scholarly journals PROVIDING AND RECEIVING FAMILY CARE ACROSS THE LIFE COURSE: INSIGHTS FROM THE OLDEST OLD

2019 ◽  
Vol 3 (Supplement_1) ◽  
pp. S612-S613
Author(s):  
Taylor Patskanick ◽  
Julie Miller ◽  
Chaiwoo Lee ◽  
Lisa D’Ambrosio

Abstract Unprecedented longevity comes with an increased need for providing and receiving care. A 2015 report estimated 39.8 million adults in the United States provided unpaid care to an adult in 2014 (NAC & AARP). Previous research has focused disproportionately on experiences of providing care to older adults, but little has explored experiences of providing care and receiving care among the oldest old. Adults aged 85 and older are likely to have provided care to an adult family member at some point in their lives, but now may be receiving care themselves. The presentation will report on findings from a mixed methods study investigating the experiences of providing and receiving care across the life course among a sample of the “oldest old.” Data draw from focus groups and a survey with the MIT AgeLab Lifestyle Leaders, a bimonthly panel study of adults ages 85 and older. Findings suggest the Lifestyle Leaders had extensive experience providing care, particularly in older age. They most often cared for family members with long-term physical or cognitive conditions. Opinions on learning new technologies to help with caregiving and robot caregivers were mixed. The majority of the Lifestyle Leaders received regular help with at least one care task regardless of household composition or living situation. Many reported help had improved their health, but they felt like a burden to their caregivers. Even in later life, the Lifestyle Leaders had few ideas about who might take care of them if they needed care in the future.

2020 ◽  
Vol 36 (3) ◽  
pp. 333-350
Author(s):  
Fabian Kratz ◽  
Alexander Patzina

Abstract According to theories of cumulative (dis-)advantage, inequality increases over the life course. Labour market research has seized this argument to explain the increasing economic inequality as people age. However, evidence for cumulative (dis-)advantage in subjective well-being remains ambiguous, and a prominent study from the United States has reported contradictory results. Here, we reconcile research on inequality in subjective well-being with theories of cumulative (dis-)advantage. We argue that the age-specific endogenous selection of the (survey) population results in decreasing inequalities in subjective well-being means whereas individual-level changes show a pattern of cumulative (dis-)advantage. Using repeated cross-sectional data from the European Social Survey (N = 15,252) and employing hierarchical age-period-cohort models, we replicate the finding of decreasing inequality from the United States with the same research design for Germany. Using panel data from the German Socio-Economic Panel Study (persons = 47,683, person-years = 360,306) and employing growth curve models, we show that this pattern of decreasing inequality in subjective well-being means is accompanied by increasing inequality in intra-individual subjective well-being changes. This pattern arises because disadvantaged groups, such as the low educated and individuals with low subjective well-being show lower probabilities of continuing to participate in a survey and because both determinants reinforce each other. In addition to allowing individual changes and attrition processes to be examined, the employed multi-cohort panel data have further key advantages for examining inequality in subjective well-being over the life course: They require weaker assumptions to control for period and cohort effects and make it possible to control for interviewer effects that may influence the results.


2017 ◽  
Vol 58 (4) ◽  
pp. 405-420 ◽  
Author(s):  
Debra Umberson

Close relationships are a resource for mental and physical health that, like other social resources, is unequally distributed in the population. This article focuses on racial disparities in the loss of relationships across the life course. Racial disparities in life expectancy in the United States mean that black Americans experience the deaths of more friends and family members than do white Americans from childhood through later life. I argue that these losses are a unique type of stress and adversity that, through interconnected biopsychosocial pathways, contribute to disadvantage in health over the life course. I focus particularly on how the interconnected pathways associated with loss undermine opportunities for and increase risks to social ties throughout life, adding to disadvantage in health. I call on social scientists and policy makers to draw greater attention to this unique source of disadvantage for black children, adults, and families.


