@article {13770, title = {Physical activity positively impacts disability outcomes during transition from midlife to early older age irrespective of body mass index.}, journal = {Archives of Gerontology and Geriatrics}, volume = {120}, year = {Forthcoming}, pages = {105339}, abstract = {

We examined the effects of physical activity (PA) and body mass index (BMI) longitudinal patterns (trajectories) on subjective measures of mobility, function, and disability in adults and assessed whether effects of PA trajectories on function varied due to BMI. Group-based trajectory analyses were used to determine patterns of change in PA and BMI using data from the Health and Retirement Study 1931-1941 birth cohort (n = 10,507). Physical function was assessed by Mobility Limitations (0-5 scale) and Large Muscle Function (0-4 scale) Indexes, as well as with score for activities of daily living (ADLs) and instrumental activities of daily living (IADLs), with higher scores being worse. Our analyses estimated four distinct PA trajectories: decreasing, (2) fluctuating, (3) stable high, and (4) emergent (previously low/sedentary with increased PA over the study period). Worse mobility limitations, large muscle function, ADLs, and IADLs were associated with Decreasing and Fluctuating PA groups. Better outcomes were associated with Emergent and Stable High PA groups. The five BMI trajectories were stable normal/overweight, modest decreasing, fluctuating, steep decreasing, and increasing. No significant interaction existed between PA and BMI trajectories for Mobility Limitations (P= 0.577), Large Muscle Function (P= 0.511), ADLs (P= 0.600), and IADLs (P= 0.152). These findings may empower clinicians to promote messages to midlifers that meaningful changes in PA can improve function in older age.

}, keywords = {Aging, Body Mass Index, Disability, Obesity, Physical activity, trajectory}, issn = {1872-6976}, doi = {10.1016/j.archger.2024.105339}, author = {Vasilopoulos, Terrie and Drozda, David and Vincent, Heather K} } @article {13698, title = {Pain, Physical Demands at Work, and Future Work Expectations Among Older Adults in the United States.}, journal = {Innovation and Aging}, volume = {7}, year = {2023}, pages = {igad089}, abstract = {

BACKGROUND AND OBJECTIVES: In the United States, pain is becoming increasingly prevalent among older adults at the same time as policies are incentivizing work longer. Given that pain and physically demanding jobs are both linked to early retirement and they often go hand-in-hand, it is important to assess how the unique effects of pain and physical work demands may interact in predicting future work expectations.

RESEARCH DESIGN AND METHODS: Using Health and Retirement Study data (1998, 2004, 2010, and 2016 waves), we assess how pain and physical job demands influence future work expectations of 10,358 adults at midlife (ages 51-56), after accounting for sociodemographic, job, health, and financial characteristics.

RESULTS: Compared to men with no pain, activity-interfering pain was associated with low expectations of full-time work past 62 regardless of job demands, while noninterfering pain was associated with 62\% higher odds (odds ratio [OR] = 1.62, 95\% confidence interval [CI]: 1.35-1.93) of expecting not to work full-time past age 62 only among those with physically demanding jobs. Having both interfering pain and a physically demanding job was associated with increased odds of expecting not to work full-time past age 65 for men (OR = 1.25, 95\% CI: 1.06-1.47) and past age 62 for women (OR = 1.18, 95\% CI: 1.00-1.39).

DISCUSSION AND IMPLICATIONS: The co-occurrence of physically demanding work with pain-particularly activity-interfering pain-is associated with low expectations of full-time work past ages 62 and 65 for adults at midlife. Working longer may be feasible for older adults whose pain does not interfere with work, but unrealistic for individuals facing both pain and physically demanding work.

}, keywords = {Disability, Retirement, Working Longer}, issn = {2399-5300}, doi = {10.1093/geroni/igad089}, author = {Andrasfay, Theresa and Fennell, Gillian and Crimmins, Eileen} } @article {11834, title = {Physical Disability and Older Adults{\textquoteright} Perceived Food and Economic Insecurity During the COVID-19 Pandemic.}, journal = {The Journals of Gerontology, Series B }, volume = {77}, year = {2022}, pages = {e123-e133}, abstract = {

OBJECTIVES: We examined whether older adults with physical disability were vulnerable to three types of perceived economic insecurity (difficulty paying regular bills, difficulty paying medical bills, income loss) and two types of perceived food insecurity (economic obstacles, logistical obstacles) during the early months of the COVID-19 pandemic. We evaluated the extent to which associations are moderated by three personal characteristics (age, sex, race/ethnicity) and two pandemic-specific risk factors (job loss, COVID-19 diagnosis).

METHODS: Data are from a random 25 percent subsample of Health and Retirement Study (HRS) participants who completed a COVID-19 module introduced in June 2020. We estimated logistic regression models to predict each of five self-reported hardships during the pandemic.

