Showing papers in "Journal of Aging and Health in 2016"
TL;DR: Racial/ethnic and socioeconomic disparities exist in hearing health care and represent critical areas for research and intervention and based on a multivariate analysis, Blacks were not more likely than Whites to use hearing aids despite being more likely to have had recent hearing testing.
Abstract: Objective: Hearing impairment is highly prevalent, but little is known about hearing health care among older minority adults. Method: We analyzed nationally representative, cross-sectional data from 1,544 older adults ≥70 years with audiometry and hearing care data from the 2005-2006 and 2009-2010 National Health and Nutritional Examination Surveys. Results: After adjusting for age and speech frequency pure tone average, Blacks (odds ratio [OR] = 1.68, vs. Whites) and those with greater education (OR = 1.63, ≥college vs.
134 citations
TL;DR: Analysis of data from the 2011 China Health and Retirement Longitudinal Study suggests that SES is the predominant factor accounting for the rural–urban depression gap in China.
Abstract: Objective: Studies have reported that rural elders in China have higher levels of depression than their urban peers. We aimed to examine the extent to which four sets of factors (socioeconomic stat...
129 citations
TL;DR: Older adults with moderate-or-greater HI had a 63% increased risk of developing frailty and falls, and HI is independently associated with the risk of frailty in older adults and with greater odds of falling over time.
Abstract: OBJECTIVE: We aimed to determine whether hearing impairment (HI) in older adults is associated with the development of frailty and falls. METHOD: Longitudinal analysis of observational data from the Health, Aging and Body Composition study of 2,000 participants aged 70 to 79 was conducted. Hearing was defined by the pure-tone-average of hearing thresholds at 0.5, 1, 2, and 4 kHz in the better hearing ear. Frailty was defined as a gait speed of RESULTS: Older adults with moderate-or-greater HI had a 63% increased risk of developing frailty (adjusted hazard ratio [HR] = 1.63, 95% confidence interval [CI] = [1.26, 2.12]) compared with normal-hearing individuals. Moderate-or-greater HI was significantly associated with a greater annual percent increase in odds of falling over time (9.7%, 95% CI = [7.0, 12.4] compared with normal hearing, 4.4%, 95% CI = [2.6, 6.2]). DISCUSSION: HI is independently associated with the risk of frailty in older adults and with greater odds of falling over time. Language: en
126 citations
TL;DR: Investigating the relationship between life course socioeconomic status (SES) and cognitive function among older adults in the United States over a 12-year observation period showed that cognitive function varied within-persons and between-Persons.
Abstract: Objective: This study investigated the relationship between life course socioeconomic status (SES) and cognitive function among older adults in the United States over a 12-year observation period. ...
118 citations
TL;DR: Younger age and greater hearing loss are independently associated with higher levels of loneliness in older adults presenting to clinic for hearing loss treatment, and Metrics of depressive symptoms and hearing-related quality of life, communication difficulties, and emotional well-being, mental health, and 36-Item Medical Outcomes Study Short-Form (SF-36) scores were moderately or highly correlated with loneliness.
Abstract: Objective: The objective of this study is to determine factors associated with loneliness in older adults presenting for hearing loss treatment. Method: A cross-sectional analysis was conducted of 145 participants (aged 50-94) who presented for hearing aids or cochlear implants and were enrolled in the Studying Multiple Outcomes After Aural Rehabilitative Treatment (SMART) study from 2011 to 2013. Social, communicative, physical, and mental health functioning were assessed using self-administered questionnaires, and loneliness using the University of California, Los Angeles (UCLA) Loneliness Scale. Results: Younger age and greater hearing loss were significantly associated with greater loneliness. Metrics of depressive symptoms and hearing-related quality of life, communication difficulties, and emotional well-being, mental health, and 36-Item Medical Outcomes Study Short-Form (SF-36) scores were moderately or highly correlated with loneliness. Discussion: Younger age and greater hearing loss are independ...
