%0 Journal Article %J Alzheimers Dement %D 2011 %T National estimates of the prevalence of Alzheimer's disease in the United States. %A Brookmeyer, Ron %A Denis A Evans %A Liesi Hebert %A Kenneth M. Langa %A Steven G Heeringa %A Brenda L Plassman %A Walter Kukull %K Age Factors %K Alzheimer disease %K Community Health Planning %K Data collection %K Humans %K Incidence %K Models, Statistical %K Prevalence %K Sampling Studies %K United States %X

Several methods of estimating prevalence of dementia are presented in this article. For both Brookmeyer and the Chicago Health and Aging project (CHAP), the estimates of prevalence are derived statistically, forward calculating from incidence and survival figures. The choice of incidence rates on which to build the estimates may be critical. Brookmeyer used incidence rates from several published studies, whereas the CHAP investigators applied the incidence rates observed in their own cohort. The Aging, Demographics, and Memory Study (ADAMS) and the East Boston Senior Health Project (EBSHP) were sample surveys designed to ascertain the prevalence of Alzheimer's disease and dementia. ADAMS obtained direct estimates by relying on probability sampling nationwide. EBSHP relied on projection of localized prevalence estimates to the national population. The sampling techniques of ADAMS and EBSHP were rather similar, whereas their disease definitions were not. By contrast, EBSPH and CHAP have similar disease definitions internally, but use different calculation techniques, and yet arrive at similar prevalence estimates, which are considerably greater than those obtained by either Brookmeyer or ADAMS. Choice of disease definition may play the larger role in explaining differences in observed prevalence between these studies.

%B Alzheimers Dement %I 7 %V 7 %P 61-73 %8 2011 Jan %G eng %N 1 %L newpubs20110328_Brookmeyer.pdf %1 http://www.ncbi.nlm.nih.gov/pubmed/21255744?dopt=Abstract %2 PMC3052294 %4 Alzheimer disease/Dementia/Cognitive impairment/Prevalence/Population-based/Projection/Probability/sampling %$ 24580 %R 10.1016/j.jalz.2010.11.007 %0 Journal Article %J Gerontologist %D 2011 %T Recruitment and retention of minority participants in the health and retirement study. %A Mary Beth Ofstedal %A David R Weir %K Aged %K Biomarkers %K Black or African American %K Female %K Health Promotion %K Health Surveys %K Hispanic or Latino %K Humans %K Male %K Middle Aged %K Minority Groups %K Minority health %K National Health Programs %K Patient Dropouts %K Patient Selection %K Retirement %K Sampling Studies %K Surveys and Questionnaires %K United States %X

PURPOSE: Minority oversamples of African Americans and Hispanics have been a key feature of the Health and Retirement Study (HRS) design from its origins in 1992. The objective of this article was to assess the quality of the HRS with respect to the recruitment and retention of minority respondents.

DESIGN AND METHODS: To evaluate minority recruitment efforts, we examine baseline response rates for the early baby boom cohort that was added in the 2004 wave and the representativeness of this cohort with regard to demographic, socioeconomic, and health characteristics. To evaluate retention, we focus on minority differentials in 2008 interview, nonresponse and mortality outcomes for the full HRS sample. We also examine minority differentials in participation in supplemental components of the HRS.

RESULTS: Minority response rates at baseline and in longitudinal follow-ups for the main HRS interview have been equal to or better than that of majority Whites. Conversely, response rates to some specific supplemental components have been lower for minority sample members.

IMPLICATIONS: The oversample strategies that the HRS has employed have been successful at identifying and recruiting minority participants at response rates very comparable with that of Whites and others. Minority differentials in participation in supplemental components have been overcome to some extent through interviewer training and targeted follow-up strategies. The HRS experience suggests that well-trained interviewers can overcome most if not all of whatever race and ethnic differentials exist in willingness to participate in surveys, including those involving biological data collection.

