TY - JOUR T1 - Family caregiving and place of death: Insights from cross-national analysis of the Harmonized End of Life Data. JF - The Journals of Gerontology: Series B Y1 - 2021 A1 - Jennifer A Ailshire A1 - Osuna, Margarita A1 - Wilkens, Jenny A1 - Jinkook Lee KW - Activities of Daily Living KW - Aging KW - Disability KW - family caregivers KW - Nursing homes KW - SHARE KW - spouse KW - Terminally Ill AB -
OBJECTIVES: Family is largely overlooked in research on factors associated with place of death among older adults. We determine if family caregiving at the end of life is associated with place of death in the United States and Europe.
METHODS: We use the Harmonized End of Life data sets developed by the Gateway to Global Aging Data for the Survey of Health, Ageing and Retirement in Europe (SHARE) and the Health and Retirement Study (HRS). We conducted multinomial logistic regression on 7,113 decedents from 18 European countries and 3,031 decedents from the United States to determine if family caregiving, defined based on assistance with activities of daily living, was associated with death at home versus at a hospital or nursing home.
RESULTS: Family caregiving was associated with reduced odds of dying in a hospital and nursing home, relative to dying at home in both the United States and Europe. Care from a spouse/partner or child/grandchild was both more common and more strongly associated with place of death than care from other relatives. Associations between family caregiving and place of death were generally consistent across European welfare regimes.
DISCUSSION: This cross-national examination of family caregiving indicates that family-based support is universally important in determining where older adults die. In both the United States and in Europe, most care provided during a long-term illness or disability is provided by family caregivers, and it is clear families exert tremendous influence on place of death.
VL - 76 IS - Supplement_1 ER - TY - JOUR T1 - Cross-Country Comparisons of Disability and Morbidity: Evidence from the Gateway to Global Aging Data JF - The Journals of Gerontology: Series A Y1 - 2018 A1 - Jinkook Lee A1 - Drystan F. Phillips A1 - Wilkens, Jenny A1 - Chien, Sandy A1 - Lin, Yu-Chen A1 - Marco Angrisani A1 - Eileen M. Crimmins KW - Cross-National KW - Disabilities KW - Disease KW - Gateway to Global Aging AB - Background International comparisons of disease prevalence have been useful in understanding what proportion of disease might be preventable and in informing potential policy interventions in different cultural and economic contexts. Using newly available, harmonized data from 20 countries, we compare disability and morbidity of older adults between the ages of 55 and 74. Methods The Gateway to Global Aging Data, a data and information portal, provides access to easy-to-use individual-level longitudinal data from 10 surveys covering over 30 countries. Exploiting harmonized measures available from the Gateway, we descriptively examine how disability and morbidity differ across countries. Results Significant cross-country differences are observed for several health indicators. Comparing countries with the highest and lowest prevalence rates, we observe that hypertension rates vary twofold and stroke rates vary threefold, while disability and arthritis rates vary more than fivefold. Among women, higher gross domestic product and life expectancy are related to lower diabetes, heart disease, and better functioning. Among men, national indicators of economic conditions are not significantly associated with reported disease prevalence. Conclusions We document substantial heterogeneity in disability and morbidity across countries, separately for men and women and after controlling for population age composition and education. Rich data from various surveys across the world offers remarkable opportunities for cross-country analyses, calling for further investigation of what drives observed differences. The Gateway to Global Aging Data provides easy-to-use harmonized data files and tools to facilitate this type of research. VL - 73 UR - http://academic.oup.com/biomedgerontology/advance-article/doi/10.1093/gerona/glx224/4683782http://academic.oup.com/biomedgerontology/advance-article-pdf/doi/10.1093/gerona/glx224/22474170/glx224.pdf IS - 11 ER - TY - JOUR T1 - Effects of Recent Stress and Variation in the Serotonin Transporter Polymorphism (5-HTTLPR) on Depressive Symptoms: A Repeated-Measures Study of Adults Age 50 and Older. JF - Behavior Genetics Y1 - 2016 A1 - Thalida E. Arpawong A1 - Jinkook Lee A1 - Drystan F. Phillips A1 - Eileen M. Crimmins A1 - Morgan E. Levine A1 - Carol A Prescott KW - Aged KW - Alleles