2017 ◽  
Vol 72 (2) ◽  
pp. 160-167 ◽  
Author(s):  
Roger Keller Celeste ◽  
Johan Fritzell

BackgroundInequalities over the life course may increase due to accumulation of disadvantage or may decrease because ageing can work as a leveller. We report how absolute and relative socioeconomic inequalities in musculoskeletal pain, oral health and psychological distress evolve with ageing.MethodsData were combined from two nationally representative Swedish panel studies: the Swedish Level-of-Living Survey and the Swedish Panel Study of Living Conditions of the Oldest Old. Individuals were followed up to 43 years in six waves (1968, 1974, 1981, 1991/1992, 2000/2002, 2010/2011) from five cohorts: 1906–1915 (n=899), 1925–1934 (n=906), 1944–1953 (n=1154), 1957–1966 (n=923) and 1970–1981 (n=1199). The participants were 15–62 years at baseline. Three self-reported outcomes were measured as dichotomous variables: teeth not in good conditions, psychological distress and musculoskeletal pain. The fixed-income groups were: (A) never poor and (B) poor at least once in life. The relationship between ageing and the outcomes was smoothed with locally weighted ordinary least squares, and the relative and absolute gaps were calculated with Poisson regression using generalised estimating equations.ResultsAll outcomes were associated with ageing, birth cohort, sex and being poor at least once in live. Absolute inequalities increased up to the age of 45–64 years, and then they decreased. Relative inequalities were large already in individuals aged 15–25 years, showing a declining trend over the life course. Selective mortality did not change the results. The socioeconomic gap was larger for current poverty than for being poor at least once in life.ConclusionInequalities persist into very old age, though they are more salient in midlife for all three outcomes observed.


2021 ◽  
Vol 2021 ◽  
pp. 1-11
Author(s):  
Liam Foster ◽  
Alan Walker

“Active ageing” has become the leading scientific and policy conceptualization of a later life over the past two decades in the European Union (EU). It has been used as a key strategy for responding to demographic ageing. In the United States, in contrast, discourses around successful ageing have been more prevalent. This review article charts the development of active ageing responses to demographic change, showing how the concept compares with the notion of successful ageing and other terms associated with “ageing well.” It identifies how, in practice, active ageing has been dominated by a narrow economic or productivist interpretation that prioritizes the extension of working life (to reduce the “burden” of population ageing). Such interpretations of active ageing undermine its value and emphasize the need for a more comprehensive approach which is set out. The development of the Active Ageing Index in 2012 provided a new analytical tool to promote evidence-based strategies towards population ageing. However, in practice, we show how it has not yet engaged fully with a comprehensive approach to active ageing or with the critical role of the life course in shaping the experience of old age. Nonetheless, this review article shows that the concept of active ageing still has an important role to play in our understanding of and responses to population ageing.


Author(s):  
Mary L. Sellers

Folklore occurs at every stage of a person’s life, and this chapter covers the way folklore and folklife across, and of, the life course has been studied. Six divisions in the life course that mark traditions of age groups as well as perceived stages in the United States are pregnancy and birth, infancy and early childhood, childhood and adolescence, adulthood, seniority, and death. Although much of the scholarship of age groups has been on the beginning and end of life, I demonstrate the conditions of aging in adolescence through the senior years that generate folklore and should be studied in relation to formation of age-group identity. This chapter emphasizes the use of folklore as an adaptation to aging. It examines the connection of folk traditions to the role that anxiety plays in the aging process, the formation of self and group identity, and the rites of passage that mark transitions from one stage to another. It shows that the presence of invented and emerging traditions indicates changing values and beliefs across the life course and encourages research in age-based research as a basic component of folklore and folklife studies.


2020 ◽  
Vol 4 (Supplement_1) ◽  
pp. 37-37
Author(s):  
Sadie Giles

Abstract Racial health disparities in old age are well established, and new conceptualizations and methodologies continue to advance our understanding of health inequality across the life course. One group that is overlooked in many of these analyses, however, is the aging American Indian/Native Alaskan (AI/NA) population. While scholars have attended to the unique health inequities faced by the AI/NA population as a whole due to its discordant political history with the US government, little attention has been paid to unique patterns of disparity that might exist in old age. I propose to draw critical gerontology into the conversation in order to establish a framework through which we can uncover barriers to health, both from the political context of the AI/NA people as well as the political history of old age policy in the United States. Health disparities in old age are often described through a cumulative (dis)advantage framework that offers the benefit of appreciating that different groups enter old age with different resources and health statuses as a result of cumulative inequalities across the life course. Adding a framework of age relations, appreciating age as a system of inequality where people also gain or lose access to resources and status upon entering old age offers a path for understanding the intersection of race and old age. This paper will show how policy history for this group in particular as well as old age policy in the United States all create a unique and unequal circumstance for the aging AI/NA population.


