@article {12098, title = {The Association Between Patterns of Social Engagement and Conversion From Mild Cognitive Impairment to Dementia: Evidence From the Health and Retirement Study.}, journal = {Alzheimer Disease \& Associated Disorders}, volume = {36}, year = {2022}, pages = {7-14}, abstract = {

OBJECTIVES: This study examined the association between patterns of social engagement and conversion from cognitive impairment, no dementia (CIND) to dementia. It also tested whether social engagement is associated with conversion independently from physical and cognitive engagements.

METHOD: Data from 2 waves (2010 and 2014) of the Health and Retirement Study (HRS) were used. The sample consisted of 1227 people who had CIND in 2010. To identify the heterogeneity of social engagement, latent class analysis was utilized. Multinomial logistic regression analysis was utilized to investigate the association between patterns of social engagement and probability of conversion to dementia and death or dropout.

RESULTS: The result showed that patterns of social engagement that represent higher level and more variety of social engagement were associated with lower probabilities of conversion to dementia in 4 years but not with probabilities of death or dropout. The relationship held after controlling for physical and cognitive engagements.

DISCUSSION: Findings implied that promoting social engagement may be protective against developing dementia even for the high-risk group of people with CIND. Future studies should investigate the mechanism behind the relationship between patterns of social engagement and lower probabilities of conversion to dementia.

}, keywords = {cognitive impairment, environmental enrichment model, Latent Class Analysis}, issn = {1546-4156}, doi = {10.1097/WAD.0000000000000486}, author = {Amano, Takashi and Sojung Park and Morrow-Howell, Nancy and Carpenter, Brian} } @article {11475, title = {Within-couple dissimilarities in functional impairment as determinants of spousal care arrangement among older married couples.}, journal = {Research in Nursing \& Health}, volume = {44}, year = {2021}, pages = {365-375}, abstract = {

Existing research on spousal care focuses on one spouse receiving care from the other, which fails to address the complexity that is created when both spouses experience some impairments. Our study included situations in which one or both spouses have functional impairments when examining the extent to which spouses from the same couple hold a (dis)similar level of functional impairment and whether such within-couple (dis)similarity has an impact on the spousal care arrangement. A subsample of 1170 older married couples was selected from the 2014 Health and Retirement Study. Descriptive statistics were used for describing the level of each spouse{\textquoteright}s functional impairment regarding the number of limitations in activities (activities of daily living [ADL]) or instrumental ADL (IADL). Logistic regressions were used to examine whether spousal dissimilarity in functional impairment (dissimilar, similarly low, similarly high) was associated with spousal care arrangement. Within couples with one functionally impaired spouse, the impaired spouse was more likely to receive spousal care when reporting a higher level of ADL/IADL impairment. Within couples with two functionally impaired spouses, the more impaired person was more likely to receive spousal care (without giving back) when spouses reported dissimilar level of IADL impairment; spouses were more likely to report mutual care when they had similarly high levels of IADL impairment. By documenting the role of spousal dissimilarities in functioning for determining spousal care arrangement, our study can inform couple-based interventions that capitalize on each spouse{\textquoteright}s capabilities and resources.

}, keywords = {Caregiving, family sociology, Functional health status, Marriage, within-couple perspective}, issn = {1098-240X}, doi = {10.1002/nur.22113}, author = {Liu, Huiying and Li, Yuekang and Wang, Yi and Morrow-Howell, Nancy and Vivian W Q Lou and Shen, Huei-Wern} } @article {10042, title = {Patterns of social engagement among older adults with mild cognitive impairment.}, journal = {The Journals of Gerontology, Series B: Psychological Sciences \& Social Sciences}, volume = {75}, year = {2020}, pages = {1361-1371}, abstract = {

OBJECTIVES: Promoting engagement in social activities may be an intervention that prevents or delays cognitive impairment. Nevertheless, little is known about social engagement among people with mild cognitive impairment. We aim to examine patterns of social engagement among people with mild cognitive impairment and to assess whether factors under four domains of the WHO{\textquoteright}s ICF model (personal factors, environmental factors, body functions and structure, and health condition) associate with different patterns of social engagement.

METHOD: Data were drawn from the 2010 Health and Retirement Study. The final sample comprised 1,227 people with Cognitive Impairment No Dementia (CIND). Latent class analysis and multinomial logistic regression were utilized.

RESULTS: Three patterns of social engagement were identified: informal social engagement only, formal and informal social engagement, and low social engagement. Factors in each of the four ICF model domains were associated with the probability of class membership.

