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Objectives Informal care provided by adult children is of great importance for older adults' well-being in China. This paper investigates and compares the functional transitions among older adults living in rural areas who receive care from daughters' and from sons' families. Methods This study utilizes the "Well-being of Elderly Survey in Anhui Province" (WESAP) from 2001 to 2021. Our sample included 2,797 individuals aged 60 years or older. Functional status was based on the activities of daily living and the instrumental activities of daily living. We employed a random-effects ordered logit model to examine the functional transitions among the older adults. Results Receiving care from daughters' families is significantly associated with a lower likelihood of functional decline compared to receiving care from sons' families in rural China. The advantage associated with daughter care becomes more pronounced among older individuals with a severe functional difficulty compared to those with a mild or moderate functional difficulty. The difference is prevalent among older adults aged 75 and older, with less wealth or multiple chronic diseases, or who live alone. Furthermore, among those with severe functional difficulties, the daughter advantage is more significant for fathers as compared to mothers. Discussion Nowadays, daughters' families can provide high-quality informal care, often surpassing that offered by sons' families. This daughter advantage becomes even more significant among older adults who have a higher need for family care, such as those with severe disabilities and limited financial resources. [ABSTRACT FROM AUTHOR]

In celebration of the National Institute on Aging's (NIA) 50th anniversary, this paper highlights the significant advances in cognitive aging research and the promotion of cognitive health among older adults. Since its inception in 1974, the NIA has played a pivotal role in understanding cognitive aging, including cognitive epidemiology, interventions, and methods, for measuring cognitive change. Key milestones include the shift toward understanding cognitive impairment and Alzheimer's disease and Alzheimer's disease-related dementias (AD/ADRD), the development of large-scale longitudinal studies, and the incorporation of AD/ADRD-related biomarkers in cognitive aging cohorts. Additionally, NIA has championed diversifying the scientific workforce through initiatives, such as the Resource Centers for Minority Aging Research and the Butler-Williams Scholars Program. The next 50 years will continue to emphasize the importance of inclusion, innovation, and impactful research to enhance the cognitive health and well-being of older adults. [ABSTRACT FROM AUTHOR]

Objectives Previous studies have indicated that compared to older adults, younger older adults (e.g. baby boomers) are more susceptible to obesity, but their risk decreases as they age. However, there is a lack of research on how individuals experience sarcopenic obesity, which increases in later life and is a mortality risk factor. This study examined how younger cohorts of older Americans and their demographic traits are related to sarcopenic obesity. Methods Generalized estimating equations were used to analyze participants aged 65 years and older, stratified by sex using data from the 2006–2016 Health and Retirement Study, with survey weights (n = 2,896 men and n = 4,268 women). Results The findings indicate that the youngest cohort (born between 1948 and 1953) had greater odds of sarcopenic obesity than older cohorts (born before 1931). However, the youngest cohort did not have significantly different risks from those born between 1931 and 1947. Unexpectedly, the youngest cohort of older women living alone tended not to have sarcopenic obesity compared to the older cohorts living alone. These results remained significant even after adjusting for various covariates, including marital status, race, education level, wealth, and other factors. Discussion This paper contributes to the existing literature on population health and demographic change in 2 ways. First, the risk of sarcopenic obesity is higher among younger cohorts of older Americans relative to older cohorts (born before 1931). Second, living alone may not necessarily be considered a worse health condition, particularly for younger female cohorts. [ABSTRACT FROM AUTHOR]

Objectives Research among older adults reveals that the loss of core network members is a risk factor for loneliness. Still, it is not clear whether all such losses induce similar levels of loneliness, particularly as network members are distributed at varied geographic distances. Neither is it clear whether tie addition—the other ubiquitous aspect of network turnover in later life—offsets the loneliness that arises from different network loss scenarios. Methods This paper scrutinized core network losses across multiple relationship–distance scenarios. We used the fourth and sixth waves of data from the Survey of Health, Ageing, and Retirement in Europe and estimated fixed-effect models. Results The loss of a child from a core network increases feelings of loneliness across variant distances, especially when not complemented by additional connections. Losing relatives or nonkin core connections in proximity (within 1 km and 5 km radius, respectively) is also associated with increased loneliness, yet such effects are also largely mitigated by the addition of new core network members. Discussion The relationship between core network member losses and loneliness can significantly differ based on the nature of the lost connection and its geographic distance. Active rebalancing of one's core network following losses and proactive network expansion can serve as pivotal strategies to prevent loneliness for the aging population. [ABSTRACT FROM AUTHOR]

An introduction is presented in which the editor discusses the various topics within the issue, including loneliness progression among older adults, the cultural factors that could promote resilience, and psychology and aging during the COVID-19 pandemic.

Objectives Social cognitive function often declines in older age but the mechanisms underlying these declines are not completely clear. Cardiorespiratory fitness (CRF) and muscular strength are positively associated with broader cognitive function in older adults, yet surprisingly, no study has examined whether a similar relationship exists between CRF or muscular strength and social cognition in older age. Methods We assessed whether higher CRF and muscular strength were associated with enhanced social cognitive function in a sample of fifty older adults (M age = 70.08, standard deviation = 3.93). Participants completed a gold-standard cardiopulmonary exercise test to assess CRF, an isometric handgrip strength test to index muscular strength, and validated measures of social cognition to index emotion perception and theory of mind (ToM). Results The results showed that CRF and muscular strength did not explain any unique variance in older adults' social cognitive performance. Bayesian analyses confirmed that the evidence for the null hypothesis was moderate for all tested relationships, except for the relationship between CRF and cognitive ToM where the evidence for the null was anecdotal. Discussion This study has provided the first evidence to suggest that CRF and muscular strength—two important modifiable lifestyle factors—are not associated with social cognition in healthy older adults. However, replication studies are now needed to cross-validate these findings and to clarify whether any moderating variables may be important for understanding the relationship between fitness and social cognition in older age. [ABSTRACT FROM AUTHOR]

Objectives Previous evidence about the impact of parenthood on health for older adults is mixed, perhaps due to variation in number of children and context. Higher numbers of children could lead to support or strain, depending on individual and country contexts. Yet, no studies currently exist that examine associations between the number of children and several health indicators among older adults across multiple global regions. Methods We analyze cross-sectional data (1992–2017) of 166,739 adults aged 50+ across 24 countries from the Health and Retirement Study family of surveys to document associations between the number of children, treated as a categorical variable, and 5 health outcomes (self-rated health, activities of daily living limitations, instrumental activities of daily living limitations, chronic conditions, and depression). We perform multivariable analyses by estimating logistic regression models for each country and each outcome. Results Multiple comparisons between categories of number of children revealed at least 1 significant difference in each country, and a majority of significant differences indicated those with more children had poorer health. The risk of poorer health for parents of multiple children was observed in 15 countries, but in some countries, fewer children predict poorer health. The greatest number of differences was identified for depression and chronic conditions, and very few for functional limitations. Discussion We observe a greater probability that more children are associated with poorer health in later life, especially for chronic conditions and depression. However, a universal global or regional pattern could not be identified. These findings raise new questions about how country contexts shape fertility and health. [ABSTRACT FROM AUTHOR]

Objectives To develop effective promotion strategies for exercise behavior in older adults, it is essential to identify the psychological determinants. Previous studies investigated affective and instrumental attitudes as determinants. However, from the conceptual assumptions of socioemotional selectivity theory, affective attitudes might be more influential on the exercise behavior of older adults with an expansive future time perspective, whereas instrumental attitudes would be more influential on those with limited perspectives. This study examined whether the associations of affective and instrumental attitudes with behavioral intention and exercise behavior differed according to future time perspective among older Japanese adults. Methods Data were obtained from a 3-wave longitudinal questionnaire survey of 886 individuals (Wave 1: December 2017–January 2018; Wave 2, 1-year follow-up; Wave 3, 3-year follow-up). Using the data on exercise behavior, affective and instrumental attitudes, and behavioral intention at each wave, and the data of future time perspective and demographic factors at Wave 1, this study performed multiple regression analyses and a multigroup cross-lagged model. Results Affective attitude was a significant predictor of behavioral intention regardless of future time perspective. Although instrumental attitude significantly predicted behavioral intention among those with a lower future time perspective, it did not predict behavioral intention among those with middle-to-higher future time perspective. Regardless of future time perspective, affective attitude, but not instrumental attitude, significantly predicted exercise behavior. Discussion Unlike the socioemotional selectivity theory, this study found that affective attitude was more influential on exercise behavior than instrumental attitude regardless of future time perspective among them. [ABSTRACT FROM AUTHOR]

