%0 Journal Article %J Omega %D Forthcoming %T The Effects of Religiosity on Depression Trajectories After Widowhood. %A Hawes, Frances M %A Jane Tavares %A Corina R Ronneberg %A Miller, Edward Alan %K depression %K Depressive symptoms %K religiosity %K Social Support %K Widowhood %X

This longitudinal study analyzed data from the 2006-2016 waves of the nationally representative Health and Retirement Study (HRS). Trajectories of depression among older adults ≥ 50 years ( = 1254) were examined over time to explore patterns of depression among those entering widowhood and the potential impact of religiosity on depressive symptoms during various stages of widowhood. Ordinary least squares (OLS) regression analysis was used to examine the association between widowhood and depression and the role of religiosity as a moderator of this association. Older adults experienced a statistically significant increase in depressive symptomology after the onset of widowhood, and depressive symptomology decreased post widowhood, but did not return to pre-widowhood levels. Additionally, high religious service attendance and higher intrinsic religiosity were both associated with lower depressive symptomology. High religious service attendance moderated the relationship between widowhood and depression among widowed older adults living alone.

%B Omega %G eng %R 10.1177/00302228211051509 %0 Journal Article %J Alzheimers & dementia: the journal of the Alzheimer's Association %D Forthcoming %T An outcome-wide analysis of the effects of diagnostic labeling of Alzheimer's disease and related dementias on social relationships. %A Amano, Takashi %A Halvorsen, Cal J %A Kim, Seoyoun %A Reynolds, Addam %A Scher, Clara %A Jia, Yuane %K diagnostic label of dementia %K Health and Retirement Study (HRS) %K outcome-wide analysis %K Propensity score analysis %K social engagement %K social network %K Social Support %X

INTRODUCTION: This study examines how receiving a dementia diagnosis influences social relationships by race and ethnicity.

METHODS: Using data from the Health and Retirement Study (10 waves; 7,159 observations) of adults 70 years and older predicted to have dementia using Gianattasio-Power scores (91% accuracy), this study assessed changes in social support, engagement, and networks after a dementia diagnosis. We utilized quasi-experimental methods to estimate treatment effects and subgroup analyses by race/ethnicity.

RESULTS: A diagnostic label significantly increased the likelihood of gaining social support but reduced social engagement and one measure of social networks. With some exceptions, the results were similar by race and ethnicity.

DISCUSSION: Results suggest that among older adults with assumed dementia, being diagnosed by a doctor may influence social relationships in both support-seeking and socially withdrawn ways. This suggests that discussing services and supports at the time of diagnosis is important for healthcare professionals.

%B Alzheimers & dementia: the journal of the Alzheimer's Association %G eng %R 10.1002/alz.13574 %0 Journal Article %J Journal of Applied Gerontology %D Forthcoming %T Religious Involvement and the Impact on Living Alone and Depression: An Examination of Gendered Pathways Post-Widowhood. %A Hawes, Frances M %A Tavares, Jane L %K depression %K gender %K Religion %K Social Support %K Widows %X

This study analyzed data from the nationally representative Health and Retirement Study (HRS) to examine the association between widowhood and depression. The results revealed that both men and women experienced increased depression after widowhood, with women exhibiting a better recovery pattern over time. Religiosity, especially attending religious services, was found to be a beneficial coping mechanism for both genders, although men were less religious than women. Living alone was a significant factor associated with depression in widowhood for both men and women. High religious service attendance moderated the association between living alone and depression for women, while both high and moderate religious service attendance moderated this association for men. These findings emphasize the importance of considering gender differences and the potential benefits of religious involvement in addressing depression during widowhood, highlighting the need for tailored interventions and support services for widows and widowers, particularly those living alone.

%B Journal of Applied Gerontology %P 7334648231225355 %G eng %R 10.1177/07334648231225355 %0 Journal Article %J Aging Ment Health %D 2023 %T Aging alone and financial insecurity predict depression: a path analysis of objective and subjective indices. %A Choi, Shinae L %A Choi, Jaimie M %A McDonough, Ian M %A Jiang, Zhehan %A Black, Sheila R %K Depressive symptoms %K financial insecurity %K Living Alone %K social isolation %K Social Support %X

OBJECTIVES: This study draws on conservation of resources theory and transactional stress theory to guide our understanding of how social isolation, financial insecurity, and social support serve as a balance of both risk and protection for late-life depression.

METHODS: Data were from the Leave-Behind Questionnaire in the 2016 ( = 4293) and 2018 ( = 4714) waves of the Health and Retirement Study. We conducted a cross-sectional path analysis via structural equation modeling, including objective and subjective perspectives. The same model was tested in both samples.

RESULTS: Both social isolation and financial insecurity were associated with depression. We found several mediating risks and protective factors of these relationships. Objective financial status affected depression through both perceived financial insecurity and perceived social isolation, whereas objective isolation affected depression through perceived social support. This mediation model was -significant after adjusting for confounders.

CONCLUSION: This study underscores the importance of investigating the balance between risk and protection for depression, in the rising number of older adults aging alone in society. Findings suggest that objective and perceived measures offer unique windows into psychological constructs. Considering both objective and subjective perspectives may provide alternative targets for subsequent interventions to improve mental health in later life.

%B Aging Ment Health %P 1-10 %G eng %R 10.1080/13607863.2023.2243446 %0 Journal Article %J Behavioral Medicine %D 2023 %T Health Behavior Changes after a Diabetes Diagnosis: The Moderating Role of Social Support. %A Qin, Weidi %K Diabetes %K Health Behavior %K Self-efficacy %K Social Support %X

The present study aims to investigate the relationship between a diagnosis of diabetes and health behavior changes among middle-aged and older adults, and whether self-efficacy and social support moderate the relationship. The study sample was selected from the 2006 to 2016 waves of the Health and Retirement Study (N = 13,143). A diagnosis of diabetes was ascertained by self-reported physician-diagnosed condition. Self-efficacy was measured using a 5-item scale. Social support from family and friends was measured separately by a same 3-item scale. Three health behaviors were assessed, including drinking, smoking, and physical activity. Mixed-effects regression models were conducted to test the study aims. Findings showed that participants reduced drinking after a diagnosis of diabetes. A significant interaction between social support from family and a diabetes diagnosis was found in predicting drinking reduction and smoking cessation. These findings suggest that a diagnosis of diabetes may trigger individuals' motivation to initiate health-promoting behaviors. Mobilizing social support from family may help individuals adopt health-promoting behaviors and manage diabetes after a diagnosis.

%B Behavioral Medicine %V 49 %P 292-301 %G eng %N 3 %R 10.1080/08964289.2022.2050670 %0 Journal Article %J The American Journal of Psychiatry %D 2023 %T Polygenic Risk and Social Support in Predicting Depression Under Stress. %A Cleary, Jennifer L %A Fang, Yu %A Zahodne, Laura B %A Bohnert, Amy S B %A Burmeister, Margit %A Sen, Srijan %K depression %K Risk Factors %K Social Environment %K Social Support %K Stress %X

OBJECTIVE: Despite substantial progress in identifying genomic variation associated with major depression, the mechanisms by which genomic and environmental factors jointly influence depression risk remain unclear. Genomically conferred sensitivity to the social environment may be one mechanism linking genomic variation and depressive symptoms. The authors assessed whether social support affects the likelihood of depression development differently across the spectrum of genomic risk in two samples that experienced substantial life stress: 1,011 first-year training physicians (interns) in the Intern Health Study (IHS) and 435 recently widowed Health and Retirement Study (HRS) participants.

METHODS: Participants' depressive symptoms and social support were assessed with questionnaires that were administered before and after the life stressor. Polygenic risk scores (PRSs) for major depressive disorder were calculated for both samples.

RESULTS: Depressive symptom scores increased by 126% after the start of internship in the IHS sample and by 34% after widowing in the HRS sample. There was an interaction between depression PRS and change in social support in the prediction of depressive symptoms in both the IHS sample (incidence rate ratio [IRR]=0.96, 95% CI=0.93, 0.98) and the HRS sample (IRR=0.78, 95% CI=0.66, 0.92), with higher depression PRS associated with greater sensitivity to changes in social support. Johnson-Neyman intervals indicated a crossover effect, with losses and gains in social support moderating the effect of PRS on depressive symptoms. (Johnson-Neyman interval in the IHS sample, -0.02, 0.71; in the HRS sample, -0.49, 1.92).

CONCLUSIONS: The study findings suggest that individuals with high genomic risk for developing increased depressive symptoms under adverse social conditions also benefit more from nurturing social environments.

%B The American Journal of Psychiatry %V 180 %P 139-145 %G eng %N 2 %R 10.1176/appi.ajp.21111100 %0 Journal Article %J Brain, behavior and immunity %D 2023 %T Social relationships and epigenetic aging in older adulthood: Results from the Health and Retirement Study. %A Rentscher, Kelly E %A Klopack, Eric T %A Crimmins, Eileen M %A Seeman, Teresa E %A Cole, Steve W %A Carroll, Judith E %K biological aging %K DNA Methylation %K epigenetic clock %K Social Relationships %K Social strain %K Social Support %X

Growing evidence suggests that social relationship quality can influence age-related health outcomes, although how the quality of one's relationships directly relates to the underlying aging process is less clear. We hypothesized that the absence of close relationships as well as lower support and higher strain within existing relationships would be associated with an accelerated epigenetic aging profile among older adults in the Health and Retirement Study. Adults (N = 3,647) aged 50-100 years completed ratings of support and strain in relationships with their spouse, children, other family members, and friends. They also provided a blood sample that was used for DNA methylation profiling to calculate a priori-specified epigenetic aging measures: Horvath, Hannum, PhenoAge, GrimAge, and Dunedin Pace of Aging methylation (DunedinPoAm38). Generalized linear models that adjusted for chronological age, sex, and race/ethnicity and applied a false discovery rate correction revealed that the absence of marital and friend relationships related to an older GrimAge and faster DunedinPoAm38. Among those with existing relationships, lower support from a spouse, child, other family, and friends and higher strain with friends related to an older PhenoAge and GrimAge and faster DunedinPoAm38. In secondary analyses that further adjusted for socioeconomic and lifestyle factors, lower support from other family members and friends was associated with greater epigenetic aging. Findings suggest that the absence of close relationships and lower support within existing relationships-particularly with family members and friends-relate to accelerated epigenetic aging in older adulthood, offering one mechanism through which social relationships might influence risk for age-related declines and disease.

%B Brain, behavior and immunity %V 114 %P 349-359 %G eng %R 10.1016/j.bbi.2023.09.001 %0 Journal Article %J Journal of Social and Personal Relationships %D 2023 %T Social support and social strain from children and subsequent health and well-being among older U.S. adults %A Renae Wilkinson %A Julia S. Nakamura %A Eric S. Kim %A Tyler J. VanderWeele %K children %K Social strain %K Social Support %X Social relationships contribute to well-being across the life course and may be especially vital resources for supporting healthy aging among older adults. This research examined associations between perceptions of social support and social strain from children assessed by older adult parents and 35 indicators of physical, behavioral, and psychosocial health and well-being. We utilized three waves of data from the Health and Retirement Study (HRS; N = 11,609), a diverse, national sample of U.S. adults over age 50. We found that increases in social support were associated with better subsequent outcomes on all psychological indicators (higher positive affect, life satisfaction, optimism, purpose in life, mastery, health mastery, financial mastery; lower depression, depressive symptoms, hopelessness, negative affect, perceived constraints) and most social factors (lower loneliness, greater likelihood of contact with children and other family) over the four-year follow-up period. Results also showed that increases in social strain were subsequently related to worse functioning across all indicators of psychological well-being and select social factors (i.e., higher loneliness) and psychological distress outcomes (i.e., higher hopelessness, negative affect, and perceived constraints). However, we did not find evidence that changes in social support and social strain were associated with physical health or health behavior outcomes. %B Journal of Social and Personal Relationships %P 02654075231164900 %G eng %R 10.1177/02654075231164900 %0 Journal Article %J Journal of Aging and Health %D 2023 %T Sociodemographic Factors and Neighborhood/Environmental Conditions Associated with Social Isolation Among Black Older Adults. %A Taylor, Harry O %A Tsuchiya, Kazumi %A Nguyen, Ann W %A Mueller, Collin %K African Americans %K environment %K Leave Behind Questionnaire %K Neighborhoods %K Social Support %X

To investigate sociodemographic factors and neighborhood/environmental conditions associated with social isolation (SI) among Black older adults. We utilized data from the 2014 and 2016 Leave-Behind Questionnaire from the Health and Retirement Study (HRS LBQ) among those who self-identified as Black ( = 2.323). Outcome variables for our study included SI from adult children, other family members, friends, disengagement from social participation and religious services, being unmarried, and living alone. These indicators were also combined into an overall SI index. Critical predictors included gender, age, household income, education, employment status, neighborhood cohesion, neighborhood disorder, urbanicity, and region of residence. Sociodemographic factors of gender, education and household income were significantly associated with SI indicators. Additionally, some neighborhood/environmental conditions were associated with SI indicators. SI was found to be patterned by sociodemographic factors. These results can be used to develop effective interventions to mitigate SI among Black older adults.

%B Journal of Aging and Health %V 35 %P 294-306 %G eng %N 3-4 %R 10.1177/08982643221118427 %0 Web Page %D 2023 %T Support from others in stressful times can ease impact of genetic depression risk %A Gavin, Kara %K depression %K Polygenic risk score %K Social Support %K Widowhood %X Study in first-year doctors and recently widowed older adults shows greatest impact of social support in those with highest polygenic risk scores for depression %I Michigan Medicine, University of Michigan %C Ann Arbor, MI %G eng %U https://www.michiganmedicine.org/health-lab/support-others-stressful-times-can-ease-impact-genetic-depression-risk %0 Journal Article %J JAMA Internal Medicine %D 2022 %T Association of Social Support With Functional Outcomes in Older Adults Who Live Alone. %A Sachin J Shah %A Margaret C Fang %A Wannier, S Rae %A Michael A Steinman %A Kenneth E Covinsky %K health outcomes %K Social Support %X

Importance: Older adults who live alone are at risk for poor health outcomes. Whether social support mitigates the risk of living alone, particularly when facing a sudden change in health, has not been adequately reported.

Objective: To assess if identifiable support buffers the vulnerability of a health shock while living alone.

Design, Setting, and Participants: In this longitudinal, prospective, nationally representative cohort study from the Health and Retirement Study (enrollment March 2006 to April 2015), 4772 community-dwelling older adults 65 years or older who lived alone in the community and could complete activities of daily living (ADLs) and instrumental ADLs independently were followed up biennially through April 2018. Statistical analysis was completed from May 2020 to March 2021.

Exposures: Identifiable support (ie, can the participant identify a relative/friend who could help with personal care if needed), health shock (ie, hospitalization, new diagnosis of cancer, stroke, heart attack), and interaction (multiplicative and additive) between the 2 exposures.

Main Outcomes and Measures: The primary outcomes were incident ADL dependency, prolonged nursing home stay (≥30 days), and death.

Results: Of 4772 older adults (median [IQR] age, 73 [68-81] years; 3398 [71%] women) who lived alone, at baseline, 1813 (38%) could not identify support, and 3013 (63%) experienced a health shock during the study. Support was associated with a lower risk of a prolonged nursing home stay at 2 years (predicted probability, 6.7% vs 5.2%; P = .002). Absent a health shock, support was not associated with a prolonged nursing home stay (predicted probability over 2 years, 1.9% vs 1.4%; P = .21). However, in the presence of a health shock, support was associated with a lower risk of a prolonged nursing home stay (predicted probability over 2 years, 14.2% vs 10.9%; P = .002). Support was not associated with incident ADL dependence or death.

Conclusions and Relevance: In this longitudinal cohort study among older adults who live alone, identifiable support was associated with a lower risk of a prolonged nursing home stay in the setting of a health shock.

%B JAMA Internal Medicine %V 182 %P 26-32 %G eng %N 1 %R 10.1001/jamainternmed.2021.6588 %0 Journal Article %J Journal of the American Geriatrics Society %D 2022 %T Bad company: Loneliness longitudinally predicts the symptom cluster of pain, fatigue, and depression in older adults. %A Powell, Victoria D %A Kumar, Navasuja %A Galecki, Andrzej T %A Kabeto, Mohammed %A Clauw, Daniel J %A Williams, David A %A Hassett, Afton %A Silveira, Maria J %K complex pain %K Psychosocial stress %K Quality of Life %K Social Support %X

BACKGROUND: Pain, fatigue, and depression frequently co-occur as a symptom cluster. While commonly occurring in those with cancer and autoimmune disease, the cluster is also found in the absence of systemic illness or inflammation. Loneliness is a common psychosocial stressor associated with the cluster cross-sectionally. We investigated whether loneliness predicted the development of pain, fatigue, depression, and the symptom cluster over time.

METHODS: Data from the Health and Retirement Study were used. We included self-respondents ≥50 year-old who had at least two measurements of loneliness and the symptom cluster from 2006-2016 (n = 5974). Time-varying loneliness was used to predict pain, fatigue, depression, and the symptom cluster in the subsequent wave(s) using generalized estimating equations (GEE) and adjusting for sociodemographic covariates, living arrangement, and the presence of the symptom(s) at baseline.

RESULTS: Loneliness increased the odds of subsequently reporting pain (aOR 1.22, 95% CI 1.08, 1.37), fatigue (aOR 1.47, 95% CI 1.32, 1.65), depression (aOR 2.33, 95% CI 2.02, 2.68), as well as the symptom cluster (aOR 2.15, 95% CI 1.74, 2.67). The median time between the baseline and final follow-up measurement was 7.6 years (IQR 4.1, 8.2).

CONCLUSIONS: Loneliness strongly predicts the development of pain, fatigue, and depression as well as the cluster of all three symptoms several years later in a large, nonclinical sample of older American adults. Future studies should examine the multiple pathways through which loneliness may produce this cluster, as well as examine whether other psychosocial stressors also increase risk. It is possible that interventions which address loneliness in older adults may prevent or mitigate the cluster of pain, fatigue, and depression.

%B Journal of the American Geriatrics Society %V 70 %P 2225-2234 %G eng %N 8 %R 10.1111/jgs.17796 %0 Journal Article %J Preventive Medicine %D 2022 %T A diagnosis of diabetes and health behavior maintenance in middle-aged and older adults in the United States: The role of self-efficacy and social support. %A Qin, Weidi %K Diabetes diagnosis %K Health behavior maintenance %K Self-efficacy %K Social Support %X

The present study aims to investigate the relationship between a diagnosis of diabetes and the maintenance of health behaviors, and whether self-efficacy and social support moderate the relationship. The study sample came from the 2006 to 2016 waves of the Health and Retirement Study in the United States (N = 13,143). A diagnosis of diabetes was ascertained by self-reported physician-diagnosed condition. Self-efficacy was measured using a 5-item scale. Social support from family and friends were measured separately by a 3-item scale. Three health behaviors were examined, namely alcohol consumption, smoking, and physical activity. Cox proportional hazards regression models were performed to test the study aims. Respondents who reported a diagnosis of diabetes were 1.50 times more likely to fail to maintain physical activity (95% CI = 1.26, 1.77). This relationship was moderated by social support from family, which was related to lower hazards of failure to maintain physical activity among individuals who had a diagnosis of diabetes compared to those without a diagnosis. The study suggests that a diagnosis of diabetes may be a stressful health event that negatively affects physical activity maintenance. In addition, the findings highlight the importance of incorporating strategies to mobilize social support from family, which may help individuals sustain their efforts to maintaining health-promoting behaviors after a diabetes diagnosis.

%B Preventive Medicine %V 155 %P 106958 %G eng %R 10.1016/j.ypmed.2022.106958 %0 Journal Article %J Research on Aging %D 2022 %T Grandparenting, Social Relations, and Mortality in Old Age. %A Heejung Jang %A Tang, Fengyan %A Fusco, Rachel A %A Engel, Rafael J %A Steven M. Albert %K Grandparenting %K Mortality %K Social networks %K Social Support %X

Guided by a convoy model of social relations, this study investigates the relationships between grandparenting status, social relations, and mortality among community-dwelling grandparents age 65 and older who are caring for their grandchildren. The data were drawn from the 2008 and 2016 waves of the Health and Retirement Study ( = 564). Latent class analysis was used to identify the social network structure based on six indicators of interpersonal relationships and activities. A series of hierarchical Weibull hazard models estimated the associations between grandparent caregiving, social relations, and mortality risk. Results of survival analyses indicate that co-parenting and custodial grandparents had higher all-cause mortality risk than grandparents who babysat occasionally; however, for custodial grandparents, the association was not significant once social relation variables were added to the model. This study suggests that community-based support may be beneficial to older grandparents and improved relationship quality is integral to the well-being of older adults.

%B Research on Aging %V 44 %P 265-275 %G eng %N 3-4 %R 10.1177/01640275211015433 %0 Journal Article %J The International Journal of Aging and Human Development %D 2022 %T Marital Transitions, Change in Depressive Symptomology, and Quality of Social Relationships in Midlife and Older U.S. Adults: An Analysis of the Health and Retirement Study. %A Julia E Tucker %A Nicholas J Bishop %A Wang, Kaipeng %A Phillips, Farya %K depression %K Divorce %K marital transitions %K Mental Health %K Social Support %K Widowhood %X

Preventing negative health outcomes following marital transitions can promote personal recovery and well-being. We used the Health and Retirement Study (HRS) (2012, 2014) to test whether social relationship quality moderated the association between marital transition and change in depressive symptomology among U.S. adults aged 50 and older (n = 3,705). Marital status transitions between 2012 and 2014 included remained married/partnered, divorced/separated, and widowed. Depressive symptomology was measured using the Center for Epidemiological Studies Depression Scale 8 Short Form (CES-D 8). Social support, social contact, and social strain were indicators of social relationship quality. Change in depressive symptomology was modeled using autoregressive multiple regression. Social relationship quality appeared to influence depressive symptomatology for those experiencing divorce/separation. Compared to individuals who remained married/partnered, depressive symptomatology in those experiencing separation/divorce decreased among those reporting low social support, increased among those reporting high social support, and increased among those who reported low social strain. Limitations and clinical implications are discussed.

%B The International Journal of Aging and Human Development %V 95 %P 349-371 %G eng %N 3 %R 10.1177/00914150211066551 %0 Journal Article %J Health Psychology %D 2022 %T Psychological well-being, education, and mortality. %A Boylan, Jennifer Morozink %A Tompkins, Justin L %A Patrick M. Krueger %K Education %K Life Satisfaction %K Mortality %K Optimism %K Purpose in life %K Social Support %K Wellbeing %X

OBJECTIVES: Research on older adults often focuses on mitigating health risks, and less is known about protective factors that contribute to longer, healthier lives. We examine longitudinal associations between psychological well-being and mortality among a national sample of older adults and test competing hypotheses about whether the education/mortality association depends on the level of psychological well-being.

METHOD: We use six waves (2006-2016) of the Health and Retirement Study, a national sample of adults over age 50 ( = 21,172), with 14 years of mortality follow-up. Psychological well-being is measured up to three times and includes positive affect, life satisfaction, purpose in life, social support, and optimism. Discrete-time survival models examine (a) the association between time-varying psychological well-being and mortality, and (b) interactions between psychological well-being and education on mortality.

RESULTS: Higher purpose in life, positive affect, optimism, social support, and life satisfaction predicted lower mortality. A 1 increase in most measures of psychological well-being was associated with a 2-4 year increase in life expectancy at age 50. Positive affect and purpose in life moderated the education/mortality association-the inverse association between education and mortality was stronger for those with high psychological well-being.

CONCLUSIONS: We find strong evidence that psychological well-being predicts lower mortality risk and modifies the association between education and mortality. The inverse association between education and mortality becomes stronger at higher levels of purpose in life and positive affect. Therefore, efforts to promote life satisfaction, social support, and optimism may support longer lives without widening education disparities. (PsycInfo Database Record (c) 2022 APA, all rights reserved).

%B Health Psychology %V 41 %P 225-234 %G eng %N 3 %R 10.1037/hea0001159 %0 Journal Article %J Social Work in Public Health %D 2022 %T Relationships Between Perceived Neighborhood Disorder and Depressive Symptomatology: The Stress Buffering Effects of Social Support Among Older Adults. %A Cho, Seungjong %K Depressive symptoms %K Perceived neighborhood disorder %K Social Support %X

Existing research indicates neighborhood is an important determinant of depressive symptoms. However, this research has several limitations. These include a lack of investigation of older adults' experiences and of social support as a possible moderator. The current study aims to fill these gaps by increasing knowledge about the relationships between perceived neighborhood disorder and depressive symptoms among older adults. Applying stress process theory, this study investigated the relationships between two subjective indicators of neighborhood stressors - physical and social perceived neighborhood disorder and depressive symptoms. This study also tested whether social support moderated the effects of the neighborhood stressors on depressive symptoms. This study was based on secondary data analysis from the Health and Retirement Study 2016 ( = 3,684; age 50+). This study applied a negative binomial regression in that the outcome was a count variable. The results showed the stress buffering effects of social support were not significant for both perceived neighborhood social disorder and physical disorder. Not as a moderator but as the main effect, lower social support was significantly related to higher depressive symptoms. Having a depression history, lower self-rated health, female, and lower education were also related to higher depressive symptoms. This study contributes to social work practice by addressing older adults' depressive symptomatology. Findings identified vulnerable older adults to target for interventions based on individual characteristics. Focusing on social support should be a vital component of interventions. Social workers can help older adults maintain and strengthen their social support, with beneficial effects on their depressive symptomatology.

