%0 Journal Article %J Sleep Medicine %D 2021 %T Longitudinal effects of nocturnal insomnia symptom subtypes and nonrestorative sleep on the incidence of depression among community-dwelling older adults: Results from the Health and Retirement Study %A Chen, Tuo-Yu %A Saito, Yasuhiko %K depression %K insomnia subtypes %K Older Adults %K temporal effects %X Objective The relationships between different insomnia symptom subtypes and the onset of depression among older adults are inconsistent. It may be that each subtype has a distinct temporal effect on depression not easily captured by the different follow-up intervals used in past studies. We systemically investigated the temporal effects by examining the links between subtypes and the onset of depression at different follow-up intervals among community-dwelling older adults. Methods We used the 2006 wave of the Health and Retirement Study as baseline (n=9,151). The outcome was the onset of depression at 2-year (2008 wave), 4-year (2010 wave), and 6-year (2012 wave) follow-ups. The independent variables were difficulty with falling asleep (initial insomnia), waking up during the night (middle insomnia), waking up too early and being unable to fall asleep again (late insomnia), and nonrestorative sleep at baseline. Factors known to be related to depression among older adults were included as covariates. Results Our findings showed that each insomnia symptom subtype had distinct temporal effects on the onset of depression. It appeared that the effects of initial insomnia may take longer to emerge than indicated in previous studies. Middle insomnia and late insomnia had weak relationships with depression. Nonrestorative sleep predicted the onset of depression at every follow-up period. Conclusions We found that documenting the temporal effects of insomnia symptom subtypes helps both to classify individuals’ insomnia symptoms and predict the onset of depression. We recommend taking temporal effects of insomnia symptom subtypes into account in future investigations and clinical practice. %B Sleep Medicine %V 79 %P 155-163 %@ 1389-9457 %G eng %R https://doi.org/10.1016/j.sleep.2021.01.003 %0 Book Section %B International Handbooks of Population: International Handbook of Health Expectancies %D 2020 %T Microsimulation of Health Expectancies, Life Course Health, and Health Policy Outcomes %A Laditka, Sarah B. %A Laditka, James N. %A Jagger, Carol %E Jagger, Carol %E Eileen M. Crimmins %E Saito, Yasuhiko %E De Carvalho Yokota, Renata Tiene %E Van Oyen, Herman %E Robine, Jean-Marie %K Active life expectancy %K Forecasting %K Health expectancy %K health policy %K Population Health %X Active life expectancy measures life expectancy and the proportions of remaining life with and without disease or disability. Microsimulation, a useful tool for life course research, estimates active life expectancy by simulating individual lifetime health biographies, where the individual's status in one or more outcomes is known for each measured unit of life. In this chapter we describe how researchers use microsimulation to study active life expectancy, focusing on research of the past 20 years. We summarize the microsimulation process. We describe how researchers model current and future population health, calculate new active life expectancy measures, and forecast effects of policy change. We illustrate the application of microsimulation to active life expectancy research with a study of interval need, a measure of need for health care and other services focused on resource use. We describe strengths of microsimulation, considerations regarding its use, and directions for future research. %B International Handbooks of Population: International Handbook of Health Expectancies %I Springer International Publishing %C Basel %V 9 %P 129–138 %@ 978-3-030-37668-0 %G eng %R 10.1007/978-3-030-37668-0_9 %0 Journal Article %J Journals of Gerontology Series A: Biological Sciences & Medical Sciences %D 2019 %T Changing impact of obesity on active life expectancy of older Americans. %A Yuan S Zhang %A Saito, Yasuhiko %A Eileen M. Crimmins %K Health Trajectories %K Longevity %K Obesity %X

BACKGROUND: The rise in the number and earlier age of onset of obese persons has raised critical concerns about consequences of obesity; however, recent evidence suggests that the impact of obesity on health outcomes may have changed. This study aims to assess the change of the impact of obesity on active life expectancy among Americans 70 years and older over almost two decades, 1993-1998 to 2010-2014.

METHODS: For each period, we use three waves of data from the Health and Retirement Study to estimate age-specific transition probabilities between health states. The average number of years active and disabled are calculated with Interpolated Markov Chain software based on estimated transition probabilities.

