%0 Journal Article %J The American Journal of Geriatric Psychiatry %D 2022 %T The Role of Purpose in Life in the Relationship between Widowhood and Cognitive Decline among Older Adults in the U.S. %A Su Hyun Shin %A Behrens, Emily A. %A Patricia Parmelee %A Kim, Giyeon %K Cognitive decline %K Purpose in life %K Widowhood %X Objectives The objective of this study was to examine the role of purpose in life in the relationship between widowhood and cognitive decline. Methods This study used a sample of 12,856 respondents (20,408 observations) collected from a national panel survey, the 2006-2014 waves of the Health and Retirement Study (HRS), that sampled older adults aged 50 or older. The study estimated growth-curve models with years since spousal death, purpose in life, and interaction between the two to predict cognition using three measures—total cognition, fluid, and crystallized intelligence scores. We also estimated growth-curve models by sex, race/ethnicity, and education. Results While years since spousal death negatively correlated with cognition, purpose in life positively correlated with cognition. Furthermore, purpose in life had a moderating effect on the relationship between years since spousal death and cognition. This effect was found by using total cognition (coef.= 0.0515; z= 2.64; p<0.01) and fluid intelligence scores (coef.= 0.0576; z= 3.23; p<0.05). The same effects were salient among females (coef.= 0.0556; z= 2.19; p<0.05) Whites (coef.= 0.0526; z= 2.52; p<0.05), and older adults with more education (coef.= 0.0635; z= 2.10; p<0.05). Conclusions Higher purpose in life relates to the negative correlations between widowhood and cognition of older adults. Educational programs improving purpose in life are a possible avenue for reducing the adverse effect of widowhood on cognition and warrant future exploration. %B The American Journal of Geriatric Psychiatry %V 30 %P 383-391 %@ 1064-7481 %G eng %N 3 %R 10.1016/j.jagp.2021.07.010 %0 Journal Article %J Gerontologist %D 2021 %T The Role of Polygenic Score and Cognitive Activity in Cognitive Functioning among Older Adults %A Su Hyun Shin %A Park, Soohyun %A Wright, Cheryl %A D’astous, Valerie Anne %A Kim, Giyeon %K Alzheimer’s disease %K Cognition %K Cognitively Stimulating Activity %K Genetics %X This study explored whether the intensity of cognitive activities could moderate the relationship between a genetic predisposition for developing Alzheimer’s disease (AD) and cognitive functioning among older adults in the U.S. Further, we examined whether the same moderating effects were dependent on different measures of cognition.We used a dataset from the 2000-2014 waves of the Health and Retirement Study and the Consumption and Activities Mail Survey. Our sample included 3,793 individuals aged 50 or older. We used the polygenic score (PGS) for AD as a genetic trait for cognitive functioning. Reading, listening to music, using a computer, playing cards/games/solving puzzles, singing/playing musical instruments, and creating art and crafts were included as cognitive activities, and TV viewing as passive activities. We used total cognition, fluid intelligence, and crystallized intelligence as proxies for cognitive functioning. Growth-curve models were conducted.After controlling for covariates, we found that reading books, using a computer, and playing cards/games/solving puzzles had a positive effect on cognitive functioning. An additional hour spent reading books moderated the negative effect of AD PGS on cognition. The measure of fluid, when compared with crystallized intelligence, appeared to drive these results.Reading could be a protective factor against cognitive decline among older adults who are genetically predisposed to developing AD. Implications for individuals, caregivers, clinicians, and policymakers are suggested. Furthermore, the onset of AD in those at a greater genetic risk may be delayed with this intervention. %B Gerontologist %V 61 %P 319-329 %@ 0016-9013 %G eng %N 3 %R 10.1093/geront/gnaa073 %0 Journal Article %J Aging & Mental Health %D 2020 %T The association between the number of chronic health conditions and advance care planning varies by race/ethnicity. %A Shinae L Choi %A Ian M McDonough %A Kim, Minjung %A Kim, Giyeon %K Advance care planning %K Comorbidity %K Racial/ethnic differences %X

OBJECTIVES: Although a national consensus exists on the need to increase the rates of advance care planning (ACP) for all adults, racial/ethnic differences in ACP have been consistently observed. This study investigated the intersection of racial/ethnic differences and the number of chronic health conditions on ACP among middle-aged and older adults in the United States.

METHOD: Responses from 8,926 adults from the 2014 wave of the Health and Retirement Study were entered into multilevel hierarchical logistic regression analyses with generalized linear mixed models to predict ACP focused on assigning a durable power of attorney for healthcare (DPOAHC) and having a written living will after adjusting for covariates.

