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Dichotomous data correspond with various types of commonly encountered data, e.g., positive/negative, case/control, missing/observed, in many fields, including medicine, health, and social sciences. Despite their ubiquity, criteria for determining dimensionality from dichotomous variables are not yet established. We conducted a large-scale simulation (Study 1) to evaluate four criteria—Kaiser, empirical Kaiser, parallel analysis, and profile likelihood—to determine the dimensionality of dichotomous data across combinations of correlation matrices (Pearson r or tetrachoric ρ) and analysis methods (principal component analysis or exploratory factor analysis), and combinations of study characteristics: sample sizes (100, 250, and 1000), variable splits (10%/90%, 25%/75%, and 50%/50%), dimensions (1, 3, 5, and 10), and items per dimension (3, 5, and 10) with 1000 replications per condition. Parallel analysis performed best, recovering dimensionality in 87.9% of replications when using principal component analysis with Pearson correlations. Guidance for selecting criteria is provided. In Study 2, we applied this dimensionality reduction approach to two different longitudinal data sets where missing data posed difficulty for multivariate data analysis. The applications of this approach to longitudinal data suggest that the exploration of resulting missing data meta-patterns is useful in practice. [ABSTRACT FROM AUTHOR]

Background: Self-care is a multicomponent set of capacities that influence beliefs about health and well-being. Objectives: We examined the relationship between self-care capacity, age, and disability status with two perceptions of well-being in a cohort of Medicare beneficiaries. Methods : The current study is part of a multisite research project to determine factors associated with cross-sectional and longitudinal morbidity and mortality trajectories observed in Medicare beneficiaries. Variable selection was informed by the health disparities and outcomes model. Using data from the 2013 Medicare Current Beneficiary Survey and logistic regression models, we determined associations between self-care capacity, including indicators of self-care ability and self-care agency and two perceptions of well-being. Participants were divided into four groups based on how they qualified for Medicare: (a) over 65 years of age, and below 65 years of age and disabled because of (b) physical or (c) mental disorder, or (d) disabled and could not be classified as physically or mentally disabled as the primary cause of eligibility. Results : Self-care ability limitations in activities of daily living (ADL), instrumental activities of living (IADL), and social activity participation were associated with both health perceptions. Those with physical disabilities reported more ADL and IADL limitations when compared with the other eligibility groups and were significantly more likely to have negative health perceptions. Those with serious mental illness were most likely to report the most severe IADL limitations. The over 65 years of age group reported less self-care incapacity than the other three eligibility types. Other components of self-care, including health literacy, agency, and health behaviors, significantly influenced perceptions of health. Women and people identifying as non-Whites were more likely to have negative health perceptions. Discussion : Self-care capacity is a complex construct, and its varied elements have differential relationships with perceptions of well-being. Those with physical disabilities reported more self-care limitations, poorer perceived health, and more health worries than the other groups. Still, there were different patterns of self-care capacities in the serious mental illness type-especially in IADL limitations. The study adds empirical evidence to previous research documenting inequities in health outcomes for women and non-Whites. Findings provide empirical support for the health disparities and outcomes model. [ABSTRACT FROM AUTHOR]

Introduction Computerized neuropsychological testing is a cornerstone of sport-related concussion assessment. Female soccer players are at an increased risk for concussion as well as exposures to repetitive head impacts from heading a soccer ball. Our primary aim was to examine factorial validity of the Automated Neuropsychological Assessment Metrics (ANAM) neuropsychological test battery in computing the multiple neurocognitive constructs it purports to measure in a large cohort of interscholastic female soccer players. Methods Study participants included 218 interscholastic female soccer players (age = 17.0±0.7 year; mass = 55.5±6.8 kg; height = 164.7±6.6 cm) drawn from a large (850+) prospective database examining purposeful heading from four area high schools over a 10-year period. The ANAM-2001 measured neurocognitive performance. Three methods were used to identify integral constructs underlying the ANAM: (a) exploratory factor analysis (EFA), (b) first-order confirmatory factor analysis (CFA), and (c) hierarchical CFA. Results Neuropsychological phenomena measured by the ANAM-2001 were best reproduced by a hierarchical CFA organization, composed of two lower level factors (Simple Reaction Time , Mental Efficiency) and a single, general composite. Although the ANAM was multidimensional, only the composite was found to possess sufficient construct dimensionality and reliability for clinical score interpretation. Findings failed to uphold suppositions that the ANAM measures seven distinct constructs, or that any of its seven tests provide unique information independent of other constructs, or the composite, to support individual interpretation. Conclusions Outcomes infer the ANAM possesses factorial-validity evidence, but only scores from the composite appear to sufficiently internally valid, and reliable, to support applied use by practitioners. [ABSTRACT FROM AUTHOR]

Aim: The aim of this was to psychometrically adapt and evaluate the Tilburg Frailty Indicator to assess frailty among older people living in Slovenia's community and nursing home settings. Design: A cross- cultural adaptation and validation of instruments throughout the cross- sectional study. Methods: Older people living in the community and nursing homes throughout Slovenia were recruited between March and August 2021. Among 831 participants were 330 people living in nursing homes and 501 people living in the community, and all were older than 65 years. Results: All items were translated into the Slovene language, and a slight cultural adjustment was made to improve the clarity of the meaning of all items. The average scale validity index of the scale was rated as good, which indicates satisfactory content validity. Cronbach's α was acceptable for the total items and subitems. Conclusions: The Slovenian questionnaire version demonstrated adequate internal consistency, reliability, and construct and criterion validity. The questionnaire is suitable for investigating frailty in nursing homes, community dwelling and other settings where older people live. Impact: The Slovenian questionnaire version can be used to measure and evaluate frailty among older adults. We have found that careful translation and adaptation processes have maintained the instrument's strong reliability and validity for use in a new cultural context. The instrument can foster international collaboration to identify and manage frailty among older people in nursing homes and community-dwelling homes. Reporting Method: The Strengthening the Reporting of Observational Studies in Epidemiology checklist for reporting cross-sectional studies was used. No Patient or Public Contribution: No patient or public involvement in the design or conduct of the study. Head nurses from nursing homes and community nurses helped recruit older adults. Older adults only contributed to the data collection and were collected from nursing homes and community dwelling. [ABSTRACT FROM AUTHOR]

