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Background and Objectives This study investigated the association between information and communication technology (ICT) use and loneliness among community-dwelling older adults (aged 65+), as well as the mediating effects of social relations, perceived control, and purpose-in-life. Research Design and Methods The study used data from the 2014 and 2018 Health and Retirement Study (N = 3,026), employing autoregressive path models with contemporaneous mediation to assess the association of 2 kinds of ICT use, social media communication and general computer use, with loneliness through the pathways of perceived social support, social contact, perceived constraints, and purpose-in-life. Results Social media communication had a negative association with loneliness. Perceived social support and social contact mediated this association, but not perceived constraints, or purpose-in-life. General computer use did not have a significant total effect on loneliness; however, a significant indirect effect through perceived constraints, purpose-in-life, and social contact was found. Discussion and Implications Our findings extended the existing literature regarding the important factors associated with variation in loneliness among older adults. Health programs and ICT solutions could be more effective in mitigating loneliness if they target the root causes of loneliness, including reducing perceptions of constraints and increasing a sense of purpose-in-life, along with strengthening social relationships. [ABSTRACT FROM AUTHOR]

We examine cross-spouse associations between education and financial literacy among older couples, net of own education, and whether the cross-spouse associations differ by gender. Using data from the Cognitive Economics Study, we employ multilevel actor–partner interdependence regression models to examine both the actor and partner associations between education and financial literacy (N = 205 dyads) and the moderating role of gender. Findings indicate that the partner association between education and financial literacy was moderated by gender. Husbands' education was associated with wives' financial literacy, net of own education and controls, but wives' education was not associated with husbands' financial literacy. The study adds to our knowledge of the role of the family context in financial literacy, net of own education. Results suggest that factors shaping financial knowledge may spill over from husbands to wives. Interventions to enhance older adults' financial knowledge should take into account the family context and consider couple-based approaches. [ABSTRACT FROM AUTHOR]

Extant research offers limited understanding of the context in which economic resource and hardship at older ages are assessed. This study investigates the association between location-specific income security and hardship, and the moderating role of financial knowledge, using data from the Understanding America Study. We found that respondents with better location-specific income security were less likely to experience hardship and that financial knowledge strengthened the negative association between income security and hardship. Findings suggest that interventions to improve later-life financial knowledge may offer protection against hardship and that evaluations of later-life income adequacy may benefit from location-specific assessments of cost-of-living. [ABSTRACT FROM AUTHOR]

Objectives Guided by the social convoy model, this study investigated the association between friendship and cognitive functioning among older Chinese adults, as well as the moderating effect of marital status (married vs widowed). We also explored whether depression might account for the link between friendship and cognitive functioning. Methods We used data from the China Longitudinal Aging Social Survey in 2014 (N = 8,482). Cognitive functioning was measured with the Mini-Mental State Examination instrument and friendship was assessed with a 3-item Lubben Social Network Scale. Linear regression and path analyses within a structural equation modeling framework were performed to examine the hypotheses. Results Results indicated that friendship was significantly related to better cognitive functioning among older Chinese adults (β = 0.083, p <.001) and marital status moderated this association (β = −0.058, p <.01). In addition, depression partially mediated the relationship between friendship and cognitive functioning (β = 0.015, p <.001). Discussion The results implied that friendship is important for maintaining cognitive functioning in later life and widowed older Chinese adults may benefit more from friendship in its relationship to cognitive functioning than married older Chinese adults. Further, one potential pathway linking friendship to cognitive functioning may be through depression; however, more research is needed to support this finding. Intervention programs aimed at building friendship opportunities may be one way to achieve better cognitive aging. [ABSTRACT FROM AUTHOR]

As the age-friendly movement grows in its second decade, urgent questions of initiative sustainability have taken hold in the academic literature and among advocates implementing age-friendly changes. The creation of authentically age-inclusive environments requires not just the continuation of the initiative, but that its principles become embedded in formal and informal organizational processes, across sectors and beyond familiar networks focused on older populations. This embedding ensures the initiative's values take root permanently in a community's institutional culture. This article argues that the sustainability of age-friendly initiatives is enhanced by "spillover" effects, in which a behavioral or policy change in one environment spurs change in another environment. Evidence for such spillover and an understanding of how and when it occurs is currently limited in the context of age-friendly environments. This article draws on the experiences of Age-Friendly Boston, which has been working toward age-friendly goals for more than 5 years. Based on Boston's experience, we identify, describe, and exemplify 3 pathways to positive spillover across environments: (a) branding positively, (b) publicizing successes, and (c) embarking on new relationships, while strengthening existing ones, in pursuit of shared goals. We also draw conclusions about what positive spillover means for the sustainability of age-friendly environments. [ABSTRACT FROM AUTHOR]