RESULTS: Overall obesity and severe obesity increased markedly over time yet active life expectancy expanded for all individuals and the increases are greater among the obese and women. Increases in total and active life expectancy occurred because of the changing association of obesity with disability and mortality.

CONCLUSION: Individuals at age 70 in the later period in each weight group could expect to live a smaller proportion of remaining life with ADL disability than those in the earlier period. High levels of obesity continue to have significant adverse effects on the quality of life. The increasing prevalence of severe obesity and the growing number of older persons may result in substantial additional health care needs and costs. Continued effort to improve cardiovascular health is required to control the burden of obesity in later life in an era of rising obesity.

%B Journals of Gerontology Series A: Biological Sciences & Medical Sciences %8 11/2019 %G eng %1 http://www.ncbi.nlm.nih.gov/pubmed/31120111?dopt=Abstract %R 10.1093/gerona/glz133 %0 Journal Article %J Journal of the American Geriatrics Society %D 2019 %T Cognitive Performance Among Older Persons in Japan and the United States %A Saito, Yasuhiko %A Jung K Kim %A Davarian, Shieva %A Hagedorn, Aaron %A Eileen M. Crimmins %K cognitive performance %K Education %K Japan %K Nihon University Japanese Longitudinal Study of Aging %K United States %X OBJECTIVE To compare cognitive performance among Japanese and American persons, aged 68 years and older, using two nationally representative studies and to examine whether differences can be explained by differences in the distribution of risk factors or in their association with cognitive performance. DESIGN Nationally representative studies with harmonized collection of data on cognitive functioning. SETTING Nihon University Japanese Longitudinal Study of Aging and the US Health and Retirement Study. PARTICIPANTS A total of 1953 Japanese adults and 2959 US adults, aged 68 years or older. MEASUREMENTS Episodic memory and arithmetic working memory are measured using immediate and delayed word recall and serial 7s. RESULTS Americans have higher scores on episodic memory than Japanese people (0.72 points on a 20-point scale); however, when education is controlled, American and Japanese people did not differ. Level of working memory was higher in Japan (0.36 on a 5-point scale) than in the United States, and the effect of education on working memory was stronger among Americans than Japanese people. There are no differences over the age of 85 years. CONCLUSION Even with large differences in educational attainment and a strong effect of education on cognitive functioning, the overall differences in cognitive functioning between the United States and Japan are modest. Differences in health appear to have little effect on national differences in cognition. %B Journal of the American Geriatrics Society %G eng %U https://onlinelibrary.wiley.com/doi/abs/10.1111/jgs.16163 %R 10.1111/jgs.16163 %0 Journal Article %J The Journals of Gerontology: Series B %D 2019 %T Religion, Life Expectancy and Disability-Free Life Expectancy Among Older Women and Men in the United States %A Mary Beth Ofstedal %A Chi-Tsun Chiu %A Jagger, Carol %A Saito, Yasuhiko %K Disabilities %K Gender Differences %K Mortality %K Religion %X OBJECTIVES Existing literature shows religion is associated with health and survival separately. We extend this literature by considering health and survival together using a multi-state life table approach to estimate total, disability-free and disabled life expectancy, separately for women and men, for two disability measures, and by two indicators of religion. METHOD Data come from the Health and Retirement Study (1998-2014 waves). Predictors include importance of religion and attendance at religious services. The disability measures are defined by ADLs and IADLs. Models control for sociodemographic and health covariates. RESULTS Attendance at religious services shows a strong and consistent association with life and health expectancy. Men and women who attend services at least once a week (compared to those who attend less frequently or never) have between 1.1 and 5.1 years longer total life expectancy and between 1.0 and 4.3 years longer ADL disability-free life expectancy. Findings for IADL disability are similar. Importance of religion is related to total and disabled life expectancy (both ADL and IADL), but the differentials are smaller and less consistent. Controlling for sociodemographic and health factors does not explain these associations. DISCUSSION By estimating total, disability-free and disabled life expectancy we are able to quantify the advantage of religion for health. Results are consistent with previous studies that have focused on health and mortality separately. %B The Journals of Gerontology: Series B %V 74 %P e107–e118 %G eng %U https://academic.oup.com/psychsocgerontology/article-abstract/74/8/e107/5078835?redirectedFrom=fulltext %N 8 %9 Journal %R 10.1093/geronb/gby098 %0 Journal Article %J Journals of Gerontology Series B: Psychological Sciences & Social Sciences %D 2018 %T Educational Differences in the Prevalence of Dementia and Life Expectancy with Dementia: Changes from 2000 to 2010. %A Eileen M. Crimmins %A Saito, Yasuhiko %A Jung K Kim %A Yuan S Zhang %A Sasson, Isaac %A Mark D Hayward %K Dementia %K Education %K Mortality %X

