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Despite the importance of kin in caring for older relatives, few studies have examined the relationship between the family network and the risk of nursing home placement. Data from a cohort of noninstitutionalized elderly persons living in New Haven in 1982 were used to predict nursing home admission through 1985. Logistic regression analyses show that older persons who have regular contact with kin have a lower risk of institutionalization. For men, the spouse is most important in reducing the risk of entry; for women, having regular contact with at least one family member--of any relation--reduces the risk of entry. (Am J Public Health. 1994;84:843-845), Elderly people who have regular contact with family members are less likely to require admission to a nursing home. A total of 2,812 non-institutionalized men and women aged 65 years and older were interviewed about nursing home admissions and family support networks in 1982. Data from annual interviews conducted between 1982 and 1985 were analyzed. For both women and men regular contact with a family member reduced the risk of nursing home admission. However, there were differences in risk factors between women and men. Women who had at least one family member with whom they had regular contact were significantly less likely to require nursing home admission than women who had no contact with relatives. Men with wives were significantly less likely to require nursing home admission than men without spouses. This relationship existed for men regardless of the size of the family network.

Experienced well-being measures tap a distinct form of subjective well-being (SWB) and have different age-related properties than the more widely studied evaluations of life satisfaction. Unlike evaluations of the quality of life as a whole, experiential measures capture affective reactions soon after they occur. Recent advances in measurement have allowed for the inclusion of such experiential measures even in large-scale studies. However, respondent burden remains a concern; hence, surveys have also employed shorter experiential modules. The psychometric properties of these brief measures are not well understood. We examine the psychometric characteristics, including the factor structure and correlations with theoretically relevant criteria, of experienced wellbeing measures included in two supplements to the Panel Study of Income Dynamics (PSID). The first supplement included a detailed time diary whereas the second included a brief review of the prior day. Results show that for the detailed time diaries a single index of affective experience provides a useful summary of the associations among individual affect items, both within and between participants. For the abbreviated method, two or more subscales better describe the underlying structure. [ABSTRACT FROM AUTHOR]

Background: Racial and ethnic differences in disability persist and are possibly widening in recent years, but evidence is limited for racial and ethnic differences in disability progression through the entire disablement process and potential influential factors. The objective of this study is to examine racial and ethnic differences in patterns of late-life disability transitions, using a new disability spectrum that incorporates successful accommodation with assistive devices in response to capacity limitations to prolong independence.Methods: The study cohort consisted of a nationally representative sample of Medicare beneficiaries aged 65 and older in the United States who were enrolled in the 2011 National Health and Aging Trends Study and followed up annually until 2015 (n = 6,198). First-order Markov transition models were used to determine racial/ethnic differences in transitions among three stages of self-care and mobility limitations (fully able, successful accommodation, difficulty/assistance) and death.Results: After adjustment for age and sex, non-Hispanic Black and Hispanic respondents had higher probabilities of unfavorable transitions and lower probabilities of remaining in the successful accommodation stage than non-Hispanic White respondents. The racial and ethnic differences in probabilities of maintaining successful accommodation remained statistically significant after adjustment for socioeconomic and health factors (Black: 0.56, 95% CI = 0.52-0.60; Hispanic: 0.53, 95% CI = 0.44-0.61; White: 0.63, 95% CI = 0.61-0.65).Conclusions: Successful accommodation with assistive devices may provide possibilities for implementing interventions to enhance older adults' capacities and reducing racial/ethnic differences in late-life disability. [ABSTRACT FROM AUTHOR]

Objective. The purpose of this study was to provide new evidence on disability trends among elderly persons from 1982 to 1996. Methods. The sample includes 124,949 participants aged 70 and older in the 1982-1996 National Health Interview Surveys. Logistic analysis was used to estimate the trend in disability prevalence after controlling for various sociodemographic factors. Results. We found that: (a) the prevalence of disability has declined, but the gains did not persist throughout the entire period or accelerate over time; (b) only routine care disability has declined, whereas more severe personal care disability shows no improvements; (c) estimates are robust to the exclusion of the nursing home population but may be sensitive to growth in the assisted living population; (d) estimates of decline in disability prevalence are fairly consistent across five national surveys; (e) gains have been concentrated among the most educated elderly persons; and (f) gains in education appear to be an important confounder of the improvements. Discussion. Evidence from several surveys using various measures indicates that disability has declined among elderly persons. Determining the causes of the improvements should be a high priority in future research efforts.

