Disruption as Antecedent to New Business Startup: A Study of Entrepreneurship Using the Understanding America Study

Abstract We use data from a nationally representative study to examine antecedents of entrepreneurial activity in the US among younger (< age 50) and older (≥ age 50) adults using Shapero’s and Sokol’s Model of the “Entrepreneurial Event” (hereafter SEE). The “entrepreneurial event” here refers to the initiation of entrepreneurial behavior. The SEE approach assumes that individuals default to inertia until their lives are disrupted by exogenous factors such as life-changing events (Shapero & Sokol, 1982). The disruptor could be either positive or negative, and has the net effect of driving the individual to reconsider entrepreneurship as a viable opportunity (Krueger & Brazeal, 1994; Krueger & Day, 2010). We examine the correlation between negative disruptions and a person initiating entrepreneurial behavior (starting a new business), including whether the process is similar across younger and older adults. Using data collected in 2014 and 2019 from 3,586 individuals in the Understanding America Study panel, we run survey Cox proportional hazards models to analyze the effects of negative disruptions (getting separated or divorced) on starting a new business over a five-year period starting in 2014. We found that negative disruptions have a significant, positive effect but only among older adults. Further, the magnitude of that effect is about 3-7 times that of younger adults. Our findings support the validity of the SEE approach in advancing our understanding of the transition of individuals from potential to actual entrepreneurs. However, the findings suggest the SEE approach better explains this process in older rather than younger adults.

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Association Between Informant-Reported Sleep Disturbance and Incident Dementia: An Analysis of the National Alzheimer’s Coordinating Center Uniform Data Set

Journal of Applied Gerontology ◽

10.1177/0733464820967202 ◽

2020 ◽

pp. 073346482096720

Author(s):

Woojung Lee ◽

Shelly L. Gray ◽

Douglas Barthold ◽

Donovan T. Maust ◽

Zachary A. Marcum

Keyword(s):

Older Adults ◽

Sleep Disturbance ◽

Proportional Hazards ◽

Cox Proportional Hazards ◽

Cognitive Screening ◽

Cognitive Level ◽

Data Set ◽

Cox Proportional Hazards Models ◽

Incident Dementia ◽

Normal Cognition

Informants’ reports can be useful in screening patients for future risk of dementia. We aimed to determine whether informant-reported sleep disturbance is associated with incident dementia, whether this association varies by baseline cognitive level and whether the severity of informant-reported sleep disturbance is associated with incident dementia among those with sleep disturbance. A longitudinal retrospective cohort study was conducted using the uniform data set collected by the National Alzheimer’s Coordinating Center. Older adults without dementia at baseline living with informants were included in analysis. Cox proportional hazards models showed that participants with an informant-reported sleep disturbance were more likely to develop dementia, although this association may be specific for older adults with normal cognition. In addition, older adults with more severe sleep disturbance had a higher risk of incident dementia than those with mild sleep disturbance. Informant-reported information on sleep quality may be useful for prompting cognitive screening.

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Abstract P030: Variations in Cardiovascular Risk Among Different Clinical Presentations of Metabolic Syndrome in the REasons for Geographic And Racial Differences in Stroke (REGARDS) Study

Circulation ◽

10.1161/circ.125.suppl_10.ap030 ◽

2012 ◽

Vol 125 (suppl_10) ◽

Author(s):

Todd M Brown ◽

Joshua Richman ◽

Vera Bittner ◽

Cora E Lewis ◽

Jenifer Voeks ◽

...

Keyword(s):