DISCUSSION: Our findings suggest that social engagement is heterogeneous among people with CIND and that some groups of people with CIND have possibilities of engaging in more social activities, especially in formal social activities. Results also indicate that providing informal social resources may be essential for social programs designed specifically for people with CIND to promote their formal social engagement. Future study is needed to examine possible differences in outcomes across groups with similar patterns of social engagement.

}, keywords = {CIND, Cognition \& Reasoning, Health Conditions and Status, Social Support}, issn = {1758-5368}, doi = {10.1093/geronb/gbz051}, author = {Amano, Takashi and Morrow-Howell, Nancy and So Jung Park} } @article {10074, title = {Consolidated measures of activity among older adults: results of a three data set comparison.}, journal = {Journal of Gerontological Social Work}, year = {2019}, abstract = {This study explores the potential to consolidate a broad range of activity items to create more manageable measures that could be used in statistical modeling of multi-activity engagement. We utilized three datasets in the United States: Panel Study of Income Dynamics, Health and Retirement Study, and Midlife in the United States. After identifying activity items, exploratory and confirmatory factor analysis were used to empirically explore composite activity measures. Findings suggest that discrete activity items can be consolidated into activity domains; however, activity domains differ across datasets depending on availability of activity items. Implications for research and practice are further discussed.}, keywords = {Physical activity}, issn = {1540-4048}, doi = {10.1080/01634372.2019.1582123}, author = {Lee, Yung Soo and Putnam, Michelle and Morrow-Howell, Nancy and Inoue, Megumi and Jennifer C. Greenfield and Chen, Huajuan} } @article {10446, title = {PATTERNS OF WEALTH TRAJECTORY IN LATER LIFE: CRITICAL PERIOD, ACCUMULATION, AND SOCIAL MOBILITY MODELS}, journal = {Innovation in Aging}, volume = {3}, year = {2019}, month = {2019/11/08}, pages = {S382 - S382}, abstract = {Wealth, an important financial cushion for older adults to buffer economic stress, requires a longer time to accumulate and develop in one{\textquoteright}s course of life. However, little is known about the trajectories of wealth in later life, and how the life course socioeconomic status (SES) may contribute to the development of wealth at old-age. This study investigated longitudinal patterns of wealth trajectory and whether SES across the life course affects these trajectories using critical period, accumulation, and social mobility models. Using data from 16,189 adults aged 51 and older from the 2004-2014 Health and Retirement Study, a growth mixture model was used to explore distinct wealth trajectories. Impacts of life course models were studied using multinomial logistic regression. Results showed that four heterogeneous latent classes of wealth were identified: Stable high (reference group), Low and increasing, Stable low, and High but decline. Disadvantaged adulthood SES, accumulated exposure to socioeconomic risks, and downward or persistent socioeconomic disadvantage over the life course were associated with Stable low, Low and increasing, and High but decline, supporting all three life course mechanisms on wealth development in later life. Evidence suggests that wealth development is heterogeneous across individuals, and a strong gradient effect of life-course SES on wealth trajectories are clearly observed. Programs and policies should address the effects of life course on wealth development to strengthen the economic well-being in later life.