2020 ◽  
Vol 4 (Supplement_1) ◽  
pp. 461-461
Author(s):  
Laura Upenieks

Abstract Of all the various forms of adversity experienced during childhood, childhood maltreatment (emotional and physical abuse) is shown to have the largest impacts on mental health and well-being. Yet we still have a limited understanding of why some victims of early maltreatment suffer immense mental health consequences later on in the life course, while others are able to cushion the blow of these early insults. Using two waves of data from the National Survey of Midlife Development in the United States (MIDUS), this study considers change in religiosity as a buffer across three dimensions for victims of childhood abuse: religious importance, attendance, and the specific act of seeking comfort through religion. Results suggest that increases in religious comfort during adulthood are positively associated with adult mental health for victims of abuse, while decreases in religious comfort over time were associated with worse mental health. Changes in religious attendance and religious importance were not significant associated with mental health for victims of abuse. Taken together, my results show that the stress-moderating effects of religion for victims of childhood maltreatment are contingent on the stability or increases or decreases in religiosity over the life course, which has been overlooked in previous work.


2020 ◽  
Vol 4 (Supplement_1) ◽  
pp. 504-504
Author(s):  
Ruijia Chen ◽  
Jennifer Weuve ◽  
Laura Kubzansky ◽  
David Williams

Abstract Introduction: Racial disparities in cognitive function have been well-documented in the literature, but factors driving the disparities remain under explored. This study aims to quantify the extent to which cumulative stress exposures across the life course explain Black–White disparities in executive function and episodic memory. Method: Data were drawn from the 2004–2006 wave of the Midlife Development in the United States (MIDUS) and the MIDUS refresher study (N=5,967, 5,277 White, 690 Black). Cumulative stress exposures were assessed by using 10 domains of stressors (e.g., financial stress, childhood adversity). Cognitive function was assessed using the Brief Test of Adult Cognition by Telephone. Marginal structural models were conducted to quantify the proportion of the effect of race/ethnicity status on cognitive function that can be explained by cumulative stress exposures. Result: Blacks reported higher levels of cumulative stress exposures and lower average levels of executive function and episodic memory than Whites. Cumulative stress exposures explained 8.43% of the disparities in executive function and 13.21 % of the disparities in episodic memory. Cumulative stress exposures had stronger effects on racial disparities in cognitive function in the older age group (age≥ 55 years old) than in the younger age group (age < 55 years old). Conclusion: Cumulative stress exposures explain modest proportions of racial disparities in levels of cognitive function. Interventions that focus on reducing stress exposures or improving coping resources among Blacks may help lessen racial disparities in cognitive function at the population level.


2020 ◽  
Vol 41 (Supplement_2) ◽  
Author(s):  
C.C Topriceanu ◽  
J.C Moon ◽  
R Hardy ◽  
A.D Hughes ◽  
N Chaturvedi ◽  
...  

