This article used the nationally representative Chinese Longitudinal Healthy Longevity Survey to explore the associations between living arrangements and health among older adults. Living arrangements were stratified into six categories. Health was measured by self-rated health, activities of daily living (ADL) disability, and cognitive impairment. Random-effects ordered probit regressions were applied. The results indicated that coresidence had a positive effect on self-rated health compared with living alone. After introducing psychological well-being, the health differences observed in living with a spouse and living with both spouse and children were not significant. Participants with each of the living arrangement were more likely to have a higher rate of cognitive impairment and ADL disability than those living alone. Living arrangements were associated with older adults’ health. Psychological well-being was a key factor in this association, which may result from living with a spouse, and could contribute to the self-rated health of older adults.
Our understanding of the mechanisms through which racial/ethnic disparities in disability in older adults develop and are maintained is limited. We examined the role of physical impairment, socioeconomic factors and health for racial/ethnic disparities in activities of daily living (ADL), and the modifying role of the indoor home environment. Data come from the National Health and Aging Trends Study (N = 5,640), and negative binomial regression models were specified separately for men and women. Blacks and Hispanics reported more ADL difficulty than Whites. Living in homes with clutter was associated with higher rates of ADL difficulty, but it was not related to racial/ethnic disparities. Racial/ethnic differences were explained by physical impairment for men, but not for women. Socioeconomic factors and health accounted for remaining disparities for Black, but not for Hispanic women. Attention to individual and environmental factors is necessary to fully understand and address race/ethnic disparities in disability in older Americans.
Cross-national studies can elucidate the influence of sociocultural contexts on a wide variety of aging issues. This study aims to develop methods for using secondary data for cross-national comparisons using productive activities as an example. The study also identifies challenges in conducting cross-national research. Using the national representative data from the United States, China, and South Korea, this study developed a sequence of methods for cross-national analysis. Results indicate that productive activities vary by country, and this variation could possibly be due to the differences in sociocultural context and variations in operationalization and measurement. Given the difficulty of making decisions and drawing conclusions across different cultural contexts, team members must include scholars who are familiar with the culture and language of the region of study. Researchers also need to determine whether data sets are valid for cross-national comparisons and understand the limitations of the comparisons, given constraints in the data.
Reducing or eliminating Social Security’s retirement earnings test (RET) can encourage labor supply of older individuals receiving benefits. However, these reforms can encourage earlier claiming of Social Security benefits, permanently lowering future benefits. We explore the consequences, for older women, of eliminating the RET from the full retirement age to age 69 (in 2000), relying on the intercohort variation in exposure to changes in the RET to estimate these effects. The evidence is consistent with the conclusion that eliminating the RET increased the likelihood of having very low incomes among women in their mid-70s and older—ages at which the lower benefits from claiming earlier could outweigh higher income in the earlier period when women or their husbands increased their labor supply.
This phenomenological study involved focus groups with church-affiliated, African American women and men (N = 50; ages 50 and older) in southeast Michigan to determine their attitudes and expectations around formal mental health care. Data analysis employed a constant comparative approach and yielded themes related to formal mental health care, along with delineating concerns about defining depression, health, and well-being. Health and well-being were defined as inclusive of physical and spiritual aspects of self. Churches have a central role in how formal mental health care is viewed by their attendees, with prayer being an important aspect of this care. Provider expectations included privacy and confidentiality; respect for autonomy and need for information, having providers who discuss treatment options; and issues related to environmental cleanliness, comfort, and accessibility. Implications include providing effective, culturally tailored formal depression care that acknowledges and integrates faith for this group.
In a randomized controlled trial, we investigated the effects of karate versus a mindfulness-based stress reduction (MBSR) intervention on well-being and cognitive functioning in older adults. Fifty-five adults (52–81 years old) participated in twice-weekly karate versus MBSR sessions or no training for 8 weeks. In pre- and postassessments, subjective well-being, health, cognitive functioning, and chronic stress were measured. Preassessment hair cortisol served as physiological stress marker. The results showed an improvement for the karate group, but not the MBSR and control group, in subjective mental health and anxiety as well as cognitive processing speed. The MBSR group showed by trend as a decrease in stress. No significant correlation between preassessment hair cortisol and postassessment outcomes could be established. But the higher the level of baseline self-reported perceived stress, the higher the increase in depression, anxiety, and chronic stress. Generally, it can be assumed that karate and MBSR showed only small training effects concerning the assessed emotional and cognitive parameters.
Working longer is an important area of research given extended life expectancy, shortfalls of retirement income, desires to remain socially engaged, and solvency concerns of social insurance programs. The purpose of this longitudinal population-based study of older adults is to examine how different types of social resources (social bonding, bridging, and linking) relate to returning to work after retirement. Data were drawn from the Health and Retirement Study of fully retired older adults aged 62+ in 1998 (N = 8,334) and followed to 2008. After controlling for a comprehensive set of fixed and time-varying covariates, findings suggest that social bridging (informal volunteering) and social linking (formal volunteering, partnered with an employed spouse) were strongly and positively related to returning to work (Hazard Ratio [HR]: 1.49, p < .001; HR: 1.58, p < .0001; and HR: 1.75, p < .0001, respectively). Social bonding resources were not significantly associated with returning to work. Implications for social policy are discussed.
Subjective indicators of age add to our understanding of the aging process beyond the role of chronological age. We examined whether financial stress contributes to subjective age as rated by others and the self. The participants (N = 228), aged 26–75, were from a Boston area satellite of the Midlife in the United States (MIDUS) longitudinal study. Participants reported how old they felt and how old they thought they looked, and observers assessed the participants’ age based on photographs (other-look age), at two occasions, an average of 10 years apart. Financial stress was measured at Time 1. Controlling for income, general stress, health, and attractiveness, participants who reported higher levels of financial stress were perceived as older than their actual age to a greater extent and showed larger increases in other-look age over time. We consider the results on accelerated aging of appearance with regard to their implications for interpersonal interactions and in relation to health.
This prospective multiperspective study provides insight into the decision trajectories of people with dementia by studying the decisions made and related key events. This study includes three waves of interviews, conducted between July 2010 and July 2012, with 113 purposefully selected respondents (people with beginning to advanced stages of dementia and their informal and professional caregivers) completed in 12 months (285 interviews). Our multilayered qualitative analysis consists of content analysis, timeline methods, and constant comparison. Four decision themes emerged—managing daily life, arranging support, community living, and preparing for the future. Eight key events delineate the decision trajectories of people with dementia. Decisions and key events differ between people with dementia living alone and living with a caregiver. Our study clarifies that decisions relate not only to the disease but to living with the dementia. Individual differences in decision content and sequence may effect shared decision-making and advance care planning.
Successful aging (SA) is a concept that remains without a consensus definition. The purpose of the current study was to explore the components of SA by systematically reviewing factors correlated with SA. We also compared the relative strength of the components by using the meta-analytic method.
A meta-analysis was conducted to quantitatively synthesize the correlates of SA from three online databases: PubMed, CINAHL, and SCOPUS.
The correlates were categorized into four domains: (1) avoiding disease and disability, (2) having high cognitive/mental/physical function, (3) actively engaging in life, and (4) psychologically well adapted in later life. The domain "psychologically well adapted in later life" showed the strongest association with SA, ES(r) = .482.
The findings of this study were meaningful in terms of examining the strength of the correlations between the domains and overall SA and, further, providing evidence for building interventions for aging population.
In the context of the current policy emphasis on extending working lives, we investigate whether the relationship between participation in paid work, other formal, and informal activities among people aged 50–69 is complementary or competitive. We also investigate differences in associations between countries using comparable longitudinal data from Denmark, France, Italy, and England. We find positive associations between informal and formal engagement in cross-sectional and longitudinal analyses. Paid work was negatively associated with formal and informal engagement, and respondents who stopped working were more likely to be engaged in formal (Denmark and France) and informal activities (England and Italy) at follow-up than respondents who continued working. However, the strongest predictor of formal and informal engagement at follow-up was baseline engagement. In the context of policy aims to extend working lives and broaden older people’s participation in other productive activities, new balances between work and other forms of engagement are still to be found.