%B Gerontologist %I 51 Suppl 1 %V 51 Suppl 1 %P S8-20 %8 2011 Jun %G eng %N Suppl 1 %1 http://www.ncbi.nlm.nih.gov/pubmed/21565822?dopt=Abstract %2 PMC3106365 %R 10.1093/geront/gnq100 %0 Journal Article %J J Gerontol B Psychol Sci Soc Sci %D 2009 %T Statistical design and estimation for the national social life, health, and aging project. %A O'Muircheartaigh, Colm %A Eckman, Stephanie %A Smith, Stephen %K Aged %K Aged, 80 and over %K Aging %K Bias %K Data collection %K Data Interpretation, Statistical %K Female %K Health Status %K Health Surveys %K Humans %K Longitudinal Studies %K Male %K Mass Screening %K Middle Aged %K Research Design %K Sampling Studies %K Sexual Behavior %K Social Behavior %K United States %X

OBJECTIVES: The paper discusses the sample design of the National Social Life, Health, and Aging Project (NSHAP) and how the design affects how estimates should be calculated from the survey data. The NSHAP study allows researchers to study the links between sexuality and health in older adults. The goal of the design was to represent adults aged 57-85 years in six demographic domains.

METHODS: The sample design begins with a national area probability sample of households, carried out jointly with the 2004 round of the Health and Retirement Study. Selection of respondents for NSHAP balanced age and gender subgroups and oversampled African Americans and Latinos. Data collection was carried out from July 2005 to March 2006.

RESULTS: The survey obtained an overall response rate of 75.5%.

DISCUSSION: The complex sample design requires that the selection probabilities and the field implementation be accounted for in estimating population parameters. The data set contains weights to compensate for differential probabilities of selection and response rates among demographic groups. Analysts should use weights in constructing estimates from the survey and account for the complex sample design in estimating standard errors for survey estimates.

%B J Gerontol B Psychol Sci Soc Sci %I 64B %V 64 Suppl 1 %P i12-9 %8 2009 Nov %G eng %N Suppl 1 %L newpubs20091202_OMuircheartaigh.pdf %1 http://www.ncbi.nlm.nih.gov/pubmed/19567827?dopt=Abstract %2 PMC2763522 %4 Survey Methods/Statistics and Numerical Data/Demographics %$ 21180 %R 10.1093/geronb/gbp045 %0 Journal Article %J Am J Epidemiol %D 2009 %T Trajectories of cognitive function in late life in the United States: demographic and socioeconomic predictors. %A Arun S Karlamangla %A Miller-Martinez, Dana %A Carol S Aneshensel %A Teresa Seeman %A Richard G Wight %A Joshua Chodosh %K Aged %K Aged, 80 and over %K Aging %K Black or African American %K Cognition %K Confidence Intervals %K Education %K Female %K Geriatric Assessment %K Hispanic or Latino %K Humans %K Income %K Male %K Marital Status %K Mexican Americans %K Poverty %K Sampling Studies %K Socioeconomic factors %K Surveys and Questionnaires %K United States %K White People %X

This study used mixed-effects modeling of data from a national sample of 6,476 US adults born before 1924, who were tested 5 times between 1993 and 2002 on word recall, serial 7's, and other mental status items to determine demographic and socioeconomic predictors of trajectories of cognitive function in older Americans. Mean decline with aging in total cognition score (range, 0-35; standard deviation, 6.00) was 4.1 (0.68 standard deviations) per decade (95% confidence interval: 3.8, 4.4) and in recall score (range, 0-20; standard deviation, 3.84) was 2.3 (0.60 standard deviations) per decade (95% confidence interval: 2.1, 2.5). Older cohorts (compared with younger cohorts), women (compared with men), widows/widowers, and those never married (both compared with married individuals) declined faster, and non-Hispanic blacks (compared with non-Hispanic whites) and those in the bottom income quintile (compared with the top quintile) declined slower. Race and income differences in rates of decline were not sufficient to offset larger differences in baseline cognition scores. Educational level was not associated with rate of decline in cognition scores. The authors concluded that ethnic and socioeconomic disparities in cognitive function in older Americans arise primarily from differences in peak cognitive performance achieved earlier in the life course and less from declines in later life.