Objectives To quantify how poor health and inhospitable working conditions each contribute to educational disparities in work disability in midlife and old age. Methods We used the Health and Retirement Study (2006–2016) to examine educational disparities in reporting "any impairment or health problem that limits the kind or amount of paid work" in ages 51–80. Results We found disparities to be profound and persistent over time. Blinder–Oaxaca threefold decomposition revealed that distributions of income and employer insurance made the largest contribution to explaining different rates of work limitations among respondents with versus without high school degrees, followed by work characteristics (physical job demands, insufficient hours) and health conditions (diabetes, lung disease). Comparing respondents with high school versus college degrees, distributions of health conditions mattered most (high blood pressure, lung disease, heart disease, stroke), followed by health behaviors (smoking, drinking). Health-induced work limitations are often used as a measure of health, but we found that work characteristics explained 57% of the disadvantage of those without a high school degree and 44% of the disadvantage of high school compared to college graduates. Discussion Work environments appear to play an important role in educational disparities in mid- to late-life disability. [ABSTRACT FROM AUTHOR]

Objectives Telehealth use flourished during the COVID-19 pandemic, as older patients faced obstacles to seeking in-person care. Heavy reliance on telehealth may continue postpandemic, due to increased Medicare investments in its use. However, it is unclear if older adults with disabilities face obstacles to effective telehealth use. We evaluate (a) how sensory, physical, and cognitive impairments affect older adults' use of telehealth only, traditional in-person care only, neither, or both (i.e. combined care); and (b) whether these patterns differ on the basis of socioeconomic and social resources that may facilitate telehealth use. Method Data are from the Self-Administered Questionnaire in the 2020 wave of the Health and Retirement Study (n  = 4,453). We estimated multinomial logistic regression models to evaluate associations between impairments and health care service use and tested 2-way interaction terms to evaluate moderation effects. Results Persons without impairments were most likely to use combined care, considered the optimal form of care. Persons with vision or cognitive impairment were more likely to use telehealth or traditional care only, whereas persons with 3 or more physical limitations were least likely to use telehealth alone, relative to combined care. Patterns did not differ significantly on the basis of any of the potential moderators. Discussion We discuss implications for health care policy and practice, in light of reimbursement changes proposed by the Centers for Medicare and Medicaid Services for telehealth services. These proposals include the elimination of voice-only services which may be particularly beneficial to vision-impaired older adults. [ABSTRACT FROM AUTHOR]

Objectives To provide a longitudinal analysis of how functional decline over time among older adults affects provision of family and unpaid care, overall and stratified by dementia status. Methods Longitudinal cohorts of community-dwelling adults ≥65 years between 2015 and 2017 from the National Health and Aging Trends Study (NHATS; n  = 5,103) and their caregivers from the National Study of Caregiving (n  = 862 caregivers for 595 NHATS care recipients). A panel data fixed-effects model was used to examine how increases in mobility, self-care, and household activity-related impairment between 2015 and 2017 affected family and unpaid care (care recipient reported: total number of family and unpaid caregivers, total hours of care received; caregiver reported: hours of care provided, caregiving-related emotional, and physical difficulties). Results Among community-dwelling older adults overall, impairment in 1 additional self-care activity led to 0.12 more caregivers and 19 additional total monthly hours of care. Among those with dementia, impairment in 1 additional self-care activity led to 0.14 more caregivers and 28 additional total monthly hours of care; among those without dementia, this was 0.11 caregivers and 15 total monthly hours of care. For dementia caregivers, impairment in 1 additional self-care activity among their care recipients led to 8% higher probability of caregiving-related emotional difficulty. Discussion There is a mismatch between the large additional hours of care received by older adults who experience functional decline (particularly self-care activities) and the relatively small accompanying increase in family and unpaid caregivers. Targeted functional supports, particularly for self-care activities, may benefit both older adults and their caregivers. [ABSTRACT FROM AUTHOR]

Objectives Older adults often have difficulty remembering the details of recently encountered objects. We previously found this with the Mnemonic Similarity Task (MST). Surprisingly, the older adults' MST Lure Discrimination Index (LDI) was significantly correlated with visual acuity but not with memory or executive function. Here we ran a replication with new, larger samples of young (N = 45) and older adults (N = 70). We then combined the original and replication older adult samples (N = 108) to critically examine the relative contributions of visual acuity, memory, and executive function composite scores to LDI performance using dominance analysis. This provided, to our knowledge, the first direct statistical comparison of all 3 of these factors and their interactions on LDI. Methods Participants completed the MST and a battery assessing visual acuity, memory, and executive function. We examined age group differences on MST performance in the new (i.e. replication) young and older adult samples and performed multiple regression and dominance analysis on the combined older adult sample. Results Consistent with previous findings, the older adults showed significantly poorer LDI but preserved item recognition. LDI was significantly correlated with both memory and executive function but not with visual acuity. In the combined older adult sample, all 3 composites predicted LDI, but dominance analysis indicated that executive function was the most important predictor. Discussion Older adults' MST LDI difficulty may be predicted by their executive function and visual acuity. These factors should be considered when interpreting older adults' MST performance. [ABSTRACT FROM AUTHOR]

Objectives To test the hypotheses that decision making ability declines in old age and that a higher level of cognitive reserve is associated with a reduced rate of decline. Methods As part of an ongoing cohort study, 982 older adults without dementia at study enrollment completed measures of purpose in life and cognitive activity which were used as markers of cognitive reserve. At annual intervals thereafter, they completed 6 tests of decision making. Results In a factor analysis of baseline decision making scores, 3 measures (financial/health literacy, financial/health decision making, scam susceptibility) loaded on an "analytic" factor and 3 (temporal discounting small stakes, temporal discounting large stakes, risk aversion) loaded on a "preferences" (for temporal discounting and avoiding risk) factor. During a mean of 4.7 years of follow-up (standard deviation = 2.9), analytic factor scores decreased (mean = 0.042-unit per year, standard error [ SE ] = 0.006, p <.001) and preferences factor scores increased (mean = 0.021-unit per year, SE = 0.006, p <.001), with a correlation of 0.13 (p <.001) between rates of change. Evidence of an association between cognitive reserve and decision making was mixed with purpose in life related to change in analytic decision making, whereas past (but not current) cognitive activity was related to change in decision making preferences. Discussion Decision making analysis and preferences change over time in late life. Change over time in decision making components is relatively independent and differentially related to age and cognitive reserve. [ABSTRACT FROM AUTHOR]

Objectives Connections between social integration and health throughout the life span are well established, including at the neighborhood level and among older adults. Less explored is how pathways between neighborhood social cohesion and well-being may differ by race/ethnicity or by neighborhood disorder. This study investigates whether perceived neighborhood social cohesion is associated with loneliness in adults aged 50 and older, and whether this association is moderated by race/ethnicity or perceived neighborhood disorder. Methods We used pooled cross-sectional data from the 2016 and 2018 waves of the Health and Retirement Study and respondents to the Leave-behind Questionnaire age 50 and older, living in the community (N = 10,713). Data were analyzed using multivariate ordinary least squares regression. Results Perceived social cohesion was negatively associated with loneliness (B = −0.13, p <.001); however, this effect was strongest among White respondents, and significantly weaker for respondents who were Black (B = 0.02, p <.05), Hispanic (B = 0.03, p <.05), or of another race/ethnicity (B = 0.03, p <.05). Further, neighborhood disorder moderated the association between social cohesion and loneliness (B = 0.02, p <.001), reducing the strength of relationship for those in areas of high disorder. Inclusion of this interaction also attenuated the interaction between neighborhood cohesion and race for Black older adults. Discussion Findings show that neighborhood social cohesion matters for midlife and older adults' loneliness, but that this relationship varies by race/ethnicity and neighborhood disorder. As such, neighborhood racial/ethnic makeup and both social and objective neighborhood characteristics should be considered when designing interventions to reduce loneliness. [ABSTRACT FROM AUTHOR]

