bluuebunny/crossref_metadata_2025 huggingface dataset:
CREATING STRENGTH IN AGE: THE ROLE OF ARTS, ETHICS, AND HUMANITIES IN GERONTOLOGY EDUCATION
Authors: Saunders Pamela
Published: November 2019

What are the necessary and ideal components of an interdisciplinary master’s degree program in gerontology? What is the role of arts, humanities, and ethics to teach students and future leaders the power of social networks? This paper presents a case study of one academic program. Data are semi-structured interviews with students and faculty analyzed using content analysis to discover themes. In 2018, inspired by aging demographics, Georgetown University launched a one-year, interdisciplinary MS degree in Aging & Health. Informed by AGHE competencies including arts, ethics, and humanities, the program provides theoretically and scientifically grounded content, hands-on experience, and professional engagement. One core course specifically focuses on arts, ethics, and humanities, and provides a basis for students to see interdisciplinary links across the curriculum. Findings includes themes that illustrate the value of harnessing the power of arts, humanities, and ethics, including a diverse, and intergenerational cohort, and students’ cultural value systems.
FOR BETTER OR FOR WORSE: MARITAL TRANSITIONS AND SEXUAL LIFE IN MIDDLE AND OLDER AGE
Authors: Stokes Jeffrey E , Gallagher Elizabeth A , Kanyat Remona , Bui Cindy N , Beaulieu Celeste
Published: November 2019

Marital transitions have known implications for health and well-being. However, little research has examined the effects of such transitions on adults’ sexual lives. This study uses longitudinal data from the National Study of Midlife Development in the United States (1995–2014) to compare different marital status and transition groups’ sexual activity, satisfaction, control, and effort throughout mid-and-later life. Across all outcomes, effects of marital status/transitions were contingent upon baseline values of the outcome. Consistently married adults reported more frequent sexual activity, greater sexual satisfaction, and greater effort put into sexual life than other groups when baseline values of those outcomes were average or above-average; such group differences were reduced or reversed at below-average baseline values. Among the not-married, women reported significantly less sexual activity than men. The consistently divorced/separated, consistently widowed, newly divorced/separated, and newly widowed all reported greater control over sexual life at follow-up than the consistently married, when baseline sexual control was average and/or below-average. Lastly, women reported lesser effort put into sexual life at follow-up than men across all groups, accounting for baseline effort; these gender gaps were least pronounced among the consistently and newly married, and most pronounced among the newly widowed and newly divorced/separated. Overall, findings indicate that implications of marital transitions for midlife and older adults’ sexual lives depend upon both gender and pre-transition context. Marriage is not always beneficial for sexual life; rather, poor quality sexual lives during marriage can reduce opportunities for improvement that may arise with marital transitions, including divorce and widowhood.
THE IMPACT OF SEXUAL FLUIDITY AND SOCIAL SUPPORT ON EGO INTEGRITY IN OLDER ADULTS
Authors: Figueroa Alicia C
Published: November 2019

The population of lesbian, gay, and bisexual (LGB) Americans is growing as the number of older adults “come out. ” While we know that “coming out” later in life impacts the experience of aging, little research has examined ways in which social support and sexual fluidity influence ego integrity in older adults. The present study investigated ego integration, changed sexual behavior, and perceived social support in adults 45 years of age and older who had been in a long-term relationship with the opposite sex prior to “coming out” as LGB. The average of participants was 61 years, sixty-eight percent (N = 43) were currently married or in a domestic partnership, and eighty-six percent (N = 54) identified as Caucasian. Individuals were recruited to participate in the survey utilizing online social media. Results (N = 63) suggested that those whose behavior was more sexually fluid were least ego integrated. Timing of “coming out” LGB, Early (44 and younger) versus Late (after the age of 45) impacted the degree of sexual fluidity and perceived social support. Results indicated those who “came out” Late were more sexually fluid and were less fearful of “coming out. ” The most significant result revealed social support from significant others to be most impactful compared to friends and family. This research expands on the challenges of those who are aging in a non-normative environment. The implications suggest that individuals who “come out” later have a more difficult time with accepting their sexual fluidity.
SOUND HEALTH: HARNESSING MUSIC FOR HEALTH AND WELL-BEING IN SERVICE OF OLDER PEOPLE
Authors: Edwards Emmeline
Published: November 2019

