scholarly journals Validation of Self-Reported Cancer Diagnosis by Cognitive Status in the Health and Retirement Study

2021 ◽  
Vol 5 (Supplement_1) ◽  
pp. 165-166
Author(s):  
Megan Mullins ◽  
Jasdeep Kler ◽  
Marissa Eastman ◽  
Mohammed Kabeto ◽  
Lauren Wallner ◽  
...  
Keyword(s):  
Older Adults ◽  
Cancer Diagnosis ◽  
Cognitive Status ◽  
Health And Retirement Study ◽  
Fee For Service ◽  
Incident Cancer ◽  
The Us ◽  
Sensitivity Specificity ◽  
The Relationship ◽  
Retirement Study

Abstract Exploring the relationship between cognition and cancer is increasingly important as the number of older adults in the US grows. The Health and Retirement Study (HRS) has longitudinal data on cognitive status and self-reported cancer diagnoses, but these self-reports have not been validated. Using HRS linked to Medicare Fee for Service (FFS) claims (1998-2016), we evaluated the validity of self-reported cancer diagnoses (excluding non-melanoma skin) against Medicare claims by respondent cognitive status. We included 8,280 Medicare-eligible HRS participants aged ≥67 with at least 90% FFS coverage. Cognitive status was ascertained from the HRS interview following the date of cancer diagnosis (or reference claim date) using the Langa-Weir method and was classified as normal, cognitive impairment no dementia (CIND), or dementia. We calculated the sensitivity, specificity, and Cohen's kappa for first incident malignant cancer diagnosis by cognitive status group. The majority (76.4%) of participants scored as cognitively normal, 9.6% had CIND, 14.0% had dementia and, overall, 1,478 had an incident cancer diagnosis. Among participants with normal cognition, sensitivity of self-reported cancer diagnosis was 70.2% and specificity was 99.8% (kappa=0.79). Among participants with CIND, sensitivity was 56.7% and specificity was 99.8% (kappa=0.66). Among participants with dementia, sensitivity was 53.0% and specificity was 99.6% (kappa=0.64). Results indicate poor validity of self-reported cancer diagnoses for older adults with CIND or dementia. These findings suggest researchers interested in cancer and cognition should use the HRS-Medicare linkage to ascertain cancer diagnosis from claims, and they highlight the importance of cognitive status in research among older adults.

scholarly journals Memory Aging Phenotypes Among Older Cancer Survivors: A Latent Growth Analysis of the Health and Retirement Study

2021 ◽  
Vol 5 (Supplement_1) ◽  
pp. 691-691
Author(s):  
Ashly Westrick ◽  
Kenneth Langa ◽  
Lindsay Kobayashi
Keyword(s):  
Cancer Survivors ◽  
Cancer Diagnosis ◽  
Word List ◽  
Health And Retirement Study ◽  
Latent Growth ◽  
Non Melanoma Skin Cancer ◽  
Incident Cancer ◽  
Health Related ◽  
Memory Group ◽  
Retirement Study

Abstract While cancer survivors experience many long-term health effects, there is limited evidence on the potentially heterogeneous memory aging of older cancer survivors. We identified memory aging phenotypes of older US cancer survivors, and determined sociodemographic and health-related predictors of membership. Data were from 2,755 survivors aged ≥50 in the U.S. Health and Retirement Study (1998 – 2016). Self-reported first incident cancer diagnosis (except non-melanoma skin cancer) and memory (composite immediate and delayed word-list recall score, combined with proxy-reported cognition) were assessed at biennial interviews. Memory aging phenotypes were identified using latent growth curve (LGC) models, with baseline being time of cancer diagnosis. Logistic regression evaluated predictors of group membership. 5 distinct memory aging groups were identified: low memory (n=165, 6.16%); medium-low memory (n=459, 17.1%); medium-high memory (n=733, 27.4%); high memory (n=750, 28.0%); and very high memory (n=571, 21.3%). The low memory group received less chemotherapy compared to the other groups (20.0% vs. 25.5%, 31.7%, 36.8%, 41.5%%, respectively), and had the shortest mean survival time after diagnosis (1.08 vs 2.10, 2.76, 3.37, 4.31 years, respectively). Older age at diagnosis (OR: 1.71, 95%CI: 1.61-1.82), being male (OR: 4.10, 95%CI: 2.82-6.51), having a history of stroke (OR: 4.62, 95%CI: 2.57-8.30) and depression prior to diagnosis (OR: 1.19, 95%CI: 1.05-1.34) were independently associated with being in the low memory group vs. the medium-high memory group. We identified distinct memory aging phenotypes among older cancer survivors. Further research should evaluate the influence of pre-cancer memory and how these phenotypes differ from the general population.

