Boundaries of the Construct of Unemployment in the Pre-Retirement Years: Exploring an Expanded Measurement of Lost-Work Opportunity

There is uncertainty related to whether retirement negatively affects health—possibly due to complexity around retirement decisions. Lost-work opportunity through unemployment or forced retirement has been shown to negatively affect health. Lost-work opportunity can be captured in two measurement fields, either a reported experience of being forced into retirement or reported unemployment. However, 17% of individuals retiring due to the loss of work opportunity identified in qualitative interviewing (i.e., unemployment, temporary lay-offs, company buy-outs, forced relocations, etc.) do not report this unemployment or involuntary retirement in quantitative survey responses. We propose broadening the conceptualization of late-career unemployment to incorporate other lost work opportunity scenarios. Using the Health and Retirement Study (HRS), a lost-work opportunity score (LOS) was computed from items indicating unemployment and forced or unplanned retirement. Correlations were computed between this LOS and all continuous variables in the RAND longitudinal compilation of the HRS to determine its convergent and discriminant validity. The LOS demonstrated a Chronbach’s alpha of α = .82 and had convergent validity with constructs of employment (9 variables), finances (36 variables), and health (14 variables), as predicted by the literature on retirement timing. No other continuous variables in the HRS were identified with a moderate or strong correlation to LOS, demonstrating discriminant validity. Further research should explore whether a combination of variables in the HRS can improve the accuracy of measuring lost-work opportunity. Improved precision in measurement, through an expanded conceptualization of lost-work opportunity, may help explicate the retirement-related factors that affect health, to inform policy and support healthy aging decisions at a societal level

Arthritis and cognitive impairment in older adults

Adults aged 65 or older with arthritis may be at increased risk for cognitive impairment [cognitive impairment but not dementia (CIND) or dementia]. Studies have found associations between arthritis and cognition impairments; however, none have examined whether persons with arthritis develop cognitive impairments at higher rates than those without arthritis. Using data from the Health and Retirement Study, we estimated the prevalence of cognitive impairments in older adults with and without arthritis, and examined associations between arthritis status and cognitive impairments. We calculated incidence density ratios (IDRs) using generalized estimating equations to estimate associations between arthritis and cognitive impairments adjusting for age, sex, race/ethnicity, marital status, education, income, depression, obesity, smoking, the number of chronic conditions, physical activity, and birth cohort. The prevalence of CIND and dementia did not significantly differ between those with and without arthritis (CIND: 20.8%, 95% CI 19.7-21.9 vs. 18.3%, 95% CI 16.8-19.8; dementia: 5.2% 95% CI 4.6-5.8 vs. 5.1% 95% CI 4.3-5.9). After covariate control, older adults with arthritis did not differ significantly from those without arthritis for either cognitive outcome (CIND IDR: 1.6, 95% CI = 0.9-2.9; dementia IDR: 1.1, 95% CI = 0.4-3.3) and developed cognitive impairments at a similar rate to those without arthritis. Older adults with arthritis were not significantly more at risk to develop cognitive impairments and developed cognitive impairments at a similar rate as older adults without arthritis over 6 years

The burden of health conditions for middle-aged and older adults in the United States: disability-adjusted life years

Abstract Background Many adults are living longer with health conditions in the United States. Understanding the disability-adjusted life years (DALYs) for such health conditions may help to inform healthcare providers and their patients, guide health interventions, reduce healthcare costs, improve quality of life, and increase longevity for aging Americans. The purpose of this study was to determine the burden of 10 health conditions for a nationally-representative sample of adults aged 50 years and older in the United States. Methods Data from the 1998–2014 waves of the Health and Retirement Study were analyzed. At each wave, participants indicated if they were diagnosed with the following 10 conditions: cancer, chronic obstructive pulmonary disease (COPD), congestive heart failure, diabetes, back pain, hypertension, a fractured hip, myocardial infarction, rheumatism or arthritis, and a stroke. Years lived with a disability and years of life lost to premature mortality were summed for calculating DALYs. Sample weights were utilized in the analyses to make the DALY estimates nationally-representative. Results for the DALYs were presented in thousands. Results There were 30,101 participants included. Sex stratified DALY estimates ranged from 4092 (fractured hip)-to-178,055 (hypertension) for men and 13,621 (fractured hip)-to-200,794 (hypertension) for women. The weighted overall DALYs were: 17,660 for hip fractures, 62,630 for congestive heart failure, 64,710 for myocardial infarction, 90,337 for COPD, 93,996 for stroke, 142,012 for cancer, 117,534 for diabetes, 186,586 for back pain, 333,420 for arthritis, and 378,849 for hypertension. In total, there were an estimated 1,487,734 years of healthy life lost from the 10 health conditions examined over the study period. Conclusions The burden of these health conditions accounted for over a million years of healthy life lost for middle-aged and older Americans over the 16 year study period. Our results should be used to inform healthcare providers and guide health interventions aiming to improve the health of middle-aged and older adults. Moreover, shifting health policy and resources to match DALY trends may help to improve quality of life during aging and longevity.https://deepblue.lib.umich.edu/bitstream/2027.42/148568/1/12877_2019_Article_1110.pd

