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In 2019, the National Institutes of Health combined the Multicenter AIDS Cohort Study (MACS) and the Women's Interagency HIV Study (WIHS) into the MACS/WIHS Combined Cohort Study (MWCCS). In this paper, participants who made a study visit during October 2018–September 2019 (targeted for MWCCS enrollment) are described by human immunodeficiency virus (HIV) serostatus and compared with people living with HIV (PLWH) in the United States. Participants include 2,115 women and 1,901 men with a median age of 56 years (interquartile range, 48–63); 62% are PLWH. Study sites encompass the South (18%), the Mid-Atlantic/Northeast (45%), the West Coast (22%), and the Midwest (15%). Participant race/ethnicity approximates that of PLWH throughout the United States. Longitudinal data and specimens collected for 35 years (men) and 25 years (women) were combined. Differences in data collection and coding were reviewed, and key risk factor and comorbidity data were harmonized. For example, recent use of alcohol (62%) and tobacco (28%) are common, as are dyslipidemia (64%), hypertension (56%), obesity (42%), mildly or severely impaired daily activities (31%), depressive symptoms (28%), and diabetes (22%). The MWCCS repository includes serum, plasma, peripheral blood mononuclear cells, cell pellets, urine, cervicovaginal lavage samples, oral samples, B-cell lines, stool, and semen specimens. Demographic differences between the MACS and WIHS can confound analyses by sex. The merged MWCCS is both an ongoing observational cohort study and a valuable resource for harmonized longitudinal data and specimens for HIV-related research. [ABSTRACT FROM AUTHOR]

Greater attention is being paid to issues surrounding end-of-life care for aging adults with developmental disabilities. The purpose of this qualitative study was to explore the end-of-life experiences of two aging adults with developmental disabilities and life-limiting serious illnesses who received care in settings in the United States. Using a comparative case study design, data from three sources (records, staff, surrogates) were collected sequentially and triangulated via within and cross-case analyses. Although the setting and design limit the generalizability of these findings, the feasibility of delivering high quality care to adults with developmental disabilities as they age and experience terminal illnesses is supported. Insights are presented regarding how nurses can address barriers by adapting policies and practices to accommodate the distinct needs that arise as people with developmental disabilities age, become seriously ill, and reach life's end. [ABSTRACT FROM AUTHOR]

Background: Outside of the United States, international perspectives on normative data for neuropsychological test performance, within diverse populations, have been scarce. The neuropsychological test battery from the Uniform Data Set (UDS) of the Alzheimer's Disease Centers (ADC) program of the United States National Institute on Aging (NIA) is one of the most sensitive batteries for the evaluation of both normal cognitive aging and pathological cognitive decline.Objective: This study aimed to determine the feasibility of the Czech Neuropsychological Test Battery from the Uniform Data Set (UDS-Cz 2.0), while also evaluating the results obtained from an international perspective.Methods: This paper describes data from 520 cognitively normal participants. Regression analyses were used to describe the influence of demographic variables on UDS-Cz test performance.Results: Cognitive performance on all measures declined with age, with patient education level serving as a protective factor. Therefore, the present study provides normative data for the UDS-Cz, adjusted for the demographic variables of age and education.Conclusion: The present study determines the psychometric properties of the UDS-Cz and establishes normative values in the aging Czech population, which can be used in clinical settings. [ABSTRACT FROM AUTHOR]

Background: Elder mistreatment (EM) prevalence varies greatly according to definitional criteria. However, little is known regarding the significance of different EM definitions with respect to health outcome. This paper explores the association between different definitions of EM and their subtypes and suicidal ideation (SI) in an U.S. Chinese aging population.Methods: The Population Study of ChINese Elderly in Chicago Study was conducted from 2011 to 2013 of 3157 community-dwelling Chinese older adults aged 60 years. Psychological, physical mistreatment (PM), caregiver neglect (CN), financial exploitation (FE), and overall EM were measured by different definitional approaches varying in the strictness. SI in the past 2 weeks and 12 months were assessed.Results: After adjusting for confounders, the least restrictive EM definition (odds ratio [OR], 2.10 [1.34-3.28]; OR, 2.43 [1.66-3.55]), moderately restrictive EM definition (OR, 2.87 [1.80-4.56]; OR, 2.71 [1.82-4.04]), and most restrictive EM definition (OR, 2.24 [1.36-3.66]; OR, 2.34 [1.54-3.56]) were associated with increased risk for 2-week and 12-month SI. For subtypes of EM, psychological mistreatment (the least and most restrictive definitions, 2-week SI: OR, 2.83 [1.71-4.68]; OR, 3.13 [1.10-8.91]; 12-month SI: OR, 2.43 [1.56-3.78]; OR, 2.88 [1.10-7.54]), PM (2-week SI: OR, 5.12 [1.83-14.29]; 12-month SI: OR, 3.45 [1.30-9.13]), and FE was not associated with 2-week SI, only the broadly defined FE (OR, 1.73 [1.01-2.96]) was associated with higher odds of reporting 12-month SI. CN was only associated with higher odds of reporting 12-month SI (OR, 2.17 [1.19-3.96]; OR, 1.94 [1.24-3.04]) but not 2-week SI.Conclusion: EM and its subtypes were significantly associated with SI; some associations varied by definitions and subtypes. [ABSTRACT FROM AUTHOR]

