scholarly journals Marital Status and Dementia: Evidence from the Health and Retirement Study

2019 ◽  
Vol 75 (8) ◽  
pp. 1783-1795 ◽  
Author(s):  
Hui Liu ◽  
Zhenmei Zhang ◽  
Seung-won Choi ◽  
Kenneth M Langa
Keyword(s):  
Marital Status ◽  
The United States ◽  
Population Based ◽  
Cognitive Status ◽  
Baseline Survey ◽  
Health And Retirement Study ◽  
Related Factors ◽  
Never Married ◽  
Vulnerable Subpopulations ◽  
Retirement Study

Abstract Objectives We provide one of the first population-based studies of variation in dementia by marital status in the United States. Method We analyzed data from the Health and Retirement Study (2000–2014). The sample included 15,379 respondents (6,650 men and 8,729 women) aged 52 years and older in 2000 who showed no evidence of dementia at the baseline survey. Dementia was assessed using either the modified version of the Telephone Interview for Cognitive Status (TICS) or the proxy’s assessment. Discrete-time hazard regression models were estimated to predict odds of dementia. Results All unmarried groups, including the cohabiting, divorced/separated, widowed, and never married, had significantly higher odds of developing dementia over the study period than their married counterparts; economic resources and, to a lesser degree, health-related factors accounted for only part of the marital status variation in dementia. For divorced/separated and widowed respondents, the differences in the odds of dementia relative to married respondents were greater among men than among women. Discussion These findings will be helpful for health policy makers and practitioners who seek to better identify vulnerable subpopulations and to design effective intervention strategies to reduce dementia risk.

scholarly journals Same-Sex Couples and Cognitive Impairment: Evidence From the Health and Retirement Study

2020 ◽  
Author(s):  
Hui Liu ◽  
Ning Hsieh ◽  
Zhenmei Zhang ◽  
Yan Zhang ◽  
Kenneth M Langa
Keyword(s):  
Cognitive Impairment ◽  
The United States ◽  
Population Based ◽  
Cognitive Status ◽  
Health And Retirement Study ◽  
Sex Partners ◽  
Physical And Mental Health ◽  
Same Sex ◽  
Same Sex Couples ◽  
Retirement Study

Abstract Objectives We provide the first nationally representative population-based study of cognitive disparities among same-sex and different-sex couples in the United States. Methods We analyzed data from the Health and Retirement Study (2000–2016). The sample included 23,669 respondents (196 same-sex partners and 23,473 different-sex partners) aged 50 and older who contributed to 85,117 person-period records (496 from same-sex partners and 84,621 from different-sex partners). Cognitive impairment was assessed using the modified version of the Telephone Interview for Cognitive Status. Mixed-effects discrete-time hazard regression models were estimated to predict the odds of cognitive impairment. Results The estimated odds of cognitive impairment were 78% (p < .01) higher for same-sex partners than for different-sex partners. This disparity was mainly explained by differences in marital status and, to a much lesser extent, by differences in physical and mental health. Specifically, a significantly higher proportion of same-sex partners than different-sex partners were cohabiting rather than legally married (72.98% vs. 5.42% in the study sample), and cohabitors had a significantly higher risk of cognitive impairment than their married counterparts (odds ratio = 1.53, p < .001). Discussion The findings indicate that designing and implementing public policies and programs that work to eliminate societal homophobia, especially among older adults, is a critical step in reducing the elevated risk of cognitive impairment among older same-sex couples.

scholarly journals Everyday Discrimination and Kidney Function Among Older Adults: Evidence From the Health and Retirement Study

2019 ◽  
Vol 75 (3) ◽  
pp. 517-521
Author(s):  
Ryon J Cobb ◽  
Roland J Thorpe ◽  
Keith C Norris
Keyword(s):  
Older Adults ◽  
Chronic Kidney Disease ◽  
Kidney Disease ◽  
Kidney Function ◽  
The United States ◽  
Health And Retirement Study ◽  
Disease Epidemiology ◽  
Lower Egfr ◽  
Everyday Discrimination ◽  
Retirement Study

