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Author(s):  
Adrianna Westbrook ◽  
Ruiyuan Zhang ◽  
Mengyao Shi ◽  
Alexander C Razavi ◽  
Zhijie Huang ◽  
...  

Abstract We aimed to evaluate associations of baseline telomere length with overall and annual change in estimated glomerular filtration rate (eGFR) and trajectory of kidney function during an 8-year follow-up. A total of 3,964 participants of the Health and Retirement Study (HRS) were included. We identified three trajectory groups of kidney function: consistently normal (n=1,163 or 29.3%), normal to impaired (n=2,306 or 58.2%), and consistently impaired groups (n=495 or 12.5%). After controlling for age, sex, race, education, smoking, drinking, diabetes, heart disease, blood pressure, body mass index, total cholesterol, and hemoglobin A1c, participants with longer telomere length were 20% less likely (odds ratio [OR]=0.80, 95% confidence interval [CI]: 0.69-0.93, P=0.003) to have a normal to impaired kidney function trajectory than a consistently normal function trajectory. Telomere length was not associated with changing rate of eGFR over 8 years (P=0.45). Participants with longer telomere length were more likely to have consistently normal kidney function.


2021 ◽  
pp. 1-17
Author(s):  
Benson Wu ◽  
Mohammad Usama Toseef ◽  
Ariana M. Stickel ◽  
Hector M. González ◽  
Wassim Tarraf

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.


2021 ◽  
Author(s):  
Rita Dias Pereira

The literature of Equality of Opportunity (EOp) has long acknowledged the existence of 'talents', 'innate ability' or 'genetic ability'. Nonetheless, attempts to explicitly incorporate a measure of innate ability in the quantification of EOp have been rare. On the other hand, the literature of social-science genetics has found credible genetic-based components of EOp, without an explicit quantification of overall EOp. In addition, there exists prevalent disagreement within both kinds of literature on whether innate ability should be perceived as a fair or unfair source of advantage. This paper proposes to quantify EOp while explicitly including a genetic-based measure of innate ability. It proposes two formal definitions of EOp that draw on both stances regarding the compensation of innate ability. Novel testable implications are derived. The educational attainment polygenic index is used as a measure of innate ability while correcting for genetic nurture and accounting for the correlation between genes and other circumstances. An empirical application in the US Health and Retirement Study finds that the share of inequality of opportunity is 26% under the view that genetic differences are unfair sources of advantage and 21% otherwise. A comparative analysis over cohorts reveals that the trend in EOp depends on the definition adopted; if genetic advantage is a fair source of inequality then EOp has improved; the opposite holds if one considers genetic advantage an unfair source of inequality. These results highlight the importance of accounting for genetic differences in the EOp framework.


PLoS ONE ◽  
2021 ◽  
Vol 16 (12) ◽  
pp. e0261532
Author(s):  
Meg Fluharty ◽  
Elise Paul ◽  
Jessica Bone ◽  
Feifei Bu ◽  
Jill Sonke ◽  
...  

Introduction Arts and cultural engagement are associated with a range of mental and physical health benefits, including promoting heathy aging and lower incidence of age-related disabilities such as slower cognitive decline and slower progression of frailty. This suggests arts engagement constitutes health-promoting behaviour in older age. However, there are no large-scale studies examining how the predictors of arts engagement vary with age. Methods Data from the Health and Retirement Study (2014) were used to identify sociodemographic, life satisfaction, social, and arts appreciation predictors of (1) frequency of arts engagement, (2) cultural attendance, (3) difficulty participating in the arts, and (4) being an interested non-attendee of cultural events. Logistic regression models were stratified by age groups [50–59, 60–69, ≥70] for the frequency of arts participation outcome and [50–69 vs ≥70] all other outcomes. Results Findings indicated a number of age-related predictors of frequent arts engagement, including gender, educational attainment, wealth, dissatisfaction with aging, and instrumental activities of daily living (iADL). For cultural event attendance, lower interest in the arts predicted lack of engagement across age groups, whereas higher educational attainment and more frequent religious service attendance became predictors in older age groups (≥ 70). Adults in both age groups were less likely to report difficulties engaging in the arts if they had lower neighbourhood safety, whilst poor self-rated health and low arts appreciation also predicted reduced likelihood of this outcome, but only in the younger (50–69) age group. Adults in the older (≥ 70) age group were more likely to be interested non-attendees of cultural events if they had higher educational attainment and less likely if they lived in neighbourhoods with low levels of safety. Conclusions Our results suggest that certain factors become stronger predictors of arts and cultural engagement and barriers to engagement as people age. Further, there appear to be socioeconomic inequalities in engagement that may increase in older ages, with arts activities overall more accessible as individuals age compared to cultural engagement due to additional financial barriers and transportation barriers. Ensuring that these activities are accessible to people of all ages will allow older adults to benefit from the range of health outcomes gained from arts and cultural engagement.