RESULTS: We found a significant positive relationship between the number of chronic health conditions and ACP. Non-Hispanic Blacks/African Americans and Hispanics were less likely to engage in ACP than non-Hispanic Whites/Caucasians. Racial/ethnic disparities were even starker for completing a living will. The number of chronic health conditions had a greater effect for Hispanics than non-Hispanic Whites/Caucasians on ACP through assigning a DPOAHC and having a living will. The initial disparity in ACP among Hispanics with no chronic health conditions decreased as the number of chronic health conditions increased.

CONCLUSION: Our findings suggest that more chronic health conditions increase the likelihood that Hispanics will complete ACP documents. These ACP differences should be highlighted to researchers, policymakers, and healthcare professionals to reduce stark racial/ethnic disparities in ACP. A comprehensive and culturally caring decision-making approach should be considered when individuals and families engage in ACP.

%B Aging & Mental Health %V 24 %P 453-463 %G eng %U https://www.tandfonline.com/doi/abs/10.1080/13607863.2018.1533521?journalCode=camh20 %N 3 %9 Journal %1 http://www.ncbi.nlm.nih.gov/pubmed/30593253?dopt=Abstract %R 10.1080/13607863.2018.1533521 %0 Journal Article %J FINANCIAL PLANNING REVIEW %D 2019 %T Estate planning among older Americans: The moderating role of race and ethnicity %A Shinae L Choi %A Ian M McDonough %A Kim, Minjung %A Kim, Giyeon %K bequest expectations %K charitable giving %K estate planning %K ethnicity %K race %K valid will %X This study investigated whether race and ethnicity moderated the associations of bequest expectations to leave an inheritance and charitable giving with having a valid will among older Americans. Drawn from the 2014 Health and Retirement Study, we analyzed 13,261 respondents using multilevel logistic regression with generalized linear mixed models. People with higher bequest expectations and more charitable giving were more likely to have a valid will. Ethnic minorities had much lower bequest expectations and much less charitable giving than non-Hispanic Whites, controlling for socioeconomic indicators. Hispanics showed a stronger effect of bequest expectations but a weaker effect of charitable giving on having a valid will compared with non-Hispanic Whites. Our findings reveal novel racial and ethnic disparities in engagement in estate planning among older adults and suggest alternative means are needed to promote interest in estate planning in later life depending on one's racial and ethnic background. %B FINANCIAL PLANNING REVIEW %V 2 %P e1058 %G eng %N 3-4 %R 10.1002/cfp2.1058 %0 Journal Article %J American Journal of Geriatric Psychiatry %D 2019 %T Purpose in life protects against cognitive decline among older adults. %A Kim, Giyeon %A Su Hyun Shin %A Monica A Scicolone %A Patricia Parmelee %K Cognition & Reasoning %K Purpose in life %X

OBJECTIVE: This study examined whether having a sense of purpose in life protects against cognitive decline among older adults and whether purpose in life moderates the relationship between selected risk factors (age, sex, and race/ethnicity) and cognitive abilities.

METHODS: This was a longitudinal analysis of existing secondary data of adults (N = 11,557) aged 50 or older using the 2006-2012 waves of the Health and Retirement Study. The study measured purpose in life, cognitive functioning score, and various covariates.

RESULTS: Growth curve modeling revealed that, after adjusting for covariates, purpose in life was positively associated with participants' total cognition scores. Purpose in life significantly moderated the relationship between age and race/ethnicity and cognitive decline. Further, purpose in life was a protective factor against cognitive decline for those who were older and black. There was no significant interaction between purpose in life and sex.

CONCLUSION: Having a purposeful life protects against cognitive decline in older adults, and the associations varied by age and race/ethnicity, but not by sex. Potential ways to increase purpose in life are discussed in a clinical context.