107 citations
TL;DR: Significant age differences were found in lifetime experience of anti-transgender discrimination, harassment, and victimization within health care settings and Medicare policy changes and this study’s findings prompt further consideration for revising other health insurance policies.
Abstract: Objective: Given the increasing diversity among older adults and changes in health policy, knowledge is needed on potential barriers to health care for transgender and gender non-conforming (GNC) individuals. Method: Using the 2010 National Transgender Discrimination Survey (NTDS), logistic regression models test differences between age groups (below 35, 35-49, 50-64, and 65 and above) in lifetime experience of anti-transgender discrimination, harassment, and victimization within health care settings while considering the influences of insurance status, level of passing, time of transition, and other socio-demographic factors. Results: Although more than one fifth of transgender and GNC individuals of all ages reported health discrimination, harassment, or victimization, significant age differences were found. Insurance status and level of passing were also influential. Discussion: Medicare policy changes and this study’s findings prompt further consideration for revising other health insurance policies. ...
101 citations
TL;DR: Investigating whether associations of hearing impairment (HI) with functional outcomes in older adults differ when using self-report versus pure-tone audiometry found significant associations of audiometric HI with both subjective and objective outcomes.
Abstract: Objective: The aim was to investigate whether associations of hearing impairment (HI) with functional outcomes in older adults differ when using self-report versus pure-tone audiometry. Method: We ...
71 citations
TL;DR: The findings confirmed group ties as a stronger predictor of cognitive health than individual ties and supported the proposed sequential mediation model suggesting that the benefits of group ties arise from their capacity to enhance a sense of shared social identification and this, in turn, provides the basis for effective social support.
Abstract: Objective: Social relationships are protective of cognitive health as we age and recent findings show that social group ties (e.g., with community and peer groups) are especially important. The present research examines this relationship further to explore (a) the contribution of group, relative to interpersonal, ties and (b) underlying mechanism. Method: Two cross-sectional survey studies were conducted. Study 1 was conducted online (N = 200) and Study 2 involved face-to-face interviews (N = 42). Results: The findings confirmed group ties as a stronger predictor of cognitive health than individual ties. It also supported our proposed sequential mediation model suggesting that the benefits of group ties arise from their capacity to enhance a sense of shared social identification and this, in turn, provides the basis for effective social support. Discussion: Both studies provided evidence consistent with claims that group ties were especially beneficial because they cultivated social identification that pr...
66 citations
TL;DR: Community initiatives that address specific features of the social environment and street-level environment may increase community participation of older adults.
Abstract: Objective: The objective of this study is to identify features of the environment associated with community participation of older adults. Method: A systematic review of studies that examined assoc...
61 citations
TL;DR: Results suggest that among a sample of community-based adults aged 50+, loneliness was associated with reduced alcohol use frequency, but not with at-risk or binge drinking.
Abstract: OBJECTIVES: We examined the association between alcohol use, at-risk drinking, and binge drinking, and loneliness in a sample of middle-aged and older adults. METHOD: We studied participants aged 50+ years from the 2008 wave of the Health and Retirement Study who reported alcohol use. We ran separate multinomial logistic regressions to assess the association of three alcohol use outcomes (i.e., weekly alcohol consumption, at-risk drinking, and binge drinking) and loneliness. RESULTS: After adjusting for covariates, being lonely was associated with reduced odds of weekly alcohol consumption 4 to 7 days per week, but not 1 to 3 days per week, compared with average alcohol consumption 0 days per week in the last 3 months. No association was found between at-risk drinking or binge drinking and loneliness. DISCUSSION: Results suggest that among a sample of community-based adults aged 50+, loneliness was associated with reduced alcohol use frequency, but not with at-risk or binge drinking. Language: en
61 citations
TL;DR: The analysis of trends in WLE at age 50, particularly when set in relation to remaining LE, provides useful insights about the development of the distribution of economically active and inactive years in Europe’s aging societies.