RESULTS: Bivariate analyses showed that persons with three or more functional limitations were more likely to report both types of food insecurity, and difficulty paying regular and medical bills since the start of the pandemic, relative to those with no limitations. After controlling for health conditions, effects were no longer significant for paying medical bills, and attenuated yet remained statistically significant for other outcomes. Patterns did not differ significantly on the basis of the moderator variables. Job loss substantially increased the risk of economic insecurity but not food insecurity.

DISCUSSION: Older adults with more functional limitations were vulnerable to economic and food insecurity during the pandemic, potentially exacerbating the physical and emotional health threats imposed by COVID-19. Supports for older adults with disability should focus on logistical as well as financial support for ensuring their food security.

}, keywords = {COVID-19, Disability, Financial hardship, Food insecurity, Job insecurity}, issn = {1758-5368}, doi = {10.1093/geronb/gbab162}, author = {Choi, Shinae L and Deborah Carr and Namkung, Eun Ha} } @article {11947, title = {Physical inactivity in older adults with cognitive impairment without dementia: room for improvement.}, journal = {Aging Clinical and Experimental Research}, volume = {34}, year = {2022}, pages = {837-845}, abstract = {

BACKGROUND: Persons with cognitive impairment without dementia are at high risk of adverse health outcomes. Tailored intervention targeting moderate-vigorous physical activity (MVPA) may reduce these risks.

AIMS: To identify the prevalence and predictors of physical inactivity among older adults with cognitive impairment, no dementia (CIND); and estimate the proportion of inactive people with CIND who are capable of greater MVPA.

METHODS: We studied 1875 community dwelling participants (over age 65) with CIND in the Health and Retirement Study. Physical inactivity was defined as MVPA <= 1x/week. Associations of physical inactivity with sociodemographic, health, and physical function were examined using chi-square and modified Poisson regression. We considered physically inactive participants capable of greater MVPA if they reported MVPA at least 1-3x/month, no difficulty walking several blocks, or no difficulty climbing several flights of stairs.

RESULTS: Fifty-six percent of participants with CIND were physically inactive. Variables with the highest age, sex, and race/ethnicity adjusted risk ratio (ARR) for physical inactivity were self-rated health (poor [76.9\%]vs. excellent [34.2\%]; ARR [95\% CI] 2.27 [1.56-3.30]), difficulty walking (across the room [86.5\%] vs. none [40.5\%]; ARR [95\% CI] 2.09 [1.87-2.35]), total assets (lowest quartile [62.6\%] vs. highest quartile [43.1\%]; ARR [95\% CI] 1.54 [1.29-1.83]), and lower education attainment (less than high school [59.6\%] vs college graduate [42.8\%]; ARR [95\% CI] 1.46 [1.17-1.83]). Among physically inactive older adults with CIND, 61\% were estimated to be capable of greater MVPA.

CONCLUSIONS: Although physical inactivity is prevalent among older adults with CIND, many are capable of greater MVPA. Developing tailored physical activity interventions for this vulnerable population may improve cognitive, health, and quality of life outcomes.