%B Social Work in Public Health %V 37 %P 45-56 %G eng %N 1 %R 10.1080/19371918.2021.1974636 %0 Web Page %D 2022 %T Relocation later in life and contact frequency with friends: Do contact modes matter? %A Wadley, Jared %K relocation %K Social interactions %K Social Support %K Well-being %I Michigan News, University of Michigan %G eng %U https://news.umich.edu/relocation-later-in-life-and-contact-frequency-with-friends-do-contact-modes-matter/ %0 Journal Article %J The International Journal of Aging and Human Development %D 2022 %T Is Secularization an Age-Related Process? %A Idler, Ellen %K Religion %K secularization %K Social Support %X

Secularization has been studied for decades by sociologists of religion. Long-running surveys in the United States and Europe show steady generational decline in religious affiliation and participation, and yet this trend has largely been ignored by gerontologists and life course researchers. We examined data from the Health and Retirement Study, hypothesizing between-cohort declines in religious participation. Based on data from a sample stratified by 10-year birth cohorts, we identified variation in patterns of religious involvement from 2004 to 2016. Measures of attending religious services, feeling religion is very important, and having good friends in the congregation show age-graded patterns; older cohorts have a higher level of religiosity than those following them, with only minor exceptions. For all three measures, differences by cohort within waves of data are statistically significant. We confirm, with longitudinal data, the findings of repeated cross-sectional surveys in the United States showing a generational pattern of decline in religiousness. The consequences of this loss of a common social tie for future older cohorts are unknown, since current older cohorts still maintain a high level of religious participation. However, future generations of older adults are likely to be less familiar with social support from religious institutions, and those institutions may be less available to provide such support as the apparently inexorable processes of secularization continue.

%B The International Journal of Aging and Human Development %V 94 %P 8-22 %G eng %N 1 %1 http://www.ncbi.nlm.nih.gov/pubmed/34459225?dopt=Abstract %R 10.1177/00914150211027547 %0 Journal Article %J The Journals of Gerontology, Series B %D 2022 %T Social isolation and loneliness before and during the COVID-19 pandemic: a longitudinal study of US Adults over 50. %A Peng, Siyun %A Roth, Adam R %K COVID-19 %K Digital isolation %K Mental Health %K Social Relationships %K Social Support %X

OBJECTIVES: The potential impact of social distancing policies during the COVID-19 pandemic on social isolation and loneliness is of increasing global concern. Although many studies focus primarily on loneliness, patterns of social isolation-particularly physical and digital isolation-are understudied. We examined changes in social isolation, physical isolation, digital isolation, and loneliness in US adults over 50 before and during the lockdown.

METHODS: Two waves of the Health and Retirement Study, a national panel sample of US adults over 50 years old, were used. Fixed-effects regression models were fitted to identify within-person change from 2016 to 2020 to examine the impact of social distancing policies during the pandemic.

RESULTS: There was an increase in physical isolation and social isolation among respondents during the COVID-19 social distancing policies. However, respondents experienced no change in digital isolation or loneliness. The increase in physical isolation was only present for people with high COVID-19 concern whereas people with low concern experienced no change in physical isolation.

DISCUSSION: Despite an increase in physical isolation due to the social distancing policies, US adults aged over 50 stayed connected through digital contact and were resilient in protecting themselves from loneliness.

%B The Journals of Gerontology, Series B %V 77 %P e185-e190 %G eng %N 7 %R 10.1093/geronb/gbab068 %0 Journal Article %J Gerontology %D 2022 %T Structural and Functional Aspects of Social Relationships and Episodic Memory: Between-Person and Within-Person Associations in Middle-Aged and Older Adults. %A Hülür, Gizem %K Episodic Memory %K longitudinal change %K Social networks %K Social Relationships %K Social Support %X

OBJECTIVES: A growing body of research has documented associations between social relationships and cognitive function, while findings are less clear regarding specific aspects of social relationships that are relevant to change in cognitive function. Furthermore, it is unclear whether associations differ at the between-person and within-person levels.

METHOD: The present study used 8-year longitudinal data from the Health and Retirement Study (HRS) to examine the role of structural (partnered/married, number of social network partners, and contact frequency) as well as functional (support, strain, and loneliness) aspects of social relationships for episodic memory at the between-person and within-person levels. Analyses are based on up to 3 waves of data from 19,297 participants (mean age at baseline = 66 years, SD = 10, range = 50-104; 58% women). Control variables include age at baseline, gender, education, functional health, and depressive symptoms.

RESULTS: Findings showed that at the between-person level, most structural and functional aspects were related to levels of memory performance, with participants with higher numbers of social network members, more frequent contact, and more positive experiences outperforming others. An exception was a higher number of family (child or relative) relationships. At the within-person level, on occasions where participants had a higher number of close family relationships than usual, had more social contact than usual, and felt less lonely than usual, they also showed higher than usual episodic memory performance. Finally, negative effects of social strain and loneliness on episodic memory performance at the between-person level were moderated by social network size, indicating that effects were more negative among individuals with larger social networks.

DISCUSSION: Both structural and functional aspects of social relationships contribute to between-person differences in levels and fluctuations of episodic memory performance. Ups and downs of relationships to relatives, social contact, and feelings of loneliness contribute to ups and downs of episodic memory. Potential mechanisms underlying these associations are discussed.

%B Gerontology %V 68 %P 86-97 %G eng %N 1 %R 10.1159/000514949 %0 Thesis %B Social Welfare %D 2021 %T Diagnosis of Diabetes and Health Behaviors in Middle-Aged and Older Adults: The Role of Self-Efficacy and Social Support %A Qin, Weidi %K Diabetes %K Self-efficacy %K Social Support %X Focusing on middle-aged and older adults, the present study objectives are to investigate the effects of a diabetes diagnosis on the initiation and maintenance of healthy behaviors and whether self-efficacy and social support modify the relationships. The study sample came from the Health and Retirement Study. The predictor variables were diabetes diagnosis, self-efficacy, and social support from family and friends. The outcome variables were three health behaviors (alcohol consumption, smoking status, and physical activity) and utilization of four preventive care services (blood test for cholesterol, influenza vaccination, prostate cancer exam, and mammography). Study 1 utilized a matched case-control difference-in-differences approach to estimate the effect of a diabetes diagnosis on the likelihood of change in health behaviors and utilization of preventive care services. Study 2 applied mixed-effects regression models to analyze the longitudinal effects of diabetes diagnosis, self-efficacy, and social support on health behavior changes and to examine the moderating effects of self-efficacy and social support. Study 3 performed Cox proportional hazards regression models to examine the effects of a diabetes diagnosis, self-efficacy, and social support on the hazards of failure to maintain healthy behaviors and to examine the moderating effects of self-efficacy and social support. Results from study 1 indicated that individuals reduced alcohol consumption and increased utilization of blood tests for cholesterol and influenza vaccination after a diagnosis of diabetes. Findings from study 2 showed that a diagnosis of diabetes was associated with reduced drinking. A significant interaction between social support from family and diabetes diagnosis was found in predicting drinking and smoking. Last, study 3 reported that a diagnosis of diabetes was associated with higher hazards of failure to maintain physical activity. A significant interaction between social support from family and diabetes diagnosis was found in predicting physical activity maintenance. The collective findings of the three studies suggest that a diagnosis of diabetes can be both a teachable moment that motivates the initiation of reducing health-risking behaviors, and a stressful health event that hinders maintenance of health-promoting behaviors. Mobilizing social support from family may help individuals adopt and maintain healthy behaviors after a diabetes diagnosis. %B Social Welfare %I Case Western Reserve University %C Cleveland, OH %V Ph.D. %G eng %U http://rave.ohiolink.edu/etdc/view?acc_num=case1625841228065432 %0 Journal Article %J Social Work in Public Health %D 2021 %T Examining the Family Support Role of Older Hispanics, African Americans, and Non-Hispanic Whites and Their Breast Cancer Screening Behaviors. %A Tamara J. Cadet %A Shanna Lynn Burke %A Naseh, Mitra %A Grudzien, Adrienne %A Kozak, Rebecca Shoaf %A Romeo, Jessica %A Bullock, Karen %A Davis, Cindy %K Blacks %K family support %K Health Promotion %K Hispanics %K Mammograms %K Older women %K Social Support %X

Disparities in breast cancer mortality rates among older Black and Hispanic women are due in part to low participation in cancer screening. Participation in cancer screening could be affected by an array of factors, including social support. Understanding the complex interplay between social support and breast cancer screening among older female adults, specifically among groups with higher mortality rates, is extremely important for timely and appropriate interventions to increase survival rates. Thus, utilizing the social network theory as the conceptual framework, this study aims to examine effects of social support on receiving a mammogram among a representative sample of older adults, specifically African American and Hispanic populations in the United States. Logistic regression models were conducted using the 2008 and 2012 Health and Retirement Study data. Findings from this study indicate that specific aspects of social support influence breast cancer screening participation among older Hispanic and non-Hispanic White women. However, this was not the case for the older Black women after adjusting for the sociodemographic factors. Given the role that family members play in the care of older adults, it is critical that social workers consider both the possible positive and negative interactions older women may have and how these interactions may affect their cancer screening behaviors. Findings can provide formative data to develop public health and social work interventions to increase positive social support and reduce negative social support by spouses and children to enhance breast cancer screening among older adults.

%B Social Work in Public Health %V 36 %P 38-53 %G eng %N 1 %R 10.1080/19371918.2020.1852993 %0 Journal Article %J Gerontologist %D 2021 %T Midlife Marital Dissolution and the Onset of Cognitive Impairment. %A Susan L. Brown %A Lin, I-Fen %A Vielee, Alyssa %A Kagan A Mellencamp %K Divorce %K health %K Marriage %K Social Support %K Widowhood %X

BACKGROUND AND OBJECTIVES: Marital dissolution has become more common in midlife with the doubling of the divorce rate among middle-aged adults. Guided by the stress model that stipulates losing economic, social, and psychological resources lowers well-being, we posited that midlife adults who experienced divorce or widowhood were at greater risk of cognitive impairment than the continuously married. Subsequent repartnering was expected to negate the increased risk.

RESEARCH DESIGN AND METHODS: We used data from the 1998-2016 Health and Retirement Study to estimate discrete-time event history models using logistic regression to predict cognitive impairment onset for men and women.

RESULTS: Roughly 27% of men who experienced spousal death in midlife went on to experience mild cognitive impairment by age 65. For women, experiencing divorce or widowhood was associated with higher odds of cognitive impairment onset although these differentials were accounted for by economic, social, and psychological resources. Men and women who repartnered after marital dissolution did not appreciably differ from their continuously married counterparts in terms of their likelihoods of cognitive impairment onset.

DISCUSSION AND IMPLICATIONS: A stressful life event, midlife marital dissolution can be detrimental to cognitive well-being, placing individuals at increased risk of developing dementia in later life. The growing diversity of partnership experiences during the second half of life points to the continued importance of examining how union dissolution and formation shape health and well-being.

%B Gerontologist %V 61 %P 1085-1094 %G eng %N 7 %R 10.1093/geront/gnaa193 %0 Journal Article %J Aging & Mental Health %D 2021 %T The relationship between perceived support and depression in spousal care partners: a dyadic approach. %A Meyer, Kylie %A Patel, Neela %A White, Carole %K Caregiving %K depression %K Social Support %X

OBJECTIVES: Caregiving within a spousal partnership marks a novel relationship stage for couples. Caregiving introduces new stressors and affects couples' ability to cope, and potentially alters perceptions of emotional support. Prior research on older married couples illustrates how perceived support not only affects an individual's mental health, but also that of their partner. To date, the dyadic relationship between emotional support and mental health is largely unexamined among caregiving partners, where support expectations may differ.

METHOD: Actor partner interdependence models using linear mixed modeling were applied to data from spouses where one partner received caregiving within the 2014 and 2016 waves of the Health and Retirement Study. We examined the cross-sectional and lagged associations between perceived emotional support and strain from a spouse on actor and partner depression scores, as well as whether one was the caregiver or the care recipient moderated associations.

RESULTS: More positive perceptions of support were associated with lower depression scores for oneself (= -0.55,  < 0.001) and one's partner (= -0.24,  < 0.001). Actor effects-how one's own perceptions of support associate with one's own depressive symptomology-were stronger for care recipients than for caregivers (= -0.83,  < 0.001 v. = -0.26,  < 0.05). Higher perceptions of strain were also associated with higher depression scores for oneself ( = 0.57,  < 0.001) and one's partner ( = 0.39,  < 0.001), associations that remained even in lagged models.

CONCLUSIONS: The observation of both actor and partner effects in this study suggests opportunities to improve care recipient outcomes through intervention with caregivers or both members of the care dyad.

%B Aging & Mental Health %V 25 %P 1830-1838 %G eng %N 10 %R 10.1080/13607863.2020.1836474 %0 Thesis %D 2021 %T The Role of Social Support and Health Promotion Behaviors For U.S. Aging Adults %A Akers, Erika %K Health behaviors. gender %K Social Support %X Background and Objectives: Perceived social support may influence health outcomes among older adults by influencing the practice of health-related behaviors, including preventive and lifestyle behaviors. This study examines how social support influences health behaviors in the aging United States (U.S.) population. Methods: I analyzed data from 4,891 respondents aged 50 and older in the 2014-2016 Health and Retirement Study, a nationally representative longitudinal survey of midlife and older adults. Multivariate logistic regression was used to examine the relationship between positive social support and health behaviors by gender. Results: Results show that the role of children’s positive social support is important for the engagement of moderate and vigorous physical activity for both men and women. Discussion: These findings contribute to current research and bode the importance of social support related interventions within public health efforts to address population health disparities through the social determinants of health (SDOH) frameworks. %I University of Nebraska, Lincoln %C Lincoln, NE %G eng %U https://digitalcommons.unl.edu/honorsembargoed/191/ %0 Book Section %B Annual Review of Gerontology and Geriatrics, Volume 41, 2021: Black Older Adults in the Era of Black Lives Matter %D 2021 %T Social Network Typology and Cognitive Status Among African Americans: Findings From the Health and Retirement Study %A Lincoln, Karen D. %A Nguyen, Ann W. %K African Americans %K cognitive function %K cognitive impairment %K Network diversity %K Social networks %K Social Support %X Social network diversity has been linked to cognitive status in older adults. While social network diversity is often operationalized by the proportion of social roles represented within one’s network, the additive effect of social roles is often unrecognized. Moreover, very few studies examine social relationships and cognitive status among African American older adults-a population with a high risk of cognitive impairment. The current study examined the relationship between social network diversity and cognitive status in a nationally representative sample of middle-aged and older African Americans. Data from the Health and Retirement Study (N = 2, 308) and latent class analysis were used to identify a social network typology using children, extended family members, and friends as social network indicators. Multinomial logistic regression was used to determine the association between social network types and cognitive status. Three social network types were identified-friend-focused, diverse, and restricted network types. African Americans with higher cognitive status were more likely to be assigned to the friend-focused social network type rather than the diverse or restricted network types. Neither the diverse nor restricted social network types were associated with cognitive status. A social network typology accounted for heterogeneity within the social networks of African American middle-aged and older adults and identified a unique social network type that appears to be protective for their cognitive health. Findings have implications for the measurement and operationalization of social networks and cognitive status and the role of social networks in maintaining cognitive functioning in African Americans. %B Annual Review of Gerontology and Geriatrics, Volume 41, 2021: Black Older Adults in the Era of Black Lives Matter %I Springer Publishing Company %V 41 %P 63 – 84 %G eng %& 3 %R 10.1891/0198-8794.41.63 %0 Journal Article %J Journal of Evidence-Based Social Work (2019) %D 2021 %T Social Support and Depressive Symptoms among Trauma-Impacted Older Adults. %A Cho, Seungjong %A Bulger, Morgan %K depression %K Social Support %K trauma-impacted older adults %K trauma-informed research %X

: The present study investigates the association between social support and depressive symptomatology among older adults who have been impacted by trauma. Previous studies have not sufficiently explored this topic to date. : The current study analyzed public-use data from the 2012 Health and Retirement Study ( = 4,195), focusing specifically on community-dwelling older adults (> 50). They had at least one traumatic event in their lifetime. : This study found that higher levels of social support were significantly associated with lower levels of depressive symptoms after controlling for life satisfaction, age, gender, race, ethnicity, and education.. : The recent emergence of trauma-informed research has consistently emphasized the importance of social interaction for mental health. The current study shows that social support can reduce depressive symptoms of those who have experienced trauma.

%B Journal of Evidence-Based Social Work (2019) %V 18 %P 371-378 %G eng %N 4 %R 10.1080/26408066.2020.1866729 %0 Web Page %D 2021 %T Solo Seniors with Social Support Are Less Likely to Need Nursing Home Care %A Leigh, Suzanne %K Long-term Care %K Social Support %B News %I University of California, San Fransisco %G eng %U https://www.ucsf.edu/news/2021/11/421776/solo-seniors-social-support-are-less-likely-need-nursing-home-care %0 Journal Article %J The Journal of Positive Psychology %D 2020 %T Building sense of purpose in older adulthood: Examining the role of supportive relationships. %A Sara J Weston %A Nathan A Lewis %A Patrick L Hill %K No terms assigned %K older adulthood %K Sense of purpose %K Social Support %K Well-being %X Having supportive others appears valuable for developing a purpose, at least during adolescence and young adulthood. However, work has yet to consider whether sense of purpose and social support change in tandem or predict one another during older adulthood. Using a subsample (N = 7,452) of older adults from the Health and Retirement Study, we estimate the associations of purpose in life to social support and social strain in four domains (spouses/partners, children, family, friends) using bivariate growth models. Participants provided responses at three assessment occasions, 4 years apart. Analyses controlled for social contact frequency to focus on the unique role of supportive relationships. Initial levels of support correlated positively with levels for sense of purpose, while strain was negatively associated with purpose. Moreover, with the exception of family support, changes in sense of purpose were correlated with changes in support and strain in the same direction across doma %B The Journal of Positive Psychology %G eng %U http://dx.doi.org/10.1080/17439760.2020.1725607 %0 Journal Article %J Journal of Aging and Health %D 2020 %T Depressive symptoms among aging Hispanic Americans: Longitudinal effects of positive spousal support and previous depressive symptoms. %A James R Muruthi %A Lauren C Zalla %A Denise C Lewis %K Depressive symptoms %K Hispanic %K Marriage %K Racial/ethnic differences %K Social Support %X

OBJECTIVE: We aimed to investigate the longitudinal effects of spousal support on aging Hispanic Americans' depressive symptoms using population-based data from the Health and Retirement Study (HRS).

METHOD: Using hierarchical multiple regressions, we investigated whether baseline positive spousal support and previous depressive symptoms were significant predictors of depressive symptoms 8 years later in a sample of 264 aging Hispanic Americans.

RESULTS: We discovered that previous depressive symptoms, baseline chronic conditions, and positive spousal support were all significant predictors of long-term depressive symptoms.

DISCUSSION: Our findings underline the need to address persistent depression and chronic diseases in the aging Hispanic population. We also highlight the potential benefits of empowering spouses as a resource for promoting mental health in this group. These findings are also encouraging for future studies in depression, aging, and comorbidity, especially in the vastly increasing population of aging Hispanic Americans.

%B Journal of Aging and Health %V 32 %P 481-490 %G eng %U http://www.ncbi.nlm.nih.gov/pubmed/30829098?dopt=Abstract %N 5-6 %R 10.1177/0898264319825755 %0 Journal Article %J Innovation in Aging %D 2020 %T Depressive Symptoms and Loneliness Among Black and White Older Adults: The Moderating Effects of Race. %A Taylor, Harry O %A Ann W Nguyen %K Mental Health %K Negative interactions %K Social networks %K Social Support %X

Background and Objectives: Loneliness is consistently linked to worse depression/depressive symptoms; however, there are few studies that have examined whether the relationship between loneliness and depressive symptoms varies by race. The purpose of this study was to determine whether race moderated the relationship between loneliness and depressive symptoms.

Research Design and Methods: Data come from the 2014 wave of the Health and Retirement Study (HRS) Core survey and Psychosocial Leave-Behind Questionnaire; only black and white older adults were included in the analysis ( = 6,469). Depressive symptoms were operationalized by the eight-item Center for Epidemiological Studies-Depression scale; however, the "felt lonely" item was removed given concerns with collinearity. Loneliness was operationalized using the Hughes 3-Item Loneliness Scale. Sociodemographic variables included gender, age, education, household income, employment status, marital status, and living alone or with others. Furthermore, social support and negative interactions from family members and friends, and religious service attendance were included in the analysis. Lastly, we created an interaction term between race and loneliness. All analyses used survey weights to account for the complex multistage sampling design of the HRS. Missing data were multiply imputed.

Results: In multivariable analysis, we found race significantly moderated the relationship between loneliness and depressive symptoms while controlling for sociodemographic covariates, social support and negative interaction variables, and religious service attendance.

Discussion and Implications: Our findings demonstrate a differential racial effect for loneliness and depressive symptoms. For both blacks and whites, greater loneliness affected depressive symptoms; however, the effect was stronger among whites than it was for blacks. Given this is one of the first studies to examine the differential effects of race on loneliness and depressive symptoms, more research is necessary to determine the consistency of these results.

%B Innovation in Aging %V 4 %P igaa048 %G eng %N 5 %R 10.1093/geroni/igaa048 %0 Journal Article %J Innovation in Aging %D 2020 %T Do Social Support and Strain Mediate the Relationship Between Childhood Exposures and Frailty in Later Life? %A Monica Williams-Farrelly %A Kenneth F Ferraro %K Childhood exposures %K Frailty %K Social strain %K Social Support %X Previous studies have identified the early origins of physical frailty, notably poor childhood health and socioeconomic status, but relatively few studies examine whether social support in later life mitigates the influence of early noxious exposures on frailty. Given the established relationship between health and social relationships in older adults, this research uses data from the Health and Retirement study (2004-2016) to examine whether social support and strain mediate the effect of childhood exposures on frailty in later life. A series of linear regression and pathway models were estimated to test whether childhood exposures, including socioeconomic status, infectious and chronic diseases, impairments, and risky adolescent parental behaviors, were associated with phenotypic frailty (Fried et al. 2001). After adjusting for demographic and adult factors, accumulated childhood misfortune was directly (b=0.015, p<.01) and indirectly (b=0.007, p<.001) associated with more frailty. Average social support, but not strain, from oneā€™s spouse, children, family and friends significantly mediated the relationship between accumulated misfortune and frailty (b= -.002, p<.01). Path analysis revealed that social support reduces later life frailty directly (b=-0.106 ,p<.001) and indirectly through a reduction in adult morbidity (b=-0.031, p<.001). However, counterintuitively we found that accumulated misfortune was associated with more social support. Supplemental analyses reveal that one or more infectious diseases in childhood were responsible for the positive relationship (b= 0.393, p<.001). These results have implications for how we may reduce the burden of frailty on those who have experienced misfortune early in life. %B Innovation in Aging %V 4 %P 497 %@ 2399-5300 %G eng %N Suppl 1 %R 10.1093/geroni/igaa057.1606 %0 Journal Article %J Innovation in Aging %D 2020 %T Hopelessness among Middle-aged and Older Blacks: The Negative Impact of Discrimination and Protecting Power of Social and Religious Resources %A Uchechi A Mitchell %A Gutierrez-Kapheim, Melissa %A Ann W Nguyen %A Al-Amin, Nadia %K African American %K Mental Health %K Minority Issues %K race %K Religion and spirituality %K Social networks %K Social Support %K Stress & Coping %X Hopelessness—a state of despair characterized by a negative outlook towards the future and a belief in insurmountable challenges—is a risk factor for major depression, cardiovascular disease, and all-cause mortality among older adults. It is also an understudied consequence of discrimination. Older Blacks disproportionately report experiencing discrimination and, as a result, may be at greater risk of feeling hopeless. However, social and religious resources may protect against the adverse effects of discrimination. The current study examines whether social support, social engagement, religious attendance, and religiosity buffer the effects of self-reported everyday discrimination on hopelessness among a nationally representative sample of Blacks.Using data from the 2010/2012 psychosocial assessment of the Health and Retirement Study, we regressed hopelessness on everyday discrimination, stratifying by two age groups, ages 51-64, representing middle-age (n=1,302) and age 65 and older, representing old age (n=887). Interaction terms tested whether each resource moderated the discrimination-hopelessness relationship controlling for depressive symptoms, socioeconomic status, and demographic characteristics.Greater reports of everyday discrimination were associated with higher levels of hopelessness for middle-aged and older Blacks. For middle-aged Blacks, the resources did not moderate the discrimination-hopelessness relationship; rather higher levels of support (b=-.294, p<0.01), religiosity (b=-.297, p<0.001), religious attendance (b=-.218, p<0.05) were independently and inversely associated with hopelessness. For older Blacks, higher levels of religiosity moderated the discrimination-hopelessness relationship (b=-.208, p<0.05) and higher levels of support (b=-.304, p<0.05) and social engagement (b=-.236, p<0.05) were independently and inversely associated with hopelessness.Findings suggest that self-reported everyday discrimination increases hopelessness among middle-aged and older Blacks but social and religious resources may counterbalance its effects, in age-specific ways, to protect against hopelessness. Religiosity may be especially important for older Blacks as a buffer against the negative consequences of discrimination on hopelessness. %B Innovation in Aging %V 4 %P igaa044 %@ 2399-5300 %G eng %N 5 %R 10.1093/geroni/igaa044 %0 Journal Article %J Journal of Aging and Health %D 2020 %T Neighborhood Disorder, Social Ties, and Preventive Healthcare Utilization among Urban-Dwelling Older Adults %A Kenzie Latham-Mintus %A Ashley Vowels %A Swapnali Chavan %K environment %K healthcare utilization %K neighborhood disorder %K Neighborhoods %K preventive health care %K Social Support %K social ties %X This research examines whether perceived neighborhood disorder influences the use of preventive healthcare services (i.e. influenza vaccine, pneumonia vaccine, cholesterol screening, colonoscopy, and dental care) by older adults and whether social ties buffer the potential adverse effects of perceived neighborhood disorder. Methods: Using data from the 2012 wave of the Health and Retirement Study, binary logistic regression was used to generate odds ratio estimates of preventive healthcare use in the past 2 years. Results: We find that greater levels of neighborhood disorder were associated with fewer dental care visits net of social and health factors. Regular participation in four or more social activities was associated with decreased odds of restricted use and increased odds of receiving a pneumonia vaccine and colonoscopy. Discussion: This research provides evidence that perceived neighborhood disorder may act as a barrier for specific preventive healthcare services and highlights the need for targeted intervention. %B Journal of Aging and Health %G eng %R 10.1177/0898264320929544 %0 Journal Article %J The Journals of Gerontology, Series B: Psychological Sciences & Social Sciences %D 2020 %T Patterns of social engagement among older adults with mild cognitive impairment. %A Amano, Takashi %A Morrow-Howell, Nancy %A So Jung Park %K CIND %K Cognition & Reasoning %K Health Conditions and Status %K Social Support %X

OBJECTIVES: Promoting engagement in social activities may be an intervention that prevents or delays cognitive impairment. Nevertheless, little is known about social engagement among people with mild cognitive impairment. We aim to examine patterns of social engagement among people with mild cognitive impairment and to assess whether factors under four domains of the WHO's ICF model (personal factors, environmental factors, body functions and structure, and health condition) associate with different patterns of social engagement.