We assessed factors contributing to ethnic and racial disparities in mental health quality of life (MHQOL) among lesbian, gay, and bisexual (LGB) midlife and older adults. We utilized cross-sectional survey data from a sample of non-Hispanic White and Hispanic LGB adults aged 50 and older. Structural equation modeling was used to test the indirect effect of ethnicity/race on MHQOL via explanatory factors including social connectedness, lifetime discrimination, socioeconomic status (SES), and perceived stress. Hispanics reported significantly lower levels of MHQOL, compared to non-Hispanic Whites. In the final model, the association between ethnicity/race and MHQOL was explained by higher levels of perceived stress related to lower SES, higher frequency of lifetime discrimination, and lack of social connectedness among Hispanic LGB adults. This study suggests that perceived stress related to social disadvantage and marginalization plays an important role in MHQOL disparities among Hispanic LGB midlife and older adults.
This study assessed the odds of dying in hospital associated with enrollment in Medicare Advantage (M-A) versus conventional Medicare Fee-for-Service (M-FFS). Data were derived from the 2008 and 2010 waves of the Health and Retirement Study (n = 1,030). The sample consisted of elderly Medicare beneficiaries who died in 2008–2010 (34% died in hospital, and 66% died at home, in long-term senior care, a hospice facility, or other setting). Logistic regression estimated the odds of dying in hospital for those continuously enrolled in M-A from 2008 until death compared to those continuously enrolled in M-FFS and those switching between the two plans. Results indicate that decedents continuously enrolled in M-A had 43% lower odds of dying in hospital compared to those continuously enrolled in M-FFS. Financial incentives in M-A contracts may reduce the odds of dying in hospital.
Spouses often serve as the primary caregivers to their ill or disabled partners. Studies have shown that men receive more care from their wives than vice versa, but few studies have focused on how the gender gap in care varies across the later life course. Drawing on data from the Health and Retirement Study, this study examined the moderating effects of age, gender, and full-time employment on married women’s and men’s receipt of spousal care. This study found that among community-dwelling married adults, the gender gap in care was larger among those in middle age (50–65) than it was among those in older age. As women and men aged, the gender gap decreased primarily because men left full-time work and increased the amount of time that they spent caring for their wives. As gender differences in full-time employment narrowed, the gender gap in spousal care narrowed.
Self-rated health (SRH) is widely used to capture racial and ethnic disparities in health. It is therefore critical to understand whether individuals with different racial and ethnic backgrounds assess their SRH differently. Despite the high overall predictive validity of SRH for subsequent mortality, few studies paid attention to potential variations by race and ethnicity. This study examines racial and ethnic differences in the predictive validity of SRH for subsequent mortality risk among older adults (55–84) by estimating Cox Proportional Hazard models using data from the National Health Interview Surveys Linked Mortality Files (1989–2006; N = 289,432). Results indicate that SRH predicts mortality risk less well for non-Hispanic Blacks and Hispanics than non-Hispanic Whites. Three proposed mechanisms—socioeconomic status, immigration status, and cause of death—explain only a modest proportion of the variation. These results suggest that individuals from different racial and ethnic groups may evaluate their heath differently, and thus caution is necessary when using SRH to estimate racial and ethnic health disparities.
From a role theoretical perspective, it can be expected that individuals differ in the extent to which they experience aspects of the work role after they have fully retired from it. This study presents a measure of these "postretirement work role residuals" and examines them in relation to structural preretirement factors, psychological preretirement factors, and the nature of the retirement transition. Heckman selection models were estimated based on three-wave panel data collected among 848 older Dutch individuals who were employed at Wave 1 and fully retired thereafter. Although for the majority of retirees prior work plays only a minor role in their current lives, also for a considerable share prior work is still important. Higher levels of postretirement work role residuals were observed among those who expected to miss work-related social status in retirement, who were less disengaged from work in preretirement years, and among those who retired involuntarily.
This study examines whether frailty is associated with mortality independently of physiological dysregulation (PD) and, if so, which is the more accurate predictor of survival. Data come from the Social Environment and Biomarkers of Aging Study. We use Cox proportional hazard models to test the associations between PD, frailty, and 4- to 5-year survival. We use Harrell’s concordance index to compare predictive accuracy of the models. Both PD and frailty are significantly, positively, and independently correlated with mortality: Worse PD scores and being frail are associated with a higher risk of dying. The overall PD score is a more accurate predictor of survival than frailty, although model prediction improves when both measures are included. PD and frailty independently predict mortality, suggesting that the two measures may be capturing different aspects of the same construct and that both may be important for identifying individuals at risk for adverse health outcomes.
Older adults comprise an increasing share of new legal admits to the United States. While many are financially dependent on their families, a more complete picture requires taking into account the nonmonetary contributions of this population. Using the American Time Use Survey, this study examines whether older recent immigrant women provide more unpaid childcare than their native-born and more established immigrant counterparts. Results suggest that while older recent immigrant women are more likely to provide unpaid childcare, this effect is eliminated upon controlling for demographic characteristics. However, among those who do provide childcare, older recent immigrant women provide more hours of care even after controlling for demographic and household characteristics. This pattern holds up even after restricting the analysis to women living with young children. These results may signal reciprocal supportive networks. Working-age adults may financially support older recent immigrants, while older recent immigrants provide unremunerated childcare for working-age adults.
This study examines dyadic reports of marital quality and loneliness over a two-year period among 932 older married couples resident in Ireland. Data from the first two waves of The Irish Longitudinal Study on Ageing (2009–2013) were analyzed to determine whether husbands’ and wives’ marital quality and loneliness at baseline predicted both spouses’ loneliness 2 years later. Two-wave lagged models tested the cognitive perspective on loneliness, the induction hypothesis, and actor–partner interdependence. Results indicated that perceptions of negative marital quality at baseline were related with greater loneliness 2 years later, supporting the cognitive perspective. Further, both spouses’ reports of loneliness at baseline were related with loneliness 2 years later, supporting the induction hypothesis. Partners’ reports of marital quality were not related with future loneliness, failing to support actor–partner interdependence. I discuss the implications of these findings for theory, practice, and future research concerning intimate relationships and loneliness in later life.
Little longitudinal data exist on grandparent caregivers and few studies have examined their physical health outcomes. This study examined the effect of caring for grandchildren on grandparents’ physical health and the role of intergenerational support from adult children. Longitudinal data derived from a survey on the well-being of older adults in China were used to conduct path analysis of previous grandparent caregivers (vs. noncaregivers) and repeated grandparent caregivers (vs. noncaregivers). The final sample was 799 grandparents aged 60 or older living in rural China. Three aspects of intergenerational support were measured: financial, emotional, and instrumental support. Repeated grandparent caregivers had better self-rated health (SRH) and fewer limitations than noncaregivers. Previous grandparent caregivers had better SRH compared to noncaregivers. Emotional support mediated the relationship between caregiving and SRH among repeated caregivers. Findings suggest that any caregiving experience (previous or repeated) provides health benefits to grandparents.
Policies to "rebalance" funding away from nursing homes and toward home and community-based services (HCBS) have encouraged national trends of nursing home closure and an expansion of the HCBS industry. These changes are unfolding without a clear understanding of what services are available at the local level. The purpose of this study was: (1) to describe the current distribution of community-based services (CBS) in areas where nursing homes have closed and (2) to examine differences in availability of CBS using local market and population characteristics as regressors in a multinomial logistic model. We collected data on and geocoded CBS facilities and then used ArcGIS to define a 5-mile radius around all nursing homes that closed between 2006 and 2010 and compared these local market areas. In rural areas, availability of CBS does not appear to compensate for nursing home closures. Policies encouraging HCBS may be outpacing availability of CBS, especially in rural areas.
The present study investigated how volunteering was influenced by individual resources and social capital among four racial/ethnic groups of adults aged 50 and older. The data came from the California Health Interview Survey, a statewide sample that includes non-Hispanic Whites (n = 18,927), non-Hispanic Asians (n = 2,428), non-Hispanic Blacks (n = 1,265), and Hispanics (n = 3,799). Logistic regression models of volunteering were estimated to explore the effects of human and social capital within and across the racial/ethnic groups. Compared to Whites, racial/ethnic minority adults volunteered less. Although education was a significant predictor of volunteering across all groups, the findings indicated group-specific factors related to human and social capital. Results showed similarities and differences associated with volunteer participation among diverse racial/ethnic groups. The findings underscore the importance of understanding ways of creating inclusive opportunities for civic engagement among an increasingly diverse population.
