@article {6510, title = {Education and Psychosocial Functioning Among Older Adults: 4-Year Change in Sense of Control and Hopelessness.}, journal = {J Gerontol B Psychol Sci Soc Sci}, volume = {73}, year = {2018}, month = {2018 Jun 14}, pages = {849-859}, abstract = {

OBJECTIVES: This study investigates education differences in levels and change in sense of control and hopelessness among older adults.

METHOD: We used data from the Health and Retirement Study, an ongoing biennial survey of a nationally representative sample of older Americans, to examine education differences in sense of control (e.g., mastery and perceived constraints) and hopelessness. Our sample included 8,495 adults aged 52 and older who were interviewed in 2006/2008 and 2010/2012. We assessed separate models for change in sense of control and hopelessness, accounting for recent changes in social circumstances and health status.

RESULTS: Low mastery, perceived constraints, and hopelessness were highest among individuals with less than a high school education. Over a 4-year period, this group experienced the greatest declines in psychosocial functioning, as indicated by greater increases in low mastery, perceived constraints, and hopelessness. Education differences existed net of recent negative experiences, specifically the loss of intimate social relationships and social support and increases in disease and disability.

DISCUSSION: These findings highlight the importance of education for sense of control and hopelessness in older adulthood and demonstrate the cumulative advantage of higher levels of education for psychosocial functioning.

}, keywords = {Activities of Daily Living, Aged, Educational Status, Female, Humans, Internal-External Control, Male, Middle Aged, Psychology, Sadness, Social participation, Social Support}, issn = {1758-5368}, doi = {10.1093/geronb/gbw031}, url = {http://psychsocgerontology.oxfordjournals.org/content/early/2016/03/23/geronb.gbw031.abstract}, author = {Uchechi A Mitchell and Jennifer A Ailshire and Lauren L Brown and Morgan E. Levine and Eileen M. Crimmins} } @article {8703, title = {Timing of Advance Directive Completion and Relationship to Care Preferences.}, journal = {J Pain Symptom Manage}, volume = {53}, year = {2017}, month = {2017 01}, pages = {49-56}, abstract = {

CONTEXT: Given recent Medicare rules reimbursing clinicians for engaging in advance care planning, there is heightened need to understand factors associated with the timing of advance directive (AD) completion before death and how the timing impacts care decisions.

OBJECTIVE: The purpose of this study was to investigate patterns in timing of AD completion and the relationship between timing and documented care preferences. We hypothesize that ADs completed late in the course of illness or very early in the disease trajectory will reflect higher preferences for aggressive care.

METHODS: We conducted a retrospective study using logistic regressions to analyze data from the Health and Retirement Study, a nationally representative longitudinal survey of older adults.

RESULTS: The analytic sample included exit interviews conducted from 2000 to 2012 among 2904 proxy reporters of deceased participants who had an AD. Nearly three-quarters (71\%) of ADs were completed a year or more before death. Being younger or a racial/ethnic minority, and having lower education, a diagnosis of cancer or lung disease, and an expected death were associated with completing an AD within the three months before death, while having the lowest quartile of assets and memory problems were inversely associated with AD completion. Minorities, those with lower education, expected death, and timing of AD completion were associated with electing aggressive care.

CONCLUSION: Early documentation of care wishes may not be associated with an increased likelihood of electing aggressive care; however, ADs completed in the last months of life have higher rates of election of aggressive care.

}, keywords = {Advance care planning, Advance directives, Aged, Aged, 80 and over, Female, Humans, Male, Middle Aged, Patient Participation, Patient Preference, Retrospective Studies}, issn = {1873-6513}, doi = {10.1016/j.jpainsymman.2016.08.008}, url = {https://linkinghub.elsevier.com/retrieve/pii/S0885-3924(16)30336-0}, author = {Enguidanos, Susan and Jennifer A Ailshire} } @article {8086, title = {Fine particulate matter air pollution and cognitive function among older US adults.}, journal = {Am J Epidemiol}, volume = {180}, year = {2014}, note = {Ailshire, Jennifer A Crimmins, Eileen M eng K99 AG039528/AG/NIA NIH HHS/ K99AG039528/AG/NIA NIH HHS/ P30 AG017265/AG/NIA NIH HHS/ P30AG17265/AG/NIA NIH HHS/ R00 AG039528/AG/NIA NIH HHS/ R21 AG045625/AG/NIA NIH HHS/ T32 AG000037/AG/NIA NIH HHS/ T32AG0037/AG/NIA NIH HHS/ U01 AG009740/AG/NIA NIH HHS/ U01AG009740/AG/NIA NIH HHS/ Research Support, N.I.H., Extramural 2014/06/27 06:00 Am J Epidemiol. 2014 Aug 15;180(4):359-66. doi: 10.1093/aje/kwu155. Epub 2014 Jun 24.}, month = {2014 Aug 15}, pages = {359-66}, publisher = {180}, abstract = {

Existing research on the adverse health effects of exposure to pollution has devoted relatively little attention to the potential impact of ambient air pollution on cognitive function in older adults. We examined the cross-sectional association between residential concentrations of particulate matter with aerodynamic diameter of 2.5 μm or less (PM2.5) and cognitive function in older adults. Using hierarchical linear modeling, we analyzed data from the 2004 Health and Retirement Study, a large, nationally representative sample of US adults aged 50 years or older. We linked participant data with 2000 US Census tract data and 2004 census tract-level annual average PM2.5 concentrations. Older adults living in areas with higher PM2.5 concentrations had worse cognitive function (β = -0.26, 95\% confidence interval: -0.47, -0.05) even after adjustment for community- and individual-level social and economic characteristics. Results suggest that the association is strongest for the episodic memory component of cognitive function. This study adds to a growing body of research highlighting the importance of air pollution to cognitive function in older adults. Improving air quality in large metropolitan areas, where much of the aging US population resides, may be an important mechanism for reducing age-related cognitive decline.

}, keywords = {Aged, Aged, 80 and over, Cognition, Cognition Disorders, Cross-Sectional Studies, Female, Humans, Inhalation Exposure, Male, Memory, Episodic, Middle Aged, Neuropsychological tests, Particulate Matter, Socioeconomic factors, United States, Urban Population}, issn = {1476-6256}, doi = {10.1093/aje/kwu155}, url = {http://aje.oxfordjournals.org/content/early/2014/06/24/aje.kwu155.abstract}, author = {Jennifer A Ailshire and Eileen M. Crimmins} }