Journal of Aging and Health最新文献

Objectives: To compare rural-urban health care costs among Latinx adults ages 51+ and examine variations by dementia status.

Methods: Data are from the Health and Retirement Study (2006-2018 waves; n = 15,567). We inflation-adjusted all health care costs using the 2021 consumer price index. Geographic context and dementia status were the main exposure variables. We applied multivariate two-part generalized linear models and adjusted for sociodemographic and health characteristics.

Results: Rural residents had higher total health care costs, regardless of dementia status. Total health care costs were $850 higher in rural ($2,640) compared to urban ($1,789) areas (p < .001). Out-of-pocket costs were $870 higher in rural ($2,677) compared to urban ($1,806) areas (p < .001). Dementia status was not an effect modifier.

Discussion: Health care costs are disproportionately higher among Latinx rural, relative to urban, residents. Addressing health care costs among Latinx rural residents is a public health priority.

Objective: To explore differences in depressive symptoms for older adults (Black, Latinx, and White) by cognitive status during the 2020 COVID-19 pandemic. Methods: Data from the Health and Retirement Study identified older adults as cognitively normal, cognitively impaired without dementia (CIND), and persons living with dementia (PLWD). Multiple linear regression analyses examined associations between cognitive status and depressive symptoms among these racialized groups. Results: Compared to the cognitively normal older adults racialized as Black, those with CIND reported higher depressive symptoms during the pandemic (overall and somatic) and PLWD had higher somatic symptoms (p < .01). Older adults racialized as White with CIND reported higher somatic (p < .01) symptoms compared to cognitively normal older adults racialized as White. Discussion: The COVID-19 pandemic was a challenging event among older adults racialized as Black with CIND and PLWD. Future studies should examine if these depressive symptoms persist over time.

ObjectivesTo assess how cognitive trajectories from mid-to-later life relate to wealth change, overall and by mid-life income. Methods: Data were from participants (51-64 years) in the 2000-2018 U.S. Health and Retirement Study who were cognitively healthy at baseline (year 2000; unweighted n = 3821). Longitudinal latent class analyses generated cognitive and wealth trajectories, independently, and multinomial logistic regressions estimated the association between cognitive trajectories and wealth profiles, overall and by median income. Results: We identified three cognitive: cognitively healthy (CH), increasing cognitive impairment (ICI), and increasing dementia (ID) and four wealth profiles: stable wealth loss (SWL), delayed gradual wealth loss (DGWL), stable wealth gain (SWG), and gradual wealth gain (GWG). The ID group had higher probability of being in the SWL group and lower probability of SWG, which was more pronounced in respondents with greater median income. Discussion: Individuals with ID may be vulnerable to wealth loss, particularly for middle-class households.

Objectives: To examine the relationship between children's educational attainment and the risk of food insecurity among older parents and to determine if this relationship varies by the sex and residence of the children. Methods: This study utilized data from the Longitudinal Ageing Survey in India (LASI, 2017-18), comprising 25,914 individuals aged 60+ with at least one living child. Logistic regression, interaction analysis, and propensity score matching were employed to achieve the study's objectives. Results: Having a child with higher education (undergraduate or above) was associated with a 35% reduction in the odds of parents experiencing food insecurity. This negative relationship was significant for both sons' and daughters' education, with daughters' education having higher effect size. Conclusion: In a country like India, characterized by a weak welfare system but a strong collectivist family culture, children's education may play an important role in ensuring older parents' food security.

Objectives: We investigated whether functional social support-the degree to which one perceives support is available when needed-is associated with executive function, a key cognitive domain for everyday functioning and adaptation to change.

Methods: Analyses (n = 23,491) utilized cross-sectional data from the Comprehensive cohort of the Canadian Longitudinal Study on Aging (CLSA), a population-based study of community-dwelling adults aged 45-85 years. Executive function was assessed by neurocognitive battery. Perceived social support was measured using the 19-item Medical Outcomes Study-Social Support Survey. Logistic regression models were adjusted for sociodemographic, health, and social covariates.

Results: Positive social interactions as well as affectionate and emotional/informational functional social support were positively associated with executive function.

Discussion: Social support plays an important role in cognitive health. Diversifying social programming beyond tangible social support to target other subtypes of support may help preserve executive function in middle-aged and older adults.

