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The study evaluated the association between ultra-processed foods (UPF) and nutrient intake and identified the socio-demographic characteristics associated with UPF consumption among a nationally representative sample of middle-older adults. Dietary assessment was collected in 2013 using a validated FFQ. The Nova system was used to classify food and drinks into UPF. The percentage of dietary energy from UPF was calculated and used throughout the analyses, and average nutrient intake across quintiles of UPF was evaluated. The determinants associated with the dietary caloric contribution of UPF intake were investigated using linear regression models. A cross-sectional analysis of a nationally representative study of Americans over the age of 50, the Health and Retirement Study, was conducted. The analysis included 6220 participants. The mean age was 65 (se 0·28) years, with 55 % being female. UPF intake accounted for 51 % (se 0·25) of total intake. An increase in the percentage of (%UPF) consumption was correlated with an increase in calories, carbohydrates, saturated fat and sugar, and a decrease in fibre, vitamins and minerals. %UPF intake was inversely associated with being Hispanic, higher income, physical activity, vegetarian diet and Mediterranean diet but positively associated with very low food insecurity. UPF represented half of the calories consumed. A higher %UPF intake was associated with a lower nutrient profile, suggesting decreasing %UPF intake as a strategy to improve the nutritional quality of middle-older adults. A few socio-demographic factors were associated with %UPF, which would help in planning strategies to reduce UPF consumption.
Three factors converge to underscore the heightened importance of evaluating the potential health/well-being effects of friendships in older adulthood. First, policymakers, scientists, and the public alike are recognizing the importance of social relationships for health/well-being and creating national policies to promote social connection. Second, many populations are rapidly aging throughout the world. Third, we currently face what some call a ‘friendship recession’. Although, growing research documents associations between friendship with better health and well-being, friendship can also have a ‘dark side’ and can potentially promote negative outcomes. To better capture friendship’s potential heterogeneous effects, we took an outcome-wide analytic approach.
Methods
We analysed data from 12,998 participants in the Health and Retirement Study (HRS) – a prospective and nationally representative cohort of U.S. adults aged >50, and, evaluated if increases in friendship strength (between t0; 2006/2008 and t1; 2010/2012) were associated with better health/well-being across 35 outcomes (in t2; 2014/2016). To assess friendship strength, we leveraged all available friendship items in HRS and created a composite ‘friendship score’ that assessed the following three domains: (1) friendship network size, (2) friendship network contact frequency and (3) friendship network quality.
Results
Stronger friendships were associated with better outcomes on some indicators of physical health (e.g. reduced risk of mortality), health behaviours (e.g. increased physical activity) and nearly all psychosocial indicators (e.g. higher positive affect and mastery, as well as lower negative affect and risk of depression). Friendship was also associated with increased likelihood of smoking and heavy drinking (although the latter association with heavy drinking did not reach conventional levels of statistical significance).
Conclusions
Our findings indicate that stronger friendships can have a dual impact on health and well-being. While stronger friendships appear to mainly promote a range of health and well-being outcomes, stronger friendships might also promote negative outcomes. Additional research is needed, and any future friendship interventions and policies that aim to enhance outcomes should focus on how to amplify positive outcomes while mitigating harmful ones.
Using a sample of US adults aged 65 years and older, we examined the role of dietary quality in cystatin C change over 4 years and whether this association varied by race/ethnicity. The Health and Retirement Study provided observations with biomarkers collected in 2012 and 2016, participant attributes measured in 2012, and dietary intake assessed in 2013. The sample was restricted to respondents who were non-Hispanic/Latino White (n 789), non-Hispanic/Latino Black (n 108) or Hispanic/Latino (n 61). Serum cystatin C was constructed to be equivalent to the 1999–2002 National Health and Nutrition Examination Survey (NHANES) scale. Dietary intake was assessed by a semi-quantitative FFQ with diet quality measured using an energy-adjusted form of the Alternative Healthy Eating Index-2010 (AHEI-2010). Statistical analyses were conducted using autoregressive linear modelling adjusting for covariates and complex sampling design. Cystatin C slightly increased from 1·2 mg/l to 1·3 mg/l over the observational period. Greater energy-adjusted AHEI-2010 scores were associated with slower increase in cystatin C from 2012 to 2016. Among respondents reporting moderately low to low dietary quality, Hispanic/Latinos had significantly slower increases in cystatin C than their non-Hispanic/Latino White counterparts. Our results speak to the importance of considering racial/ethnic determinants of dietary intake and subsequent changes in health in ageing populations. Further work is needed to address measurement issues including further validation of dietary intake questionnaires in diverse samples of older adults.
