TY - JOUR T1 - Association Between Purpose in Life and Glucose Control Among Older Adults. JF - Annals of Behavioral Medicine Y1 - 2018 A1 - Hafez, Dina A1 - Michele M Heisler A1 - Choi, Hwajung A1 - Claire K. Ankuda A1 - Winkelman, Tyler A1 - Jeffrey T Kullgren KW - Biomarkers KW - Diabetes KW - Glutamic Acid KW - Purpose in life AB -

Background: Greater purpose in life is associated with lower rates of certain chronic diseases. Whether purpose in life can protect against development of prediabetes or type 2 diabetes is unknown.

Purpose: To examine the association between purpose in life and blood glucose control among adults ≥50 years.

Methods: We conducted a longitudinal cohort study of 3,907 participants of the Health and Retirement Study who at baseline did not have type 2 diabetes or prediabetes. Baseline purpose in life was measured using the Ryff and Keyes' Scales of Psychological Well-Being and grouped into tertiles (high, medium, and low). We used multivariable linear regression to examine the association between baseline purpose in life and HbA1c over 4 years. Multivariable logistic regression was used to examine the association between baseline purpose and incident prediabetes or type 2 diabetes over the same period.

Results: After adjusting for sociodemographic factors, body mass index, physical activity, and physical and mental health factors, HbA1c was 0.07 percentage points lower among participants with high purpose than those with low purpose (95% confidence interval [CI] -0.12 to -0.02; p = .011). Participants with high purpose had lower odds of developing prediabetes or type 2 diabetes than those with low purpose (adjusted odds ratio 0.78; 95% CI 0.62 to 0.98; p = .037).

Conclusions: Among older adults, greater purpose in life is associated with a lower incidence of prediabetes or type 2 diabetes. Strategies to promote greater purpose in life should be tested as a part of type 2 diabetes prevention efforts.

VL - 52 IS - 4 U1 - http://www.ncbi.nlm.nih.gov/pubmed/30084896?dopt=Abstract ER - TY - JOUR T1 - Are older adults living in more equal counties healthier than older adults living in more unequal counties? A propensity score matching approach. JF - Soc Sci Med Y1 - 2015 A1 - Choi, Hwajung A1 - Sarah A. Burgard A1 - Irma Elo A1 - Michele M Heisler KW - Aged KW - Aged, 80 and over KW - Female KW - Health Status Indicators KW - Health Surveys KW - Healthcare Disparities KW - Humans KW - Logistic Models KW - Male KW - Middle Aged KW - Propensity Score KW - Self Report KW - Socioeconomic factors AB -

We assessed the potential contextual effect of income inequality on health by: 1) comparing individuals with similar socioeconomic status (SES) but who reside in counties with different levels of income inequality; and 2) examining whether the potential effect of county-level income inequality on health varies across SES groups. We used the Health and Retirement Study, a nationally representative study of Americans over the age of 50. Using propensity score matching, we selected SES-comparable individuals living in high-income inequality counties and in low-income inequality counties. We examined differences in self-rated overall health outcomes and in other specific physical/mental health outcomes between the two groups using logistic regression (n = 34,994) and imposing different sample restrictions based on residential duration in the area. We then used logistic regression with interactions to assess whether, and if so how, health outcomes differed among participants of different SES groups defined by wealth, income, and education. In bivariate analyses of the unmatched full sample, adults living in high-income inequality counties have worse health outcomes for most health measures. After propensity score matching, adults in high-income inequality counties had worse self-rated health status (AOR = 1.12; 95% CI 1.04-1.19) and were more likely to report diagnosed psychiatric problems (AOR = 1.08; 95% CI 0.99-1.19) than their matched counterparts in low-income inequality counties. These associations were stronger with longer-term residents in the area. Adverse health outcomes associated with living in high-income inequality counties were significant particularly for individuals in the 30(th) or greater percentiles of income/wealth distribution and those without a college education. In summary, after using more precise matching methods to compare individuals with similar characteristics and addressing measurement error by excluding more recently arrived county residents, adults living in high-income inequality counties had worse reported overall physical and mental health than adults living in low-income inequality counties.