We examined the influence of neighborhood socioeconomic position (SEP), racial/ethnic composition, and living in a major city on cognitive trajectories and intervention outcomes. Data came from the Advanced Cognitive Training for Independent and Vital Elderly study (N = 2,438). Mixed effects analyses examined the associations between neighborhood variables and memory, reasoning, speed of processing, and everyday cognition, estimating differences in initial gains (potentially related to practice) and long-term rate of change over 10 years. The effect of reasoning training on initial gain was weaker for individuals in a major city. For everyday cognition, there was a stronger initial gain for memory-trained and control participants in areas with more racial/ethnic minorities and for speed-trained and control individuals in higher SEP areas. The racial/ethnic minority effect was no longer significant after adjustment for multiple comparisons. Neighborhood factors may be more important in practice-related improvement than in long-term change.
This study examines the transition from independent living to a coresidential living arrangement across the late life course among older unmarried (i.e., widowed, divorced/separated, and single) Mexican Americans. Using 18 years’ worth of panel data from the Hispanic Established Populations for the Epidemiologic Study of the Elderly, event history analyses revealed that age at migration, physical disability, and cognitive impairment were strong predictors of the transition to a coresidential living arrangement. Importantly, a decline in physical and cognitive abilities heightened the risk of transition to a coresidential living arrangement, net of time-variant measures of disability and impairment. These findings provide evidence for incorporating a dynamic approach to examining living arrangements across the late life course for Mexican-origin Hispanics living in the United States, with implications for policy and service providers.
This article explores the factor structure of a new family satisfaction with nursing home care instrument and determines the relationship of resident quality of life (QOL) and facility characteristics with family satisfaction. Data sources include (1) family satisfaction interviews (n = 16,790 family members), (2) multidimensional survey of resident QOL (n = 13,433 residents), and (3) facility characteristics (n = 376 facilities). We used factor analysis to identify domains of family satisfaction and multivariate analyses to identify the role of facility-level characteristics and resident QOL on facility-mean values of family satisfaction. Four distinct domains were identified for family satisfaction: "care," "staff," "environment," and "food." Chain affiliation, higher resident acuity, more deficiencies, and large size were all associated with less family satisfaction, and resident QOL was a significant (albeit weak) predictor of family satisfaction. Results suggest that family member satisfaction is distinct from resident QOL but is associated with resident QOL and facility characteristics.
This article explores whether understanding of the effects of children’s problems on older parents’ well-being can be advanced by exploring differences in parent–child relationships within families. Using data from a study in which mothers reported on all adult children, we addressed the question: Do patterns of maternal favoritism moderate the impact of children’s problems on psychological well-being? Based on the literature on the effects of children’s problems and on parental favoritism, we hypothesized that problems in the lives of favored adult children will have a more detrimental impact than when they affect unfavored offspring. Results revealed strong and detrimental effects of any offspring’s problems on mothers’ well-being; these effects occurred, however, regardless of parental preference for an adult child. The findings suggest that the well-documented effects of parental preference may be limited in domains such as problems and difficult transitions in adult children’s lives.
The health implications of multigenerational coresidence for older adults is a well-researched topic in the aging literature. Much less is known of its impact for women in midlife. We used data from the Cebu Longitudinal Health and Nutrition Study (2002, 2005, 2007, and 2012) to study the influence of transitions in multigenerational household composition on depressive symptoms for women in midlife transitioning into old age. Our initial analysis showed little effect when we use the conventional classification of nuclear versus extended family and transition in and out of extended family. When we described shifts in the family environment by compositional changes, that is, change in the presence and absence of particular family members, we found significant association between depressive symptoms and two types of role transitions: the loss of a spouse in the household and the entry and exit of grandchildren in the household.
This study examined the longitudinal reciprocal effects between health and social support in older adults’ relationships with their children and friends. Data are from the 2006 and 2010 waves of the Health and Retirement Study (N = 3,760). We focused on three specific aspects of social support: frequency of contact, positive interactions, and negative interactions. We used autoregressive cross-lagged models to examine the bidirectional effects between social support and health. When the bidirectional effects between health and social support were simultaneously examined, the longitudinal effect of social support on health was not significant. In contrast, older adults’ poor health was associated with decreased contact and decreased positive interactions with friends as well as with increased negative interactions with their adult children and friends. The findings suggest that older adults’ poor health has a negative impact on their social relationships and that such effect surpasses the impact of social relationships on health.
Data were used from the 1991–2009 China Health and Nutrition Survey to examine the influence of informal care on labor market outcomes for married women of working aged, with emphasis on caregiving intensity. After accounting for potential endogeneity between caregiving and labor force participation (LFP) through simultaneous equations modeling, caregivers who provided more than 15 or 20 hr of caregiving per week were 4.5–7.7% less likely to be LFPs. Intensive caregivers who remained working had significantly lower (4.97–7.20) weekly hours of work. The significant positive effect of informal care on LFP only existed in the rural sample, and these women also had much lower hours of work than their urban counterparts. Opportunities exist for policy interventions that target intensive caregivers in order to allow them to balance both work and caregiving.
The present study examined trajectory patterns of self-rated health (SRH) among older rural Chinese adults and gender differences in the relationship between intergenerational relationships and SRH trajectories. Using data from four waves of a longitudinal study on the well-being of older adults in Anhui province, a general growth mixture model was estimated to examine the SRH trajectory patterns and antecedents of SRH trajectory class memberships. A two-class model was selected to interpret the SRH trajectory patterns. The two classes were labeled remaining poor and good but declining. Intergenerational relationships were a significant antecedent of SRH trajectory class memberships among men but not women. Gender differences in the cumulative effects of intergenerational relationships on the health of older adults were identified in rural China. Policy implications regarding how to help rural families support their elderly members are discussed.
Active life engagement is important for successful aging of societies and individuals. We tested predictors of engagement in French adults aged 60–74 (the GAZEL cohort).
Participants (n = 10,764) reported the previous day’s activities in a time-use survey. We modeled concurrent social, demographic, and health predictors of participation incidence and intensity in paid work, volunteering, caregiving, community involvement, and informal social interaction.
Men were more active in volunteering/community activities and women in caregiving and informal social interaction. Participation varied inversely with socioeconomic status (SES). Paid work participation declined linearly with age and health status, but this relationship did not hold for other activities.
Men and those of higher SES were more likely to participate in certain activities than were women and those of low lifetime SES, potentially limiting the latter groups’ future health and well-being benefits from such activities. Findings suggest groups that could benefit from interventions to increase engagement.
The current study tests the indirect effect of activity-related physical activity, cognitive activity, social interaction, and emotional exchange on the relationship between activity involvement and health (physical and emotional) in later life. Longitudinal data from the Health and Retirement Study (N = 5,442) were used to estimate a series of linear regression models. We found significant indirect effects for social interaction and benefit to others (emotional exchange) on emotional health (depressive symptoms) and indirect effects for use of body and benefit to others (physical) on physical health (frailty). The most potent indirect effect associated with emotional and physical health was experienced by those engaged in all four domains (use of body, use of mind, social interaction, and benefit to others). While effect sizes are small and results should be interpreted with caution, findings shed light on ways in which public health interventions aimed toward increasing role engagement in later life could be improved.
Many retirees remain insufficiently physically active for health benefits. Self-perceptions can influence physical activity. Possible selves and identity are two self-perceptions that, when examined relative to physical activity, may help explain physical activity levels among retirees. Scholars claim that a focus on possible selves may impact identity, which, in the physical activity domain, is a known physical activity correlate. The aim of this study was to examine the relationship between these variables, and more specifically, to determine whether exercise identity mediates the relationship between physical activity possible selves and physical activity. We examined the proposed mediation relationship in 531 new retirees. Data were collected across three time points (1 month apart). We conducted mediation analyses with bootstrapping. Identity mediated the relationship between possible selves (content and processes) and behavior—all related to physical activity. These findings represent an important first step toward designing relevant physical activity interventions for retirees.
This study aims to assess the reliability, construct validity (convergent/divergent), and criterion validity of the Italian version of the Tilburg Frailty Indicator (TFI). The TFI is a self-report questionnaire for screening frailty in older adults. Two hundred and sixty-seven community-dwelling older adults were involved. Psychometric properties were analyzed using validated instruments. Adverse outcomes such as disability, falls, and visits to a general practitioner were detected. Participants were mainly women (59.9%), with a mean age of 73.4 years (SD = 6.0). Internal consistency reliability was acceptable. Construct validity was good, since each item of the TFI correlated as expected with corresponding frailty measures. Convergent and divergent validity were adequate for all the domains of the TFI. Criterion validity was excellent for disability and mediocre for the other two outcomes. This study supports the validity of the Italian TFI and offers to clinicians and scientists a multidimensional instrument for identifying frail individuals in the Italian context.
