scholarly journals MIDLIFE HEALTH FACTORS AND LATER-LIFE COGNITIVE DISEASE: RESULTS FROM THE 1998-2014 HEALTH AND RETIREMENT STUDY

2019 ◽  
Vol 3 (Supplement_1) ◽  
pp. S950-S951
Author(s):  
Benson Wu ◽  
Mohammad Usama Toseef ◽  
Wassim Tarraf ◽  
Hector M González
Keyword(s):  
Public Health ◽  
Health Outcomes ◽  
Multinomial Logistic Regression ◽  
Later Life ◽  
Cognitive Status ◽  
Older Age ◽  
Fine Motor ◽  
Health And Retirement Study ◽  
Reported Health ◽  
Retirement Study

Abstract Understanding lifecourse determinants of older-age health outcomes is indispensable for resources planning and optimizing public health in light of continued gains in longevity in the US and worldwide. Data increasingly points to midlife health and modifiable risk factors as critical targets for improving older-age health outcomes and mitigating potential cognitive impairment and disease. We used 16-years of biennial data (1998-2014) from the Health and Retirement Study (unweighted-n=6,724), to examine how a comprehensive battery of midlife (age 50-64 years) health measures (disability, physical function, comorbid conditions, and self-reported health) affect cognitive status (using Langa-Weir criteria: Normal, Cognitively Impaired Not Dementia (CIND), and Dementia) and death 16-years later. Additionally, we test for racial/ethnic and gender modifications in the effects of these conditions on the outcomes of interest. We used survey multinomial logistic regression models adjusting for predisposing sociodemographic factors, health-enabling economic characteristics and health behaviors. Relative risk ratios (RRR) across all unadjusted models varied from 1.36-4.84 and 1.36-3.31 for those with dementia and who died in 2014 respectively, suggesting worse health outcomes in midlife are associated with higher dementia/mortality risk in later-life. After covariates-adjustment, comorbidities (RRR=1.15[1.04,1.27]) and Self-reported Health (RRR=1.36[1.22,1.52]) were associated with CIND, and attenuation was particularly pronounced for IADLS (RRR=3.15[2.25,4.43]) and Fine Motor Skills (RRR=1.94[1.46,2.57]) for individuals with dementia in 2014. Neither sex nor race/ethnicity modified these associations. Modifying the midlife health profile of US adults can yield important public health savings and reductions in structural and social health burdens through extenuating the prevalence of dementias and reducing excess mortality.

Associations Between Midlife Functional Limitations and Self-Reported Health and Cognitive Status: Results from the 1998–2016 Health and Retirement Study

2021 ◽  
pp. 1-17
Author(s):  
Benson Wu ◽  
Mohammad Usama Toseef ◽  
Ariana M. Stickel ◽  
Hector M. González ◽  
Wassim Tarraf
Keyword(s):  
Cognitive Impairment ◽  
Physical Function ◽  
Cognitive Aging ◽  
Multinomial Logistic Regression ◽  
Functional Limitations ◽  
Later Life ◽  
Cognitive Status ◽  
Health And Retirement Study ◽  
Reported Health ◽  
Retirement Study

Background: Life-course approaches to identify and help improve modifiable risk factors, particularly in midlife, may mitigate cognitive aging. Objective: We examined how midlife self-rated physical functioning and health may predict cognitive health in older age. Methods: We used data from the Health and Retirement Study (1998–2016; unweighted-N = 4,685). We used survey multinomial logistic regression and latent growth curve models to examine how midlife (age 50–64 years) activities of daily living (ADL), physical function, and self-reported health affect cognitive trajectories and cognitive impairment not dementia (CIND) and dementia status 18 years later. Then, we tested for sex and racial/ethnic modifications. Results: After covariates-adjustment, worse instrumental ADL (IADL) functioning, mobility, and self-reported health were associated with both CIND and dementia. Hispanics were more likely to meet criteria for dementia than non-Hispanic Whites given increasing IADL impairment. Conclusion: Midlife health, activities limitations, and difficulties with mobility are predictive of dementia in later life. Hispanics may be more susceptible to dementia in the presence of midlife IADLs. Assessing midlife physical function and general health with brief questionnaires may be useful for predicting cognitive impairment and dementia in later life.

scholarly journals Childhood Lead Exposure and Cognitive Functioning Among Older Adults: Evidence From the Health and Retirement Study