METHOD: Data were drawn from the 2010 Health and Retirement Study. The final sample comprised 1,227 people with Cognitive Impairment No Dementia (CIND). Latent class analysis and multinomial logistic regression were utilized.

RESULTS: Three patterns of social engagement were identified: informal social engagement only, formal and informal social engagement, and low social engagement. Factors in each of the four ICF model domains were associated with the probability of class membership.

DISCUSSION: Our findings suggest that social engagement is heterogeneous among people with CIND and that some groups of people with CIND have possibilities of engaging in more social activities, especially in formal social activities. Results also indicate that providing informal social resources may be essential for social programs designed specifically for people with CIND to promote their formal social engagement. Future study is needed to examine possible differences in outcomes across groups with similar patterns of social engagement.

%B The Journals of Gerontology, Series B: Psychological Sciences & Social Sciences %V 75 %P 1361-1371 %G eng %N 7 %R 10.1093/geronb/gbz051 %0 Journal Article %J Journals of Gerontology, Series B. Psychological Sciences and Social Sciences %D 2020 %T Relationship quality among older cohabitors: A comparison to remarrieds. %A Matthew R Wright %K Cohabitation %K Divorce %K Marriage %K Relationships %K Social Support %X

OBJECTIVES: Later life marital patterns have undergone shifts over the past few decades, including a rapid growth of cohabiting unions. Despite the increase in older adult cohabitation, research on this population has been slow to keep up. Intimate relationships are linked to well-being and relationship quality is especially important because high quality relationships offer a number of benefits for well-being, whereas poor quality relationships often are detrimental. This study compares cohabiting and remarried individuals on two measures of relationship quality.

METHOD: Using data from the 2010 and 2012 Health and Retirement Study, I investigate the positive and negative relationship quality of cohabitors relative to their remarried counterparts and whether the association of union type and relationship quality varies by race.

RESULTS: Across both positive and negative relationship quality, I found few differences between cohabiting and remarried individuals. Black cohabitors report higher positive relationship quality than remarrieds, whereas White cohabitors and remarrieds do not differ.

DISCUSSION: These findings suggest that cohabiting unions and remarriages are comparable among White older adults, but that Black cohabitors may gain more in terms of positive relationship quality than their remarried counterparts.

%B Journals of Gerontology, Series B. Psychological Sciences and Social Sciences %V 75 %P 1808-1017 %G eng %N 8 %9 Journal %R 10.1093/geronb/gbz069 %0 Thesis %B Social Welfare %D 2020 %T RELATIONSHIPS BETWEEN NEIGHBORHOOD STRESSORS AND DEPRESSIVE SYMPTOMS: THE MODERATING EFFECTS OF SOCIAL SUPPORT AMONG OLDER ADULTS %A Cho, Seungjong %K Depressive symptoms %K neighborhood stressors %K Older Adults %K Social Support %X About 20% of Americans have experienced depressive symptoms in their lives. Prior research has shown one’s neighborhood of residence is an important determinant of one’s mental health. However, major limitations in existing research are limited research on older adults, limited studies including both objective and subjective neighborhood stressors, and limited studies including social support as a possible moderator. The purpose of this dissertation was to increase knowledge about the relationships between neighborhood stressors and depressive symptoms among older adults. Applying social disorganization theory and stress process theory, this study investigated the associations between four neighborhood stressors (three objective indicators of neighborhood disadvantage – neighborhood poverty, racial and ethnic composition, residential instability – and one subjective characteristic – perceived neighborhood disorder) and a count of depressive symptoms. This study also tested whether social support (from spouse, child, relatives, and friends) moderated the effects of the neighborhood stressors on depressive symptoms. This dissertation was based on secondary analysis of merged data from the Health and Retirement Study 2010, RAND HRS, U.S. Census 2010, and HRS restricted-use data. The final sample (N = 1,468) were all urban-dwelling; age 50 or older; married or partnered; having at least one child, relative, and friend. This study applied structural equation modeling with Full Information Maximum Likelihood estimation. Findings of this dissertation did not support the neighborhood effects hypotheses. Contrary to previous studies, this study found higher neighborhood poverty was associated with lower levels of depressive symptoms. No other neighborhood stressors were associated with depressive symptoms. Stress buffering effects of social support were not significant, for any neighborhood stressor. Not as a moderator but as a main effect, lower social support was significantly related to higher depressive symptoms. Lower income, female, lower education, and poorer health were also related to higher depressive symptoms. This dissertation contributes to social work practice by addressing older adults’ depressive symptomatology. Findings identified vulnerable older adults to target for interventions, based on individual characteristics. Focusing on social support should be a vital component of interventions. Social workers can help older adults to maintain and strengthen their social support, with beneficial effects for their depressive symptomatology. %B Social Welfare %I Case Western Reserve University %C Cleveland, OH %V Doctor of Philosophy %G eng %U http://rave.ohiolink.edu/etdc/view?acc_num=case1592324389134903 %0 Journal Article %J Journal of Aging and Health %D 2020 %T Social integration, self-rated health . . . and genes? %A Aniruddha Das %K Genetics %K Self Report %K Social Support %X

OBJECTIVE: This study examined genetic roots of later life social integration, and their confounding of this social factor's health linkages.

METHOD: Data were from the 2010 wave of the Health and Retirement Study. Two dimensions of integration were examined: with one's "stakeholder" network of family and friends and with the community. Genetic measures included polygenic scores for extraversion and educational attainment.

RESULTS: Ties to one's stakeholder network had no genetic associations. The extraversion polygenic score was linked to community integration among Blacks as well as Whites. Among the latter, the same was true of one's genetic propensity for educational attainment. Although this score also influenced self-rated health, neither confounded associations of social integration with this indicator.

DISCUSSION: Later life social integration seems influenced by genetically rooted propensities for both sociability and human capital accumulation. Health linkages of integration, however, may not reflect mutual dependencies on the same genetic substrates.

%B Journal of Aging and Health %G eng %1 http://www.ncbi.nlm.nih.gov/pubmed/30819014?dopt=Abstract %R 10.1177/0898264319831513 %0 Journal Article %J Innovation in Aging %D 2020 %T Social Support and Depressive Outcomes in Older Adults: An Analysis of the Health and Retirement Study %A Julia E Tucker %A Nicholas J Bishop %K depressive outcomes %K Social Support %X Given population aging and impact of both spousal and social support on the health of older adults, the protective role of social support amongst recently bereaved older adults represents an important area of research. The aim of this study is to identify the relationship between recent widowhood and change in depressive symptoms in older adults, and how social support moderates this association. Utilizing observations from the nationally representative Health and Retirement Study, the analytic sample consisted of 2,890 adults age 50 and over who were partnered or married in 2012. Depression was measured using the Center for Epidemiological Studies Depression scale short form (CESD-8). Positive social support was measured as perceived social support from family, friends, and children. Widowhood was a dichotomous measure indicating mortality of spouse between 2012 and 2014. Autoregressive multiple regression was used to determine if widowhood was associated with change in depression from 2012-2104 and whether positive social support moderated this relationship. Widowhood was associated with an increase in depressive symptoms from 2012-2014 (b=0.967, SE=0.145, p <.001) and social support was negatively associated with change in depression (b=-0.021, SE=0.004, p <.001). Social support appeared to moderate the association between widowhood and change in depression (b=0.068, SE=0.026, p =.010), though widowed older adults with higher social support appear to have more rapid increase in depression than those with lower social support. These preliminary findings and implications for supporting bereaved older adults will be discussed. %B Innovation in Aging %V 4 %P 69 %@ 2399-5300 %G eng %N Suppl 1 %R 10.1093/geroni/igaa057.226 %0 Journal Article %J Journals of Gerontology Series B Psychological Sciences and Social Sciences %D 2020 %T Structural Social Support and Changes in Depression during the Retirement Transition: "I Get by With a Little Help from My Friends". %A Ben Lennox Kail %A Dawn C Carr %K depression %K Retirement %K Social Support %X

OBJECTIVES: This study evaluated whether (a) retirement was associated with increased depressive symptoms, (b) four sources social support were associated with decreased depressive symptoms, and (c) whether the relationship between retirement and depressive symptoms varied across four sources social support.

METHOD: Health and Retirement Study data were used to assess whether four measures of structural support moderated the association between transitioning to full retirement (relative to remaining in full time work) and symptoms of depression.

RESULTS: Results from two stage mixed-effects multilevel models indicated (a) on average retirement was associated with a small but significant increase in depressive symptoms after adjusting for pre-retirement social support, (b) on average, social support not associated with changes in symptoms of depression, but (c) social support from friends moderates the association between retirement and symptoms of depression such that at low levels of social support, retirement was associated with a sizeable increase in depressive symptoms, but this association decreased as level of social support from friends increased.

DISCUSSION: Results suggest people with low levels of social support may benefit from actively cultivating friendships in retirement to help mitigate some of deleterious effects of retirement.

%B Journals of Gerontology Series B Psychological Sciences and Social Sciences %V 75 %P 2040-2049 %G eng %N 9 %R 10.1093/geronb/gbz126 %0 Journal Article %J The Journals of Gerontology: Series B %D 2020 %T Use of Informal Support as a Predictor of Home- and Community-Based Services Utilization %A Kristen N Robinson %A Menne, Heather L %A Gaeta, Raphael %K Activities of Daily Living %K Living Alone %K Social Support %X Home- and community-based services (HCBS) help older adults remain living safely in their homes by delaying or preventing the need for institutionalization. This analysis is guided by the Andersen Behavioral Model of Health Services Use to examine the association between informal support and use of HCBS.Health and Retirement Study data from 2011 and 2012 are used in the bivariate analyses and multivariate logistic regression models to examine differences in HCBS utilization among extremely vulnerable older adults who have informal caregivers and those who do not.For extremely vulnerable older adults who report difficulties with any instrumental or basic activities of daily living, use of HCBS is not strongly associated with access to informal caregivers. However, for this same population of extremely vulnerable older adults, those who live alone have roughly three times the odds of using any HCBS compared to those who do not live alone.Among already vulnerable older adults, this study revealed that living alone is an important enabling factor of the Andersen model as applied in HCBS research. Further investigation is needed to see if more resources should be allocated to senior centers and local providers to identify vulnerable older adults who live alone and may have unmet needs. %B The Journals of Gerontology: Series B %V 76 %P 133-140 %G eng %N 1 %R 10.1093/geronb/gbaa046 %0 Journal Article %J The Gerontologist %D 2019 %T Determinants of Hearing Aid Use Among Older Americans With Hearing Loss %A Michael M McKee %A Choi, Hwajung %A Wilson, Shelby %A Melissa J DeJonckheere %A Zazove, Philip %A Helen G Levy %K Hearing aids %K Hearing loss %K Social Support %K Stigma %X Background and Objectives Hearing loss (HL) is common among older adults and is associated with significant psychosocial, cognitive, and physical sequelae. Hearing aids (HA) can help, but not all individuals with HL use them. This study examines how social determinants may impact HA use. Research Design and Methods We conducted an explanatory sequential mixed methods study involving a secondary analysis of a nationally representative data set, the Health and Retirement Study (HRS; n = 35,572). This was followed up with 1:1 qualitative interviews (n = 21) with community participants to clarify our findings. Both samples included individuals aged 55 and older with a self-reported HL, with or without HA. The main outcome measure was the proportion of participants with a self-reported HL who use HA. Results and Discussion Analysis of HRS data indicated that younger, nonwhite, non-Hispanic, lower income, and less-educated individuals were significantly less likely to use HA than their referent groups (all p values < .001). Area of residence (e.g., urban) were not significantly associated with HA use. Qualitative findings revealed barriers to HA included cost, stigma, vanity, and a general low priority placed on addressing HL by health care providers. Facilitators to obtaining and using HA included family/friend support, knowledge, and adequate insurance coverage for HA. Implications Many socioeconomic factors hinder individuals’ ability to obtain and use HA, but these obstacles appeared to be mitigated in part when insurance plans provided adequate HA coverage, or when their family/friends provided encouragement to use HA. %B The Gerontologist %G eng %U https://academic.oup.com/gerontologist/advance-article/doi/10.1093/geront/gny051/5000029http://academic.oup.com/gerontologist/advance-article-pdf/doi/10.1093/geront/gny051/24836322/gny051.pdf %R 10.1093/geront/gny051 %0 Journal Article %J Inquiry %D 2019 %T Determinants of hip and knee replacement: The role of social support and family dynamics. %A Demiralp, Berna %A Koenig, Lane %A Jennifer T Nguyen %A Samuel A Soltoff %K Family Roles/Relationships %K Health care utilization %K Joint replacement %K Social Support %X The objective of this study was to examine variations in the determinants of joint replacement (JR) across gender and age, with emphasis on the role of social support and family dynamics. We analyzed data from the US Health and Retirement Study (1998-2010) on individuals aged 45 or older with no prior receipt of JR. We used logistic regression to analyze the probability of receiving knee or hip replacement by gender and age (<65, 65+). We estimated the effect of demographic, health needs, economic, and familial support variables on the rate of JR. We found that being married/partnered with a healthy spouse/partner is positively associated with JR utilization in both age groups (65+ group OR: 1.327 and <65 group OR: 1.476). While this finding holds for men, it is not statistically significant for women. Among women younger than 65, having children younger than 18 lowers the odds (OR: 0.201) and caring for grandchildren increases the odds (1.364) of having a JR. Finally, elderly women who report availability of household assistance from a child have higher odds of receiving a JR as compared with elderly women without a child who could assist (OR: 1.297). No effect of available support from children was observed for those below 65 years old and elderly men. Our results show that intrafamily dynamics and familial support are important determinants of JR; however, their effects vary by gender and age. Establishing appropriate support mechanisms could increase access to cost-effective JR among patients in need of surgery. %B Inquiry %V 56 %P 46958019837438 %8 2019 Jan-Dec %G eng %1 http://www.ncbi.nlm.nih.gov/pubmed/30947603?dopt=Abstract %R 10.1177/0046958019837438 %0 Journal Article %J Journals of Gerontology, Series B: Psychological Sciences & Social Sciences %D 2019 %T A friend in need? Exploring the influence of disease and disability onset on the number of close friends among older adults. %A Kenzie Latham-Mintus %K Disabilities %K Health Conditions and Status %K Social Support %X

OBJECTIVES: This research examines whether onset of life-threatening disease (i.e., cancer, lung disease, heart disease, or stroke) or Activities of Daily Living (ADL) disability influences the reported number of close friends.

METHODS: Using data from the Health and Retirement Study (HRS) (2006-2012), this research capitalizes on panel data to assess changes in number of close friends over a four-year period. Lagged dependent variable (LDV) and change score (CS) approaches were employed.

RESULTS: Both the LDV and CS models provide evidence that onset of life-threatening disease was associated with reporting more friends four years later. In particular, onset of cancer was associated with reporting more close friends.

DISCUSSION: This research provides evidence of the network activation hypothesis following onset of life-threatening disease among older adults.

%B Journals of Gerontology, Series B: Psychological Sciences & Social Sciences %G eng %1 http://www.ncbi.nlm.nih.gov/pubmed/31056663?dopt=Abstract %R 10.1093/geronb/gbz050 %0 Journal Article %J Journal of Gerontological Social Work %D 2019 %T Gender differences in the effect of social resources and social status on the retirement satisfaction and health of retirees. %A Wang, Yihan %A Matz-Costa, Christina %K Gender Differences %K Retirement Planning and Satisfaction %K Social Support %X This study explores the effect of positive and negative social support, social reciprocity, and subjective social status on the retirement satisfaction and health of retirees and gender differences therein. Using cross-sectional data from the 2010 and 2012 waves of the Health and Retirement Study (HRS), we found that social support seems to matter more for the retirement satisfaction and health of women, while social reciprocity matters more for the health of men and subjective social status for the retirement satisfaction of men. Implications for the development of social programs and policies over the life course are discussed.< %B Journal of Gerontological Social Work %G eng %1 http://www.ncbi.nlm.nih.gov/pubmed/29768108?dopt=Abstract %R 10.1080/01634372.2018.1474156 %0 Report %D 2019 %T How cognitive ability and financial literacy shape the demand for financial advice at older ages %A Hugh Hoikwang Kim %A Maurer, Raimond %A Olivia S. Mitchell %K Cognition & Reasoning %K Financial literacy %K Social Support %X We investigate how cognitive ability and financial literacy shape older Americans’ demand for financial advice using an experimental module in the 2016 Health and Retirement Study. We show that cognitive ability and financial literacy strongly improve the quality, but not the quantity, of financial advice sought. Most importantly, the financially literate and more cognitively able tend to seek financial help from professionals rather than family members, and they are less likely to accept so-called ‘free’ financial advice that may entail conflicts of interest. Nevertheless, those with higher cognitive function also tend to distrust financial advisors, leading them to eschew their services. %B NBER Working Paper Series %I National Bureau of Economic Research %C Cambridge, MA %P 1-20 %8 04/2019 %G eng %U http://www.nber.org/papers/w25750.pdf %R 10.3386/w25750 %0 Journal Article %J Research on Aging %D 2019 %T Intersections of Home, Health, and Social Engagement in Old Age: Formal Volunteering as a Protective Factor to Health After Relocation. %A Guillermo Ernest Gonzales %A Shen, Huei-Wern %A Tam E Perry %A Wang, Yi %K Moves %K Protective factors %K Social Support %K Volunteerism %X This study aims to further our understanding of formal volunteering as a protective mechanism for health in the context of housing relocation and to explore race, gender, and education as moderators. A quasi-experimental design evaluated the effects of volunteering on older adults' health (self-report health, number of instrumental activities of daily living [IADLs], and depressive symptoms) among individuals who relocated but did not volunteer at Time 1 ( N = 682) in the Health and Retirement Study (2008-2010). Propensity score weighting examined health differences at Time 2 between 166 volunteers (treated) and 516 nonvolunteers (controlled). Interaction terms tested moderation. Individuals who moved and engaged in volunteering reported higher levels of self-rated health and fewer IADL difficulties compared to the control group. Race moderated the relationship between volunteering and depressive symptoms, while gender moderated the relationship between volunteering and self-assessed health. Formal volunteering protects different dimensions of health after relocation. Volunteering was particularly beneficial for females and older Whites. %B Research on Aging %V 41 %P 31-53 %G eng %N 1 %1 http://www.ncbi.nlm.nih.gov/pubmed/29742961?dopt=Abstract %R 10.1177/0164027518773125 %0 Journal Article %J Journal of Diabetes Investigation %D 2019 %T Longitudinal investigation of the reciprocal relationship between depressive symptoms and glycemic control: The moderation effects of sex and perceived support. %A Chiu, Ching-Ju %A Du, Ye-Fong %K Biomarkers %K Depressive symptoms %K Diabetes %K Gender Differences %K Social Support %X

AIMS/INTRODUCTION: The present study investigated the longitudinal associations between depressive symptoms and glycemic control in nationally representative adults with type 2 diabetes, and tested the effects of sex and perceived family support in moderating this association.

MATERIALS AND METHODS: In this longitudinal study of middle-aged and older adults who participated in the 2002 and 2006 Health and Retirement Study, and the 2003 and 2006 Diabetes Study (n = 398), we applied a cross-lagged structural equation model to examine the reciprocal relationship between depressive symptoms and glycemic control over a 3-year period.

RESULTS: Men and women were not different in terms of the depressive symptoms and glycemic control relationship, with a stronger association noted for higher depressive symptom scores predicting worse glycemic control (β = 0.22, critical ratio 3.03), as opposed to worse glycemic control predicting higher depressive symptom scores. Family and friend support for diabetes self-management serves as an important buffer. In patients with low family and friend support, more depressive symptoms at baseline were associated with subsequent worse glycemic levels (β = 0.36, critical ratio 4.03). In contrast, in individuals who had strong support, depressive symptoms did not predict subsequent glycemic control.

CONCLUSIONS: The present study provided evidence for the relationship between glycemic control and depression, finding that depressive symptoms predicted poorly controlled glycemic status, especially when the participants perceived inadequate support from their family or friends. A quick survey in clinics to assess the level of family or friend support for diabetes management and depressive symptoms might be an important part of individualized diabetic care.

%B Journal of Diabetes Investigation %V 10 %P 801-808 %G eng %N 3 %1 http://www.ncbi.nlm.nih.gov/pubmed/30390387?dopt=Abstract %R 10.1111/jdi.12969 %0 Journal Article %J Gerontologist %D 2019 %T Measuring Social Participation in the Health and Retirement Study. %A Bret Howrey %A Carri L. Hand %K Social Factors %K Social Support %K Survey Methodology %X

Background and Objectives: Large data sets have the potential to reveal useful information regarding social participation; however, most data sets measure social participation via individual items without a global assessment of social participation.

Research Design and Methods: We used data from the Health and Retirement Study (HRS) to assess whether 8 items from questionnaire pertaining to social participation (religious attendance, caring for an adult, activities with grandchildren, volunteering, charity work, education, social clubs, nonreligious organizations) formed a reliable, cohesive scale and to explore the predictive validity of this scale. We included respondents 65 years and older in the HRS who returned the psychosocial questionnaire in 2010 and 2012 with responses to the social participation items (n = 4,317 and n = 3,978). Three scales were explored: SoPart-30 using the original scoring; SoPart-10 using modified scoring; and SoPart-5 using dichotomous scoring.

Results: Five items were retained as a single factor for each scale, and graded response models and Mokken scale analysis confirmed the scale items with the SoPart-10 scale having the highest reliability (alpha = 0.74).

Discussion and Implications: Results suggest that a scale derived from the social participation items in the HRS may be useful in characterizing general social participation levels and identifying modifiable factors that can promote it in older populations.

%B Gerontologist %G eng %1 http://www.ncbi.nlm.nih.gov/pubmed/30169644?dopt=Abstract %R 10.1093/geront/gny094 %0 Journal Article %J Journal of Applied Gerontology %D 2019 %T Nature of Retirement and Loneliness: The Moderating Roles of Social Support %A Shin, O. %A So Jung Park %A Amano, T. %A Kwon, E. %A BoRin Kim %K Loneliness %K Retirement %K Social Support %X Drawing from the social convoy model, this study investigates whether the nature of retirement (voluntary or involuntary) influences loneliness among retirees, and how different social support types may affect this association. Data come from the 2014 Health and Retirement Study (N = 2,055). Five social support types were identified: weak, ambivalent, strong positive, children strain, and family strain. Involuntary retirement was associated with a higher level of loneliness; however, involuntarily retired individuals with strong positive social support had a relatively lower level of loneliness. Findings from this study suggest that social support may alleviate the negative impacts of involuntary retirement. Our research provides a theoretical basis for developing a practical program to reduce the negative impacts of involuntary retirement on well-being. © The Author(s) 2019. %B Journal of Applied Gerontology %G eng %R 10.1177/0733464819886262 %0 Journal Article %J Ageing and Society %D 2019 %T The race paradox in subjective wellbeing among older Americans %A Tang, Fengyan %A Heejung Jang %A Mary Beth Rauktis %A Donald Musa %A Scott Beach %K Happiness %K Racial/ethnic differences %K Social Support %K Well-being %X This study aims to assess racial differences in subjective wellbeing (SWB) and to examine whether the pathways of social support and social engagement to SWB vary by racial groups in the United States of America. Using a local sample (N = 1,035) and a nationally representative sample of the Health and Retirement Study (N = 7,718), we compared life satisfaction and happiness between non-Hispanic Whites and Blacks aged 55 and over. We evaluated the extent to which race, other socio-demographic characteristics, health, social engagement and social support explained the variances in SWB and examined the moderation effects of race on the relationships of SWB with age, social support and social engagement. Multiple regression analyses showed that non-Hispanic Blacks were at least as satisfied as, and even happier than White peers, after equalising social resources and health variables. Social support was significantly related to SWB, and it seemed that positive support was more important to Whites than to Blacks in predicting life satisfaction. In addition, the racial crossover effect existed, that is, the old-old (80+) Blacks were happier than their White peers. Findings indicate a national trend of the race paradox in SWB and underscore the importance of social support in promoting older adults’ wellbeing. Future research is recommended to investigate other potential mechanisms among Black older Americans to explain their relatively better SWB. %B Ageing and Society %V 39 %P 568-589 %G eng %U https://www.cambridge.org/core/product/identifier/S0144686X17001064/type/journal_articlehttps://www.cambridge.org/core/services/aop-cambridge-core/content/view/S0144686X17001064 %N 3 %! Ageing and Society %R 10.1017/S0144686X17001064 %0 Journal Article %J Psychology and Aging %D 2019 %T Social relations and age-related change in memory. %A Laura B Zahodne %A Kristine J. Ajrouch %A Sharifian, Neika %A Toni C Antonucci %K Cognitive Ability %K Family Roles/Relationships %K Memory %K Social Support %X Previous research suggests that social relations are associated with age-related memory change. However, social relations are complex and multidimensional, and it is not yet clear which aspects (structure, quality) may be beneficial over time. Further, the strength and direction of associations may differ depending on relationship type (partner, children, other family, friends). Using longitudinal data from the Health and Retirement Study (n = 10,390; Mage = 69, SD = 9.53 at baseline), latent growth curve models tested which aspects of social relations predicted 6-year episodic memory trajectories. Both structure and quality of social relations were associated with initial memory level, such that being married/partnered, reporting more frequent contact with children and friends, reporting less support from family members other than partners and children, and reporting less strain across relationship types were each independently associated with better initial memory. In contrast, only structure was associated with subsequent memory decline. Specifically, being married/partnered and reporting more frequent contact with friends were each independently associated with slower memory decline. No evidence of bidirectionality was found, as baseline memory did not predict subsequent changes in social relations. This longitudinal study helps to clarify which aspects of social relations are most likely to influence late-life episodic memory trajectories. Future intervention studies may focus on increasing social interactions with nonfamily members to minimize memory decline with age. (PsycINFO Database Record (c) 2019 APA, all rights reserved). %B Psychology and Aging %V 34 %P 751-765 %G eng %N 6 %R 10.1037/pag0000369 %0 Journal Article %J Gerontologist %D 2019 %T Social Support and Preventive Healthcare Behaviors Among Couples in Later Life. %A Sae Hwang Han %A Kyungmin Kim %A Jeffrey A Burr %K Marriage %K Preventative Care %K Social Support %X

Background and Study Objectives: Intimate partners and close friends represent two major sources of social support that are central to one's health and health behaviors in later life. The aim of this study was to examine dyadic linkages between perceived social support (from spouses and friends) and preventive healthcare behaviors among coupled-individuals.