Objectives We aim to investigate the association between children's economic status and parents' self-rated health and examine the potential mediating mechanisms for this relationship. Methods Utilizing nationally representative data in China in 2014, this study predicted parent's self-rated health from children's economic status using inverse probability of treatment weighting to account for selection and endogeneity bias. We further examined depressive symptoms, kin and nonkin social support networks, emotional closeness to children, and economic support from children, as potential mediators of this relationship. Results The study reveals that parents whose children had greater economic success tended to have better self-rated health. For both rural and urban older adults, depressive symptoms served as the most influential mediator. However, only among rural older adults did the size of their support networks mediate the relationship between children's economic status and perceived health. Discussion The results from this study suggest that children's economic success contributes to better self-rated health among older adults. In part, this relationship was explained by better emotional well-being and greater availability of support resources among parents in rural areas with successful children. This quasi-causal analysis demonstrates that adult children remain important for the well-being of their older parents in China, but also suggests that health inequalities in later life are exacerbated by the chance of having economically successful offspring. [ABSTRACT FROM AUTHOR]

Objectives Measuring cognition in an aging populabtion is a public health priority. A move towards survey measurement via the web (as opposed to phone or in-person) is cost-effective but challenging as it may induce bias in cognitive measures. We examine this possibility using an experiment embedded in the 2018 wave of data collection for the U.S. Health and Retirement Study (HRS). Methods We utilize techniques from multiple group item response theory to assess the effect of survey mode on performance on the HRS cognitive measure. We also study the problem of attrition by attempting to predict dropout and via approaches meant to minimize bias in subsequent inferences due to attrition. Results We find evidence of an increase in scores for HRS respondents who are randomly assigned to the web-based mode of data collection in 2018. Web-based respondents score higher in 2018 than experimentally matched phone-based respondents, and they show much larger gains relative to 2016 performance and subsequently larger declines in 2020. The differential in favor of web-based responding is observed across all items, but is most pronounced for the Serial 7 task and numeracy items. Due to the relative ease of the web-based mode, we suggest a cutscore of 12 being used to indicate CIND (cognitively impaired but not demented) status when using the web-based version rather than 11. Discussion The difference in mode may be nonignorable for many uses of the HRS cognitive measure. In particular, it may require reconsideration of some cutscore-based approaches to identify impairment. [ABSTRACT FROM AUTHOR]

Objectives This study examined short- and long-term psychological adjustment to parental bereavement in later life for mothers and fathers. Methods Using 9 waves of data from the United States (1998–2014 Health and Retirement Study), I estimated trajectories of mothers' and fathers' depressive symptoms surrounding child death in later life, highlighting gender differences in adjustment. Moderation analyses were performed to uncover heterogeneous trajectories across parental characteristics. Results Mothers were more likely to experience child death and reported higher depressive symptoms prior to parental bereavement than fathers. Mothers and fathers who lost a child reported an increase in depressive symptoms that diminished over time. The short-term elevation in depressive symptoms was marginally greater for mothers than fathers, but depressive symptoms declined at a faster rate for mothers than fathers in the years following the death. These counterbalancing changes resulted in mothers and fathers returning to their respective prebereavement levels of depressive symptoms between 2 and 4 years postbereavement. Parental age moderated trajectories distinctly by gender, and the presence of surviving children buffered the impact of child death on depressive symptoms for mothers but not fathers. Discussion Mothers more often experience child death in later life and their adjustment process differs from that of fathers, underscoring the salience of gender in shaping how older parents respond to the death of a child. Older parents and mothers without surviving children are vulnerable to prolonged elevations in depressive symptoms following the death of a child in later life. [ABSTRACT FROM AUTHOR]

Objectives The main purpose of the study has been to examine changes in Internet use among men and women in 3 age groups (midlife, early old age, and advanced old age) between 2014 and 2021. We tested 2 hypotheses: The complementary hypothesis posits that online activities reproduce gender differences in offline activities. The compensatory hypothesis posits that women are catching up over time in male-typed activities as Internet access approaches saturation for both genders. Methods We used representative, longitudinal data from the German Ageing Survey collected in 2014, 2017, 2020, and 2021 (n = 21,505, age range 46–90 years). We ran logistic regressions on Internet access and Internet use for 4 different gender-typed activities: social contact (female-typed), shopping (gender-neutral), entertainment (male-typed), and banking (male-typed). Results Between 2014 and 2021, women drew level with men in Internet access. Gender differences in all 4 forms of Internet use declined considerably between 2014 and 2021. Women overtook men in using the Internet for social contact. In older age groups, men held the lead regarding online banking. During the coronavirus disease 2019 (COVID-19) crisis, women caught up to men in Internet use, especially for entertainment. Discussion Overall time trends support the complementary hypothesis. By contrast, the finding that women have been catching up in some male-typed online activities during the COVID-19 pandemic supports the compensatory hypothesis. [ABSTRACT FROM AUTHOR]

Objectives Negative age stereotypes have negative, assimilative effects on the subjective aging experience due to internalization processes, but sometimes positive contrast effects are reported as well, reflecting dissociation and downward comparisons. Our aim was thus to compare short-term and long-term consequences of age stereotypes on the subjective aging experience, to test the hypothesis that contrast effects are visible cross-sectionally, whereas internalization processes are observed when considering long-term changes. Methods We assessed age stereotypes and subjective age in a core sample of N = 459 participants (initial age range 30–80 years) from the Ageing as Future project across 3 consecutive measurement occasions spanning a longitudinal interval of 10 years. Short-term and long-term effects were estimated with latent growth models by assessing the effects of age stereotypes on the intercepts (cross-sectional) and on the slopes (longitudinal) of subjective age, respectively, while controlling for current self-views. Results Age stereotypes had opposite effects on subjective age depending on the time frame. A cross-sectional contrast effect was found, whereas longitudinal effects were assimilative in nature. Discussion Our findings support the time-dependent nature of the effects of age stereotypes on the subjective aging experience. Negative age stereotypes temporarily lead to a significantly younger subjective age, indicating dissociation from one's age group and downward comparison. In the long run, however, negative (positive) age stereotypes become internalized into the self-views of older people and are linked to a relatively older (younger) subjective age. [ABSTRACT FROM AUTHOR]

Objectives The natural learning experience from infancy to emerging adulthood, when considerable cognitive and functional growth is observed, mandates learning multiple real-world skills simultaneously. The present studies investigated whether learning multiple real-world skills simultaneously is possible in older adults and also whether it improves both their cognitive abilities (working memory, episodic memory, and cognitive control) and functional independence. Methods Over two studies (15 and 27 participants), older adults learned at least three new skills (e.g. Spanish, drawing, music composition) simultaneously for 3 months. Participants completed cognitive and functional assessments before, during, and after the intervention in both studies. Participants were recruited sequentially for an intervention or no-contact control group in Study 1, and Study 2 included only an intervention group, who also completed assessments 4–6 weeks prior to the start of the intervention (i.e. they served as their own control group). Results Results from both studies show that simultaneously learning multiple skills is feasible and potentially beneficial for healthy older adults. Learning multiple skills simultaneously increased cognitive abilities in older adults by midpoint of the intervention, to levels similar to performance in a separate sample of middle-aged adults. Discussion Our findings demonstrate the feasibility and potential of conducting a real-world skill-learning intervention involving learning three novel skills with older adults. Our multiskill intervention may provide broad cognitive gains, akin to the benefits experienced earlier in the life span. [ABSTRACT FROM AUTHOR]