Abstract Background With advancing age, there is an increase in the time of and number of experiences with psychosocial stressors that may lead to the initiation and/or progression of chronic kidney disease (CKD). Our study tests whether one type of experience, everyday discrimination, predicts kidney function among middle and older adults. Methods The data were from 10 973 respondents (ages 52–100) in the 2006/2008 Health and Retirement Study, an ongoing biennial nationally representative survey of older adults in the United States. Estimated glomerular filtration rate (eGFR) derives from the Chronic Kidney Disease Epidemiology Collaboration equation. Our indicator of everyday discrimination is drawn from self-reports from respondents. Ordinary Least Squared regression (OLS) models with robust standard errors are applied to test hypotheses regarding the link between everyday discrimination and kidney function. Results Everyday discrimination was associated with poorer kidney function among respondents in our study. Respondents with higher everyday discrimination scores had lower eGFR after adjusting for demographic characteristics (B = −1.35, p < .05), and while attenuated, remained significant (B = −0.79, p < .05) after further adjustments for clinical, health behavior, and socioeconomic covariates. Conclusions Our study suggests everyday discrimination is independently associated with lower eGFR. These findings highlight the importance of psychosocial factors in predicting insufficiency in kidney function among middle-aged and older adults.

Validation of self-reported incident cancer diagnoses in the U.S. Health and Retirement Study: A tool for population-based cancer and aging research.

2021 ◽  
Vol 39 (28_suppl) ◽  
pp. 312-312
Author(s):  
Megan Mullins ◽  
Jasdeep Kler ◽  
Marissa Eastman ◽  
Mohammed Kabeto ◽  
Lauren P. Wallner ◽  
...  
Keyword(s):  
The United States ◽  
Population Based ◽  
Self Report ◽  
Sensitivity Analyses ◽  
Cancer Site ◽  
Fee For Service ◽  
Site Specific ◽  
Incident Cancer ◽  
Self Reports ◽  
Retirement Study

312 Background: Population aging and improving cancer survival rates are resulting in a growing population of older cancer survivors in the United States (US). As a result, there is an increasing need for longitudinal, population-representative data for interdisciplinary cancer research among older adults. The US Health Retirement Study (HRS) is an ongoing population-representative cohort of US adults over age 50 that contains rich interview and biomarker data on health during aging. Interviews have collected self-reported cancer diagnoses since 1998, but these self-reports have not been validated. We compared first incident cancer diagnoses self-reported in HRS interviews against diagnostic claims from linked Medicare records. Methods: We examined the validity of first incident cancer diagnoses self-reported in biennial HRS interviews from 2000 through 2016 against ICD-9 and ICD-10 diagnostic claim records among 8,242 HRS participants aged ≥65 with 90% continuous enrollment in fee-for-service Medicare, using the claim records as the gold standard. We calculated the sensitivity, specificity, and k for first incident cancer diagnoses (all cancers combined, excluding non-melanoma skin cancer, and each of bladder, breast, colorectal/anal, uterine, kidney/renal, lung/bronchus, and prostate cancers) cumulatively over the follow-up, and at each biennial study interview. Results: Self-reports of first incident cancer diagnosis (agnostic of site) between 2000 and 2016 had 73.2% sensitivity and 96.2% specificity against Medicare claims (k = 0.73). For site-specific self-reports, sensitivities ranged from 44.7% (kidney) to 75.0% (breast), and specificities ranged from 99.2% (prostate) to 99.9% (bladder, uterine, and kidney). Results were similar in sensitivity analyses restricting to individuals with 100% continuous fee-for-service Medicare enrollment and when restricting to individuals with at least 24 months of Medicare enrollment. Conclusions: Self-reported cancer diagnoses in the HRS have reasonable validity for population-based research on cancer and aging across cancer types. Apart from breast cancer, cancer site specific analyses will greatly benefit from the improved validity of self-report with Medicare claim linkage.

scholarly journals Prenatal origins of suicide mortality: A prospective cohort study in the United States

2022 ◽  
Vol 12 (1) ◽  
Author(s):  
Pablo Vidal-Ribas ◽  
Theemeshni Govender ◽  
Rajeshwari Sundaram ◽  
Roy H. Perlis ◽  
Stephen E. Gilman
Keyword(s):  
Pregnancy Complications ◽  
Parental Education ◽  
The United States ◽  
Sociodemographic Factors ◽  
Population Based ◽  
Suicide Mortality ◽  
Related Factors ◽  
Parental Occupation ◽  
Smoking During Pregnancy ◽  
Neonatal Complications