The Scarr–Rowe effect is a gene × environment interaction, which is characterized by a negative association between exposure to low socioeconomic status (SES) environments and the additive heritability of cognitive ability. Utilizing a polygenic score for educational attainment (EA3), it was found that the two-way interaction between EA3 and parental educational attainment (EA; used as a proxy for parental SES) was a significant positive predictor of participants’ composite cognitive ability (IQ) score (β = .018, SE = .008, p = .028) after controlling hierarchically for the direct effects of (population-stratification-controlled) EA3, parental EA, and 20 distinct interaction terms (10 involving the interactions between the principal components [PCs] and EA3, and 10 involving the interaction between the PCs and parental EA). The presence of this interaction is consistent with the Scarr–Rowe effect, as the expressivity of EA3 on cognitive ability increases with increasing parental EA. No statistically significant sex differences in the effect magnitudes were found, although the effect was significantly present in the female but not male sample.
The association between organic food consumption and biomarkers of inflammation, C-reactive protein (CRP) and cystatin C (CysC) was explored in this cross-sectional analysis of older adults.
Design:
Dietary data and organic food consumption was collected in 2013 from a FFQ. Alternative Mediterranean diet score (A-MedDiet) was calculated as a measure of healthy eating. Biomarkers CRP and CysC were collected in serum or plasma in 2016. We used linear regression models to assess the associations between organic food consumption and CRP and CysC.
Setting:
This cross-sectional analysis uses data from the nationally representative, longitudinal panel study of Americans over 50, the Health and Retirement Study.
Participants:
The mean age of the analytic sample (n 3815) was 64·3 (se 0·3) years with 54·4 % being female.
Results:
Log CRP and log CysC were inversely associated with consuming organic food after adjusting for potential confounders (CRP: β = –0·096, 95 % CI 0·159, –0·033; CysC: β = –0·033, 95 % CI –0·051, –0·015). Log CRP maintained statistical significance (β = –0·080; 95 % CI –0·144, –0·016) after additional adjustments for the A-MedDiet, while log CysC lost statistical significance (β = –0·019; 95 % CI –0·039, 0·000). The association between organic food consumption and log CRP was driven primarily by milk, fruit, vegetables and cereals, while log CysC was primarily driven by milk, eggs and meat after adjustments for A-MedDiet.
Conclusions:
These findings support the hypothesis that organic food consumption is inversely associated with biomarkers of inflammation CRP and CysC, although residual confounding by healthy eating and socioeconomic status cannot be ruled out.
Studies have indicated government transfers greatly alleviate poverty among older Americans. Yet recent social policy changes were suggested to increase older Americans’ fiscal insecurity. New evidence is needed to expand the evaluation of government transfers. Longitudinal Health and Retirement Study data from 2002 to 2014 were used. We computed individuals’ poverty status both when household income included and did not include government transfers. Results indicated the poverty rate dropped dramatically when household income included government transfers. The poverty alleviation effect was significantly greater among people who were female, older, members of a minority group, having fewer years of education, residing in the South, and living in a bigger household. Evidence from this study solidified the overall poverty alleviation effect of government transfers in old age. Differential effects among various demographic groups could be attributed to their initial status and divergent political beliefs about who should receive government transfers.
Existing research suggests walnut intake may be associated with better cognitive function in older adults, yet few studies utilise longitudinal data from observational studies of ageing populations. Our objective was to estimate the association between whole walnut intake and cognitive change in a representative sample of older Americans.
