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Apolipoprotein E (APOE) genotype is believed to play a role in the onset of dementia, though less is known about its relationship with non-pathogenic age-related cognitive decline. We assessed whether APOE was a risk factor for cognitive decline among older Taiwanese adults using nationally representative data. General cognition was measured longitudinally over eleven years; domain-specific cognitive assessments of working memory, declarative learning and three aspects of attention (executive function, alerting, and orientation) were performed once. Having at least one risky APOE allele was associated with more rapid longitudinal cognitive decline compared to those with no risky alleles. Some evidence from the cross-sectional analysis of domain-specific cognitive assessments suggested that APOE genotype may be more closely associated with working memory and declarative learning than with attention. Most genetic studies of cognition include only populations of European descent; extension is crucial. This study confirmed the association between APOE genotype and the rate of cognitive decline in a predominantly Han Chinese population. Additional studies on diverse populations are warranted. [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]

Abstract: The death of a child is one of the most traumatic events that a parent can experience. The psychological and physical consequences of bereavement are well established, and the consequences are more severe for mothers than fathers. However, little is known about how the death of an adult child affects parental wellbeing in old age or how the deceased child's sex may moderate the association. We use data from the Taiwanese Longitudinal Study of Aging (TLSA) to investigate how the death of a son or a daughter differentially affects the wellbeing of older parents, measured by depressive symptoms and self-rated health. We find that for mothers, a son's death is associated with an increase in depressive symptoms and a decline in self-rated health, but fathers' health is not adversely affected by a son's death. There is little evidence that a daughter's death has a negative effect on either maternal or paternal wellbeing. We situate these findings within their social and cultural contexts and discuss social policies that would reduce gender and health inequality. [Copyright &y& Elsevier]

Perceived stress is associated with poor health outcomes including negative affect, increased susceptibility to the common cold and cardiovascular disease; the consequences of perceived stress for mortality, however, have received less attention. This study characterizes the relationship between perceived stress and 11-year mortality in a population of Taiwanese adults aged 53+ years. Using the Survey of Health and Living Status of the Near Elderly and Elderly of Taiwan, we calculated a composite measure of perceived stress based on six items pertaining to the health, financial situation, and occupation of the respondents and their families. Proportional hazard models were used to determine whether perceived stress predicted mortality. After adjusting for sociodemographic factors only, we found that a one standard deviation increase in perceived stress was associated with a 19% increase in all-cause mortality risk during the 11-year follow-up period (hazard ratio, HR = 1.19, 95% confidence interval, CI 1.13-1.26). The relationship was greatly attenuated when perceptions of stress regarding health were excluded, and was not significant after adjusting for medical conditions, mobility limitations and depressive symptoms. We conclude that the association between perceived stress and mortality is explained by an individual's current health; however, our data do not allow us to distinguish between two possible interpretations of this conclusion: (a) the relationship between perceived stress and mortality is spurious, or (b) poor health acts as the mediator. [ABSTRACT FROM AUTHOR]

Abstract: Obesity among the Mexican-origin adult population in the US has been associated with longer stays in the US and with being US- vs. Mexican-born, two proxies for acculturation. This pattern is less clear for Mexican-origin children and young adults: recent evidence suggests that it may be reversed, with foreign-born Mexican youth in the US at higher risk of obesity than their US-born Mexican–American counterparts. The objective of this study is to evaluate the hypothesis that the immigrant advantage in obesity prevalence for Mexican-origin populations in the US does not hold for children and young adults. We use data from the Los Angeles Family and Neighborhood Survey (N = 1143) and the California Health Interview Survey (N = 25,487) for respondents ages 4–24 to calculate the odds of overweight/obesity by ethnicity and nativity. We find support for the hypothesis that overweight/obesity prevalence is not significantly lower for first-generation compared to second- and third-generation Mexican-origin youth. Significantly higher obesity prevalence among the first generation was observed for young adult males (ages 18–24) and adolescent females (ages 12–17). The previously-observed protective effect against obesity risk among recent adult immigrants does not hold for Mexican-origin youth. [Copyright &y& Elsevier]