Abstract: Objective: The aim of the article is to analyze past and present developments of working life expectancy (WLE) at age 50 by age, sex, and education in Europe WLE is also compared with life expectancy (LE) and healthy life expectancy (HLE) Method: WLE is calculated with the Sullivan method Labor force participation is based on the European Union (EU) Labor Force Survey Results: WLE at age 50 has been increasing since the mid- to late 1990s in most European countries Increases were more pronounced among women than men Differences in WLE by education are substantial The comparison of WLE, LE, and HLE for the year 2009 reveals that the correlation between WLE and LE is smaller than between WLE and HLE Discussion: The analysis of trends in WLE at age 50, particularly when set in relation to remaining LE, provides useful insights about the development of the distribution of economically active and inactive years in Europe’s aging societies
TL;DR: Higher levels of social isolation and increases in the level of isolation are closely tied to loneliness, which has implications for future assessment or monitoring of loneliness in older adult populations.
Abstract: Objective: To understand the longitudinal relationship between loneliness and isolation. Method: Participants included 5,870 adults 65 years and older (M = 72.89 ± 5.59 years) from the first 5 years of the Cardiovascular Health Study. Loneliness was assessed using a dichotomized loneliness question. Social isolation was assessed using six items from the Lubben Social Network Scale. Yearly life events were included to assess abrupt social network changes. Mixed effects logistic regression was employed to analyze the relationship between isolation and loneliness. Results: Higher levels of social isolation were associated with higher odds of loneliness, as was an increase (from median) in level of social isolation. Life events such as a friend dying were also associated with increased odds of loneliness. Discussion: These results suggest that average level of isolation and increases in the level of isolation are closely tied to loneliness, which has implications for future assessment or monitoring of lonelin...
TL;DR: This article explored the association between subjective age and having grandchildren and provision of grandchild care by gender and age groups, and found that grandparenthood is central in shaping the personal experience of aging.
Abstract: OBJECTIVES: Guided by the acknowledged importance of measures of aging alternative to chronological age, we explored the association between subjective age, on the one hand, and having grandchildren and provision of grandchild care, on the other, by gender and age groups. METHOD: Data from the Health and Retirement Study (HRS; N = 1,701 men and 2,395 women aged 50-85) and linear regression models were used to test two hypotheses. RESULTS: Grandparents feel older than their grandchildless counterparts at younger ages, but such association is reversed in later life if they look after their grandchildren. A cumulative negative association between subjective age and both having grandchildren and providing grandchild care holds for older women. DISCUSSION: This study extends prior research by examining age and gender differences in factors associated with subjective age. The findings suggest that grandparenthood is central in shaping the personal experience of aging. Future studies should address the causality of the factors analyzed.
TL;DR: The complexity of health for elderly inmates should continue to be monitored to aid correctional and community health programs in understanding clinical risks, exposures, and health care needs for this population.
Abstract: Objective: This study examines patterns of multimorbidity among elderly male inmates across four domains of health (chronic medical conditions, drug- and alcohol-related diseases, impairments, and mental and behavioral health) to understand the complex health care needs of this growing population. Method: We use the 2004 Survey of Inmates in State Correctional Facilities and Latent Class Regression Analysis to examine 22 health problems among 1,026 men aged 50 and older. Results: There are four groups of elderly male inmates: (a) relatively healthy (45.1%), (b) substance users with behavioral health issues (23.4%), (c) chronic unhealthy with impairments and violence/injury (23.6%), and (d) very unhealthy across all domains (7.9%). These groups have unique sociodemographic background and incarceration history characteristics. Conclusion: This study demonstrates the complexity of health for elderly inmates. Prison health should continue to be monitored to aid correctional and community health programs in un...
TL;DR: An increased risk of having marginal ties with friends was observed among individuals with perceived financial strain, greater functional impairment, and a shorter stay in the United States.