%B American Journal of Geriatric Psychiatry %V 27 %P 593-601 %G eng %N 6 %1 http://www.ncbi.nlm.nih.gov/pubmed/30824327?dopt=Abstract %R 10.1016/j.jagp.2019.01.010 %0 Journal Article %J Innovation in Aging %D 2019 %T RACIAL-ETHNIC DIFFERENCES IN THE EFFECTS OF POSITIVE AND NEGATIVE AFFECT, AND DEPRESSION ON COGNITIVE TRAJECTORIES %A Park, Soohyun %A Su Hyun Shin %A Rebecca S Allen %A Kim, Giyeon %K Cognition %K cognitive trajectories %K depression %K race %K race-ethnicity %X Purpose of study: This study investigated (1) whether positive affect(PA), negative affect(NA), and depression are related to trajectories of cognitive functioning among older adults, (2) whether PA or NA could moderate the relationship between depression and cognitive trajectories, and (3) whether there are racial/ethnic differences in the relationships among PA, NA, depression and cognitive trajectories. Design and Methods: Growth-curve modeling was conducted using the sample of 10,289 individuals in the U.S. aged 50 or older from the 2006-2014 Health and Retirement Study. Racial/ethnic groups in this study were non-Hispanic Whites (NHW, n=8.009), African Americans (AA, n=1,428), Hispanics (n=611), and others (n=241). Results: After adjusting for covariates, PA showed positive effect, and depression had negative effect on cognitive functioning trajectories (p < .05, z = 8.76, 95% CI= 0.27, 0.43; p < .05, z = -6.38, 95% CI= -0.19, -0.10). Racial/ethnic minorities (i.e., AA, Hispanics, others) exhibited lower cognitive functioning over time compared to NHW. PA significantly moderated the effect of depression on cognitive trajectories (p < .05, z = - 8.04, 95% CI = -0.19, -0.11), and the protective effect of PA against cognitive decline was pronounced for AA (p < .05, z = 2.75, 95% CI = 0.10, 0.63). Conclusion: Findings suggest that PA may protect against cognitive decline in older adults, providing a buffer against the negative effect of depression or racial/ethnic minority status on cognitive trajectories. Potential intervention strategies are discussed to assist older adults in maintaining and improving PA to promote cognitive health. %B Innovation in Aging %V 3 %P S652-S652 %@ 2399-5300 %G eng %N Suppl 1 %R 10.1093/geroni/igz038.2419 %0 Journal Article %J American Journal of Geriatric Psychiatry %D 2018 %T Widowhood Status as a Risk Factor for Cognitive Decline among Older Adults. %A Su Hyun Shin %A Kim, Giyeon %A Park, Soohyun %K Bereavement %K Cognitive Ability %K Risk Factors %K Widowhood %X

OBJECTIVES: This study investigated whether widowhood status has an effect on cognitive decline among older adults in the United States.

DESIGN: Longitudinal analysis of existing secondary data.

SETTING: The 1996-2012 waves of the Health and Retirement Study.

PARTICIPANTS: A total of 6,766 individuals (28,420 observations) aged 50 years and older who responded to all questions.

MEASUREMENTS: Widow/widower status, cognitive functioning score, and various covariates.

RESULTS: Growth-curve models show that after controlling for covariates, widowhood status was related to cognitive decline (95% CI: -0.8090, -0.4674). We also found a linear relationship between time since spousal loss and cognitive decline. Conditional upon spousal bereavement status, higher education and having at least one living sibling were found to be protective factors against cognitive decline.

CONCLUSIONS: Widowhood status accelerated cognitive decline over time among widowed older adults. Findings suggest that extra support is needed to monitor cognitive functioning for those experiencing widowhood.

%B American Journal of Geriatric Psychiatry %V 26 %P 778-787 %8 07/2018 %G eng %N 7 %1 http://www.ncbi.nlm.nih.gov/pubmed/29748078?dopt=Abstract %R 10.1016/j.jagp.2018.03.013 %0 Journal Article %J The American journal of geriatric psychiatry : official journal of the American Association for Geriatric Psychiatry %D 2014 %T Racial/ethnic variations in the relation between body mass index and cognitive function among older adults %A Bryant, Ami N. %A Ford, Katy-Lauren %A Kim, Giyeon %K Demographics %K Health Conditions and Status %K Women and Minorities %X OBJECTIVES: The present study examines racial/ethnic variations in the relation between body mass index (BMI) and cognitive function among older adults. DESIGN: Cross-sectional study of secondary data. SETTING: Data were obtained from the 2010 Health and Retirement Study. PARTICIPANTS: Racial/ethnic groups analyzed were black (n = 546), Hispanic (n = 110), and non-Hispanic white (n = 4,104). MEASUREMENTS: BMI was calculated based on self-reported height and weight. Cognitive function was measured based on Telephone Interview for Cognitive Status-Health and Retirement Study version scores. RESULTS: Significant main effects were found for both BMI and race/ethnicity, indicating that cognitive function varies significantly by both. The BMI race/ethnicity interaction was also found to be significant. The interaction revealed that among the white sample cognitive function scores tended to increase as BMI increased whereas the opposite relation was observed in the Hispanic sample. The black sample displayed a similar pattern as the white sample, although a decrease was observed in cognitive function scores once BMI reached obesity. CONCLUSION: The results suggest that the relation between BMI and cognitive function does vary by race ethnicity. Therefore, it can be concluded that high or low BMI may vary as a risk or protective factor for cognitive dysfunction among older adults by race/ethnicity. Implications for research and clinical work are discussed. %B The American journal of geriatric psychiatry : official journal of the American Association for Geriatric Psychiatry %I 22 %V 22 %P 653-60 %G eng %N 7 %4 Cognitive function/body mass index/racial/ethnic differences/weight/African American/Hispanic %$ 999999 %R 10.1016/j.jagp.2013.08.006