Background and Objectives Framed within Conservation of Resources theory, this study addressed race–ethnic differences in the relationships between emotional distress and current and expected coronavirus disease 2019 (COVID-19) pandemic stressors. Research Design and Methods The study employed data from the Household Pulse Survey, a large national survey collecting weekly data to understand the experiences of Americans during the COVID-19 pandemic (age 55 and above; N = 94,550). Emotional distress included depression and anxiety symptoms. COVID-19 stressors included current and expected income, housing, health care, and food insecurities. Results Older persons of color reported higher rates of stressors and emotional distress than their White counterparts. In relation to current stressors, older Black persons responded with less emotional distress and older Latino persons responded with more emotional distress than older White persons. In addition, older persons of color were more likely to expect future resource losses related to COVID-19, and the association between these expectations and emotional distress varied by race–ethnic group. Discussion and Implications The findings reflected the disproportionate negative impact of COVID-19 stressors on emotional distress among older persons of color, providing a baseline for future studies to further examine the impacts of the pandemic among diverse older adult populations. [ABSTRACT FROM AUTHOR]

Objective: We estimate depressive symptoms in a sample of older Hmong refugees in the United States, and investigate factors shaping risk of depression in this population. Method: Data were collected in California and Minnesota (N = 127). The study sample included Hmong immigrants aged 55 and over. The measure of depression used is the Hopkins Symptom Checklist–10 (HSCL-10) inventory. Linear regression models were used to identify significant correlates of depressive symptoms. Results: More than 72% of the participants indicated being symptomatic of depression, as reflected by having a HSCL-10 score of 1.85 or higher. Self-reported health was a risk factor for depression. Protective factors from depression were larger household size and older age of arrival into the United States. Discussion: This study updated knowledge about the mental health status of Hmong refugees, who are now at later life. Our findings suggest that depression may be a lifelong experience in this high risk population. [ABSTRACT FROM AUTHOR]

Background and Objectives The purpose of this study is to compare treatment preferences of patients to those of surrogates on the Physician Orders for Life-Sustaining Treatment (POLST) forms. Research Design and Methods Data were collected from a sequential selection of 606 Massachusetts POLST (MOLST) forms at 3 hospitals, and corresponding electronic patient health records. Selections on the MOLST forms were categorized into All versus Limit Life-Sustaining Treatment. Multivariable mixed effects (grouped by clinician) logistic regression models estimated the impact of using a surrogate decision maker on choosing All Treatment, controlling for patient characteristics (age, severity of illness, sex, race/ethnicity), clinician (physician vs non-physician), and hospital (site). Results Surrogates signed 253 of the MOLSTs (43%). A multivariable logistic regression model taking into consideration patient, clinician, and site variables showed that surrogate decision makers were 60% less likely to choose All Treatment than patients who made their own decisions (odds ratio = 0.39 [95% confidence interval = 0.24–0.65]; p <.001). This model explained 44% of the variation in the dependent variable (Pseudo- R 2 = 0.442; p <.001); mixed effects logistic regression grouped by clinician showed no difference between the models (LR test = 4.0e-13; p = 1.00). Discussion and Implications Our study took into consideration variation at the patient, clinician, and site level, and showed that surrogates had a propensity to limit life-sustaining treatment. Surrogate decision makers are frequently needed for hospitalized patients, and nearly all states have adopted the POLST. Researchers may want study decision-making processes for patients versus surrogates when the POLST paradigm is employed. [ABSTRACT FROM AUTHOR]

Older Americans rely heavily on Social Security benefits (SSBs) to support independent lifestyles, and many have few or no additional sources of income. We establish the extent to which SSBs adequately support economic security, benchmarked by the Elder Economic Security Standard Index. We document variability across U.S. counties in the adequacy levels of SSBs among older adults. We find that the average SSBs fall short of what is required for economic security in every county in the United States, but the level of shortfall varies considerably by location. Policy implications relating to strengthening Social Security and other forms of retirement income are discussed. [ABSTRACT FROM AUTHOR]