Objectives. This study explored whether improvements in cognitive functioning occurred during the 1990s among older Americans and investigated several possible explanations for such changes. Methods. Using the 1993 Asset and Health Dynamics. of the Oldest Old study (N = 7,443) and 1998 Health and Retirement Survey (N = 7,624), this study examined aggregate changes in the proportion of the noninstitutionalized population aged 70 and older with severe cognitive impairment. Impairment was measured for self-respondents using a modified version of the Telephone Interview Cognitive Screen; for proxy respondents, ratings of memory and judgment were used. Logistic regression was used to investigate potential explanations aggregate changes. Results. The percentage of older Americans with severe cognitive impairment declined from 6.1% in 1993 to 3.6% in 1998 (p [is less than] .001). The decline was statistically significant among self-respondents but not among those with proxy interviews. Improvements between 1993 and 1998 were not explained by shifts in demographic and socioeconomic factors or by changes in the prevalence of stroke, vision, or hearing impairments. Discussion. As a group, older persons, especially those well into their 80s, appear to have better cognitive functioning today than they did in the early 1990s.

Objectives. This study explores the analytic implications of using questions about difficulty with daily activities that do not specify whether to consider assistance. Methods. For 1,054 Asset and Health Dynamics of the Oldest Old Study Wave 2 respondents, we compared responses to questions about difficulty without reference to assistance (ambiguous difficulty) to those about difficulty without help or equipment (underlying difficulty) and difficulty with help or equipment, if used (residual difficulty). We modelled predictors of discordance by means of logistic regression. Results. Discordance exists for 15% of respondents between summary variables indicating underlying and ambiguous difficulty with one or more activities. Discrepancies are evenly split between respondents reporting (a) underlying but no ambiguous difficulty and (b) ambiguous but no underlying difficulty. Discordance also exists for 15% of respondents between summary variables indicating residual and ambiguous difficulty with one or more activities; most of these discrepancies involve reports of ambiguous but no residual difficulty. Most respondent characteristics investigated are not significant predictors of discrepancies. Discussion. Analysts should be aware that (a) ambiguously worded questions appear to be a better proxy for underlying than for residual difficulty, (b) discrepancies seem to be lower for separate activities than for summary variables indicating difficulty with one or more activities, and (c) being Hispanic and receiving help may affect reporting discrepancies.

Relatively low response rates in mixed mode studies remain a concern. Whether targeting protocols to match respondents' likely mode is an effective strategy remains unclear. For those without a clear likely mode, how the details about sequencing influence response rates, mode, field work effort, and potential response bias remain important questions. This article describes a targeted sequential design implemented in a 2016 mixed mode supplement with individuals aged 30 years and older in the Panel Study of Income Dynamics, the longest running national panel study in the United States. Respondents predicted to be likely to respond by web were invited to a web study and sent a paper copy after six weeks (web-first); those likely to respond by paper were also invited to participate by web but told that a paper copy would be sent shortly (signal-andsend paper). An embedded experiment measured the impact of the two protocols among a group of respondents with no clear likely mode. More than 40 percent of individuals with no likely mode are under the age of 40 years, and the group falls between the likely web and paper groups in terms of education and internet use and includes more women and single respondents. Compared to the likely web and paper groups, those with no likely mode had lower response rates and required more fieldwork effort. Among those randomly assigned, the signal-and-send protocol increased response over the web-first protocol from weeks 4 through 7. By week 16, both protocols yielded similar response rates, field effort and distributions of respondent characteristics. Among those responding, cases randomized to web-first were more likely than those randomized to signal-and-send paper to respond by web. We discuss implications for targeted protocols in mixed mode panel surveys. [ABSTRACT FROM AUTHOR]

'Disability' refers to an individual's capacity to function within a given social and environmental context. Nearly 50 million Americans, one of every five people ages 5 and older have a disability, according to the 2000 U.S. Census.