Objectives: This article provides the first estimates of educational differences in age-specific prevalence, and changes in prevalence over time, of dementia by education levels in the United States. It also provides information on life expectancy, and changes in life expectancy, with dementia and cognitively healthy life for educational groups.

Method: Data on cognition from the 2000 and 2010 Health and Retirement Study are used to classify respondents as having dementia, cognitive impairment without dementia (CIND), or being cognitively intact. Vital statistics data are used to estimate life tables for education groups and the Sullivan method is used to estimate life expectancy by cognitive state.

Results: People with more education have lower prevalence of dementia, more years of cognitively healthy life, and fewer years with dementia. Years spent in good cognition increased for most sex-education groups and, conversely, years spent with dementia decreased for some. Mortality reduction was the most important factor in increasing cognitively healthy life. Change in the distribution of educational attainment has played a major role in the reduction of life with dementia in the overall population.

Discussion: Differences in the burden of cognitive loss by education point to the significant cost of low social status both to individuals and to society.

%B Journals of Gerontology Series B: Psychological Sciences & Social Sciences %V 73 %P S20-S28 %G eng %N suppl_1 %1 http://www.ncbi.nlm.nih.gov/pubmed/29669097?dopt=Abstract %R 10.1093/geronb/gbx135 %0 Journal Article %J SSM Popul Health %D 2016 %T Change in Cognitively Healthy and Cognitively Impaired Life Expectancy in the United States: 2000-2010. %A Eileen M. Crimmins %A Saito, Yasuhiko %A Jung K Kim %X

OBJECTIVE: To determine how cognitively healthy and cognitively impaired life expectancy have changed from 2000 to 2010 among American men and women 65 years of age and over.

METHODS: The prevalence of dementia, cognitive impairment without dementia (CIND), and normal cognition is determined from the nationally representative data from the U.S. Health and Retirement Study (HRS). Mortality rates are from U.S. Decennial Life Table for 2000 and the U.S. annual life table for 2010. Life expectancy by cognitive status is estimated using the Sullivan method.

RESULTS: Most of the increase in life expectancy has been concentrated in cognitively healthy years in this 10 year period. The increase in expected years cognitively intact at age 65, which exceeded that in total life expectancy, was 1.8 for men and 1.6 for women.

CONCLUSION: This study provides evidence suggesting that there has been a compression of cognitive morbidity.

%B SSM Popul Health %V 2 %P 793-797 %8 2016 Dec %G eng %U http://linkinghub.elsevier.com/retrieve/pii/S2352827316301148http://api.elsevier.com/content/article/PII:S2352827316301148?httpAccept=text/plainhttp://api.elsevier.com/content/article/PII:S2352827316301148?httpAccept=text/xml %1 http://www.ncbi.nlm.nih.gov/pubmed/27917398?dopt=Abstract %! SSM - Population Health %R 10.1016/j.ssmph.2016.10.007 %0 Journal Article %J J Aging Health %D 2016 %T A Comparison of Educational Differences on Physical Health, Mortality, and Healthy Life Expectancy in Japan and the United States. %A Chi-Tsun Chiu %A Mark D Hayward %A Saito, Yasuhiko %K Activities of Daily Living %K Age Distribution %K Aged %K Cause of Death %K Cross-Cultural Comparison %K Educational Status %K Employment %K Family Characteristics %K Female %K Health Status %K Health Surveys %K Healthy Lifestyle %K Humans %K Japan %K Life Expectancy %K Life Tables %K Longitudinal Studies %K Male %K Middle Aged %K Regression Analysis %K Retirement %K Sex Distribution %K United States %X

OBJECTIVE: This study examined the educational gradient of health and mortality between two long-lived populations: Japan and the United States.