Music can get you moving, lift your mood, help you recall a memory, and can potentially improve your health. A partnership between the National Institutes of Health and the John F. Kennedy Center for the Performing Arts, called Sound Health is expanding current knowledge and understanding of how listening, performing, or creating music involves intricate circuitry in the brain that could be harnessed for health and wellness. The presentation will focus on research that shows that music provides cognitive, socio-emotional, motor benefits as well as evidence for neural plasticity. The potential for music as therapy for several neurological disorders associated with aging will be discussed. Dr. Edwards will also highlight research gaps and opportunities in basic/mechanistic and clinical research on music and the aging brain.
LEARNING FROM LIFE STORIES: RECRUITING NURSING HOME RESIDENTS FOR A LIFE STORY WORK PROGRAM
Authors: Polk Brian K , Ejaz Farida , Rose Miriam
Published: November 2019

Recruiting nursing home (NH) residents to participate in program evaluations is a consistent challenge. This was evident in a federally supported project to improve person-centered care of long-stay NH residents enrolled in Medicaid. Evaluators sought to examine the impact of a life story work intervention using a pre-post study design involving interviews of NH residents and surveys of their family members and staff. Other resident eligibility criteria included willingness to participate in both research and life story interviews, age 60+, a Brief Inventory Mental Status (BIMS) score of 8 or higher, English-speaking, and consent from a legal guardian, if applicable. A total of 16 NHs agreed to participate in the implementation and evaluation of the program, which developed complimentary, individualized life story booklets for residents and a companion summary for staff. Of the homes’ combined population of 1,817 residents, 569 met eligibility criteria for the research study. Non-response from legal guardians excluded 37 residents, and 174 residents approached for recruitment declined to have their names released to the researchers. During baseline interviews, 20 residents failed the BIMS, 21 were unavailable, and 79 refused when approached by a research interviewer. Ultimately, 238 resident interviews were completed at baseline. Common themes for refusals included disinterest in participating in life story work, statements that theirs was not a good life worth talking about, and doubts that quality of care would improve. Strategies for addressing such challenges included displaying sample life story materials during recruitment and providing residents additional time to consider participation.
PREDICTORS OF SELF-CONTINUITY IN LATER LIFE
Authors: Lampraki Charikleia , Spini Dario , Jopp Daniela
Published: November 2019

Self-continuity is an identity mechanism that inter-connects past and present experiences with future expectations, creating a coherent whole. However, research is limited regarding inter-individual differences and life course determinants of change in self-continuity. Using a life-course perspective on vulnerability, we investigate how the accumulation of resources (e.g., social, hopeful attitude) and the occurrence of critical life events (e.g., childhood adversity, divorce) across the life course may affect changes in self-continuity. Data derived from the LIVES Intimate Partner Loss Study conducted in Switzerland from 2012 to 2016 (3 waves). The sample consisted of individuals having experienced divorce (N = 403, Mage = 55.43) or bereavement (N = 295, Mage = 69.91) in the second half of life, using a continuously married group as a reference (N = 535, Mage = 65.60). Multilevel hierarchical models were used. Results indicated that as individuals grew older they experienced more self-continuity. More childhood adversity was negatively associated with inter-individual differences in self-continuity for all groups. Divorcees with more childhood adverse events felt significantly less self-continuity as they grew older than divorcees with less childhood adversity. In the bereaved group, more childhood adversity and less hope was linked to lower levels of self-continuity. More hopeful married individuals felt more self-continuity as they grew older than less hopeful ones. In sum, findings demonstrate that self-continuity changes as a function of age, but also differs with regard to the critical life events experienced across the life course and the availability of resources.
EXPLORING THE EFFICACY AND EFFECTIVENESS OF REMINISCENCE USING THREE-DIMENSIONAL PRINTED OBJECTS
Authors: Anderson Keith A , Berg-Weger Marla , Plocher Tom , Farina Anne , Gaugler Joseph E
Published: November 2019