This article describes the results of an experiment designed to examine the impact of the use and amount of delayed unconditional incentives in a mixed mode (push to web) supplement on response rates, response mode, data quality, and sample bias. The supplement was administered to individuals who participate in the U.S. Panel Study of Income Dynamics, the longest running national household panel in the world. After 10 weeks of data collection, individuals who had not yet completed the interview were sent a final survey request and randomly assigned to one of three treatment conditions: no incentive, US$5, and US$10. The impact of the incentives on response rates and mode, effects on data quality, and sample bias are described. The implications for the use of incentives in mixed mode surveys and directions for future research are discussed. [ABSTRACT FROM AUTHOR]

Objectives: To provide a profile of older adults who successfully accommodate declines in capacity by using assistive devices. Method: Using the National Health and Aging Trends Study, we provide national estimates of prevalent, incident, and persistent successful accommodation of mobility and self-care activity limitations. For incident and persistent accommodation groups, we describe their subjective wellbeing and participation restrictions, health and functioning, demographic and socioeconomic characteristics, and acquisition of assistive devices and environmental features. We estimate regression models predicting incident and persistent successful accommodation and the extent of wellbeing and participation restrictions for incident and persistent groups (vs. those who are fully able). Results: Nearly one-quarter of older adults have put in place accommodations that allow them to carry out daily activities with no assistance or difficulty. In adjusted models, incident and persistent successful accommodation is more common for those ages 80-89, those with more children, and those living in homes with environmental features already installed; well-being levels for these groups are similar and participation restrictions only slightly below those who are fully able. Discussion: A focus on facilitating successful accommodation among those who experience declines in capacity may be an effective means of promoting participation and wellbeing in later life. [ABSTRACT FROM AUTHOR]

Objective: The objective of this study was to develop and assess a composite measure of physical capacity using self-report and physical performance items. Method: Item response theory (IRT) is used to evaluate measurement properties of self-report and performance items and to develop a composite measure for 7,609 participants in the National Health and Aging Trends Study. Results: Self-reports distinguish differences at the lower end of physical capacity but not at mid-to-high levels. Performance-based measures discriminate across a fuller spectrum. An IRT-based composite score, drawing on both, provides increased measurement precision across the physical capacity spectrum and detects age group differences if either self-report or performance does so—suggesting it is better suited for studying age-related changes than either measure alone. Discussion: Self-report and performance measures have different strengths on the physical capacity spectrum. IRT provides a means of combining these different measurement approaches for analyses of physical capacity across a broad range of functioning in later life. [ABSTRACT FROM AUTHOR]

Background: Blacks have higher stroke incidence and experience greater poststroke disability than whites. To optimize care for stroke survivors, it is important to understand the amount of care that they receive and the implications for stroke caregivers.Methods and Results: Data from 2 nationally representative, population-based studies, the NHATS (National Health and Aging Trends Study) linked to the NSOC (National Study of Caregiving), were used to identify elderly stroke survivors and their caregivers. We compared hours of care received and unmet activity need among the 581 white and 225 black stroke survivors. We then performed racial comparisons of positive and negative aspects of caregiving reported by caregivers of black and white stroke survivors. Black stroke survivors were more likely than white stroke survivors to have a caregiver (62.5% versus 49.7%; P<0.01) and received on average more hours of help per week (31.7 versus 20.5; P<0.01). There was little racial difference in unmet need for assistance. Caregivers of black stroke survivors reported more positive aspects of caregiving than caregivers of white stroke survivors (6.8 versus 6.0; P<0.01). There was no racial difference in negative aspects of caregiving, depression, or anxiety.Conclusions: Black stroke survivors received an average of ≈11 more hours of care than white stroke survivors without substantial differences in unmet need. Despite providing more hours of care, caregivers of black stroke were more positive about their caregiver role than caregivers of white stroke survivors. [ABSTRACT FROM AUTHOR]