Design and Methods: Prospective data from the Health and Retirement Study (2010, 2012) were used to analyze a sample of coupled-individuals (dyad N = 1,902). A series of multilevel logistic regression (actor-partner interdependence) models were estimated to evaluate whether perceived social support from spouses and friends was associated with the likelihood of using two common forms of preventive healthcare services (i.e., influenza vaccination and cancer screenings).

Results: Apart from the role of perceived support from spouse on flu vaccinations, wives' preventive healthcare behaviors were unrelated to perceived social support. In contrast, husbands' preventive healthcare behaviors showed consistent associations with perceived social support from friends for the 2-year observation period. Further, husbands' receipt of prostate cancer screening was associated with wives' perceptions of social support from spouse as well as friends.

Discussion and Implications: These findings contributed to our understanding of the health advantages associated with being in a marital relationship for preventive healthcare behaviors, especially for men. Future research should unpack the pathways through which social support of various forms is associated with obtaining needed preventive health services.

%B Gerontologist %G eng %1 http://www.ncbi.nlm.nih.gov/pubmed/30517629?dopt=Abstract %R 10.1093/geront/gny144 %0 Journal Article %J Aging & Mental Health %D 2019 %T Typologies of older adult companion animal owners and non-owners: moving beyond the dichotomy. %A Dawn C Carr %A Miles G Taylor %A Nancy R Gee %A Natalie J Sachs-Ericsson %K Pets %K Social Support %X

OBJECTIVES: Research on the influence of companion animals (CA) on the health of older adults has yielded contradictory results. Selection factors, leading to heterogeneity both between and within groups of CA owners and non-owners, likely bias results. We conduct analyses to identify typologies of owners and non-owners.

METHODS: Using data on older adults (60+) from the 2012 Health and Retirement Study (HRS), and the HRS companion animal module, (owners = 478) and (non-owners = 624), we conducted latent class analyses (LCA). We used key demographic, health, daily engagement, and pet characteristic variables to complete our analyses.

RESULTS: Analyses revealed five clusters of CA owners and four clusters of non-owners. Health and CA related characteristics distinguishing clusters suggest important sources of variability and reflect qualitatively different profiles of owners and non-owners. We also found CA owners were more likely than non-owners to be high on neuroticism and to be less extroverted than non-owners-but again there was considerable within group variability.

IMPLICATIONS: Factors that select people into pet ownership not only work individually to characterize ownership, they create distinct typologies of CA owners and non-owners that likely contribute to subsequent health outcomes. In order to determine if having a CA is beneficial to health in later life and for whom, future research should consider selection factors like those identified in the typologies. Statistical analyses, such as LCA, that can adequately account for these selection factors is necessary to avoid biases in the interpretation of results.

%B Aging & Mental Health %G eng %1 http://www.ncbi.nlm.nih.gov/pubmed/30380913?dopt=Abstract %R 10.1080/13607863.2018.1503999 %0 Journal Article %J Archives of Clinical Neuropsychology %D 2019 %T Unique effects of perceived neighborhood physical disorder and social cohesion on episodic memory and semantic fluency. %A Afsara B. Zaheed %A Sharifian, Neika %A A Zarina Kraal %A Sol, Ketlyne %A Hence, Alyssia %A Laura B Zahodne %K Memory %K Neighborhoods %K Perception %K Social Support %X

Objective: Objective measures of neighborhood quality are associated with physical and mental health outcomes for older adults, but the relationship between perceived neighborhood quality and cognitive health has not been fully explored. Furthermore, positive and negative neighborhood characteristics may influence cognition through different mechanisms. The present study aimed to determine whether perceptions of neighborhood quality predict cognitive functioning in two domains, above and beyond individual-level risk factors, in a nationally representative sample of older adults.

Method: Using cross-sectional weighted data from 13,919 participants aged 51 and older from the Health and Retirement Study, linear regression models tested independent associations between perceived neighborhood quality (physical disorder and social cohesion) and cognition (episodic memory and semantic verbal fluency), controlling for sociodemographic characteristics, chronic disease burden, and depressive symptoms. Interaction terms tested whether neighborhood social cohesion moderated the relationship between neighborhood physical disorder and each cognitive outcome.

Results: Perception of greater neighborhood physical disorder was significantly associated with worse episodic memory, while perception of lower neighborhood social cohesion was significantly associated with worse semantic fluency. There were no significant interactions between physical disorder and social cohesion.

Conclusions: Results provide preliminary evidence for different mechanisms underlying associations between aspects of neighborhood quality and cognition (e.g., stress vs. social interaction). Additional intervention work is needed to determine whether improving neighborhood physical conditions and promoting social cohesion at the neighborhood level could reduce cognitive morbidity among older adults.

%B Archives of Clinical Neuropsychology %G eng %1 http://www.ncbi.nlm.nih.gov/pubmed/30715092?dopt=Abstract %R 10.1093/arclin/acy098 %0 Journal Article %J American Journal of Geriatric Psychiatry %D 2019 %T Using Skype to Beat the Blues: Longitudinal Data from a National Representative Sample. %A Alan R Teo %A Markwardt, Sheila %A Hinton, Ladson %K Depressive symptoms %K Social Support %K Technology %X

OBJECTIVES: This study aimed to determine whether use of certain types of online communication technology is associated with subsequent depressive symptoms.

DESIGN: Nationally representative, population-based prospective cohort.

SETTING: Data were obtained from the 2012 and 2014 waves of the Health and Retirement Study (HRS).

PARTICIPANTS: 1,424 community-residing older adults (mean age, 64.8) in the United States.

MEASUREMENTS: We examined associations between use of four communication technologies (email, social networks, video chat, and instant messaging) in 2012 and depressive symptoms (eight-item Center for Epidemiologic Studies Depression scale) at two-year follow-up.

RESULTS: 564 participants (39.6%) did not use any communication technologies, 314 (22.1%) used email only, and 255 (17.9%) used video chat (e.g., Skype). Compared to non-users (13.1%, 95% CI: 9.5-16.7%) or those who used only email (14.3%, 95% CI: 10.1-18.5%), users of video chat had approximately half the probability of depressive symptoms (6.9%, 95% CI: 3.5-10.3%, Wald Chi test, Chi=13.82, p < 0.001; 7.6%, 95% CI: 3.6-11.6, Wald Chi test, Chi=13.56, p < 0.001). Use of email, social media, and instant messaging were not associated with a lower risk of depression.

CONCLUSIONS: Older adults who use video chat such as Skype, but not other common communication technologies, have a lower risk of developing depression.

%B American Journal of Geriatric Psychiatry %V 27 %P 254-262 %G eng %N 3 %1 http://www.ncbi.nlm.nih.gov/pubmed/30442532?dopt=Abstract %R 10.1016/j.jagp.2018.10.014 %0 Journal Article %J Personal Relationships %D 2019 %T Who gives and receives more? Older couples' personality and spousal support. %A Kyuho Lee %A Peter Martin %K Marriage %K No terms assigned %K Personality %K Social Support %X This study examined the effects of the Big Five personality traits on support/strain exchange within older couples. Data of 1,775 older couples aged between 50 and 85 years in 2014 from the Health and Retirement Study were assessed, and actor–partner interdependent models were used. For the actor effects, all the five factors predicted their report on the spousal support/strain from the spouse; some differences between husbands and wives, as well as support and strain, were detected. For the partner effects, conscientiousness, agreeableness, and neuroticism predicted the support/strain provision reported by the partner. The findings of this study illustrate that certain personality factors work as predictors of spousal support/strain in older couples. The possible mechanism with regard to older adults' personality and marital relationship was discussed. (PsycINFO Database Record (c) 2019 APA, all rights reserved) %B Personal Relationships %G eng %R http://dx.doi.org/10.1111/pere.12290 %0 Journal Article %J Journal of Health Psychology %D 2018 %T Adjusting after stroke: Changes in sense of purpose in life and the role of social support, relationship strain, and time. %A Nathan A Lewis %A Brazeau, Hannah %A Patrick L Hill %K Purpose in life %K Social Support %K Stroke %X It is unclear how the onset of a major health condition, such as a stroke, may impact sense of purpose long-term and whether social factors influence this change. We examined changes in purpose in 716 stroke patients ( M = 72.09 years, 52.5% female) who participated in the Health and Retirement Study between 2006 and 2014. Multilevel growth modeling indicated that recent stroke patients' sense of purpose declined over time relative to pre-stroke purpose, whereas those suffering stroke prior to baseline demonstrated relative stability. Furthermore, social support was associated with initial levels but not change in sense of purpose. %B Journal of Health Psychology %G eng %9 Journal %1 http://www.ncbi.nlm.nih.gov/pubmed/29734856?dopt=Abstract %R 10.1177/1359105318772656 %0 Journal Article %J Ageing International %D 2018 %T Association Between Social Support and Health of Aging Adults with Dementia %A Pakstis, Allyson %A Kim, Jinhee %A Bhargava, Vibha %K Cognitive Ability %K Dementia %K Health Conditions and Status %K Social Support %X The purpose of this cross-sectional study was to explore the relationship between social support and the health outcomes of older adults, ages 50 and older, with dementia in the United States, using data from the 2012 wave of the Health and Retirement Study (N = 446). The dependent variables included depressive symptoms (CES-D), self-reported health, number of chronic conditions, and the sum of activities of daily living (ADL) limitations. The key independent variables were measures of social support including marital status, children living within ten miles, relatives near, good friends near or in congregation, how often they attend religious services, relatives in congregation, and number of times they get together with people. Guided by the convoy model, this study focused on the layers of social support that typically surround an aging adult and the types of support within those layers. Findings of the logistic regression suggest that attending religious services was significantly associated with the ADL (p = .004). Having friends near or in a congregation was negatively associated with number of ADL limitations (p < .001), and positively associated with the likelihood of fewer depressive symptoms (p < .001). Results suggest that social support may be playing an important role in the health of aging adults with dementia. It may be important to focus on how to better ensure reliable social networks for aging adults with dementia and how to help secure meaningful social connections. Future research should prioritize assessing the effects of the quality of social supports on different types of health outcomes, within varying social proximities. %B Ageing International %V 43 %P 477-495 %G eng %N 4 %! Ageing Int %R 10.1007/s12126-018-9325-y %0 Journal Article %J Research on Aging %D 2018 %T Chronic discrimination and sleep problems in late life: Religious involvement as buffer %A Bierman, Alex %A Lee, Yeonjung %A Schieman, Scott %K Discrimination %K Religion %K Sleep %K Social Support %X The association between chronic discrimination and sleep problems is important to examine in older adults because sleep is highly reactive to stress and impaired sleep has diverse adverse health effects. The association between chronic discrimination and sleep problems may, however, be confounded by a number of time-stable influences, and this association may also vary by religious involvement. In three waves (2006, 2010, and 2014) of the Health and Retirement Study (N = 7,130), the overall association between chronic discrimination and sleep problems is negated in econometric models that control for all time-stable sources of confounding. Religious involvement does not modify this association for men, but a significant association is found among women who do not attend religious services. These analyses suggest that the association between chronic discrimination and sleep quality in late life is substantially inflated due to unobserved time-stable confounders, although women who do not attend religious services may be at risk. %B Research on Aging %V 40 %P 933-955 %G eng %N 10 %! Res Aging %R 10.1177/0164027518766422 %0 Journal Article %J International Journal of Behavioral Development %D 2018 %T The co-development of perceived support and the Big Five in middle and older adulthood %A Patrick L Hill %A Sara J Weston %K Personality %K Retirement Planning and Satisfaction %K Self-reported health %K Social Support %X The current study examined whether relationships also influence personality trait development during middle and older adulthood, focusing on the individual's perception of support from the relationship partner. Using data from the Health and Retirement Study (n = 20,422; mean age = 65.9 years), we examined the longitudinal relationships between Big Five personality trait levels and perceived support from children, family, friends, and spouses. Results found that participants who reported more positive social support and lower negative support also tended to score higher on conscientiousness, extraversion, agreeableness, and openness to experience, but lower on neuroticism. Moreover, changes in positive support across relationship partners coincided with trait changes over time, in the form of more positive support was associated with seemingly adaptive changes on the Big Five. Findings are discussed with respect to identifying social influences on personality development in adulthood. %B International Journal of Behavioral Development %V 42 %P 26-33 %G eng %N 1 %! International Journal of Behavioral Development %R 10.1177/0165025417690262 %0 Journal Article %J J Gerontol B Psychol Sci Soc Sci %D 2018 %T Education and Psychosocial Functioning Among Older Adults: 4-Year Change in Sense of Control and Hopelessness. %A Uchechi A Mitchell %A Jennifer A Ailshire %A Lauren L Brown %A Morgan E. Levine %A Eileen M. Crimmins %K Activities of Daily Living %K Aged %K Educational Status %K Female %K Humans %K Internal-External Control %K Male %K Middle Aged %K Psychology %K Sadness %K Social participation %K Social Support %X

OBJECTIVES: This study investigates education differences in levels and change in sense of control and hopelessness among older adults.

METHOD: We used data from the Health and Retirement Study, an ongoing biennial survey of a nationally representative sample of older Americans, to examine education differences in sense of control (e.g., mastery and perceived constraints) and hopelessness. Our sample included 8,495 adults aged 52 and older who were interviewed in 2006/2008 and 2010/2012. We assessed separate models for change in sense of control and hopelessness, accounting for recent changes in social circumstances and health status.

RESULTS: Low mastery, perceived constraints, and hopelessness were highest among individuals with less than a high school education. Over a 4-year period, this group experienced the greatest declines in psychosocial functioning, as indicated by greater increases in low mastery, perceived constraints, and hopelessness. Education differences existed net of recent negative experiences, specifically the loss of intimate social relationships and social support and increases in disease and disability.

DISCUSSION: These findings highlight the importance of education for sense of control and hopelessness in older adulthood and demonstrate the cumulative advantage of higher levels of education for psychosocial functioning.

%B J Gerontol B Psychol Sci Soc Sci %V 73 %P 849-859 %8 2018 Jun 14 %G eng %U http://psychsocgerontology.oxfordjournals.org/content/early/2016/03/23/geronb.gbw031.abstract %N 5 %1 http://www.ncbi.nlm.nih.gov/pubmed/27013537?dopt=Abstract %4 Health and Retirement Study/Longitudinal analysis/Mastery/Perceived constraints %$ 999999 %R 10.1093/geronb/gbw031 %0 Journal Article %J Nature Communications %D 2018 %T Elucidating the genetic basis of social interaction and isolation %A Day, Felix R %A Ong, Ken K %A Perry, John R B %K Depressive symptoms %K Genetics %K Social Factors %K Social Support %X The negative impacts of social isolation and loneliness on health are well documented. However, little is known about their possible biological determinants. In up to 452,302 UK Biobank study participants, we perform genome-wide association study analyses for loneliness and regular participation in social activities. We identify 15 genomic loci (P < 5 × 10−8) for loneliness, and demonstrate a likely causal association between adiposity and increased susceptibility to loneliness and depressive symptoms. Further loci were identified for regular attendance at a sports club or gym (N = 6 loci), pub or social club (N = 13) or religious group (N = 18). Across these traits there was strong enrichment for genes expressed in brain regions that control emotional expression and behaviour. We demonstrate aetiological mechanisms specific to each trait, in addition to identifying loci that are pleiotropic across multiple complex traits. Further study of these traits may identify novel modifiable risk factors associated with social withdrawal and isolation. %B Nature Communications %V 9 %P 1-6 %G eng %U http://www.nature.com/articles/s41467-018-04930-1http://www.nature.com/articles/s41467-018-04930-1.pdfhttp://www.nature.com/articles/s41467-018-04930-1.pdfhttp://www.nature.com/articles/s41467-018-04930-1 %N 1 %! Nat Commun %R 10.1038/s41467-018-04930-1 %0 Journal Article %J Journal of Religion and Health %D 2018 %T Examining the Effects of Religious Attendance on Resilience for Older Adults %A Lydia K Manning %A Miles, Andrew %K Depressive symptoms %K Religion %K Resilience %K Social Support %K Trauma %X Growing older often brings hardship, adversity, and even trauma. Resilience is a broad term used to describe flourishing despite adversity. To date, resilience and the connections to religion have not been well studied, despite compelling evidence that religious practice can promote psychological health. This research examines the role that religion plays in promoting resilience among older adults. Research questions include: (a) What is the relationship between religion and trait resilience? and (b) Does religion promote resilient reintegration following traumatic life events? Results indicate that religious service attendance is tied to higher levels of trait resilience and that both service attendance and trait resilience directly predict lower levels of depression and higher rates of resilient reintegration following traumatic life events. Findings suggest that religious service attendance has protective properties that are worthy of consideration when investigating resilience. %B Journal of Religion and Health %V 57 %P 191-208 %G eng %N 1 %! J Relig Health %R 10.1007/s10943-017-0438-5 %0 Journal Article %J Journal of Marriage and Family %D 2018 %T Gender, Spousal Caregiving, and Depression: Does Paid Work Matter? %A Glauber, Rebecca %A Day, Melissa D. %K Caregiving %K Depressive symptoms %K Gender Differences %K Purpose in life %K Social Support %X Studies have shown that spousal caregiving leads to psychological distress, but few have analyzed the moderating effect of paid work. Using the 2000 to 2012 Health and Retirement Study and two-stage least squares regression models, this study found that caregiving increased women's and men's depressive symptoms. Ordinary least squares models showed that caregiving had more adverse effects on women's mental health than on men's, but these differences were eliminated in two-stage least squares models that accounted for the bidirectional effects of depression and caregiving. The current study also found that for women, part-time work attenuated the depressive effect of spousal caregiving, whereas for men, part-time work exacerbated it. These gender differences persisted even for intensive spousal caregivers. The authors suggest that caregiving women who work part-time may benefit from work-related resources. Caregiving men who work part-time, however, may feel distressed, as their work-family experiences conflict with traditional gender norms. %B Journal of Marriage and Family %V 80 %P 537-554 %G eng %N 2 %! Fam Relat %R 10.1111/jomf.2018.80.issue-210.1111/jomf.12446 %0 Journal Article %J BMC Public Health %D 2018 %T Human-animal interaction as a social determinant of health: Descriptive findings from the Health and Retirement study %A Megan K Mueller %A Nancy R Gee %A Regina M. Bures %K Depressive symptoms %K Pets %K Social Support %X Background: We focused on human-animal interaction (HAI) as an important aspect of social functioning at the individual level, framing this emerging field from a public health perspective. Methods: Using data from the Health and Retirement Study (HRS) 2012 HAI module, we describe the characteristics of pet ownership in a population of older adults, and examine the relation between pet ownership and multiple mental and physical health indicators such as health status, depression, and physical activity. Results: Of the 1657 participants in our subsample, approximately half (51.5%) reported being pet owners; the majority owned dogs or cats, and most had only one pet. Pet ownership was significantly associated with a higher likelihood of ever having had depression, with pet owners being 1.89 times more likely to have experienced depression. However, pet ownership was not associated with having experienced depression within the last week. Conclusions: The findings from this study could indicate a relationship between pet ownership and depression, but it is impossible to determine the directionality of that relationship. It is possible that owning a pet may put a person at an increased risk of developing depression, or individuals who are at risk, or who have already developed depression, may acquire a pet as a way of managing their depressive symptoms. The findings of this study provide an initial step in contributing to our understanding of the relationship between companion animals and the social, physical, and mental well-being of the HRS study population. Future research should include measures of HAI in longitudinal, population-based surveys. %B BMC Public Health %V 18 %P 305 %G eng %U https://bmcpublichealth.biomedcentral.com/articles/10.1186/s12889-018-5188-0http://link.springer.com/content/pdf/10.1186/s12889-018-5188-0.pdf %N 1 %! BMC Public Health %R 10.1186/s12889-018-5188-0 %0 Journal Article %J The Journal of the Economics of Ageing %D 2018 %T Impact of volunteering on cognitive decline of the elderly %A Gupta, Sumedha %K Cognitive Ability %K Engagement %K Social Support %K Volunteerism %X Cognitive decline among the elderly imposes a large welfare and health care cost on the individual as well as society. Little however is known about factors that can mitigate cognitive decline. Using seven waves of the Health and Retirement Study and a fixed effects – instrumental variable methodology, this study estimates the effects of volunteering on old age cognitive decline. Although cognitive decline is an inevitable aspect of aging, our results suggest that volunteering participation significantly forestalls its progress among individuals aged 60 years and older. %B The Journal of the Economics of Ageing %V 12 %P 46-60 %G eng %U http://linkinghub.elsevier.com/retrieve/pii/S2212828X17300646http://api.elsevier.com/content/article/PII:S2212828X17300646?httpAccept=text/xmlhttp://api.elsevier.com/content/article/PII:S2212828X17300646?httpAccept=text/plain %! The Journal of the Economics of Ageing %R 10.1016/j.jeoa.2018.01.002 %0 Journal Article %J SSM Popul Health %D 2018 %T Machine learning approaches to the social determinants of health in the Health and Retirement study. %A Seligman, Benjamin %A Tuljapurkar, Shripad %A David Rehkopf %K Biomarkers %K Computer science %K Machine learning %K Neural network %K Social Factors %K Social Support %X

Background: Social and economic factors are important predictors of health and of recognized importance for health systems. However, machine learning, used elsewhere in the biomedical literature, has not been extensively applied to study relationships between society and health. We investigate how machine learning may add to our understanding of social determinants of health using data from the Health and Retirement Study.

Methods: A linear regression of age and gender, and a parsimonious theory-based regression additionally incorporating income, wealth, and education, were used to predict systolic blood pressure, body mass index, waist circumference, and telomere length. Prediction, fit, and interpretability were compared across four machine learning methods: linear regression, penalized regressions, random forests, and neural networks.

Results: All models had poor out-of-sample prediction. Most machine learning models performed similarly to the simpler models. However, neural networks greatly outperformed the three other methods. Neural networks also had good fit to the data (between 0.4-0.6, versus <0.3 for all others). Across machine learning models, nine variables were frequently selected or highly weighted as predictors: dental visits, current smoking, self-rated health, serial-seven subtractions, probability of receiving an inheritance, probability of leaving an inheritance of at least $10,000, number of children ever born, African-American race, and gender.

Discussion: Some of the machine learning methods do not improve prediction or fit beyond simpler models, however, neural networks performed well. The predictors identified across models suggest underlying social factors that are important predictors of biological indicators of chronic disease, and that the non-linear and interactive relationships between variables fundamental to the neural network approach may be important to consider.