Introduction: Chronic pain is one of the leading causes of disability that may accelerate biological aging and reduce physical function. Epigenetic clocks provide an estimate of how the system ages and can predict health outcomes such as physical function. Physical function declines may be attributed to decreases in muscle quality due to disuse that can be measured quickly and noninvasively using grip strength. The purpose of this study was to explore the associations among self-reported pain, grip strength, and epigenetic aging in those with chronic pain. Methods: Participants (57.91 ± 8.04 years) completed pain questionnaires, a blood draw and hand grip strength task. We used an epigenetic clock previously associated with knee pain (DNAmGrimAge), and used the subsequent difference of predicted epigenetic age from chronological age (DNAmGrimAge-Difference). Results: Exploratory pathway analyses revealed that pain intensity mediated the association between DNAmGrimAge-difference and handgrip strength in males only (β = −0.1115; CI [−0.2929, −0.0008]) and pain interference mediated the association between DNAmGrimAge-difference and handgrip strength in males β = −0.1401; CI [−0.3400, −0.0222]), and females (β = −0.024; CI [−0.2918, −0.0020]). Discussion: Chronic knee pain may accelerate epigenetic aging processes that may influence handgrip strength in older age adults. Chronic pain could be a symptom of the aging body thus contributing to declines in musculoskeletal function in later life. [ABSTRACT FROM AUTHOR]

Objectives: To examine the need for and arrangements pertaining to personal care assistance among individuals 65 and older, and how life stage at migration impacts nativity differences in aging-related care. Methods: Using data from the Survey of Income and Program Participation (2001, 2004, and 2008), I examine the odds of needing care assistance, who provides care assistance, and the duration of time care assistance is needed, comparing U.S.-born individuals to migrants who arrived before age 50 ("earlier-life migrants") and those who arrived after age 50 ("later-life migrants"). Results: While earlier-life migrants showed similar patterns to U.S.-born, later-life migrants showed higher care needs, were more likely to receive care from an adult child, and were particularly likely to need care for longer durations compared to U.S.-born. Discussion: Aging later-life migrants have strikingly distinct care needs and arrangements, with implications for individual and family well-being, especially considering their barriers to public support. [ABSTRACT FROM AUTHOR]

Associative memory involves the ability to encode and remember the relationship between individual items. This ability can become diminished when there is a high degree of similarity between stimuli that are being learned. Associative memory errors often stem from the fact that lures include a high degree of item familiarity as well as mnemonic similarity with the original associative episode. The current set of experiments examined how this overlap, in the form of within-category similarity, affects veridical and false retrieval in both younger and older adults. Across three experiments, results suggest that mnemonic overlap between targets and lures is detrimental to the ability to discriminate between highly similar information. Specifically, shared category membership for targets and lures led to increased false associative memories across age groups. These results have implications for scenarios where there is a high degree of overlap between target and lure events and indicate that these types of associative memory distinctions are difficult irrespective of age. [ABSTRACT FROM AUTHOR]

As aging women take relatively high counts of medications and nutritional supplements, each addition to their supplements roster increases the likelihood of experiencing adverse health outcomes. Given these public health implications, we isolate the effects of chronological age and old age stereotypes in driving up the number of nutritional supplements taken by middle age and older women in the United States. We use multiple models that converge on the finding that middle age women, but not older women, who highly endorse negative old age stereotypes take more supplements than their age peers who fail to highly endorse negative old age stereotypes. [ABSTRACT FROM AUTHOR]