}, keywords = {modeling, social mobility, Wealth, wealth trajectory}, isbn = {2399-5300}, url = {https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6840301/}, author = {Chen, Yu-Chih and So Jung Park and Morrow-Howell, Nancy} } @article {10.1093/geront/gny023, title = {Activity Patterns and Health Outcomes in Later Life: The Role of Nature of Engagement}, journal = {The Gerontologist}, volume = {59}, year = {2018}, month = {04}, pages = {698-708}, abstract = {The health benefit of activity participation at older ages is documented in the current literature. Many studies, however, only explored the health benefits of engaging in a few activities and did not examine mechanisms connecting activity participation to health. We investigated the pathway between activity and health by testing the mediation role of the nature of engagement (physical, cognitive, and social) on physical, mental, and cognitive health of older adults.We analyzed data of 6,044 older adults from the 2010 and 2012 Health and Retirement Study linked with 2011 Consumption and Activity Mail Survey. We used latent class analysis to identify the patterns of participating in 33 activities as well as patterns of nature of engagement, and examined how these patterns were associated with cognition, depressive symptoms, and self-rated health in later life.Meaningful patterns of activity (high, medium, low, passive leisure, and working) and the nature of activity engagement (full, partial, and minimal) were identified. High and working groups, compared to the passive leisure group, showed better health and cognition outcomes. The nature of engagement mediated the relationship between activity patterns and health, especially for older adults who were either full or partially engaged.The nature of engagement may play a more important role than the activity itself in relation to health. Identifying the heterogeneity in activity engagement in later life is critical for tailoring interventions and designing programs that can improve the health of older adults.}, keywords = {Activity engagement, Cognition, depression, Self-rated health}, issn = {0016-9013}, doi = {10.1093/geront/gny023}, url = {https://www.ncbi.nlm.nih.gov/pubmed/29659800}, author = {Chen, Yu-Chih and Putnam, Michelle and Lee, Yung Soo and Morrow-Howell, Nancy} } @article {9295, title = {The Association Between Cognitive Impairment and Patterns of Activity Engagement Among Older Adults.}, journal = {Research on Aging}, volume = {40}, year = {2018}, pages = {645-667}, abstract = {This study aims to assess the association between cognitive impairment and activity engagement patterns. Data from the 2012 Health and Retirement Study were used. A total of 3,943 participants aged 65 or older were included in analyses. Latent class analysis and multinomial logistic regression analysis were used. Four activity engagement profiles were identified: high activity (31.2\%), active leisure (18.9\%), passive leisure (28.2\%), and low activity (21.7\%). People in the high activity group engaged in all activities more than people in any other group, whereas people in the low activity group did not actively engage in most activities. Multinomial logistic regression analysis showed that cognitive impairment had an independent effect on the probability of being assigned to the low activity group compared to other groups. Cognitive impairment was associated with inactivity in a variety of activities. Future studies should examine supportive factors, which facilitate active patterns among people with cognitive impairment.}, keywords = {Activity engagement, Cognitive Ability}, issn = {1552-7573}, doi = {10.1177/0164027517728553}, author = {Amano, Takashi and So Jung Park and Morrow-Howell, Nancy} } @book {8924, title = {Handbook of Theories of Aging}, year = {2016}, pages = {752}, publisher = {Springer Publishing Company}, organization = {Springer Publishing Company}, edition = {Third}, address = {New York City, NY}, keywords = {Aging, Older Adults}, author = {Vern L. Bengtson and Richard A. Settersten Jr.}, editor = {Brian K. Kennedy and Morrow-Howell, Nancy and Jacqui Smith} } @inbook {5250, title = {Long-Term Care in the United States}, booktitle = {Financial Capability and Asset Holding in Later Life: A Life Course Perspective}, year = {2015}, pages = {161-174}, publisher = {Oxford University Press}, organization = {Oxford University Press}, chapter = {9}, address = {New York}, keywords = {Healthcare, Public Policy}, author = {Jennifer C. Greenfield}, editor = {Morrow-Howell, Nancy and Sherraden, Margaret S.} } @article {8028, title = {An investigation of activity profiles of older adults.}, journal = {J Gerontol B Psychol Sci Soc Sci}, volume = {69}, year = {2014}, month = {2014 Sep}, pages = {809-21}, publisher = {69}, abstract = {