Risk Factors ◽

Metabolic Syndrome ◽

Racial Differences ◽

Central Obesity ◽

Proportional Hazards ◽

Cox Proportional Hazards ◽

Next Of Kin ◽

Cox Proportional Hazards Models ◽

Chd Risk ◽

The Individual

Background: Some individuals classified as having metabolic syndrome (MetSyn) are centrally obese while others are not with unclear implications for cardiovascular (CV) risk. Methods: REGARDS is following 30,239 individuals ≥45 years of age living in 48 states recruited from 2003-7. MetSyn risk factors were defined using the AHA/NHLBI/IDF harmonized criteria with central obesity being defined as ≥88 cm in women and ≥102 cm in men. Participants with and without central obesity were stratified by whether they met >2 or ≤2 of the other 4 MetSyn criteria, resulting in the creation of 4 groups. To ascertain CV events, participants are telephoned every 6 months with expert adjudication of potential events following national consensus recommendations and based on medical records, death certificates, and interviews with next-of-kin or proxies. Acute coronary heart disease (CHD) was defined as definite or probable myocardial infarction or acute CHD death. To determine the association between these 4 groups and incident acute CHD, we constructed Cox proportional hazards models in those free of CHD at baseline by race/gender group, adjusting for sociodemographic variables. Results: A total of 20,018 individuals with complete data on MetSyn components were free of baseline CHD. Mean age was 64+/−9 years, 58% were women, and 42% were African American. Over a mean follow-up of 3.4 (maximum 5.9) years, there were 442 acute CHD events. In the non-centrally obese with>2 other risk factors, risk for CHD was higher for all but AA men, though significant only for white men. In contrast, in the centrally obese with >2 other risk factors, risk was doubled for women, but only non-significantly and modestly increased for men. Only AA women with central obesity and ≤2 other risk factors had increased CHD risk (Table). Conclusion: The CHD risk associated with the MetSyn varies by the presence of central obesity as well as the race and gender of the individual.

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Suicide risk within one year of cognitive impairment diagnosis in older adults: a nationwide retrospective cohort study

10.21203/rs.2.19129/v1 ◽

2019 ◽

Author(s):

Jae Woo Choi ◽

Kang Soo Lee ◽

Euna Han

Keyword(s):

Alzheimer’S Disease ◽

Older Adults ◽

Alzheimer's Disease ◽

Cognitive Impairment ◽

Mental Disorders ◽

Suicide Risk ◽

Proportional Hazards ◽

Cox Proportional Hazards ◽

Cox Proportional Hazards Models ◽

One Year

Abstract Background This study aims to investigate suicide risk within one year of receiving a diagnosis of cognitive impairment in older adults without mental disorders. Methods This study used National Health Insurance Service-Senior Cohort data on older adults with newly diagnosed cognitive impairment including Alzheimer’s disease, vascular dementia, other/unspecified dementia, and mild cognitive impairment from 2004 to 2012. We selected 41,195 older adults without cognitive impairment through 1:1 propensity score matching using age, gender, Charlson Comorbidity Index, and index year, with follow-up throughout 2013. We eliminated subjects with mental disorders and estimated adjusted hazard ratios (AHR) of suicide deaths within one year after diagnosis using the Cox proportional hazards models. Results We identified 49 suicide deaths during the first year after cognitive impairment diagnosis. The proportion of observed suicide deaths was the highest within one year after cognitive impairment diagnosis (48.5% of total); older adults with cognitive impairment were at a higher suicide risk than those without cognitive impairment (AHR, 1.89; 95% confidence interval [CI], 1.18–3.04). Subjects with Alzheimer’s disease and other/unspecified dementia were at greater suicide risk than those without cognitive impairment (AHR, 1.94, 1.94; 95% CI, 1.12–3.38, 1.05–3.58). Suicide risk in female and young-old adults (60–74 years) with cognitive impairment was higher than in the comparison group (AHR, 2.61, 5.13; 95% CI, 1.29–5.28, 1.48–17.82). Conclusions Older patients with cognitive impairment were at increased suicide risk within one year of diagnosis. Early intervention for suicide prevention should be provided to older adults with cognitive impairment.

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Illiteracy, dementia risk, and cognitive trajectories among older adults with low education

Neurology ◽

10.1212/wnl.0000000000008587 ◽

2019 ◽

Vol 93 (24) ◽

pp. e2247-e2256 ◽

Cited By ~ 3

Author(s):

Miguel Arce Rentería ◽

Jet M.J. Vonk ◽

Gloria Felix ◽

Justina F. Avila ◽

Laura B. Zahodne ◽

...

Keyword(s):