%B Am J Epidemiol %I 170 %V 170 %P 331-42 %8 2009 Aug 01 %G eng %N 3 %L newpubs20090908_Karlamangla.pdf %1 http://www.ncbi.nlm.nih.gov/pubmed/19605514?dopt=Abstract %2 PMC2727175 %4 Cognition/health outcomes/Socioeconomic Factors %$ 20810 %R 10.1093/aje/kwp154 %0 Journal Article %J Am J Epidemiol %D 2007 %T Childhood social and economic well-being and health in older age. %A Sandra Y. Moody-Ayers %A Lindquist, Karla %A Sen, Saunak %A Kenneth E Covinsky %K Aged %K Aged, 80 and over %K Black or African American %K Child %K Confidence Intervals %K Educational Status %K Female %K Frail Elderly %K Health Status %K Health Status Indicators %K Hispanic or Latino %K Humans %K Male %K Middle Aged %K Mobility Limitation %K Odds Ratio %K Poverty %K Retrospective Studies %K Sampling Studies %K San Francisco %K Socioeconomic factors %K Surveys and Questionnaires %K White People %X

Childhood socioeconomic status (SES) acts over a lifetime to influence adult health outcomes. Whether the impact of childhood SES differs by age or race/ethnicity is unclear. The authors studied 20,566 community-living US adults aged > or =50 years. Parental education was the main predictor. Outcomes evaluated (1998-2002) included self-reported health and functional limitation. The influence of childhood SES on later-life health was also examined in groups stratified by age and race/ethnicity, with adjustment for demographic factors and current SES. Participants' mean age was 67 years; 57% were women. By race/ethnicity, 76% were White, 14% were Black, and 8% were Latino. The relation between low parental education and fair/poor self-rated health declined with advancing age (age 50-64 years: adjusted odds ratio (AOR) = 1.42, 95% confidence interval (CI): 1.24, 1.63; age > or =80 years: AOR = 1.14, 95% CI: 0.96, 1.36). The relation between low parental education and fair/poor self-rated health differed across racial/ethnic groups and was significant in White (AOR = 1.33, 95% CI: 1.21, 1.47) and Black (AOR = 1.37, 95% CI: 1.14, 1.64) participants but not Latinos. These findings suggest that childhood SES affects health status through midlife but the effects may abate in late life; its effects also may be weaker in Latinos than in Whites or Blacks.

%B Am J Epidemiol %I 166 %V 166 %P 1059-67 %8 2007 Nov 01 %G eng %N 9 %L newpubs20071203_ChildSES_AJE.pdf %1 http://www.ncbi.nlm.nih.gov/pubmed/17720682?dopt=Abstract %4 childhood conditions/Socioeconomic Status/health status/Activities of Daily Living/Mobility Difficulty/Frail Elderly %$ 18270 %R 10.1093/aje/kwm185 %0 Journal Article %J Med Care %D 2003 %T Racial disparities in joint replacement use among older adults. %A Dorothy D Dunlop %A Larry M Manheim %A Song, Jing %A Rowland W Chang %K Aged %K Aged, 80 and over %K Arthroplasty, Replacement %K Black or African American %K Cohort Studies %K Data Interpretation, Statistical %K Health Services Accessibility %K Health Services Needs and Demand %K Health Status %K Health Surveys %K Hispanic or Latino %K Humans %K Interviews as Topic %K Osteoarthritis %K Sampling Studies %K United States %K White People %X

BACKGROUND: Although joint replacement can restore function for arthritis patients with severe joint disease, this procedure has not been used equally across racial groups. Differences in joint replacement use are assessed from a national sample.

OBJECTIVE: This study evaluates the role of health conditions and economic access to explain differences in joint replacement among older black and Hispanic minorities relative to white persons.

DESIGN: Longitudinal (1993-1995) Asset and Health Dynamics Among the Oldest Old (AHEAD) study.

SETTING: National probability sample of US community-dwelling older adults.

PATIENT POPULATION: AHEAD participants (n = 6159) aged 69 to 103 years.

MEASUREMENTS: The outcome is subject-reported 2-year use of any arthritis-related joint-replacement. Independent variables are demographics, health needs (arthritis, other medical conditions, functional health), and economic access (income, assets, education, and health insurance).

