Journal of Aging and Health最新文献

Objectives: Guided by a life course perspective and fundamental cause theory, this study aims to visualize co-trajectories of health between partners and examine how changes in one spouse's cognitive status can cohesively impact the health of the other spouse along three dimensions (functional, mental, and cognitive).

Methods: Drawing longitudinal data from the Health and Retirement Study 2000-2016 (N = 3582), we measure women's health profiles by functional limitation (physical health), depression (mental health), and cognitive function (cognitive health). We use multivariate linear mixed models to summarize these paths in the same visual representation.

Results: The approach provides a visualization tool that depicts data and model in the same spatial representation allowing assessment of model fit and comparison. This study advances the traditional life course studies by representing underlying processes as a multidimensional time vector of health outcomes.

Discussion: The described approach provides a blueprint for studying complex health profiles or trajectories.

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.

Objectives: To examine the influence of sociodemographic factors on employment changes among adult children following onset of parental Alzheimer's disease and related dementia (ADRD).

Methods: We used Health and Retirement Study (2010-2018; N = 20,110) data to examine adult child (ages 50-70) changes in employment and work hours at onset of parental ADRD and potential variation by gender, age, race, ethnicity, and education.

Results: Parental ADRD onset was not associated with changes in adult child employment overall, although associations differed substantially across subpopulations defined by education level. Sons with the lowest education were least likely to cease employment, while daughters with the lowest education were most likely to reduce work hours. Sons at older ages were increasingly likely to reduce work hours or end employment following parental ADRD onset.

Discussion: The potential impact of parental ADRD on adult child employment is complex and should be considered in the context of sociodemographic factors.

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.