OBJECTIVES: In this study, we advance knowledge about activity engagement by considering many activities simultaneously to identify profiles of activity among older adults. Further, we use cross-sectional data to explore factors associated with activity profiles and prospective data to explore activity profiles and well-being outcomes.

METHOD: We used the core survey data from the years 2008 and 2010, as well as the 2009 Health and Retirement Study Consumption and Activities Mail Survey (HRS CAMS). The HRS CAMS includes information on types and amounts of activities. We used factor analysis and latent class analysis to identify activity profiles and regression analyses to assess antecedents and outcomes associated with activity profiles.

RESULTS: We identified 5 activity profiles: Low Activity, Moderate Activity, High Activity, Working, and Physically Active. These profiles varied in amount and type of activities. Demographic and health factors were related to profiles. Activity profiles were subsequently associated with self-rated health and depression symptoms.

DISCUSSION: The use of a 5-level categorical activity profile variable may allow more complex analyses of activity that capture the "whole person." There is clearly a vulnerable group of low-activity individuals as well as a High Activity group that may represent the "active ageing" vision.

}, keywords = {Aged, Aged, 80 and over, Aging, Black or African American, Cohort Studies, Cross-Sectional Studies, Employment, Female, Florida, Health Surveys, Hispanic or Latino, Human Activities, Humans, Male, Middle Aged, Models, Psychological, Motor Activity, Prospective Studies, Regression Analysis, United States}, issn = {1758-5368}, doi = {10.1093/geronb/gbu002}, url = {http://psychsocgerontology.oxfordjournals.org/content/early/2014/02/12/geronb.gbu002.abstract}, author = {Morrow-Howell, Nancy and Putnam, Michelle and Lee, Yung Soo and Jennifer C. Greenfield and Inoue, Megumi and Chen, Huajuan} } @mastersthesis {6320, title = {The Long-Term Costs of Caring: How Caring for an Aging Parent Impacts Wealth Trajectories of Caregivers}, volume = {Ph.D.}, year = {2013}, note = {Copyright - Copyright ProQuest, UMI Dissertations Publishing 2013 Last updated - 2013-05-28 First page - n/a}, month = {May 2013}, pages = {128}, school = {Washington University in St. Louis}, type = {Dissertation}, abstract = {Long-term care in the U.S. is a growing concern as our aging population exerts pressure on formal and informal care systems. Public expenditures on formal care are increasing rapidly, even as reliance on informal caregivers expands. Recent policy innovations are shifting Medicaid and Medicare funding toward home- and community-based services (HCBS) as an alternative to nursing home care. This may help reduce overall LTC care costs to states and the federal government, but it also shifts more responsibility to families and informal care networks. Not only can caregiving have negative impacts on the physical and mental health of caregivers, but it also can be expensive, both in terms of direct costs and in terms of lost wages and work opportunities. However, to date, these financial consequences are not fully understood. This project uses longitudinal, nationally representative data from six waves of the Health and Retirement Study (1998-2008) to evaluate whether caring for aging parents impacts caregivers{\textquoteright} assets over time. Latent trajectory analysis was used to identify groups for whom caregiving had a negative impact on wealth trajectories. A four-group model fit best and revealed one group, with 4.3\% of respondents, for whom caregiving had a significant, negative relationship. Further, race, education, and caregivers{\textquoteright} health were significantly related to these trajectories. Gender and marital status were not related. Lastly, among caregivers, care duration did not significantly impact asset trajectories, and care intensity had mixed effects. Findings indicate that caring for an aging parent has a significant, negative impact for some adults over age 50, but only for a small group. Importantly, those who are negatively impacted are more likely to be in already vulnerable groups. As reliance on informal caregiving increases, special attention should be paid to those caregivers who may be particularly vulnerable to the financial impacts of caregiving; better assessments and more economic supports are needed to offset the potential exacerbating impacts of caregiving.}, keywords = {Adult children, Health Conditions and Status, Healthcare, Medicare/Medicaid/Health Insurance, Net Worth and Assets}, url = {http://search.proquest.com.proxy.lib.umich.edu/docview/1353672076?accountid=14667http://mgetit.lib.umich.edu/?ctx_ver=Z39.88-2004\&ctx_enc=info:ofi/enc:UTF-8\&rfr_id=info:sid/ProQuest+Dissertations+\%26+Theses+A\%26I\&rft_val_fmt=info:ofi/fmt:kev:mtx:dissertat}, author = {Jennifer C. Greenfield} } @article {7489, title = {Health outcomes of Experience Corps: a high-commitment volunteer program.}, journal = {Soc Sci Med}, volume = {71}, year = {2010}, note = {Using Smart Source Parsing pp. Jul Elsevier Science, Amsterdam The Netherlands}, month = {2010 Jul}, pages = {414-420}, publisher = {71}, abstract = {

Experience Corps (EC) is a high-commitment US volunteer program that brings older adults into public elementary schools to improve academic achievement of students. It is viewed as a health promotion program for the older volunteers. We evaluated the effects of the EC program on older adults{\textquoteright} health, using a quasi-experimental design. We included volunteers from 17 EC sites across the US. They were pre-tested before beginning their volunteer work and post-tested after two years of service. We compared changes over time between the EC participants (n = 167) and a matched comparison group of people from the US Health and Retirement Study (2004, 2006). We developed the comparison group by using the nearest available Mahalanobis metric matching within calipers combined with the boosted propensity scores of those participating in the EC. We corrected for clustering effects via survey regression analyses with robust standard errors and calculated adjusted post-test means of health outcomes, controlling for all covariates and the boosted propensity score of EC participants. We found that compared to the comparison group, the EC group reported fewer depressive symptoms and functional limitations after two years of participation in the program, and there was a statistical trend toward the EC group reporting less decline in self-rated health. Results of this study add to the evidence supporting high-intensity volunteering as a social model of health promotion for older adults.

}, keywords = {Activities of Daily Living, Aged, Aged, 80 and over, depression, Female, Health Promotion, Health Status, Humans, Male, Middle Aged, Program Evaluation, Regression Analysis, Self Concept, Volunteers}, issn = {1873-5347}, doi = {10.1016/j.socscimed.2010.04.009}, author = {S I Hong and Morrow-Howell, Nancy} }