The apolipoprotein E (ApoE) gene, which has three common alleles (ϵ2, ϵ3, and ϵ4), has been linked to a number of health outcomes and longevity. The ϵ2 allele has been reported to have neuroprotective effects, whereas the ϵ4 allele has been shown to be a risk factor for cardiovascular disease and Alzheimer's disease in various populations. The relationships between ApoE and mortality and ApoE and physical function, however, are not clear-cut. We used the Social Environment and Biomarkers of Aging Study (SEBAS) to examine the relationship between ApoE polymorphisms and physical and pulmonary function in approximately 1,000 Taiwanese adults aged 53 years and older in 2006. In the 2006 SEBAS wave, measures of physical function included self-reported difficulties with respect to activities of daily living (ADLs) and other physical function indicators, as well as performance-based measures of grip strength (kg), walking speed (m/s) over a distance of 3 m, and chair stand speed (stand/s). Peak expiratory flow (PEF; L/min) rate was also examined as an indicator of pulmonary function. We used logistic regression models to determine the association between ApoE and inability to complete each of the tests of physical and pulmonary function. These models revealed no significant association between ApoE carrier status and any of the indicators of function. Among participants able to complete a given task, we next used linear regression models to examine self-reported limitations with ADLs and performance on the given test by ApoE carrier status. Similarly, there were no significant relationships between ApoE carrier status and the measures of function. Our estimates provide further confirmation that the ApoE gene may not be a risk factor for functional decline among older Taiwanese adults. [ABSTRACT FROM AUTHOR]

Abstract: Polymorphisms of the apolipoprotein E gene (ApoE) have been associated with health and longevity. Numerous studies have linked ApoE to health outcomes including cardiovascular disease and mortality, but far fewer studies have examined the relationship of ApoE to other biological markers of health. This study investigates the relationship between ApoE and mortality, as well as ApoE and a set of biomarkers related to cardiovascular and immune function, in a population-based sample of Taiwanese adults ages 54+. ApoE ɛ2 carriers were less likely to have at-risk levels of high-density lipoprotein (HDL-C) and total cholesterol (total-C) than non-carriers (odds ratio [OR] 0.45, 95% confidence interval [CI] 0.25–0.83 and OR 0.45, 95% CI 0.29–0.71, respectively). ApoE ɛ4 carriers were less likely to have elevated levels of C-reactive protein (CRP) than non-carriers (OR 0.62, 95% CI 0.39–0.96). ApoE genotype was not, however, associated with mortality after 8 years of follow-up. Our findings confirm the association between ApoE ɛ2 and cholesterol levels, suggesting a potential protective effect of ApoE ɛ2 on blood lipids. They also contribute to reports on the relationship between ApoE ɛ4 carrier status and lower CRP levels. [Copyright &y& Elsevier]

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]

Objectives. We used nationally representative longitudinal data from the Mexican Family Life Survey to determine whether recent migrants from Mexico to the United States are healthier than other Mexicans. Previous research has provided little scientific evidence that tests the "healthy migrant" hypothesis. Methods. Estimates were derived from logistic regressions of whether respondents moved to the United States between surveys in 2002 and 2005, by gender and urban versus rural residence. Covariates included physical health measurements, self-reported health, and education measured in 2002. Our primary sample comprised 6446 respondents aged 15 to 29 years. Results. Health significantly predicted subsequent migration among females and rural males. However, the associations were weak, few health indicators were statistically significant, and there was substantial variation in the estimates between males and females and between urban and rural dwellers. Conclusions. On the basis of recent data for Mexico, the largest source of migrants to the United States, we found generally weak support for the healthy migrant hypothesis. (Am J Public Health. 2008;98:78-84. doi:10.2105/AJPH.2006. 098418) [ABSTRACT FROM AUTHOR]

Purpose: This study examines the importance of clinical risk factors for predicting self-ratings of general health status, with and without controls for a broad range of self-reported indicators of physical and psychological well-being.Methods: Ordered probit models, estimated on 928 respondents aged 54 years and older who participated in an ongoing national survey in Taiwan, are used to examine the correlates of self-rated health. The model is estimated in two stages, first testing the association between clinical risk factors and self-rated health and second, examining whether those clinical measures remain significant after controlling for a large number of other factors hypothesized to affect self-ratings.Results: Most of the clinical variables are significantly associated with self-rated health, even in the presence of control variables. The largest effects pertain to the BMI, ratio of total to HDL cholesterol (among men) and presence of the epsilon4 allele of the APOE gene (among women).Conclusions: The results suggest a variety of pathways linking clinical measures to the self-ratings. The findings also suggest that the clinical measures are less powerful predictors than self-reports about diverse aspects of well-being. [ABSTRACT FROM AUTHOR]

We investigated relationships between independently observed, visual cues of residential environments and subsequent participant-reported stress within a population-based cohort of Black breast cancer survivors (n = 476). Greater visual cues of engagement - presence of team sports, yard decorations, outdoor seating - (compared to less engagement) was marginally associated with lower perceived stress in univariate models, but attenuated towards null with adjustment for socio-demographic, behavioral, and health-related covariates. Similarly, physical disorder and perceived stress were not associated in adjusted models. Relationships between observed built environment characteristics and perceived stress might be influenced by socioeconomic and health behavior factors, which longitudinal studies should investigate. [ABSTRACT FROM AUTHOR]