Abstract: Objective: Given the importance of social ties and connectedness in the lives of older ethnic immigrants, the present study examined the prevalence of social isolation and its risk factors in older Korean Americans. Method: Using survey data from 1,301 participants (Mage = 70.5, SD = 7.24), risk groups for marginal social ties with family and friends were identified and predictors of each type of social isolation explored. Results: Male gender and poorer rating of health were identified as common risk factors for marginal ties to both family and friends. Findings also present specific risk factors for each type of social isolation. For example, an increased risk of having marginal ties with friends was observed among individuals with perceived financial strain, greater functional impairment, and a shorter stay in the United States. Discussion: The common and specific risk factors should be incorporated in programs to reduce social isolation in older immigrant populations.
TL;DR: Chronic disease diagnosis may be an important teachable moment that can motivate individuals to adopt multiple risk-reducing health behaviors and test the modifying effect of time since diagnosis on intervention effectiveness.
Abstract: Objective: To examine the impact of a new chronic disease diagnosis on substance use (i.e., smoking and drinking), utilization of preventive medical procedures, and physical activity among middle-aged and older adults. Method: Individual-level data came from 1996 to 2010 waves of the U.S. Health and Retirement Study. Disease diagnosis was ascertained from self-reports of physician-diagnosed diseases. A case-control difference-in-differences approach estimated in logistic regression was applied to test study hypotheses. Results: After a diagnosis of chronic disease, participants decreased substance use and increased utilization of preventive medical procedures. Physical activity declined after a diagnosis of lung disease, cancer, and stroke. Discussion: Chronic disease diagnosis may be an important teachable moment that can motivate individuals to adopt multiple risk-reducing health behaviors. Future research needs to elucidate the mechanisms through which disease diagnosis affects behaviors and test the m...
TL;DR: It is suggested that subjective variables such as self-rated health, economic situation, and life satisfaction should be considered when addressing the onset of depressed mood.
Abstract: Objective: The study examined the relationship of self-rated health and self-rated economic situation with depressed mood, and life satisfaction as mediator of this relationship among older adults in Costa Rica. Method: A longitudinal study was conducted with a subsample (N = 1,618) from the Costa Rican Longevity and Healthy Aging Study (CRELES). Self-rated health, self-rated economic situation, depressed mood, and life satisfaction were measured at baseline, and depressed mood was reassessed 18 months later. Putative mechanisms for changes in depressed mood were examined by means of conditional process analysis. Results: Self-rated health was negatively associated to depressed mood. This effect took place via life satisfaction. An interaction showed that better economic situation compensated the effect of a low self-rated health on life satisfaction. Discussion: This study suggests that subjective variables such as self-rated health, economic situation, and life satisfaction should be considered when add...
TL;DR: It is confirmed that cost of dementia care increases with dependence and that the impact of other disease indicators is mainly mediated by dependence.
Abstract: Objective: To estimate the cost of dementia care and its relation to dependence. Method: Disease severity and health care resource utilization was retrieved from the Swedish National Study on Aging ...
TL;DR: Top themes of international research on disability in the past three decades are discussed: disability dynamics, buffers and barriers for disability, disability trends, and disability among very old persons, and contemporary models of disability are presented.
Abstract: Top themes of international research on disability in the past three decades are discussed: disability dynamics, buffers and barriers for disability, disability trends, and disability among very old persons. Each theme is highlighted by research examples. Turning to measurement, I discuss traditional measures of disability, new longer and shorter ones, and composites like disability-free life expectancy, noting their merits. Contemporary models of disability are presented, ranging from visual images to formal theories. The article ends on how scientists can facilitate movement of disability science into health care practice and policy.
TL;DR: QoL is significantly associated with select resident and LTC facility characteristics with implications for improving residents’ QoL and L TC facility programming, and guiding future research and social policy development.