scholarly journals Associations of Loneliness and Social Isolation with Healthspan and Lifespan in the US Health and Retirement Study

2020 ◽  
Author(s):  
Christopher L Crowe ◽  
Benjamin W Domingue ◽  
Gloria Hu ◽  
Katherine M Keyes ◽  
Dayoon Kwon ◽  
...  
Keyword(s):  
Older Adults ◽  
Social Isolation ◽  
Healthy Aging ◽  
National Sample ◽  
Biological Aging ◽  
Health And Retirement Study ◽  
Increased Risk ◽  
The Us ◽  
Retirement Study

Background. Loneliness and social isolation are emerging public health challenges for aging populations. Methods. We followed N=11,305 US Health and Retirement Study (HRS) participants aged 50-95 from 2006-2014 to measure persistence of exposure to loneliness and social isolation. We tested associations of longitudinal loneliness and social-isolation phenotypes with disability, morbidity, mortality, and biological aging through 2018. Results. During follow-up, 18% of older adults met criteria for loneliness and, for 6%, symptoms persisted across two or more follow-up assessments. For social isolation, these fractions were 21% and 8%. HRS participants who experienced loneliness and social isolation were at increased risk for disease, disability, and mortality. Older adults experiencing persistent loneliness were at a 59% increased hazard of mortality compared to those who were never lonely. For social isolation, the increase was 28%. Effect-sizes were somewhat larger for counts of prevalent activity limitations and somewhat smaller for counts of prevalent chronic diseases. Covariate adjustment for socioeconomic and psychological risks attenuated but did not fully explain associations. Older adults who experienced loneliness and social isolation also exhibited physiological indications of advanced biological aging (Cohen's-d for persistent loneliness and social isolation=0.26 and 0.21, respectively). For loneliness, but not social isolation, persistence of symptoms was associated with increased risk. Conclusion. Deficits in social connectedness prevalent in a national sample of older adults in the US were associated with morbidity, disability, and mortality and with more advanced biological aging. Bolstering social connection to interrupt experiences of loneliness may promote healthy aging.

scholarly journals Self-reported Instances of Major Discrimination, Race/Ethnicity, and Inflammation Among Older Adults: Evidence From the Health and Retirement Study

2018 ◽  
Author(s):  
Ryon J Cobb ◽  
Lauren J Parker ◽  
Roland J Thorpe
Keyword(s):  
Older Adults ◽  
High Risk ◽  
Psychosocial Factor ◽  
Prevalence Ratio ◽  
The United States ◽  
Health And Retirement Study ◽  
Race Ethnicity ◽  
Nationally Representative ◽  
The Relationship ◽  
Retirement Study

Abstract Background This study examines the relationship between self-reported instances of major discrimination and inflammation among older adults, and explores whether this relationship varies in accordance with race/ethnicity. We hypothesized that self-reported instances of major discrimination would be associated with higher levels of high-risk inflammation and that this relationship would be stronger for racial/ethnic minorities than whites. Methods Data from the 2006/2008 Health and Retirement Study, an ongoing biennial nationally representative sample of older adults in the United States, were used to collect measures of self-reported instances of major discrimination and high-risk C-reactive protein (CRP), which was assayed from blood samples. Modified Poisson regression with robust standard errors was applied to estimate the prevalence ratios of self-reported instances of major discrimination, as it relates to high-risk CRP (CRP ≥ 22 kg/m2), and test whether this relationship varies by race/ethnicity. Results Respondents who experienced any instances of major discrimination had a higher likelihood of high-risk CRP (prevalence ratio [PR]: 1.14, 95% confidence interval [CI] = 1.07–1.22) than those who did not report experiencing any instances of major discrimination. This association was independent of differences in newly diagnosed health conditions and socioeconomic status. The relationship between any self-reported instance of major discrimination and high-risk CRP was weaker for blacks than whites (PR: 0.81, 95% CI = 0.69–0.95). Conclusions Our study confirms that self-reported instances of major lifetime discrimination is a psychosocial factor that is adversely associated with high-risk CRP among older adults; this association is especially pronounced among older whites. Future studies among this population are required to examine whether the relationship between self-reported instances of major discrimination and high-risk CRP changes over time.