Design:
Secondary analysis of the Health and Retirement Study and Health Care and Nutrition Study. Walnut consumption was defined as a categorical measure (none, low intake (0·01–0·08 1 oz. servings per day) and moderate intake (>0·08 1 oz. servings per day)) and cognitive function was measured using the Telephone Interview for Cognitive Status. Latent growth modelling estimated the association between walnut consumption and trajectories of cognitive status over a 4-year observational period. Sensitivity analyses assessing non-random dropout and Monte Carlo power analyses were conducted to contextualise results.
Setting:
The USA.
Participants:
A sample of 3632 US adults aged 65 years and older.
Results:
Those reporting any walnut consumption had greater cognitive scores at baseline than those not consuming walnuts (low walnut consumption, b = 1·53, se = 0·21, P < 0·001; moderate walnut consumption, b = 2·22, se = 0·27, P < 0·001), but walnut consumption was not associated with cognitive change. Walnut consumption was positively associated with socioeconomic status and health behaviours as well as intake of nutrients identified to have neuroprotective benefits.
Conclusions:
We identified an association between walnut consumption and cognitive function in older adults, although we did not find that walnut consumption was protective against age-related cognitive decline.
To estimate latent dietary profiles in a community-dwelling sample of older Americans and identify associations between dietary profile membership and individual demographic, socio-economic and health characteristics.
Design:
Secondary analysis of the 2012 Health and Retirement Study (HRS) and linked 2013 Health Care and Nutrition Study (HCNS). Latent profile analysis identified mutually exclusive subgroups of dietary intake and bivariate analyses examined associations between dietary profile membership, participant characteristics and nutrient intakes.
Setting:
USA.
Participants:
An analytic sample of 3558 adults aged 65 years or older.
Results:
Four dietary profiles were identified with 15·5 % of the sample having a ‘Healthy’ diet, 42·0 % consuming a ‘Western’ diet, 29·7 % having a diet consisting of high intake of all food groups and 12·7 % reporting relatively low intake of all food groups. Members of the ‘Healthy’ profile reported the greatest socio-economic resources and health, and members of the ‘Low Intake’ profile had the fewest resources and worst health outcomes. Macronutrient and micronutrient intakes varied across profile although inadequate and excessive intakes of selected nutrients were observed for all profiles.
Conclusions:
We identified dietary patterns among older Americans typified by either selective intake of foods or overall quantity of foods consumed, with those described as ‘Low Intake’ reporting the fewest socio-economic resources, greatest risk of food insecurity and the worst health outcomes. Limitations including the presence of measurement error in dietary questionnaires are discussed. The causes and consequences of limited dietary intake among older Americans require further study and can be facilitated by the HRS and HCNS.
Substantial research shows that cardiovascular disease is a major cause of disability in the United States of America (USA) and worldwide. Despite the well-documented significance of intimate partnerships for cardiovascular health and disease management, how relationship quality contributes to the functional health of older adults diagnosed with cardiovascular disease is much less understood than mental health and mortality risk. Informed by the disablement process model and the lifecourse perspective, this study examines the association between relationship quality and functional limitations among partnered older adults aged 50 years and older diagnosed with cardiovascular disease in the USA. Data are from the Health and Retirement Study, 2006–2012 (N = 1,355). Multi-level linear regression analyses show that baseline negative relationship quality is significantly associated with increased functional limitations over the two- and four-year follow-ups. Additionally, the link between negative relationship quality and functional limitations is stronger among older adults with lower household income over a two-year span, compared to their higher-income counterparts, suggesting that these older adults are doubly disadvantaged by higher relationship strains and limited economic resources. Our findings demonstrate the significance of relationship quality for the functional health of older adults with cardiovascular disease and shed light on the importance of marriage/partnerships as an important social context for a critical stage in the disablement process (i.e. functional limitations).