This study investigates whether low self-control theory explains self-reported criminal activity in late adulthood. Cross-sectional survey data from telephone interviews conducted with individuals aged 60 years and older in Arizona and Florida (N = 2,000) are used. Regression analyses show that low self-control is related to criminal offending. The relationship between low self-control and offending persists after the introduction of potential mediators (e.g., unstructured socializing, negative emotions, and familial ties) and is even observed across different stages of late adulthood (i.e., young–old, old–old, and oldest–old) characterized by declining physical and cognitive abilities. Robustness checks using alternative measurement and modeling strategies also provide empirical support. Although strong causal inferences are limited by the nature of the data, the findings generally support the notion that low self-control theory partially explains criminal offending in late adulthood.
The present study is based upon a multidimensional model of successful aging. It aims to identify subgroups of centenarians sharing communalities in successful aging profiles, and determine the role of sociodemographic factors and psychological, social, and economic resources on successful aging.
A total of 80 centenarians were face-to-face interviewed. A cluster analysis was performed to identify distinct groups of successful aging, and logistic regression models were performed considering the cluster membership as dependent covariate.
Two distinct clusters were grouped, with 40 centenarians in each, one of them presenting better results in all domains. Male sex and better income adequacy were the best predictors of successful aging.
Results help to identity different patterns of successful aging and provide greater clarity regarding its correlates, increasing current understanding of its modifiable aspects.
Relationships with children are important for parents’ psychological well-being, yet limited research addresses whether and how relationships with adult children matter for aging parents’ psychological well-being in mid- to later life. We used four waves of national longitudinal data (Americans’ Changing Lives, N = 1,692) and growth curve models to test how multiple dimensions of the intergenerational relationship—social support, strain, equity, and dissatisfaction—shape mid- to later life parents’ psychological distress over time. Results showed that social support and strain were associated with parents’ distress at baseline but not over time, while relationship equity and dissatisfaction affected change in parents’ psychological distress over time. Findings further showed how the effects of dissatisfaction varied for mothers and fathers. This study adds to an understanding of the social context of aging by drawing attention to how specific dimensions of the parent–child tie matter longitudinally for mid- to later life parents’ psychological distress.
The factorial survey (FS) method is increasingly used in the social sciences. It is particularly suitable for studying decision situations that are difficult to assess empirically. This article evaluates whether the FS method is suitable for studying decisions in gerontological research.
The present article draws on data from the Housing Opportunities & Mobility in the Elderly study. A total of 103 respondents (between 55 and 90 years) were asked to make hypothetical relocation decisions. The consistency of these responses was assessed as a function of respondents’ age, gender, immigration background, education, household income, employment status, and intention to move.
No significant differences in response consistency were attributable to age, gender, education, or immigration background. The personal relevance of the survey topic was positively related to response consistency in multiperson households.
FS method can, under certain methodological conditions, be used among older adults especially when the topic of the survey is relevant to their daily lives.
The present study explores patterns of parity and disparity in the effect of filial responsibility on health-related evaluations and caregiving decisions. Participants who identified as White, Black, Hispanic, or Asian/Pacific Islander read a vignette about an older man needing medical care. They were asked to imagine that they were the man’s son and answer questions regarding their likelihood of hiring a health care advocate (HCA) for services related to the father’s care. A multigroup (ethnicity) path analysis was performed, and an intercept invariant multigroup model fits the data best. Direct and indirect effect estimation showed that filial responsibility mediated the relationship between both the perceived severity of the father’s medical condition and the perceived need for medical assistance and the likelihood of hiring an HCA only for White and Hispanic participants, albeit differently. The findings demonstrate that culture and ethnicity affect health evaluations and caregiving decision making.
This study examines the relationships among depressive symptoms, transitions to widowhood, worsening health, and family support in Japan over 10 years. The analyses focus on availability and receipt as the two primary dimensions of intergenerational support relationships. We used growth curve models to analyze data from the Nihon University Japanese Longitudinal Study of Aging, finding that (1) becoming widowed correlated with increased depressive symptoms and this relationship was weaker among women than men, (2) continuous widowhood was associated with fewer depressive symptoms over time, (3) transitions to coresidence with sons and daughters among the widowed was correlated with reduced depressive symptoms, (4) self-reported health and difficulty with activities of daily living were predictors of depressive symptoms over time. The findings suggest the importance of new research on household transitions, availability and proximity of family caregivers, and social embeddedness as protections against depressive symptoms.
This article describes the development and validation of the Function Self-Efficacy Scale (FSES) for assessing the degree of confidence in self-functioning while facing decline in health and function (DHF). The FSES was evaluated in two studies of older Israelis, aged 75+ years. Data were collected by structured home interviews. Exploratory factor analyses conducted in both studies clearly revealed two underlying factors: emotion self-efficacy and action self-efficacy. Confirmatory factor analyses resulted in acceptable model fit criteria. The shortened final 13-item FSES had good internal consistency and satisfactory criterion and convergent validity. Multiple regression analyses, conducted to predict subjective well-being in each of the studies, showed that function self-efficacy had a positive and significant contribution to the explanation of well-being, while controlling for general self-efficacy, self-rated health, and sociodemographic variables. We propose that appropriate interventions can strengthen function self-efficacy, thus improving the well-being of elderly persons and their ability to cope with DHF.
The goal of this study was to investigate individual and contextual factors associated with dental care utilization by U.S. informal caregivers. The sample included all 2010 Behavioral Risk Factor Surveillance System respondents who completed the caregiver module and reported providing care for 1 year or more to an individual aged ≥ 50 years or older (n = 1,196). Multiple logistic regressions were used to examine associations of caregiver and care characteristics and county-level contextual characteristics (from Area Resource File data) with two outcomes: dental visits and dental cleaning during previous year. Caregivers with health insurance coverage and higher education were more likely to use dental care; those who had lost more teeth and who were spouse caregivers were less likely to do so. Community characteristics were not correlated with caregivers’ use of dental care. Our findings suggest that better access to dental care could improve dental care utilization by caregivers.
A retrospective, cross-sectional study was conducted to describe the occurrence of daytime sleep (DS) and to examine factors associated with DS in nursing home residents. We used the Minimum Data Set 2.0 records of 300 residents in a nursing home from January 2005 to March 2010. Descriptive statistics, independent t-test, chi-square, Pearson correlations, and logistic regression were utilized in analysis. About 71.3% of the residents slept more than 2 hours during the day, and this was significantly associated with residents’ comorbidity (t = 2.0, p = .04), cognitive performance (t = 7.3, p = .01), activities of daily living (t = 3.7, p = .01), and social involvement (t = –7.6, p = .01). Cognitive performance and social involvement significantly predicted the occurrence of DS with social involvement being the strongest predictor (odds ratio: .58; 95% confidence interval: [.45, .75]). The findings suggest that interventions to engage nursing home residents in more social activities during the day may be beneficial to minimize their DS, especially for those who have difficulties with engaging socially on their own.
This study addresses whether age, functional limitation and other stressor exposure, and psychosocial coping resources influence variation in perceived stigma and the form this influence takes (i.e., independent and/or interdependent).
Using data from two waves of a large community study of adults (age 20–93) with chronic health conditions (n = 417), a residual change regression analysis considers direct and moderating factors influencing perceived stigma over a 3-year period.
Age, functional limitation, the experience of discrimination, and self-esteem independently account for variation in perceived stigma. Moderation tests reveal that age is associated with a greater increase in stigma in the context of greater functional limitation and increases in limitation. Functional limitation and stressor exposure are also associated with declines in stigma in the context of greater mastery and self-esteem.
Multiple processes bear on perceived stigma among people with chronic health conditions. Implications for stigma and stress research are discussed.
Using newly available data on family caregivers from a large epidemiological study of elderly Mexican-origin adults (Hispanic Established Population for the Epidemiologic Study of the Elderly [HEPESE], 2010/2011), we identify which types of impairment (functional, psychological, and cognitive) in the elderly individual are associated with family caregiver depressive symptoms. Results from ordinary least squares regressions using 626 caregiver–care recipient dyads demonstrate that more severe mobility limitations (Performance-Oriented Mobility Assessment), social disability (instrumental activities of daily living), neuropsychiatric disturbances related to cognitive decline (Neuropsychiatric Inventory), and depressive symptoms in the elderly subject are positively associated with caregiver psychological distress. Perceived social stress partially accounts for these associations. We also identify certain segments of this caregiver population that are especially vulnerable to burden when caring for a family member with high levels of impairment, namely female and low-income caregivers. These vulnerabilities should be the focus of intervention efforts to reduce stress and improve the emotional and psychological well-being of Mexican-origin caregivers.