scholarly journals Changes in life expectancy and disability-free life expectancy in successive birth cohorts of older cancer survivors: a longitudinal modeling analysis of the US Health and Retirement Study

2021 ◽  
Author(s):  
Collin F Payne ◽  
Lindsay C Kobayashi
Keyword(s):  
Life Expectancy ◽  
Cancer Survivors ◽  
Early Period ◽  
Population Level ◽  
Health And Retirement Study ◽  
Birth Cohorts ◽  
Incident Cancer ◽  
The Us ◽  
Using Data ◽  
Retirement Study

Abstract The population of older cancer survivors in the US is rapidly growing. However, little is currently known about how the health of older cancer survivors has changed over time and across successive birth cohorts. Using data from the US Health and Retirement Study, we parameterized a demographic microsimulation model to compare partial cohort life expectancy (LE) and disability-free LE for US men and women without cancer and with prevalent and incident cancer diagnoses for four successive 10-year birth cohorts born 1918-1927 to 1948-1957. Disability was defined as being disabled in ≥1 activity of daily living. These cohorts had mid-point ages of 55-64, 65-74, and 75-84 years during the periods 1998-2008 (the “early” period) and 2008-2018 (the “later” period). Across all cohorts and periods, those with incident cancer had the lowest LE, followed by those with prevalent cancer and cancer-free individuals. We observed declines in partial LE and an expansion of life spent disabled among more recent birth cohorts of prevalent cancer survivors. Our findings suggest that advances in treatments that prolong life for individual cancer patients may have led to population-level declines in conditional LE and disability-free LE across successive cohorts of older cancer survivors.

scholarly journals Impact of Housing and Neighborhood on Depression Among Older Adults in the Health and Retirement Study

2021 ◽  
Vol 5 (Supplement_1) ◽  
pp. 392-392
Author(s):  
Rachel Wilkie ◽  
Jennifer Ailshire ◽  
Margarita Osuna
Keyword(s):  
Older Adults ◽  
Depressive Symptoms ◽  
Psychological Wellbeing ◽  
Health And Retirement Study ◽  
Depression Symptoms ◽  
Housing Conditions ◽  
Neighborhood Conditions ◽  
Poor Neighborhood ◽  
The Relationship ◽  
Retirement Study

Abstract Prior research has suggested that poor neighborhood and housing conditions can lead to worse psychological wellbeing. Most studies examine either neighborhood or housing conditions, but not both. Since neighborhood and housing conditions may be correlated it raises the question of whether one is a proxy for the other. We use data from the 2006 and 2008 waves of the Health and Retirement Study to examine associations between perceived neighborhood and housing conditions in 2006 and depressive symptoms (CES-D 8) score in 2008. We find that worse housing conditions and neighborhood safety are associated with more depressive symptoms two years later, even when controlling for prior depressive symptoms. Furthermore, housing and neighborhood conditions are independently related to increased depression symptoms over time. Our research contributes to a deeper understanding of the relationship between home and neighborhood environments and psychological wellbeing in older adults.

scholarly journals INTERNET USE AND LONELINESS OF OLDER ADULTS OVER TIME: THE MEDIATION EFFECT OF SOCIAL CONTACT

2019 ◽  
Vol 3 (Supplement_1) ◽  
pp. S194-S194
Author(s):  
Kexin Yu ◽  
Kexin Yu ◽  
Shinyi Wu ◽  
Iris Chi
Keyword(s):  
Older Adults ◽  
Older People ◽  
Internet Use ◽  
Social Contact ◽  
Total Effect ◽  
Mediation Effect ◽  
Health And Retirement Study ◽  
Longitudinal Association ◽  
Retirement Study ◽  
Over Time

Abstract Internet is increasingly popular among older adults and have changed interpersonal interactions. However, it remains controversial whether older people are more or less lonely with internet use. This paper tests the longitudinal association of internet use and loneliness among older people. One pathway that explains the association, the mediation effect of social contact, was examined. Data from the 2006, 2010 and 2014 waves of Health and Retirement Study was used. Hierarchical liner modeling results showed internet use was related to decreased loneliness over 12-year period of time (b=-0.044, p<.001). Internet use was associated with more social contact with family and friends overtime (b=0.261, p<.001), social contact was related to less perceived loneliness longitudinally (b=0.097, p<.001). The total effect of internet use on loneliness is -0.054 and the mediated effect is -0.025. The findings imply that online activities can be effective for reducing loneliness for older people through increased social contact.

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.

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