The primary aim of this study was to examine the pattern of associations among PD patient and caregiver sleep problems, caregiver burden, and caregiver life satisfaction. A secondary aim was to assess whether the pattern of associations differed between Mexican and U.S. caregivers. Analyses were performed on data obtained from 253 caregivers (M age = 59.92). A composite score was produced for caregiver and patient sleep problems. The Zarit Burden Interview and Satisfaction with Life Scale measured caregiver burden and life satisfaction, respectively. A structural equation model with an invariance design was developed to examine and compare the pattern of associations. The model was generally invariant across U.S. and Mexican caregivers. Three significant indirect effects were found: caregiver sleep problems were negatively associated with life satisfaction via caregiver burden (p = 0.003); PD patient sleep problems were positively related to caregiver burden via caregiver sleep problems (p = 0.005) and life satisfaction via caregiver burden and caregiver sleep problems (p = 0.002). PD patient sleep problems were associated with caregiver sleep problems, leading to increased burden in caregivers and poorer life satisfaction. The findings highlight a potential opportunity for empirically supported sleep interventions. Parkinson's disease is a progressive neurological condition that impacts patient and caregiver quality of life. Patient sleep problems contribute to greater caregiver burden, sleep problems, and reduced life satisfaction. The findings suggest patient and caregiver sleep may be a worthwhile target for intervention in order to reduce risk of caregiver burden and improve life satisfaction. [ABSTRACT FROM AUTHOR]

Policy PointsThe focus of successful aging is on the social contexts that enable individuals to be productively engaged and secure, with an emphasis on equity. There is currently no index to measure progress towards this goal at the US state level.We developed an empirical index for the evaluation of US state adaptation to societal aging across five critical domains that support successful population aging: (1) productivity and engagement, (2) security, (3) equity, (4) cohesion, and (5) well‐being.Our index shows substantial variability over time and is not overly influenced by the performance of an individual domain. This suggests that it can be used to monitor state progress over time toward the goal of supporting successful aging.Rather than a major national trend, there are large between‐state differences and changes in our index over time. This suggests individual US state policies and programs, as well as local economic conditions, may have a substantial impact on adaptations to societal aging. Context: Although it is recognized that aspects of US state environments impact the likelihood that older adults age successfully, there is currently no reliable and comprehensive measure of contexts that best support successful aging at a state level. The current project adapts a multidimensional index previously used to assess adaptation to successful aging in developed countries and applies it to the 50 US states and the District of Columbia. Methods: We obtained data from multiple sources for all 50 US states and the District of Columbia from 2003 to 2017 in order to measure five distinct domains that define successful population aging: (1) productivity and engagement, (2) security, (3) equity, (4) cohesion, and (5) well‐being. We created a ranking of states for the year 2017 based on these domains, and also examined how individual US state rankings changed over time from 2003 to 2017. Findings: The level of adaptation to successful aging varied substantially between states and over time. The highest‐ranked states in 2017 were Vermont, Hawaii, Iowa, Colorado, and New Hampshire, and the lowest‐ranked states were Louisiana, Arkansas, Kentucky, West Virginia, and Mississippi. Mississippi, South Carolina, Iowa, Arizona, and Delaware had the greatest improvement in their ranking over the period of 2003 to 2017. Our findings were generally robust to the weighting scheme used and were not overly influenced by any particular domain. Conclusions: The US State Index of Successful Aging can be used to monitor US state progress in promoting the well‐being and health of aging populations. Factors driving the changes in the index remain to be elucidated. [ABSTRACT FROM AUTHOR]