%B SSM Popul Health %V 4 %P 95-99 %G eng %1 http://www.ncbi.nlm.nih.gov/pubmed/29349278?dopt=Abstract %R 10.1016/j.ssmph.2017.11.008 %0 Journal Article %J Demography %D 2018 %T Parental Investments in College and Later Cash Transfers %A Steven Haider %A Kathleen McGarry %K College %K Family transfers %K Finances %K Social Support %X Parents often provide generous financial transfers to their adult children, perhaps assisting with college expenses, recognizing major life course events, or cushioning against negative financial shocks. Because resources are limited, a transfer made to one child likely affects transfers made to others in the family. Despite such possibilities, data limitations have led previous authors to focus almost exclusively on a single type of transfer made at a single point in time. Using data from the Health and Retirement Study, we examine the relationships among parental transfers for college and later cash transfers to all children within a family. We find that parents typically spend differentially on the postsecondary schooling of their children but find no evidence that this differential spending is offset by later cash transfers. %B Demography %V 55 %P 1705-1725 %8 10/2018 %G eng %U http://link.springer.com/10.1007/s13524-018-0703-6http://link.springer.com/content/pdf/10.1007/s13524-018-0703-6.pdfhttp://link.springer.com/content/pdf/10.1007/s13524-018-0703-6.pdfhttp://link.springer.com/article/10.1007/s13524-018-0703-6/fulltext.html %N 5 %! Demography %R 10.1007/s13524-018-0703-6 %0 Journal Article %J Journal of Gerontological Social Work %D 2018 %T Productive aging via volunteering: Does social cohesion influence level of engagement? %A Kimberly J. Johnson %A Kenzie Latham-Mintus %A Judith L Poey %K Neighborhoods %K Social Support %K Volunteerism %X This study investigated whether neighborhood social cohesion influenced volunteer intensity over two years. The sample was drawn from Health and Retirement Study respondents who completed the 2010 or 2012 Psychosocial and Lifestyle Questionnaire (n = 12,929). Results showed that compared to nonvolunteers, a one-unit increase in neighborhood social cohesion increased the odds of moderate (OR: 1.07, p < .05) and high volunteering (OR: 1.10, p < .001). However, other productive roles, social contact, and education were significant in distinguishing high intensity from moderate volunteering while neighborhood social cohesion was not. Social workers should consider the neighborhood environment when recruiting volunteers. %B Journal of Gerontological Social Work %V 61 %G eng %N 8 %1 http://www.ncbi.nlm.nih.gov/pubmed/29697314?dopt=Abstract %R 10.1080/01634372.2018.1467523 %0 Journal Article %J Journal of Poverty and Social Justice %D 2018 %T Social exclusion factors influencing life satisfaction among older adults %A Lee, Joonyup %A John G. Cagle %K Depressive symptoms %K Life Satisfaction %K Social capital %K Social Support %X This study aims to examine the relative impact of social exclusion factors on older adults' life satisfaction. This study conducted a cross-sectional analysis of psychosocial measures from the 2012 wave of the Health and Retirement Study (N=4,139). Results found that social exclusion factors indeed affect life satisfaction. Health had the strongest effect on life satisfaction. Good social relationships also positively affect life satisfaction. These findings call for considering multidimensionality of social exclusion in the future research. Researchers and practitioners could pay greater attention to social exclusion, ways to measure it, and its impact on life satisfaction through this study. %B Journal of Poverty and Social Justice %V 26 %P 35-50 %G eng %U http://www.ingentaconnect.com/content/10.1332/175982717X15127351091521http://www.ingentaconnect.com/content/tpp/jpsj/2018/00000026/00000001/art00003http://www.ingentaconnect.com/content/tpp/jpsj/2018/00000026/00000001/art00003 %N 1 %! j poverty soc justice %R 10.1332/175982717X15127351091521 %0 Journal Article %J Health Psychology %D 2018 %T Social integration and age-related decline in lung function. %A Crittenden, Crista N. %A Murphy, Michael L. M. %A Cohen, Sheldon %K Lung Volume Measurements %K Mortality %K Population Health %K Social Support %X We tested the hypothesis that social integration, measured as number of social roles, is associated with less age-related loss of lung function, an important marker of health and longevity. We also investigated possible psychological factors through which social integration might influence lung health. Methods: Data were analyzed from the Health and Retirement Study (ages 52-94, n = 4,224). Results and Conclusions: Each additional social role reported at baseline was associated with less of a decline in lung function between baseline and the ifollow-up assessment four years later. The association withstood controls for demographics, weight, and height and was mediated by more positive and less negative affect and lower rates of cigarette smoking and more physical activity. Roles were mostly substitutable, with both high (spouse, parent, friends, relatives) and low (employee, religious service attendee, volunteer, members of other groups) intimacy roles independently contributing to less age related decline in lung function. %B Health Psychology %V 37 %P 472-480 %G eng %U http://doi.apa.org/getdoi.cfm?doi=10.1037/hea0000592http://psycnet.apa.org/journals/hea/37/5/472.pdf %N 5 %! Health Psychology %R 10.1037/hea0000592 %0 Thesis %B Gerontology %D 2018 %T Social Relationships and Obesity in Later Life %A Jane Tavares %K 0384:Behavioral psychology %K 0451:Social psychology %K 0493:Aging %K Aging %K Behavioral psychology %K Health and environmental sciences %K Obesity %K Psychology %K Social psychology %K Social Relationships %K Social structural location %K Social Support %K Weight Change %X The majority of U.S. older adults are overweight or obese. Social relationships are a key factor linked to obesity among younger age groups, but there are no known investigations of this association among older adults. This study examined the association between quantitative and qualitative indicators of social relationships and obesity among middle-aged and older adults. Further, this study investigated psychosocial and health behavior variables as mediators and moderators of the association between social relationships and obesity as well as explored demographic differences in this relationship. Using the 2004, 2006, and 2010 waves of the Health and Retirement Study, a series of ordinary least squared (OLS) regression models were used to examine the hypothesized association between social relationships and obesity both cross-sectionally and longitudinally. Psychosocial and health behaviors variables were sequentially added into the OLS regression models to explore the potential mediation of these variables and interaction terms were utilized to estimate their moderation effects. The sample was stratified by age, gender, and race to investigate demographic differences in the cross-sectional and longitudinal regression model analyses. In summary, the analyses showed that only qualitative indicators of social relationships were significantly related to obesity for the full sample. Specifically, results indicated that higher positive social support and lower negative social support were associated with lower waist circumference cross-sectionally and longitudinally. Daily exercise was observed to be a full mediator of these associations and anxiety was a partial mediator; both variables also acted as moderators. Longitudinal analyses also revealed that higher positive support and lower negative support were associated with decreased self-reported BMI from 2004 to 2010. In the stratified analyses, higher loneliness was associated with lower waist circumference for those 65 and older compared to middle-aged adults and higher social participation and weekly contact with friends were associated with lower waist circumference for non-Hispanic blacks compared to non-Hispanic whites. There were generally no other significant demographic differences. Findings from this study highlight several conceptual, programmatic, and policy implications and recommendations based upon these findings are presented. Healthcare providers are encouraged to inquire about older adults’ levels of social support and loneliness in order to achieve a more comprehensive assessment of wellness. Service providers and policymakers are encouraged to develop and fund programs that provide widespread and ample opportunities for older adults to engage socially, particularly those that incorporate or encourage physical activity and healthy eating. %B Gerontology %I University of Massachusetts Boston %V PhD %P 243 %@ 9780438003767 %G eng %U https://scholarworks.umb.edu/doctoral_dissertations/392/ %9 phd %0 Journal Article %J Research on Aging %D 2018 %T Subjective memory problems and availability of emotional support %A Jung-Hwa Ha %A Pai, Manacy %K Cognition & Reasoning %K Depressive symptoms %K Memory %K Social Support %X This study examines (1) whether subjective memory problems (SMP) influence perceived emotional support from and frequency of contact with family and friends; and, (2) the extent to which this relationship is moderated by gender, education, and functional limitations. We use the 2014 wave of the Health and Retirement Study, a nationally representative panel survey of adults aged 51 and over in the United States. While SMP does not affect perceived emotional support for younger group (YG; aged 51-64), in older group (OG; aged 65+), SMP is associated with reduced perceived support from friends. Also, SMP is predictive of fewer writing-based contact with children and friends among OG but not among YG. Lastly, we find that the effect of SMP on support from children is contingent upon activity of daily living (YG) and gender (OG), while the effect of SMP on writing-based contact with both children and friends is contingent upon education (YG only). %B Research on Aging %V 40 %P 978-1007 %G eng %N 10 %! Res Aging %R 10.1177/0164027518797622 %0 Journal Article %J Social Science & Medicine %D 2017 %T Hearing impairment, social support, and depressive symptoms among U.S. adults: A test of the stress process paradigm. %A Jessica S West %K Depressive symptoms %K Disabilities %K Hearing loss %K Social Support %X Hearing impairment is a growing physical disability affecting older adults and is an important physical health stressor, but few studies have examined it in relation to mental health outcomes and even fewer have considered the role of social support in buffering this relationship. The current study builds on the stress process framework and uses longitudinal data from three waves of the Health and Retirement Study (2006, 2010, 2014) to examine the relationship between hearing impairment and depressive symptoms among U.S. adults aged 50 and older (n = 6075). The analysis uses fixed-effects models to assess this relationship and examine the extent to which social support mediates (buffers) or moderates (interaction) the association. The results found that worse self-rated hearing was associated with a significant increase in depressive symptoms, even after controlling for sociodemographic factors. Social support did not buffer this relationship. Instead, social support interacted with hearing impairment: low levels of social support were associated with more depressive symptoms but only among people with poor self-rated hearing. Among those with excellent self-rated hearing, low levels of social support did not increase depressive symptoms. Moreover, high levels of social support reduced depressive symptoms for those with poor hearing. These findings suggest that hearing impairment is a chronic stressor in individuals' lives, and that responses to this stressor vary by the availability of social resources. %B Social Science & Medicine %V 192 %P 94-101 %G eng %1 http://www.ncbi.nlm.nih.gov/pubmed/28963989?dopt=Abstract %R 10.1016/j.socscimed.2017.09.031 %0 Book %D 2017 %T Later-Life Social Support and Service Provision in Diverse and Vulnerable Populations: Understanding Networks of Care %A Janet M Wilmoth %A Merril Silverstein %K Racial/ethnic differences %K Social Support %X Later-Life Social Support and Service Provision in Diverse and Vulnerable Populations offers current, multidisciplinary perspectives on social support and service provision to older Americans. The chapters trace how our understanding of social support among older adults has developed over the past 40 years and explore current gerontological research in the area. They consider how informal care arrangements articulate with formal long-term care policies and programs to provide support to the diverse population of older Americans. They also emphasize heterogeneity in the composition of support networks, particularly in relation to gender, sexual orientation, race/ethnicity, and immigrant status. Collectively, the chapters provide insight into the complexity of older adult’s social support networks that can be used to improve the services provided to caregivers and care recipients as well as the policies that promote high-quality support to people of all ages who are in need of assistance. %I Routledge %C Abingdon, UK %P 234 %@ 9780415788304 %G eng %0 Journal Article %J BMJ Open %D 2017 %T Likelihood that expectations of informal care will be met at onset of caregiving need: a retrospective study of older adults in the USA. %A Abrahamson, Kathleen %A Hass, Zachary %A Laura Sands %K Caregiving %K Community-dwelling %K Marriage %K Social Support %X

BACKGROUND: Ageing adults are likely to expect informal caregiving assistance from a friend or family member, reflecting the reality that most long-term care (LTC) is provided by family and friends. The purpose of the study was to determine the likelihood that expectations of care will be unmet at the onset of functional disability, and the factors that impact that likelihood.

METHODS: Community-dwelling respondents from biannual repeated assessments (2006-2010) of the Health and Retirement Study over age 65 who expressed a caregiving expectation prior to need were included in the final analytical sample (n=1352). Logistic regression and change models were specified to address impact of variables on unmet expectations.

RESULTS: Expectations of care were unmet for almost one-third (32%) of the sample, among whom 30% were not receiving needed care. Unmet expectations were associated with being unmarried, older and having a higher number of ADL deficits. Change over time in the number of predictor variables influenced the likelihood of unmet expectations.

CONCLUSIONS: Unplanned dependence on formal care systems and/or having unmet care needs places elders at risk of negative outcomes. Knowledge of factors that impact whether expected care is eventually received provides robust evidence for counselling individuals regarding the need to plan for additional LTC services.

%B BMJ Open %V 7 %P e017791 %G eng %N 12 %1 http://www.ncbi.nlm.nih.gov/pubmed/29259058?dopt=Abstract %R 10.1136/bmjopen-2017-017791 %0 Journal Article %J Soc Sci Med %D 2017 %T Neighborhood age structure and cognitive function in a nationally-representative sample of older adults in the U.S. %A Esther M Friedman %A Regina A Shih %A Mary E Slaughter %A Margaret M Weden %A Kathleen A. Cagney %K Aged %K Aged, 80 and over %K Aging %K Cognition %K Female %K Health Status %K Humans %K Interpersonal Relations %K Male %K Residence Characteristics %K Social Support %K Socioeconomic factors %K United States %X

Recent evidence suggests that living in a neighborhood with a greater percentage of older adults is associated with better individual health, including lower depression, better self-rated health, and a decreased risk of overall mortality. However, much of the work to date suffers from four limitations. First, none of the U.S.-based studies examine the association at the national level. Second, no studies have examined three important hypothesized mechanisms - neighborhood socioeconomic status and neighborhood social and physical characteristics - which are significantly correlated with both neighborhood age structure and health. Third, no U.S. study has longitudinally examined cognitive health trajectories. We build on this literature by examining nine years of nationally-representative data from the Health and Retirement Study (2002-2010) on men and women aged 51 and over linked with Census data to examine the relationship between the percentage of adults 65 and older in a neighborhood and individual cognitive health trajectories. Our results indicate that living in a neighborhood with a greater percentage of older adults is related to better individual cognition at baseline but we did not find any significant association with cognitive decline. We also explored potential mediators including neighborhood socioeconomic status, perceived neighborhood cohesion and perceived neighborhood physical disorder. We did not find evidence that neighborhood socioeconomic status explains this relationship; however, there is suggestive evidence that perceived cohesion and disorder may explain some of the association between age structure and cognition. Although more work is needed to identify the precise mechanisms, this work may suggest a potential contextual target for public health interventions to prevent cognitive impairment.

%B Soc Sci Med %V 174 %P 149-158 %8 2017 02 %G eng %U http://linkinghub.elsevier.com/retrieve/pii/S0277953616306669http://api.elsevier.com/content/article/PII:S0277953616306669?httpAccept=text/plainhttp://api.elsevier.com/content/article/PII:S0277953616306669?httpAccept=text/xml %1 http://www.ncbi.nlm.nih.gov/pubmed/28033564?dopt=Abstract %! Social Science & Medicine %R 10.1016/j.socscimed.2016.12.005 %0 Journal Article %J International Journal of Environmental Research and Public Health %D 2017 %T Neighborhood Environment and Falls among Community-Dwelling Older Adults. %A Emily J Nicklett %A Matthew C. Lohman %A Matthew Lee Smith %K Community-dwelling %K Health Shocks %K Neighborhoods %K Older Adults %K Social Support %X

Background: Falls present a major challenge to active aging, but the relationship between neighborhood factors and falls is poorly understood. This study examined the relationship between fall events and neighborhood factors, including neighborhood social cohesion (sense of belonging, trust, friendliness, and helpfulness) and physical environment (vandalism/graffiti, rubbish, vacant/deserted houses, and perceived safety walking home at night). Methods: Data were analyzed from 9259 participants over four biennial waves (2006-2012) of the Health and Retirement Study (HRS), a nationally representative sample of adults aged 65 and older in the United States. Results: In models adjusting for demographic and health-related covariates, a one-unit increase in neighborhood social cohesion was associated with 4% lower odds of experiencing a single fall (odds ratio (OR): 0.96, 95% confidence interval (CI): 0.93-0.99) and 6% lower odds of experiencing multiple falls (OR: 0.94, 95% CI: 0.90-0.98). A one-unit increase in the physical environment scale was associated with 4% lower odds of experiencing a single fall (OR: 0.96, 95% CI: 0.93-0.99) and with 5% lower odds of experiencing multiple falls (OR: 0.95, 95% CI: 0.91-1.00) in adjusted models. Conclusions: The physical and social neighborhood environment may affect fall risk among community-dwelling older adults. Findings support the ongoing need for evidence-based fall prevention programming in community and clinical settings.

%B International Journal of Environmental Research and Public Health %V 14 %8 2017 Feb 10 %G eng %N 2 %R 10.3390/ijerph14020175 %0 Journal Article %J J Gerontol B Psychol Sci Soc Sci %D 2017 %T Older Adults With Three Generations of Kin: Prevalence, Correlates, and Transfers. %A Rachel Margolis %A Wright, Laura %K Aged %K Black or African American %K Family %K Family Characteristics %K Female %K Hispanic or Latino %K Humans %K Intergenerational Relations %K Male %K Middle Aged %K Resource Allocation %K Social Support %K Surveys and Questionnaires %K United States %K White People %X

OBJECTIVES: We document the prevalence and sociodemographic correlates of older adults with three generations of living kin and examine the patterns of transfers among this group compared with those with fewer generations of kin available.

METHOD: We use the Health and Retirement Study (1998-2010) to estimate kin availability and intergenerational transfers among respondents in their 50s, 60s, and 70s.

RESULTS: It is far more common for older adults to have aging parents, children, and grandchildren than to have just two generations of kin (parents and children). Forty percent of adults in their 50s, 30% of those in their 60s, and 7.5% of those in their 70s have three generations of kin available. Hispanics and the least educated are more likely to have this generational configuration. The vast majority provides financial or in-kind transfers to at least one generation, and a large minority provides support to both older and younger generations.

DISCUSSION: Although there has been much concern about the strains among those sandwiched between parents and children, it is far more common among older adults to also have grandchildren, and many of these adults are transferring resources both upward and downward to multiple generations.

%B J Gerontol B Psychol Sci Soc Sci %V 72 %P 1067-1072 %8 2017 Oct 01 %G eng %U http://psychsocgerontology.oxfordjournals.org/content/early/2016/01/26/geronb.gbv158.abstract %N 6 %1 http://www.ncbi.nlm.nih.gov/pubmed/26817631?dopt=Abstract %4 Intergenerational exchange/Intergenerational support/Population aging/Sandwich generation %$ 999999 %R 10.1093/geronb/gbv158 %0 Journal Article %J Psychol Health Med %D 2017 %T The relationship between family support; pain and depression in elderly with arthritis. %A Hung, Man %A Bounsanga, Jerry %A Maren W Voss %A Anthony B. Crum %A Wei Chen %A Wendy Church Birmingham %K Aged %K Aged, 80 and over %K Aging %K Arthralgia %K Arthritis %K depression %K Family %K Female %K Humans %K Male %K Middle Aged %K Social Support %K United States %X

The prevalence and chronic nature of arthritis make it the most common cause of disability among U.S.A adults. Family support reduces the negative impact of chronic conditions generally but its role in pain and depression for arthritic conditions is not well understood. A total of 844 males (35.0%) and 1567 females (65.0%) with arthritic conditions (n = 2411) were drawn from the 2012 Health and Retirement Study to examine the effect of family support on pain and depressive symptoms. Using regression analysis and controlling for age, ethnicity, gender, marital/educational status and employment/income, physical function/disability status, pain and antidepressant medications, and other clinical indicators of chronic health conditions, we examined the effects of family support (spouse, children, other) on pain and depression levels. Results indicated that depressive symptoms decreased significantly with strong family and spousal support (p < .05). Pain decreased as support levels increased, but was non-statistically significant. This study provides new insights into the relationship between family support, pain, and depression for individuals with arthritis. Future longitudinal studies are needed to evaluate family support and relationships over a wider spectrum of demographics.

%B Psychol Health Med %V 22 %P 75-86 %8 2017 01 %G eng %U https://www.ncbi.nlm.nih.gov/pubmed/27427504 %N 1 %1 http://www.ncbi.nlm.nih.gov/pubmed/27427504?dopt=Abstract %R 10.1080/13548506.2016.1211293 %0 Journal Article %J Gerontologist %D 2017 %T Social connectedness, perceived isolation, and dementia: Does the social environment moderate the relationship between genetic risk and cognitive well-being? %A Judith L Poey %A Jeffrey A Burr %A J Scott Roberts %K Cognitive Ability %K Dementia %K Depressive symptoms %K Genetics %K Isolation %K Older Adults %K Social Support %X Purpose of the Study: This study examined whether the social environment moderates the relationship between the APOE e4 allele and cognitive functioning. Design and Methods: The Aging, Demographics, and Memory Study (ADAMS) data and multinomial logistic regression models were used to investigate these relationships for a nationally representative sample of U.S. adults aged 70 and older (n = 779). Results: Living alone (relative risk ratio [RRR] = 5.814; p = .000) and self-reported loneliness (RRR = 1.928, p = .049) were associated with a greater risk of cognitive difficulty. Living arrangements, perceived social support, and loneliness were found to moderate the relationship between the APOE e4 allele and cognitive function. Implications: The results support the need to consider the social context when examining cognitive well-being in later life. These findings also indicate a need for the development of policies and services that promote a rich social environment. %B Gerontologist %V 57 %P 1031-1040 %G eng %U https://academic.oup.com/gerontologist/article/2951236/Social %N 6 %R 10.1093/geront/gnw154 %0 Journal Article %J Journal of Aging and Health %D 2017 %T Social Isolation and Medicare Spending: Among Older Adults, Objective Isolation Increases Expenditures While Loneliness Does Not %A Jonathan G Shaw %A Farid, Monica %A Claire Noël-Miller %A Joseph, Neesha %A Houser, Ari %A Steven Asch %A Bhattacharya, Jay %A Flowers, Lynda %K Depressive symptoms %K Isolation %K Loneliness %K Medicare expenditures %K Medicare linkage %K Medicare/Medicaid/Health Insurance %K Social Support %X Objective: The purpose of this study was to evaluate the impact of objective isolation and loneliness on Medicare spending and outcomes. Method: We linked Health and Retirement Study data to Medicare claims to analyze objective isolation (scaled composite of social contacts and network) and loneliness (positive response to three-item loneliness scale) as predictors of subsequent Medicare spending. In multivariable regression adjusting for health and demographics, we determined marginal differences in Medicare expenditures. Secondary outcomes included spending by setting, and mortality. Results: Objective isolation predicts greater spending, US$1,644 (p <.001) per beneficiary annually, whereas loneliness predicts reduced spending, 'US$768 (p <.001). Increased spending concentrated in inpatient and nursing home (skilled nursing facilities [SNFs]) care; despite more health care, objectively isolated beneficiaries had 31% (p <.001) greater risk of death. Loneliness did not predict SNF use or mortality, but predicted slightly less inpatient and outpatient care. Discussion: Objectively isolated seniors have higher Medicare spending, driven by increased hospitalization and institutionalization, and face greater mortality. Policies supporting social connectedness could reap significant savings. %B Journal of Aging and Health %V 29 %P 1119-1143 %G eng %U http://journals.sagepub.com/doi/10.1177/0898264317703559http://journals.sagepub.com/doi/pdf/10.1177/0898264317703559 %N 7 %! J Aging Health %R 10.1177/0898264317703559 %0 Newspaper Article %B The Kentucky Standard %D 2017 %T Solo agers plan to age alone without the help of nearby family or close friends %A Marak, Carol %K Marriage %K News %K Singles %K Social Support %B The Kentucky Standard %C Bardstown, KY %G eng %U http://www.kystandard.com/content/solo-agers-plan-age-alone-without-help-nearby-family-or-close-friends %& Aging Matters %0 Journal Article %J J Gerontol B Psychol Sci Soc Sci %D 2017 %T Successful Aging as the Intersection of Individual Resources, Age, Environment, and Experiences of Well-being in Daily Activities. %A Shannon T. Mejia %A Lindsay H Ryan %A Gonzalez, Richard %A Jacqui Smith %K Activities of Daily Living %K Adult %K Aged %K Aged, 80 and over %K Aging %K environment %K Female %K Follow-Up Studies %K Health Status %K Humans %K Male %K Middle Aged %K Personal Satisfaction %K Social Support %K United States %X

Objective: We conceptualize successful aging as a cumulative index of individual resources (the absence of disease and disability, high cognitive and physical functioning, social embeddedness) in the service of successful aging outcomes (global well-being, experienced well-being, and vital status), and conditioned by age, social structure, and environment.

Method: The study used baseline and follow-up data from the 2008-2014 waves of the Health and Retirement Study (N = 17,230; age = 51-101). Linear, multilevel, and logistic models compared individual resources at baseline as independent, cumulative, and binary predictors of outcomes 4 years later.

Results: Individual resources were unequally distributed across age group and social structures (education, wealth, race, gender) and had a cumulative effect on all successful aging outcomes. For experienced well-being, individual resources were most important at midlife and for groups with lower education. Person-environment congruence (social cohesion, city satisfaction) was associated with all successful aging outcomes and conditioned the effect of individual resources on experienced well-being.

Discussion: A cumulative index allows for gradations in resources that can be compensated for by external factors such as person-environment congruence. This index could guide policy and interventions to enhance resources in vulnerable subgroups and diminish inequalities in successful aging outcomes.

%B J Gerontol B Psychol Sci Soc Sci %V 72 %P 279-289 %8 2017 Mar 01 %G eng %U http://psychsocgerontology.oxfordjournals.org/cgi/pmidlookup?view=long&pmid=28077430 %N 2 %1 http://www.ncbi.nlm.nih.gov/pubmed/28077430?dopt=Abstract %R 10.1093/geronb/gbw148 %0 Journal Article %J Int J Environ Res Public Health %D 2016 %T Changes in Depressive Symptoms among Older Adults with Multiple Chronic Conditions: Role of Positive and Negative Social Support. %A Ahn, SangNam %A Kim, Seonghoon %A Zhang, Hongmei %K Aged %K Aged, 80 and over %K Aging %K depression %K Family %K Female %K Friends %K Humans %K Male %K Multiple Chronic Conditions %K Social Support %K United States %X

Depression severely affects older adults in the United States. As part of the social environment, significant social support was suggested to ameliorate depression among older adults. We investigate how varying forms of social support moderate depressive symptomatology among older adults with multiple chronic conditions (MCC). Data were analyzed using a sample of 11,400 adults, aged 65 years or older, from the 2006-2012 Health and Retirement Study. The current study investigated the moderating effects of positive or negative social support from spouse, children, other family, and friends on the association between MCC and depression. A linear mixed model with repeated measures was used to estimate the effect of MCC on depression and its interactions with positive and negative social support in explaining depression among older adults. Varying forms of social support played different moderating roles in depressive symptomatology among older adults with MCC. Positive spousal support significantly weakened the deleterious effect of MCC on depression. Conversely, all negative social support from spouse, children, other family, and friends significantly strengthened the deleterious effect of MCC on depression. Minimizing negative social support and maximizing positive spousal support can reduce depression caused by MCC and lead to successful aging among older adults.

%B Int J Environ Res Public Health %V 14 %8 2016 12 26 %G eng %U http://www.mdpi.com/1660-4601/14/1/16 %N 1 %1 http://www.ncbi.nlm.nih.gov/pubmed/28035968?dopt=Abstract %! IJERPH %R 10.3390/ijerph14010016 %0 Journal Article %J J Gerontol Soc Work %D 2016 %T Does Volunteering Experience Influence Advance Care Planning in Old Age? %A Shen, Huei-Wern %A Khosla, Nidhi %K Advance care planning %K Aged %K Aging %K Female %K Humans %K Income %K Logistic Models %K Male %K Middle Aged %K Social Support %K Socioeconomic factors %K Terminal Care %K Volunteers %X

Advance care planning (ACP) increases the likelihood patients will receive end-of-life care that is congruent with their preferences and lowers stress among both patients and caregivers. Previous efforts to increase ACP have mainly focused on information provision in the very late stage of life. This study examines whether a relationship exists between volunteering and ACP, and whether this relationship is associated with social support. The sample comprises 877 individuals who were aged 55+ in 2008, and were deceased before 2010. The sample is derived from seven waves (1998-2010) of data from the Health and Retirement Study. Logistic regression results showed that overall ACP and durable power of attorney for health care (DPAHC) were both higher (OR = 1.61 and 1.71, respectively) for older adults with volunteering experience in the past 10 years than those without such experience. Available social support (relatives and friends living nearby) was not associated with the relationship between volunteering and ACP. Other factors related to ACP included poorer health, death being expected, death due to cancer, older age, and being a racial minority. Involving older people in volunteer work may help to increase ACP. Future research is encouraged to identify reasons for the association between volunteering and ACP.