METHOD: This analysis is based on the Nihon University Japanese Longitudinal Study of Aging and the Health and Retirement Study to compare educational gradients in multiple aspects of population health-life expectancy with/without disability, functional limitations, or chronic diseases, using prevalence-based Sullivan life tables.

RESULTS: Our results show that education coefficients from physical health and mortality models are similar for both Japan and American populations, and older Japanese have better mortality and health profiles.

DISCUSSION: Japan's compulsory national health service system since April 1961 and living arrangements with adult children may play an important role for its superior health profile compared with that of the United States.

%B J Aging Health %V 28 %P 1256-78 %8 2016 10 %G eng %N 7 %1 http://www.ncbi.nlm.nih.gov/pubmed/27590801?dopt=Abstract %R 10.1177/0898264316656505 %0 Journal Article %J International Journal of Population Studies %D 2015 %T Diagnosis and control of hypertension in the elderly populations of Japan and the United States %A Saito, Yasuhiko %A Davarian, Shieva %A Takahashi, Atsuhiko %A Schneider, Edward %A Eileen M. Crimmins %K Blood pressure %K Cross-National %K Health Conditions and Status %K Heart disease %K Hypertension %K Older Adults %X The Japanese have the highest life expectancy in the world while the United States (U.S.) has relatively low life expectancy. Furthermore, the Americans have relatively poorer health compared to the Japanese. Examination of the treatment of specific conditions such as hypertension in these two countries may provide insights into how the health care system con-tributes to the relative health in these two countries. In this study, we focus on the treatment of hypertension, as this is the most common condition requiring therapeutic interventions in se-niors. This study examines hypertension diagnoses and controls in nationally representative samples of the older populations (68 years old or older) of Japan and the U.S. Data come from two nationally representative samples: the Nihon University Japanese Longitudinal Study of Aging (NUJLSOA) (n = 2,309) and the U.S. Health and Retirement (HRS) Study (n = 3,517). The overall prevalence of hypertension is higher in Japan than the U.S. Undiagnosed hyperten-sion is about four times higher in Japan than in the U.S., while the control of blood pressure is more than four times higher in the U.S. than in Japan. Thus, the use of antihypertensive medi-cation is much more frequent and more effective in the U.S. The medical care system seems to be more effective in controlling hypertension in the U.S. than in Japan. This may be due to the more aggressive diagnosis and treatment of hypertension in the U.S. %B International Journal of Population Studies %V 1 %P 19-28 %8 Jul-01-2016 %G eng %U http://ijps.whioce.com/index.php/ijps/article/view/01008 %R 10.18063/IJPS.2015.01.008 %0 Journal Article %J Eur J Epidemiol %D 2010 %T Cross-national comparison of sex differences in health and mortality in Denmark, Japan and the US. %A Oksuzyan, Anna %A Eileen M. Crimmins %A Saito, Yasuhiko %A Angela M O'Rand %A James W Vaupel %A Christensen, Kaare %K Aged %K Aged, 80 and over %K Denmark %K Disability Evaluation %K Female %K Health Status %K Humans %K Japan %K Male %K Middle Aged %K Mortality %K Sex Distribution %K United States %X

The present study aims to compare the direction and magnitude of sex differences in mortality and major health dimensions across Denmark, Japan and the US. The Human Mortality Database was used to examine sex differences in age-specific mortality rates. The Danish twin surveys, the Danish 1905-Cohort Study, the Health and Retirement Study, and the Nihon University Japanese Longitudinal Study of Aging were used to examine sex differences in health. Men had consistently higher mortality rates at all ages in all three countries, but they also had a substantial advantage in handgrip strength compared with the same-aged women. Sex differences in activities of daily living (ADL) became pronounced among individuals aged 85+ in all three countries. Depression levels tended to be higher in women, particularly, in Denmark and the HRS, and only small sex differences were observed in the immediate recall test and Mini-Mental State Exam. The present study revealed consistent sex differentials in survival and physical health, self-rated health and cognition at older ages, whereas the pattern of sex differences in depressive symptoms was country-specific.