Background: Cerebrovascular events, dementia, and cancer can contribute to physical disability with activities of daily living (ADL). It is unclear whether low-dose aspirin reduces this burden in aging populations. In a secondary analysis, we now examine aspirin's effects on incident and persistent ADL disability within a primary prevention aspirin trial in community-dwelling older adults.Methods: The ASPREE (ASPirin in Reducing Events in the Elderly) trial of daily 100 mg aspirin versus placebo recruited 19 114 healthy adults aged 70+ years (65+ years if U.S. minority) in Australia and the United States. Six basic ADLs were assessed every 6 months. Incident ADL disability was defined as inability or severe difficulty with ≥1 ADL; persistence was confirmed if the same ADL disability remained after 6 months. Proportional hazards modeling compared time to incident or persistent ADL disability for aspirin versus placebo; death without prior disability was a competing risk.Results: Over a median of 4.7 years, incident ADL disability was similar in those receiving aspirin (776/9525) and placebo (787/9589) with walking, bathing, dressing, and transferring the most commonly reported. Only 24% of incident ADL disability progressed to persistent. Persistent ADL disability was lower in the aspirin group (4.3 vs 5.3 events/1000 py; hazard ratio [HR] = 0.81, 95% confidence interval [CI]: 0.66-1.00), with bathing and dressing the most common ADL disabilities in both groups. Following persistent ADL disability, there were more deaths in the aspirin group (24 vs 12).Discussion: Low-dose aspirin in initially healthy older people did not reduce the risk of incident ADL disability, although there was evidence of reduced persistent ADL disability. [ABSTRACT FROM AUTHOR]

Purpose: Nonmetropolitan communities are faced with health care professional shortages and prior reports suggest that general surgeons are no exception. The purpose of this brief is to evaluate the age difference and distribution of rural versus urban general surgeons to highlight the growing need to recruit medical students and residents for rural practice. Methods: A secondary data analysis of residency graduated general surgeon demographics at the county level was performed using data from the Area Health Resource File. General surgeon demographic data were compared between nonmetropolitan and metropolitan areas. Findings: The number of general surgeons practicing in rural communities is decreasing by a rate of approximately 0.5%‐1.0% annually. Moreover, the entry of younger (<35 years of age) general surgeons into rural counties (8.7%) was less than urban regions (12.1%). Rural general surgeons tended to be older than their urban peers, and on average, rural general surgeon age exhibits a negative skewed, platykurtic distribution. Conclusions: Immediate action must be taken to generate more surgeons for rural practice. A failure to increase recruitment and retention of rural surgeons may have severe consequences on the health status of rural communities. [ABSTRACT FROM AUTHOR]

Biological age captures some of the variance in life expectancy for which chronological age is not accountable, and it quantifies the heterogeneity in the presentation of the aging phenotype in various individuals. Among the many quantitative measures of biological age, the mathematically uncomplicated frailty/deficit index is simply the proportion of the total health deficits in various health items surveyed in different individuals. We used 3 different statistical methods that are popular in machine learning to select 17-28 health items that together are highly predictive of survival/mortality, from independent study cohorts. From the selected sets, we calculated frailty indexes and Klemera-Doubal's biological age estimates, and then compared their mortality prediction performance using Cox proportional hazards regression models. Our results indicate that the frailty index outperforms age and Klemera-Doubal's biological age estimates, especially among the oldest old who are most prone to biological aging-caused mortality. We also showed that a DNA methylation index, which was generated by applying the frailty/deficit index calculation method to 38 CpG sites that were selected using the same machine learning algorithms, can predict mortality even better than the best performing frailty index constructed from health, function, and blood chemistry. [ABSTRACT FROM AUTHOR]

Background: Individuals are often counseled to use behavioral weight loss strategies to reduce risk for cardiovascular disease (CVD). We examined whether any benefits for CVD risk from weight loss intervention extend uniformly to individuals across a range of underlying health states.Methods: The time until first occurrence of a composite of fatal and nonfatal myocardial infarction and stroke, hospitalized angina, or CVD death was analyzed from 8 to 11 years of follow-up of 4,859 adults who were overweight or obese, aged 45-76 years with Type 2 diabetes. Individuals had been randomly assigned to either an intensive lifestyle intervention (ILI) or diabetes support and education (DSE). Participants were grouped by intervention assignment and a frailty index (FI) based on deficit accumulation, ordered from fewer (first tertile) to more (third tertile) deficits.Results: Baseline FI scores were unrelated to intervention-induced weight losses and increased physical activity. The relative effectiveness of ILI on CVD incidence was inversely related to baseline FI in a graded fashion (p = .01), with relative benefit (hazard ratio = 0.73 [95% CI 0.55,0.98]) for individuals in the first FI tertile to no benefit (hazard ratio = 1.15 [0.94,1.42]) among those in the third FI tertile. This graded relationship was not seen for individuals ordered by age tertile (p = .52), and was stronger among participants aged 45-59 years (three-way interaction p = .04).Conclusions: In overweight/obese adults with diabetes, multidomain lifestyle interventions may be most effective in reducing CVD if administered before individuals have accrued many age-related health deficits. However, these exploratory analyses require confirmation by other studies.Clinical Trial Registration: NCT00017953. [ABSTRACT FROM AUTHOR]