Objectives Despite media and public dialog portraying loneliness as a worsening problem, little is known about how the prevalence of loneliness has changed over time. Our study aims to identify (a) temporal trends in episodic and sustained loneliness (lonely in 1 wave vs consistently lonely in 3 consecutive waves); (b) trends across sociodemographic subgroups by sex, race/ethnicity, birth cohort, education, employment status, marital status, and living alone; and (c) longitudinal predictors of loneliness in middle-aged and older Americans (≥50 years). Methods Based on Waves 3 (1996) to 14 (2018) of the Health and Retirement Study (n = 18,841–23,227), we conducted a series of lagged mixed-effects Poisson regression models to assess trends of episodic and sustained loneliness in the overall and sociodemographic subgroup samples (by sex, race/ethnicity, birth cohort, education, employment, relationship, and living alone status). To examine the predictors of episodic and sustained loneliness, we used a multivariate mixed-effects Poisson regression model with all sociodemographic variables entered into the same model. Results Episodic loneliness prevalence decreased from 20.1% to 15.5% and sustained loneliness from 4.6% to 3.6%. Trends were similar across most subgroups. Males, Caucasians, those born in 1928–1945, with university education, working, married/partnered, and those not living alone reported lower episodic and sustained loneliness, although associations with sustained loneliness were stronger. Discussion Contrary to common perceptions, loneliness has decreased over 20 years of follow-up in middle-aged and older Americans. Several sociodemographic subgroups have been identified as having a higher risk of loneliness, prompting targeted public health attention. [ABSTRACT FROM AUTHOR]

Objectives This study pursued 3 goals: (1) to determine how depressive symptoms among U.S. older adults changed in 2018–2020, a period transitioning to the first wave of coronavirus disease (COVID) pandemic, compared to in prepandemic periods, (2) to determine whether physical disability predicts change in depressive symptoms in 2018–2020, and (3) to assess whether psychological resilience moderates the association between physical disability and change in depressive symptoms in 2018–2020. Methods Based on biennial longitudinal data of the Health and Retirement Study from 2010 to 2020, we used a before–after design and latent change score model to examine whether depressive symptoms change in 2018–2020 represents a continuation or departure from the overall trend of between-wave changes in 2010–2018. We also used physical disability in 2018 and psychological resilience in 2016–2018 to predict depressive symptoms change score in 2018–2020. Results In contrast to the relatively stable between-wave change trend in 2010–2018, there was an abrupt elevation in the latent change score of depressive symptoms in 2018–2020, which was primarily driven by increased affective symptoms (e.g. depressed mood, loneliness, unhappiness, and sadness). Increase in depressive symptoms in 2018–2020 was associated positively with physical disability but negatively with psychological resilience. Moderation effect of psychological resilience, however, was not significant. Discussion Our findings reveal heavier COVID-related mental health burden for older adults with physical disabilities and the potential benefits of enhancing individual psychological resilience. They also suggest that health interventions addressing the COVID impacts need to particularly focus on the affective aspects of depressive symptoms. [ABSTRACT FROM AUTHOR]

Objectives To examine the circumstances and needs of older adults who were "kinless," defined as having no living spouse or children, when they developed dementia. Methods We conducted a secondary analysis of information from the Adult Changes in Thought study. Among 848 participants diagnosed with dementia between 1994 and 2016, we identified 64 who had no living spouse or child at dementia onset. We then conducted a qualitative analysis of administrative documents pertaining to these participants: handwritten comments recorded after each study visit, and medical history documents containing clinical chart notes from participants' medical records. Results In this community-dwelling cohort of older adults diagnosed with dementia, 8.4% were kinless at dementia onset. Participants in this sample had an average age of 87 years old, half lived alone, and one third lived with unrelated persons. Through inductive content analysis, we identified 4 themes that describe their circumstances and needs: (1) life trajectories, (2) caregiving resources, (3) care needs and gaps, and (4) turning points in caregiving arrangements. Discussion Our qualitative analysis reveals that the life trajectories that led members of the analytic cohort to be kinless at dementia onset were quite varied. This research highlights the importance of nonfamily caregivers and participants' own roles as caregivers. Our findings suggest that clinicians and health systems may need to work with other parties to directly provide dementia caregiving support rather than rely on family, and address factors such as neighborhood affordability that particularly affect older adults who have limited family support. [ABSTRACT FROM AUTHOR]

Objectives This study examines how age and cognitive ability predict use of different emotion regulation strategies in a laboratory task eliciting emotions varying in valence and arousal. Methods Participants (N = 287) aged 25–85 completed the NIH Toolbox Cognitive Battery and an emotion regulation task in a laboratory setting. They watched a series of emotional clips (disgust, sadness, amusement, and contentment) under instructions to increase positive emotions or decrease negative emotions. After each clip, they rated the extent to which they used emotion regulation strategies that involve different types of engagement with emotional stimuli and disengagement from emotional stimuli. Results Older age was predictive of greater use of immersive-engagement strategies (e.g. perspective taking) and less use of disengagement strategies (e.g. distraction). Fluid cognitive ability was positively associated with immersive-engagement strategy use, particularly for high-arousal clips. For older adults, fluid cognitive ability was also associated with using positive-engagement strategies (e.g. positive reappraisal) to a greater extent to regulate negative emotions. Discussion Patterns of emotion regulation strategy use varied by age, even when accounting for differences in reactivity. Findings suggest that older adults may not necessarily prefer strategies that are lower in cognitive demands or that focus on enhancing positivity. Results support the idea that strategy preferences are driven by a combination of characteristics of the regulator and the regulation context. The relevance of cognitive resources likely varies across situations, perhaps being most consequential for deeper processing of high-arousal stimuli and for older adults' engagement with positive aspects of an otherwise negative situation. [ABSTRACT FROM AUTHOR]

Objectives This study aims to examine age differences in the intensity of chronic pain among middle-aged and older adults, where intensity is measured on a scale differentiating between chronic pain that is often troubling and likely requires intervention versus more endurable sensations. We aim to explore whether individual health and national gross domestic product (GDP) explain these differences as well. Methods Cross-nationally harmonized data from 20 countries on self-reported intensity of chronic pain (0 = no, 1 = mild, 2 = moderate, 3 = severe) in 104,826 individuals aged 50+ observed in 2012–2013. Two-level hierarchical ordinal linear models with individuals nested within countries were used to isolate estimations from heterogeneity explained by methodological differences across single-country studies. Results Overall, mean participant age was 66.9 (SD = 9.9), 56.1% were women, and 41.9% of respondents reported any chronic pain. Chronic pain intensity rose sharply with age in some countries (e.g. Korea and Slovenia), but this association waned or reversed in other countries (e.g. the United States and Denmark). Cross-country variation and age differences in chronic pain were partly explained (85.5% and 35.8%, respectively) by individual-level health (especially arthritis), country-level wealth (as indicated by GDP per capita), and demographics. Discussion Chronic pain intensity is not an inevitable consequence of chronological age, but the consequence of potential selection effects and lower activity levels combined with individual-level health and country-level wealth. Our findings suggest further investigation of health conditions and country affluence settings as potential targets of medical and policy interventions aiming to prevent, reduce, or manage chronic pain among older patients and aging populations. [ABSTRACT FROM AUTHOR]

Objectives Previous research has suggested cross-national differences in the association between living alone and well-being among older adults. This study examined whether the association varied across social contexts within the country, Japan, in terms of varying degree of urbanization and differential time periods. Methods Data were obtained from a nine-wave nationwide longitudinal survey with a probability sample of Japanese adults aged 60 years and over. Respondents belonged to one of the three periods (around 1990, 2000, and 2015) according to the year they commenced participation. As many as 4,655 individuals from 575 municipalities provided 9,016 observation sets of two consecutive waves (t − 1 and t). Within a framework of the Hierarchical Generalized Linear Model, depressive symptoms at t were predicted based on changes in living arrangements from t − 1 to t and their cross-level interactions with gender, level of urbanization, and time period, controlling for various covariates at t −  1. Results In general, older adults living alone continuously as well as those who started living alone between the waves showed more depressive symptoms than those coresiding with someone continuously. However, this tendency was more prominent among rural residents than their urban counterparts, especially for men. Moreover, the effect of continuously living alone on depressive symptoms became smaller in Period 2015 than that in Period 1990, because of the increase in depressiveness in coresident older adults. Discussion Our findings indicate that living alone has a differential effect on older adults' well-being depending on the social context where residents' preferences for living arrangements and availability of formal services could vary. [ABSTRACT FROM AUTHOR]