Objective: To evaluate snacking and diet quality among US adolescents. Design: Cross-sectional analysis examined snack frequency (snacks/day), size (kcal/snack) and energy density (kcal/g/snack) as predictors of diet quality using the mean of two 24-h dietary recalls. Diet quality was assessed using the Healthy Eating Index (HEI-2015, 0–100), a mean adequacy ratio (MAR, 0–100) for under-consumed nutrients (potassium, fibre, Ca, vitamin D) and mean percentage of recommended limits for over-consumed nutrients (added sugar, saturated fat, Na). Linear regression models examined total snacks, food only snacks and beverage only snacks, as predictors of diet quality adjusting for demographic characteristics and estimated energy reporting accuracy. Setting: 2007–2018 National Health and Nutrition Examination Survey. Participants: Adolescents 12–19 years (n 4985). Results: Snack frequency was associated with higher HEI-2015 (β = 0·7 (0·3), P < 0·05) but also with higher intake of over-consumed nutrients (β = 3·0 (0·8), P ≤ 0·001). Snack size was associated with lower HEI (β = –0·005 (0·001), P ≤ 0·001) and MAR (β = –0·005 (0·002), P < 0·05) and higher intake of over-consumed nutrients (β = 0·03 (0·005), P ≤ 0·001). Associations differed for food only and beverage only snacks. Food only snack frequency was associated with higher HEI-2015 (β = 1·7 (0·03), P ≤ 0·001), while food only snack size (β = –0·006 (0·0009), P ≤ 0·001) and food only snack energy density (β = –1·1 (0·2), P ≤ 0·001) were associated with lower HEI-2015. Conversely, beverage only snack frequency (β = 4·4 (2·1) P < 0·05) and beverage only snack size (β = 0·03 (0·01), P ≤ 0·001) were associated with higher intake of over-consumed nutrients. Conclusions: Smaller, frequent, less energy-dense food only snacks are associated with higher diet quality in adolescents; beverages consumed as snacks are associated with greater intake of over-consumed nutrients. [ABSTRACT FROM AUTHOR]

Background: Universal access to the School Breakfast Program (SBP) is intended to help low-income and food-insecure students overcome barriers to eating breakfast. However, SBP participation is often still low despite universal access. Further information is needed with regard to these children's breakfast behaviors, and in particular breakfast behaviors among youth from food-insecure families, to inform effective breakfast interventions.Objectives: The objective of this study was to examine breakfast behaviors among a large sample of urban students with universal access to the SBP and to identify differences in breakfast behaviors among children from food-secure compared with food-insecure households.Methods: A cross-sectional study of 821 fourth- through sixth-grade students and their parents from 16 schools was conducted. Students reported the foods/drinks selected and location of obtaining food/drink on the morning of data collection, parents reported household food security status using the 6-item Food Security Survey Module, and the school district provided SBP participation data during the fall semester of 2013. Multivariable linear regression models accounting for school-level clustering were used to examine differences in breakfast behaviors across 3 levels of household food security: food secure, low food secure, and very low food secure.Results: Students participated in the SBP 31.2% of possible days, with 13% never participating in the SBP. One-fifth (19.4%) of students purchased something from a corner store for breakfast, and 16.9% skipped breakfast. Forty-six percent of students were food insecure; few differences in breakfast behaviors were observed across levels of food security.Conclusions: Despite universal access to the SBP, participation in the SBP is low. Breakfast skipping and selection of foods of low nutritional quality in the morning are common, regardless of household food security status. Additional novel implementation of the SBP and addressing students' breakfast preferences may be necessary to further reduce barriers to students obtaining a free, healthful breakfast. This trial was registered at clinicaltrials.gov as NCT01924130. [ABSTRACT FROM AUTHOR]

Background/Study Context: We demonstrate that observer-rated factor structure of personality in centenarians is congruent with the normative structure. Prevalence of cognitive impairment, which has previously been linked to changes in personality in younger samples, is high in this age group, requiring observer ratings to obtain valid data in a population-based context. Likewise, the broad range of cognitive functioning necessitates synthesis of results across multiple measures of cognitive performance. Methods and Results: Data from 161 participants in the Georgia Centenarian Study (GCS;MAge = 100.3 years, 84% women, 20% African American, 40% community-dwelling, 30% low cognitive functioning) support strong overall correspondence with reference structure (full sample: .94; higher cognitive functioning: .94; lower cognitive functioning: .90). Centenarians with lower cognitive functioning are higher on neuroticism and lower on openness to experience, agreeableness, and conscientiousness. Facet-level differences (higher N1–N6: anxiety, hostility, depression, self-consciousness, impulsiveness, vulnerability to stress; lower E1: warmth; lower O4–O6: actions, ideas, values; lower A1, A3, A4: trust, altruism, compliance; C1, C5: competence, self-discipline) are also observed. Multivariate factor-level models indicate only neuroticism of the five broad factors predicts membership in cognitively impaired group; facet-level models showed that lower-order scales from three of the five domains were significant. Centenarians with higher self-consciousness (N4), impulsiveness (N5), and deliberation (C6) but lower ideas (O5), compliance (A4), and self-discipline (C5) were more likely to be in the lower cognitive functioning category. Conclusion: Results present first normative population-based data for personality structure in centenarians and offer intriguing possibilities for the role of personality in cognitive impairment centered on neuroticism. [ABSTRACT FROM AUTHOR]

The recent recession constitutes one of the macro forces that may have influenced workers’ retirement plans. We evaluate a multilevel model that addresses the influence of macro-, meso-, and micro-level factors on retirement plans, changes in these plans, and expected retirement age. Using data from Waves 8 and 9 of the Health and Retirement Study (N = 2,618), we find that individuals with defined benefit plans are more prone to change toward plans to stop work before the stock market declined, whereas the opposite trend holds for those without pensions. Debts, ability to reduce work hours, and firm unionization also influenced retirement plans. Findings suggest retirement planning education may be particularly important for workers without defined pensions, especially in times of economic volatility. [ABSTRACT FROM PUBLISHER]

Aging in Sweden has been uniquely shaped by its history—most notably the long tradition of locally controlled services for older adults. We considered how local variations and local control shape the experience of aging in Sweden and organized the paper into 3 sections. First, we examine aging in Sweden along demography, economy, and housing. Next, we trace the origins and development of the Swedish welfare state to consider formal supports (service provision) and informal supports (caregiving and receipt of care). Finally, we direct researchers to additional data resources for understanding aging in Sweden in greater depth. Sweden was one of the first countries to experience rapid population aging. Quality of life for a majority of older Swedes is high. Local control permits a flexible and adaptive set of services and programs, where emphasis is placed on improving the quality and targeting of services that have already reached a plateau as a function of population and expenditures. [ABSTRACT FROM PUBLISHER]