RESULTS: Older minorities reported arthritis-related joint replacements (black: 0.98%; Hispanic: 0.97%, annually) less frequently compared with white persons (1.48% annually). Older minorities were significantly less likely to use joint replacement compared with white persons (OR, 0.37; 95% CI, 0.20, 0.71) controlling for demographics, and arthritis and other health needs. Disparities remained significant (OR, 0.46; 95% CI, 0.22, 0.98) after additionally controlling for economic medical access. Use was lower among people who depended solely on Medicare compared with those with supplemental health insurance (OR, 0.46; 95% CI, 0.22, 0.95).

CONCLUSIONS: These national data document low rates of arthritis-related joint replacement among older Hispanic persons comparable to black persons. Less use among older minorities compared with white persons is not explained by differences in health needs or economic access. Other cultural and attitudinal factors merit investigation to explain disparities.

%B Med Care %I 41 %V 41 %P 288-98 %8 2003 Feb %G eng %N 2 %1 http://www.ncbi.nlm.nih.gov/pubmed/12555056?dopt=Abstract %4 Arthritis/Health Care/Racial disparities %$ 10172 %R 10.1097/01.MLR.0000044908.25275.E1 %0 Journal Article %J J Gerontol B Psychol Sci Soc Sci %D 2001 %T The role of job-related rewards in retirement planning. %A Karl Kosloski %A David J Ekerdt %A Stanley DeViney %K Career Mobility %K Decision making %K Employment %K Factor Analysis, Statistical %K Female %K Florida %K Health Surveys %K Humans %K Interpersonal Relations %K Job Satisfaction %K Male %K Middle Aged %K Models, Psychological %K Planning Techniques %K Regression Analysis %K Retirement %K Reward %K Salaries and Fringe Benefits %K Sampling Studies %X

The authors used data from the first wave of the Health and Retirement Study ( F. Juster and R. Suzman 1995) to evaluate whether certain job-related gratifications might reduce retirement planning. Three definitions of retirement planning were evaluated and then regressed separately on a set of variables that included 3 types of job-related satisfactions (intrinsic gratification, positive social relations, and ascendance in the workplace) and 7 covariates: education, age, sex, health, marital status, race, and pension eligibility. Findings indicated that jobs high in ascendance were related to an increase in certain types of retirement planning, but jobs high in intrinsic rewards and positive social relations were related to less planning, regardless of how planning was defined. The findings suggest that information about work-related rewards may be useful in targeting individuals who might benefit from retirement planning programs, in developing planning programs to help workers realize more complex retirement plans, and in assisting employers who hope to retain older workers.

%B J Gerontol B Psychol Sci Soc Sci %I 56B %V 56 %P P160-9 %8 2001 May %G eng %N 3 %L pubs_1997_Kosloski_KJGSeriesB.pdf %1 http://www.ncbi.nlm.nih.gov/pubmed/11316834?dopt=Abstract %4 Job Satisfaction/Retirement Planning/Health Status %$ 8460 %R 10.1093/geronb/56.3.p160 %0 Journal Article %J Int J Aging Hum Dev %D 2000 %T Older adults and financial bequests. %A Goetting, Marsha A. %A Peter Martin %A Johnson, Christine %K Activities of Daily Living %K Age Factors %K Aged %K Aged, 80 and over %K Aging %K Attitude %K Female %K Health Care Costs %K Health Status %K Humans %K Male %K Mental Health %K Michigan %K Models, Economic %K Sampling Studies %K Sex Factors %K Socioeconomic factors %K Spouses %K Surveys and Questionnaires %K Wills %X

Using data from Aging and Health Dynamics (AHEAD), this research investigated a model predicting an older adult's assessment regarding the chances (from 0 to 100) of leaving a financial bequest. Structural equation modeling analyses revealed three significant predictors of a high assessment (i.e., older age, high sense of control, and high socioeconomic status) and three predictors of a low assessment (i.e., race, physical health problems, and assessment of the chances of medical expenses depleting savings). Whites had higher financial bequests assessments than non-Whites. Physical health problems and the depleting savings assessment exerted negative effects on the financial bequest assessment. Marital status and negative psychological functioning exerted indirect effects through sense of control and through the depleting savings assessment.