Objectives During social isolation imposed by the coronavirus disease 2019 (COVID-19) pandemic, older adults with impaired hearing and vision potentially experienced more communication challenges, increasing their risk for poor mental health. Digital communication (e.g. video calls, e-mail/text/social media) may alleviate in-person isolation and protect against depression. We addressed this question using data from the National Social Life, Health, and Aging Project, a nationally representative panel study of community-dwelling older adults. Method Two thousand five hundred fifty-eight adults aged 55 and older comprised the analytic sample. Interviewer rating at baseline (2015–2016) classified those with vision impairment (VI) or hearing impairment (HI). Olfactory impairment (OI) was measured by objective testing. During COVID-19 (2020–2021), respondents reported how often they contacted nonhousehold family or friends and whether this was by phone, e-mail/text/social media, video, or in-person. They also quantified the frequency of depressive feelings. Results Older adults with VI or HI but not OI at baseline were significantly less likely to report regular use of video calling and e-mail/text/social media during the pandemic compared to those without impairment. Sensory impairments did not affect the frequency of phone or in-person communication. Adults with VI or HI were more likely to experience frequent depressive feelings during COVID-19. Video calls mitigated this negative effect of VI- and HI-associated depressive feelings in a dose-dependent manner. Discussion Among communication modalities, video calling had a protective effect against depressive feelings for people with sensory impairment during social isolation. Improving access to and usability of video communication for older adults with sensory impairment could be a strategy to improve their mental health. [ABSTRACT FROM AUTHOR]

Objectives Excess sugar consumption, particularly in sugar-sweetened beverages (SSBs), has been linked to poor cognitive performance. We aimed to assess the association of consumption of total sugar, as well as the consumption of SSBs, solid desserts, and 100% fruit juice with cognitive performance among older adults. Methods Consumption of total sugar, SSBs, solid desserts, and 100% fruit juice were obtained from the 24-hr recall interview. Cognitive performance was evaluated using the Consortium to Establish a Registry for Alzheimer's Disease word list, the Animal Fluency Test, and the Digit Symbol Substitution Test. Binary logistic regression models were used to evaluate the association between consumption of sugar (total and from different sources) and cognitive performance. Results A total of 1,938 participants aged 60 years or older from the National Health and Nutrition Examination Survey 2011–2014 were included. Compared to the lowest tertile, the highest tertile of total sugar consumption was independently associated with higher odds of low memory performance (odds ratio [OR] = 1.87, 95% confidence interval [CI] = 1.00; 3.50, p  = .049). Consumption of SSBs was associated with higher risk of low memory (OR = 1.58, 95% CI = 1.11; 2.25, p  = .014), whereas consumption of solid desserts was associated with lower risk of low verbal fluency performance (OR = 0.62, 95% CI = 0.41; 0.95, p  = .032). Discussion Higher consumption of total sugars and SSBs was associated with lower memory performance, while consumption of solid desserts was associated with higher verbal fluency performance. [ABSTRACT FROM AUTHOR]

Objectives Heterogeneity among Black adults' experiences of discrimination and education quality independently influence cognitive function and sleep, and may also influence the extent to which sleep is related to cognitive function. We investigated the effect of discrimination on the relationship between objective sleep characteristics and cognitive function in older Black adults with varying education quality. Method Cross-sectional analyses include Black participants in the Einstein Aging Study (N  = 104, mean age = 77.2 years, 21% males). Sleep measures were calculated from wrist actigraphy (15.4 ± 1.3 days). Mean ambulatory cognitive function (i.e. spatial working memory, processing speed/visual attention, and short-term memory binding) was assessed with validated smartphone-based cognitive tests (6 daily). A modified Williams Everyday Discrimination Scale measured discriminatory experiences. Linear regression, stratified by reading literacy (an indicator of education quality), was conducted to investigate whether discrimination moderated associations between sleep and ambulatory cognitive function for individuals with varying reading literacy levels. Models controlled for age, income, sleep-disordered breathing, and sex assigned at birth. Results Higher reading literacy was associated with better cognitive performance. For participants with both lower reading literacy and more discriminatory experiences, longer mean sleep time was associated with slower processing speed, and lower sleep quality was associated with worse working memory. Later sleep midpoint and longer nighttime sleep were associated with worse spatial working memory for participants with low reading literacy, independent of their discriminatory experiences. Discussion Sociocultural factors (i.e. discrimination and education quality) can further explain the association between sleep and cognitive functioning and cognitive impairment risk among older Black adults. [ABSTRACT FROM AUTHOR]

Objectives Subjective cognitive decline (SCD) is a known risk factor for Alzheimer's disease. However, little research has examined whether healthy older adults with SCD (SCD+) exhibit lower cognition and increased rates of cognitive decline compared to those without SCD (SCD−). The goal of this study was to examine if cognitive change over a 15-year period differs between SCD+ and SCD−. Method 3,019 cognitively normal older adults (831 SCD+) from 3 Rush Alzheimer's Disease Center cohort studies were followed annually for up to a maximum of 15 years. Due to attrition, the average follow-up time was 5.7 years. Cognition was measured using z-scores of global cognition, episodic memory, semantic memory, perceptual speed, visuospatial ability, and working memory. Linear mixed-effects models investigated whether SCD was associated with cognitive change. Results Both baseline cognition and cognitive change over time differed between SCD+ and SCD−. People with SCD+ exhibited lower baseline scores and a steeper decline in global cognition, episodic memory, semantic memory, and perceptual speed. People with SCD+ did not differ from SCD− in baseline visuospatial ability or working memory but exhibited increased change over time in those two domains compared to SCD−. Discussion The observed results reveal that older adults with SCD+ have lower baseline cognition and steeper declines in cognition over time compared to SCD−. Older adults with SCD may be aware of subtle cognitive declines that occur over time in global cognition, episodic memory, semantic memory, perceptual speed, visuospatial ability, and working memory compared to those without SCD. [ABSTRACT FROM AUTHOR]

Objectives To examine the effect of mindfulness interventions on cognitive tasks in healthy older adults and older adults with diagnoses of mild cognitive impairment (MCI) or dementia. Methods Three-level meta-analysis and systematic review of 30 published randomized-controlled trials. Results Mindfulness interventions provided a small, yet significant positive effect on cognition compared to a control group (average weighted Hedges' g  = 0.36, 95% confidence interval [CI] [0.06–0.65]). Attention (g  = 0.22, 95% CI = [0.09, 0.35]), long-term memory (g  = 0.32, 95% CI = [0.08, 0.56]), and visuospatial processing (g  = 0.22, 95% CI = [0.10, 0.34]) all showed significantly meaningful changes regardless of cognitive status of the participants. There was no evidence for publication bias. Healthy older adults showed higher effect sizes than those with MCI (g  = 0.27, 95% CI = [0.11, 0.43], vs. (g  = −0.09, 95% CI = [−0.35, 0.17], respectively). Otherwise, there were no significant moderating effects of age, marital status, education, region, intervention type, length, number of sessions, adherence, or gender on effect size. Moderator analyses within cognitive domains suggest that focused attention practices might be the best for improving cognition. Lastly, meditation interventions seem to work as effectively as other mind-body interventions, but not as effectively as other interventions to improve cognitive functioning in older adults. Discussion Mindfulness interventions appear to be a useful tool for improving cognitive functioning in older adults. [ABSTRACT FROM AUTHOR]