KW - depression KW - Depressive Disorder KW - Ethnic Groups KW - Female KW - Gene-Environment Interaction KW - Genetic Association Studies KW - Genetic Predisposition to Disease KW - Haplotypes KW - Humans KW - Life Change Events KW - Male KW - Middle Aged KW - Polymorphism, Single Nucleotide KW - Promoter Regions, Genetic KW - Serotonin Plasma Membrane Transport Proteins KW - Stress, Psychological AB -Depending on genetic sensitivity to it, stress may affect depressive symptomatology differentially. Applying the stress-diathesis hypothesis to older adults, we postulate: (1) recent stress will associate with increased depressive symptom levels and (2) this effect will be greater for individuals with at least one short allele of the serotonin transporter gene promoter region (5-HTTLPR). Further, we employ a design that addresses specific limitations of many prior studies that have examined the 5-HTTLPR × SLE relation, by: (a) using a within-person repeated-measures design to address fluctuations that occur within individuals over time, increase power for detecting G × E, and address GE correlation; (b) studying reports of exogenous stressful events (those unlikely to be caused by depression) to help rule out reverse causation and negativity bias, and in order to assess stressors that are more etiologically relevant to depressive symptomatology in older adults. The sample is drawn from the Health and Retirement Study, a U.S. population-based study of older individuals (N = 28,248; mean age = 67.5; 57.3 % female; 80.7 % Non-Hispanic White, 14.9 % Hispanic/Latino, 4.5 % African American; genetic subsample = 12,332), from whom measures of depressive symptoms and exogenous stressors were collected biannually (1994-2010). Variation in the 5-HTTLPR was characterized via haplotype, using two single nucleotide polymorphisms (SNPs). Ordered logit models were constructed to predict levels of depressive symptoms from 5-HTTLPR and stressors, comparing results of the most commonly applied statistical approaches (i.e., comparing allelic and genotypic models, and continuous and categorical predictors) used in the literature. All models were stratified by race/ethnicity. Overall, results show a main effect of recent stress for all ethnic groups, and mixed results for the variation in 5-HTTLPR × stress interaction, contingent upon statistical model used. Findings suggest there may be a differential effect of stressors and 5-HTTLPR on depressive symptoms by ethnicity, but further research is needed, particularly when using a haplotype to characterize variation in 5-HTTLPR in population-based sample with a diverse ethnic composition.
PB - 46 VL - 46 IS - 1 U2 - PMC4720538 U4 - 5-HTTLPR/Depressive symptoms/G/Older adults/Race differences/Stressful life events/Genetic analysis ER - TY - JOUR T1 - Health Effects of Short-Term Fluctuations in Macroeconomic Conditions: The Case of Hypertension for Older Americans. JF - Health Econ Y1 - 2016 A1 - Marco Angrisani A1 - Jinkook Lee KW - Aged KW - Commerce KW - Economic Recession KW - Female KW - Health Status KW - Humans KW - Hypertension KW - Longitudinal Studies KW - Male KW - Middle Aged KW - Socioeconomic factors KW - Stress, Psychological KW - Surveys and Questionnaires KW - Unemployment KW - United States AB -We investigate the health effects of short-term macroeconomic fluctuations as described by changes in unemployment rate, house, and stock market price indexes. The 'Great Recession' provides the opportunity to conduct this analysis as it involved contemporaneous shocks to the labor, housing, and stock markets. Using panel data from the Health and Retirement Study over the period 2004-2010, we relate changes in hypertension status to changes in state-level unemployment rate and house prices and to changes in stock market prices. We consider hypertension, a disease related to stress and of high prevalence among older adults, that has received little attention in the literature linking macroeconomic conditions to individual health. Our analysis exploits self-reports of hypertension diagnosis as well as directly measured blood pressure readings. Using both measures, we find that the likelihood of developing hypertension is negatively related to changes in house prices. Also, decreasing house prices lower the probability of stopping hypertension medication treatment for individuals previously diagnosed with the condition. We do not observe significant associations between hypertension and either changes in unemployment rate or stock market prices. We document heterogeneity in the estimated health effects of the recession by gender, education, asset ownership, and work status. Copyright © 2016 John Wiley & Sons, Ltd.
