%0 Journal Article %J The Journals of Gerontology: Series B %D 2020 %T The Impact of Stressful Life Events on the Incidence of Type 2 Diabetes in U.S. Adults from the Health and Retirement Study. %A Betsy E Smith %A Toni Miles %A Elkins, Jennifer %A Jennifer L. Barkin %A Mark H. Ebell %A Amara E. Ezeamama %K Depressive symptoms %K Diabetes %K Health Factors %K Stress %X

Objectives: We evaluated the association between cumulative stressful life events (SLE) and type of stress (lifetime vs. recent) and incident diabetes (T2DM) in middle-aged U.S. adults.

Methods: Data from the 2006-2014 waves of the Health and Retirement Study (HRS) were analyzed (n = 7956). Stress-related differences in age at T2DM diagnosis were estimated using Cox proportional hazards models.

Results: The adjusted risk of T2DM significantly increased by six percent per unit increase in cumulative SLE (95% CI = 1.03, 1.11), by five percent per unit increase in lifetime stress (95% CI = 1.00, 1.09), and by 23% per unit increase in recent stress (95% CI = 1.12, 1.36). Each level of cumulative SLE (one, two, three, and > four events) and recent stress (one and > two events) compared to no stress was significantly associated with an increased risk of T2DM. Each level of lifetime stress compared to no stress was significantly associated with an elevated risk of T2DM except for three events.

Discussion: Cumulative SLE and type of stress were associated with incident T2DM in middle-aged adults. Reducing the direct effect of stress with management interventions may reduce the indirect effect of developing T2DM and warrants further investigation.

%B The Journals of Gerontology: Series B %V 75 %P 640-649 %G eng %N 3 %R 10.1093/geronb/gby040 %0 Journal Article %J American Journal of Hospice and Palliative Medicine %D 2016 %T In a Longevity Society, Loss and Grief Are Emerging Risk Factors for Health Care Use: Findings From the Health and Retirement Survey Cohort Aged 50 to 70 Years %A Toni Miles %A Joseph C. Allegra %A Amara E. Ezeamama %A Simpson, Cherie %A Kerstin Gerst %A Elkins, Jennifer %K Adult children %K Healthcare %X In a society of long lives, parent and child life can overlap by as much as 50 years. Most children now experience the death of their parents as adults. Many of the 2.5 million deaths each year in the United States are parents. Parental loss is a risk factor for subsequent illness. The Health and Retirement Survey is a representative cohort of persons aged 50 to 70 years. Using the 2010 cohort data, we estimate risk for use of health care after the death of a parent. Loss is a near universal experience in the cohort (87 ). A report of any loss increases risk of health care utilization by 20 to 30 . For a longevity society, preventing loss-related hospitalization is a measurable outcome for bereavement care. %B American Journal of Hospice and Palliative Medicine %I 33 %V 33 %P 41-46 %G eng %N 1 %4 parental Longevity/parent death/health Care Utilization/hospitalization %$ 999999 %R 10.1177/1049909114552125 %0 Journal Article %J Quality of life research : an international journal of quality of life aspects of treatment, care and rehabilitation %D 2016 %T Indicators of resilience and healthcare outcomes: findings from the 2010 health and retirement survey %A Amara E. Ezeamama %A Elkins, Jennifer %A Simpson, Cherie %A Smith, Shaniqua L. %A Joseph C. Allegra %A Toni Miles %K Expectations %K Health Conditions and Status %K Healthcare %X OBJECTIVE: To test the hypothesis that higher levels of resilience indicators are associated with lower overall healthcare utilization (HCU) as well as improvements in self-rated health (SRH), we analyzed a representative sample of 4562 adults 50-70years old enrolled in the US 2010 health and retirement survey. METHODS: Multivariable logistic regression models estimated odds ratios (ORs) and 95 confidence intervals (CIs) for high versus low resilience in relation to HCU and SRH improvements over 2years. Resilience indicators included: cumulative lifetime adversity, social support, global mastery and domain-specific mastery. Cumulative lifetime adversity was defined as 0, 1-2, 3-4 or 5 events. HCU included hospitalization (any vs. none) and physician visits ( 20 vs. 20) over 2years. FINDINGS: Hospitalization odds declined by 25 (OR 0.75, 95 CI 0.64-0.86), odds of 20 physician visits declined by 47 (OR 0.53, 95 CI 0.45-0.63) and the odds of SRH improvement increased by 49 (OR 1.49, 95 CI 1.17-1.88) for respondents with high versus low health mastery. Cumulative lifetime adversity manifested a dose-dependent positive relationship with HCU. Specifically, hospitalization odds was, respectively, 25, 80 and 142 elevated for participants that reported 1-2, 3-4 and 5 versus 0 lifetime adversities. High versus low global, financial and health mastery, respectively, predicted improved SRH, lower physician's visits and hospitalizations. CONCLUSION: In this sample of adults near or in retirement, resilience predicted lower HCU and improved SRH. Resilience is a dynamic state that can be enhanced in adults with positive impacts on subjective well-being and HCU. %B Quality of life research : an international journal of quality of life aspects of treatment, care and rehabilitation %I 25 %V 25 %P 1007-15 %G eng %N 4 %4 Resilience/lifetime adversity/HOSPITALIZATION/subjective well-being %$ 999999 %R 10.1007/s11136-015-1144-y %0 Journal Article %J Qual Life Res %D 2015 %T Population-level impact of loss on survivor mortality risk. %A Joseph C. Allegra %A Amara E. Ezeamama %A Simpson, Cherie %A Toni Miles %K Bereavement %K Female %K Humans %K Longevity %K Male %K Quality of Life %K Risk %K Survivors %X