Background: Chronic bronchitis (CB) has been related to poor outcomes in Chronic Obstructive Pulmonary Disease (COPD). From a clinical standpoint, we have shown that subjects with CB in a group with moderate to severe airflow obstruction were younger, more likely to be current smokers, male, Caucasian, had worse health related quality of life, more dyspnea, and increased exacerbation history compared to those without CB. We sought to further refine our clinical characterization of chronic bronchitics in a larger cohort and analyze the CT correlates of CB in COPD subjects. We hypothesized that COPD patients with CB would have thicker airways and a greater history of smoking, acute bronchitis, allergic rhinitis, and occupational exposures compared to those without CB. Methods: We divided 2703 GOLD 1-4 subjects in the Genetic Epidemiology of COPD (COPDGene®) Study into two groups based on symptoms: chronic bronchitis (CB+, n = 663, 24.5%) and no chronic bronchitis (CB-, n = 2040, 75.5%). Subjects underwent extensive clinical characterization, and quantitative CT analysis to calculate mean wall area percent (WA%) of 6 segmental airways was performed using VIDA PW2 (http://www.vidadiagnostics.com). Square roots of the wall areas of bronchi with internal perimeters 10 mm and 15 mm (Pi10 and Pi15, respectively), % emphysema, % gas trapping, were calculated using 3D Slicer (http://www.slicer.org). Results: There were no differences in % emphysema (11.4 ± 12.0 vs. 12.0 ± 12.6%, p = 0.347) or % gas trapping (35.3 ± 21.2 vs. 36.3 ± 20.6%, p = 0.272) between groups. Mean segmental WA% (63.0 ± 3.2 vs. 62.0 ± 3.1%, p < 0.0001), Pi10 (3.72 ± 0.15 vs. 3.69 ± 0.14 mm, p < 0.0001), and Pi15 (5.24 ± 0.22 vs. 5.17 ± 0.20, p < 0.0001) were greater in the CB + group. Greater percentages of gastroesophageal reflux, allergic rhinitis, histories of asthma and acute bronchitis, exposures to dusts and occupational exposures, and current smokers were seen in the CB + group. In multivariate binomial logistic regression, male gender, Caucasian race, a lower FEV1%, allergic rhinitis, history of acute bronchitis, current smoking, and increased airway wall thickness increased odds for having CB. Conclusions: Histories of asthma, allergic rhinitis, acute bronchitis, current smoking, a lower FEV1%, Caucasian race, male gender, and increased airway wall thickness are associated with CB. These data provide clinical and radiologic correlations to the clinical phenotype of CB. [ABSTRACT FROM AUTHOR]

Centenarians represent a rare but rapidly growing segment of the oldest-old. This study presents item-level data from the Mini- Mental State Examination ( MMSE) in a cross-sectional, population-based sample of 244 centenarians and near-centenarians (aged 98-108, 16% men, 21% African-American, 38% community dwelling) from the Georgia Centenarian Study (2001-2008) according to age, education, sex, race, and residential status. Multiple- Indicator Multiple- Cause ( MIMIC) models were used to identify systematic domain-level differences in MMSE scores according to demographic characteristics in this age group. Indirect effects of age, educational attainment, race, and residential status were found on MMSE scores. Direct effects were limited to concentration for education and race and orientation for residential status. Mean levels of cognitive functioning in centenarians were low, with mean values below most commonly-used cutoffs. Overall scores on the MMSE differed as a function of age, education, race, and residential status, with differences in scale performance limited primarily to concentration and orientation and no evidence of interactions between centenarian characteristics. Adjusting for education was not sufficient to account for differences according to race, and adjusting for residential status was not sufficient to account for differences according to age. [ABSTRACT FROM AUTHOR]

Limited research has examined caregivers for the oldest old (85+), a distinct group among older adults who are most likely to experience functional and cognitive limitations that require care. To profile socio-demographic characteristics of the oldest-old and their informal caregivers and assess their caregiving situations, we used data from 3163 care recipients with at least one functional limitation from the 2004 National Long-Term Care Survey and 1363 caregivers who were either adult children or spouses of care recipients. The oldest- old with functional disabilities were less likely to be married and more likely to be women living alone. Compared with those under 85, the oldest-old group were likely to have more extensive IADL and ADL limitations. However, with the exception of dementia, the oldest-old had a lower prevalence of chronic illness than younger elders. The oldest-old care recipients also tended to use more formal care service. While caregivers for the oldest old were less likely to be a sole caregiver and more likely to use formal care service, their physical and emotional stress from caregiving remained the same with their counterpart group of caregivers. Comparison of caregivers by their relationships to care recipients also indicated that adult children who cared for the oldest-old parents tended to express the most stress from caregiving. We contend that formal services need to be better incorporated with informal caregiving to attenuate negative caregiver outcomes, especially for the oldest-old whose informal caregiving network is rather limited. [ABSTRACT FROM AUTHOR]

We linked individual-level data from the 2004 wave of the National Long-Term Care Survey with state-level data from the National Aging Program Information Systems (NAPIS) State Program Reports to predict care mix and unmet need for assistance. Our sample consisted of 2422 community-dwelling individuals aged 65 and older (69% women, 8% nonwhite) who reported at least one limitation in an instrumental or basic activity of daily living. We used the data to predict the mix of formal and informal support received, and the probability of having at least one unmet need from individual (predisposing, enabling, and need) characteristics with state-level home help coverage rates, intensity of home help services, and proportion of population aged 60+ residing in institutional settings. Consistent with past research, a majority (52.6%) of the disabled sample reported unmet need. At the individual level, enabling (availability of kin support) and need (number of basic and instrumental activity of daily living impairments, BADLs and IADLs) were most strongly associated with care mix and unmet need. State-level services were not associated with receipt of informal supports. In states providing home help services to a higher proportion of elders, women were more likely to receive formal help. In states providing more intensive services, women were less likely and individuals living alone more likely to receive formal supports. In states where a higher proportion of elders lived in nursing homes, individuals living alone were more likely to receive formal assistance, less likely overall to report unmet needs, but the oldest-old were more likely to report unmet need. [ABSTRACT FROM AUTHOR]