AbstractMost suicide research focuses on acute precipitants and is conducted in high-risk populations. Yet, vulnerability to suicide is likely established years prior to its occurrence. In this study, we aimed to investigate the risk of suicide mortality conferred by prenatal sociodemographic and pregnancy-related factors. Offspring of participants (N = 49,853) of the Collaborative Perinatal Project, a U.S. population-based cohort of pregnancies enrolled between 1959 and 1966, were linked to the U.S. National Death Index to determine their vital status by the end 2016. We examined associations between sociodemographic factors during pregnancy, pregnancy complications, labor and delivery complications, and neonatal complications with suicide death coded according to ICD-9/10 criteria. By the end of 2016, 3,555 participants had died. Of these, 288 (214 males, 74 females) died by suicide (incidence rate = 15.6 per 100,000 person-years, 95% Confidence Interval [CI] = 13.9–17.5). In adjusted models, male sex (Hazard Ratio [HR] = 2.98, CI: 2.26–3.93), White race (HR = 2.14, CI = 1.63–2.83), low parental education (HR = 2.23, CI = 1.38–3.62), manual parental occupation (HR = 1.38, CI = 1.05–1.82), being a younger sibling (HR = 1.52, CI = 1.10–2.11), higher rates of pregnancy complications (HR = 2.36, CI = 1.08–5.16), and smoking during pregnancy (HR = 1,28, CI = 0.99–1.66) were independently associated with suicide risk, whereas birth and neonatal complications were not. Consistent with the developmental origins of psychiatric disorders, vulnerability to suicide mortality is established early in development. Both sociodemographic and pregnancy factors play a role in this risk, which underscores the importance of considering life course approaches to suicide prevention, possibly including provision of high-quality prenatal care, and alleviating the socioeconomic burdens of mothers and families.

scholarly journals Fact or artefact? Childhood adversity and adulthood trauma in the U.S. population-based Health and Retirement Study

2020 ◽  
Vol 11 (1) ◽  
pp. 1721146 ◽  
Author(s):  
David Bürgin ◽  
Cyril Boonmann ◽  
Marc Schmid ◽  
Paige Tripp ◽  
Aoife O’Donovan
Keyword(s):  
Childhood Adversity ◽  
Population Based ◽  
Health And Retirement Study ◽  
Retirement Study ◽  
The U.S

The Association between Marital Status and Psychological Well-being: Variation across Negative and Positive Dimensions

2020 ◽  
Vol 41 (11) ◽  
pp. 2179-2202 ◽  
Author(s):  
Tze-Li Hsu ◽  
Anne E. Barrett
Keyword(s):  
Marital Status ◽  
Personal Growth ◽  
Well Being ◽  
The United States ◽  
Married Women ◽  
Psychological Well Being ◽  
Never Married ◽  
Negative Dimension ◽  
Environmental Mastery ◽  
Better Than

Marital status is associated with psychological well-being, with the married faring better than the formerly and never-married. However, this conclusion derives from research focusing more on negative than positive well-being. We examine the association between marital status and negative well-being, measured as depressive symptoms, and positive well-being, measured as autonomy, environmental mastery, personal growth, positive relations with others, self-acceptance, and purpose in life. Using Wave 2 of Midlife in the United States (2004–2006; n = 1,711), we find that the continuously married fare better on the negative dimension than do the formerly married. The results for some measures of positive well-being also reveal an advantage for the continuously married, compared with the formerly and the never-married. However, results for other positive measures indicate that the unmarried, and the remarried, fare better—not worse—than the continuously married. Further, some results suggest greater benefits for remarried or never-married women than men.

scholarly journals Genetic heterogeneity in depressive symptoms following the death of a spouse: Polygenic score analysis of the US Health and Retirement Study

2016 ◽  
Author(s):  
Benjamin W. Domingue ◽  
Hexuan Liu ◽  
Aysu Okbay ◽  
Daniel W. Belsky
Keyword(s):  
Older Adults ◽  
Depressive Symptoms ◽  
Life Stress ◽  
Genome Wide Association Study ◽  
The United States ◽  
Health And Retirement Study ◽  
Polygenic Score ◽  
Polygenic Scores ◽  
Retirement Study

AbstractExperience of stressful life events is associated with risk of depression. Yet many exposed individuals do not become depressed. A controversial hypothesis is that genetic factors influence vulnerability to depression following stress. This hypothesis is most commonly tested with a “diathesis-stress” model, in which genes confer excess vulnerability. We tested an alternative model, in which genes may buffer against the depressogenic effects of life stress. We measured the hypothesized genetic buffer using a polygenic score derived from a published genome-wide association study (GWAS) of subjective wellbeing. We tested if married older adults who had higher polygenic scores were less vulnerable to depressive symptoms following the death of their spouse as compared to age-peers who had also lost their spouse and who had lower polygenic scores. We analyzed data from N=9,453 non-Hispanic white adults in the Health and Retirement Study (HRS), a population-representative longitudinal study of older adults in the United States. HRS adults with higher wellbeing polygenic scores experienced fewer depressive symptoms during follow-up. Those who survived death of their spouses during follow-up (n=1,829) experienced a sharp increase in depressive symptoms following the death and returned toward baseline over the following two years. Having a higher polygenic score buffered against increased depressive symptoms following a spouse's death. Effects were small and clinical relevance is uncertain, although polygenic score analyses may provide clues to behavioral pathways that can serve as therapeutic targets. Future studies of gene-environment interplay in depression may benefit from focus on genetics discovered for putative protective factors.