Older Adults ◽

Cognitive Decline ◽

Proportional Hazards ◽

Cox Proportional Hazards ◽

Independent Effect ◽

Growth Curve Models ◽

Cox Proportional Hazards Models ◽

Dementia Risk ◽

Incident Dementia ◽

Low Education

ObjectiveTo investigate whether illiteracy was associated with greater risk of prevalent and incident dementia and more rapid cognitive decline among older adults with low education.MethodsAnalyses included 983 adults (≥65 years old, ≤4 years of schooling) who participated in a longitudinal community aging study. Literacy was self-reported (“Did you ever learn to read or write?”). Neuropsychological measures of memory, language, and visuospatial abilities were administered at baseline and at follow-ups (median [range] 3.49 years [0–23]). At each visit, functional, cognitive, and medical data were reviewed and a dementia diagnosis was made using standard criteria. Logistic regression and Cox proportional hazards models evaluated the association of literacy with prevalent and incident dementia, respectively, while latent growth curve models evaluated the effect of literacy on cognitive trajectories, adjusting for relevant demographic and medical covariates.ResultsIlliterate participants were almost 3 times as likely to have dementia at baseline compared to literate participants. Among those who did not have dementia at baseline, illiterate participants were twice as likely to develop dementia. While illiterate participants showed worse memory, language, and visuospatial functioning at baseline than literate participants, literacy was not associated with rate of cognitive decline.ConclusionWe found that illiteracy was independently associated with higher risk of prevalent and incident dementia, but not with a more rapid rate of cognitive decline. The independent effect of illiteracy on dementia risk may be through a lower range of cognitive function, which is closer to diagnostic thresholds for dementia than the range of literate participants.

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Restriction of Pharmacoepidemiologic Cohorts to Initiators of Medications in Unrelated Preventive Drug Classes to Reduce Confounding by Frailty in Older Adults

American Journal of Epidemiology ◽

10.1093/aje/kwz083 ◽

2019 ◽

Vol 188 (7) ◽

pp. 1371-1382 ◽

Cited By ~ 2

Author(s):

Henry T Zhang ◽

Leah J McGrath ◽

Alan R Ellis ◽

Richard Wyss ◽

Jennifer L Lund ◽

...

Keyword(s):

Older Adults ◽

Proportional Hazards ◽

Cox Proportional Hazards ◽

Standardized Mortality Ratio ◽

Drug Classes ◽

Cox Proportional Hazards Models ◽

Hazard Ratios ◽

All Cause Mortality ◽

Preventive Drug ◽

Mortality Ratio

Abstract Nonexperimental studies of the effectiveness of seasonal influenza vaccine in older adults have found 40%–60% reductions in all-cause mortality associated with vaccination, potentially due to confounding by frailty. We restricted our cohort to initiators of medications in preventive drug classes (statins, antiglaucoma drugs, and β blockers) as an approach to reducing confounding by frailty by excluding frail older adults who would not initiate use of these drugs. Using a random 20% sample of US Medicare beneficiaries, we framed our study as a series of nonrandomized “trials” comparing vaccinated beneficiaries with unvaccinated beneficiaries who had an outpatient health-care visit during the 5 influenza seasons occurring in 2010–2015. We pooled data across trials and used standardized-mortality-ratio–weighted Cox proportional hazards models to estimate the association between influenza vaccination and all-cause mortality before influenza season, expecting a null association. Weighted hazard ratios among preventive drug initiators were generally closer to the null than those in the nonrestricted cohort. Restriction of the study population to statin initiators with an uncensored approach resulted in a weighted hazard ratio of 1.00 (95% confidence interval: 0.84, 1.19), and several other hazard ratios were above 0.95. Restricting the cohort to initiators of medications in preventive drug classes can reduce confounding by frailty in this setting, but further work is required to determine the most appropriate criteria to use.

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Individual and community-level determinants of retention of Anglophone and Francophone immigrants across Canada

Canadian Studies in Population ◽

10.25336/p6831w ◽

2017 ◽

Vol 44 (1-2) ◽

pp. 59 ◽

Cited By ~ 1

Author(s):

Michael Haan ◽

Jake Arbuckle ◽

Elena Prokopenko

Keyword(s):

Proportional Hazards ◽

Census Data ◽

Cox Proportional Hazards ◽

Official Language ◽

Cox Proportional Hazards Models ◽

Base De Données ◽

Official Language Minority ◽

Language Capacity ◽

Data Files ◽

The Individual

This paper uses Cox Proportional Hazards Models, the Longitudinal Immigration Database, and Harmonized Census Data files to investigate the individual and community determinants of retention of Anglophone and Francophone immigrants in Canada among 1990, 1995, 2000 and 2005 landing cohorts in the first five years after landing. We focus on both the official language capacity of immigrants and the linguistic composition of the communities in which they settle. We find that Official Language Minority Communities (OLMCs) successfully retained Francophone immigrants better than non-OLMCs outside of Quebec. We also find that most cohorts of Anglophone immigrants are more likely to exit Quebec if they started out in an OLMC than if they did not.Cette étude utilise des modèles à risque proportionnel de Cox, la base de données longitudinales sur l’immigration, des fichiers de données harmonisés des recensements de la population afin d’examiner les déterminants au niveau individuel et communautaire sur la rétention à l’arrivée au pays des cohortes admises en 1990, 1995, 2000 et 2005 au cours des cinq premières années après leur établissement. L’accent de l’étude porte sur la capacité linguistique dans les deux langues officielles des nouveaux arrivants et la composition linguistique des communautés d’accueil. L’étude révèle que les communautés de langue officielle en situation minoritaire (CLOSM) ont plus de succès à maintenir les immigrants francophones que les communautés de langue officielle en situation majoritaire hors-Québec. L’étude révèle aussi que la plupart des cohortes anglophones sont plus susceptible de quitter le Québec si initialement établies dans une CLOSM.