%B Eur J Epidemiol %I 25 %V 25 %P 471-80 %8 2010 Jul %G eng %N 7 %L newpubs20101112_Oksuzyan.pdf %1 http://www.ncbi.nlm.nih.gov/pubmed/20495953?dopt=Abstract %2 PMC2903692 %4 cross-national comparison/Activities of Daily Living/Sex Differences/depression/SELF-RATED HEALTH/NUJLSOA/NUJLSOA %$ 23760 %R 10.1007/s10654-010-9460-6 %0 Journal Article %J J Women Aging %D 2008 %T Life with and without heart disease among women and men over 50. %A Eileen M. Crimmins %A Mark D Hayward %A Ueda, Hiroshi %A Saito, Yasuhiko %A Jung K Kim %K Activities of Daily Living %K Aged %K Female %K Health Status %K Heart Diseases %K Humans %K Life Expectancy %K Male %K Middle Aged %K Myocardial Infarction %K Patient Education as Topic %K Prejudice %K Risk Factors %K United States %K Women's Health %K Women's Health Services %X

This article uses a demographic approach and data from the Health and Retirement Survey, a nationally representative sample of the U.S. population, to investigate sex differences in the length of life lived with heart disease and after a heart attack for persons in the United States age 50 and older. On average, women live longer than men with heart disease. At age 50 women can expect to live 7.9 years and men 6.7 years with heart disease. The average woman experiences heart disease onset three years older and heart attacks 4.4 years older than men.

%B J Women Aging %I 20 %V 20 %P 5-19 %8 2008 %G eng %N 1-2 %L newpubs20101112_Crimmins2.pdf %1 http://www.ncbi.nlm.nih.gov/pubmed/18581697?dopt=Abstract %2 PMC2994551 %4 Activities of Daily Living/health Status/Heart disease/life Expectancy/EDUCATION/risk factors/WOMEN %$ 23780 %R 10.1300/j074v20n01_02 %0 Journal Article %J Gerontologist %D 2005 %T The impact of obesity on active life expectancy in older American men and women. %A Sandra L Reynolds %A Saito, Yasuhiko %A Eileen M. Crimmins %K Activities of Daily Living %K Aged %K Female %K Health Status %K Health Surveys %K Humans %K Life Expectancy %K Life Tables %K Logistic Models %K Male %K Markov chains %K Obesity %K Risk Factors %K United States %X

PURPOSE: The purpose of this article is to estimate the effect of obesity on both the length of life and length of nondisabled life for older Americans.

DESIGN AND METHODS: Using data from the first 3 waves of the Asset and Health Dynamics Among the Oldest Old (AHEAD) survey, this article develops estimates of total, active, and disabled life expectancy for obese and nonobese older men and women. We used the Interpolation of Markov Chains (IMaCh) method to estimate the average number of years obese and nonobese older persons can expect to live with and without activity of daily living (ADL) disability.

RESULTS: Our findings indicate that obesity has little effect on life expectancy in adults aged 70 years and older. However, the obese are more likely to become disabled. This means that obese older adults live both more years and a higher proportion of their remaining lives disabled.

IMPLICATIONS: The lack of significant differences in life expectancy by obesity status among the old suggests that obesity-related death is less of a concern than disability in this age range. Given steady increases in obesity among Americans at all ages, future disability rates may be higher than anticipated among older U.S. adults. In order to reduce disability among future cohorts of older adults, more research is needed on the causes and treatment of obesity and evaluations done on interventions to accomplish and maintain weight loss.

%B Gerontologist %I 45 %V 45 %P 438-44 %8 2005 Aug %G eng %N 4 %L pubs_2005_obesity_ale.pdf %1 http://www.ncbi.nlm.nih.gov/pubmed/16051906?dopt=Abstract %4 Disability/Disability/Obesity/Life Expectancy %$ 15170 %R 10.1093/geront/45.4.438