Background Decreased estimated glomerular filtration rate (eGFR) and higher serum creatinine (sCR) levels have been associated with longitudinal decline in global mental status measures. Longitudinal data describing change in multiple domains of cognitive functioning are needed in order to determine which specific abilities are most affected in individuals with impaired renal function. Methods We conducted a 5-year longitudinal study with 590 community-living individuals (mean age 62.1 years, 60.2% female, 93.2% white, 11.4% with diabetes mellitus, mean eGFR 78.4 mL/min/1.73 m²) free from dementia, acute stroke and end-stage renal disease. To measure longitudinal change-over-time, cognitive performance measures were regressed on eGFR adjusting for baseline eGFR and cognitive performance, comorbidity and vascular risk factors. Outcome measures were scores from 17 separate tests of cognitive abilities that were used to index 5 theoretically relevant domains: verbal episodic memory, visual-spatial organization and memory, scanning and tracking, working memory and similarities (abstract reasoning). Results Declines in eGFR values were associated with cognitive declines, when adjusted for eGFR and cognitive function scores at baseline. Change in renal functioning over time was related to change observed in global cognitive ability [b = 0.21SD decline per unit ln(eGFR), 95% CI: 0.04–0.38, P = .018], verbal episodic memory [b = 0.28 SD decline per unit ln(eGFR), 95% CI: 0.02–0.54, P = 0.038] and abstract reasoning [b = 0.36 SD decline per unit ln(eGFR), 95% CI: 0.04–0.67, P = 0.025]. Decline in cognitive functioning in association with declining renal functioning was observed despite statistical adjustment for demographic variables and CVD risk factors and the exclusion of persons with dementia or a history of acute stroke. Conclusions Early detection of mild to moderate kidney disease is an important public health concern with regard to cognitive decline. [ABSTRACT FROM AUTHOR]

Care-giving research has focused on primary care-givers and relied on cross-sectional data. This approach neglects the dynamic and systemic character of care-giver networks. Our analyses address changes in care-givers and care networks over a two-year period using pooled data from the US Health and Retirement Study, 1992–2000. Based on a matrix of specific adult-child care-givers across two consecutive time-points, we assess changes in any adult-child care-giver and examine the predictors of change. A change in care-giver occurred in about two-fifths of care-giving networks. Ability to provide care based on geographical proximity, availability of alternative care-givers, and gender play primary roles in the stability of care networks. Results underline the need to shift care-giving research toward a dynamic and systemic perspective. [ABSTRACT FROM PUBLISHER]

Family caregiving research is increasingly contextual and dynamic, but few studies have examined prevalence and predictors of change in primary caregivers, those with the most frequent contact with healthcare professionals. We identified prevalence and predictors of 2-year change in primary adult-child caregivers. Data pooled from the 1992-2000 waves of the Health and Retirement Study (HRS) represent 1,068 parent-level care occasions and 3,616 child-level occasions. There is considerable 2-year stability in primary adult-child caregivers. Parents are more prone to experience a change in adult-child primary caregivers if they live by themselves and if they have more sons and daughters. As far as the adult children are concerned, daughters and children living closer to parents are more likely to remain primary caregivers. Results suggest that change in primary caregivers is more strongly associated with available alternatives and gender norms than burden and competing obligations. [ABSTRACT FROM AUTHOR]

Family caregiving research is increasingly contextual and dynamic, but few studies have examined prevalence and predictors of change in primary caregivers, those with the most frequent contact with healthcare professionals. We identified prevalence and predictors of 2-year change in primary adult-child caregivers. Data pooled from the 1992-2000 waves of the Health and Retirement Study (HRS) represent 1,068 parent-level care occasions and 3,616 child-level occasions. There is considerable 2-year stability in primary adult-child caregivers. Parents are more prone to experience a change in adult-child primary caregivers if they live by themselves and if they have more sons and daughters. As far as the adult children are concerned, daughters and children living closer to parents are more likely to remain primary caregivers. Results suggest that change in primary caregivers is more strongly associated with available alternatives and gender norms than burden and competing obligations. [ABSTRACT FROM AUTHOR]

Background/Study Context: The goal of the study was to identify and characterize latent profiles (clusters) of cognitive functioning in centenarians and the psychometric properties of cognitive measures within them. Methods: Data were collected from cross-sectional, population-based sample of 244 centenarians (aged 98 to 108, 15.8% men, 20.5% African American, 38.0% community-dwelling) from 44 counties in northern Georgia participating in the Georgia Centenarian Study (2001-2008). Measures included the Mini-Mental State Examination (MMSE), Severe Impairment Battery (SIB), Wechsler Adult Intelligence Scale-III Similarities subtest (WAIS), Hand Tapping, Behavioral Dyscontrol Scale (BDS), Controlled Oral Word Association Test (COWAT), and Fuld Object Memory Evaluation (FOME). The Global Deterioration Rating Scale (GDRS) was used to independently evaluate criterion-related validity for distinguishing cognitively normal and impaired groups. Relevant covariates included directly assessed functional status for basic and instrumental activities of daily living (DAFS), race, gender, educational attainment, Geriatric Depression Scale Short Form (GDS), and vision and hearing problems. Results: Results suggest two distinct classes of cognitive performance in this centenarian sample. Approximately one third of the centenarians show a pattern of markedly lower cognitive performance on most measures. Group membership is independently well predicted (area under the curve [AUC]=.83) by GDRS scores (sensitivity 67.7%, specificity 82.4%). Membership in the lower cognitive performance group was more likely for individuals who were older, African Americans, had more depressive symptoms, lower plasma folate, carriers of the apolipoprotein E (APOE) c4 allele, facility residents, and individuals who died in the 2 years following interview. Conclusions: In a population expected to have high prevalence of dementia, latent subtypes can be distinguished via factor mixture analysis that provide normative values for cognitive functioning. The present study allows estimates for normative cognitive performance in this age group. [ABSTRACT FROM AUTHOR]

OBJECTIVE--Certain dietary and physical activity behaviors have been associated with the risk of developing type 2 diabetes, yet little is known about the prevalence of these behaviors among Latinas (Latino women). The purpose of this cross-sectional study was to compare the prevalence of diabetes-related behaviors in Latinas and non-Latinas. RESEARCH DESIGN AND METHODS--Using data from the 2009 California Health Interview Survey, we compared self-reported diabetes-related behaviors of Latinas (n = 4,321) to non-Latinas (n = 21,112) after excluding women who were pregnant or had diabetes. For six behaviors, we determined the cut point for the least healthy tertile: walking, doing moderate to vigorous physical activity, and consuming fried potatoes, sugar-sweetened beverages (SSBs), desserts, and fast food. We used logistic regression to examine the association between Latina ethnicity and being in the least healthy tertile compared with the other two tertiles for each of these behaviors. RESULTS--In multivariate models adjusted for age, income, education, marital status, health status, smoking, and acculturation, Latinas had a higher risk (odds ratio [95%CI]) of being in the least healthy tertile for the consumption of fast food (1.94 [1.63-2.31]), SSBs (1.53 [1.29-1.82]), and fried potatoes (1.32 [1.18-1.67]), and lower risk for desserts (0.82 [0.70-0.95]). Latinas and non-Latinas had similar physical activity levels. CONCLUSIONS--Dietary differences between Latinas and non-Latinas (particularly in the consumption of fast food and SSBs) may be the focus of interventions to prevent diabetes in Latinas. Further research among Latinas is needed to understand and modify these dietary behaviors. [ABSTRACT FROM AUTHOR]