Objectives: To examine the reciprocal associations between walking performance, physical activity (PA), and perceived autonomy in outdoor mobility in 322 older adults. Methods: At baseline and four years later, a 6-min walk test assessed walking performance. A thigh-mounted accelerometer monitored relative PA (acceleration exceeding the individual's preferred walking intensity on the walk test) and absolute MVPA (acceleration exceeding 3 METs) in free-living. Autonomy in outdoor mobility was self-reported using the IPA subscale. Cross-lagged panel model was used for analyses. Results: Higher relative PA at baseline predicted better walking performance four years later and vice versa (p < .05). Baseline MVPA did not predict subsequent walking performance, but better initial walking performance predicted higher subsequent MVPA (p < .001). In both models, only walking performance predicted perceived autonomy at follow-up (p < .05). Discussion: Accumulating enough PA of a sufficient relative intensity can maintain good walking performance, which in turn helps to maintain perceived autonomy in mobility.

Objective: This study tries to investigate the association between two measures of poverty (subjective poverty and material deprivation) with depression and its underlying mechanism(s). Method: A total sample of 28,723 older adults aged 60 years and above was included from the Longitudinal Aging Study in India. Multivariable logistic regression models were used to estimate the association between poverty measures and depression after adjustment of control variables. The Karlson-Holm-Breen (KHB) method was used for mediation analysis to assess the indirect effect of functional, behavioral, and psycho-social factors between poverty measures and depression. Results: The findings suggested that "subjective poverty" has a significantly stronger impact on depression in comparison to material deprivation. Further, functional and psycho-social factors have significantly mediated the relationship between subjective poverty, material deprivation, and depression but are not favorable for behavioral components. Discussion: We believe that policymakers should reconsider the mental health aspects of poverty to promote healthy aging in India.

Objective: The aim of this study was to examine a continuum of grandparenting intensity and its association with physical activity using three perspectives: grandparents are active, the more constraints perspective, and the selection bias perspective. Method: We use 2014 data from the Health and Retirement Study (HRS), a nationally-representative panel study of the US population over the age of 50 and their spouses (n = 17,851). Results: We found that greater grandparenting intensity was inversely associated with physical activity, providing support for both the more constraints perspective and the selection bias perspective. Discussion: We discuss the implications of inequality in which the most advantaged with physical activity are those who were either not grandparents, or grandparents who provided less care.

Objectives: This study compared the United States and China in examining the predictors of community-based residential relocation and its associated mortality risk.

Methods: Data from the 2010 to 2018 US Health and Retirement Study and from 2011 to 2018 China Health and Retirement Longitudinal Study were used (N_US = 20,292 and N_China = 11,694). Community-dwelling respondents (aged 50+) reported whether they had relocated and were followed up until 2018. Log-binomial regression and Cox survival analysis were used.

Results: In both countries, younger age, higher education, urban residence, and being a renter were associated with higher likelihood of relocation. Community-based relocation was associated with a lower mortality risk (US: HR = 0.63, 95% CI = 0.57, 0.70; China: HR = 0.40, 95% CI = 0.31, 0.50), and this association was significantly stronger in China compared to the United States.

Discussion: Common predictors of community-based relocation were found in the United States and China. The relocation-related survival advantages may be attributed to a better post-move adaptation and living environment.

Background: The well-known disablement process has been conceptualized as a series of transitions between progressive states of functional decline. We studied joint patterns of change within disablement states defined as walking speed, grip strength, and self-reported disability.

Methods: 1702 participants aged 65 and over were included from the Longitudinal Aging Study Amsterdam, spanning seven waves over 20 years (1996-2016). Group-based multi-trajectory modeling yielded trajectory clusters (TCs) of different patterns of change, further characterized by baseline sociodemographic characteristics, physical and cognitive health, and survival rate.

Results: Five TCs were identified, distinguished by increasing baseline age. Walking speed and disability showed generally concomitant trajectories. Women had poorer trajectories in grip strength than men, but not in walking speed and disability. Poor physical health distinguished especially the poorest, and cognitive impairment distinguished especially the one-before-poorest from the better TCs.

Discussion: The findings suggest that the disablement states are not generally distinct or sequential.