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Few reliable estimates have been available for assessing the impact of the COVID-19 pandemic on mortality among Native Americans. Using deidentified publicly available data on deaths and populations by age, we estimated life expectancy for the years 2019-2022 for single-race non-Hispanic Native Americans. Life expectancy in 2022 was 67.8 years, 2.3 years higher than in 2021 but a huge 4-year loss from 2019. Although our life expectancy estimates for 2022 varied under different assumptions about racial/ethnic classification and age misreporting errors, all estimates were lower than the average for middle-income countries. Estimates of losses and gains in life expectancy were consistent across assumptions. Large reductions in COVID-19 death rates between 2021 and 2022 were largely offset by increases in rates of death from unintentional injuries (particularly drug overdoses), chronic liver disease, diabetes, and heart disease, underscoring the difficulties facing Native Americans in achieving reductions in mortality, let alone returning to levels of mortality prior to the pandemic. Serious data problems have persisted for many years, but the scarcity and inadequacy of estimates during the pandemic have underscored the urgent need for timely and accurate demographic data on the Native American population. [ABSTRACT FROM AUTHOR]

Recent studies have found mixed results regarding the association between leukocyte telomere length (LTL)--thought to be a marker of cellular aging--and all-cause mortality. Some studies have reported a significant inverse relationship, but others have not, perhaps in part owing to insufficient power. We examine the relationship using data from a nationally representative sample of older Taiwanese (54+ in 2000), which is larger (n = 942) than most previous studies, and which includes comprehensive information on potential confounders including white blood cell distribution and inflammatory markers. Results from a Cox hazards model demonstrate a small, but significant, association between LTL and mortality that is independent of age, sex, and lifestyle factors. White blood cell distribution, especially the proportion of neutrophils, is an important predictor of LTL; however, the association between LTL and mortality changes little controlling for white blood cell distribution. In contrast, the association between LTL and mortality weakens considerably (by 48%) after adjustment for inflammatory markers and homocysteine. Our results suggest that the relationship between short telomeres and mortality is tied to inflammation and homocysteine. Longitudinal studies are needed to explore bidirectional influences resulting from the fact that inflammation leads to shorter leukocyte telomeres, which in turn results in senescence, which exacerbates inflammation. [ABSTRACT FROM AUTHOR]

Background: The allostatic load framework implies that cumulative exposure to stressors results in multi-system physiological dysregulation. Purpose: The purpose of this study was to investigate the effect of stress burden on subsequent changes (2000-2006) in physiological dysregulation. Methods: Data came from a population-based cohort study in Taiwan ( n = 521, aged 54+ in 2000, re-examined in 2006). Measures of stressful events and chronic strain were based on questions asked in 1996, 1999, and 2000. A measure of trauma was based on exposure to the 1999 earthquake. Dysregulation was based on 17 biomarkers (e.g., metabolic, inflammatory, neuroendocrine). Results: There were some small effects among men: chronic strain was associated with subsequent increases in dysregulation (standardized β = 0.08, 95 % CI = 0.01 to 0.20), particularly inflammation; life events were also associated with increased inflammation ( β = 0.10, CI = 0.01 to 0.26). There were no significant effects in women. Conclusions: We found weak evidence that stress burden is associated with changes in dysregulation. [ABSTRACT FROM AUTHOR]

This study examined associations among life satisfaction, perceptions of future happiness, and mobility limitations in a population-based sample of 3,363 older persons from the Survey of Health and Living Status of the Near Elderly and Elderly in Taiwan. We used zero-inflated Poisson regression to determine if current life satisfaction and perceptions of future happiness were independently related to the number of mobility limitations that developed during an approximately 8-year period. We adjusted for sociodemographic characteristics, health status, social involvement, and depressive symptoms at baseline. Life satisfaction and perceptions of future happiness were both associated with the development of fewer mobility limitations during follow-up, but only for those participants who had no mobility limitations at baseline. The results suggest a protective relationship between psychological well-being and physical decline in later life. This study examined associations among life satisfaction, perceptions of future happiness, and mobility limitations in a population-based sample of 3,363 older persons from the Survey of Health and Living Status of the Near Elderly and Elderly in Taiwan. We used zero-inflated Poisson regression to determine if current life satisfaction and perceptions of future happiness were independently related to the number of mobility limitations that developed during an approximately 8-year period. We adjusted for sociodemographic characteristics, health status, social involvement, and depressive symptoms at baseline. Life satisfaction and perceptions of future happiness were both associated with the development of fewer mobility limitations during follow-up, but only for those participants who had no mobility limitations at baseline. The results suggest a protective relationship between psychological well-being and physical decline in later life. [ABSTRACT FROM AUTHOR]