Objectives To describe the prevalence of diabetes mellitus ( DM) in centenarians. Design Cross-sectional, population-based. Setting Forty-four counties in northern Georgia. Participants Two hundred forty-four centenarians (aged 98-108, 15.8% male, 20.5% African American, 38.0% community dwelling) from the Georgia Centenarian Study (2001-2009). Measurements Nonfasting blood samples assessed glycosylated hemoglobin ( HbA1c) and relevant clinical parameters. Demographic, diagnosis, and DM complication covariates were assessed. Results 12.5% of centenarians were known to have DM. DM was more prevalent in African Americans (27.7%) than whites (8.6%, P < .001). There were no differences between men (16.7%) and women (11.7%, P = .41) or between centenarians living in the community (10.2%) and in facilities (13.9%, P = .54). DM was more prevalent in overweight and obese (23.1%) than nonoverweight (7.1%, P = .002) centenarians. Anemia (78.6% vs 48.3%, P = .004) and hypertension (79.3% vs 58.6%, P = .04) were more prevalent in centenarians with DM than in those without, and centenarians with DM took more nonhypoglycemic medications (8.6 vs 7.0, P = .02). No centenarians with HbA1c of less than 6.5% had random serum glucose levels greater than 200 mg/dL. DM was not associated with 12-month all-cause mortality, visual impairment, amputations, cardiovascular disease, or neuropathy. Thirty-seven percent of centenarians reported onset before age 80 (survivors), 47% between age 80 and 97 (delayers), and 15% aged 98 and older (escapers). Conclusion Diabetes mellitus is a risk factor for cardiovascular disease and mortality but is seen in persons who live into very old age. Aside from higher rates of anemia and use of more medications, few clinical correlates of DM were observed in centenarians. [ABSTRACT FROM AUTHOR]

Since its inception, family therapy (FT) has been distinguished by its explicit theoretical and practical focus on families and relationships as systems, with an emphasis on second order rather than first order change. As a result of these conceptual underpinnings we suggest that FT needs to look for manifestations of change which differ from individually focused disciplines such as clinical psychology. Studies of second order change have most commonly appeared in the form of conceptual papers and doctoral dissertations. We begin by revisiting the conceptual underpinnings of second order change. Building on this framework, we develop these aspects of change within the framework of recent developments in the empirical study of change. Finally, we point towards some promising directions for further evaluative work of FT as well as ways to incorporate some of these principles into training of FT students. [ABSTRACT FROM AUTHOR]

This study provides, for the first time, normative data on cognitive functioning and physical performance, health and health behaviors, and diseases from a population-based sample of 244 centenarians and near-centenarians (M age = 100.5 years, range 98-108, 84.8% women, 21.3% African American) from the Georgia Centenarian Study. Data are presented by the four key dimensions of gender, race, residence, and educational attainment. Results illustrate the profound range of functioning in this age group and indicate considerable differences as a function of each dimension. Bivariate models generally suggest that cognitive functioning and physical performance is higher for men than women; whites than African Americans; community than facility residents; and those with more than high school education than those with less than high school education. Multivariate models elaborate that differences in educational attainment generally account for the largest proportion of variance in cognitive functioning and residential status generally accounts for the largest proportion of variance in physical performance measures. Addition of health variables seldom increases variance accounted for in each domain beyond these four dimensions. [ABSTRACT FROM AUTHOR]

Abstract: Analysis of sediment and macrofaunal samples collected during the Tasmanian marine farming finfish monitoring program – a six-year partnership between industry, management and researchers – revealed several univariate indicators to be useful for detecting effects of aquaculture on the benthic environment. Comparisons with reference sites revealed a significant decline in sediment redox potential to at least 4cm depth at farm sites, and increased proportional abundance of capitellids and decreased bivalve/total mollusc ratio. At compliance sites located 35m out from lease boundaries, sediment redox potential and faunal assemblage composition were intermediate between patterns found at farm and reference sites. Redox potential at the sediment surface declined on average by 178eV at reference sites converted to farm sites, with this indicator proving the most sensitive for detecting regional impacts of farming activity. Fish farm effects that extended to regional scales could not be adequately assessed within the project because reference regions without fish farms were not monitored; however, a significant decrease through time at reference and compliance sites in surface redox potential, and increases in sediment organic matter and total macrofaunal abundance, were suggestive that organic enrichment may have extended at low levels across regional scales. Given the implications to biodiversity conservation of region-wide impacts and a need to distinguish fish farm effects from unrelated long-term environmental change, monitoring of reference sites in regions lacking fish farms is urgently needed. [ABSTRACT FROM AUTHOR]

Relationships between grandparents and grandchildren provide an excellent framework for integrating family theory and family methodology. Systematic differences as a function of age, gender, life expectancy, and health as played out through generations suggest some topics are best studied by disentangling variability between and within families. Using data from 1,345 grandchildren (52% girls, mean age 13.69 years, range 9 to 20) reporting on 3,664 grandparents, we compare results obtained from studying grandparent-grandchild relationships individually and at the family level. Results suggest important predictors of relationship quality at the within-subject and between-subject levels. Future research should more carefully integrate each level into theory and design. [ABSTRACT FROM AUTHOR]

Background. We examined within-family variation in siblings' memories of experiences with parents and their associations with current positive and negative affect. Methods. Participants were 1,369 adults with at least 1 sibling, aged 26-74 years from 498 families in the MacArthur Study of Midlife in the United States (Mage = 47 years, 59% women, 94% White). Results. There was considerable variability in recalled maternal and paternal treatment across the dimensions of affection (intraclass correlation coefficients [ICCs] 0.33 and 0.41, respectively), discipline (ICCs 0.39 and 0.43), and conflict (ICCs 0.24 and 0.26). In turn, recalled parental treatment, particularly affection, made unique contributions to current positive (ICC 0.12) and negative affect (ICC 0.08) over and above individual and familial level characteristics such as offspring demographic characteristics, extraversion and neuroticism, family structure, recalled early family environment, and parents' current status. Conclusions. Results link adults' memories of experiences with their parents in childhood to their current well-being and highlight the importance of considering within-family models for family theory. [ABSTRACT FROM AUTHOR]