Objectives Most older adults with dementia are assisted by multiple caregivers, but the relationship of care network structure with health care access and quality is underexamined. We sought to test the associations of care network characteristics with the physician visit experience for older adults with dementia across diverse racial/ethnic groups. Methods We used data on Medicare beneficiaries (aged 65+) with dementia from the National Health and Aging Trends Study (2015–2019) to fit logistic regression models to test associations between physician visit outcomes and (a) size of the potential care network and (b) proportion of potential care network members (PCNMs) currently helping with daily functioning tasks. We also tested for modifications by race/ethnicity. Results Hispanic respondents had the largest potential care networks (M = 6.89, standard deviation [ SD ] = 3.58) and the smallest proportion of PCNMs providing help with daily functioning (M = 29.89%, SD = 22.29). In models adjusted for demographics and dementia classification, both network size and proportional involvement of PCNMs were positively associated with the presence of a PCNM and assistance during the visit. Associations remained significant at 4-year follow-up for the presence of PCNM at the visit and were robust to further adjustments for insurance type, income, and health factors. Associations were not modified by race/ethnicity. Discussion Larger networks and a higher proportion of PCNMs providing assistance predicted caregiver presence and assistance at the physician visit but not access to care. Findings suggest that strengthening care networks early in the disease may support improved health care outcomes for persons with dementia across diverse populations. [ABSTRACT FROM AUTHOR]

Objectives Paid care provided in the home includes important support services for older adults with dementia such as cleaning and personal care assistance. By reducing unmet needs, these services could delay the transition to residential long-term care, but access may differ across racial groups. This study examined the relationship between paid care and transitioning out of the community among Black and White older adults with dementia. Methods Using data from 303 participants (29.4% Black) with probable dementia in the 2011 National Health and Aging Trends Study, competing risk hazards models estimated the association between receiving paid care at baseline and the probability of transitioning out of the community over 8 years (through 2019). Covariate selection was guided by the Andersen model of health care utilization. Results Paid care was associated with lower risk of transitioning out of the community (subhazard ratios [SHR] = 0.70, 95% CI [0.50, 0.98]). This effect was similar after controlling for predisposing factors and most prominent after controlling for enabling and need for services factors (SHR = 0.65, 95% CI [0.44, 0.95]). There was no racial difference in the use of paid care despite evidence of greater care needs in Blacks. Furthermore, Black participants were less likely to transition out of the community than Whites. Discussion Paid care services may help delay transitions out of the community. Future research should seek to explain racial differences in access to and/or preferences for home-based, community-based, and residential care. [ABSTRACT FROM AUTHOR]

Objectives To examine the association between prepandemic social integration and posttraumatic stress disorder (PTSD) symptoms during the coronavirus disease 2019 (COVID-19) pandemic and test whether the association is mediated by social support received and social events missed during the pandemic. We also explored age, race, gender, and socioeconomic differences in the association. Methods We adopted a prospective design. Path analysis was conducted using data from the COVID-19 supplement (2020) and the 2019 wave of the National Health and Aging Trends Study (NHATS). The sample represents Medicare beneficiaries aged 70 years and older (N  = 2,694). Social integration was measured using a six-item index. A standardized scale assessed PTSD symptoms. Both social support received and social events missed were single-item measures. The analysis controlled for sociodemographic characteristics, prepandemic physical and mental health, and coronavirus exposure during the pandemic. Results Prepandemic social integration was positively associated with PTSD symptoms during the pandemic. The association was primarily mediated by social events missed—high levels of prepandemic social integration were associated with missing more social events during the pandemic resulting in more PTSD symptoms. Social support received was also a mediator—social integration was positively associated with social support received during the pandemic, with more received support associated with greater PTSD symptoms. Prepandemic social integration had no significant direct effect on PTSD symptoms. The direct, indirect, and total effects of social integration on PTSD symptoms did not significantly differ by age, race, gender, education, or poverty status. Discussion Social integration may carry mental health risks in times of infectious disease outbreaks. [ABSTRACT FROM AUTHOR]

Objectives Policies aiming at reducing rates of hospitalization and death from coronavirus disease 2019 (COVID-19) encouraged older people to reduce physical interactions. In England, until July 2021, provision of care for grandchildren was allowed only under very limited circumstances. Evidence also suggests that reduced face-to-face interactions took a toll on mental health during the pandemic. This study aims to investigate associations between changes in grandchild care provision during the first 8/9 months of the pandemic and grandparents' mental health. Methods Using prepandemic data from Wave 9 (2018/2019) and the second COVID-19 substudy (November/December 2020) of the English Longitudinal Study of Ageing, we first describe changes in grandchild care provision during the pandemic to then investigate, using regression models, associations between changes in grandchild care provision and mental health (depression, quality of life, life satisfaction), while controlling for prepandemic levels of the outcome variables. Results About 10% of grandparents stopped looking after grandchildren altogether during the first 9 months of the pandemic, with 22% reporting an overall decrease in the amount of grandchild care provided. Compared to grandparents who mostly maintained unchanged their grandchild care provision, those who stopped altogether and those who mostly reduced the amount of grandchild care provided were more likely to report poorer mental health, even accounting for prepandemic health. Discussion While measures to limit physical contact and shield older people were necessary to reduce the spread of COVID-19, policymakers should acknowledge potential adverse consequences for mental health among grandparents who experienced changes in their roles as grandchild caregivers. [ABSTRACT FROM AUTHOR]

Objectives This study applied an extended Protection Motivation Theory to investigate the relative importance of fear of falling (FoF) among motivational and intentional determinants of physical activity (PA) behavior. Methods Older U.S. adults (N = 667, 65+) were surveyed using online research panels and completed measures of self-efficacy and response efficacy (coping appraisal), perceived vulnerability and perceived severity (threat appraisal), FoF, autonomous motivation, intention, physical health, and past PA level. Results Our structural equation model showed that past PA level and health predicted intention via cognitive constructs. PA and health predicted FoF and motivation via threat and coping appraisal. FoF did not directly predict intention. Discussion Results from this sample provide support for the predictive effects of threat appraisal on fear. However, findings suggest that FoF may not be of great importance for the formation of PA intention compared with an established habit of being physically active and a subsequently fostered coping appraisal and motivation. [ABSTRACT FROM AUTHOR]

Objectives In a longitudinal design, the objective is to investigate the association between transitions in living arrangements and life satisfaction with special consideration for preferred living arrangement, and to assess whether such associations are moderated by age among Chinese older adults. Methods Data were from 4 waves of the Chinese Longitudinal Healthy Longevity Survey, 2005–2014. Living arrangement transitions (N = 12,654) distinguished coresidence with children and non-coresidence and matched preference. Random effect ordinal logistic models predicted life satisfaction by transitions in living arrangements between baseline and follow-up, transitions in matched living arrangement preferences between baseline and follow-up, and these transitions interacted with age at baseline, adjusting for life satisfaction at baseline. Predicted probabilities for the highest level of life satisfaction for several transition combinations were calculated and the difference was tested for significance. Results Although matching actual and preferred living arrangement transition is an important factor in determining life satisfaction, actual coresidence with children remains positively significant. Moreover, results show significant interaction effects of the two transitions with age: while the association of life satisfaction with consistent matching gradually declines into older ages, the association of life satisfaction with consistent coresidence increases with age. Discussion While preference-matched living arrangement is critical for life satisfaction, especially for the young-old, the role of coresidence becomes more prominent at very old ages when various needs are likely to arise. It is too early to dismiss the role of coresidence with children in the Chinese context. [ABSTRACT FROM AUTHOR]

Objectives Community-living older Medicare and Medicaid enrollees ("dual-enrollees") have high care needs and commonly receive paid and unpaid long-term services and supports (LTSS) to help with routine activities. Little is known about whether receiving paid help or individuals' state and neighborhood environmental context ("LTSS environment") relates to dual-enrollees' care experiences. Methods We examine a sample of n = 979 community-dwelling dual-enrollees with disabilities from 2011 to 2015 National Health and Aging Trends Study, linked to measures of neighborhood disadvantage and state Medicaid home and community-based services (HCBS) generosity. Logistic regression models stratified by dementia status assess associations between paid help and: (a) adverse consequences due to unmet care needs, and (b) participation restrictions in valued activities, among dual-enrollees with and without dementia, adjusting for individual and LTSS environmental characteristics. Results Use of paid help was greater for those with (versus without) dementia (46.9% vs. 37.8%). Neighborhood disadvantage was associated with greater use of paid help among dual-enrollees living with dementia. High state Medicaid HCBS generosity was associated with the use of paid help, regardless of dementia status. Dual-enrollees with dementia receiving paid help had higher odds of experiencing adverse consequences due to unmet need (adjusted odds ratio = 2.05; 95% confidence interval 1.16–3.61; p =.02)―no significant associations were observed for participation restrictions. Use of paid help and LTSS environment were not significantly associated with care experiences for dual-enrollees without dementia. Discussion Findings highlight the complexities of caring for dual-enrollees, particularly those with dementia, and emphasize the need to strengthen the delivery of paid care with considerations for the LTSS environment. [ABSTRACT FROM AUTHOR]