2021 ◽  
Vol 5 (Supplement_1) ◽  
pp. 313-313
Author(s):  
Haena Lee ◽  
Mark Lee ◽  
John Robert Warren
Keyword(s):  
Educational Attainment ◽  
Cognitive Functioning ◽  
Lead Exposure ◽  
Population Level ◽  
Later Life ◽  
Cognitive Status ◽  
Health And Retirement Study ◽  
Childhood Health ◽  
Lead Pipes ◽  
Retirement Study

Abstract Many children born in the early 20th century were exposed to water-borne lead, a neurotoxin that negatively impacts brain development. While lead exposure has been linked to poor cognition among children and young adults, no population-level research has examined the long-term implications of lead exposure for cognitive functioning in later life. Our study is the first to address this gap by utilizing novel data linkages between the 1940 U.S. Census and the Health and Retirement Study (HRS). Our sample includes respondents who were under age 17 (born 1924-1940) by the time of the decennial enumeration on April 1, 1940. Given that the dominant source of lead exposure was water during this period, we assessed lead exposure by using water chemistry and piping material data for each HRS respondent’s city of residence in 1940. Late-life cognitive functioning for HRS participants (observed 1998-2016) was measured using the Telephone Interview for Cognitive Status. We find that lead exposure during childhood is significantly and negatively associated with cognitive functioning in later life. HRS participants who lived in cities with lead pipes and acidic or alkaline water—the conditions required for lead to leech into municipal water—showed lower levels of cognitive functioning decades later as compared to other participants. This association persisted net of race, gender, childhood socioeconomic status and childhood health. However, the association was largely accounted for by adjusting for educational attainment. This implies that childhood lead exposure impacts later-life cognition via its effect on educational attainment.

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 Is Childhood Socioeconomic Status Related to Coronary Heart Disease? Evidence From the Health and Retirement Study (1992-2012)

2017 ◽  
Vol 3 ◽  
pp. 233372141769667 ◽  
Author(s):  
Minjee Lee ◽  
M. Mahmud Khan ◽  
Brad Wright
Keyword(s):  
Socioeconomic Status ◽  
Coronary Heart Disease ◽  
Heart Disease ◽  
Later Life ◽  
Study Data ◽  
Health And Retirement Study ◽  
Increased Risk ◽  
Childhood Socioeconomic Status ◽  
Nationally Representative ◽  
Retirement Study

Objective: We investigated the association between childhood socioeconomic status (SES) and coronary heart disease (CHD) in older Americans. Method: We used Health and Retirement Study data from 1992 to 2012 to examine a nationally representative sample of Americans aged ≥50 years ( N = 30,623). We modeled CHD as a function of childhood and adult SES using maternal and paternal educational level as a proxy for childhood SES. Results: Respondents reporting low childhood SES were significantly more likely to have CHD than respondents reporting high childhood SES. Respondents reporting both low childhood and adult SES were 2.34 times more likely to have CHD than respondents reporting both high childhood and adult SES. People with low childhood SES and high adult SES were 1.60 times more likely than people with high childhood SES and high adult SES to report CHD in the fully adjusted model. High childhood SES and low adult SES increased the likelihood of CHD by 13%, compared with high SES both as a child and adult. Conclusion: Childhood SES is significantly associated with increased risk of CHD in later life among older adult Americans.

How Self-Employed Older Adults Differ by Age: Evidence and Implications From the Health and Retirement Study

2020 ◽  
Author(s):  
Cal J Halvorsen
Keyword(s):  
Older Adults ◽  
Binary Logistic Regression ◽  
Later Life ◽  
Safety Net ◽  
Risk Tolerance ◽  
Health And Retirement Study ◽  
Retirement Benefits ◽  
Self Employment ◽  
Design And Methods ◽  
Retirement Study

Abstract Background and Objectives There has been increased attention in recent years on self-employment in later life, with about 1 in 5 workers past of the age of 50 working for themselves. This study aims to build upon previous documentation of the characteristics of self-employed older adults by estimating how these characteristics vary by age. Research Design and Methods Using 7 waves of the Health and Retirement Study with a sample of more than 16,000 working older adults, this study considers how the association between self-employment and sociodemographic characteristics; indicators of human, social, and financial capital; and risk tolerance differ between adults aged 50–61 and 62 years and older. Binary logistic regression and seemingly unrelated estimation are used to estimate and compare the characteristics by age group. Results Compared to wage-and-salary work and controlling for all other factors in the models, the oldest self-employed group was more likely to identify as Black, report lower health, and receive health insurance from several sources than the younger group. Further, the older group reported lower individual earnings from work yet higher total household income (less individual earnings) and was also less likely to formally volunteer at the highest commitment levels. Discussion and Implications With some exceptions, these results indicate that the diversity of self-employed older adults within traditional retirement age is greater than among those before this age. Implications regarding how access to key safety net programs, such as Social Security retirement benefits and Medicare, may lead to this finding are discussed.