Objectives. This study examined socioeconomic differentials in mortality among Hispanics in the United States, focusing on the older ages. We address previous research suggesting that social disparities in health are smaller for Hispanics than for non-Hispanic Whites and examine whether these differentials in survival are related to the mortality advantage that characterizes the older Hispanic population (i.e., the Hispanic paradox). Methods. We used Poisson regression models based on data from the 1989 to 1994 waves of the National Health Interview Survey, with linked mortality through 1997, to estimate death rates for Hispanics and non-Hispanic Whites by age, gender, and socioeconomic status. Results. Deaths rates varied significantly (p < .05) by education and income for Whites and Hispanic subgroups defined by nativity (U.S. born and foreign born) and nationality (Mexican, Puerto Rican, and other Hispanic). However, with the exception of Puerto Ricans, the effects of education were significantly smaller for Hispanics than for Whites. The ethnic differences in mortality patterns by income were not statistically significant. Discussion. The findings reveal that the mortality advantage for Hispanics is concentrated at lower levels of socioeconomic status, with little or no advantage at higher levels. We propose several mechanisms related to immigration and assimilation patterns that may underlie these patterns of mortality. [ABSTRACT FROM AUTHOR]

Background. Few studies focus on "preclinical" warning signs associated with mortality. In this article, we investigate associations between all-cause mortality and two clusters of biological risk factors: (i) standard clinical measures related to cardiovascular disease and metabolic function; and (ii) nonclinical measures pertaining to hypothalamic-pituitary-adrenal axis activity, sympathetic nervous system activity, and inflammatory response. Methods. Data come from the 2000 Social Environment and Biomarkers of Aging Stud,. a national sample of Taiwanese persons aged 54 years or older; 1497 persons were interviewed in their homes, and 1023 participated in a hospital examination. The analysis is based on 927 respondents with complete information. Logistic regression models describe the association between biomarkers and the 3-year probability of dying. Results. Although both groups of biomarkers are significantly associated with mortality, the model with neuroendocrine and immune biomarkers has better explanatory and discriminatory power than the one with clinical measures. The association between these nonclinical measures and mortality remains strong after adjustment for the clinical markers, suggesting that the physiological effects of the nonclinical biomarkers are broader than those captured by the cardiovascular and metabolic system measures included here. Conclusions. Nonclinical markers are likely to provide warning signs of deteriorating health and function beyond what can be learned from conventional markers. Our findings are consistent with those of recent studies that (i) demonstrate the importance of neuroendocrine and immune system markers for survival, and (ii) indicate that standard clinical variables are less predictive of mortality in older than in younger populations. [ABSTRACT FROM AUTHOR]

We investigate how biological markers of individual responses to stressful experiences are associated with profiles of physical and mental functioning in a national sample of middle-aged and elderly Taiwanese. Data come from a population-based sample of middle-aged and elderly Taiwanese in 2000. The data combine rich biological measures with self-reported information on physical and mental health. Grade of membership methods are used to summarize functional status, and multinomial logit models provide information on the association between biological measures and function. The analysis identifies significant associations between biomarkers of stressful experience and profiles of physical and mental functioning. The estimates reveal the potential importance for health of both low and high values of biological parameters. The findings point to directions for future research regarding development of aggregate measures of cumulative dysregulation across multiple physiological systems. [ABSTRACT FROM AUTHOR]

The Social Environment and Biomarkers of Aging Study (SEBAS) is a nationally representative longitudinal survey of Taiwanese middle-aged and older adults. It adds the collection of biomarkers and performance assessments to the Taiwan Longitudinal Study of Aging (TLSA), a nationally representative study of adults aged 60 and over, including the institutionalized population. The TLSA began in 1989, with follow-ups approximately every 3 years; younger refresher cohorts were added in 1996 and 2003. The first wave of SEBAS, based on a sub-sample of respondents from the 1999 TLSA, was conducted in 2000. A total of 1023 respondents completed both a face-to-face home interview and, several weeks later, a hospital-based physical examination. In addition to a 12-h (7 pm-7 am) urine specimen collected the night before and a fasting blood specimen collected during the examination, trained staff measured blood pressure, height, weight and waist and hip circumferences. A second wave of SEBAS was conducted in 2006 using a similar protocol to SEBAS 2000, but with the addition of performance assessments conducted by the interviewers at the end of the home interview. Both waves of SEBAS also included measures of health status (physical, emotional, cognitive), health behaviours, social relationships and exposure to stressors. The SEBAS data, which are publicly available at [http://www.icpsr.umich.edu/icpsrweb/NACDA/studies/3792/version/5], allow researchers to explore the relationships among life challenges, the social environment and health and to examine the antecedents, correlates and consequences of change in biological measures and health. [ABSTRACT FROM AUTHOR]

Previous research evaluating quality of health interview survey data has generally relied upon comparisons of household interview data with medical records or other external sources of information. However, “gold standards” are not always satisfactory or available. This paper Illustrates an alternative approach to the evaluation of data quality—examination of the reliability of reports of chronic conditions in longitudinal surveys. The data come from national samples of older Americans (First National Health and Nutrition Examination Survey Epidemiologic Followup Study, 1971–1975, 1982–1984, 1986) and older Taiwanese (Survey of Health and Living Status of the Elderly, 1989, 1993, 1996). The results show that, among respondents who reported a chronic condition at a given interview, the likelihood that the condition was acknowledged at the subsequent interview was higher for hypertension and diabetes than for arthritis and stroke. Low levels of consistency for stroke appear to result partly from the poor wording of questions. In Taiwan, younger, more educated persons and those experiencing severe conditions were somewhat more likely to acknowledge the condition at follow-up compared with their respective counterparts. Women and persons of high cognitive status in the United States and respondents in both countries who used a proxy to report the occurrence of a stroke were also more likely to acknowledge conditions at follow-up. Am J Epidemiol 2000; 151: 315–23. [ABSTRACT FROM PUBLISHER]