%B J Gerontol Soc Work %V 59 %P 423-438 %8 2016 07 %G eng %N 5 %1 http://www.ncbi.nlm.nih.gov/pubmed/27592593?dopt=Abstract %R 10.1080/01634372.2016.1230567 %0 Journal Article %J The Journals of Gerontology Series B: Psychological Sciences and Social Sciences %D 2016 %T Gender, Illness-Related Diabetes Social Support, and Glycemic Control Among Middle-Aged and Older Adults %A Mondesir, Favel L. %A White, Kellee %A Liese, Angela D. %A Alexander C McLain %K Diabetes %K Gender Differences %K Older Adults %K Social Support %K Women and Minorities %X This study examined whether the association between illness-related diabetes social support (IRDSS) and glycemic control among middle-aged and older adults is different for men and women. This cross-sectional analysis included 914 adults with diabetes who completed the Health and Retirement Study's 2003 Mail Survey on Diabetes. IRDSS is a composite score of 8 diabetes self-care measures. Hemoglobin A1c levels were obtained to measure good glycemic control (< 8.0%). Gender-stratified multivariate log-binomial regression models were used to estimate prevalence ratios and examine the association between IRDSS and glycemic control after controlling for sociodemographic, lifestyle, and clinical characteristics. The prevalence of good glycemic control was 48.9% among women and 51.1% among men. Mean composite IRDSS scores did not differ by gender. Among women, composite IRDSS was associated with adequate glycemic control (prevalence ratio: 1.06; 95% confidence interval: 1.02, 1.08), and all individual components of IRDSS, with the exception of keeping appointments, were positively associated with adequate glycemic control. No significant associations were observed in men for composite or individual components of IRDSS. Determining the gender-specific impact derived from IRDSS is a worthwhile approach to highlighting factors that differentially predict optimal glycemic control among middle-aged and older adults. %B The Journals of Gerontology Series B: Psychological Sciences and Social Sciences %V 71 %P 1081 - 1088 %8 May-11-2017 %G eng %U http://psychsocgerontology.oxfordjournals.org/lookup/doi/10.1093/geronb/gbv061https://academic.oup.com/psychsocgerontology/article/71/6/1081/2194711/Gender-IllnessRelated-Diabetes-Social-Support-and %N 6 %! GERONB %R 10.1093/geronb/gbv061 %0 Journal Article %J J Gerontol B Psychol Sci Soc Sci %D 2016 %T Neighborhood Support and Aging-in-Place Preference Among Low-Income Elderly Chinese City-Dwellers. %A Terry Y S Lum %A Vivian W Q Lou %A Chen, Yanyan %A Wong, Gloria %A Luo, Hao %A Tracy Tong %K Aged %K Aged, 80 and over %K Aging %K Asian Continental Ancestry Group %K Female %K Hong Kong %K Humans %K Independent Living %K Interview, Psychological %K Male %K Middle Aged %K Poverty %K Quality of Life %K Residence Characteristics %K Social Support %K Urban Population %X

OBJECTIVES: Preferences for aging-in-place are unclear among low-income elderly Chinese city-dwellers, who are more likely to be geographically bound, to have little care support, but possess strong filial values and family cohesiveness. This study investigated the preferences for aging-in-place and its contributing neighborhood factors among low-income Chinese elderly in a metropolitan city.

METHOD: We conducted interviews with 400 older people residing in public housing estates in Hong Kong.

RESULTS: The majority of low-income elderly persons (80.4%) prefer to age in place even if their health and functioning has deteriorated beyond independent living. Logistic regression showed that (a) having very low income (

DISCUSSION: Low-income elderly Chinese city-dwellers prefer to age in place, given appropriate neighborhood support. These findings can be interpreted in light of Lawton's ecological theory of aging and suggest a service model similar to the Naturally Occurring Retirement Community with Supportive Service Programs.

%B J Gerontol B Psychol Sci Soc Sci %V 71 %P 98-105 %8 2016 Jan %G eng %U http://www.ncbi.nlm.nih.gov/pubmed/25384636 %N 1 %1 http://www.ncbi.nlm.nih.gov/pubmed/25384636?dopt=Abstract %4 Aged Aged, 80 and over Aging/psychology Asian Continental Ancestry Group/psychology Female Hong Kong Humans *Independent Living/psychology/statistics & numerical data Interview, Psychological Male Middle Aged *Poverty/psychology/statistics & numerical data *Quality of Life *Residence Characteristics *Social Support Urban Population %R 10.1093/geronb/gbu154 %0 Journal Article %J J Pers Soc Psychol %D 2016 %T Personality trait development at the end of life: Antecedents and correlates of mean-level trajectories. %A Wagner, Jenny %A Ram, Nilam %A Jacqui Smith %A Denis Gerstorf %K Aged %K Aged, 80 and over %K Aging %K Anxiety Disorders %K Berlin %K Extraversion, Psychological %K Female %K Health Status %K Human Development %K Humans %K Internal-External Control %K Longitudinal Studies %K Male %K Neuroticism %K Personality %K Social Support %X

Empirical evidence over the past 20 years has documented that key aspects of personality traits change during adulthood. However, it is essentially an open question whether and how traits change at the very end of life and what role health, cognitive performance, perceived control, and social factors play in those changes. To examine these questions, we applied growth models to 13-year longitudinal data obtained from now-deceased participants in the Berlin Aging Study (N = 463; age at baseline M = 85.9 years, SD = 8.4; 51% men). Results revealed that neuroticism, on average, increases (about 0.3 SD in the last 10 years) and that this increase becomes even steeper at the end of life. In contrast, extraversion and openness decline rather steadily at the end of life (about -0.5 SD in the last 10 years). Additionally, poor health manifested as a risk factor for declines in extraversion and openness late in life but not neuroticism. Similar to earlier phases of life, better cognitive performance related to more openness. More loneliness was associated with higher neuroticism, whereas more social activity was associated with higher levels of extraversion and openness. Intriguing additional insights indicated that more personal control was associated with higher levels of extraversion and openness, whereas the feeling that one's life is controlled by others was associated with higher neuroticism but also with higher openness closer to death. We discuss potential pathways by which health, cognitive performance, control, and social inclusion resources and risk factors affect personality development late in life. (PsycINFO Database Record

%B J Pers Soc Psychol %V 111 %P 411-29 %8 2016 09 %G eng %N 3 %1 http://www.ncbi.nlm.nih.gov/pubmed/26479363?dopt=Abstract %R 10.1037/pspp0000071 %0 Journal Article %J Gerontologist %D 2016 %T The Protective Effects of Religiosity on Depression: A 2-Year Prospective Study. %A Corina R Ronneberg %A Edward Alan Miller %A Dugan, Elizabeth %A Frank Porell %K Adult %K Aged %K Aging %K depression %K Depressive Disorder %K Female %K Health Surveys %K Humans %K Male %K Middle Aged %K Prospective Studies %K Religion %K Religion and Psychology %K Social Support %K Spirituality %K United States %X

PURPOSE OF THE STUDY: Approximately 20% of older adults are diagnosed with depression in the United States. Extant research suggests that engagement in religious activity, or religiosity, may serve as a protective factor against depression. This prospective study examines whether religiosity protects against depression and/or aids in recovery.

DESIGN AND METHODS: Study data are drawn from the 2006 and 2008 waves of the Health and Retirement Study. The sample consists of 1,992 depressed and 5,740 nondepressed older adults (mean age = 68.12 years), at baseline (2006), for an overall sample size of 7,732. Logistic regressions analyzed the relationship between organizational (service attendance), nonorganizational (private prayer), and intrinsic measures of religiosity and depression onset (in the baseline nondepressed group) and depression recovery (in the baseline depressed group) at follow-up (2008), controlling for other baseline factors.

RESULTS: Religiosity was found to both protect against and help individuals recover from depression. Individuals not depressed at baseline remained nondepressed 2 years later if they frequently attended religious services, whereas those depressed at baseline were less likely to be depressed at follow-up if they more frequently engaged in private prayer.

IMPLICATIONS: Findings suggest that both organizational and nonorganizational forms of religiosity affect depression outcomes in different circumstances (i.e., onset and recovery, respectively). Important strategies to prevent and relieve depression among older adults may include improving access and transportation to places of worship among those interested in attending services and facilitating discussions about religious activities and beliefs with clinicians.

%B Gerontologist %V 56 %P 421-31 %8 2016 06 %G eng %U https://www.ncbi.nlm.nih.gov/pubmed/25063937 %N 3 %1 http://www.ncbi.nlm.nih.gov/pubmed/25063937?dopt=Abstract %R 10.1093/geront/gnu073 %0 Journal Article %J Journal of the American Geriatrics Society %D 2016 %T Racial and Ethnic Differences in End-of-Life Medicare Expenditures. %A Byhoff, Elena %A Tamara B Harris %A Kenneth M. Langa %A Theodore J Iwashyna %K African Continental Ancestry Group %K Aged %K Aged, 80 and over %K Cohort Studies %K Comorbidity %K Cross-Cultural Comparison %K Ethnic Groups %K European Continental Ancestry Group %K Female %K Health Care Surveys %K Health Expenditures %K Hispanic Americans %K Humans %K Life Support Care %K Longitudinal Studies %K Male %K Medicare %K Rate Setting and Review %K Social Support %K Socioeconomic factors %K Terminal Care %K United States %X

OBJECTIVES: To determine to what extent demographic, social support, socioeconomic, geographic, medical, and End-of-Life (EOL) planning factors explain racial and ethnic variation in Medicare spending during the last 6 months of life.

DESIGN: Retrospective cohort study.

SETTING: Health and Retirement Study (HRS).

PARTICIPANTS: Decedents who participated in HRS between 1998 and 2012 and previously consented to survey linkage with Medicare claims (N = 7,105).

MEASUREMENTS: Total Medicare expenditures in the last 180 days of life according to race and ethnicity, controlling for demographic factors, social supports, geography, illness burden, and EOL planning factors, including presence of advance directives, discussion of EOL treatment preferences, and whether death had been expected.

RESULTS: The analysis included 5,548 (78.1%) non-Hispanic white, 1,030 (14.5%) non-Hispanic black, and 331 (4.7%) Hispanic adults and 196 (2.8%) adults of other race or ethnicity. Unadjusted results suggest that average EOL Medicare expenditures were $13,522 (35%, P < .001) more for black decedents and $16,341 (42%, P < .001) more for Hispanics than for whites. Controlling for demographic, socioeconomic, geographic, medical, and EOL-specific factors, the Medicare expenditure difference between groups fell to $8,047 (22%, P < .001) more for black and $6,855 (19%, P < .001) more for Hispanic decedents than expenditures for non-Hispanic whites. The expenditure differences between groups remained statistically significant in all models.

CONCLUSION: Individuals-level factors, including EOL planning factors do not fully explain racial and ethnic differences in Medicare spending in the last 6 months of life. Future research should focus on broader systemic, organizational, and provider-level factors to explain these differences.

%B Journal of the American Geriatrics Society %V 64 %P 1789-1797 %G eng %N 9 %R 10.1111/jgs.14263 %0 Journal Article %J Int J Environ Res Public Health %D 2015 %T Effects of Co-Worker and Supervisor Support on Job Stress and Presenteeism in an Aging Workforce: A Structural Equation Modelling Approach. %A Tianan Yang %A Shen, Yu-Ming %A Zhu, Mingjing %A Liu, Yuanling %A Deng, Jianwei %A Chen, Qian %A See, Lai-Chu %K Aged %K Cross-Sectional Studies %K Female %K Health Surveys %K Humans %K Interpersonal Relations %K Male %K Middle Aged %K Models, Statistical %K Occupational Health %K Population Dynamics %K Presenteeism %K Social Support %K Stress, Psychological %K United States %X

We examined the effects of co-worker and supervisor support on job stress and presenteeism in an aging workforce. Structural equation modelling was used to evaluate data from the 2010 wave of the Health and Retirement Survey in the United States (n = 1649). The level of presenteeism was low and the level of job stress was moderate among aging US workers. SEM revealed that co-worker support and supervisor support were strongly correlated (β = 0.67; p < 0.001). Job stress had a significant direct positive effect on presenteeism (β = 0.30; p < 0.001). Co-worker support had a significant direct negative effect on job stress (β = -0.10; p < 0.001) and presenteeism (β = -0.11; p < 0.001). Supervisor support had a significant direct negative effect on job stress (β = -0.40; p < 0.001) but not presenteeism. The findings suggest that presenteeism is reduced by increased respect and concern for employee stress at the workplace, by necessary support at work from colleagues and employers, and by the presence of comfortable interpersonal relationships among colleagues and between employers and employees.

%B Int J Environ Res Public Health %I 13 %V 13 %P ijerph13010072 %8 2015 Dec 23 %G eng %N 1 %1 http://www.ncbi.nlm.nih.gov/pubmed/26703705?dopt=Abstract %2 PMC4730463 %4 job stress/Presenteeism/workplace/labor Force Participation %$ 999999 %R 10.3390/ijerph13010072 %0 Journal Article %J Psychoneuroendocrinology %D 2015 %T Loneliness, eudaimonia, and the human conserved transcriptional response to adversity. %A Steven W. Cole %A Morgan E. Levine %A Jesusa M. G. Arevalo %A Ma, Jeffrey %A David R Weir %A Eileen M. Crimmins %K Aged %K Aged, 80 and over %K Down-Regulation %K Female %K Humans %K Inflammation %K Loneliness %K Longitudinal Studies %K Male %K Mental Health %K Middle Aged %K social isolation %K Social Support %K Stress, Psychological %K Transcriptome %X

BACKGROUND: Chronic social adversity activates a conserved transcriptional response to adversity (CTRA) marked by increased expression of pro-inflammatory genes and decreased expression of antiviral- and antibody-related genes. Recent findings suggest that some psychological resilience factors may help buffer CTRA activation, but the relative impact of resilience and adversity factors remains poorly understood. Here we examined the relative strength of CTRA association for the two best-established psychological correlates of CTRA gene expression-the risk factor of perceived social isolation (loneliness) and the resilience factor of eudaimonic well-being (purpose and meaning in life).

METHODS: Peripheral blood samples and validated measures of loneliness and eudaimonic well-being were analyzed in 108 community-dwelling older adults participating in the longitudinal US Health and Retirement Study (56% female, mean age 73). Mixed effect linear model analyses quantified the strength of association between CTRA gene expression and measures of loneliness and eudaimonic well-being in separate and joint analyses.

RESULTS: As in previous studies, separate analyses found CTRA gene expression to be up-regulated in association with loneliness and down-regulated in association with eudaimonic well-being. In joint analyses, effects of loneliness were completely abrogated whereas eudaimonic well-being continued to associate with CTRA down-regulation. Similar eudaimonia-dominant effects were observed for positive and negative affect, optimism and pessimism, and anxiety symptoms. All results were independent of demographic and behavioral health risk factors.

CONCLUSIONS: Eudaimonic well-being may have the potential to compensate for the adverse impact of loneliness on CTRA gene expression. Findings suggest a novel approach to targeting the health risks associated with social isolation by promoting purpose and meaning in life.

%B Psychoneuroendocrinology %I 62 %V 62 %P 11-7 %8 2015 Dec %G eng %U http://www.sciencedirect.com/science/article/pii/S0306453015002358 %1 http://www.ncbi.nlm.nih.gov/pubmed/26246388?dopt=Abstract %2 PMC4637182 %4 Social genomics/Psychoneuroimmunology/Gene expression/Transcriptome/Microarray/Stress/Social support/Psychological well-being/Eudaimonia/Positive psychology %$ 999999 %R 10.1016/j.psyneuen.2015.07.001 %0 Journal Article %J Journals of Gerontology Series B: Psychological Sciences and Social Sciencess %D 2015 %T Older Adults' Residential Proximity to Their Children: Changes After Cardiovascular Events. %A Choi, Hwajung %A Robert F. Schoeni %A Kenneth M. Langa %A Michele M Heisler %K Cardiovascular health %K Heart disease %K Older Adults %K Proximity %K Social Support %X

OBJECTIVES: To assess changes in family residential proximity after a first cardiovascular (CV) event among older adults and to identify families most likely to experience such moves.

METHOD: Using a nationally representative longitudinal study of older adults in the United States, we identified respondents with no prior diagnosis of CV disease (CVD). We examined subsequent development of stroke, heart attack, and/or heart failure among these older adults and examined changes in their residential proximity to their closest child before and after the CV event. We then compared the likelihood of changes in proximity between families with and without CV events. Finally, we determined which types of families are most likely to relocate following a CV event.

RESULTS: Having a first CV event increases the 2-year predicted probability of children and adult parents moving in with and closer to each other (relative risk ratio = 1.61 and 1.55, respectively). Families are especially likely to move after a first CV event if the older person experiencing the event is spouseless or has a daughter.

DISCUSSION: CVD is a leading cause of disability, which in turn creates a significant need for personal care among older adults. Assessment of changes in family residential proximity responding to CV events is important to fully understand the consequences of older adults' CV events including the cost of caregiving.

%B Journals of Gerontology Series B: Psychological Sciences and Social Sciencess %V 70 %P 995-1004 %8 2015 Nov %G eng %N 6 %R 10.1093/geronb/gbu076 %0 Journal Article %J J Gerontol Soc Work %D 2015 %T The prevalence of older couples with ADL limitations and factors associated with ADL help receipt. %A Shen, Huei-Wern %A Sheila Feld %A Ruth E Dunkle %A Tracy Schroepfer %A Amanda J Lehning %K Activities of Daily Living %K Aged %K Aged, 80 and over %K Cross-Sectional Studies %K Female %K Health Services Accessibility %K Humans %K Male %K Social Support %K Socioeconomic factors %X

Using the Andersen-Newman model, we investigated the prevalence of activities of daily living (ADLs) limitations in married couples, and couple characteristics associated with ADL help-receipt. In this sample of 3,235 couples age 65+ in the 2004 Health and Retirement Study, 74.3%, 22.1%, and 3.6% were couples in which neither partner, one partner, or both partners had limitations, respectively. Logistic regression results indicate that help-receipt was associated with certain health needs in the couple, but not with their predisposing characteristics or enabling resources. Social workers could target couples most in need of assistance by assessing both partners' health problems.

%B J Gerontol Soc Work %I 58 %V 58 %P 171-89 %8 2015 %G eng %U http://dx.doi.org/10.1080/01634372.2014.944248 %N 2 %1 http://www.ncbi.nlm.nih.gov/pubmed/25036802?dopt=Abstract %2 PMC4297741 %4 health/functional limitations/care needs/spousal caregiving/marital dyad %$ 999999 %R 10.1080/01634372.2014.944248 %0 Journal Article %J J Gerontol B Psychol Sci Soc Sci %D 2015 %T Social Relationships, Gender, and Recovery From Mobility Limitation Among Older Americans. %A Kenzie Latham %A Philippa J Clarke %A Gregory Pavela %K Aged %K Aged, 80 and over %K Cohort Studies %K Family %K Female %K Humans %K Interpersonal Relations %K Male %K Middle Aged %K Mobility Limitation %K Peer Group %K Recovery of Function %K Residence Characteristics %K Sex Factors %K Social Support %K United States %X

OBJECTIVES: Evidence suggests social relationships may be important facilitators for recovery from functional impairment, but the extant literature is limited in its measurement of social relationships including an over emphasis on filial social support and a paucity of nationally representative data.

METHODS: Using data from Waves 4-9 (1998-2008) of the Health and Retirement Study (HRS), this research examines the association between social relationships and recovery from severe mobility limitation (i.e., difficulty walking one block or across the room) among older Americans. Using a more nuanced measure of recovery that includes complete and partial recovery, a series of discrete-time event history models with multiple competing recovery outcomes were estimated using multinomial logistic regression.

RESULTS: Providing instrumental support to peers increased the odds of complete and partial recovery from severe mobility limitation, net of numerous social, and health factors. Having relatives living nearby decreased the odds of complete recovery, while being engaged in one's neighborhood increased the odds of partial recovery. The influence of partner status on partial and complete recovery varied by gender, whereby partnered men were more likely to experience recovery relative to partnered women. The effect of neighborhood engagement on partial recovery also varied by gender. Disengaged women were the least likely to experience partial recovery compared with any other group.

DISCUSSION: The rehabilitative potential of social relationships has important policy implications. Interventions aimed at encouraging older adults with mobility limitation to be engaged in their neighborhoods and/or provide instrumental support to peers may improve functional health outcomes.

%B J Gerontol B Psychol Sci Soc Sci %I 70 %V 70 %P 769-81 %8 2015 Sep %G eng %U http://psychsocgerontology.oxfordjournals.org/content/early/2015/01/11/geronb.gbu181.abstract %N 5 %1 http://www.ncbi.nlm.nih.gov/pubmed/25583597?dopt=Abstract %2 PMC4635643 %4 Functional health/Gender/Mobility/Recovery/neighborhood effects/Social relationships/Social support %$ 999999 %R 10.1093/geronb/gbu181 %0 Journal Article %J Journal of Behavioral Medicine %D 2014 %T Spousal social support and strain: impacts on health in older couples. %A Lindsay H Ryan %A Wylie H Wan %A Jacqui Smith %K Health Conditions and Status %K Marriage %K Older Adults %K Social Support %K Stress %X

Using a nationally representative sample of couples aged 51+ in the United States (N = 1,923 couples), the current study investigated whether both partners' perceptions of relationship support and strain are associated with an individual's self-rated health and functional limitations. The sample had an average age of 67.17 years (SD = 9.0; range 50-97). Actor-Partner Interdependence Models adjusting for couple interdependencies were applied using multilevel models. After accounting for age, education, gender, race, and couple differences in length of marriage, results indicate that individual perceptions of support were significantly associated with higher self-rated health and fewer functional limitations. These individual-level benefits increased if the spouse also perceived positive support and low strain. Finally, the negative association of an individual's perceived support on functional limitations was greater in those with a spouse reporting low levels of perceived strain. Findings are discussed relative to theory on behavioral and psychological pathways between partners' perceptions of support and health.

%B Journal of Behavioral Medicine %V 37 %P 1108-17 %8 2014 Dec %G eng %N 6 %R 10.1007/s10865-014-9561-x %0 Journal Article %J J Gerontol B Psychol Sci Soc Sci %D 2013 %T Former stepparents' contact with their stepchildren after midlife. %A Claire Noël-Miller %K Adolescent %K Adult %K Aged %K Aged, 80 and over %K Child %K Family Characteristics %K Female %K Health Surveys %K Humans %K Male %K Marital Status %K Middle Aged %K Parent-Child Relations %K Parents %K Social Support %K Young Adult %X

OBJECTIVES: Based on the life course perspective and gender differences in stepparental roles, this study examines frequency of social contact between mid- to late-life stepparents and their stepchildren after stepparents' marriage to their stepchildren's biological parent has been dissolved through widowhood or divorce.

METHOD: Using 5 waves of panel data on stepparent-stepchild pairs from the Health and Retirement Study (N = 12,947 stepchild observations on 4,063 stepchildren belonging to 1,663 stepparents) spanning 10 years (1998-2008), I estimate ordered logit multilevel models predicting former stepparent-stepchild contact frequency.

RESULTS: Results indicate that former stepparents have notably less frequent contact with their stepchildren than current stepparents, particularly following divorce. Widowed stepparents' contact with their stepchildren diminishes gradually following union disruption, whereas divorced stepparents' contact frequency drops abruptly. Former stepfathers have less contact with their stepchildren than former stepmothers. Finally, I uncover evidence of the moderating role of (step)parents' marriage length and stepparents' number of biological children on widowed stepparent-stepchild contact frequency.

DISCUSSION: Older stepparents' social contact with their stepchildren is largely conditional on stepparents' enduring marital bond to their stepchildren's biological parent. This study contributes to a growing literature portraying relatively weak ties between older adults and their stepchildren.

%B J Gerontol B Psychol Sci Soc Sci %I 68 %V 68 %P 409-19 %8 2013 May %G eng %U http://search.proquest.com.proxy.lib.umich.edu/docview/1329184768?accountid=14667 %N 3 %1 http://www.ncbi.nlm.nih.gov/pubmed/23591569?dopt=Abstract %2 PMC3693606 %4 Middle age/Stepfamilies/intergenerational Transfers/Intergenerational relationships %$ 68974 %R 10.1093/geronb/gbt021 %0 Journal Article %J Patient Educ Couns %D 2012 %T The influence of diabetes psychosocial attributes and self-management practices on change in diabetes status. %A Donna M Zulman %A Ann Marie Rosland %A Choi, Hwajung %A Kenneth M. Langa %A Michele M Heisler %K Aged %K Blood Glucose Self-Monitoring %K Cross-Sectional Studies %K Diabetes Mellitus, Type 1 %K Diabetes Mellitus, Type 2 %K Disease Management %K Female %K Glycated Hemoglobin %K Health Knowledge, Attitudes, Practice %K Health Status %K Humans %K Interviews as Topic %K Male %K Middle Aged %K Multivariate Analysis %K Risk Factors %K Self Care %K Self Efficacy %K Severity of Illness Index %K Social Support %K Stress, Psychological %K Surveys and Questionnaires %K Treatment Outcome %X

OBJECTIVE: To examine the influence of diabetes psychosocial attributes and self-management on glycemic control and diabetes status change.

METHODS: Using data from the Health and Retirement Study, a nationally representative longitudinal study of U.S. adults >51 years, we examined cross-sectional relationships among diabetes psychosocial attributes (self-efficacy, risk awareness, care understanding, prioritization of diabetes, and emotional distress), self-management ratings, and glycemic control. We then explored whether self-management ratings and psychosocial attributes in 2003 predicted change in diabetes status in 2004.

RESULTS: In multivariate analyses (N=1834), all diabetes psychosocial attributes were associated with self-management ratings, with self-efficacy and diabetes distress having the strongest relationships (adj coeff=8.1, p<0.01 and -4.1, p<0.01, respectively). Lower self-management ratings in 2003 were associated cross-sectionally with higher hemoglobin A1C (adj coeff=0.16, p<0.01), and with perceived worsening diabetes status in 2004 (adj OR=1.36, p<0.05), with much of this latter relationship explained by diabetes distress.