The Association of Coordination with Physical Activity Levels of Older Adults

Aim: To examine the association between coordination ability and self-reported physical activity among community dwelling older adults. Methods: We conducted a cross-sectional study of 77 adults (81.51 ± 5.46 years) using motion capture and a gait walkway to assess rhythmic interlimb ankle, shoulder, and gait coordination. Physical activity was assessed using the Physical Activity Scale for the Elderly (PASE). We conducted multivariable linear regression modeling using backward elimination with age, gender, body mass index, Mini-Mental State Exam score, number of chronic conditions, falls, Short Physical Performance Battery (SPPB) score, and interlimb ankle, shoulder, and gait coordination as predictors, and PASE score as the outcome. Results: Gender and SPPB score accounted for 19.4% and the three coordination measures an additional 10%, of the variance in PASE score. Conclusion: The results showed that ankle, shoulder, and gait coordination contribute to self-reported physical activity levels among older adults, even after accounting for SPPB score

Problem Drinking among Mexican-Americans: The Influence of Nativity and Neighborhood Context?

We examined the influence of nativity and community context (Hispanic neighborhood concentration) on two measures of problem drinking among Mexican-Americans

Is Sensory Loss an Understudied Risk Factor for Frailty? A Systematic Review and Meta-analysis

[Abstract] Background. Age-related sensory loss and frailty are common conditions among older adults, but epidemiologic research on their possible links has been inconclusive. Clarifying this relationship is important because sensory loss may be a clinically relevant risk factor for frailty. Methods. In this systematic review and meta-analysis, we searched 3 databases for observational studies investigating 4 sensory impairments—vision (VI), hearing (HI), smell (SI), and taste (TI)—and their relationships with frailty. We meta-analyzed the cross-sectional associations of VI/HI each with pre-frailty and frailty, investigated sources of heterogeneity using meta-regression and subgroup analyses, and assessed publication bias using Egger’s test. Results. We included 17 cross-sectional and 7 longitudinal studies in our review (N = 34,085) from 766 records. Our cross-sectional meta-analyses found that HI and VI were, respectively, associated with 1.5- to 2-fold greater odds of pre-frailty and 2.5- to 3-fold greater odds of frailty. Our results remained largely unchanged after subgroup analyses and meta-regression, though the association between HI and pre-frailty was no longer significant in 2 subgroups which lacked sufficient studies. We did not detect publication bias. Longitudinal studies largely found positive associations between VI/HI and frailty progression from baseline robustness, though they were inconclusive about frailty progression from baseline pre-frailty. Sparse literature and heterogenous methods precluded meta-analyses and conclusions on the SI/TI–frailty relationships. Conclusions. Our meta-analyses demonstrate significant cross-sectional associations between VI/HI with pre-frailty and frailty. Our review also highlights knowledge gaps on the directionality and modifiability of these relationships and the impact of SI/TI and multiple sensory impairments on frailty

Cardiovascular disease, depressive symptoms, and heart failure in Mexican American aged 75 years and older during 12 years of follow up