PB - 141 VL - 141 N1 - Times Cited: 0 0 U1 - http://www.ncbi.nlm.nih.gov/pubmed/26256736?dopt=Abstract U2 - PMC4550487 U4 - income inequality/Socioeconomic Status/cross-national comparison ER - TY - JOUR T1 - Adults with cardiovascular disease who help others: a prospective study of health outcomes. JF - J Behav Med Y1 - 2013 A1 - Michele M Heisler A1 - Choi, Hwajung A1 - John D Piette A1 - Ann Marie Rosland A1 - Kenneth M. Langa A1 - Stephanie Brown KW - Activities of Daily Living KW - Aged KW - Cardiovascular Diseases KW - depression KW - Female KW - Health Status KW - Helping Behavior KW - Humans KW - Longitudinal Studies KW - Male KW - Middle Aged KW - Prospective Studies KW - Time Factors AB -

Little is known about the health impact of helping behaviors among individuals with high-risk chronic diseases such as cardiovascular disease (CVD). Using a nationally representative, longitudinal survey, we examined the subsequent health of adults with CVD (n = 4,491) who spent time providing non-paid assistance to family and friends outside of their households compared with those who had provided no assistance. After both adjusting for baseline characteristics and using propensity score matching methods, spending up to 200 h over the prior 12 months helping others was associated with lower odds of experiencing a new CVD event or dying in the subsequent 2 years. Providing up to 100 h of assistance was associated with reporting fewer depressive symptoms. This threshold effect raises the question of whether assistance beyond a certain number of hours may impose a burden that mitigates health benefits from helping others. Health care providers could play an important role exploring ways that patients with CVD can provide beneficial levels of assistance to others in their own social networks or communities, thereby possibly also improving their own health.

PB - 36 VL - 36 UR - http://search.proquest.com.proxy.lib.umich.edu/docview/1318045378?accountid=14667 IS - 2 N1 - Copyright - Springer Science Business Media New York 2013 Last updated - 2013-04-30 DOI - 2922261571; 76454332; 69709; BVMD; 22481214; SPVLBVMD108653629414 U1 - http://www.ncbi.nlm.nih.gov/pubmed/22481214?dopt=Abstract U4 - Psychology/Cardiovascular disease/Chronic conditions/caregivers/Depressive Symptoms/health care policy ER - TY - JOUR T1 - Association between cognitive function and social support with glycemic control in adults with diabetes mellitus. JF - J Am Geriatr Soc Y1 - 2009 A1 - Okura, Toru A1 - Michele M Heisler A1 - Kenneth M. Langa KW - Aged KW - Blood Glucose KW - Cognition KW - Cross-Sectional Studies KW - Diabetes Mellitus KW - Female KW - Humans KW - Male KW - Middle Aged KW - Social Support AB -

OBJECTIVES: To examine whether cognitive impairment in adults with diabetes mellitus is associated with worse glycemic control and to assess whether level of social support for diabetes mellitus care modifies this relationship.

DESIGN: Cross-sectional analysis.

SETTING: The 2003 Health and Retirement Study (HRS) Mail Survey on Diabetes and the 2004 wave of the HRS.

PARTICIPANTS: Adults aged 50 and older with diabetes mellitus in the United States (N=1,097, mean age 69.2).

MEASUREMENTS: Glycosylated hemoglobin (HbA1c) level; cognitive function, measured with the 35-point HRS cognitive scale (HRS-cog); sociodemographic variables; duration of diabetes mellitus; depressed mood; social support for diabetes mellitus care; self-reported knowledge of diabetes mellitus; treatments for diabetes mellitus; components of the Total Illness Burden Index related to diabetes mellitus; and functional limitations.

RESULTS: In an ordered logistic regression model for the three ordinal levels of HbA1c (<7.0, 7.0-7.9, >or=8.0 mg/dL), respondents with HRS-cog scores in the lowest quartile had significantly higher HbA1c levels than those in the highest cognitive quartile (adjusted odds ratio=1.80, 95% confidence interval=1.11-2.92). A high level of social support for diabetes mellitus care modified this association; for respondents in the lowest cognitive quartile, those with high levels of support had significantly lower odds of having higher HbA1c than those with low levels of support (1.11 vs 2.87, P=.02).

CONCLUSION: Although cognitive impairment was associated with worse glycemic control, higher levels of social support for diabetes mellitus care ameliorated this negative relationship. Identifying the level of social support available to cognitively impaired adults with diabetes mellitus may help to target interventions for better glycemic control.

PB - 57 VL - 57 IS - 10 U1 - http://www.ncbi.nlm.nih.gov/pubmed/19682129?dopt=Abstract U2 - PMC2810258 U4 - Cognitive Function/Social Support/Diabetes Mellitus/Health care management ER -