scholarly journals LIFE COURSE ORIGINS OF FRAILTY IN LATER LIFE

2019 ◽  
Vol 3 (Supplement_1) ◽  
pp. S59-S59
Author(s):  
Monica Williams-Farrelly ◽  
Kenneth F Ferraro
Keyword(s):  
Health Outcomes ◽  
Parental Behavior ◽  
Later Life ◽  
Clinical State ◽  
Adult Health ◽  
Logistic Regression Models ◽  
Health Outcomes Research ◽  
Age Related ◽  
And Function ◽  
Retirement Study

Abstract Frailty, generally characterized as a clinical state of increased vulnerability resulting from age-related decline in reserve and function across multiple physiologic systems, has been gaining attention in recent years due to its high correlates with a number of poor health outcomes including falls, hospitalization, and mortality. Similar to other adult health outcomes, research on the etiology of frailty has begun to move from proximal risk factors only to those more distal in time. This research uses data from the Health and Retirement study (2004-2016) to examine whether childhood exposures predict developing frailty in later life. A series of ordinal logistic regression models were estimated to test whether six domains of childhood exposures (socioeconomic status, infectious disease, chronic disease, impairments, risky adolescent behavior, and risky parental behavior) were associated with frailty, composed of five components: unintentional weight loss, weakness, slowness, exhaustion, and low energy expenditure (Fried et al., 2001). After adjusting for demographic factors, experiencing multiple SES misfortunes or risky adolescent behaviors in childhood are associated with higher odds of frailty in later life (OR= 1.24 and 2.37, respectively), while experiencing any infectious diseases is associated with lower odds of frailty (OR= 0.67 and 0.72). After further adjusting for adult characteristics, experiencing 2 or more chronic diseases in childhood is associated with a 1.35 higher odds of incident frailty over an 8-year period. These results reveal some of the early exposures that may raise frailty risk in later life but also the mid-life factors that mediate those risks.

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.

Longitudinal associations of hopelessness and loneliness in older adults: results from the US health and retirement study

2017 ◽  
Vol 29 (9) ◽  
pp. 1451-1459 ◽  
Author(s):  
Amber M. Gum ◽  
Sharon Shiovitz-Ezra ◽  
Liat Ayalon
Keyword(s):  
Later Life ◽  
Health And Retirement Study ◽  
Small Magnitude ◽  
Simultaneous Evaluation ◽  
The Us ◽  
Lagged Effects ◽  
The Stability ◽  
Time Frames ◽  
Retirement Study ◽  
Lagged Effect

ABSTRACTBackground:Hopelessness and loneliness are potent risk factors for poor mental and physical health in later life, although the nature of their relationships with each other over time is not clear. The aim of the current study was to examine relationships between hopelessness and loneliness over an eight-year study period.Methods:Three waves of data from the US Health and Retirement Study (2006, 2010, 2014) were used to test a cross-lagged model of hopelessness and loneliness (N= 7,831), which allows for the simultaneous evaluation of the reciprocal associations of loneliness and hopelessness. Age in 2006, gender, years of education, number of medical conditions, and depressive symptoms were included as covariates.Results:The autoregressive effects of loneliness (B(SE) = 0.63 (0.02),p< 0.001) and hopelessness (B(SE) = 0.63 (0.02),p< 0.001) were substantive and significant across the three waves, pointing to the stability of both constructs over the eight-year study period. The lagged effect of loneliness on hopelessness was non-significant (B(SE) = 0.05 (0.03),p= 0.16), whereas the lagged effect of hopelessness on loneliness was significant (B(SE) = 0.01 (0.01),p= 0.03). These lagged effects were not significantly different from each other, however, χ2(1) = 2.016,p= 0.156.Conclusions:Participants who were more hopeless tended to become lonelier four years later, but lonelier participants did not become more hopeless four years later. Findings are tentative given the small magnitude and lack of difference between the cross-lagged effects. Future directions include replicating these findings in different samples and time frames, examining potential mechanisms of relationships between hopelessness and loneliness, and potential intervention strategies that might improve both conditions.

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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