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Indicators of Crash Risk in Older Adults: A Longitudinal Analysis From the ACTIVE Study

Journal of Aging and Health ◽

10.1177/08982643211031346 ◽

2021 ◽

pp. 089826432110313

Author(s):

Karlene K. Ball ◽

Olivio J. Clay ◽

Jerri D. Edwards ◽

Bernadette A. Fausto ◽

Katie M. Wheeler ◽

...

Keyword(s):

Older Adults ◽

Proportional Hazards ◽

Secondary Data ◽

Cox Proportional Hazards ◽

Crash Risk ◽

Significant Finding ◽

Site Location ◽

Cox Proportional Hazards Models ◽

Male Sex

Objective: This study aims to examine indicators of crash risk longitudinally in older adults ( n = 486). Method: This study applied secondary data analyses of the 10 years of follow-up for the ACTIVE study combined with state-recorded crash records from five of the six participating sites. Cox proportional hazards models were first used to examine the effect of each variable of interest at baseline after controlling for miles driven and then to assess the three cognitive composites as predictors of time to at-fault crash in covariate-adjusted models. Results: Older age, male sex, and site location were each predictive of higher crash risk. Additionally, worse scores on the speed of processing cognitive composite were associated with higher crash risk. Discussion: Results support previous findings that both age and male sex are associated with higher crash risk. Our significant finding of site location could be attributed to the population density of our testing sites and transportation availability.

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Effect of Financial Literacy on Starting a New Business: Using Survival Analysis to Examine Differences between Older and Younger Entrepreneurs

ESIC MARKET Economic and Business Journal ◽

10.7200/esicm.169.0522.2 ◽

2020 ◽

pp. 343-372

Author(s):

Felichism W. Kabo

Keyword(s):

United States ◽

Older Adults ◽

Financial Literacy ◽

Proportional Hazards ◽

The United States ◽

Study Data ◽

Cox Proportional Hazards ◽

Wide Range ◽

New Business ◽

Nationally Representative

Objective: This paper focuses on financial literacy as an antecedent to entrepreneurial involvement in order to examine and better understand differences between older and younger entrepreneurs. Financial literacy is the ability to apply the knowledge and skills needed to effectively manage financial resources over the life-course and is related to a wide range of economic outcomes. Methodology: The antecedence of financial literacy with respect to entrepreneurial engagement is examined using novel entrepreneurship data the United States. The study uses three waves (2014, 2016, and 2019) of complex survey data the Understanding America Study (UAS), a nationally representative and probability-based internet panel of households representing roughly 8,500 respondents ages 18 and older, and active since 2014. The data are used to generate survival curves using the Kaplan-Meier method, and to run survey linear and Cox proportional hazards regression models outcomes are starting a new business with respect to two time frames: over one’s lifetime, and since 2014. Results: The results show that there are associations between financial literacy and the rate of starting a new business both over one’s lifetime and since 2014, but only among older adults. Limitations: The study data were collected using a sample of adults in the United States which may limit the generalizability of the study findings to countries and regions other than the United States. Practical implications: This paper presents evidence that indicates that financial literacy is correlated with business start-up activities among older adults. This implies that financial literacy programs targeted at older adults may have an appreciable and significant multiplier effect.

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Abstract MP07: Metabolic Signature Improves Heart Failure Risk Prediction In Older Adults

Circulation ◽

10.1161/circ.143.suppl_1.mp07 ◽

2021 ◽

Vol 143 (Suppl_1) ◽

Author(s):

Guning Liu ◽

Quynh Nguyen ◽

Sunil K Agarwal ◽

David Aguilar ◽

Eric Boerwinkle ◽

...