Reminiscence therapy (RT) is a form of person-centered care that involves the exploration of past activities, events, and experiences with another person or in a small group. Research on RT has found an array of benefits for older adults, including improvements in mood, quality of life, social interaction, cognition, and memory. In this presentation, the researchers report on Phases I and II of an evaluation of a reminiscence using three-dimensional (3D) printed objects from older adults’ pasts. Advances in 3D printing technology now allow researchers to create scale replicas of cherished items from peoples’ pasts, such as toys, bicycles, pets, automobiles, boats, and houses. In Phase I, the researchers evaluated the efficacy of incorporating 3D objects in reminiscence using a parallel convergent mixed methods design. Participants agreed or strongly agreed that the 3D object reminiscence was well-received (88.9%), facilitated reminiscence (83.3%), increased engagement and alertness (72.3%). Qualitative data identified additional benefits of the use of 3D objects in reminiscence, including increases in social engagement and interactions with staff and family members. In Phase II, the researchers are evaluating the effectiveness of a formal 3D reminiscence intervention using a randomized control trial of 175 older adults. The researchers hypothesize that 3D object reminiscence will be more effective than reminiscence using verbal cues in stimulating memory and enhancing cognition, engagement, mood, and quality of life. Preliminary findings from Phase II will be reported along with the findings from Phase I.
LINKS BETWEEN LONELINESS AND HAPPINESS IN JAPAN’S AGING POPULATION
Authors: Yamashita Takashi , Bardo Anthony R , Lam Jack
Published: November 2019

Fertility rates in Japan have been historically low over several decades while life expectancy remains among the highest in the world. Consequently, traditional social networks consisting of immediate family and relatives have shrunk, and a growing number of older adults in contemporary Japanese society report feeling lonely. Thus, the well-being of Japans aging population is a major concern. While the negative effects of loneliness on perceived well-being (e.g., happiness) in later life have been well documented in western nations, relatively little is known from a Japanese context. Thus, we utilized a sample (n = 258) of urban community-dwelling Japanese adults age 65 years and older from the 2012 Survey of Mid-Life in Japan (MIDJA) to examine the association between happiness and loneliness. Consistent with findings from western nations, we identified strong links between happiness and loneliness in Japan. Results from ordinal logistic regression models showed that loneliness (OR = 0.80, p < 0.05) was negatively associated with happiness even after accounting for sociodemographic characteristics. Additionally, this study examined relevant demographic and cultural characteristics in order to contextualize the findings and identify possible explanations. For example, the cultural importance of family ties and gendered family roles was discussed in relation to the likely impact that increased levels of loneliness will have on the well-being of older Japanese adults. In sum, if the well-being of Japan’s rapidly aging population is to be maintained (or possibly even enhanced), then the growing societal issue of loneliness must be addressed.
RETIREES’ MEMORIES OF WORK LIFE AND WELL-BEING AFTER RETIREMENT: A QUALITATIVE INQUIRY
Authors: Hahnel Tina , Hommelhoff Sabine , Liao Hsiao-Wen
Published: November 2019