Research on the division of family work has focused on household work and child-care to the exclusion of other domains, whereas studies on care-giving for older people typically ignore spouses' support to care-givers. In this paper we apply an approach that is typical of research on spouses' division of family work in caring for parents, in that the theoretical model focuses on the 'cultural mandates' that guide spouses' division of care, namely gender ideologies about appropriate roles, kinship obligations, and taboos against cross-gender personal care. Other predictors of the spousal division of care drawn from economic and health-care utilisation models are also examined. The analyses use pooled data on 1,449 care occasions from the first five waves of the US Health and Retirement Study. It was found that most couples to some extent share parent care, and that the involvement of husbands depended on a complex interplay of cultural mandates and contexts. Husbands participated most in personal care for parents if the care was mandated by kinship obligations (they cared more for their own than their wife's parents), and by cross-gender care taboos (they cared more for fathers than mothers). Other cultural contexts (such as race), a spouse's other commitments, health-related ability, resources (including support from the parents' other children), and care-burden also played a role. The findings demonstrate that decisions to care for parents emerge from complex negotiations among spouses and their children and siblings or, in other words, that parental care is a family endeavour. [ABSTRACT FROM AUTHOR]

Abstract: Personality structure of African-American older adults using the Baltimore Study of Black Aging (BSBA; N =234; Age range 49–88, M =67; 72% women; Education M =11 years) was compared with the census-matched normative NEO-PI-R factor structure. Principal components with Procrustes rotation was used to calculate factor, facet, and total congruence coefficients. Significant factor congruence coefficients at a 99% probability level or beyond were found, and only three facet-level congruence coefficients did not reach significance. With the exception of cross-loadings on a few facets, most primary and secondary loadings generally replicated the normative structure providing evidence that there are little differences among the African-American older adults and the largely European American normative structure. [Copyright &y& Elsevier]

Given its relative ethnic and socio-economic homogeneity, Sweden is an ideal nation for the study of variations in formal and informal care as a function of gender, disability and advanced age. This paper reports an analysis of the relationships between gender, disability and age and the formal care delivered to more than 1,200 people aged 75 or more years in Sweden in 1994 and 2000. In municipalities that provided above-average home-help hours per recipient, and that had high institutional placement rates, women were relatively less likely to have been receiving informal assistance alone, those with greater disability were more likely to have been receiving all forms of assistance, the oldest-old were less likely to have been receiving either informal or formal help alone, and rates of formal assistance and of no informal care were relatively low. In municipalities with high rates of institutional placement, the oldest-old were relatively more likely to have been receiving both formal and informal assistance. Sweden's system of old-age care appears broadly equitable although the quality of care could not be fully assessed. Although home and community-based service provision (HCBS) has recently decreased, variations in the volume and mix of delivered formal services reflect differences in need. [ABSTRACT FROM AUTHOR]

Purpose: Caregiving research has typically relied on cross-sectional data that focus on the primary caregiver. This approach neglects the dynamic and systemic character of caregiver networks. Our analyses addressed changes in adult child care networks over a 2-year period. Design and Methods: The study relied on pooled data from Waves 1 through 5 of the Health and Retirement Study. Based on a matrix of specific adult child caregivers across two consecutive time points, we assessed changes in any adult child caregiver as well as in the primary adult child caregiver. Results: More than half of all adult-child care networks, including more than one fourth of primary adult child caregivers, changed between waves. Gender composition of the caregiver network and availability of other adult child caregivers were particularly important for network change, but socioeconomic context, caregiver abilities and resources, and caregiver burden played a role as well. Implications: The results underline the need to shift caregiving research toward a dynamic life course and family systems perspective. They also raise concerns about the viability of informal care networks for future smaller birth cohorts and suggest that health care providers need to recognize and address coordination and potential conflicts among care network members. [ABSTRACT FROM PUBLISHER]

Changes in three domains of leisure (i.e., informal, formal, and physical) were examined using data from individuals ages 50 and over from all three waves of the Americans' Changing Lives study ( N = 1,911), and different patterns of change were found. Individual growth curve modeling suggested that while no change occurred over time on average within domains, significant individual differences were found in these patterns across all domains. Limitations in physical functioning and depressive symptoms predicted lower participation across domains, but other predictors including age, race, and gender made a difference. Older age only predicted decreases in the physical domain. [ABSTRACT FROM AUTHOR]

The article discusses the study on the significance of selective optimization with compensation on the physical, formal and informal domains of leisure of adults in the U.S. During the analysis, samples of adults were gathered and results revealed that there is likelihood of adults being involved in leisure activities in later life and the factor that could change that behavior is disability. Moreover, the continued involvement in leisure activities leads to a better psychological well-being.

This study explores how grandchild care in conjunction with grandparents' retirement affects depressive symptoms, using data from the Health and Retirement Survey. The findings demonstrate that retirement moderates the influence of grandchild care obligations on well-being, measured by depressive symptoms. For retired men, freedom from grandchild care obligations is associated with heightened well-being. Among women, continued employment seems to protect against potential negative effects of extensive grandchild care obligations on well-being. The results for men seem most in line with the argument that family care obligations spoil retirement, whereas the results for women suggest a scenario that is most compatible with the role enhancement thesis. [ABSTRACT FROM AUTHOR]

Effects of incomplete data on fit indexes remain relatively unexplored. We evaluate a wide set of fit indexes (χ2, root mean squared error of appproximation, Normed Fit Index [NFI], Tucker-Lewis Index, comparative fit index, gamma-hat, and McDonald's Centrality Index) varying conditions of sample size (100-1,000 in increments of 50), factor loadings (.4 or .8), factor covariances (.4 or .8), type of missing data (missing completely at random or missing at random), and extent of missing data (0-95% on 3 of 9 indicators in increments of 5%) for correct and 2 misspecified (measurement or structural) models. Incremental and absolute fit indexes indicate better fit with higher proportions of missing data. Effects of missing data on the NFI were more varied, indicating poorer model fit as missing data increased for the correct model, and indicating better or poorer fit as an interaction of all the other factors for misspecified models. Recommendations are made for researchers and software developers. [ABSTRACT FROM AUTHOR]