scholarly journals A non-APOE Polygenic score for Alzheimer’s disease and APOE-ε4 have independent associations with dementia in the Health and Retirement Study

2020 ◽  
Author(s):  
Kelly M. Bakulski ◽  
Harita S. Vadari ◽  
Jessica D. Faul ◽  
Steven G. Heeringa ◽  
Sharon LR Kardia ◽  
...  
Keyword(s):  
Alzheimer’S Disease ◽  
Cognitive Impairment ◽  
Genetic Risk ◽  
Population Based ◽  
Health And Retirement Study ◽  
Polygenic Score ◽  
Genetic Region ◽  
Apoe Ε4 ◽  
Normal Cognition ◽  
Retirement Study

AbstractINTRODUCTIONAlzheimer’s disease (AD) is a common and costly neurodegenerative disorder. A large proportion of risk is heritable and many genetic risk factors for AD have been identified. The cumulative genetic risk of known markers has not been benchmarked for dementia in a population-based sample.METHODSIn the United States population-based Health and Retirement Study (HRS) (waves 1995-2014), we evaluated the role of cumulative genetic risk for AD, with and without the APOE-ε4 alleles, on dementia status (dementia, cognitive impairment without dementia, borderline cognitive impairment without dementia, cognitively normal). We used logistic regression, accounting for demographic covariates and genetic principal components, and analyses were stratified by European and African genetic ancestry.RESULTSIn the European ancestry sample (n=8399), both AD polygenic score excluding the APOE genetic region (odds ratio (OR)=1.10; 95% confidence interval (CI): 1.00, 1.20) and the presence of any APOE-ε4 alleles (OR=2.42; 95% CI: 1.99, 2.95) were associated with the odds of dementia relative to normal cognition in a mutually-adjusted model. In the African ancestry sample (n=1605), the presence of any APOE-ε4 alleles was associated with 1.77 (95% CI: 1.20, 2.61) times higher odds of dementia, while the AD polygenic score excluding the APOE genetic region was not significantly associated with the odds of dementia relative to normal cognition 1.06 (95% CI: 0.97, 1.30).DISCUSSIONCumulative genetic risk for AD and APOE-ε4 are both independent predictors of dementia. This study provides important insight into the polygenic nature of dementia and demonstrates the utility of polygenic scores in dementia research.

scholarly journals The Relationship Between Fertility History and Incident Dementia in the US Health and Retirement Study

2020 ◽  
Author(s):  
Alison Gemmill ◽  
Jordan Weiss
Keyword(s):  
Population Based ◽  
Older Age ◽  
Health And Retirement Study ◽  
Age At First Birth ◽  
First Birth ◽  
Men And Women ◽  
Incident Dementia ◽  
Younger Age ◽  
Increased Risk ◽  
Retirement Study

ObjectivesAn emerging literature suggests that fertility history, which includes measures of parity and birth timing, may influence cognitive health in older ages, especially among women given their differential exposure to pregnancy and sex hormones. Yet, few studies have examined associations between measures of fertility history and incident dementia in a population-based sample.MethodsWe examined the associations between parity, younger age at first birth, and older age at last birth with incident dementia over a 16-year period in a prospective sample of 15,361 men and women aged 51-100 years at baseline in 2000 drawn from the Health and Retirement Study. We used Cox regression and the Fine and Gray model from which we obtained cause-specific (csHRs) and subdistribution hazard ratios (sdHRs) for incident dementia from gender-stratified models in which we accounted for the semi-competing risk of death.ResultsDuring the follow-up period (median 13.0 years), the crude incidence rate for dementia was 16.6 and 19.9 per 1,000 person-years for men and women, respectively. In crude models estimating csHRs, higher parity (vs. parity 2) and younger age at first birth were associated with increased risk of dementia for both genders. These associations did not persist after full covariate adjustment. Across all models in which we estimated sdHRs, we observed a positive relationship between older age at last birth and incident dementia for women only.DiscussionIn this population-based, multi-ethnic cohort, we observed limited evidence for an association between measures of fertility history and incident dementia among men and women after adjusting for potential confounders.

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