I analyze the effects of state public pension parameters on the retirement of public employees. Using a panel data set of public sector workers from 12 waves of the Health and Retirement Study, I model the probability of retirement as a function of pension wealth at early and normal retirement eligibility and Social Security coverage in the public sector job. I find that becoming eligible for early retirement, or receiving an early-out offer, significantly increases the probability of retiring. I do not find any effect of retirement wealth levels. These findings suggest that state legislative action to affect retirement decisions and reduce future pension costs would be most effective operating through plan eligibility rules and early-out incentives.
The aim of this study was to examine the extent to which an exposure to disaster is associated with change in health behaviors.
Methods
Federal disaster declarations were matched at the county-level to self-reported behaviors for participants in the Health and Retirement Study (HRS), 2000-2014. Multivariable logistic regression was used to evaluate the relationship between disaster and change in physical activity, body mass index (BMI), and cigarette smoking.
Results
The sample included 20,671 individuals and 59,450 interviews; 1,451 unique disasters were declared in counties in which HRS respondents lived during the study period. Exposure to disaster was significantly associated with weight gain (unadjusted RRR=1.19; 95% CI, 1.11-1.27; adjusted RRR=1.21; 95% CI, 1.13-1.30). Vigorous physical activity was significantly lower among those who had experienced a disaster compared to those who had not (unadjusted OR=0.89; 95% CI, 0.84-0.95; adjusted OR=0.84; 95% CI, 0.79-0.89). No significant difference in cigarette smoking was found.
Conclusions
This study found an increase in weight gain and decrease in physical activity among older adults after disaster exposure. Adverse health behaviors such as these can contribute to functional decline among older adults.
BellSA, ChoiH, LangaKM, IwashynaTJ. Health Risk Behaviors after Disaster Exposure Among Older Adults. Prehosp Disaster Med. 2019;34(1):95–97.
One of the major aspects of successful ageing is active engagement in later life. Retirement and widowhood are two significant life transitions that may largely influence leisure engagement patterns among older adults. Limited findings exist regarding the impact of life transitions on leisure activity engagement due to the scarcity of longitudinal data with repeated measurement of older individuals’ leisure engagement. This study longitudinally examined changes in leisure activity engagement as influenced by retirement and widowhood using five waves of national panel data from the Health and Retirement Study and its supplementary Consumption and Activities Mail Survey. Multi-level modelling was conducted with retirement and widowhood status as time-varying variables. Socio-economic status, depressive symptoms, cognitive function, self-rated health and functional limitations were also included as time-varying and time-invariant covariates. Findings show that engagement in mental, physical, social and household activities significantly decreased during an eight-year period. Moreover, transition from working to retired status was associated with increased engagement in mental, social and household activities but decreased engagement in physical activities among men only. Transition from married to widowhood status was associated with decreased engagement in household activities among women only. Encouraging active leisure engagement among individuals who experience either or both life transitions may help maintain their health after transition.
The enormous economic burden of dementia in the United States of America falls disproportionately on families coping with this devastating disease. Black Americans, who are at greater risk of developing dementia than white Americans, hold on average less than one-eighth of the wealth of white Americans. This study explores whether dementia exacerbates this wealth disparity by examining dementia's effect on wealth trajectories of black versus non-black Americans over an eight-year period preceding death, using five waves of data (beginning in 2002 or 2004) on decedents in the 2012 and 2014 waves of the Health and Retirement Study (N = 2,429). Dementia is associated with a loss of 97 per cent of wealth among black Americans, compared with 42 per cent among non-black Americans, while wealth loss among black and non-black Americans without dementia did not differ substantially (15% versus 19%). Dementia appears to increase the probability of wealth exhaustion among both black and non-black Americans, although the estimate is no longer significant after adjusting for all covariates (for blacks, odds ratio (OR) = 2.04, 95% confidence interval (CI) = 0.83, 5.00; for non-blacks, OR = 1.47, 95% CI = 0.95, 2.27). Dementia has a negative association with home-ownership, and the loss or sale of a home may play a mediating role in the exhaustion of wealth among black Americans with dementia.
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.