VL - 25 Suppl 2 UR - http://doi.wiley.com/10.1002/hec.3374https://api.wiley.com/onlinelibrary/tdm/v1/articles/10.1002%2Fhec.3374http://onlinelibrary.wiley.com/wol1/doi/10.1002/hec.3374/fullpdf U1 - http://www.ncbi.nlm.nih.gov/pubmed/27870298?dopt=Abstract JO - Health Econ. ER - TY - JOUR T1 - A polygenic risk score associated with measures of depressive symptoms among older adults. JF - Biodemography Soc Biol Y1 - 2014 A1 - Morgan E. Levine A1 - Eileen M. Crimmins A1 - Carol A Prescott A1 - Drystan F. Phillips A1 - Thalida E. Arpawong A1 - Jinkook Lee KW - Aged KW - Aged, 80 and over KW - Depressive Disorder, Major KW - Female KW - Genetic Predisposition to Disease KW - Genetic Variation KW - Genome-Wide Association Study KW - Humans KW - Male KW - Middle Aged KW - Multifactorial Inheritance KW - Odds Ratio KW - Risk Factors AB -It has been suggested that depression is a polygenic trait, arising from the influences of multiple loci with small individual effects. The aim of this study is to generate a polygenic risk score (PRS) to examine the association between genetic variation and depressive symptoms. Our analytic sample included N = 10,091 participants aged 50 and older from the Health and Retirement Study (HRS). Depressive symptoms were measured by Center for Epidemiological Studies-Depression scale (CESD) scores assessed on up to nine occasions across 18 years. We conducted a genome-wide association analysis for a discovery set (n = 7,000) and used the top 11 single-nucleotide polymorphisms, all with p < 10(-5) to generate a weighted PRS for our replication sample (n = 3,091). Results showed that the PRS was significantly associated with mean CESD score in the replication sample (β = .08, p = .002). The R(2) change for the inclusion of the PRS was .003. Using a multinomial logistic regression model, we also examined the association between genetic risk and chronicity of high (4+) CESD scores. We found that a one-standard-deviation increase in PRS was associated with a 36 percent increase in the odds of having chronically high CESD scores relative to never having had high CESD scores. Our findings are consistent with depression being a polygenic trait and suggest that the cumulative influence of multiple variants increases an individual's susceptibility for chronically experiencing high levels of depressive symptoms.
PB - 60 VL - 60 IS - 2 N1 - Times Cited: 0 SI 0 U1 - http://www.ncbi.nlm.nih.gov/pubmed/25343367?dopt=Abstract U2 - PMC4298361 U4 - GENOME-WIDE ASSOCIATION/INDIVIDUAL GENETIC RISK/MAJOR DEPRESSION/DISEASE RISK/HERITABILITY/genetics/genetics/depression/Depressive Symptoms/CES Depression Scale/CES Depression Scale/regression Analysis ER - TY - RPRT T1 - Harmonization of Cross-National Studies of Aging to the Health and Retirement Study: Income Measures Y1 - 2012 A1 - Marco Angrisani A1 - Jinkook Lee KW - CHARLS KW - Cross-National KW - ELSA KW - IFLS KW - JSTAR KW - KLoSA KW - LASI KW - Methodology KW - SHARE KW - TILDA AB - This paper summarizes and compares measures of household and individual income in the Health and Retirement Study (HRS) and its sister surveys from other countries: the English Longitudinal Study of Ageing (ELSA), the Survey of Health, Ageing, and Retirement in Europe (SHARE), the Korean Longitudinal Study of Aging (KLoSA), the Japanese Study on Aging and Retirement (JSTAR), the Indonesian Family Life Survey (IFLS), The Irish Longitudinal Study on Aging (TILDA), the Chinese Health and Retirement Longitudinal Study (CHARLS), and the Longitudinal Aging Study in India (LASI). The authors analyze and discuss the extent, to which these measures are comparable, the methodological differences in the way information was collected for these measures, and the implications for secondary data analysis. This paper is one in a series of similar papers, each comparing different domains (e.g., chronic medical conditions, cognition, expectations, transfers, and wealth) across these surveys with an aim to encourage rigorous, cross-national and international comparison research on aging populations. JF - RAND Working Paper PB - RAND Corporation CY - Santa Monica, CA, U4 - cross-national comparison/ELSA_/SHARE/CHARLS/KLOSA/JSTAR/TILDA/Methodology ER -