Objective: The purpose of this study was to investigate the association between three helping behaviors and incident cardiovascular disease (CVD; heart attack, stroke; fatal and nonfatal), with an exploration of gender differences. The study is framed within the caregiving system model. Helping others is argued to be an evolved characteristic of humans that yields beneficial health effects. Methods: Data were taken from the 2004-2014 waves of the Health and Retirement Study. The three forms of helping others considered were formal volunteering, informal helping, and caregiving for a parent or spouse. Cox proportional hazards models were estimated for gender-stratified samples. Results: Women who volunteered showed a lower risk of incident CVD compared to women who did not volunteer. Men who informally helped others in the community exhibited a lower risk of incident CVD compared to men who did not provide this form of help. Caregiving status was generally not associated with incident CVD for women or men. Discussion: The results demonstrated that specific types of prosocial behavior may be beneficial for women and men. However, tests for effect differences showed that gender did not moderate the relationships between these helping behaviors and CVD risk. [ABSTRACT FROM AUTHOR]

This study examines whether the cost of living is related to the probability of living alone among unmarried persons age 65 years and older in the United States. Cost of living is measured at the metropolitan area level by the Elder Economic Security Standard Index, which takes into account geographic variability in cost of housing, food, transportation, and medical care. Using multilevel modeling, we find that higher cost of living is related to a lower likelihood of living alone net of personal resources. Results also show that the gap in the likelihood of living alone between high- and low-income older adults is slightly lessened in low-cost metropolitan areas. We conclude that the price of “purchasing privacy” is substantially higher in some metropolitan areas than in others. These findings inform policies designed to help older adults age in place. [ABSTRACT FROM AUTHOR]

Objective: There is a growing demand for interpreters in the cancer setting. Interpreters, the link to quality care for limited English proficiency patients, face many psychosocial stressors in their work. This project assessed interpreters' experiences of stress and piloted a resiliency program to help interpreters cope with stressors.Methods: From 2013 to 2014, we pilot tested a targeted resiliency program with interpreters from three Boston-based hospitals. In Phase 1, we conducted five focus groups (n = 31) to identify interpreters' psychosocial needs. In Phase 2, we developed and tested a 4-h group program with 29 interpreters (response rate = 90%; 69% female, 54% Hispanic, 85% born outside of the U.S.).Results: Phase 1. Stressors were patient-based (seeing young patients decline), interactions with medical team (unsure of role), and systems-based (appointment unpredictability). Phase 2. At baseline interpreters reported low abilities to cope with stress (measured by the Measure of Current Status (MOCS-A)). At 4-week follow-up we found improvements in job satisfaction (p = .02; Cohen's d = .41) and declines in sick days (p = .08; Cohen's d = .38). Stress reactivity (MOCS-A) improved; specifically participants reported feeling more assertive about their needs (p = .10; Cohen's d = .30) and more able to relax at will (p = .10; Cohen's d = .35)-important mechanisms to lower distress.Conclusions: We piloted a resiliency program for medical interpreters in cancer care. We found that interpreters experience distress and have low coping skills. This program resulted in improved work factors and stress reactivity. Future research should include further implementation and testing in a larger, randomized trial.Copyright © 2016 John Wiley & Sons, Ltd. [ABSTRACT FROM AUTHOR]

For the first time, adults with intellectual and developmental disabilities (I/DD) are living to experience old age. The purpose of this project was to assess the activities of aging and disability resource centers (ADRCs) as they seek to serve older adults with intellectual disabilities and their family caregivers. Data come from 21 in-depth qualitative interviews with ADRC staff in seven states. Results of this qualitative analysis indicate that ADRCs are not focusing explicitly on adults aging with I/DD and their family caregivers, but meeting the needs of this population is a future goal of ADRCs. Challenges related to accessing and providing information and referral services for adults aging with I/DD were described and highlight existing unmet needs of this population. Supporting adults who simultaneously require aging and disability services requires true coordination of aging and disability service systems. [ABSTRACT FROM AUTHOR]