@article {8904, title = {Racial and ethnic differences in smoking changes after chronic disease diagnosis among middle-aged and older adults in the United States.}, journal = {BMC Geriatrics}, volume = {17}, year = {2017}, month = {2017 Feb 08}, pages = {48}, abstract = {

BACKGROUND: Middle-aged and older Americans from underrepresented racial and ethnic backgrounds are at risk for greater chronic disease morbidity than their white counterparts. Cigarette smoking increases the severity of chronic illness, worsens physical functioning, and impairs the successful management of symptoms. As a result, it is important to understand whether smoking behaviors change after the onset of a chronic condition. We assessed the racial/ethnic differences in smoking behavior change after onset of chronic diseases among middle-aged and older adults in the US.

METHODS: We use longitudinal data from the Health and Retirement Study (HRS 1992-2010) to examine changes in smoking status and quantity of cigarettes smoked after a new heart disease, diabetes, cancer, stroke, or lung disease diagnosis among smokers.

RESULTS: The percentage of middle-aged and older smokers who quit after a new diagnosis varied by racial/ethnic group and disease: for white smokers, the percentage ranged from 14\% after diabetes diagnosis to 32\% after cancer diagnosis; for black smokers, the percentage ranged from 15\% after lung disease diagnosis to 40\% after heart disease diagnosis; the percentage of Latino smokers who quit was only statistically significant after stoke, where 38\% quit. In logistic models, black (OR = 0.43, 95\% CI: 0.19-0.99) and Latino (OR = 0.26, 95\% CI: 0.11-0.65) older adults were less likely to continue smoking relative to white older adults after a stroke, and Latinos were more likely to continue smoking relative to black older adults after heart disease onset (OR = 2.69, 95\% CI [1.05-6.95]). In models evaluating changes in the number of cigarettes smoked after a new diagnosis, black older adults smoked significantly fewer cigarettes than whites after a new diagnosis of diabetes, heart disease, stroke or cancer, and Latino older adults smoked significantly fewer cigarettes compared to white older adults after newly diagnosed diabetes and heart disease. Relative to black older adults, Latinos smoked significantly fewer cigarettes after newly diagnosed diabetes.

CONCLUSIONS: A large majority of middle-aged and older smokers continued to smoke after diagnosis with a major chronic disease. Black participants demonstrated the largest reductions in smoking behavior. These findings have important implications for tailoring secondary prevention efforts for older adults.

}, keywords = {Chronic disease, Health Conditions and Status, Older Adults, Racial/ethnic differences, Smoking}, issn = {1471-2318}, doi = {10.1186/s12877-017-0438-z}, author = {Ana R Qui{\~n}ones and Corey L Nagel and Jason T Newsom and Nathalie Huguet and Sheridan, Paige and Stephen M Thielke} } @article {7252, title = {Gender differences in functional status in middle and older age: are there any age variations?}, journal = {J Gerontol B Psychol Sci Soc Sci}, volume = {63}, year = {2008}, month = {2008 Sep}, pages = {S282-92}, publisher = {63B}, abstract = {

OBJECTIVES: The present study examines gender differences in changes in functional status after age 50 and how such differences vary across different age groups.

METHODS: Data came from the Health and Retirement Study, involving up to six repeated observations of a national sample of Americans older than 50 years of age between 1995 and 2006. We employed hierarchical linear models with time-varying covariates in depicting temporal variations in functional status between men and women.

RESULTS: As a quadratic function, the worsening of functional status was more accelerated in terms of the intercept and rate of change among women and those in older age groups. In addition, gender differences in the level of functional impairment were more substantial in older persons than in younger individuals, although differences in the rate of change between men and women remained constant across age groups.

DISCUSSION: A life course perspective can lead to new insights regarding gender variations in health within the context of intrapersonal and interpersonal differences. Smaller gender differences in the level of functional impairment in the younger groups may reflect improvement of women{\textquoteright}s socioeconomic status, greater rate of increase in chronic diseases among men, and less debilitating effects of diseases.

}, keywords = {Activities of Daily Living, Age Factors, Aged, Aged, 80 and over, Disabled Persons, Female, Health Status, Humans, Linear Models, Longitudinal Studies, Male, Middle Aged, Sex Factors, United States}, issn = {1079-5014}, doi = {10.1093/geronb/63.5.s282}, author = {Jersey Liang and Joan M. Bennett and Benjamin A Shaw and Ana R Qui{\~n}ones and Wen Ye and Xiao Xu and Mary Beth Ofstedal} }