This study examined engagement in leisure activities among older adults, specifically focusing on how life transition factors in later life, including retirement and marital status, are associated with leisure activity engagement using a national sample of older American men and women. We conducted multiple regression analyses with a sample of 5,405 individuals (2,318 men; 3,087 women) from the Consumption and Activities Mail Survey, a supplementary sample of the Health and Retirement Study. We analysed activity engagement in each of four domains of leisure activities: mental, physical, social and religious. Retirement status was categorised into three groups: working (referent), completely retired and partly retired. Marital status was categorised into four groups: married (referent), divorced or separated, widowed and never married. We found an overall trend of a positive relationship between retirement and leisure activity engagement, which suggests that retirement provides a chance for older adults to participate in leisure activities after withdrawal from the labour force. The overall trend of a negative relationship between non-married status and leisure activity engagement suggests that the loss or absence of a spouse may serve as a barrier to participate in leisure activities. Nevertheless, variation among retirees and non-married individuals suggests future studies should compare completely and partly retired individuals or those who are widowed, divorced or separated, or never married to elucidate distinguishable leisure activity profiles.
This article conceptualized emergency preparedness as a complex, multidimensional construct and empirically examined an array of sociodemographic, motivation, and barrier variables as predictors of levels of emergency preparedness.
Methods
The authors used the 2010 wave of the Health and Retirement Study’s emergency preparedness module to focus on persons 50 years old and older in the United States by use of logistic regression models and reconsidered a previous analysis.
Results
The models demonstrated 3 key findings: (1) a lack of preparedness is widespread across virtually all sociodemographic variables and regions of the country; (2) an authoritative voice, in the role of health care personnel, was a strong predictor of preparedness; and (3) previous experience in helping others in a disaster predisposes individuals to be better prepared. Analyses also suggest the need for caution in creating simple summative indexes and the need for further research into appropriate measures of preparedness.
Conclusion
This population of older persons was generally not well prepared for emergencies, and this lack of preparedness was widespread across social, demographic, and economic groups in the United States. Findings with implications for policy and outreach include the importance of health care providers discussing preparedness and the use of experienced peers for outreach. (Disaster Med Public Health Preparedness. 2017;11:80–89)
A dynamic latent structure model of the work–retirement transition process was identified, focusing on transitions of work and retirement status for men and women aged 51–74 years. Using the Health and Retirement Study data (1998–2004), latent transition analysis was used to identify a best fitting model capturing work–retirement statuses in four samples defined by age and sex. The prevalence of each status was described and the dynamic transition probabilities within the latent structure were examined. Using multinomial logistic regression, socio-demographic, health, family and occupational factors were assessed to determine how each was related to the likelihood of occupying a specific latent status at baseline. Results showed that study respondents were classified into distinct groups: full retiree, partial retiree or part-time worker, full-time worker, work-disabled or home-maker. The prevalence of full retiree status increased, while the prevalence for full-time worker status decreased over time for both men and women. Membership rates in the work-disabled and partial retiree status were generally consistent, with decreased probabilities of the work-disabled status in the older age groups and increased probabilities of partial retirees among younger men. Our findings indicated that many older Americans experience multiple transitions on the pathway to retirement. Future research on late-life labour-force transitions should evaluate the impact of the recent Great Recession and examine the role of larger socio-economic contexts.
Studies using data from the early 1990s suggested that while the progressive Social Security benefit formula succeeded in redistributing benefits from individuals with high earnings to individuals with low earnings, it was much less successful in redistributing benefits from households with high earnings to households with low earnings. Wives often earned much less than their husbands. As a result, much of the redistribution at the individual level was effectively from high earning husbands to their own lower earning wives. In addition, spouse and survivor benefits accrue disproportionately to women from high income households. Both factors mitigate redistribution at the household level. It has been argued that with the increase in the labor force participation and earnings of women, Social Security now should do a better job of redistributing benefits at the household level. To be sure, when we compare outcomes for a cohort with a household member age 51 to 56 in 1992 with those from a cohort born twelve years later, redistribution at the household level has increased over time. Nevertheless, as of 2004 there still is substantially less redistribution of benefits from high to low earning households than from high to low earning individuals.
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