The recent recession constitutes one of the macro forces that may have influenced workers’ retirement plans. We evaluate a multilevel model that addresses the influence of macro-, meso-, and micro-level factors on retirement plans, changes in these plans, and expected retirement age. Using data from Waves 8 and 9 of the Health and Retirement Study (N = 2,618), we find that individuals with defined benefit plans are more prone to change toward plans to stop work before the stock market declined, whereas the opposite trend holds for those without pensions. Debts, ability to reduce work hours, and firm unionization also influenced retirement plans. Findings suggest retirement planning education may be particularly important for workers without defined pensions, especially in times of economic volatility.
According to Erik Erikson’s theory on the stages of human development, achieving wisdom later in life involves revisiting previous crises and renewing psychosocial accomplishments. However, few studies have used Erikson’s theory as a framework for examining how older adults self-manage physical and mental health changes that commonly occur later in life. This article presents findings from two qualitative studies that demonstrate how older adults apply wisdom in new domains. Specifically, it was found that older adults (1) reasserted autonomy by initiating creative problem solving and (2) applied skills gained from productive activities earlier in life to new health-related problems that arise later in life. These findings highlight the importance of engaging older adults to repurpose their life skills and thus reapply wisdom to new areas of their lives. Implications for practice are discussed.
This article examines the distribution of wealth and then tests associations between elder abuse and wealth in Rajshahi district of Bangladesh. Data from 896 respondents (60 years old and over) were collected in April 2009. Principal component analysis was used to construct a wealth index, and logistic regressions were performed to test the associations between wealth and elder abuse. Results reveal that about 62% of individuals from poor households face abuse of some kind, whereas only 6% of individuals from rich households do. The test of the relationship between elder abuse and wealth also suggests that individuals from rich households were more likely not to be abused than individuals from poor households. Results of this study may be useful to policy makers developing policies and programs aimed at preventing elder abuse and reducing inequalities in elder abuse in Rajshahi district as well as in the whole of Bangladesh.
Guided by stress process and life course theory, the purpose of this study was to examine adult child caregivers’ psychological and physical health trajectories and how their multiple family (caregiving, marital, and parenting) and nonfamily (employment) roles contributed to these health outcomes over time. Seven waves of data from the Health and Retirement Study were analyzed for 1,300 adult child caregivers using latent growth curve models. Adult child caregivers have distinct psychological and physical health trajectories that are related to their roles over time. The importance of any given role varies by the type of health outcome and timing in the life course. Caregiving alone does not contribute to adult child caregivers’ psychological and physical health; marital and employment roles also contribute significantly to caregivers’ life courses.
Drawing on interdependence theory, this study examined the cross-spouse impact of driving cessation on productive (work, formal volunteering, and informal volunteering) and social engagement of older couples aged 65+ using longitudinal data from the Health and Retirement Study (1998–2010; N = 1,457 couples). Multilevel modeling results indicate that driving cessation reduced husbands’ productive and social engagement, and wives’ productive engagement. Spousal driving cessation reduced husbands’ likelihood of working or formal volunteering, and wives’ likelihood of working or informal volunteering. The more time since spousal driving cessation, the less likely husbands were to work and the less likely wives were to formally volunteer. Results suggest the need for greater recognition of the impact of driving cessation on couples, rather than just individuals, as well as the need for enhanced services or rehabilitation efforts to maintain driving even among couples with one remaining driver.
Based on the 2005 and 2008 Chinese Longitudinal Healthy Longevity Survey, this study examined the prevalence of undermet needs for assistance in personal activities of daily living (ADL) and its associated risk factors among the oldest old aged 80+. Multilevel multinomial logistic modeling was used to analyze the risk factors and changes of undermet needs over time. The results show that the prevalence of slightly undermet needs decreased in urban China from 2005 to 2008. However, the prevalence of undermet needs remained high; 50% or more for both rural and urban residents. Compared to 2005, the likelihood of having slightly undermet needs in 2008 significantly decreased by 28% among rural residents and 22% among urban residents. The common risk factors of undermet needs among rural and urban residents included financial dependence, living alone, having unwilling caregivers, more ADL disabilities, and having poor self-rated health.
Using a nationally representative sample, we compared Latino and Asian older adults in terms of lifetime and 12-month prevalence of Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition, anxiety and mood disorders. Given the strong family norms and collectivist cultures shared by the two groups, we also examined whether 12-month prevalence rates were associated with various family relation and social connection variables. The findings showed that older Latinos were almost twice as likely as older Asians to have any anxiety or mood disorders in their lifetime (34.5% vs. 17.7%) and in the past year (14.3% vs. 7.4%). Logistic regressions revealed different predictors of anxiety and mood disorders in the two groups: Family cultural conflict was associated with a higher prevalence of anxiety disorders, whereas family cohesion was associated with a lower prevalence of mood disorders. We argue that more research is needed on negative family interactions and their implications for the mental health of older ethnic minorities.
A growing body of research underscores the early origins of health in later life; however, relatively little is known about the relationship between childhood physical health and adult mental health. This research explores the relationship between childhood disability and depressive symptoms among a nationally representative sample of late midlife adults (N = 3,572). Using data from Waves 8–10 (2006–2010) of the Health and Retirement Study, a series of ordinary least squares regression models were created to assess the number of depressive symptoms. Childhood disability was significantly associated with higher levels of depressive symptoms; however, late midlife social and health factors accounted for differences between those with and without childhood disability. Late midlife physical health appeared to be a particularly salient mediator. Individuals who experience childhood disability may accumulate more physical impairment over the life course, thus experiencing worse mental health such as greater depressive symptoms in late midlife.
Detection of elder abuse risk is a critical issue because a lot of cases remain hidden. Screening tools can be used to detect elder abuse. However, few tools have been developed for use with caregivers. The purpose was to develop a translation and adaptation of a Spanish version of the Caregiver Abuse Screen (CASE) and to assess its validity and reliability. The CASE was then used with 211 primary caregivers. Validity and reliability were evaluated, as well as the factorial structure of the instrument. This version showed good psychometric properties. It was found to have strong internal consistency and split-half reliability as well as allowing for a good replication of the original factorial structure. Additionally, several variables related to elder abuse were linked to the CASE such as depression, burden, frequency, and reactions to problem behaviors. The version developed showed sufficient validity and reliability and could be considered as a suitable instrument to assess risks of elder abuse in a Spanish-speaking context.
The pursuit of personal goals has been linked to general psychological well-being; however, less is known about the association with depression in later adulthood when individuals are contending with age-related changes in health and social relationships. We explored the connection between both health- and social related goals (as measured by possible selves) and depressive symptoms in a sample of 85 community-dwelling older adults who ranged in age from 60 to 92 (M = 74, standard deviation = 7.5). Participants took part in face-to-face, semistructured interviews in which they responded to measures of possible selves (future images of oneself), health, and depressive symptoms. We found that the presence of health-related, but not social-related, possible selves was significantly associated with fewer reported depressive symptoms. Additionally, the presence of health-related fears was specifically linked to fewer reported depressive symptoms. These findings suggested that the promotion of and investment in health-related personal goals may be useful in off-setting depressive symptoms in older adults, as well as indicated a potential benefit of a disease prevention focus regarding health in later life. Finally, the results may have implications for potential clinical interventions in addressing late-life depression.
Few studies have explored older people’s expected future quality of life (QoL), despite evidence that perceptions of one’s future influence healthy aging. Research on this topic should embrace a range of potential influences, including perceptions of one’s neighborhood and region. This study examined expected QoL in a random sample of the population of Dalarna, a Swedish region. A self-completion questionnaire assessed demographic characteristics, current neighborhood and regional evaluations, self-evaluations, expectations for the future, and current and expected QoL. In total, 786 people aged ≥65 years participated. A sequential multiple regression model explained 44% of the variance in older people’s expected QoL, with self-reported health (sr 2 = .03), Expected Regional Opportunity (sr 2 = .03), and Perceived Regional Status (sr 2 = .02) having the strongest associations with expected QoL. Research on the importance of one’s neighborhood to QoL in older people should encompass people’s perceptions of their region, to better inform social policy for healthy aging.