Abstract Background Cardiovascular diseases are an important component of the multi-morbidity syndrome which is associated with negative health outcomes resulting in a major societal economic burden. An objective way to assess multi-morbidity is to calculate a frailty index based on medical deficit accumulation. Late-life frailty has been validated to predict mortality, but little is known about the association between life-course frailty and cardiovascular health in later-life. Purpose To study the association between life-course frailty and later-life heart size and function using data from the world's longest running birth cohort with continuous follow-up. Methods A 45-deficit frailty index (FI) was calculated at 4 age-intervals across the life-course (0 to 16 years old, 19 to 44 years old, 45 to 54 years old and 60 to 64 years old) in participants from the UK 1946 Medical Research Council (MRC) National Survey of Heath and Development (NSHD) birth cohort. The life-course frailty indices (FI0_16, FI19_44, FI45_54 and FI60_64) reflect the cumulative medical deficits at the corresponding age-intervals. They were used to derive FImean and FIsum reflecting overall-life frailty. The step change in deficit accumulation between age-intervals was also calculated (FI2-1, FI3-1, FI4-1, FI3-2, FI4-2, FI4-3). Echocardiographic data at 60–64 years provided: E/e' ratio, ejection fraction (EF), myocardial contraction fraction index (MCFi) and left ventricular mass index (LVmassi). Generalized linear mixed models with gamma distribution and log link assessed the association between FIs and echo parameters after adjustment for sex, socio-economic position and body mass index. Results 1.805 NSHD participants were included (834 male). Accumulation of a single deficit had a significant impact (p<0.0001 to p<0.049) on LVmassi and MCFi in all the life-course FIs and overall FIs. LVmassi increased by 0.89% to 1.42% for the life-course FIs and by 0.36%/1.82% for FIsum and FImean respectively. MCFi decreased by 0.62% to 1.02% for the life-course FIs and by 0.33%/ 1.04%. for FIsum and FImean respectively. One accumulated deficit translated into higher multiplicative odds (13.2 for FI60-64, 2.1 for FI4-1, 75.4 for FI4-2 and 78.5 for FI4-3) of elevated filling pressure (defined as E/e' ratio >13, p<0.0.005 to p<0.02).A unit increase in frailty decreased LV EF (%) by 11%/12% for FI45-54 and FI60-64 respectively, by 10% to 12% for FI2-1, FI3-1, FI4-1 and FI4-2, and 4%/15% for FIsum and FImean respectively (p<0.0014 to p<0.044). Conclusion Frailty during the life-course, overall life-frailty and the step change in deficit accumulation is associated with later-life cardiac dysfunction. Frailty strain appears to have its greatest impact on pathological myocardial hypertrophy (high LVmassi and low MCFi) potentially paving the way to later-life systolic or diastolic dysfunction in susceptible individuals. Funding Acknowledgement Type of funding source: None


BMC Urology ◽  
2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Saira Khan ◽  
K. Y. Wolin ◽  
R. Pakpahan ◽  
R. L. Grubb ◽  
G. A. Colditz ◽  
...  

Abstract Background Existing evidence suggests that there is an association between body size and prevalent Benign Prostatic Hyperplasia (BPH)-related outcomes and nocturia. However, there is limited evidence on the association between body size throughout the life-course and incident BPH-related outcomes. Methods Our study population consisted of men without histories of prostate cancer, BPH-related outcomes, or nocturia in the intervention arm of the Prostate, Lung, Colorectal, and Ovarian Cancer Screening Trial (PLCO) (n = 4710). Associations for body size in early- (age 20), mid- (age 50) and late-life (age ≥ 55, mean age 60.7 years) and weight change with incident BPH-related outcomes (including self-reported nocturia and physician diagnosis of BPH, digital rectal examination-estimated prostate volume ≥ 30 cc, and prostate-specific antigen [PSA] concentration > 1.4 ng/mL) were examined using Poisson regression with robust variance estimation. Results Men who were obese in late-life were 25% more likely to report nocturia (Relative Risk (RR): 1.25, 95% Confidence Interval (CI): 1.11–1.40; p-trendfor continuous BMI < 0.0001) and men who were either overweight or obese in late-life were more likely to report a prostate volume ≥ 30 cc (RRoverweight: 1.13, 95% CI 1.07–1.21; RRobese: 1.10, 95% CI 1.02–1.19; p-trendfor continuous BMI = 0.017) as compared to normal weight men. Obesity at ages 20 and 50 was similarly associated with both nocturia and prostate volume ≥ 30 cc. Considering trajectories of body size, men who were normal weight at age 20 and became overweight or obese by later-life had increased risks of nocturia (RRnormal to overweight: 1.09, 95% CI 0.98–1.22; RRnormal to obese: 1.28, 95% CI 1.10–1.47) and a prostate volume ≥ 30 cc (RRnormal to overweight: 1.12, 95% CI 1.05–1.20). Too few men were obese early in life to examine the independent effect of early-life body size. Later-life body size modified the association between physical activity and nocturia. Conclusions We found that later-life body size, independent of early-life body size, was associated with adverse BPH outcomes, suggesting that interventions to reduce body size even late in life can potentially reduce the burden of BPH-related outcomes and nocturia.


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