Objective: To examine the relationship of cardiovascular disease (CVD) and high depressive symptoms (HDS) with heart failure (HF) among Mexican American older adults without HF at baseline over 12-years of follow-up. Methods: A 12-year prospective cohort study of 1,018 Mexicans Americans aged 75 and older from the Hispanic Established Population for the Epidemiologic Study of the Elderly (2004–2016). Measures included socio-demographics, CVD (heart attack or stroke), HDS, smoking status, body mass index, cognitive function, and HF. Participants were grouped into: CVD and HDS (n = 11), CVD only (n = 122), HDS only (n = 44), and no CVD or HDS (n = 841). Odds ratio (OR) and 95 % Confidence Interval (CI) of HF over time were estimated using the Generalized Estimating Equation. Results: Participants with CVD and HDS and those with HDS only had greater odds (OR=4.70, 95 %CI=1.98–11.2 and OR=3.26, 95 %CI=1.82–5.84, respectively) of HF over time, after controlling for all covariates. No significant association was found between CVD only and HF (OR=1.25, 95 %CI=0.90–1.76). Conclusion: Mexican American older adults with HDS only or both HDS and CVD were at high risk of HF. Appropriate management of CVD and depressive symptoms may reduce the onset of HF among this population

Falls among elderly persons in Latin America and the Caribbean and among elderly Mexican-Americans Las caídas en ancianos de América Latina y el Caribe y en ancianos mexicanoestadounidenses

OBJECTIVE: To estimate the prevalence of and risk factors for falls among community-dwelling elders in Latin America and the Caribbean and among elderly Mexican-Americans in the southwestern United States. METHODS: Data for the study came from a project called Health, Well-Being, and Aging in Latin America and the Caribbean (Salud, Bienestar y Envejecimiento en América Latina y el Caribe) (the "SABE project") (surveys from seven cities, with a total of 9 765 subjects) and from the Hispanic Established Populations for Epidemiologic Studies of the Elderly (H-EPESE) (1 483 subjects). RESULTS: The overall prevalence of falls across the seven SABE cities and the H-EPESE ranged from 21.6% in Bridgetown, Barbados, to 34.0% in Santiago, Chile. In multiple logistic regression analyses, female gender, increased age, high depressive symptoms, and having any functional limitations were significant independent risk factors for falls in most of the cities studied as well as among the elderly Mexican-Americans. In several of the cities, significant risk factors also included diabetes, urinary incontinence, and arthritis. CONCLUSIONS: The prevalence of falls had a large variation among the countries studied. Some of the risk factors that we identified could be modified so as to help prevent falls in older people in these populations. The factors deserving attention include depressive symptoms, functional limitations, diabetes, and urinary incontinence.<br>OBJETIVO: Estimar la prevalencia de caídas y de sus factores de riesgo en ancianos que habitan en el seno de la comunidad en América Latina y el Caribe y en ancianos mexicanoestadounidenses que viven en la zona sudoeste de Estados Unidos. MÉTODOS: Los datos usados para el estudio procedieron del proyecto Salud, Bienestar y Envejecimiento en América Latina y el Caribe (proyecto "SABE") (encuestas en siete ciudades que abarcaron a un total de 9 765 personas) y de las Poblaciones Hispanas Establecidas para Estudios Epidemiológicos en Ancianos [Hispanic Established Populations for Epidemiologic Studies of the Elderly (H-EPESE)] (1 483 personas). RESULTADOS: La prevalencia general de caídas en personas de edad en las siete ciudades que participaron en el proyecto SABE varió de 21,6% en Bridgetown, Barbados, a 34,0% en Santiago, Chile. Según análisis de regresión logística, el ser de sexo femenino, tener más edad, y tener síntomas de depresión profunda o alguna limitación funcional fueron factores de riesgo asociados de forma independiente y estadísticamente significativa con las caídas en personas de edad en la mayor parte de las ciudades estudiadas, así como en ancianos mexicanoestadounidenses. En varias ciudades también fueron factores de riesgo estadísticamente significativos la diabetes, la incontinencia urinaria y la artritis. CONCLUSIONES: La prevalencia de caídas varió mucho entre los países estudiados. Algunos de los factores de riesgo identificados se podrían modificar a fin de prevenir las caídas en personas de edad avanzada en estas poblaciones. Los factores a los que se debe prestar atención son los síntomas de depresión, las limitaciones funcionales, la diabetes y la incontinencia urinaria