Reminiscence research has grown immensely in the past 30 years. Yet, research on personal memories of work lives is lacking. This is surprising because work is a crucial aspect of many people’s lives and an important life story chapter (Thomsen, Pillemer, & Ivcevic, 2011). Part of a larger project, the present qualitative study aimed to understand (1) what retirees remember about their work lives and (2) whether and how retirees tie those memories to their current well-being. Six in-depth interviews on lives before and after retirement (4 women and 2 men with different careers, age range 65 to 87 years) were conducted and transcribed verbatim. Findings of a thematic analysis (Braun & Clarke, 2006) revealed that participants reported both big and small stories. They first narrated landmark events (e.g., job loss after the Fall of the German Wall) and continued to recount many little incidents (e.g., a child asking an unretiring teacher if she is now "done with retirement”). Additionally, participants not only reminisced about work itself (i.e., what jobs were like) but equally about workplace relationships (e.g., particularly positive or negative relations with supervisors). Despite difficult times at work, participants reported that they were now at peace with how things went and generally satisfied with their current lives. We discuss how the type (i.e., big or small) and content (i.e., work- or relationship-focused) of retirees’ memories and positive meaning-making (i.e., recounting work lives in a positive light) may contribute to well-being and propose a conceptual model for future research.
EMOTIONS SURROUNDING THE 2018 MIDTERM ELECTIONS
Authors: Krueger Sydney , Ochsner Kevin
Published: November 2019

Over the adult life-span there is a self-reported shift in daily life emotions towards feeling less negative and more positive. We hypothesized that variations in emotion regulation behavior over the life-span could explain why aging is associated with this “rosy glow”. We collected survey data from 400 adults on Prolific (18-90, M = 47, SD = 16) at three time points: once before and two times following the 2018 Midterm Elections. We collected political engagement ratings, baseline emotion ratings, emotion ratings following the election, and self-reported emotion regulation behavior (e.g., situation modification, situation selection, reappraisal, seeking social-support). In our analyses we treated age as a continuous variable predicting differences in emotion ratings and emotion regulation reports. Consistent with past research, age predicted a decrease in negative and an increase in positive emotions at baseline (before the election). Controlling for political affiliation and we found that age predicted a lower likelihood of using social support regulation and situation modification. We also found that age was inversely predictive of the use of multiple strategies, such that younger adults are more likely to rely on a larger array of regulatory strategies than older adults. These results suggest that age-related differences in self-reported emotions in daily life may be attributed to a reduction in regulation-strategy usage over the life-span, and perhaps a reduced need to regulate negative emotion.
RELATED FACTORS OF MENTAL HEALTH WELL-BEING IN THE PARTICIPANTS OF SENIOR CITIZENS' COLLEGE
Authors: Uchida Hayato , Matsuura Shinro
Published: November 2019

The aim of this study was to clarify the mental health well-being and its related factors of participants in senior citizen’s college. The participants were 364 persons (age 69.4+/-6.1) aged sixty years or over living in Hyogo Prefecture, Japan. We conducted a cross- sectional study that included age, family structure, employed status, self-related health, presence of chronic disorders, Instrumental ADL (TMIG index of competence score), dietary variety score (1-10), cognitive social capital, structural social capital, the scales of grandchild-grandparent relationships, Japanese version of the abbreviated Lubben Social Network Scale (LSNS-6), the frequency of going outdoors, and Mental health well-being was assessed using the Japanese version of the World Health Organization Mental Health Well-being Index-five items, WHO-5. We carried out the surveys in October in 2018. The total score of WHO-5 was 19. 6+/-4.7 among all participants. From the results of multivariate logistic regression analysis, “social isolation” (OR=4.001, 95%CI=1.584-10.043) was independently associated with low mental health well-being (WHO-5). These results suggest that, to advance the well-being of the elderly, it is necessary to develop and implement the projects which promote social functions including close relationship with others, neighbors or family members.
BURDENS OF HONOR: EXAMINING HONOR IDEOLOGY, SUICIDE RISK-FACTORS, AND AGEISM IN OLDER ADULTS
Authors: Bock Jarrod , Brown Ryan P
Published: November 2019