Research on spouses’ joint work exits is scarce, although household factors such as spouses’ work status, marital quality, and caregiving burdens are likely to affect seniors’ work engagement. We therefore examine whether the work exit probability of one spouse affects that of the other. Discrete-time hazard regression analyses of survey data linked to later registry information including all gainfully employed married respondents aged 50–74 with a working spouse (N = 1,764) were used to assess subsequent work exits. A spouse’s work exit is a strong predictor of a respondent’s work exit (hazard ratio 3.1, 95% confidence interval [2.5, 4.0]). Educational attainment, poor marital quality, and spouses’ health and care needs do not predict work exits. Surprisingly, no gender differences are observed. Research on larger survey samples to distinguish different work exit routes and reasons for spouses’ joint work exits appears warranted. To account for cultural and welfare state characteristics, cross-national studies ought to be undertaken.
Objectives: This study evaluates a latent variable model that assesses the relationships among hostility, church attendance, helping others, gratitude, and self-rated health. Methods: The participants come from the sixth wave of a nationwide survey of older adults (N = 1,011). Results: The data suggest that older individuals who go to church less often help others less frequently, older people who help others less are less grateful, and older adults who are less grateful rate their health in a less favorable manner. In addition, the data indicate that older people with high hostility scores help others less often and are less grateful. The results reveal that the way in which older people view their health may be traced in part to the interplay between personality traits (i.e., hostility) and virtues that are part of most faith traditions (e.g., helping others).
Building on a tripartite model of capitals necessary to perform productive activities and on work suggesting that cumulative (dis-)advantage processes are important mechanisms for life course inequalities, our study set out to investigate the potential role of family social background and inheritance in later life volunteering. We hypothesized that older individuals who inherited work-relevant economic and cultural capitals from their family of origin are more likely to be engaged in voluntary activities than their counterparts with a less advantageous family social background. Our main findings from the analysis of a representative sample of community-dwelling Israelis aged 50 and over provide strong support for this hypothesis: the likelihood to volunteer is significantly higher among those who received substantial financial transfers from their family of origin ("inherited economic capital") and among those having a "white collar" parental background ("inherited cultural capital"). We conclude with perspectives for future research.
While the official retirement age for most Organization for Economic Co-operation and Development (OECD) countries is 65 years, the average employee in the majority of OECD countries retires considerably earlier. With the coming retirement of the baby boom generation, increasing life expectancy, and budget restrictions due to the financial crisis, most countries want to motivate employees to work longer. For these reasons, studying early retirement is highly relevant. In this article, we examine the determinants of early retirement among working and retired senior teachers between 45 and 65 years old in Flanders, Belgium. Although a widespread early exit culture exists among teachers and teacher shortages are expected in several countries, little attention has been given to the specific determinants of early retirement among teachers. Using multivariate linear regression analysis, we study the preferred retirement age of working teachers (n = 1,878) and the actual retirement age of retired teachers (n = 1,246). Financial factors, feelings of emotional exhaustion, and dissatisfaction with nonteaching-related workload (such as meetings and paperwork) have an important influence on the retirement decision. Results show that the majority of teachers make use of early exit schemes. This illustrates the existence of a widespread early exit culture among senior teachers in Flanders.
In 2008, South Korea launched a Basic Old-Age Pension program, which provides income support for the bottom 60% of the population, and a universal Long-Term Care Insurance (LTCI) program. We investigate the effect of both policies on subjective well-being of the elderly. We use panel data from the Korean Longitudinal Study of Aging, with the 2006 data representing the "pretreatment" and the 2008 data the "posttreatment" situations. We use regression methods for purposes of inferring program impacts. Our findings suggest that satisfaction with economic status was slightly improved by LTCI alone, and by LTCI and basic old-age pension in combination, depending on the estimator used. We found no policy impacts on satisfaction with health conditions. The benefits provided by the two programs may be insufficient to raise well-being in the population as a whole; alternatively, the outcomes may have been measured too soon after the policies were implemented.
Data from the Women’s Health and Aging Study were used to test a model of factors explaining depressive symptomology. The primary purpose of the study was to explore the association between performance-based measures of functional ability and depression and to examine the role of self-rated physical difficulties and perceived instrumental support in mediating the relationship between performance-based functioning and depression. The inclusion of performance-based measures allows for the testing of functional ability as a clinical precursor to disability and depression: a critical, but rarely examined, association in the disablement process. Structural equation modeling supported the overall fit of the model and found an indirect relationship between performance-based functioning and depression, with perceived physical difficulties serving as a significant mediator. Our results highlight the complementary nature of performance-based and self-rated measures and the importance of including perception of self-rated physical difficulties when examining depression in older persons.
This study investigated whether transitioning into the role of activities of daily living (ADL) spousal caregiver is associated with increased depressive symptoms for older husbands and wives among a sample of coresiding community-dwelling older couples. Using data from the Health and Retirement Study, we estimated a two-level linear model to examine the association between change in caregiver status and respondents’ depressive symptoms at follow-up, controlling for other factors identified in Pearlin’s stress process model (PSPM). Results indicate that both husbands and wives who become ADL caregivers have more follow-up depressive symptoms than noncaregivers. Furthermore, wives continuing as caregivers have more follow-up depressive symptoms than wives who do not provide care. Finally, the physical health of the spousal caregiver is related to depressive symptoms at follow-up. We conclude with policy and practice implications of these three main findings.
Past studies have extensively examined factors associated with coping strategies that caregivers use to ameliorate distress or solve problems. While these studies have found that stressors and individual resources influence choices of coping strategies, they have tended to overlook caregivers’ social resources and have rarely considered the possibility that distinct groups of caregivers may use different sets of coping strategies. We conducted latent-class analyses to identify distinct groups of caregivers: those using no particular patterns of coping (unpatterned-coping), those centering on ameliorating distress (emotional-coping), and those focusing on both ameliorating distress and solving problems (hybrid-coping). Stressors distinguished all three coping groups, individual resources differentiated the hybrid-coping group from the emotional-coping group and the unpatterned-coping group, and social resources separated the emotional-coping group and the hybrid-coping group from the unpatterned-coping group. These findings indicate different factors contributing to caregivers’ use of different coping styles and suggest ways to better help caregivers.
Despite increased interest in parent–adult child relations, there has been little attention to how these are influenced by changes in their lives, reflecting transitions and linked lives within a life-course perspective. Hybrid multilevel models are used to analyze the change in parent–adult child contact over two waves of the National Survey of Families and Households. Changes in parent–child proximity, parent and child marital status, and child parental status are associated with change in contact; continued coresidence with another adult child is related to contact with non-coresidential children; but change in parent health does not affect contact. Some patterns are stronger for daughters and biological children who tend to have stronger relationships with their parents. These analyses demonstrate how life-course transitions of parents and adult children can be examined in family context to understand how changes in the life of one family member may influence relations with another.
Working long hours may be related to obesity in older adults. No studies have focused on older workers and long work hours, although the risk of obesity is high among this population group. This study is the first attempt to investigate the relationship between obesity and the older workforce. Panel data from the Health and Retirement Study are examined using Cox regression techniques. We found that older workers who work more than 59 hr a week are more likely to gain weight than older workers who work less than 59 hr per week.
Economic and behavioral theories arrive at different conclusions about the effect of being allowed to borrow from one’s defined-contribution (DC) retirement plan on people’s contributions to DC plans. Traditional life-cycle models unambiguously suggest that the borrowing option makes people better off than not being able to borrow. Households consequently contribute more to their DC plans than they would absent the borrowing option. Previous research finds that the ability to borrow from a DC plan increases contemporaneous contributions, consistent with traditional models. Behavioral finance, in contrast, suggests that some workers may operate with nonlinear time discounting. They plan on saving more in the future but change their mind and save less than initially planned as time passes. These workers may enjoy higher lifetime utility if they have no loan option because DC plans serve as commitment devices for retirement saving. The money cannot be used prior to retirement. Absent this commitment device, contributions may be lower for some households than would be the case without a DC loan option. We study DC plan contributions for households with heterogeneous preferences about discounting. We separate households into those that demonstrate inconsistent (or paradoxical) borrowing behavior, which may reflect nonlinear time discounting, and those with more consistent borrowing behavior. We find that a DC loan option raises current savings, but does so more for households with consistent borrowing behavior than for those with inconsistent borrowing behavior.
Talking about sexual health can be a challenge for some older women. This project was initiated to identify key factors that improve communication between aging women and their primary care providers. A sample of women (aged 60+) completed an online survey regarding their intent to communicate with a provider about sexual health. Using the integrative model of behavioral prediction as a guide, the survey instrument captured data on attitudes, perceived norms, self-efficacy, and intent to communicate with a provider about sexual health. Data were analyzed using structural equation modeling. Self-efficacy and perceived norms were the most important factors predicting intent to communicate for this sample of women. Intent did not vary with race, but mean scores of the predictors of intent varied for African American and White women. Results can guide practice and intervention with ethnically diverse older women who may be struggling to communicate about their sexual health concerns.