Objectives. To examine changes in active life expectancy in the United States over 30 years for older men and women (aged ≥ 65 years). Methods. We used the 1982 and 2004 National Long Term Care Survey and the 2011 National Health and Aging Trends Study to estimate age-specific mortality and disability rates, the overall chances of survival and of surviving without disability, and years of active life for men and women. Results. For older men, longevity has increased, disability has been postponed to older ages, disability prevalence has fallen, and the percentage of remaining life spent active has increased. However, for older women, small longevity increases have been accompanied by even smaller postponements in disability, a reversal of a downward trend in moderate disability, and stagnation of active life as a percentage of life expectancy. As a consequence, older women no longer live more active years than men, despite their longer lives. Conclusions. Neither a compression nor expansion of late-life disability is inevitable. Public health measures directed at older women to postpone disability may be needed to offset impending long-term care pressures related to population aging. [ABSTRACT FROM AUTHOR]

Objectives. We evaluate (a) associations between marital quality (emotional support, strain, and overall appraisal) and three negative aspects of experienced well-being (frustration, sadness, and worry) among older husbands and wives and (b) the relative importance of own versus spouse's marital quality assessments for understanding experienced well-being in later life. Method. Data are from the 2009 Disability and Use of Time daily diary supplement to the Panel Study of Income Dynamics (N = 722). We estimate actor-partner interdependence models, using seemingly unrelated regression. Results. Own reports of marital strain are associated with own frustration, sadness, and worry among wives and are associated with frustration only among husbands. Own reports of marital support are associated with negative emotion among husbands only: higher levels of marital support are associated with less worry. Results from partner effects analyses also are mixed. Husbands' reports of marital strain are associated with wives' elevated frustration levels, whereas wives' reports of greater marital support are associated with their husbands' higher frustration levels. Discussion. One's own and spouse's marital appraisals play a complex role in shaping negative emotions among older adults. Findings suggest that frustration is a particularly complex emotion and a promising area for further study among older married couples. [ABSTRACT FROM AUTHOR]

Adaptive survey designs are increasingly used by survey practitioners to counteract ongoing declines in household survey response rates and manage rising fieldwork costs. This paper reports findings from an evaluation of an early-bird incentive (EBI) experiment targeting high-effort respondents who participate in the 2019 wave of the US Panel Study of Income Dynamics. We identified a subgroup of high-effort respondents at risk of nonresponse based on their prior wave fieldwork effort and randomized them to a treatment offering an extra time-delimited monetary incentive for completing their interview within the first month of data collection (treatment group; N  = 800) or the standard study incentive (control group; N  = 400). In recent waves, we have found that the costs of the protracted fieldwork needed to complete interviews with high-effort cases in the form of interviewer contact attempts plus an increased incentive near the close of data collection are extremely high. By incentivizing early participation and reducing the number of interviewer contact attempts and fieldwork days to complete the interview, our goal was to manage both nonresponse and survey costs. We found that the EBI treatment increased response rates and reduced fieldwork effort and costs compared to a control group. We review several key findings and limitations, discuss their implications, and identify the next steps for future research. [ABSTRACT FROM AUTHOR]

Event History Analysis. Kazuo Yamaguchi. Newbury Park, CA: Sage Publications, 1991. ix + 182 pp. $28.50 (hardcover); $13.95 (softcover). Survival models are far from new to biostatisticians, who traditionally have [...]