Objectives As within-group differences have emerged as a key area of inquiry for health disparities among African Americans, skin tone has been identified as an important factor. This study aims to examine: (a) the moderating role of skin tone in the relationship between discrimination, self-rated mental health, and serious psychological distress (SPD) and (b) whether this moderating effect differs across genders in a nationally representative sample of older African Americans. Methods Analyses were conducted on a subsample of African Americans aged 55+ (N = 837) from the National Survey of American Life. The mental health outcomes were SPD and self-rated mental health. Discrimination was assessed with the Everyday Discrimination Scale. Skin tone was self-reported. Multiple linear regressions tested the study aims. Results Discrimination was associated with worse self-rated mental health and SPD in the total sample and among women. Skin tone moderated the association between discrimination and SPD in the total sample and among men and women. The associations between discrimination and mental health outcomes were stronger among darker-skinned respondents than lighter respondents. Gender-stratified analyses indicated skin tone moderated the association between discrimination and self-rated mental health for men but not women. Discussion This study contributes to the emerging body of literature on skin tone, discrimination, and mental health. Uncovering mechanisms behind the "why" is an important next step in understanding how skin tone influences the relationship between discrimination and mental health. The negative psychological effects associated with darker complexion provide several areas to be examined. [ABSTRACT FROM AUTHOR]

Objectives To examine how intergenerational support varies by parents' living arrangements and whether there are gender differences in received support in Puerto Rico. Methods Data come from the 2006–2007 Puerto Rican Elderly and Health Conditions Project, a representative longitudinal study of adults aged 60 and older in Puerto Rico (n = 2,288). We examined the association between parents' living arrangements (alone, with spouse/partner only, with children) and their receipt of functional (help with errands/housework/transport) and health (help when sick) support from children, and whether parents' gender moderates the association. Results Intergenerational coresidence was associated with higher odds of receiving functional and health support than living alone. Women were more likely than men to receive both forms of support. Parents' gender significantly moderated the association between living arrangements and receiving health support—men living with their partners were less likely to receive health support from children than women in similar living arrangements. These associations persisted when analyses were restricted to those with disability. Discussion Our findings suggest that parents' receipt of support from children is conditioned upon their living arrangement and gender, even when their functional health is jeopardized. We discuss these results in relation to the heterogeneous influence of living arrangements for older adults' support needs and provide suggestions for policy and directions for future research in rapidly aging Puerto Rico. [ABSTRACT FROM AUTHOR]

Objectives To examine whether racial disparities are narrowing or widening with historical time among U.S. middle-aged and older adults, and test the extent to which educational attainment moderates racial disparities over historical time. Methods Multilevel models were applied to longitudinal data on middle-aged (ages 40–65) and older adults (ages 66 and older) from the Health and Retirement Study. Historical change was indexed as cohort or birth year. The outcomes of focus were depressive symptoms, episodic memory, health conditions, functional limitations, and self-rated health. Results Results revealed a differential pattern of racial disparities in historical change between midlife and old age. Across midlife and old age, on average, Blacks and Hispanics reported poorer levels of mental and physical health, compared with Whites. In midlife, racial disparities narrowed with historical time; later-born cohorts of Hispanics but not Whites reported fewer depressive symptoms than their earlier-born peers. Likewise, historical improvements in health were stronger among Hispanics and Blacks than Whites. Conversely, in old age, later-born cohorts across race consistently showed historical improvements in each of the outcomes examined. Regarding educational attainment, we observed little consistent evidence that health-promoting effects of educational attainment differ across race and cohort. Examining questions about heterogeneity, results revealed that in midlife and old age there was greater heterogeneity between race across each of the outcomes. Discussion Our discussion elaborates on reasons behind the documented racial differences in historical changes among U.S. middle-aged and older adults, and how the protective role of education is changing over time. [ABSTRACT FROM AUTHOR]

Objectives Discrimination is a major contributor to health disparities between Black and White older adults. Although the health effects of discrimination are well established, less is known about factors that may intervene in the discrimination–health connection, such as coping strategies. The study aim was to determine whether John Henryism (JH; high-effort coping) moderates the association between racial discrimination and hypertension in nationally representative samples of older African Americans and Caribbean Blacks. Methods The analytic sample was drawn from the National Survey of American Life—Reinterview, which was conducted 2001–2003, and included African Americans (N = 546) and Caribbean Blacks (N = 141) aged 55 and older. Study variables included racial discrimination, JH, and hypertension. Logistic regressions, which controlled key sociodemographic differences, were used to test the study aim. Results Among both Black ethnic groups, discrimination and JH were not associated with hypertension. For African Americans low and moderate in JH, discrimination was unrelated to hypertension; discrimination was positively associated with hypertension for African Americans high in JH. For Caribbean Blacks, discrimination was positively associated with hypertension among respondents low in JH. Among Caribbean Blacks moderate and high in JH, discrimination was not associated with hypertension. Discussion The findings indicate that JH, in the face of discrimination, is associated with hypertension of older African Americans but may be an effective coping strategy for older Caribbean Blacks due to cultural and sociodemographic differences between the 2 ethnic groups. Future research should investigate the differing mechanisms by which JH influences health in heterogeneous older Black populations. [ABSTRACT FROM AUTHOR]

Objectives Loneliness is an important concern for older adults. Studies have linked demographic characteristics with loneliness, showing that it varies by ethnic and migrant statuses in countries in Europe and North America. Characteristics of the physical environment in which older adults are embedded have also received some attention, though prior studies have not fully investigated whether older adults from different ethnic–migrant backgrounds may report variation in loneliness because of characteristics of, or satisfaction with, their neighborhoods, which may shape their social interactions. Methods Drawing on up to 4 waves of data from the Household, Income, and Labour Dynamics in Australia Surveys and random-effects models, I examine whether loneliness differs across ethnic/migrant groups in the Australian context. Furthermore, I examine whether neighborhood characteristics (its conditions and sociality) and satisfaction with the neighborhood (with its safety, with the neighborhood itself, and with "feeling part of the local community") may be mediators for the association between ethnic–migrant status and loneliness. Results Findings show migrants from non-English-speaking countries report higher levels of loneliness, as compared with native-born, non-Indigenous Australians. More favorable neighborhood characteristics and higher levels of satisfaction with different aspects of the neighborhood are consistently associated with lower levels of loneliness. Neighborhood sociality and satisfaction with aspects of the neighborhood partially mediated the association between ethnicity status and loneliness for migrants from non-English-speaking countries. Discussion This study showed loneliness differs across older Australians of different ethnic and migrant backgrounds. It also showed how loneliness differences are explained by different mechanisms. [ABSTRACT FROM AUTHOR]