Prior research has demonstrated that rates of suicide increase as men enter older adulthood and that these rates are even higher in honor-oriented regions of the U.S. (particularly among White men). Research into the honor-suicide link has suggested explanatory factors that coincide with the interpersonal theory of suicide, such as untreated depression, heightened risk-taking, and the use of firearms in suicide; however, factors related to aging (e.g., ageism, anxiety about aging) have yet to be examined. The present study examined ambivalent ageism, permissive attitudes toward suicide, and interpersonal risk-factors for suicide as explanations for the honor-suicide link among a sample of 201 older American men (Mage = 56.45, SD = 8.35, range = 44-77 years of age). After controlling for participant age and religiosity, participants with greater endorsement of honor ideology but lower levels of honor fulfillment expressed heightened levels of thwarted belongingness (β = 0.35, p = .001)—an established interpersonal risk-factor for suicide. Additionally, lower levels of honor fulfillment predicted greater anxiety about aging (β = -0.41, p < .001), greater perceived burdensomeness (β = -0.39, p < .001), and more positive implicit attitudes toward youth (β = 0.27, p = .019). Conversely, greater levels of honor fulfillment predicted more positive attitudes toward aging (β = 0.20, p = .025). Our results extend previous research on the honor-suicide relationship by demonstrating the utility of marrying the interpersonal theory of suicide with research on cultures of honor.
STRENGTHENING AGE-FRIENDLY COMMUNITIES THROUGH CAPACITY BUILDING TO ADDRESS BEHAVIORAL HEALTH CONCERNS
Authors: Keefe Bronwyn , Kostiuk Rita
Published: November 2019

The Center for Aging and Disability Education and Research at Boston University in collaboration with the Age-Friendly New Bedford received funding from Tufts Health Plan Foundation to reduce the stigma of mental illness and increase awareness of the effects of social isolation in the community. In order for older adults to be fully engaged in community life, behavioral health concerns need to be addressed with a focus on social isolation, depression, and substance use. Many Age Friendly efforts don’t address these issues even though significant numbers of older adults are impacted. Without a community-wide capacity building effort, behavioral health issues among older adults often fade into the background. We developed and implemented a 3-tiered approach to incorporating behavioral health into an Age Friendly initiative. In the first tier, we focused on increasing awareness of the impact of behavioral health concerns and stigma by creating an anti-stigma campaign in multiple languages. The second tier focused on holding workshops for older adults on behavioral health related issues. The third tier provided training to key stakeholders, including aging service providers, clergy, first responders, and resident coordinators focusing on the need to effectively identify and respond to older adults with behavioral health concerns. Using the Depression Stigma Scale, we measured perceived stigma among older adults pre and post workshop participation. We found statistically significant changes in how older adults perceive depression after participation in the workshop. Training results were also statistically significant with gains pre-post training in key competency areas.
DOES MUSICKING IMPROVE WELL-BEING IN LATER LIFE? USING BASIC PSYCHOLOGICAL NEEDS THEORY TO EXPLORE THE QUESTION
Authors: Wong Anna , Matsunobu Koji
Published: November 2019

Older adults are vulnerable to developing poor mental health as they experience significant life changes such as retirement, widowhood, living alone, institutionalisation, physical and/or cognitive deterioration in oneself or one’s partner, which are associated with increased depression and loneliness. Understanding the mechanisms and identifying effective measures that strengthen their capacities to cope are therefore very important. Extensive research has suggested that active music-making with others has many psychosocial benefits for older adults. This study explored in detail the musical experiences drawn from different settings of Japanese and Hong Kong music communities. Semi-structured group interviews were conducted for members of music-making groups in Japan and Hong Kong who regularly practised, rehearsed, and performed their instruments together in community settings. A phenomenological approach was used to capture and analyse their lived experiences. A needs satisfaction theoretical framework was adopted to shed light on links between their musical engagement and wellbeing outcomes. Active musical engagement was found to be an important source of support for older musicians’ psychological needs. It was central to their positive identity development and sense of purpose in old age. The presentation will further elaborate on underlying mechanisms that linked social, emotional, and artistic experiences of active musical engagement to wellbeing. This study identified active musical engagement as an effective agent in healthy ageing. Differential manifestations of need-supportive practices in musically and culturally distinct communities in Japan and Hong Kong were also described, giving evidence for the positive value of community music groups for promoting mental health and wellbeing.
THE IMPACT OF SUBJECTIVE WELL-BEING ON LONGEVITY AMONG OLDER ADULTS
Authors: Wang Sylvia Y , Kim Giyeon , Gilpin Ansley
Published: November 2019