%B Int J Aging Hum Dev %I 50 %V 50 %P 227-44 %8 2000 %G eng %N 3 %L wp_2000/Goetting.pdf %1 http://www.ncbi.nlm.nih.gov/pubmed/10987344?dopt=Abstract %4 Racial Differences Bequests/Inheritance %$ 16270 %R 10.2190/AJJ3-AVG7-QKMW-R21R %0 Journal Article %J Demography %D 1999 %T Parental marital disruption and intergenerational transfers: an analysis of lone elderly parents and their children. %A Liliana E Pezzin %A Barbara Steinberg Schone %K Activities of Daily Living %K Adult %K Aged %K Analysis of Variance %K Caregivers %K Chi-Square Distribution %K Divorce %K Family %K Father-Child Relations %K Female %K Financial Support %K Frail Elderly %K Home Nursing %K Humans %K Intergenerational Relations %K Loneliness %K Male %K Marriage %K Parent-Child Relations %K Parents %K Sample Size %K Sampling Studies %K Socioeconomic factors %X

Although one of the most marked demographic trends observed over the twentieth century is the increased rate of divorce, relatively little research has explored the effects of these changing marital patterns in the context of an aging society. Using a sample of lone elderly parents and their adult children, we analyze the direct and indirect effects of marital disruption on four important dimensions of intergenerational transfers: coresidence, financial assistance, adult children's provision of informal care, and parental purchase of paid care. Our findings suggest that divorce has deleterious effects on intergenerational transfers, particularly for elderly fathers. Remarriage further reduces exchange. Our results reveal that parents engage in lower levels of transfers with stepchildren relative to biological children. Moreover, intergenerational transfers are sensitive to characteristics of biological children but not to those of stepchildren. Taken together, these results suggest that exchange at the end of the life course continues to be adversely affected by marital disruption.

%B Demography %I 36 %V 36 %P 287-97 %8 1999 Aug %G eng %N 3 %L pubs_1999_Pezzin_LDemog.pdf %1 http://www.ncbi.nlm.nih.gov/pubmed/10472494?dopt=Abstract %4 Marriage/Marital Dissolution/Family Structure/Economics of the Elderly/Fertility/Child Care/Children/Youth/Aging/Children/Demographics/Divorce/Elderly/Marital/Parent %$ 1094 %0 Journal Article %J J Health Care Poor Underserved %D 1996 %T Physical activity and smoking: gender comparisons among older African American adults. %A Lockery, Shirley A. %A Stanford, E. Percil %K Age Factors %K Black or African American %K Education %K Exercise %K Female %K Humans %K Income %K Male %K Marital Status %K Middle Aged %K Risk Factors %K Sampling Studies %K Sex Factors %K Smoking %K Smoking cessation %X

Little effort has been expended on the examination of systematic health risk behaviors among adult African Americans by gender. Using data from the national Health and Retirement Study (HRS), this article compares differences between male and female physical activity and smoking behaviors of African Americans aged 50 to 61. The analysis highlights a clear pattern of socioeconomic differences with current male smokers, who are more likely to be unmarried and in the lower income and educational levels. Among women, the relationship between smoking patterns, income, and education is less definitive and consistent. Our findings, confirmed by earlier studies, indicate that the largest percentage of the study population, both male and female, are not engaged in any form of regular physical exercise. Thus human service providers must be more attentive to gender and sociodemographic differences in smoking habits and patterns of physical activities to tailor policies and programs accordingly.

%B J Health Care Poor Underserved %I 7 %V 7 %P 232-51 %8 1996 Aug %G eng %N 3 %1 http://www.ncbi.nlm.nih.gov/pubmed/8768467?dopt=Abstract %4 Smoking/Sex Differences/Health Behavior/Middle Aged Adults/Exercise/African-Americans %$ 1282 %R 10.1353/hpu.2010.0617