%0 Report %D 2021 %T Heterogenous Trajectories in Physical, Mental and Cognitive Health among Older Americans: Roles of Genetics and Earlier SES %A Hoang, Cung Truong %A Amin, Vikesh %A Behrman, Jere R. %A Hans-Peter Kohler %A Iliana V. Kohler %K Aging trajectories %K childhood socioeconomic status %K polygenic scores %K schooling %X We investigate the roles of genetic predispositions, childhood SES and adult schooling attainment in shaping trajectories for three important components of the overall health and wellbeing of older adults -- BMI, depressive symptoms and cognition. We use the Health & Retirement Study (HRS) and group-based trajectory modelling (GBTM) to identify subgroups of people who share the same underlying trajectories over ages 50-94 years. After identifying common underlying trajectories, we use fractional multinomial logit models to estimate associations of (1) polygenic scores for BMI, depression, ever-smoked, education, cognition and subjective wellbeing, (2) childhood SES and (3) schooling attainment on the probabilities of trajectory group membership. While genetic predispositions do play a part in predicting trajectory group membership, our results highlight the long arm of socioeconomic factors. Schooling attainment is the most robust predictor—it predicts increased probabilities of belonging to trajectories with BMI in the normal rage, low depressive symptoms and high initial cognition. Childhood circumstances are manifested in trajectories to a lesser extent, with childhood SES only predicting the likelihood of being on the low depressive symptoms trajectory. We also find suggestive evidence that associations of schooling attainment on the probabilities of being on trajectories with BMI in the normal rage, low depressive symptoms and high initial cognition vary with genetic predispositions. %B University of Pennsylvania Population Center Working Paper (PSC/PARC) %I University of Pennsylvania %C Philadelphia, PA %G eng %U https://repository.upenn.edu/psc_publications/76/ %0 Journal Article %J SSM - Population Health %D 2020 %T Differences in physical health across populations and their implications for the old-age dependency ratio in high-, middle- and low-income countries %A Fabrice Kämpfen %A Iliana V. Kohler %A Mamadou Bountogo %A James Mwera %A Hans-Peter Kohler %A Jürgen Maurer %K Age/cohort profile of work %K Cross-country comparisons %K Hand-grip strength %K Old-age dependency ratio %K Physical Health %X The standard approach for comparing the potential challenges of population aging across countries based on conventional old-age dependency ratios (OADR) does not account for cross-population differences in health, functional capacity or disability, despite their importance for labor force participation and dependency more broadly. We investigate how OADRs observed across selected low-, middle-, and high-income countries change if population differences in physical health measured by hand-grip strength are accounted for. Specifically, we propose and calculate an adjusted measure of the OADR based on hand-grip strength, which serves as an objective indicator of muscle function and has been shown to predict future morbidity, disability and mortality. We show that adjusting the OADR for differences in hand-grip strength results in substantial changes in country rankings by OADR compared to a ranking based on the conventional OADR definition. Accounting for cross-population differences in hand-grip strength, the estimated OADRs for low- and middle-income countries tend to increase compared to the conventional OADR approach based on age only, whereas the estimated OADRs in high-income countries decline substantially relative to the standard approach. Since hand-grip strength is an important prerequisite for maintaining functional capacity and productivity and preventing disability –especially in economies in low-income settings– our grip-strength-adjusted OADRs clearly show that population aging is not just a challenge in high-income countries but also an important concern for economies in the developing world. %B SSM - Population Health %V 11 %G eng %R 10.1016/j.ssmph.2020.100579