Objectives: People tend to believe happier people live longer. However, relatively few empirical studies have examined the influence of subjective well-being (SWB) on longevity among older adults. Thus, our study investigated the impact of SWB on longevity among older adult using national representative longitudinal data in the U.S. Methods: Drawn from the National Health and Aging Trends Study, 6,757 older adults aged 65 or older with completed information of SWB from 2011 were selected and followed until 2017 annually. The Kaplan-Meier estimator was used to estimate the survival time between different levels of SWB without covariates. In addition, the Cox Proportional Hazards Model was used to investigate the impact of SWB on longevity while adjusting the influences of covariates. Results: We found that a higher level of SWB predicted longer survival times among older adults. The impact of SWB on survival times remained to be significant, but weaker, after adjusting the influences of age, educational attainment, household income, gender, marital status, number of health insurances, self-rated health, chronical medical illness, and mental health. Conclusion: Findings suggest that happier older adults live longer. Recognizing the importance of SWB on longevity, healthcare providers should develop programs promoting higher SWB to prolong life for older adults.
THE EFFECT OF OLDER ADULTS’ STRESS AND COPING ON LIFE SATISFACTION
Authors: Kim Meeryoung
Published: November 2019

Older adults experience stressors in everyday life, which can be acute or chronic stressors. When people are stressed, coping abilities and social support are important factors for increasing their life satisfaction. Using Pearlin et al.’s (1990) stress process model, this study compared whether acute or chronic stressors were more stressful. Additionally, the effectiveness of emotional, informational and instrumental support on life satisfaction were compared. This study used the 3rd and 5th addition wave of KReIS (Korean Retirement and Income Studies) which were collected in 2009 and 2014 respectively. For socio economic status, 3rd wave data was used. Independent and dependent variables were derived from 5th addition wave data. The sample size of this study was 4,072 older adults who were 65+. Daily hassles were used to indicate acute stressors, and physical and economic strain were used to indicate chronic stressors. For coping resources, social support and coping were used. Life satisfaction was used for dependent variable. Since the stress model is a process model, hierarchical multiple regression was used. Both acute and chronic stressors had a significant effect on reducing life satisfaction. Coping and social support both had significant positive effects on life satisfaction. In regard to social support, emotional and instrumental social support had significant effects on life satisfaction. These results implied that chronic stressors were more stressful than acute stressors. In addition, instrumental social support was found to be better than emotional social support for increasing life satisfaction for Korean older adults.
BUILDING RESOURCE NETWORKS IN SERVICE OF OLDER PEOPLE THROUGH STATE ARTS AGENCIES' COMMUNITIES OF PRACTICE
Authors: Bienvenu Beth
Published: November 2019

National, state, and local arts networks help build the capacity of public and private sector organizations to serve older adults through quality arts engagement opportunities. The National Endowment for the Arts has worked closely with state arts agencies to build networks through a community of practice to facilitate partnerships with artists, arts organizations, aging services, and the healthcare system. With more than 40 states participating, the initiative has resulted in new state partnerships, new state grant initiatives, and new arts learning programs for older adults. Arts service organizations also have a role to play in this work. For example, the American Alliance of Museums is building a network of museums that will develop and implement high-quality, intensive arts learning opportunities for older adults across the United States. This presentation will address how these networks are helping build capacity across the country to improve the health and well-being of older adults
CULTURAL AND SOCIAL RESILIENCE FACTORS ON HEALTH IN THE CONTEXT OF IMMIGRATION
Authors: Dong XinQi , Li Mengting , Guo Man
Published: November 2019