Keyword(s):

Risk Factors ◽

Older Adults ◽

Ejection Fraction ◽

Risk Prediction ◽

Proportional Hazards ◽

Cox Proportional Hazards ◽

Atherosclerosis Risk In Communities ◽

Reduced Ejection Fraction ◽

Metabolic Signature ◽

Cox Proportional Hazards Models

Introduction: Circulating metabolome profiling holds promise in predicting HF risk, but its prediction performance among older adults is not well established. Hypothesis: We hypothesize that metabolic signatures are associated with the risk of HF and its subtypes (HF with preserved ejection fraction (HFpEF) and HF with reduced ejection fraction (HFrEF)), and they can improve HF risk prediction beyond established risk factors. Methods: We measured 828 serum metabolites among 4,030 African and European Americans free of HF from the Atherosclerosis Risk in Communities (ARIC) study visit 5 (2011-2013). We regressed incident HF on each metabolite using Cox proportional hazards models. A metabolite risk score (MRS) was derived by summing individual metabolite levels weighted by beta coefficients estimated from least absolute shrinkage and selection operator (LASSO) regularized regressions. We regressed incident HF, HFpEF and HFrEF on the MRS. Harrell’s C-statistics were calculated to evaluate risk discrimination. We replicated the association between MRS and HF in 3,697 independent ARIC participants with metabolite measured at visit 1 (1987-1989). Results: Among 4,030 participants, the mean (SD) age was 76 (5) years. Adjusting for HF risk factors, 302 metabolites were associated with incident HF (false discovery rate < 0.05). One SD increase of the MRS, constructed from 51 metabolites selected by LASSO, was associated with two to three-fold high risk of HF, HFpEF and HFrEF in the fully adjusted models ( Table ). Five-year risk prediction analysis showed that C statistics improved from 0.850 to 0.884 by adding MRS over ARIC HF risk factors, kidney function and NT-proBNP (ΔC (95%CI) = 0.034 (0.017,0.052)). In the replication analysis, a more parsimonious MRS constructed using 15 metabolites, was associated with incident HF ( Table ). Conclusions: We identified a metabolic signature that was associated with the risk of HF and improved HF risk prediction. Our findings may shed light on pathways in HF development and at-risk populations.

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Abstract P007: Ankle-brachial Index And Cardiovascular Outcomes In Older Adults: The Atherosclerosis Risk In Communities Study

Circulation ◽

10.1161/circ.143.suppl_1.p007 ◽

2021 ◽

Vol 143 (Suppl_1) ◽

Author(s):

Frances M Wang ◽

Chao Yang ◽

Shoshana Ballew ◽

Corey A Kalbaugh ◽

Michelle L Meyer ◽

...

Keyword(s):

Risk Factors ◽

Older Adults ◽

Primary Prevention ◽

Proportional Hazards ◽

Ankle Brachial Index ◽

Cox Proportional Hazards ◽

Atherosclerotic Cardiovascular Disease ◽

Cvd Risk ◽

Atherosclerosis Risk In Communities ◽

Cox Proportional Hazards Models

Introduction: The ankle-brachial index (ABI) is a representative diagnostic indicator of peripheral artery disease (PAD) and recognized as a risk enhancer in the ACC/AHA guidelines for primary prevention of atherosclerotic cardiovascular disease (ASCVD). However, our understanding of the association between ABI and cardiovascular (CVD) risk in older adults is limited. Additionally, the prognostic value of ABI among individuals with prior ASCVD is not well understood. Hypothesis: In a contemporary cohort of older adults, low ABI is independently associated with higher risk of CVD events, regardless of prevalent ASCVD at baseline (coronary heart disease [CHD], stroke, and/or symptomatic PAD). Methods: At ARIC Visit 5 (2011-2013), we studied 5,005 participants (4,160 without prior ASCVD [median age 74 years, 38% male], and 843 with ASCVD [median age 76 years, 65% male]). We quantified the association between ABI categories and subsequent risk of heart failure (HF) and composite CHD/stroke using multivariable Cox proportional hazards models. Results: Over a median follow-up of 5.5 years, we observed 400 CHD/stroke and 338 HF cases (242 CHD/stroke and 199 HF cases in those without prior ASCVD). After adjustment for CVD risk factors, in those without ASCVD history, ABI ≤0.9 was associated with a higher risk of both CHD/stroke and HF ( Table ). In those with a history of ASCVD, low ABI was not significantly associated with CHD/stroke, but was associated with HF (hazard ratio 7.1, 95% CI: 2.5-20.5); ABI categories of 0.9-1.1 and >1.3 were also significantly associated with HF. Addition of ABI to traditional risk factors improved prediction of CHD/stroke risk in those without prior ASCVD and prediction of HF, regardless of baseline ASCVD ( Table ). Conclusions: Low ABI (≤0.9) was associated with incident CHD/stroke in those without prior ASCVD and HF regardless of baseline ASCVD status. These results support ABI as a risk enhancer for guiding primary prevention of ASCVD and suggest its potential value in HF risk assessment for older adults.

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