Research indicates that greater involvement in activities is essential for successful aging. The purpose of the current study is to examine a construct that motivates involvement in activities—finding interests in life. In the process, we also show how involvement in religion may help promote interests. In order to examine these issues, a conceptual model is tested that contains the following core hypotheses: (1) older people who go to church more often will be more likely to have stronger God-mediated control beliefs (i.e., the belief that God works together with people to resolve problems and reach desired goals); (2) older adults with a stronger sense of God-mediated control will be more likely to find things in life that are interesting; and (3) older individuals with more interests experience a greater sense of self-worth over time. Findings from a nationwide survey provide support for the key relationships described above.
The purpose of this study is to examine the direct and indirect effects of Adult Day Health Care (ADHC) and family network on Quality of Life (QOL) for low-income older Korean immigrants in Los Angeles County, CA. A cross-sectional survey of low-income older Korean immigrants who use ADHC programs was conducted. Self-reported measures included sociocultural characteristics, acculturation, cognitive function, family network, utilization of ADHC, and QOL. The study found that for QOL, two variables had only direct effects: years in ADHC and acculturation. Family network was directly associated with QOL and indirectly associated with it through the variable "years in ADHC." Our findings indicate that a strong family network is positively associated with more years of attendance in ADHC, and with higher QOL scores. Thus, policy makers and practitioners should be aware of the positive association among social networks, attendance in ADHC, and higher QOL among low-income older Korean immigrants.
Objectives: This study examined the effects of retirement on self-rated health for married couples, using interdependence and social stratification theoretical frameworks. Method: Dyadic multilevel modeling of data (N = 2,213 non-Hispanic couples) from 1992 to 2010 of the Health and Retirement Survey. Results: Retirement was associated with worse self-ratings of health (SRH) short term (ST) for both husbands and wives during the first couple of years of retirement. In addition, the longer the husbands (but not wives) were retired, the worse was their SRH. Cross-spouse effects varied by gender: When wives retired, their husbands’ SRH improved ST, but when husbands retired their wives’ SRH improved long term. Spouse education moderated the relationship between years since spouse’s retirement and SRH for wives. Discussion: Practitioners can use this information to help married couples through retirement planning and transitions. Results suggest that models of retirement in couples should pay greater attention to gender and other social stratification factors, spousal interdependence, and length of time since retirement.
The objectives of this study were (1) to develop an empirical typology of physical health risks in racially and ethnically diverse older adults and (2) to examine whether the impact of social resources on depressive symptoms differs across the identified health risk groups (low, moderate, and high risks). The data source was the Survey of Older Floridians, a statewide survey of older adults aged 65 and older (n = 1,432). Latent profile analysis with multiple indicators of physical health (chronic conditions, functional disability, and self-rated health) was used to identify three health risk groups (low, moderate, and high risks). The direct and interactive effects of the health risk group membership and social resources (social support and religious service attendance) on depressive symptoms were found. Of particular interest was that the positive impact of social support was most pronounced in the moderate health risk group.
Linking household composition of older persons and material well-being is an important step toward understanding quality of life among elders in less developed settings. The association is particularly important in sub-Saharan Africa, given the poverty in the region. Ordinary least square regressions using data from 23 countries examine how age composition among all households and presence of offspring and grandchildren among older person households associates with a wealth index that is based on ownership of resources and housing characteristics, and whether the association is consistent across countries. Results indicate older-person-only households, and older persons with youth, have, generally, less wealth than households with other age compositions. Among older person households, those without offspring or grandchildren and skip-generation households fare worst in most countries. Findings highlight the importance of considering older persons households when assessing material well-being and chances of living in poverty in poor regions of the world.
Subjective life expectancy is a powerful predictor of a variety of health and economic behaviors. This research expands upon the life expectancy literature by examining the influence of familial health histories. Using a genetic/environmental model, we hypothesize that individuals’ assessments of their life expectancies will be linked to the health of first-degree and second-degree relatives, with same-sex relatives’ health exercising a stronger effect than that of opposite-sex relatives. Multivariate analyses based on data from a 2009 survey merged with familial health records (N = 1,019) confirm that the health experiences of same-sex, first-degree relatives are linked to respondents’ subjective life expectancy. The relationship between the health experiences of second-degree relatives and subjective life expectancy is much less pronounced. These findings have the potential not only to inform our understanding of health behaviors but also to encourage communication between patients and health professionals aimed at promoting preventative behaviors.
This study investigated the impact of neighborhood social cohesion on the perceived companionship of nearly 1,500 community-dwelling older adults from the Neighborhood, Organization, Aging and Health project (NOAH), a Chicago-based study of older adult well-being in the neighborhood context. We hypothesized that the relationship between neighborhood-level social cohesion and individual residents’ reports of companionship would be more pronounced among those who lived alone than those who resided with others. Controlling for age, gender, education, race, marital status, length of neighborhood residence, and self-rated health, neighborhood social cohesion predicted companionship among those who lived alone; for a one-unit increase in neighborhood social cohesion, the odds of reporting companionship increased by half. In contrast, social cohesion did not predict the companionship of those who resided with others. The results suggest that older adults who live alone particularly profit from the benefits of socially cohesive neighborhood environments.
This study examines emergency department (ED) visits by nursing home (NH) residents aged 65 and over, and factors associated with hospital admission from the ED visit using data from the 2001–2008 National Hospital Ambulatory Medical Care Survey. Cross-sectional analyses were conducted on patient characteristics, diagnosis, procedures received, and triage status. On average, elderly NH residents visited EDs at a rate of 123 visits per 100 institutionalized persons. Nearly 15% of all ED visits had ambulatory care sensitive condition diagnoses. Nearly half of these visits resulted in hospital admission; chronic obstructive pulmonary disease, congestive heart failure, kidney/urinary tract infection, and dehydration were associated with higher odds of admission. Previous studies suggested that adequate medical staffing and appropriate care in the NH could reduce ED visits and hospital admissions. Recent initiatives seek to reduce ED visits and hospitalizations by providing financial incentives to spur better coordination between NH and hospital.
The precautionary savings model predicts that households accumulate wealth to self-insure against unexpected declines in future income and unforeseen expenditures. The goals of this study are twofold. First, we investigate whether the near-elderly who face higher health risks save more. Second, we examine the factors that contribute to health risks that the near-elderly face. We use data from the Health and Retirement Study to construct two measures of health risks. Our results do not support the hypothesis that household savings increase with the health risks that they face. Individuals who confront higher health risks in the future are those who are already in fair or poor health status or those who have a health condition such as diabetes or lung disease. Lower earnings and high medical expenditures caused by current poor health status prevent households from accumulating savings for future health adversities.
Objective: Investigating the relation between social isolation and cognitive function will allow us to identify components to incorporate into cognitive interventions. Method: Data were collected from 267 Appalachian older adults (M = 78.5, range 70–94 years). Overall cognitive functioning and specific cognitive domains were assessed from data of a self-assembled neuropsychological battery of frequently used tasks. Social isolation, social disconnectedness, and perceived isolation were measured from the Lubben Social Network scale-6. Results: Results indicated a significant positive association between all predictor variables (e.g., social isolation, social disconnectedness, and perceived isolation) and outcome variables (e.g., overall cognitive function, memory, executive functioning, attention, and language abilities). Perceived isolation accounted for nearly double the amount of variance in overall cognitive functioning than social disconnectedness (10.2% vs. 5.7%). Discussion: Findings suggest that social isolation is associated with poorer overall cognitive functioning and this remains true across varied cognitive domains.
This analysis assesses the activity level of 324 older adults and the relationship of activity to quality of life with a specific emphasis on the role of cognitive ability. Although the number of older adults with cognitive impairment continues to grow, few studies have examined the variation in activity and quality of life based on the older adults’ cognitive status. Results indicated that cognitively impaired older adults were less active than their nonimpaired peers; however, correlations revealed that regardless of impairment status, more activity was related to a higher quality of life. There was no support for the hypothesis that impaired older adults who have more cognitive ability will have a higher rated quality of life. These results should be considered in the development of programs for older adults. Regardless of impairment level, activity is paramount to maintaining quality of life.
