Precise or Imprecise Probabilities? Evidence from Survey Response Related to Late-onset Dementia

Author(s):  
Pamela Giustinelli ◽  
Charles F Manski ◽  
Francesca Molinari

Abstract We elicit numerical expectations for late-onset dementia and long-term care (LTC) outcomes in the Health and Retirement Study. We provide the first empirical evidence on dementia-risk perceptions among dementia-free older Americans and establish important patterns regarding imprecision of subjective probabilities. Our elicitation distinguishes between precise and imprecise probabilities, while accounting for rounding of reports. Imprecise-probability respondents quantify imprecision using probability intervals. Nearly half of respondents hold imprecise dementia and LTC probabilities, while almost a third of precise-probability respondents round their reports. These proportions decrease substantially when LTC expectations are conditioned on hypothetical knowledge of the dementia state. Among rounding and imprecise-probability respondents, our elicitation yields two measures: an initial rounded or approximated response and a post-probe response, which we interpret as the respondent's true point or interval probability. We study the mapping between the two measures and find that respondents initially tend to over-report small probabilities and under-report large probabilities. Using a specific framework for study of LTC insurance choice with uncertain dementia state, we illustrate the dangers of ignoring imprecise or rounded probabilities for modelling and prediction of insurance demand.

2020 ◽  
Vol 16 (S6) ◽  
Author(s):  
Chinedu T. Udeh‐Momoh ◽  
Bang Zheng ◽  
Geraint J. Price ◽  
Tam J. Watermeyer ◽  
Celeste A. Jager ◽  
...  

2021 ◽  
pp. 089826432110372
Author(s):  
Andreas M. Appel ◽  
Henrik Brønnum-Hansen ◽  
Anne H. Garde ◽  
Åse Marie Hansen ◽  
Kazi Ishtiak-Ahmed ◽  
...  

Objectives Previous research on the association between socioeconomic position (SEP) and dementia has not sufficiently accounted for the complex relationship between education and occupation. We investigated the independent and joint effects of educational attainment and occupation-based SEP on dementia. Methods We used register-based information about educational attainment, occupation-based SEP, and dementia from 1,210,720 individuals. Information about cognitive ability at conscription was available for a subsample of men. Results When mutually adjusted, lower educational attainment and occupation-based SEP were associated with higher dementia risk in a dose–response manner. Higher occupation-based SEP partly mitigated the higher dementia risk associated with lower educational attainment. After adjusting for cognitive ability in a subgroup of men, only unskilled work was associated with higher dementia risk. Discussion Occupation-based SEP is independently associated with dementia and may mitigate the higher dementia risk associated with short education. Future research should elucidate the mechanisms underlying social inequality in dementia.


2021 ◽  
pp. 1-10
Author(s):  
Carola Roβmeier ◽  
Julia Hartmann ◽  
Lina Riedl ◽  
Bianca Dorn ◽  
Julia Fischer ◽  
...  

Background: End of life symptoms and symptom management as well as the quality of dying (QoD) of persons with advanced dementia (PWAD) have not yet been systematically studied in Germany. Objective: 1) To investigate symptoms, treatment and care at the end of life, advance care planning, and circumstances of death of recently deceased PWAD; 2) To determine whether there are differences between young and late onset dementia (YOD and LOD). Methods: The study was performed in the context of the project EPYLOGE (IssuEs in Palliative care for persons in advanced and terminal stages of Young-onset and Late-Onset dementia in Germany). Closest relatives of recently deceased patients with advanced YOD (N = 46) and LOD (N = 54) living at home or in long term care were interviewed. Results: Circumstances of death, symptoms, and treatment appeared to be similar between YOD and LOD, except that persons with LOD had significantly more somatic comorbidities and were admitted to hospital in the last three months of life more often than persons with LOD. At end of life, 60%of PWAD appeared to be “at peace”. Difficulty swallowing, gurgling, shortness of breath, and discomfort were observed most frequently. Large interindividual differences in suffering and QoD were present. Determinants of QoD were not identified. Conclusion: Our findings suggest that low QoD was caused by inadequate recognition and/or insufficient treatment of burdensome physical and emotional symptoms. PWADs’ needs should be assessed regularly, and strategies focusing on treatment and implementing support for both the patient and caregiver must be established.


Aging Brain ◽  
2021 ◽  
Vol 1 ◽  
pp. 100010
Author(s):  
Kristine F. Moseholm ◽  
Karin Tybjerg ◽  
Majken K. Jensen ◽  
Rudi G.J. Westendorp

2020 ◽  
Vol 4 (Supplement_1) ◽  
pp. 714-715
Author(s):  
Marie Gualtieri

Abstract The recent reauthorization of the Older Americans Act adds language and definitions to current issues facing the aging population. Specifically, Title I includes definitions related to program adaptation and coordination, workforce and long-term care issues, nutrition and social isolation, as well as family caregivers. Different from the last authorization, these definitions span beyond the individual experience to include other entities impacted by an aging society, such as the workforce and families. Overall, the Title I reauthorization seeks to modernize policy to reflect the current influx of the older adult population and its consequences.


2020 ◽  
Vol 4 (Supplement_1) ◽  
pp. 25-25
Author(s):  
Xiao Xu ◽  
Jersey Liang ◽  
BoRin Kim ◽  
James Raymo ◽  
Mary Beth Ofstedal

Abstract Existing literature on childlessness among middle-aged and older Americans is sparse, and measuring childlessness is not straightforward for those with complex family histories. To address this knowledge gap, we examined data on 19,929 respondents age ≥50 from the 2016 Health and Retirement Study. All analyses accounted for complex sample design to generate nationally representative estimates. The proportion of respondents without children differed significantly depending on how “childless” was defined: 1) 14.9% (95% confidence interval [CI]: 13.9-15.9%) having no biological children, versus 2) 10.4% (95% CI: 9.5-11.3%) having no children/step-children that were living and in-contact. When measured based on absence of biological children, the prevalence of childlessness was higher in younger cohorts (17.7%, 13.2%, and 9.0% for age 50-64, 65-74, and ≥75 years, respectively, p<0.001) and among more educated individuals (17.4%, 12.3%, and 9.6% for more than high school, high school, and less than high school education, respectively, p<0.001). The prevalence of childlessness was also higher among men (16.7%) than women (13.2%) (p<0.001) and among non-Hispanic whites (16.0%) than Hispanics (9.8%) (p<0.001). Similar patterns, but lower prevalence, were observed when measuring childlessness based on absence of children/step-children that were living and in-contact. Although non-Hispanic whites (16.0%) were more likely than non-Hispanic blacks (13.0%) to have no biological children (p=0.007), a similar proportion of them had no children/step-children that were living and in-contact (10.8% versus 10.6%, p=0.06). Given fertility decline and growing family complexity, these findings help inform the structure of social support and long-term care needs of middle-aged and older Americans.


2014 ◽  
Vol 7 (1) ◽  
Author(s):  
Matthias Hoben ◽  
Marion Bär ◽  
Cornelia Mahler ◽  
Sarah Berger ◽  
Janet E Squires ◽  
...  

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