CONCLUSION: Psychosocial attributes, most notably diabetes-related emotional distress, contribute to difficulty with diabetes self-management, poor glycemic control, and worsening diabetes status over time.

PRACTICE IMPLICATIONS: Self-management and adherence interventions should target psychosocial attributes such as disease-related emotional distress.

%B Patient Educ Couns %I 87 %V 87 %P 74-80 %8 2012 Apr %G eng %U http://www.ncbi.nlm.nih.gov/pubmed/21840149 %N 1 %1 http://www.ncbi.nlm.nih.gov/pubmed/21840149?dopt=Abstract %2 PMC3229832 %4 Diabetes/glycemic control/glycemic control/psycho-social/self-management %$ 69486 %R 10.1016/j.pec.2011.07.013 %0 Journal Article %J Soc Sci Med %D 2012 %T Loneliness, health, and mortality in old age: a national longitudinal study. %A Ye Luo %A Louise C Hawkley %A Linda J. Waite %A John T. Cacioppo %K Aged %K Aged, 80 and over %K Aging %K Cohort Studies %K depression %K Female %K Health Behavior %K Health Status %K Humans %K Interpersonal Relations %K Loneliness %K Longitudinal Studies %K Male %K Middle Aged %K Mortality %K Social Support %K Socioeconomic factors %K United States %X

This study examined the relationship between loneliness, health, and mortality using a U.S. nationally representative sample of 2101 adults aged 50 years and over from the 2002 to 2008 waves of the Health and Retirement Study. We estimated the effect of loneliness at one point on mortality over the subsequent six years, and investigated social relationships, health behaviors, and health outcomes as potential mechanisms through which loneliness affects mortality risk among older Americans. We operationalized health outcomes as depressive symptoms, self-rated health, and functional limitations, and we conceptualized the relationships between loneliness and each health outcome as reciprocal and dynamic. We found that feelings of loneliness were associated with increased mortality risk over a 6-year period, and that this effect was not explained by social relationships or health behaviors but was modestly explained by health outcomes. In cross-lagged panel models that tested the reciprocal prospective effects of loneliness and health, loneliness both affected and was affected by depressive symptoms and functional limitations over time, and had marginal effects on later self-rated health. These population-based data contribute to a growing literature indicating that loneliness is a risk factor for morbidity and mortality and point to potential mechanisms through which this process works.

%B Soc Sci Med %I 74 %V 74 %P 907-14 %8 2012 Mar %G eng %U http://proquest.umi.com.proxy.lib.umich.edu/pqdweb?did=2601961601andFmt=7andclientId=17822andRQT=309andVName=PQD %N 6 %1 http://www.ncbi.nlm.nih.gov/pubmed/22326307?dopt=Abstract %2 PMC3303190 %4 Emotions/Emotions/Mortality/Clinical outcomes/Health behavior/Risk factors/Personal health/Older people %$ 62840 %R 10.1016/j.socscimed.2011.11.028 %0 Journal Article %J Annals of Internal Medicine %D 2011 %T Determinants of medical expenditures in the last 6 months of life. %A Amy Kelley %A Susan L Ettner %A R Sean Morrison %A Qingling Du %A Neil S. Wenger %A Catherine A Sarkisian %K Aged %K Aged, 80 and over %K Chronic disease %K Ethnic Groups %K Female %K Health Expenditures %K Humans %K Income %K Independent Living %K Male %K Medicare %K Regression Analysis %K Social Support %K Socioeconomic factors %K Terminal Care %K United States %X

BACKGROUND: End-of-life medical expenditures exceed costs of care during other years, vary across regions, and are likely to be unsustainable. Identifying determinants of expenditure variation may reveal opportunities for reducing costs.

OBJECTIVE: To identify patient-level determinants of Medicare expenditures at the end of life and to determine the contributions of these factors to expenditure variation while accounting for regional characteristics. It was hypothesized that race or ethnicity, social support, and functional status are independently associated with treatment intensity and controlling for regional characteristics, and that individual characteristics account for a substantial proportion of expenditure variation.

DESIGN: Using data from the Health and Retirement Study, Medicare claims, and The Dartmouth Atlas of Health Care, relationships were modeled between expenditures and patient and regional characteristics.

SETTING: United States, 2000 to 2006.

PARTICIPANTS: 2394 Health and Retirement Study decedents aged 65.5 years or older.

MEASUREMENTS: Medicare expenditures in the last 6 months of life were estimated in a series of 2-level multivariable regression models that included patient, regional, and patient and regional characteristics.

RESULTS: Decline in function (rate ratio [RR], 1.64 [95% CI, 1.46 to 1.83]); Hispanic ethnicity (RR, 1.50 [CI, 1.22 to 1.85]); black race (RR, 1.43 [CI, 1.25 to 1.64]); and certain chronic diseases, including diabetes (RR, 1.16 [CI, 1.06 to 1.27]), were associated with higher expenditures. Nearby family (RR, 0.90 [CI, 0.82 to 0.98]) and dementia (RR, 0.78 CI, 0.71 to 0.87]) were associated with lower expenditures, and advance care planning had no association. Regional characteristics, including end-of-life practice patterns (RR, 1.09 [CI, 1.06 to 1.14]) and hospital beds per capita (RR, 1.01 [CI, 1.00 to 1.02]), were associated with higher expenditures. Patient characteristics explained 10% of overall variance and retained statistically significant relationships with expenditures after regional characteristics were controlled for.

LIMITATION: The study limitations include the decedent sample, proxy informants, and a large proportion of unexplained variation.

CONCLUSION: Patient characteristics, such as functional decline, race or ethnicity, chronic disease, and nearby family, are important determinants of expenditures at the end of life, independent of regional characteristics.

PRIMARY FUNDING SOURCE: The Brookdale Foundation.

%B Annals of Internal Medicine %V 154 %P 235-242 %G eng %N 4 %R 10.7326/0003-4819-154-4-201102150-00004 %0 Journal Article %J J Gerontol B Psychol Sci Soc Sci %D 2011 %T Partner caregiving in older cohabiting couples. %A Claire Noël-Miller %K Aged %K Caregivers %K Disabled Persons %K Family Characteristics %K Female %K Frail Elderly %K Humans %K Interpersonal Relations %K Male %K Marriage %K Middle Aged %K Sex Factors %K Single Person %K Social Support %X

OBJECTIVES: Despite the rapidly increasing prevalence of cohabitation among older adults, the caregiving literature has exclusively focused on formally married individuals. Extending prior work on intra-couple care, this study contrasts frail cohabitors' patterns of care receipt from a partner to that of frail spouses.

METHODS: Using nationally representative panel data from the Health and Retirement Study (2000, 2002, 2004, and 2006), we estimate random effects cross-sectional times series models predicting frail cohabitors' likelihood of receiving partner care compared with their married counterparts'. Conditional on the receipt of intra-couple care, we also examine differences in marital and nonmarital partners' caregiving hours and caregiving involvement relative to other helpers.

RESULTS: Net of sociodemographic, disability, and comorbidity factors, we find that cohabitors are less likely to receive partner care than married individuals. However, caregiving nonmarital partners provide as many hours of care as spouses while providing a substantially larger share of disabled respondents' care than marital partners.

DISCUSSION: Cohabitation and marriage have distinct implications for older adults' patterns of partner care receipt. This study adds weight to a growing body of research emphasizing the importance of accounting for older adults' nontraditional union forms and of examining the ramifications of cohabitation for older adults' well-being.

%B J Gerontol B Psychol Sci Soc Sci %I 66 %V 66 %P 341-53 %8 2011 May %G eng %N 3 %1 http://www.ncbi.nlm.nih.gov/pubmed/21482588?dopt=Abstract %2 PMC3078761 %4 Cohabitation/Caregivers/Disabled Persons/Family Characteristics/WOMEN/Frail Elderly/Interpersonal Relations/Interpersonal Relations/Marriage/Middle Aged/Sex Factors/Single Person/Single Person/Social Support %$ 62762 %R 10.1093/geronb/gbr027 %0 Journal Article %J J Gerontol B Psychol Sci Soc Sci %D 2011 %T Volunteer transitions among older adults: the role of human, social, and cultural capital in later life. %A Tay K. McNamara %A Guillermo Ernest Gonzales %K Aged %K Aging %K Caregivers %K Community Participation %K Cost of Illness %K Educational Status %K Employment %K Female %K Health Status %K Health Surveys %K Humans %K Likelihood Functions %K Longitudinal Studies %K Male %K Middle Aged %K Multivariate Analysis %K Religion and Psychology %K Social Environment %K Social Identification %K Social Support %K Socioeconomic factors %K United States %K Volunteers %X

OBJECTIVES: We aim to understand how human, social, and cultural capitals are associated with the volunteer process, that is, engagement (starting), intensity (number of hours), and cessation (stopping), among older adults.

METHOD: Data from the 2000 through 2008 Health and Retirement Study and the 2001 through 2009 Consumption and Activity Mail Survey provide a sample of 4,526 respondents. Random-effects pooled time series analyses incorporate not only the presence of various types of capital but also the quality of that capital.

RESULTS: Human and cultural capitals were positively associated with increased volunteer involvement. Effects of social capital (relationships in the family, employment status, and the community) depended on the quality of the relationships, not necessarily on their presence alone.

DISCUSSION: Results suggest that bolstering older adults' capitals, particularly among lower socioeconomic status groups, can increase volunteer engagement and intensity and reduce cessation. Additionally, a variety of organizational policies including respite programs for caregivers and employer policies allowing employees to reduce their work hours might indirectly affect participation rates and commitment. Potential pools of volunteers exist in families, workplaces, and religious organizations, but more research is necessary to identify how to recruit and retain individuals in social networks where volunteer participatory rates are low.

%B J Gerontol B Psychol Sci Soc Sci %I 66B %V 66 %P 490-501 %8 2011 Jul %G eng %N 4 %1 http://www.ncbi.nlm.nih.gov/pubmed/21743042?dopt=Abstract %4 Older people/Volunteers/Human capital/Social capital %$ 62584 %R 10.1093/geronb/gbr055 %0 Journal Article %J J Aging Health %D 2011 %T Volunteering and hypertension risk in later life. %A Jeffrey A Burr %A Jane Tavares %A Jan E Mutchler %K Aged %K Aged, 80 and over %K Body Mass Index %K Confidence Intervals %K Female %K Health Behavior %K health policy %K Health Status %K Humans %K Hypertension %K Male %K Middle Aged %K Multivariate Analysis %K Odds Ratio %K Psychometrics %K Regression Analysis %K Risk Factors %K Social Support %K Surveys and Questionnaires %K Volunteers %X

OBJECTIVE: This study examined the relationship between volunteer activity and hypertension, a risk factor for cardiovascular disease, renal failure, and cognitive impairment.

METHOD: Employing data from the Health and Retirement Study, we estimated regression models of hypertension status that include volunteer activity and psychosocial and health behavior risk factors for middle-aged and older persons.

RESULTS: Multivariate analyses showed volunteers had lower hypertension risk and lower systolic and diastolic blood pressure than nonvolunteers and that a threshold effect was present, whereby a modest amount of volunteer time commitment (but not a high amount) was associated with lower risk of hypertension. We did neither find support that psychosocial and health behaviors mediated this relationship nor find support for a moderating effect of volunteering for the relationships among health behaviors and hypertension.

DISCUSSION: The results of this study indicate that research is needed to determine what mediates the relationship between volunteering and hypertension.

%B J Aging Health %I 23 %V 23 %P 24-51 %8 2011 Feb %G eng %N 1 %L newpubs20110418_Burr.pdf %1 http://www.ncbi.nlm.nih.gov/pubmed/20971920?dopt=Abstract %3 20971920 %4 Volunteers/Hypertension/Risk factors/Cardiovascular disease/Aging/Geriatrics/Older people %$ 24820 %R 10.1177/0898264310388272 %0 Journal Article %J J Psychol %D 2010 %T Activities of daily living, social support, and future health of older Americans. %A Bozo, Ozlem %A Charles A Guarnaccia %K Activities of Daily Living %K Adaptation, Psychological %K Aged %K Aging %K Caregivers %K Chronic disease %K Female %K Friends %K Humans %K Longitudinal Studies %K Male %K Middle Aged %K Personal Satisfaction %K Retirement %K Risk Factors %K Sick Role %K Social Support %K Spouses %X

The authors investigated the relation of activities of daily living (ADL) and social support satisfaction to illness status 10 years later among 4,870 married older adults in the Health and Retirement Study (F. Juster & R. Suzman, 1995). The authors tested the direct and indirect effects of 1992 ADL, as well as family and friends support satisfaction and spousal social support satisfaction on 2002 illness status. The hierarchical multiple regressions found, controlling for 1992 illness status, ADL protected against future illness, and family and friends and spousal support satisfaction had small, surprisingly positive, effects on greater 2002 illness. The ADL x Family and Friends Support Satisfaction and the ADL x Spousal Support Satisfaction crossproduct interactions were also small positive predictors of later illness. The authors discuss several possible mechanisms that explained this unexpected result. The authors concluded that, depending on whether the recipient is in need of support and depending on the source of the support, the older adults do or do not benefit from the support.

%B J Psychol %I 144 %V 144 %P 1-14 %8 2010 Jan-Feb %G eng %N 1 %1 http://www.ncbi.nlm.nih.gov/pubmed/20092067?dopt=Abstract %3 20092067 %4 Activities of Daily Living/social Support/health care/families/Transfers %$ 22220 %R 10.1080/00223980903356032 %0 Journal Article %J Chronic Illn %D 2010 %T The case for involving adult children outside of the household in the self-management support of older adults with chronic illnesses. %A John D Piette %A Ann Marie Rosland %A Maria J Silveira %A Mohammed U Kabeto %A Kenneth M. Langa %K Adult %K Chronic disease %K Family Relations %K Female %K Humans %K Male %K Middle Aged %K Self Care %K Social Support %X

OBJECTIVES: This study sought to (1) identify barriers to spousal support for chronic illness self-care among community-dwelling older adults; and (2) describe the potential availability of self-care support from adult children living outside of the household.

METHODS: Nationally representative US sample of chronically ill adults aged 51+ were interviewed as part of the Health and Retirement Study (N = 14,862). Both participants and their spouses (when available) reported information about their health and functioning. Participants also reported information about their contact with adult children and the quality of those relationships.

RESULTS: More than one-third (38%) of chronically ill older adults in the US are unmarried; and when spouses are available, the majority of them have multiple chronic diseases and functional limitations. However, the vast majority of chronically ill older adults (93%, representing roughly 60 million Americans) have adult children, with half having children living over 10 miles away. Most respondents with children (78%) reported at least weekly telephone contact and that these relationships were positive. Roughly 19 million older chronically ill Americans have adult children living at a distance but none nearby; these children are in frequent telephone contact and respondents (including those with multiple chronic diseases) report that the relationships are positive.

DISCUSSION: As the gap between available health services for disease management and the need among community-dwelling patients continues to grow, adult children-including those living at a distance-represent an important resource for improving self-care support for people with chronic diseases.

%B Chronic Illn %I 6 %V 6 %P 34-45 %8 2010 Mar %G eng %N 1 %1 http://www.ncbi.nlm.nih.gov/pubmed/20308349?dopt=Abstract %2 PMC2864454 %4 self-care/Chronic Disease %$ 25230 %R 10.1177/1742395309347804 %0 Journal Article %J J Gerontol B Psychol Sci Soc Sci %D 2010 %T Diabetes-related support, regimen adherence, and health decline among older adults. %A Emily J Nicklett %A Jersey Liang %K Activities of Daily Living %K Aged %K Diabetes Mellitus, Type 2 %K Disability Evaluation %K Female %K Health Behavior %K Health Status %K Humans %K Longitudinal Studies %K Male %K Middle Aged %K Patient Compliance %K Quality of Life %K Social Support %K Surveys and Questionnaires %K United States %X

UNLABELLED: OBJECTIVES. Social support is generally conceptualized as health promoting; however, there is little consensus regarding the mechanisms through which support is protective. Illness support has been proposed to promote regimen adherence and subsequent prevention of health decline. We hypothesize that (a) support for regimen adherence is negatively associated with self-reported health decline among older diabetic adults and that (b) regimen adherence is negatively associated with health decline among older diabetic adults.

METHODS: We used the Health and Retirement Study data on individuals over the age of 60 years with type 2 diabetes mellitus (n = 1,788), examining change in self-reported health status over a 2-year period using binomial and cumulative ordinal logistic regression models.

RESULTS: Diabetic support is not significantly associated with health decline, but it is strongly associated with adherence to health-promoting activities consisting of a diabetic regimen. Therefore, the extent to which one receives illness support for a given regimen component is highly positively associated with adhering to that component, although this adherence does not necessarily translate into protection against perceived decline in health.

CONCLUSIONS: Illness-related support appears to be a mechanism through which social support matters in the diabetic population. Although this relationship did not extend to prevention of health status decline among diabetics, the relationship between support and illness management is promising.

%B J Gerontol B Psychol Sci Soc Sci %I 10 %V 65B %P 390-9 %8 2010 May %G eng %N 3 %L newpubs20090908_Nicklett.pdf %1 http://www.ncbi.nlm.nih.gov/pubmed/19541672?dopt=Abstract %2 PMC2853599 %4 Chronic Illness/diabetes/Health care management %$ 20640 %R 10.1093/geronb/gbp050 %0 Journal Article %J Soc Sci Med %D 2010 %T Functional declines, social support, and mental health in the elderly: does living in a state supportive of home and community-based services make a difference? %A Muramatsu, Naoko %A yin, Hongjun %A Hedeker, Donald %K Activities of Daily Living %K Aged %K Cognition %K Community Health Services %K depression %K Disabled Persons %K Female %K Home Care Services %K Humans %K Logistic Models %K Male %K Mental Health %K Multilevel Analysis %K Risk Factors %K Social Support %K Spouses %K State Government %K Stress, Psychological %K United States %X

This study examines how acute and chronic stresses associated with functional declines in seniors and their spouses are moderated by their informal and formal support contexts. In the United States, states vary greatly in their support for home and community-based services (HCBS) for seniors with disabilities. This state-to-state variation allowed us to examine mental health effects of living in a society supportive of HCBS for the oldest old, who are at high risk for low or declining functions in daily activities and cognitive abilities. Using a ten-year panel study of a nationally representative sample of the oldest old (>or=70 years old) covering the period 1993-2002, we conducted mixed-effects logistic regression analysis to incorporate time-varying characteristics of persons and states. As expected, low and declining functions in daily living and cognition constituted significant stressors among seniors and their spouse. Results demonstrated the important role of informal support available from non-spouse family/friends in lowering depression. Living in a state supportive of HCBS was associated with lower depression among seniors experiencing consistently low levels of function or recent functional declines, especially among those without informal support. Our findings were consistent with moderating or buffering models of formal support, suggesting that state HCBS support is effective mainly under conditions of high levels of stressors. Political will is needed to prepare US society to collectively support community-based long-term needs, given the difficulty of preparing ourselves fully for common, but often unexpected, functional declines in later life.

%B Soc Sci Med %I 70 %V 70 %P 1050-8 %8 2010 Apr %G eng %N 7 %L newpubs20100729_Muramatsu.pdf %1 http://www.ncbi.nlm.nih.gov/pubmed/20117865?dopt=Abstract %2 PMC3360961 %4 Stress/Home Care Services/community-based services/mental Health/depression %$ 22990 %R 10.1016/j.socscimed.2009.12.005 %0 Journal Article %J Gerontologist %D 2010 %T Longitudinal changes in disabled husbands' and wives' receipt of care. %A Claire Noël-Miller %K Activities of Daily Living %K Aged %K Aged, 80 and over %K Caregivers %K Disabled Persons %K Female %K Humans %K Long-term Care %K Longitudinal Studies %K Male %K Marriage %K Middle Aged %K Models, Theoretical %K Sex Factors %K Social Support %K Socioeconomic factors %K Spouses %K Surveys and Questionnaires %K Time Factors %X

PURPOSE OF THE STUDY: This study contrasts 2-year adjustments in disabled husbands' and wives' amount of received care following both worsening and recovery in personal (activities of daily living [ADLs]) and routine care (instrumental activities of daily living [IADLs]) disability.

DESIGN AND METHODS: Using longitudinal data on 789 husbands and 778 wives from the Health and Retirement Study (2000 and 2002), changes in marital partners' monthly hours of spousal and nonspousal care were jointly modeled using bivariate Tobit models. In addition, asymmetry in the magnitude of responses to worsening and improvement of function was examined.

RESULTS: Disabled husbands receive more hours of spousal and nonspousal care following worsening in ADL function than wives. Conversely, disabled wives lose more spousal and nonspousal care hours following improvements in ADL disability than husbands. Moreover, wives recovering in ADL function lose more hours of spousal care than they receive following worsening in personal care disability. There is no evidence of corresponding gender differences in the dynamics of assistance received following changes in IADL function.

IMPLICATIONS: Compared with husbands, disabled wives are disadvantaged in the adjustment of their personal care hours. Although disabled married community residents receive more hours of care than their unmarried counterparts, there are important gender differences in the advantages offered by marriage.

%B Gerontologist %I 50 %V 50 %P 681-93 %8 2010 Oct %G eng %N 5 %1 http://www.ncbi.nlm.nih.gov/pubmed/20382664?dopt=Abstract %2 PMC2937250 %4 Activities of Daily Living/instrumental activities of daily living/DISABILITY/DISABILITY/Handicapped/Sex Differences/spousal care/Home Care Services/gender Differences %$ 23960 %R 10.1093/geront/gnq028 %0 Journal Article %J J Aging Health %D 2010 %T Older adults' expectations to move: do they predict actual community-based or nursing facility moves within 2 years? %A Julie F. Sergeant %A David J Ekerdt %A Chapin, Rosemary K %K Age Factors %K Aged %K Aged, 80 and over %K Aging %K Community Health Services %K Decision making %K Female %K Humans %K Logistic Models %K Male %K Odds Ratio %K Residence Characteristics %K Skilled Nursing Facilities %K Social Support %K Statistics as Topic %K Time Factors %K Transients and Migrants %X

OBJECTIVE: This study examined the relationship between older adults' expectations to move and actual residential relocation in the community or to a nursing facility within 2 years.

METHOD: Two waves of data (2000, 2002) from the Health and Retirement Study were used to compare expectations with subsequent moves. Logistic regression techniques were used to analyze the association between decision outcomes and expectations to move, health and functioning, physical environment, informal supports, and formal services.

RESULTS: Findings indicated that expectations to move did predict community-based moves but did not predict moves to nursing facilities. Additional factors had significant effects but did not diminish relationships between expectations and actual moves.

DISCUSSION: Results support the residential decision process as a dynamic one based on the cumulative effect of factors from an ecological model. Findings will inform policy makers and practitioners as they work to support older adults' preferences to remain living in their homes.

%B J Aging Health %V 22 %P 1029-53 %8 2010 Oct %G eng %N 7 %1 http://www.ncbi.nlm.nih.gov/pubmed/20495154?dopt=Abstract %3 20495154 %4 expectations/Residential relocation/nursing Homes %$ 22680 %R 10.1177/0898264310368296 %0 Journal Article %J J Gerontol B Psychol Sci Soc Sci %D 2010 %T Spousal loss, children, and the risk of nursing home admission. %A Claire Noël-Miller %K Activities of Daily Living %K Adult children %K Aged %K Aged, 80 and over %K Aging %K Bereavement %K Caregivers %K Family Characteristics %K Female %K Gender Identity %K Homes for the Aged %K Humans %K Long-term Care %K Male %K Nursing homes %K Parent-Child Relations %K Patient Admission %K Proportional Hazards Models %K Social Support %K Spouses %K Utilization Review %X

UNLABELLED: OBJECTIVES. Informed by a life course perspective, this study investigates the effects of spousal loss and availability of adult children on elderly husbands' and wives' risk of nursing home entry.

METHODS: Based on longitudinal data from the Health and Retirement Study, we studied 2,116 couples who were community residents in 1998. We estimate proportional hazards models for husbands' and wives' duration to first nursing home admission during 8 years of follow-up.

RESULTS: Overall, 438 (20.7%) husbands and 382 (18.1%) wives were institutionalized, and 362 (17.1%) husbands and 701 (33.1%) wives lost their spouse. Accounting for measured covariates, the risk of nursing home entry doubled for men following spousal death, but was unchanged for women. Results indicate that adult children reduced wives' risk of nursing home admission regardless of husbands' vital status, but buffered husbands' risk only after the death of their wives. We uncover suggestive evidence of parent-child gender concordance in children's buffering effect of widowed parents' risk of institutionalization. Discussion. Our findings are consistent with gender variations in spousal caregiving and in husbands' and wives' relative reliance on care from a partner and children. This study provides new evidence on the relationship between institutionalization and family structure among married elderly persons.

%B J Gerontol B Psychol Sci Soc Sci %I 65B %V 65B %P 370-80 %8 2010 May %G eng %N 3 %1 http://www.ncbi.nlm.nih.gov/pubmed/20371551?dopt=Abstract %2 PMC2853605 %4 Activities of Daily Living psychology/Adult Children/Aged, 80 and over/Aging psychology/Bereavement/Caregivers psychology supply/distribution utilization/Family Characteristics/Female/Gender Identity/Homes for the Aged utilization/Humans/Long-Term Care psychology/Nursing Homes utilization/Parent-Child Relations/Patient Admission statistics/numerical data/Proportional Hazards Models/Social Support/Spouses psychology statistics/numerical data/Utilization Review %$ 22690 %R 10.1093/geronb/gbq020 %0 Journal Article %J J Am Geriatr Soc %D 2009 %T Association between cognitive function and social support with glycemic control in adults with diabetes mellitus. %A Okura, Toru %A Michele M Heisler %A Kenneth M. Langa %K Aged %K Blood Glucose %K Cognition %K Cross-Sectional Studies %K Diabetes Mellitus %K Female %K Humans %K Male %K Middle Aged %K Social Support %X

OBJECTIVES: To examine whether cognitive impairment in adults with diabetes mellitus is associated with worse glycemic control and to assess whether level of social support for diabetes mellitus care modifies this relationship.

DESIGN: Cross-sectional analysis.