Abstract: Objective: Identify predictors of long-term care (LTC) facility residents’ self-reported quality of life (QoL). Method: QoL of a convenience sample of 928 residents from 48 volunteer LTC facilities...
TL;DR: To support community mobility among older persons, it would be important to improve different transportation options to meet older persons’ individual wishes, needs, and resources.
Abstract: OBJECTIVE: The aim of this study is to examine whether a persons' most frequently used mode of transportation is associated with life-space mobility and whether the association differs between persons with or without walking difficulties. METHOD: Life-space mobility was measured with the Life-Space Assessment in 848 community-dwelling men and women aged 75 to 90 years. Six separate mobility groups were formed according to the most frequently used mode of transportation (car driver, car passenger, public transportation) combined with the presence or absence of difficulties walking 2 km. RESULTS: Car drivers without walking difficulties had the highest life-space mobility scores, and car passengers with walking difficulties had the lowest scores. Mode of transportation influenced the odds for restricted life space differently depending on whether or not the person had walking difficulties. DISCUSSION: To support community mobility among older persons, it would be important to improve different transportation options to meet older persons' individual wishes, needs, and resources. Language: en
TL;DR: It is found that older prisoners utilized health care more often than younger prisoners although in most models the finding did not reach statistical significance.
Abstract: Objective: This study assessed health care utilization of aging prisoners and compared it with that of younger prisoners. Method: Health care utilization comprised visits to general practitioners (GPs), nurses, and mental health professionals (MHPs) for a period of 6 months. Using retrospective study design, data were extracted from medical records of 190 older prisoners (50 years and older) and 190 younger inmates (18-49 years). Age group was a dichotomous predictor variable with type of sentencing and time spent in prison as covariates. Descriptive statistics and generalized linear mixed models (GLMMs) were performed. Results: For each of the three outcome variables, two GLMMs were constructed. The first model only included age group as the predictor variable (3 × Unadjusted models). The second included the two covariates in addition to the predictor variable (3 × Adjusted model). Results from the adjusted model indicate that visits to GPs significantly differed between the two age groups (p = .022). Ol...
TL;DR: The findings encourage multidisciplinary and interdisciplinary interventions to include pharmacotherapy, psychological support, and physical rehabilitation, specifically on neuropathic pain among aged African Americans with multiple chronic conditions.
Abstract: Objective: This study examines the type, severity, and correlates of pain among underserved elderly African Americans. Method: This cross-sectional study includes 400 non-institutionalized underser...
TL;DR: Investigating factors associated with tourism experiences, and the association between tourism experiences and subsequent self-rated health in China found that those who had a tourism experience tended to be younger, men, urban residents, have a higher socioeconomic status (SES), and frequently participate in leisure activities and exercise.
Abstract: Objective: To investigate factors associated with tourism experiences, and the association between tourism experiences and subsequent self-rated health. Method: Multilevel logistic regression models and four waves of panel data from a large nationally representative survey of older adults in China were employed. Results: Those who had a tourism experience tended to be younger, men, urban residents, have a higher socioeconomic status (SES), and frequently participate in leisure activities and exercise. However, controlling for SES, women were more likely than men to have a tourism experience. Notably, tourism was negatively associated with poor self-rated health and the association was robust to adjustments for a wide range of confounders. Discussion: The net beneficial impact of tourism on self-rated health may operate through several mechanisms such as improvements in tourists’ cognitive functioning, healthy lifestyles, self-esteen, family and social relations, and psychological and spirtual well-being. ...
TL;DR: Low education is associated with shorter lives with much more disability, and there was little evidence of outcome differences between African Americans and Whites within education levels.
Abstract: Objective: This study provides estimates of associations of education with life expectancy and the percentage of remaining life from age 40 with disability. Method: We used the Panel Study of Incom...
TL;DR: Declining health status and functional limitations are risk factors that pose a threat to outdoor mobility in the frail elderly, while housing barriers and community accessibility also merit attention.