Objectives. The purpose of this study is to examine stability and change in Taiwanese elders' perceptions about the availability of social support and the sociodemographic and cultural factors associated with change. Methods. This study uses data from four waves of the Survey of Living Status of the Elderly in Taiwan that spans a 10-year period and employs latent growth curve models to examine trajectories of perceived support and the sociocultrural factors that may explain variability in baseline levels of support and variability in changes in support as respondents age. Results. Perceptions about social support appear to follow a linear trajectory across age, with significant variation in baseline perceptions and in patterns of change in perceived support across the sample. Sociocultural factors primarily explain differences in initial levels of support but also have some effect on changes in support. Discussion. Despite the increasing pressures and demands on adult children's time that are associated with social and economic development, the elderly in Taiwan on average feel supported by their social networks, with the perceived availability of support increasing with age. [ABSTRACT FROM AUTHOR]

Quantification of biological aging is of interest in gerontology as a means to surveil aging rates in the population and to evaluate the effects of interventions to increase healthy life span. Analysis of proposed methods to quantify biological aging has focused on samples of midlife or mixed-age adults in the West. Research is needed to test whether quantifications of biological aging can differentiate aging rates among older adults and if quantifications of biological aging developed in Western samples can differentiate aging rates in non-Western populations. We conducted analysis of Klemera-Doubal method (KDM) Biological Age and homeostatic dysregulation measures of biological aging developed in the U.S. NHANES and tested in a sample of older Taiwanese adults in the Social Environment and Biomarkers of Aging Study. We conducted analysis of physical and cognitive function and mortality, comparing quantifications of biological aging to a biomarker index based on norms within our analysis sample and to participants' ratings of their own health. Results showed that quantifications of biological aging (a) predicted differences in physical and cognitive function and in mortality risk among Taiwanese older adults and (b) performed as well as a traditional biomarker index and participant self-rated health for prediction of these outcomes. [ABSTRACT FROM AUTHOR]

Objectives. Models of stress incorporate both the environmental demands experienced by individuals (stressors) and the appraisal of these life events (perceptions). Because little is known about the extent to which experience and perceptions are related, we examine this relationship in a nationally representative population of older Taiwanese adults. Method. Using growth models applied to data from 3 waves (1999, 2003, and 2007) of the Taiwan Longitudinal Study of Aging, we (a) investigate patterns of change in perceived stress in later adulthood and (b) examine how experienced stressors influence perceived stress. Participants were asked to report the presence of, and in some cases the degree of, exposure to stressors including total number of medical conditions, difficulty with activities of daily living, difficulty with mobility functions, being financially worse off compared with the prior wave, experiencing the death of a child, and experiencing a marital disruption. Items reflecting perceived stress included concerns about various domains pertaining to the respondent and his/her family member. Results. Our results indicate that exposure to stressors increases, whereas perceived stress decreases, over time. Change in exposure to stressors is not generally associated with change in perceptions of stress, with the exception of a summary measure of health-related exposure to stressors. An increase in poor health over time is related to an increase in perceived stress in all domains. Discussion. The results underscore the importance of distinguishing between perceptions of stress and exposure to stressors when studying the links between stress and health among older adults. Furthermore, the diminishing linkage between experienced stressors and perceptions of stress suggests that older adults’ appraisal may be an adaptive coping strategy that emerges to buffer some of the difficulties that are inevitable in later life. [ABSTRACT FROM PUBLISHER]

Objectives. This study assesses whether socioeconomic and demographic differences in reported mobility limitations are attributable to differential perceptions of mobility difficulty that result in the differential use of response categories. Methods. Data come from the Social Environment and Biomarkers of Aging Study and its parent study, the Taiwan Longitudinal Study of Aging. Ordered probit models with person-specific cut-points are used to test whether, after controlling for underlying mobility using objective performance measures, cut-points for reporting mobility limitations vary across groups defined by demographic and socioeconomic characteristics. Results. Age is the only characteristic that is consistently associated with the location of the cut-points for reporting mobility difficulty: At the same level of underlying mobility difficulty, older adults are more likely than younger adults are to report difficulty with all tasks except short walks. Other variables showed differences but only for one specific activity, for example, urban residents are more likely to report difficulty running than are rural residents with the same underlying level of mobility function. Discussion. For most mobility activities, there are no systematic differences in the perception of difficulty by individual characteristics. Thus, for older Taiwanese adults, differences in mobility limitations associated with socioeconomic status are more likely to reflect underlying differences in function than differences in how these groups report the same capacity. The usual loss of mobility with age, however, reflects both a decrease in capacity and a lowering of the threshold for reporting difficulty. [ABSTRACT FROM PUBLISHER]