Objectives. Our objective in this study was to compare assistance received by individuals in the United States and Sweden with characteristics associated with low, moderate, or high l-year placement risk in the United States. Methods. We used longitudinal nationally representative data from 4,579 participants aged 75 years and older in the 1992 and 1993 waves of the Medicare Current Beneficiary Survey (MCBS) and cross-sectional data from 1,379 individuals aged 75 years and older in the Swedish Aging at Home (AH) national survey for comparative purposes. We developed a logistic regression equation using U.S. data to identify individuals with 3 levels (low, moderate, or high) of predicted 1-year institutional placement risk. Groups with the same characteristics were identified in the Swedish sample and compared on formal and informal assistance received. Results. Formal service utilization was higher in Swedish sample, whereas informal service use is lower overall. Individuals with characteristics associated with high placement risk received more formal and less informal assistance in Sweden relative to the United States. Discussion. Differences suggest formal services supplement informal support in the United States and that formal and informal services are complementary in Sweden. [ABSTRACT FROM AUTHOR]

This study explores how partner's employment and preretirement decision-making structures affect retirement satisfaction, using pooled data from Waves 1 to 4 of the Health and Retirement Surveys. Based on resource theory, the analyses indicate that retired husbands are least satisfied if their wives remain employed and had more say in decisions prior to the husband's retirement. Retired wives are least satisfied if their husbands remain employed and had more say in decisions prior to the wife's retirement. These results suggest that retirement transitions undermine married retirees’ satisfaction if they enhance the other partner's influence in the relationship. More research should address linkages between work and family realms during transitions such as retirement and explore the negotiation processes surrounding such transitions. [ABSTRACT FROM AUTHOR]

Purpose: Retirement is often treated as a voluntary transition, yet selected circumstances can restrict choice in retirement decision processes. We investigated conditions under which retirees perceive their retirement as "forced" rather than "wonted," Methods: Analyses relied on Waves 1-4 of the Health and Retirement Survey (N = 1,160; 572 men and 588 women). Logistic regression models estimated the effects of background factors, choice and restricted choice conditions, and retirement contexts on perceptions of forced retirement. Results: Nearly one third of older workers perceived their retirement as forced. Such forced retirement reflects restricted choice through health limitations, job displacement, and care obligations. Other predictors include marital status, race, assets, bene- fits, job tenure, and off-time retirement. implications: Future research should establish personal and policy implications of forced retirement. Programs are needed to help older workers forced into retirement find alternative employment opportunities and to reduce the conditions leading to forced retirement. [ABSTRACT FROM AUTHOR]

Objectives: The purpose of this study was to investigate the effects of type of retirement (forced, early, abrupt) and spouse's disability on longitudinal change in depressive symptoms. Methods: The analyses rely on Waves 1-4 of the Health and Retirement Survey (N = 2,649). Generalized estimating equations models with bootstrapped standard errors and adjustment for survey design and non-independence of dyad members estimate effects of retirement, type of retirement, and spouse's disability on depressive symptoms, controlling for relevant covariates. Results: The results suggest that depressive symptoms increase when retirement is abrupt and perceived as too early or forced. Women retirees who stopped employment and were either forced into retirement or perceived their retirement as too early report significantly more depressive symptoms with increasing spouse activities of daily living (ADLs) limitations. There is no similar effect for men. In contrast, for working retirees who retired on time, depressive symptoms decrease with increasing spouse ADLs. Discussion: These results highlight the importance of retirement context on postretirement well-being. They suggest that both type of retirement transition and marital contexts such as spouse's disability influence postretirement well-being, and these effects differ by gender. [ABSTRACT FROM AUTHOR]

Depressive symptoms have been represented in the research and clinical literature in terms of both an episodic phenomenon and as enduring individual differences. We investigated depressive symptoms longitudinally in a sample of older adults. Participants were 737 individuals (MAge = 73 years initially, 39% women) in the Baltimore Longitudinal Study of Aging who provided biennial Center for Epidemiological Studies-Depression data on up to five occasions over an 8-year period. We found both trait and state-residual variability, with symptoms increasing longitudinally on all subscales and accounting for an approximately 1-point increase per decade. Trait-like variability accounted for at least two thirds of the reliable variance. Interindividual differences were consistent over time, but occasion-specific variability diminished across occasions. [ABSTRACT FROM AUTHOR]

With hypotheses derived from a life course perspective in conjunction with life event stress and role theories, we examine whether a spouse's employment and length of retirement affect a person's postretirement depressive symptoms and whether such effects differ by gender. Analyses use pooled data from Waves 1-4 of the Health and Retirement Survey, using a subsample of married individuals who either remained continuously employed over time or completely retired since the Wave 1 interviews (N = 2,695). Recently retired men seem to be negatively affected by their spouses' continuous employment when compared with men whose wives were continuously not employed. In contrast, spouses' joint retirement has a beneficial influence on both recently retired and longer- retired men. However, for recently retired men, the positive effect of wives' retirement seems to be contingent on spouses' enjoyment of joint activities. Among women, effects of spouses' employment occur only among very recently retired wives (0-6 months). These wives report more depressive symptoms if their spouses were already nonemployed prior to wives' retirement. These results demonstrate the complexity of retirement adaptation processes and suggest that marital context plays an important role in retirement well-being. [ABSTRACT FROM AUTHOR]

This study examines whether the meaning of marital conflict and marital solidarity are affected by the transition to retirement, whether the retirement transition alters stability and variability of, and cross-spouse influences on, marital quality, and whether retirement influences latent means of marital quality. Data from both waves of the National Survey of Families and Households (NSFH) addressed these questions (N = 407 couples for wives' retirement, and N = 550 couples for husbands' retirement). Results suggest that the structure of marital conflict is unaffected by husbands' and wives' transition to retirement, but that wives' continued employment may be associated with greater conflict longitudinally. Husbands' and wives' constructs of marital solidarity differ from one another; they were unaffected by wives' retirement but converged with husbands' retirement through changes for each partner in the importance of joint time together and potential for divorce. Effects of the retirement transition are far subtler than previously believed. [ABSTRACT FROM AUTHOR]