Objectives Prior research indicates that depressive symptoms disproportionately affect cognition in non-Hispanic Blacks relative to non-Hispanic Whites. Depressive symptoms have been linked to worse global cognition in older adulthood through lower leisure activity engagement, but less is known regarding the distinct types of activities that drive these associations and whether associations involving depressive symptoms, leisure activities, and cognition differ across racial groups. Methods This cross-sectional study used data from the Michigan Cognitive Aging Project (n = 453, 52.80% Black, M age = 63.60 years). Principal components analysis identified 6 subtypes of leisure activities (cognitive, creative, community, physical, children, and games). Mediation models examined whether distinct leisure activity subtypes mediated the association between depressive symptoms and performance on a comprehensive neuropsychological battery and whether race moderated these associations. Results There were no racial differences in the level of depressive symptoms after adjusting for sociodemographic, socioeconomic, and health covariates. Only lower cognitive activity engagement mediated the negative association between depressive symptoms and global cognition. Multigroup models revealed that this indirect effect was only evident in Blacks, who showed a stronger negative association between depressive symptoms and cognitive activity engagement than Whites. After accounting for indirect effects, a direct effect of higher depressive symptoms on worse cognition remained and did not differ across racial groups. Discussion Depressive symptoms may disproportionately affect cognition among Blacks through a greater negative impact on engagement in cognitively stimulating activities that have been shown to promote cognitive reserve. Additional research is necessary to identify other mechanisms linking depressive symptoms and cognition. [ABSTRACT FROM AUTHOR]

Objectives The COVID-19 pandemic has profoundly affected the lives of people globally, widening long-standing inequities. We examined the COVID-19 pandemic's impact on employment conditions by race/ethnicity, gender, and educational attainment and the association between such conditions and well-being in older adults in the United States. Methods Using data from the Health and Retirement Study respondents interviewed between May 2020 and May 2021 when they were ≥55 years of age, we examined intersectional patterns in COVID-19-related changes in employment conditions among 4,107 participants working for pay at the start of the pandemic. We also examined the compounding nature of changes in employment conditions and their association with financial hardship, food insecurity, and poor self-rated health. Results Relative to non-Hispanic White men with greater than high school education (>HS), Black and Latinx men and women were more likely to experience job loss irrespective of education; among those who did not experience job loss, men with ≤HS reporting Black, Latinx, or "other" race were >90% less likely to transition to remote work. Participants who experienced job loss with decreased income or continued in-person employment with decreased income/shift changes had greater prevalence of financial hardship, food insecurity, and poor/fair self-rated health than others. Discussion The impact of COVID-19 on employment conditions is inequitably patterned and is associated with financial hardship, food insecurity, and adverse health in older adults. Policies to improve employment quality and expand social insurance programs among this group are needed to reduce growing inequities in well-being later in life. [ABSTRACT FROM AUTHOR]

Objectives With advancing age, older drivers experience greater fatal crash risks due to age-related declines in cognitive and physical capabilities. Being informed of the age-related increased risks could help older drivers form compensatory strategies and determine when to seek further help to stay on the road safely for longer. Using a self-report assessment tool, the Attentional Failure during Driving Questionnaire (AFDQ), we examined older drivers' experience of various attentional failures during daily driving and how the measures could predict their crash risks. Methods We used a new methodological approach distinguishing the occurrences of attentional failures during driving and the frequency of those occurrences. The individuals' AFDQ occurrence and frequency scores were compared with prior driving outcomes and simulated driving performance. Results Unlike middle-aged drivers, frequency rather than occurrence of attentional failures was a significant predictor of prior traffic violations and crashes among older drivers. Also, attentional failures, but not chronological age, predicted older drivers' crash risks. AFDQ frequency was also associated with older drivers' poorer performance in simulated driving. Discussion The findings suggest that the self-report assessment for attention-related driving failures can predict older drivers' crash risks. Furthermore, the two-part approach of AFDQ provides an opportunity to do a more comprehensive investigation of the associations between attentional declines and crash risks among older drivers. [ABSTRACT FROM AUTHOR]

Objectives To better understand the temporal dynamics of progression from cognitive decline to onset of dementia in the dementia-free older population in the United States. Methods We used longitudinal data from a diverse national population-based sample of older adults (N = 531) in the Aging, Demographics, and Memory Study from the Health and Retirement Study with repeated measures of cognitive function and dementia diagnosis during 12 years of follow-up from 1996 to 2009. We employed joint latent class mixed models to estimate the association between cognitive change and competing risks of dementia and nondementia death and identify heterogeneity in the age profiles of such association adjusting for baseline characteristics. Results Our analyses found 3 latent classes with distinct age profiles of cognitive decline and associated risk of dementia and mortality: "Rapid Cognitive Decline" (19.6%), "Moderate Progression" (44.6%), and "Optimal Cognitive Aging" (35.8%). When simultaneously accounting for cognitive trajectories and time-to-dementia/death, we also found associations of baseline covariates with slope of cognitive decline (e.g. steeper decline among non-Hispanic Blacks and more educated) and risk of dementia (e.g. greater risk for females and apolipoprotein E-4 carriers, but no difference by education level) that differ substantially from those in separate longitudinal mixed models or survival models. Discussion The differential age patterns of cognitive decline predicting dementia incidences identified in this study suggest variation in the course of cognitive aging in older adults that may inform future etiological and intervention studies. [ABSTRACT FROM AUTHOR]

Objectives Given the longstanding consensus that social contact can promote older adult well-being, many have focused on how social contact changed during the pandemic. Less is known, however, about whether the link between social contact and health changed during the pandemic. This study sought to understand how associations between social contact, social support, and depressive symptoms changed during the coronavirus disease 2019 (COVID-19) pandemic. Methods Data from 2 waves of the Health and Retirement Study were used. Respondents reported both virtual and in-person social contact, as well as perceived positive and negative social support. Path models were used to estimate relationships between social contact, social support, and depressive symptoms. Bootstrapping was used to estimate the change in associations between 2016 and 2020. Results Estimates show that associations between positive social support and depressive symptoms, as well as between in-person social contact and depressive symptoms, attenuated during the pandemic. Virtual social contact played a relatively minor role in determining outcomes such as social support and depressive symptoms, compared to in-person social contact. Discussion Findings suggest that researchers and policymakers should not only focus on the changing quantity of social interactions when events such as the COVID-19 pandemic happen, but also the changing content and efficacy of the social interactions that remain. [ABSTRACT FROM AUTHOR]

Objectives Negative self-perceptions of aging (SPA) and an older subjective age are associated with a greater likelihood of cardiovascular disease. We predicted that C-reactive protein (CRP), a marker of stress-related inflammation, would mediate this relation. Method Data from up to 6 602 participants ages 50–101 in the Health and Retirement Study (2008–2018) were analyzed using logistic regressions with mediation. Subjective aging was assessed in 2008 or 2010, CRP was assessed 2 years later, and diagnosis of heart disease or stroke was assessed in the years from CRP measurement to 2018. Results Significant indirect effects occurred in all models, indicating that negative SPA and older subjective age are associated with a greater likelihood of heart disease and stroke through elevated levels of the inflammatory marker CRP. Discussion These findings suggest that psychological factors such as subjective aging impact cardiovascular health through physiological mechanisms, specifically markers of inflammation. [ABSTRACT FROM AUTHOR]

Objectives Subjective aging is consistently related to a range of health-related outcomes, but little is known about its relationship with sensory functioning. The present prospective study tested whether subjective age and self-perceptions of aging (SPA) are associated with objective hearing function. Methods Participants were 7,085 individuals aged 50–93 years (60% women, mean = 65.15, standard deviation [ SD ] = 8.71) from the Health and Retirement Study. Measures of subjective age, SPA, and information on demographic factors were obtained in 2008/2010. Objective hearing function was assessed 8 years later in 2016/2018. Furthermore, potential mediating variables (C-reactive protein, body mass index, physical inactivity, and chronic conditions) were assessed in 2012/2014. Results In regression analyses that accounted for demographic factors, older subjective age and negative SPA were associated with lower hearing acuity 8 years later. In addition, 1 SD older subjective age and negative SPA were related to a 9% and 7% higher likelihood of hearing impairment. Mediation analyses revealed that physical inactivity and chronic conditions partially mediated subjective age and SPA associations with hearing acuity. There was little evidence that the link between subjective aging and hearing was moderated by hearing aids and partial support for a moderating role of age. Discussion This study provides new evidence that subjective aging is prospectively related to hearing function. Individuals with older subjective age or negative SPA have unfavorable behavioral and clinical profiles that explain part of their lower hearing function. Individuals' experience with their aging process is a marker of risk for impaired hearing. [ABSTRACT FROM AUTHOR]