INTRODUCTION: The loss of a loved one adversely affects the bereaved.

MATERIALS AND METHODS: Using data from the 2010 and 2012 waves of Health and Retirement Study (HRS), we estimate the risk for death in a 2-year span after the loss of a parent, spouse, or child for adults aged 50 to 70 years.

CONCLUSION: A respondent with a loss was twice as likely to die when compared similarly aged persons with no loss (OR 2.32; 95 % CI 1.14, 5.30). Loss of either a parent (OR 1.93; 95 % CI 1.01, 4.07), or a child (OR 1.77; 95 % CI 1.08, 2.96) also increased respondent mortality. This elevated risk persists after adjustment for gender and other high-risk health conditions. Any physical activity reduces survivor death rates during this critical period by more than 85 %.

%B Qual Life Res %I 24 %V 24 %P 2959-61 %8 2015 Dec %G eng %U https://link.springer.com/article/10.1007%2Fs11136-015-1048-x %N 12 %1 http://www.ncbi.nlm.nih.gov/pubmed/26081295?dopt=Abstract %2 PMC4615662 %R 10.1007/s11136-015-1048-x %0 Journal Article %J Family and Community Health %D 2014 %T The Impact of Mid- and Late-Life Loss on Insomnia Findings From the Health and Retirement Study, 2010 Cohort %A Simpson, Cherie %A Joseph C. Allegra %A Amara E. Ezeamama %A Elkins, Jennifer %A Toni Miles %K Adult children %K Health Conditions and Status %X Bereavement and insomnia are both well-documented risk factors for illness. We use cohort data to estimate risk of insomnia after death of a family member among adults aged 50 to 70 years. Each day, 6700 persons die in the United States. During the next 20 years, this number will increase. In this cohort, any loss increases the likelihood of insomnia. The highest rates of insomnia occur among women aged 50 to 59 years; men aged 65 to 70 years, and persons reporting death of a spouse/partner or child. Physical activity reduces this risk by one-third. Bereavement is a public health issue requiring a targeted response. %B Family and Community Health %I 37 %V 37 %P 317-326 %G eng %N 4 %4 insomnia/late-life bereavement/sleep/sleep quality/Spousal bereavement/bereavement/depression %$ 999999 %R 10.1097/fch.0000000000000039