similar findings in the single pollutant models. PM2.5 and O3 were not associated with higher hazards of ADL in single or multipollutant models after detailed adjustment for place. CONCLUSIONS:This prospective study in a nationally representative sample of older adults found some evidence that higher levels of some but not all long-term air pollutants assessed are associated with increased risk of late-life disability.}, keywords = {Activities of Daily Living, Air Pollution, Long-Term Exposure}, url = {https://ehp.niehs.nih.gov/action/doSearch?AllField=Associations+of+Long-term+Air+Pollution+Exposure+and+Incident+Late-Life+Disability+in+Older+U.S.+Adults\%3A+The+Health+Retirement+Study}, author = {Gao, Jiaqi and Carlos F. Mendes de Leon and D{\textquoteright}Souza, Jennifer and Zhang, Boya and Szpiro, Adam and Young, Michael and Weuve, Jennifer and Kenneth M. Langa and Jessica Faul and Kaufman, Joel and Richard A Hirth and Sara Dubowsky Adar} } @article {9280, title = {Association between spousal caregiver well-being and care recipient healthcare expenditures}, journal = {Journal of the American Geriatrics Society}, volume = {65}, year = {2017}, pages = {2220-2226}, abstract = {Objectives To measure the association between spousal depression, general health, fatigue and sleep, and future care recipient healthcare expenditures and emergency department (ED) use. Design Prospective cohort study. Setting Health and Retirement Study. Participants Home-dwelling spousal dyads in which one individual (care recipient) was aged 65 and older and had one or more activity of daily living or instrumental activity of daily living disabilities and was enrolled in Medicare Part B (N = 3,101). Exposure Caregiver sleep (Jenkins Sleep Scale), depressive symptoms (Center for Epidemiologic Studies Depression-8 Scale), and self-reported general health measures. Measurements Primary outcome was care recipient Medicare expenditures. Secondary outcome was care recipient ED use. Follow-up was 6 months. Results Caregiver depressive symptoms score and six of 17 caregiver well-being measures were prospectively associated with higher care recipient expenditures after minimal adjustment (P < .05). Higher care recipient expenditures remained significantly associated with caregiver fatigue (cost increase, $1,937, 95\% confidence interval (CI) = $770{\textendash}3,105) and caregiver sadness (cost increase, $1,323, 95\% CI = $228{\textendash}2,419) after full adjustment. Four of 17 caregiver well-being measures, including severe fatigue, were significantly associated with care recipient ED use after minimal adjustment (P < .05). Greater odds of care recipient ED use remained significantly associated with caregiver fatigue (odds ratio (OR) = 1.24, 95\% CI = 1.01{\textendash}1.52) and caregiver fair to poor health (OR = 1.23, 95\% CI = 1.04{\textendash}1.45) after full adjustment. Caregiver total sleep score was not associated with care recipient outcomes. Conclusion Poor caregiver well-being, particularly severe fatigue, is independently and prospectively associated with higher care recipient Medicare expenditures and ED use.}, keywords = {Caregiving, Marriage, Medical Expenses, Medicare/Medicaid/Health Insurance, Well-being}, doi = {10.1111/jgs.15039}, url = {http://doi.wiley.com/10.1111/jgs.15039http://onlinelibrary.wiley.com/wol1/doi/10.1111/jgs.15039/fullpdfhttps://api.wiley.com/onlinelibrary/tdm/v1/articles/10.1111\%2Fjgs.15039}, author = {Claire K. Ankuda and Donovan T Maust and Mohammed U Kabeto and Ryan J McCammon and Kenneth M. Langa and Deborah A Levine} } @article {8287, title = {Antidepressant Use and Cognitive Decline: The Health and Retirement Study.}, journal = {Am J Med}, volume = {128}, year = {2015}, month = {2015 Jul}, pages = {739-46}, publisher = {128}, abstract = {

BACKGROUND: Depression is associated with cognitive impairment and dementia, but whether treatment for depression with antidepressants reduces the risk for cognitive decline is unclear. We assessed the association between antidepressant use and cognitive decline over 6 years.

METHODS: Participants were 3714 adults aged 50 years or more who were enrolled in the nationally representative Health and Retirement Study and had self-reported antidepressant use. Depressive symptoms were assessed using the 8-item Center for Epidemiologic Studies Depression Scale. Cognitive function was assessed at 4 time points (2004, 2006, 2008, 2010) using a validated 27-point scale. Change in cognitive function over the 6-year follow-up period was examined using linear growth models, adjusted for demographics, depressive symptoms, comorbidities, functional limitations, and antidepressant anticholinergic activity load.

RESULTS: At baseline, cognitive function did not differ significantly between the 445 (12.1\%) participants taking antidepressants and those not taking antidepressants (mean, 14.9\%; 95\% confidence interval, 14.3-15.4 vs mean, 15.1\%; 95\% confidence interval, 14.9-15.3). During the 6-year follow up period, cognition declined in both users and nonusers of antidepressants, ranging from -1.4 change in mean score in those with high depressive symptoms and taking antidepressants to -0.5 change in mean score in those with high depressive symptoms and not taking antidepressants. In adjusted models, cognition declined in people taking antidepressants at the same rate as those not taking antidepressants. Results remained consistent across different levels of baseline cognitive function, age, and duration of antidepressant use (prolonged vs short-term).

CONCLUSIONS: Antidepressant use did not modify the course of 6-year cognitive change in this nationally representative sample.

}, keywords = {Age Distribution, Aged, Aged, 80 and over, Antidepressive Agents, Cognition, Cross-Sectional Studies, Depressive Disorder, Female, Follow-Up Studies, Geriatric Assessment, Humans, Incidence, Male, Middle Aged, Reference Values, Risk Assessment, Sex Distribution, Surveys and Questionnaires, United States}, issn = {1555-7162}, doi = {10.1016/j.amjmed.2015.01.007}, author = {Jane S Saczynski and Allison B Rosen and Ryan J McCammon and Zivin, Kara and Susan E. Andrade and Kenneth M. Langa and Sandeep Vijan and Paul A Pirraglia and Becky A. Briesacher} }