Abstract: OBJECTIVE: Outdoor mobility is critical for healthy aging, yet little is known about the factors influencing mobility in the frail elderly. We investigated the role of individual and community risk factors on trajectories of mobility in a population of vulnerable community-dwelling elderly. METHOD: Using data from 1,188 older adults in Detroit, MI, who qualify for federally funded home care, a latent class growth analysis was used to model the frequency of going outside over a 15-month period. RESULTS: Four latent trajectories were found: those with a low, high, and declining frequency of going outdoors over time, and those who do not go outdoors on a regular basis. Risk factors for membership in the homebound and infrequent mobility groups were older age, more severe mobility impairment, and fear of falling. Barriers at the entry to the home were associated with being homebound. DISCUSSION: Declining health status and functional limitations are risk factors that pose a threat to outdoor mobility in the frail elderly, while housing barriers and community accessibility also merit attention. Language: en
TL;DR: Examining racial differences in the relationship between late-life stress and health functioning and the moderating role of perceived social support (PSS) in older adults revealed a positive effect of PSS on health functioning.
Abstract: Objective: The current study examined racial differences in the relationship between late-life stress and health functioning and the moderating role of perceived social support (PSS) in older adults. Method: A biracial sample of community-dwelling older adults (65+) from the first two waves of the Duke University’s Established Populations for Epidemiologic Studies of the Elderly (EPESE; N = 2,952) was analyzed. Baseline levels of PSS and stress were obtained. Health status was assessed at baseline and follow-up. Results: Analyses revealed a positive effect of PSS on health functioning. There was a three-way interaction among race, stress, and PSS on health functioning. Probing the interaction, for Caucasians, PSS was beneficial at low stress, but not high stress. For African Americans, PSS had a positive effect regardless of stress level. Discussion: PSS is an important protective factor for preserving positive health in late-life; however, benefits may differ by race and intensity of stressor.
TL;DR: The finding that facility racial composition predicts QOL more than individual race underscores the importance of examining NH structural characteristics and practices.
Abstract: Objectives: The aim of this study is to investigate racial differences in nursing home (NH) residents’ quality of life (QOL) at the resident and facility levels. Method: We used hierarchical linear modeling to identify significant resident- and facility-level predictors for racial differences in six resident-reported QOL domains. Data came from the following: (a) resident-reported QOL (n = 10,929), (b) the Minimum Data Set, and (c) facility-level characteristics from the Minnesota Department of Human Services (n = 376). Results: White residents reported higher QOL in five of six domains, but in full models, individual-level racial differences remained only for food enjoyment. On the facility level, higher percentage of White residents was associated with better scores in three domains, even after adjusting for all characteristics. Discussion: Racial differences in QOL exist on individual and aggregate levels. Individual differences are mainly explained by health status. The finding that facility racial co...
TL;DR: Net of support and strain from other relationships, support from a spouse was related to fewer depressive symptoms among each age group, and only support/strain from family relationships influenced depressive Symptoms among adults in midlife.
Abstract: Objective: This study integrates stress process theory into a life course framework to examine how support and strain from particular relationship types (spouse/partner, children, mother, and frien...
TL;DR: This work supplements traditional measures of aging with new ones that consider the changing characteristics of people, such as remaining life expectancy, health, normal public pension age, and hand-grip strength.
Abstract: People’s views on population ageing are influenced by the statistics that they read about it. The statistical measures in common use today were first developed around a century ago, in a very different demographic environment. For around two decades, we have been studying population ageing and have been arguing that its conventional portrayal is misleading. In this chapter, we summarize some of that research, which provides an alternative picture of population ageing, one that is more appropriate for twenty-first century. More details about our new view of population ageing can be found in. (Sanderson and Scherbov 2019). Population ageing can be measured in different ways. An example of this can found in the UN’s Profiles in Ageing, 2017. One way is to report on the forecasted increase in the number of people 60+ years old in the world.