}, keywords = {cognitive impairment, Disability, Physical activity, Physical function}, issn = {1720-8319}, doi = {10.1007/s40520-021-01999-5}, author = {Miller, Matthew J and Irena Cenzer and Deborah E Barnes and Kenneth E Covinsky} } @article {10678, title = {Physical Activity and Falls Among a National Cohort of Older Veterans}, journal = {Journal of Applied Gerontology}, volume = {40}, year = {2021}, pages = {310-319}, abstract = {The more than 20 million U.S. veterans have a history of physical activity engagement but face increasing disability as they age. Falls are common among older adults, but there is little evidence on veterans{\textquoteright} fall risk. We conducted a retrospective cohort study using 48,643 observations from 14,831 older (>=65 years) Americans from the 2006{\textendash}2014 waves of the Health and Retirement Study. Veterans reported more noninjurious falls (26.6\% vs. 24.0\%, p < .002), but fewer fall-related injuries (8.9\% vs. 12.3\%, p < .001) than nonveterans. In adjusted analyses, for each 5-year increase in age, the odds of a noninjurious fall were greater for veterans (odds ratio [OR] = 1.05, 95\% confidence interval [CI] = [1.01, 1.10]) and, among those with regular physical activity, the odds were lower for veterans compared with nonveterans (OR = 0.89; 95\% CI = [0.81, 0.99]). For veterans, physical activity engagement may prove a particularly effective mechanism for reducing the aging-related risks associated with falls and fall injuries.}, keywords = {Aging, Disability, Falls, Physical activity, Veterans}, doi = {10.1177/0733464820915807}, author = {Dan Marciniak and Neil B. Alexander and Geoffrey J Hoffman} } @article {Kulminski2019, title = {Polygenic risk score for disability and insights into disability-related molecular mechanisms}, journal = {GeroScience}, year = {2019}, month = {Nov}, abstract = {Late life disability is a highly devastating condition affecting 20\% or more of persons aged 65 years and older in the USA; it is an important determinant of acute medical and long-term care costs which represent a growing burden on national economies. Disability is a multifactorial trait that contributes substantially to decline of health/wellbeing. Accordingly, gaining insights into the genetics of disability could help in identifying molecular mechanisms of this devastating condition and age-related processes contributing to a large fraction of specific geriatric conditions, concordantly with geroscience. We performed a genome-wide association study of disability in a sample of 24,068 subjects from five studies with 12,550 disabled individuals. We identified 30 promising disability-associated polymorphisms in 19 loci at p < 10-4; four of them attained suggestive significance, p < 10-5. In contrast, polygenic risk scores aggregating effects of minor alleles of independent SNPs that were adversely or beneficially associated with disability showed highly significant associations in meta-analysi}, keywords = {Disabilities, Disability, Polygenic risk score}, issn = {2509-2723}, doi = {10.1007/s11357-019-00125-8}, url = {https://doi.org/10.1007/s11357-019-00125-8}, author = {Alexander M Kulminski and Kang, Chansuk and Kolpakov, Stanislav A. and Loika, Yury and Nazarian, Alireza and Anatoliy Yashin and Stallard, Eric and Culminskaya, Irina} } @article {11237, title = {The Postretirement Well-Being of Workers With Disabilities}, journal = {Journal of Disability Policy Studies}, volume = {30}, year = {2018}, note = {doi: 10.1177/1044207318793161}, month = {2019/06/01}, pages = {46 - 55}, abstract = {Older workers who develop significant limitations in health or functioning face declines in income and consumption and an increased likelihood of poverty in the years prior to retirement. We assess the extent to which those differences persist after reaching retirement age. We use the Health and Retirement Study (HRS) linked to Social Security Administration (SSA) records to compare the postretirement financial well-being of workers who experienced disability onset during their working years with those who did not, based on their claiming behavior for Social Security disability and retirement benefits. We find that even after full retirement age, gaps that emerged prior to retirement persist; those who experienced disability prior to retirement had lower incomes, were more likely to be in poverty, and had significantly lower wealth. Workers with disabilities who claimed Social Security Disability Insurance (DI) fared better than those who were rejected for such benefits, yet both groups were worse off than those who delayed claiming benefits until they were eligible for Social Security Old Age and Survivors Insurance (OASI) benefits. Our findings indicate that any changes to the Social Security benefit structure must be mindful of the short- and longer term implications for already-vulnerable groups of workers.}, keywords = {Disabilities, Disability, Retirement, Well-being}, isbn = {1044-2073}, url = {https://doi.org/10.1177/1044207318793161}, author = {April Yanyuan Wu and Jody Schimmel Hyde} } @mastersthesis {article, title = {Partial Benefits in the Social Security Disability Insurance Program: A Policy Alternative to Foster Work among People with Disability}, year = {2011}, abstract = {The current U.S. Social Security Disability Insurance program is an all-or-nothing system that has been criticized for creating strong work disincentives. In an empirically grounded and calibrated life-cycle model, I simulate behavioral responses to a partial disability benefit system, a policy alternative to the current program, which allows individuals to claim partial disability and combine earnings with disability benefits. The appeal of this policy hinges on the possibility of inducing applicants to selfselect themselves into a given disability level, while maintaining those with some work capacity in the labor force, and therefore keep them contributing through their labor taxes to the Social Security system, easing the budgetary pressures of the overall Social Security system. The current dichotomous definition of disability can result in relatively productive individuals dropping from the labor force to receive benefits in order to have access to a total income high enough to make ends meet. Instead, the new system will establish a culture of continuous attachment to the labor force in the wake of health limitations. The simulation results show that there will be significant increases in both DI applications and DI rolls under the partial DI system; however, most of the increases are due to increases in applications for partial benefits and awards to partial benefits. In fact, full DI benefits applications and full DI benefit rolls will drop substantially. The mean duration spent on DI program will decrease dramatically. Our budgetary and welfare calculations show that a partial DI system, under some conditions, could result in financial savings for the program as well as individuals{\textquoteright} welfare improvements.}, keywords = {Disability, Social Security Benefits}, url = {https://www.researchgate.net/profile/Na_Yin7/publication/241248671_Partial_Benefits_in_the_Social_Security_Disability_Insurance_Program_A_Policy_Alternative_to_Foster_Work_among_People_with_Disability/links/5ea91eae299bf18b95845d1d/Partial-Benefits-in-the}, author = {Yin, Na} }