SETTING: The 2003 Health and Retirement Study (HRS) Mail Survey on Diabetes and the 2004 wave of the HRS.

PARTICIPANTS: Adults aged 50 and older with diabetes mellitus in the United States (N=1,097, mean age 69.2).

MEASUREMENTS: Glycosylated hemoglobin (HbA1c) level; cognitive function, measured with the 35-point HRS cognitive scale (HRS-cog); sociodemographic variables; duration of diabetes mellitus; depressed mood; social support for diabetes mellitus care; self-reported knowledge of diabetes mellitus; treatments for diabetes mellitus; components of the Total Illness Burden Index related to diabetes mellitus; and functional limitations.

RESULTS: In an ordered logistic regression model for the three ordinal levels of HbA1c (<7.0, 7.0-7.9, >or=8.0 mg/dL), respondents with HRS-cog scores in the lowest quartile had significantly higher HbA1c levels than those in the highest cognitive quartile (adjusted odds ratio=1.80, 95% confidence interval=1.11-2.92). A high level of social support for diabetes mellitus care modified this association; for respondents in the lowest cognitive quartile, those with high levels of support had significantly lower odds of having higher HbA1c than those with low levels of support (1.11 vs 2.87, P=.02).

CONCLUSION: Although cognitive impairment was associated with worse glycemic control, higher levels of social support for diabetes mellitus care ameliorated this negative relationship. Identifying the level of social support available to cognitively impaired adults with diabetes mellitus may help to target interventions for better glycemic control.

%B J Am Geriatr Soc %I 57 %V 57 %P 1816-24 %8 2009 Oct %G eng %N 10 %L newpubs20091013_OkuraJAGS.pdf %1 http://www.ncbi.nlm.nih.gov/pubmed/19682129?dopt=Abstract %2 PMC2810258 %4 Cognitive Function/Social Support/Diabetes Mellitus/Health care management %$ 21140 %R 10.1111/j.1532-5415.2009.02431.x %0 Journal Article %J Am J Prev Med %D 2009 %T Neighborhood safety, socioeconomic status, and physical activity in older adults. %A Reginald D. Tucker-Seeley %A Subramanian, S V %A Li, Yi %A Sorensen, Glorian %K Aged %K Aged, 80 and over %K Cross-Sectional Studies %K Female %K Florida %K Health Status %K Humans %K Leisure activities %K Male %K Middle Aged %K Motor Activity %K Recreation %K Residence Characteristics %K Safety %K Sex Distribution %K Social Support %K Socioeconomic factors %K Surveys and Questionnaires %X

BACKGROUND: Neighborhood environment can have a substantial influence on the level of physical activity among older adults. Yet, the moderating influence of various measures of SES on the association between perceived neighborhood safety and leisure-time physical activity (LTPA) among older adults remains unknown.

PURPOSE: The study was designed to investigate the association between perceived neighborhood safety and LTPA in a nationally representative sample of older adults, and to evaluate SES characteristics as potential effect modifiers in the association between perceived neighborhood safety and LTPA.

METHODS: Cross-sectional data from the 2004 Health and Retirement Study of older adults aged >or=50 years were used to examine the association between perceived neighborhood safety and LTPA. Differences in LTPA were evaluated across three measures of SES: education, household income, and household wealth. SES was also evaluated as a potential effect modifier in the association between perceived neighborhood safety and LTPA. The analysis was conducted in 2008.

RESULTS: An SES gradient in LTPA was noted across measures of SES used in this study. After controlling for SES and demographic characteristics and functional limitations, older adults who perceived their neighborhood as safe had an 8% higher mean rate of LTPA compared to older adults who perceived their neighborhood as unsafe. The association was no longer significant when self-rated health was added. Additionally, SES was not a significant effect modifier in the association between perceived neighborhood safety and LTPA.

CONCLUSIONS: SES, demographic characteristics, and functional limitations substantially attenuated the positive association between perceived neighborhood safety and LTPA; however, with the inclusion of self-rated health, the association was no longer present. This finding suggests that self-rated health may mediate this association. The lack of significance in the interaction between perceived neighborhood safety and SES suggests that prevention efforts to increase physical activity among older adults should consider perceptions of neighborhood safety as a potential barrier regardless of SES.

%B Am J Prev Med %I 37 %V 37 %P 207-13 %8 2009 Sep %G eng %N 3 %L newpubs20090908_Tucker-SeeleyAJPM.pdf %1 http://www.ncbi.nlm.nih.gov/pubmed/19595554?dopt=Abstract %2 PMC3685411 %4 Neighborhood Characteristics/Leisure/Physical Activity/socioeconomic status %$ 20820 %R 10.1016/j.amepre.2009.06.005 %0 Journal Article %J Am J Public Health %D 2008 %T Effects of social integration on preserving memory function in a nationally representative US elderly population. %A Karen A Ertel %A M. Maria Glymour %A Lisa F Berkman %K Aged %K Aged, 80 and over %K Cognition Disorders %K Female %K Health Behavior %K Health Status %K Humans %K Interpersonal Relations %K Male %K Mental Health %K Mental Recall %K Predictive Value of Tests %K Reproducibility of Results %K Severity of Illness Index %K social isolation %K Social Support %K Socioeconomic factors %K United States %X

OBJECTIVES: We tested whether social integration protects against memory loss and other cognitive disorders in late life in a nationally representative US sample of elderly adults, whether effects were stronger among disadvantaged individuals, and whether earlier cognitive losses explained the association (reverse causation).

METHODS: Using data from the Health and Retirement Study (N = 16,638), we examined whether social integration predicted memory change over 6 years. Memory was measured by immediate and delayed recall of a 10-word list. Social integration was assessed by marital status, volunteer activity, and frequency of contact with children, parents, and neighbors. We examined growth-curve models for the whole sample and within subgroups.

RESULTS: The mean memory score declined from 11.0 in 1998 to 10.0 in 2004. Higher baseline social integration predicted slower memory decline in fully adjusted models (P<.01). Memory among the least integrated declined at twice the rate as among the most integrated. This association was largest for respondents with fewer than 12 years of education. There was no evidence of reverse causation.

CONCLUSIONS: Our study provides evidence that social integration delays memory loss among elderly Americans. Future research should focus on identifying the specific aspects of social integration most important for preserving memory.

%B Am J Public Health %I 98 %V 98 %P 1215-20 %8 2008 Jul %G eng %N 7 %L newpubs20080822 %1 http://www.ncbi.nlm.nih.gov/pubmed/18511736?dopt=Abstract %2 PMC2424091 %4 Memory/Social Interaction/Cognitive Function %$ 19090 %R 10.2105/AJPH.2007.113654 %0 Journal Article %J Psychol Aging %D 2006 %T Loneliness as a specific risk factor for depressive symptoms: cross-sectional and longitudinal analyses. %A John T. Cacioppo %A Mary Elizabeth Hughes %A Linda J. Waite %A Louise C Hawkley %A Ronald A. Thisted %K Aged %K Cross-Sectional Studies %K depression %K Female %K Follow-Up Studies %K Health Status %K Hostility %K Humans %K Loneliness %K Male %K Middle Aged %K Risk Factors %K Severity of Illness Index %K Social Support %K Stress, Psychological %K Surveys and Questionnaires %X

The extent to which loneliness is a unique risk factor for depressive symptoms was determined in 2 population-based studies of middle-aged to older adults, and the possible causal influences between loneliness and depressive symptoms were examined longitudinally in the 2nd study. In Study 1, a nationally representative sample of persons aged 54 and older completed a telephone interview as part of a study of health and aging. Higher levels of loneliness were associated with more depressive symptoms, net of the effects of age, gender, ethnicity, education, income, marital status, social support, and perceived stress. In Study 2, detailed measures of loneliness, social support, perceived stress, hostility, and demographic characteristics were collected over a 3-year period from a population-based sample of adults ages 50-67 years from Cook County, Illinois. Loneliness was again associated with more depressive symptoms, net of demographic covariates, marital status, social support, hostility, and perceived stress. Latent variable growth models revealed reciprocal influences over time between loneliness and depressive symptomatology. These data suggest that loneliness and depressive symptomatology can act in a synergistic effect to diminish well-being in middle-aged and older adults.

%B Psychol Aging %I 21 %V 21 %P 140-51 %8 2006 Mar %G eng %N 1 %1 http://www.ncbi.nlm.nih.gov/pubmed/16594799?dopt=Abstract %4 Loneliness/Depression/Social Support/Stress %$ 25220 %R 10.1037/0882-7974.21.1.140 %0 Journal Article %J J Behav Med %D 2006 %T Religious influences on preventive health care use in a nationally representative sample of middle-age women. %A Benjamins, Maureen Reindl %K Aged %K Breast Self-Examination %K Female %K Health Behavior %K Health Status Indicators %K Health Surveys %K Humans %K Mammography %K Mass Screening %K Middle Aged %K Papanicolaou Test %K Preventive Health Services %K Religion and Medicine %K Religion and Psychology %K Social Support %K Socioeconomic factors %K United States %K Utilization Review %K Vaginal Smears %X

Despite the many benefits of preventive services, they are often underutilized. Social factors, such as religion, can figure prominently in these discrepancies by either creating barriers or facilitating use. Using data from the Health and Retirement Survey (HRS, 1992-1996), the current study examines the relationship between religious attendance, religious salience, and denomination and three types of female preventive services in a sample of middle-age women (N = 4253). Findings indicate that women who attend religious services more frequently use more mammograms, Pap smears, and self-breast exams. In addition, women belonging to Mainline Protestant or Jewish denominations use certain preventive services more than Evangelical Protestants. Finally, women with higher levels of religious salience are more likely to conduct self-breast exams. These findings add important information to the public health literature concerning factors that influence preventive service use. They also add to the growing field of religion and health research where preventive health care use is emerging as a possible mechanism linking religion to a wide variety of physical health outcomes.

%B J Behav Med %I 29 %V 29 %P 1-16 %8 2006 Feb %G eng %N 1 %L pubs_2006_BenjaminsJBM.pdf %1 http://www.ncbi.nlm.nih.gov/pubmed/16397821?dopt=Abstract %4 prevention/Health Care/Religiosity/Womens Health %$ 15650 %R 10.1007/s10865-005-9035-2 %0 Journal Article %J Gerontologist %D 2006 %T Reported expectations for nursing home placement among older adults and their role as risk factors for nursing home admissions. %A Adaeze B Akamigbo %A Frederic D Wolinsky %K Age Factors %K Aged %K Female %K Health Status %K Homes for the Aged %K Humans %K Male %K Nursing homes %K Patient Admission %K Risk Factors %K Sex Factors %K Social Support %K Socioeconomic factors %X

PURPOSE: Individual expectations among community-dwelling older adults and their subsequent effect on placement status have recently been considered. Previous studies, however, have been limited by eligibility and exclusion criteria, treating expectations as a continuous measure, omitting potential confounders, and ignoring Race x Gender interactions.

DESIGN AND METHODS: We used data on 6,242 Black or White self-respondents who were 70 years old or older when they were enrolled in the survey of Assets and Health Dynamics Among the Oldest Old. We modeled expectations for nursing home placement over the next 5 years, as well as actual placement status, by using multivariable multinomial and binomial logistic regression models.

RESULTS: Expectations are not normally distributed: 14% of the participants refused to answer, 51% estimated no chance, 10% indicated a 1% to 50% chance, 21% indicated an 11% to 50% chance and 4% indicated a 51% to 100% chance. Age, gender, education, social supports, and health status were associated with expectations, as well as an interaction effect for Black men. Age, social supports, health status, prior hospital or nursing home use, and expectations were associated with subsequent placement.

IMPLICATIONS: Black and White older adults' expectations for nursing home placement rationally reflect their individual risk profiles and are associated with subsequent placement status. The expectations question may facilitate the early identification of high-risk individuals for further evaluation.

%B Gerontologist %I 46 %V 46 %P 464-73 %8 2006 Aug %G eng %N 4 %L newpubs20071203_Akamigbo.pdf %1 http://www.ncbi.nlm.nih.gov/pubmed/16921000?dopt=Abstract %R 10.1093/geront/46.4.464 %0 Journal Article %J J Aging Health %D 2005 %T Health and living arrangements among older Americans: does marriage matter? %A Jersey Liang %A Brown, Joseph W. %A Krause, Neal M. %A Mary Beth Ofstedal %A Joan M. Bennett %K Adult children %K Aged %K Demography %K Health Status %K Humans %K Institutionalization %K Marital Status %K Marriage %K Mental Health %K Parents %K Residence Characteristics %K Social Support %K Socioeconomic factors %K Spouses %K United States %X

OBJECTIVE: This research examines how physical and mental health influence living arrangements among older Americans and whether these effects differ for married and unmarried persons.

METHODS: Data came from the Asset and Health Dynamics Among the Oldest Old study. These two intervals were pooled, and hierarchical multinomial logistic regressions were used to analyze pooled time lags.

RESULTS: Functional status and cognitive functioning are significantly associated with living arrangements among those not married. Health conditions exert no significant effects among those married. Given the same functional status, unmarried elders are significantly more likely than their married counterparts to reside with their children or with others.

DISCUSSION: These results underscore the critical role of the spouse in influencing living arrangements, providing new evidence supporting the assertion that a spouse is the greatest guarantee of support in old age and the importance of the marriage institution.

%B J Aging Health %I 17 %V 17 %P 305-35 %8 2005 Jun %G eng %N 3 %1 http://www.ncbi.nlm.nih.gov/pubmed/15857961?dopt=Abstract %4 Health/Living Conditions/Marriage/Health Physical %$ 14370 %R 10.1177/0898264305276300 %0 Journal Article %J J Gerontol B Psychol Sci Soc Sci %D 2005 %T The significance of nonmarital cohabitation: marital status and mental health benefits among middle-aged and older adults. %A Susan L. Brown %A Jennifer R. Bulanda %A Lee, Gary R. %K Aged %K depression %K Female %K Humans %K Insurance Benefits %K Male %K Marital Status %K Mental Health Services %K Middle Aged %K Sexual Partners %K Social Support %K United States %X

OBJECTIVES: According to the 2000 Census, about 1.2 million persons over age 50 are currently cohabiting. Do these unmarried cohabiting partnerships provide adults with mental health benefits that are similar to those enjoyed by marrieds? We extended prior work on marital status and depression by including cohabitation in our conceptualization of marital status.

METHODS: We used data from the 1998 Health and Retirement Study (N = 18,598) to examine the relationship between marital status and depressive symptoms among adults over age 50. We also examined gender differences in this association.

RESULTS: We found that cohabitors report more depressive symptoms, on average, than do marrieds, net of economic resources, social support, and physical health. Additional analyses revealed that only among men do cohabitors report significantly higher depression scores. Cohabiting and married women as well as cohabiting men experience similar levels of depression, and all of these groups report levels that are significantly higher than married men's.

DISCUSSION: Our findings demonstrate the importance of accounting for nontraditional living arrangements among persons aged 50 and older. Cohabitation appears to be more consequential for men's than women's depressive symptoms.

%B J Gerontol B Psychol Sci Soc Sci %I 60B %V 60 %P S21-9 %8 2005 Jan %G eng %N 1 %L pubs_2005_brown_jgss.pdf %1 http://www.ncbi.nlm.nih.gov/pubmed/15643043?dopt=Abstract %4 Couples/Depression/Housing/Social Support %$ 12972 %R 10.1093/geronb/60.1.s21 %0 Journal Article %J J Gerontol B Psychol Sci Soc Sci %D 2004 %T Economic status in later life among women who raised children outside of marriage. %A Richard W. Johnson %A Melissa Favreault %K Adolescent %K Adult %K Aged %K Aging %K Child %K Child Rearing %K Demography %K Female %K Humans %K Illegitimacy %K Middle Aged %K Single-Parent Family %K Social Support %K Socioeconomic factors %X

OBJECTIVE: Many single mothers are likely to face special economic challenges in old age, because they often have limited employment histories and cannot rely on husbands for financial support. This article examines the economic status of these women in later life.

METHODS: The analysis uses nationally representative data from the Health and Retirement Study to estimate multivariate models of income, assets, and poverty rates for women aged 65-75 in 1999.

RESULT: Controlling for education, current marital status, and race and ethnicity, the models indicate that women who spent > or =10 years raising dependent children outside of marriage are 55% more likely to live in poverty at ages 65-75 than women who were always married when their children were young.

DISCUSSION: The financial difficulties confronting single mothers raising children persist into later life. Social Security reforms, especially those that are not tied to the current system of spousal and survivor benefits, could improve retirement security for these vulnerable women, whose numbers will begin to soar when the many women who raised children outside of marriage in the 1970s retire in coming years.

%B J Gerontol B Psychol Sci Soc Sci %I 59B %V 59 %P S315-23 %8 2004 Nov %G eng %N 6 %L pubs_2004_Johnson-Favreault.pdf %1 http://www.ncbi.nlm.nih.gov/pubmed/15576862?dopt=Abstract %4 Women/Marital Status/Children %$ 13322 %R 10.1093/geronb/59.6.s315 %0 Journal Article %J J Aging Health %D 2002 %T It takes two: marriage and smoking cessation in the middle years. %A Melissa M Franks %A Pienta, Amy M. %A Linda A. Wray %K Female %K Health Behavior %K Humans %K Male %K Marital Status %K Marriage %K Middle Aged %K Smoking cessation %K Social Support %K Spouses %X

OBJECTIVES: In this prospective study of smoking cessation among married individuals in midlife we examine correspondence in the change of each partner's smoking status with that of the other, independent of established psychosocial correlates of smoking cessation.

METHODS: Using longitudinal data from the first two waves of the Health and Retirement Study, 1992-1994, hierarchical logistic regression models were estimated for married male and female smokers separately.

RESULTS: Findings support our hypothesis of correspondence in the smoking cessation of married male and female smokers net of other sociodemographic, health, and health behavior characteristics.

DISCUSSION: These findings suggest that initiation and maintenance of this positive lifestyle change may be more easily achieved when both marital partners are given information and support to quit smoking at the same time.

%B J Aging Health %I 14 %V 14 %P 336-54 %8 2002 Aug %G eng %N 3 %1 http://www.ncbi.nlm.nih.gov/pubmed/12146510?dopt=Abstract %4 Smoking Cessation %$ 11832 %R 10.1177/08964302014003002 %0 Journal Article %J Med Care %D 2001 %T The explosion in paid home health care in the 1990s: who received the additional services? %A Kenneth M. Langa %A M.E. Chernew %A Mohammed U Kabeto %A Steven J. Katz %K Activities of Daily Living %K Aged %K Aged, 80 and over %K Chronic disease %K Family Characteristics %K Female %K Financing, Government %K Frail Elderly %K Geriatric Assessment %K Health Care Surveys %K Health Expenditures %K health policy %K Home Care Services %K Home Nursing %K Humans %K Longitudinal Studies %K Male %K Marital Status %K Multivariate Analysis %K Social Support %K Socioeconomic factors %K Surveys and Questionnaires %K United States %K Utilization Review %X

OBJECTIVE: Public expenditures for home health care grew rapidly in the 1990s, but it remains unclear to whom the additional services were targeted. This study tests whether the rapidly increasing expenditures were targeted to the elderly with high levels of disability and low levels of social support, 2 groups that have historically been higher users of paid home health and nursing home services.

METHODS: The Asset and Health Dynamics Study, a nationally representative, longitudinal survey of people > or = 70 years of age (n = 7,443), was used to determine the association of level of disability and level of social support with the use of paid home care services in both 1993 and 1995. Multivariable regression models were used to adjust for sociodemographics, recent hospital or nursing home admissions, chronic medical conditions, and receipt of informal care from family members.

RESULTS: Those with higher levels of disability received more adjusted weekly hours of paid home care in both 1993 and 1995. In 1993, users of paid home care with the least social support (unmarried living alone) received more adjusted weekly hours of care than the unmarried elderly living with others (24 versus 13 hours, P < 0.01) and the married (24 versus 18 hours, P = 0.06). However, by 1995, those who were unmarried and living with others were receiving the most paid home care: 40 versus 26 hours for the unmarried living alone (P < 0.05) and 24 hours for the married (P < 0.05).

CONCLUSIONS: The recent large increase in formal home care services went disproportionately to those with greater social support. Home care policy changes in the early 1990s resulted in a shift in the distribution of home care services toward the elderly living with their children.

%B Med Care %I 39 %V 39 %P 147-57 %8 2001 Feb %G eng %N 2 %L pubs_2001_Langa_KMedCare.pdf %1 http://www.ncbi.nlm.nih.gov/pubmed/11176552?dopt=Abstract %4 Activities of Daily Living/Classification/Aged, 80 and Over/Chronic Disease/Family Characteristics/Female/Financing, Government/Frail Elderly/Geriatric Assessment/Health Care Surveys/Health Expenditures/Health Policy/Home Care Services/Home Nursing/Longitudinal Studies/Marital Status/Multivariate Analysis/Questionnaires/Social Support/Socioeconomic Factors/Support, Non U.S. Government/United States/Utilization Review %$ 4095 %R 10.1097/00005650-200102000-00005 %0 Journal Article %J J Stud Alcohol %D 2001 %T Life events and alcohol consumption among mature adults: a longitudinal analysis. %A Perreira, Krista M. %A Frank A Sloan %K Adaptation, Psychological %K Aged %K Alcohol Drinking %K Employment %K Family %K Health Status %K Humans %K Life Change Events %K Longitudinal Studies %K Middle Aged %K Social Support %K Stress, Psychological %X

OBJECTIVE: Four waves of the Health and Retirement Study were used to examine changes in alcohol consumption co-occurring and following stress associated with major health, family and employment events.

METHOD: The final sample consisted of 7,731 (3,907 male) individuals between the ages of 51 and 61 at baseline. We used multinomial logit analysis to study associations between important life events and changes in alcohol consumption over a 6-year study period. Interactions between stressful life events, gender and problem drinking were also evaluated.

RESULTS: Most persons (68%) did not change their use of alcohol over the entire 6 years. Hospitalization and onset of a chronic condition were associated with decreased drinking levels. Retirement was associated with increased drinking. Widowhood was associated with increased drinking but only for a short time. Getting married or divorced was associated with both increases and decreases in drinking, with a complex lag structure. A history of problem drinking influenced the association between certain life events (e.g., divorce and retirement) and changes in drinking. Gender modified the association between losing a spouse and changes in drinking.

CONCLUSIONS: Even after controlling for problem drinking history, social support and coping skills, changes in drinking behavior were related to several life events occurring over a 6-year period for a national cohort of individuals in late middle-age. The magnitude of these relationships, however, varied by gender and problem drinking history.

%B J Stud Alcohol %I 62 %V 62 %P 501-8 %8 2001 Jul %G eng %N 4 %L pubs_2001_Perriera_KJAlcStud.pdf %1 http://www.ncbi.nlm.nih.gov/pubmed/11513228?dopt=Abstract %4 Stress/Drinking Behavior/Family Relations/Adults/Life Events/Alcohol Abuse %$ 1240 %R 10.15288/jsa.2001.62.501 %0 Journal Article %J J Women Aging %D 2000 %T Nativity and older women's health: constructed reliance in the health and retirement study. %A Cynthia J. Buckley %A Jacqueline L. Angel %A Donahue, Dennis %K Aged %K Emigration and Immigration %K ethnicity %K Female %K Florida %K Health Status %K Humans %K Middle Aged %K Retirement %K Social Support %K Socioeconomic factors %K Women's Health %X

Gender and nativity are known risk factors for physical and economic dependency. Immigrant women are particularly disadvantaged because of their greater lack of social and economic resources. In this study, we investigate how women immigrants coordinate and utilize various support systems as they approach retirement age, as well as how choices and constraints affect their physical wellbeing. Experiences throughout the life course play a role in the maintenance of health, but the pre-retirement years are particularly crucial to the establishment of patterns of reliance to be used in later life. We examine the effects of economic resources, social support, and family ties (as well as several exogenous variables) on women's physical health using data from the Health and Retirement Survey. For the women in this study, demographic characteristics, such as Hispanic ethnicity and low education are strong risk factors for poor health. Findings also indicate that reliance patterns across resource domains do not differ significantly by nativity and that both economic and familial resource access significantly lessens the risk of poor health for both native and foreign born women.

%B J Women Aging %I 12 %V 12 %P 21-37 %8 2000 %G eng %N 3-4 %1 http://www.ncbi.nlm.nih.gov/pubmed/11151352?dopt=Abstract %4 Females/Immigrants/Health/Support Networks/Social Support/Family Relations/Socioeconomic Factors/Retirement %$ 1248 %R 10.1300/J074v12n03_03 %0 Journal Article %J Gerontologist %D 1999 %T Racial differences in the multiple social roles of older women: implications for depressive symptoms. %A Cochran, Donna %A Brown, Diane R. %A McGregor, Karl C. %K Analysis of Variance %K Black or African American %K Chi-Square Distribution %K Cross-Sectional Studies %K Demography %K depression %K Female %K Humans %K Middle Aged %K Regression Analysis %K Self Concept %K Social Environment %K Social Support %K White People %K women %X

The relationship between multiple role participation and depressive symptoms experienced by African American (n = 547) and White (n = 2,152) women aged 55-61 was explored. Data were obtained from the Health and Retirement Study (HRS). Racial differences in the social roles of marriage, employment, grandmother, care provider, and volunteer and their influence on level of depressive symptoms were examined. African Americans reported higher levels of depressive symptoms than Whites. Additionally, marriage, employment, and total number of social roles were the most powerful predictors of depressive symptoms for both African American and White women. However, employment was more important in diminishing depressive symptoms among African American than White women occupying multiple social roles.

%B Gerontologist %I 39 %V 39 %P 465-72 %8 1999 Aug %G eng %N 4 %L pubs_1999_Cochran_DGer.pdf %1 http://www.ncbi.nlm.nih.gov/pubmed/10495585?dopt=Abstract %4 Analysis of Variance/Blacks/Psychology/Chi Square Distribution/Cross Sectional Studies/Demography/Depression/Ethnology/Etiology/Female/Human/Middle Age/Regression Analysis/Self Concept/Social Environment/Social Support/Whites/Psychology/Women/Psychology %$ 4060 %R 10.1093/geront/39.4.465