TY - JOUR T1 - WHICH NEIGHBORHOOD FEATURES MATTER MOST FOR MUSCLE STRENGTH? FINDINGS FROM THE HEALTH AND RETIREMENT STUDY JF - Innovation in Aging Y1 - 2022 A1 - Kate A Duchowny A1 - L Grisell Diaz-Ramirez A1 - W John Boscardin A1 - Peggy Cawthon A1 - Maria Glymour A1 - Scarlett Lin Gomez KW - Grip strength KW - Muscle Strength KW - Neighborhood characteristics AB - Linking data from the National Neighborhood Data Archive (NaNDA) to the 2006-2018 Health and Retirement Study (N=22,245), we fit linear mixed models to assess which of 22 built and social neighborhood environment variables predicted grip strength, a measure of total-body muscle strength. Among 22,245 respondents (mean age=63 years, SD=9.2) with up to 4 grip strength measures, neighborhood physical disorder (B= -0.25 kg, 95% CI= -0.37,-0.13), number of parks (B= 0.05 kg, 95% CI= 0.01, 0.10), number of gyms/fitness centers (B=-0.44 kg, 95% CI= -0.82, -0.07), proportion of highly developed land (B=-2.06 kg, 95% CI=-4.06, -0.07), and % urban (B=-0.66 kg, 95% CI=-1.27, -0.05) were associated with grip strength level after adjustment. No social neighborhood variables were associated with grip strength. Although preliminary, findings suggest that highly developed urbanized land may be a barrier to maintaining muscle strength in later life, but resources such as parks are associated with better outcomes. VL - 6 IS - 1Suppl ER - TY - JOUR T1 - Wealth-Associated Disparities in Death and Disability in the United States and England. JF - JAMA Internal Medicine Y1 - 2017 A1 - Lena K Makaroun A1 - Rebecca T Brown A1 - L Grisell Diaz-Ramirez A1 - Cyrus Ahalt A1 - W John Boscardin A1 - Lang-Brown, Sean A1 - Sei J. Lee KW - Cross-National KW - Disabilities KW - Mortality KW - Wealth Inequality AB -

Importance: Low income has been associated with poor health outcomes. Owing to retirement, wealth may be a better marker of financial resources among older adults.

Objective: To determine the association of wealth with mortality and disability among older adults in the United States and England.

Design, Setting, and Participants: The US Health and Retirement Study (HRS) and English Longitudinal Study of Aging (ELSA) are nationally representative cohorts of community-dwelling older adults. We examined 12 173 participants enrolled in HRS and 7599 enrolled in ELSA in 2002. Analyses were stratified by age (54-64 years vs 66-76 years) because many safety-net programs commence around age 65 years. Participants were followed until 2012 for mortality and disability.

Exposures: Wealth quintile, based on total net worth in 2002.

Main Outcomes and Measures: Mortality and disability, defined as difficulty performing an activity of daily living.

Results: A total of 6233 US respondents and 4325 English respondents aged 54 to 64 years (younger cohort) and 5940 US respondents and 3274 English respondents aged 66 to 76 years (older cohort) were analyzed for the mortality outcome. Slightly over half of respondents were women (HRS: 6570, 54%; ELSA: 3974, 52%). A higher proportion of respondents from HRS were nonwhite compared with ELSA in both the younger (14% vs 3%) and the older (13% vs 3%) age cohorts. We found increased risk of death and disability as wealth decreased. In the United States, participants aged 54 to 64 years in the lowest wealth quintile (Q1) (≤$39 000) had a 17% mortality risk and 48% disability risk over 10 years, whereas in the highest wealth quintile (Q5) (>$560 000) participants had a 5% mortality risk and 15% disability risk (mortality hazard ratio [HR], 3.3; 95% CI, 2.0-5.6; P < .001; disability subhazard ratio [sHR], 4.0; 95% CI, 2.9-5.6; P < .001). In England, participants aged 54 to 64 years in Q1 (≤£34,000) had a 16% mortality risk and 42% disability risk over 10 years, whereas Q5 participants (>£310,550) had a 4% mortality risk and 17% disability risk (mortality HR, 4.4; 95% CI, 2.7-7.0; P < .001; disability sHR, 3.0; 95% CI, 2.1-4.2; P < .001). In 66- to 76-year-old participants, the absolute risks of mortality and disability were higher, but risk gradients across wealth quintiles were similar. When adjusted for sex, age, race, income, and education, HR for mortality and sHR for disability were attenuated but remained statistically significant.

Conclusions and Relevance: Low wealth was associated with death and disability in both the United States and England. This relationship was apparent from age 54 years and continued into later life. Access to health care may not attenuate wealth-associated disparities in older adults.

VL - 177 IS - 12 U1 - http://www.ncbi.nlm.nih.gov/pubmed/29059279?dopt=Abstract ER -