Purpose: Few international comparisons of health services are performed using microlevel data. Using such data, this paper compares the need for and receipt of assistance with activities of daily living (ADLs) in comparable samples in the United States and Sweden, a country with a universal system of community-based services. Design and Methods: Data from national surveys of community residents completed at approximately the same time in each nation are used to create comparable measures of need and assistance. Descriptive and logistic regression analyses compare need and assistance patterns across the nations and identify individual factors that explain receipt of assistance and unmet needs. Results: Our results indicate that a simple story of greater use of paid formal services in Sweden and more unpaid informal use in the United States masks a more complex relationship. Assistance with ADLs seems to be more targeted in Sweden; narrow differences in assistance widen considerably when the analysis is limited to those reporting need. Implications: Although these two different health systems result in similar levels of overall ADL assistance, a detailed microlevel comparison reveals key distinctions. Further microlevel comparisons of access, cost, and quality in cross-national data can further aid our understanding of the consequences of health policy. [ABSTRACT FROM AUTHOR]

The entailment model of attributions is examined for the first time using a dyadic approach and longitudinal data. In a sample of 229 married partners with children, causal attributions were distinguished empirically from responsibility attributions and, consistent with the entailment model, the effect of causal attributions on conflict was mediated through attributions of responsibility. Only 1 path was influenced by spouse gender. Examination of cross-spouse effects revealed significant effects and provided a better fit than a model with no cross-spouse effects. The importance of including cross-spouse effects in attributional models is discussed. [ABSTRACT FROM AUTHOR]

Focuses on a study which examined the influence of parents' retirement on their relationship with their adult children outside the household. Review of literature; Theoretical framework and hypotheses of the study; Methodology and results; Factors associated with the parents' contact with their children; Limitations of the study.

Although cross-sectional research has established the link between care demands and various indicators of caregiver adaptation, few studies have examined the impact of care recipients' problematic behavior over time. The present analysis determines the importance of behavior problems when predicting rates of change in subjective stressors (role overload and role captivity) and depression. Using 4-wave longitudinal data (N = 137) on dementia caregivers, the authors fit individual growth curve models for care demands (i.e., behavior problems, activities of daily living dependencies, and cognitive impairment), subjective stressors, and depression. Subsequent structural equation models found that increases in behavior problems were most likely to predict increases in role overload. The findings emphasize the deleterious long-term impact of behavior problems on individuals' emotional adaptation to caregiving. [ABSTRACT FROM AUTHOR]

Background: Nutrient-dense foods, which are often low in energy density (ED), are recommended for a healthy diet in infants and children. How ED changes during the transition from a complementary diet in infancy to a conventional diet is unknown.Objectives: We aimed to describe the ED, the amount of energy (e.g., kcal) per weight (e.g., g), of food or beverage in infants and preschool-age children. It was hypothesized that ED would be higher among older children.Methods: The ED of food (ED-Food Only) and of food and all beverages excluding human milk and infant formula (ED-Food and Beverages) of children's (6 mo-5 y) diets were examined overall and by age subgroups using data from the NHANES (2009-2018). Survey-adjusted linear regression followed by pairwise comparisons were used to compare ED across age subgroups. The percentages of calories consumed from low-, medium-, and high-ED foods across age subgroups were also examined.Results: Mean ED-Food Only was 1.21 kcal/g (95% CI: 1.13, 1.29 kcal/g) among 6- to 11-mo-olds and 1.62 kcal/g (95% CI: 1.54, 1.69 kcal/g) among 12- to 17-mo-olds (P < 0.05). ED-Food and Beverages was higher across consecutive age subgroups from 0.99 kcal/g (95% CI: 0.96, 1.02 kcal/g) in 12-17 mo through 3 y (1.22 kcal/g; 95% CI: 1.19, 1.26 kcal/g; P < 0.05). Mean percentage of calories consumed from low-ED food (≤1.0 kcal/g) became lower with age from 6- to 11-mo-olds (47.3%; 95% CI: 44.3%, 50.4%) through 18- to 23-mo-olds (16.2%; 95% CI: 14.5%, 17.9%; P < 0.05). A greater percentage of calories was consumed from high-ED food (≥3.0 kcal/g) among 18- to 23-mo-olds (39.0%; 95% CI: 37.1%, 40.9%) than among 12- to 17-mo-olds (34.0%; 95% CI: 32.0%, 35.9%; P < 0.05).Conclusions: ED increased across age subgroups, driven by a decrease in the percentage of calories consumed from low-ED food and an increase in the percentage of calories consumed from high-ED food. [ABSTRACT FROM AUTHOR]

A sample of parents (aged 50+) drawn from the 1988 and 1992 waves of the National Survey of Families and Households was used to examine two questions: How responsive is support from adult children in times of need? Is support from children greater for those who expected their children to provide help? Parents who experience one or more transitions in the time between survey waves are likely to receive help from their adult children over and above previous exchange patterns. Responsiveness on the part of children does not appear to be linked with parental expectations, however. Neither general value orientations about what children should do to support parents, nor expectations of help from one's own children in hypothetical situations are related to children's responsiveness to parental needs. Results are consistent with a contingent exchange perspective on intergenerational relationships. [ABSTRACT FROM AUTHOR]

Presents information on a study which examined models of informal support received by elders in the United States and Sweden. Demographic differences between the two countries and their association with formal and informal help; Research methods; Findings; Discussion.

In an important investigation of the longitudinal relation between marital adjustment and depressive symptoms, L. A. Kurdek (1998) reported an apparent failure to replicate prior findings reported by E D. Fincham, S. R. H. Beach, G. T. Harold, and L. N. Osborne (1997). He attributed the diverging results to differences between the analytic approach taken in each of the studies. The authors reanalyzed E D. Fincham et al.'s data using L. A. Kurdek's analytic procedures and found no change in results. A more parsimonious assessment of the diverging results is that L. A. Kurdek failed to generalize E D. Fincham et al.'s findings to a longer time lag and a sample characterized by a rather different pattern of attrition. The authors highlight several important issues that require greater attention in developing a cumulative body of knowledge on the longitudinal relation between marital processes and depression. [ABSTRACT FROM AUTHOR]

Background: Cancer affects patients and their families, but few data are available on factors associated with diversity of family structures among patients with cancer. Family is a source of both support and responsibility that must be understood to support patients and their families. Methods: Pooled data (2004–2015) from the National Health Interview Study were used to compare characteristics of cancer survivors with and without minor children and differences by sex and race/ethnicity among survivors with minor children. Results: 13.9% of cancer survivors have minor children in the household, and this experience is more likely for women and people who identify as other than non‐Hispanic White. Conclusion: There are considerable differences by sex and race/ethnicity in the characteristics of cancer survivors with minor children. Clinicians should make consideration of family circumstances a routine part of their history. Doing so will help to identify potential sources of support and responsibility that may affect adherence. [ABSTRACT FROM AUTHOR]