In recent years, population health research has focused on understanding the determinants of later-life health. Two strands of that work have focused on (1) international comparisons of later-life health and (2) assessing the early-life origins of disease and disability and the importance of life course processes. However, the less frequently examined intersection of these approaches remains an important frontier. The present study contributes to the integration of these approaches. We use the Health and Retirement Study family of data sets and a cohort dynamic approach to compare functional health trajectories across 12 high-income countries and to examine the role of life course processes and cohort dynamics in contributing to variation in those trajectories. We find substantial international variation in functional health trajectories and an important role of cohort dynamics in generating that variation, with younger cohorts often less healthy at comparable ages than the older cohorts they are replacing. We further find evidence of heterogeneous effects of life course processes on health trajectories. The results have important implications for future trends in morbidity and mortality as well as public policy. [ABSTRACT FROM AUTHOR]

The article presents information on the studies to support that influenza vaccination can prevent hospitalizations related to respiratory illness and other related illness, and to encourage immunization for older adults in long-term care settings. It states that flu is also associated to decline in function and increased risk for stroke and myocardial infarction.

Federal older worker programs are attracting attention due to the growing number of older workers across the world. They are uniquely situated to provide out-of-market work opportunities to older job seekers, who often find their age a barrier to securing desirable jobs. In 2004, the Korean government established its own program, the Korean Senior Employment Program (KSEP); however, literature for international readers on this innovative program is lacking. Thus, this article aims to provide an in-depth description of KSEP and a brief comparison between the Senior Community Service Employment Program in the U.S. and KSEP. The unique characteristics of KSEP include having the dual program foci on supplemental income and social participation; expanding work opportunities in the private sector beyond community-based jobs; accepting participants who are financially disadvantaged as well as those with a high desire for social participation regardless of their income; and broadening work opportunities for those with professional skills beyond repetitive, simple, and temporary jobs. This article may offer helpful insights to older worker advocates from various countries in creating or modifying their programs. [ABSTRACT FROM AUTHOR]

Objectives: Well-being has been conceptualized as a two-dimensional construct that includes both hedonic and eudaimonic components. To date, existing measures of well-being may not adequately capture both of these components for older adults, and limited literature has explored whether the two constructs can be integrated into one factor to measure well-being in this population. Method: This study examined the factor structure of the 11 well-being items from the National Health and Aging Trends Study (NHATS), a nationally representative panel study of Medicare recipients in the US. Using data from the 2011 wave, we divided the community-dwelling sample into two random subsamples, testing our theory in sample 1 (n = 3305) and examining the replicability of the solution in sample 2 (n = 3297). Results: We conducted confirmatory factor analyses using a correlated uniqueness approach to account for the frequency and negatively worded method effects. The findings from sample 1 indicated that the single factor structure was a superior fit to the data, and the solution was confirmed by sample 2 [x2 (33) = 85.002, p < .001, RMSEA = 0.022 (90% CI = 0.016- 0.028), CFI = 0.993, TLI = 0.989, WRMR = 0.831]. Conclusion: Findings suggest that although the hedonic and eudaimonic components of well-being may be conceptually distinct, they are highly correlated in the NHATS well-being measures and should be measured as a single construct. Implications for future research using the NHATS and research using other data sources and focusing on other populations are discussed. [ABSTRACT FROM AUTHOR]

Background: We examined physical functioning (PF) trajectories (maintaining, slowly declining, and rapidly declining) spanning 15 years in older women aged 65-80 and protective factors that predicted better current levels and less decline in functional independence outcomes after age 80.Methods: Women's Health Initiative extension participants who met criteria (enrolled in either the clinical trial or observational study cohort, >80 years at the data release cutoff, PF survey data from initial enrollment to age 80, and functional independence survey data after age 80) were included in these analyses (mean [SD] age = 84.0 [1.4] years; N = 10,478). PF was measured with the SF-36 (mean = 4.9 occasions). Functional independence was measured by self-reported level of dependence in basic and instrumental activities of daily living (ADLs and IADLs) (mean = 3.4 and 3.3 occasions).Results: Maintaining consistent PF in older adulthood extends functional independence in ADL and IADL in late-life. Protective factors shared by ADL and IADL include maintaining PF over time, self-reported excellent or very good health, no history of hip fracture after age 55, and no history of cardiovascular disease. Better IADL function is uniquely predicted by a body mass index less than 25 and no depression. Less ADL and IADL decline is predicted by better self-reported health, and less IADL decline is uniquely predicted by having no history of hip fracture after age 55.Conclusions: Maintaining or improving PF and preventing injury and disease in older adulthood (ages 65-80) has far-reaching implications for improving late-life (after age 80) functional independence. [ABSTRACT FROM AUTHOR]