Over the last two decades, research has assessed the relationship between neighborhood socioeconomic factors and individual health. However, existing research is based almost exclusively on cross-sectional data, ignoring the complexity in health transitions that may be shaped by long-term residential exposures. We address these limitations by specifying distinct health transitions over multiple waves of a 15-year study of American adults. We focus on transitions between a hierarchy of health states, (free from health problems, onset of health problems, and death), not just gradients in a single health indicator over time, and use a cumulative measure of exposure to neighborhoods over adulthood. We find that cumulative exposure to neighborhood disadvantage has significant effects on functional decline and mortality. Research ignoring a persons’ history of exposure to residential contexts over the life course runs the risk of underestimating the role of neighborhood disadvantage on health.
Despite the long-held view that Latinos’ value and reliance on family leads to greater involvement of extended family in caring for sick members and reduced perception of burden, some research reports low levels of social support and high levels of distress among Latino caregivers. We explore this seeming discrepancy in a qualitative study of 41 Latino caregivers of family members with Alzheimer’s disease, interviewing them regarding the role of familism in their caregiving experience. For some it facilitates caregiving in the traditional, expected manner. Other caregivers disavow its current relevance. Yet others feel a contrast between familism, which they may value in a general, abstract way and more personal, immediate negative feelings they are experiencing from caregiving. We discuss these complex, multidimensional findings, the variation among caregivers, and present implications for practice, policy, and research.
Falling is a major health-related risk among older adults due to injuries, disability, and even death. Although physical activity (PA) can prevent falls, most older adults are inactive due to limited motivation. The purpose was to examine a motivational framework whereby the stages of change (SOC) and PA mediated the relations between the theory of planned behavior constructs and falls risks among 172 diverse older adults (M age = 72.36). The participants were assessed using standardized scales. Based on the path analysis, the hypothesized framework fit the sample data. The SOC and perceived control had significant path coefficients for PA (.48 and .43, respectively), and PA was linked to falls risks (-.54). Subjective norm was mostly associated with the SOC followed by attitude and perceived control. The variance explained in the SOC, PA, and falls risks were 28%, 59%, and 29%, respectively. Health promoters can use the proposed framework to promote PA and decrease falls risk.
While a number of organizations and government entities have encouraged the development of more "age-friendly" environments, to date there has been limited research linking these environment features to elder outcomes. Using a representative sample of older adults living in Detroit, this study examined the association between age-friendly environment factors and self-rated health. Results indicated that access to health care, social support, and community engagement were each associated with better self-rated health, while neighborhood problems were associated with poorer self-rated health. Moreover, individual-level income and education no longer predicted self-rated health once age-friendly environment factors were taken into account. These findings highlight the need for more research documenting the effects of age-friendly environments, particularly across diverse contexts and populations.
Senior centers are ideal locations to deliver evidence-based health promotion programs to the rapidly growing population of older Americans to help them remain healthy and independent in the community. However, little reported research is conducted in partnership with senior centers; thus, not much is known about barriers and facilitators for senior centers serving as research sites. To fill this gap and potentially accelerate research within senior centers to enhance translation of evidence-based interventions into practice, the present study examined barriers and facilitators of senior centers invited to participate in a cluster-randomized controlled trial. Primary barriers to participation related to staffing and perceived inability to recruit older adult participants meeting research criteria. The primary facilitator was a desire to offer programs that were of interest and beneficial to seniors. Senior centers are interested in participating in research that provides benefit to older adults but may need assistance from researchers to overcome participation barriers.
Using data collected from qualitative interviews in 36 households, this article examines people’s use of social relations based on gender to perform tasks associated with residential relocation in later life. Without prompting, our respondents addressed the social relations of gender in the meanings of things, in the persons of gift recipients, and in the persons of actors accomplishing the tasks. They matched gender-typed objects to same-sex recipients, reproducing circumstances of possession and passing on expectations for gender identity. The accounts of our respondents also depicted a gendered division of household labor between husbands and wives and a gendered division of care work by daughters and sons. These strategies economized a big task by shaping decisions about who should get what and who will do what. In turn, these practices affirmed the gendered nature of possession and care work into another generation.
The main purpose of current research was to investigate the impact of self-rated metacognitive measures and depressive symptoms in predicting psychological well-being in different aged healthy adults. A further goal was to explore the effect of genre and age on metacognition and depression scores. Ninety-six healthy adults were, respectively, assigned to young (i.e., 20–30 years), old (i.e., 65–74 years), very old (i.e., 75–84 years), and oldest old (i.e., >85 years) groups. Participants were administered self-referent social desirability, cognitive efficiency, subjective wellness, and psychological distress questionnaires. It was found that social desirability, depression, cognitive functioning, and metamnestic scores represent the best predictors of well-being. Moreover, a significant main effect of age and genre was found on measures of depression and metamemory. Finally, personal satisfaction, coping strategies, emotional control, and general well-being levels of the very old group did not reach critical cutoff for the Italian octogenarian population.
This study aimed to identify differences in individual, social, and physical environmental factors across the stages of physical activity and explore the effect of those variables on physical activity among older adults. Two hundred and ninety adults aged over 65 years were recruited from the Seodaemun district of Seoul. Standardized scales were used to measure physical activity, stage of change, self-efficacy, decisional balance, social support, and the physical environment. The results indicated that 70.7% of older adults engaged in regular physical activity. Based on the multivariate analysis of variance, only the psychological variables of self-efficacy and perceived benefits and the environmental variables of family support and the physical environment increased significantly across the stages of physical activity change. Based on the regression analysis, the most important predictors of physical activity in a descending order of significance were self-efficacy, perceived benefits, family support, and the physical environment. The total variance in physical activity explained by these variables was 40%.
The article aims to identify differences in motivation between working and nonworking older volunteers, in order to contribute to knowledge on the relationship between work status and volunteering in later life. The study also contributes a cross-European view, given that most literature emanates from the United States. It was conducted utilizing a database of 955 working and nonworking older volunteers in three European countries: the Netherlands, Germany, and Italy. Results showed that work status has a significant impact on the motivation to volunteer, suggesting that voluntary organizations need to consider responding to different motivations between older volunteers still in paid employment and those who are retired. Specifically, those in paid work may be more driven by the desire to improve their career or knowledge, whereas older retired volunteers and those employed part time may consider volunteering as a response to challenges associated with retirement and later life or an unsatisfactory working situation.
The advent of online communication is transforming how older adults find social support with a community of peers who cope with similar health issues. This article explores whether participation in virtual health support groups demonstrates a significant interaction with users’ appraisal of their illness experience and predicts self-reappraisal among adults 50 years of age and older (N = 157). Hierarchical multiple regressions demonstrate the significance of the combined effect of virtual health support and its interaction with illness appraisal measures to predict the outcome variable of self-reappraisal. The results indicate that even though appraisal of cancer as a traumatic experience reduces positive self-reappraisal, those who appraised their illness to have been a traumatic experience perceived virtual support to be more influential on their sense of positive change after cancer. In contrast, perceived benefit of virtual support on positive self-appraisal is reduced if illness is appraised as an opportunity for personal growth.
Residential proximity is an important indicator of family members’ availability to provide assistance to each other. We investigate proximity-enhancing moves by older parents and their children and the reasons for such moves. Using the 2000–2004 waves of the Health and Retirement Study, we fit multinomial logit models examining 2-year residential transitions for parents and children living 10 or more miles apart at baseline. Our results show that family members collectively adjust intergenerational proximity to facilitate mutual support. Despite the common assumption that older parents move closer to their children to receive assistance, more than two thirds of all proximity-enhancing moves are made by adult children. While greater anticipated longevity raises the probability that older parents will move closer to their children, parents’ anticipated longevity does not influence children’s moving decisions. Including individual variability in anticipated longevity in the life course framework helps account for relocation that precedes declines in health or increases in the need for support.
This study focuses on the identification of multiple latent trajectories of pain intensity, and it examines how religiousness is related to different classes of pain trajectory. Participants were 720 community-dwelling older adults who were interviewed at four time points over a 3-year period. Overall, intensity of pain decreased over 3 years. Analysis using latent growth mixture modeling (GMM) identified three classes of pain: (1) increasing (n = 47); (2) consistently unchanging (n = 292); and (3) decreasing (n = 381). Higher levels of intrinsic religiousness (IR) at baseline were associated with higher levels of pain at baseline, although it attenuated the slope of pain trajectories in the increasing pain group. Higher service attendance at baseline was associated with a higher probability of being in the decreasing pain group. The increasing pain group and the consistently unchanging group reported more negative physical and mental health outcomes than the decreasing pain group.