2021 ◽  
Vol 9 ◽  
Author(s):  
Jing Yuan ◽  
Shuping Sang ◽  
Jessica Pham ◽  
Wei-Jia Kong

Introduction: Despite growing recognition of hearing loss as a risk factor for late life cognitive disorders, sex and gender analysis of this association has been limited. Elucidating this is one means to advocate for holistic medicine by considering the psychosocial attributes of people. With a composite Gender Score (GS), we aimed to assess this among aging participants (50+) from the 2016 Health and Retirement Study (HRS) cohort.Methods: The GS was derived from gender-related variables in HRS by factor analyses and logistic regression, ranging from 0 (toward masculinity) to 100 (toward femininity). GS tertiles were also used to indicate three gender types (GS tertile 1: lower GS indicates masculinity; GS tertile 2: middle GS indicates androgyny; GS tertile 3: higher GS indicates femininity). Univariate followed by multiple logistic regressions were used to estimate the Odds Ratio (OR) and 95% confidence intervals (CI) of cognitive impairment (assessed by adapted Telephone Interview for Cognitive Status) from hearing acuity, as well as to explore the interactions of sex and gender with hearing acuity. The risk of cognitive impairment among hearing-impaired participants was assessed using multivariable models including sex and gender as exposure variables.Results: Five variables (taking risks, loneliness, housework, drinking, and depression) were retained to compute the GS for each participant. The distribution of GS between sexes partly overlapped. After adjusting for confounding factors, the OR for cognitive impairment associated with hearing impairment was significantly higher (OR = 1.65, 95% CI: 1.26, 2.15), and this association was not modified by female sex (OR = 0.77, 95% CI: 0.46, 1.27), but by androgynous gender (OR = 0.44, 95% CI: 0.24, 0.81). In the multivariable models for participants with hearing impairment, androgynous and feminine gender, as opposed to female sex, was associated with lower odds of cognitive impairment (OR of GS tertile 2 = 0.59, 95% CI: 0.41, 0.84; OR of GS tertile 3 = 0.60, 95% CI: 0.41, 0.87; OR of female sex = 0.78, 95% CI: 0.57, 1.08).Conclusions: Hearing impairment was associated with cognitive impairment among older people, and this association may be attenuated by a more feminine GS.


Author(s):  
Ellen P McCarthy ◽  
Chiang-Hua Chang ◽  
Nicholas Tilton ◽  
Mohammed U Kabeto ◽  
Kenneth M Langa ◽  
...  

Abstract BACKGROUND Using billing data generated through healthcare delivery to identify individuals with dementia has become important in research. To inform tradeoffs between approaches, we tested the validity of different Medicare claims-based algorithms. METHODS We included 5,784 Medicare-enrolled, Health and Retirement Study participants aged >65 years in 2012 clinically assessed for cognitive status over multiple waves and determined performance characteristics of different claims-based algorithms. RESULTS Positive predictive value (PPV) of claims ranged from 53.8-70.3% and was highest using a revised algorithm and 1-year of observation. The trade-off of greater PPV was lower sensitivity; sensitivity could be maximized using 3-years of observation. All algorithms had low sensitivity (31.3-56.8%) and high specificity (92.3-98.0%). Algorithm test performance varied by participant characteristics, including age and race. CONCLUSIONS Revised algorithms for dementia diagnosis using Medicare administrative data have reasonable accuracy for research purposes, but investigators should be cognizant of the trade-offs in accuracy among the approaches they consider.


Author(s):  
Julia E. Tucker ◽  
Nicholas Bishop ◽  
Kaipeng Wang ◽  
Farya Phillips

Preventing negative health outcomes following marital transitions can promote personal recovery and well-being. We used the Health and Retirement Study (HRS) (2012, 2014) to test whether social relationship quality moderated the association between marital transition and change in depressive symptomology among U.S. adults aged 50 and older (n = 3,705). Marital status transitions between 2012 and 2014 included remained married/partnered, divorced/separated, and widowed. Depressive symptomology was measured using the Center for Epidemiological Studies Depression Scale 8 Short Form (CES-D 8). Social support, social contact, and social strain were indicators of social relationship quality. Change in depressive symptomology was modeled using autoregressive multiple regression. Social relationship quality appeared to influence depressive symptomatology for those experiencing divorce/separation. Compared to individuals who remained married/partnered, depressive symptomatology in those experiencing separation/divorce decreased among those reporting low social support, increased among those reporting high social support, and increased among those who reported low social strain. Limitations and clinical implications are discussed.


2021 ◽  
Vol 5 (Supplement_1) ◽  
pp. 456-457
Author(s):  
Felicia Wheaton ◽  
Terika Scatliffe ◽  
Matilda Johnson

Abstract Health care is important for maintaining optimal physical and mental health. However, due to the COVID-19 pandemic, many older adults have delayed or postponed care. Data from the special midterm release of the 2020 Health and Retirement Study (HRS) were used to examine the relationship between chronic conditions and delayed care, as well as between delayed care and mental health outcomes and preventative care among Americans aged 50+ (N=3,266). Approximately 30% of respondents said yes when asked “Since March 2020, was there any time when you needed medical or dental care, but delayed getting or did not get it at all?” Of those, 55% said their provider cancelled, closed or suggested rescheduling, 28.5% decided it could wait, and 20.8% were afraid to go. Results from OLS and logistic regression, controlling for sociodemographic characteristics, indicate that those with lung disease and those with a heart condition had significantly higher odds of delaying care. Delaying care was associated with significantly higher odds of poor self-rated health and feeling depressed, as well as significantly higher average hopelessness, loneliness and negative affect and significantly lower average positive affect. Surprisingly, delaying care was not associated with receiving a flu shot, cholesterol test, colonoscopy, mammogram or prostate exam in the previous two years. It is likely that the full effects of delaying health care during the pandemic have yet to be felt and there is a need to study the implications of such delays.


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