Context An aging population leads to a growing demand for long-term services and supports (LTSS). In 2002, France introduced universal, income-adjusted, public long-term care coverage for adults 60 and older, whereas the United States funds means-tested benefits only. Both countries have private long-term care insurance (LTCI) markets: American policies create alternatives to out-of-pocket spending and protect purchasers from relying on Medicaid. Sales, however, have stagnated, and the market's viability is uncertain. In France, private LTCI supplements public coverage, and sales are growing, although its potential to alleviate the long-term care financing problem is unclear. We explore whether France's very different approach to structuring public and private financing for long-term care could inform the United States' long-term care financing reform efforts. Methods We consulted insurance experts and conducted a detailed review of public reports, academic studies, and other documents to understand the public and private LTCI systems in France, their advantages and disadvantages, and the factors affecting their development. Findings France provides universal public coverage for paid assistance with functional dependency for people 60 and older. Benefits are steeply income adjusted and amounts are low. Nevertheless, expenditures have exceeded projections, burdening local governments. Private supplemental insurance covers 11% of French, mostly middle-income adults (versus 3% of Americans 18 and older). Whether policyholders will maintain employer-sponsored coverage after retirement is not known. The government's interest in pursuing an explicit public/private partnership has waned under President François Hollande, a centrist socialist, in contrast to the previous center-right leader, President Nicolas Sarkozy, thereby reducing the prospects of a coordinated public/private strategy. Conclusions American private insurers are showing increasing interest in long-term care financing approaches that combine public and private elements. The French example shows how a simple, cheap, cash-based product can gain traction among middle-income individuals when offered by employers and combined with a steeply income-adjusted universal public program. The adequacy of such coverage, however, is a concern. [ABSTRACT FROM AUTHOR]

Background: The Religious Orders Study and Rush Memory and Aging Project are both ongoing longitudinal clinical-pathologic cohort studies of aging and Alzheimer's disease (AD).Objectives: To summarize progress over the past five years and its implications for understanding neurodegenerative diseases.Methods: Participants in both studies are older adults who enroll without dementia and agree to detailed longitudinal clinical evaluations and organ donation. The last review summarized findings through the end of 2011. Here we summarize progress and study findings over the past five years and discuss new directions for how these studies can inform on aging and AD in the future.Results: We summarize 1) findings on the relation of neurobiology to clinical AD; 2) neurobiologic pathways linking risk factors to clinical AD; 3) non-cognitive AD phenotypes including motor function and decision making; 4) the development of a novel drug discovery platform.Conclusion: Complexity at multiple levels needs to be understood and overcome to develop effective treatments and preventions for cognitive decline and AD dementia. [ABSTRACT FROM AUTHOR]

Background: We focused on human-animal interaction (HAI) as an important aspect of social functioning at the individual level, framing this emerging field from a public health perspective.Methods: Using data from the Health and Retirement Study (HRS) 2012 HAI module, we describe the characteristics of pet ownership in a population of older adults, and examine the relation between pet ownership and multiple mental and physical health indicators such as health status, depression, and physical activity.Results: Of the 1657 participants in our subsample, approximately half (51.5%) reported being pet owners; the majority owned dogs or cats, and most had only one pet. Pet ownership was significantly associated with a higher likelihood of ever having had depression, with pet owners being 1.89 times more likely to have experienced depression. However, pet ownership was not associated with having experienced depression within the last week.Conclusions: The findings from this study could indicate a relationship between pet ownership and depression, but it is impossible to determine the directionality of that relationship. It is possible that owning a pet may put a person at an increased risk of developing depression, or individuals who are at risk, or who have already developed depression, may acquire a pet as a way of managing their depressive symptoms. The findings of this study provide an initial step in contributing to our understanding of the relationship between companion animals and the social, physical, and mental well-being of the HRS study population. Future research should include measures of HAI in longitudinal, population-based surveys. [ABSTRACT FROM AUTHOR]