Acculturation is a process whereby immigrants change their beliefs or behaviors in response to the prevailing norms and values in the host country. Acculturation may directly affect health outcomes, while it also operates through multi-level social factors, such as family relations, social network, and neighborhood cohesion, in shaping immigrants’ health. Asian Americans are the fastest growing minority group in the United States. Chinese Americans constitute the largest segment of Asian Americans. The five studies aim to profile multi-level cultural and social resilience factors of older Asian Americans’ health by analyzing the Asian American Quality of Life survey and the Population Study of Chinese Elderly in Chicago (PINE). Two studies, Acculturation and Cognitive Health and Factors Associated with Unmet Healthcare Needs demonstrated the direct effect of acculturation on health. Another two studies outlined a more complex mechanism between cultural and social determinants and health. Perceived Stress, Social Support, and Dry Mouth found the buffering effect of social support on the relationship between perceived stress and oral health. Neighborhood Social Integration, Social Network, and Cognitive Function identified micro- and macro-level resilience factors exert interaction effects on cognitive function. In addition, previous studies pay little attention to the dynamic nature of social relations. Transition in Family Relations in Immigrant Families took a typology approach to capture multifaceted family relations, with a longitudinal design to explore the transitions in family relations in the process of acculturation and its impact on mental health. This symposium will build an integrative resilience model for older Asian Americans.
CHRONIC CONDITION PATTERNS IN THE U.S. POPULATION AND THEIR RELATIONSHIP WITH MORTALITY
Authors: Zheng D Diane , Christ Sharon L , Lam Byron , McCollister Kathryn , Feaster Daniel J , Lee David J
Published: November 2019

Using data from 372,933 participants age >18 years from National Health Interview Survey 2002-2014, we employed latent class analysis to develop latent classes or subgroups of participants based on their combination of 13 self-reported chronic conditions. Mortality linkage with National Death Index was performed through December 31st, 2015. Survival analyses were conducted to assess how the derived latent class membership predicted all-cause mortality and cause specific mortalities. Five latent groups were identified with 70.5% of the participants belonging to the “healthy group”. The other four groups represented various degrees and patterns of multi-morbidity and were labeled accordingly: “hypertensive group” 20%, “respiratory condition group” 3.9%, “heart condition group” 3.7%, and “severely impaired group” 1.9%. 32,609 deaths were identified with average follow-up time of 6.93 years. After controlling for survey design, age, gender, race, Hispanic origin, education, income, health insurance, BMI, smoking and alcohol drinking status, compared to the healthy group, participants in all four latent disease groups had elevated mortality risk: hypertensive group Hazard Ratio(HR) 1.57 (95% confidence interval [1.49, 1.65]); respiratory condition group (2.08 [1.93, 2.24]); heart disease group (2.27 [2.13, 2.42]); and severely impaired group (3.84 [3.55, 4.16]; all p-values <0.01). Patterns of the chronic condition classes were also strongly associated with the primary underline cause of death. Four multi-morbidity groups, comprising 29.5% of the US population were at significantly elevated risk of mortality. Assessing patterns of disease co-occurrence in the US population may be useful for identifying individuals in need of targeted interventions to reduce mortality risk.
CHRONIC ILLNESSES AND FATIGUE IN OLDER INDIVIDUALS: A LITERATURE REVIEW
Authors: Torossian Maral , Jacelon Cynthia
Published: November 2019

In the United states, 60% of adults have one chronic disease and 40% have at least two chronic diseases. Fatigue is a commonly reported symptom in individuals with chronic illnesses, the prevalence of which ranges between 40-74%. It is associated with multiple risk factors and has a tremendous impact on quality of life, social functioning, mood, motivation and cognition. Despite its high prevalence, the relationship between fatigue and chronic illness has not been well explored. Accordingly, the focus of this synthesis of literature is to explore fatigue-associated factors and their relation to chronic disease. The databases searched were CINAHL, PubMed, PsychInfo and Web of Science, where the following keywords were used: “Chronic disease” OR “Chronic illness” OR “Chronic conditions”, “Fatigue”, “Elderly” OR “Older adults” OR “Seniors” OR “Geriatrics”. The synthesis resulted in four themes: understanding the concept of fatigue, factors related to fatigue, activity and fatigue, and self-management of fatigue. There were some inconsistencies in the findings among research studies which were addressed, in addition to the strengths and weaknesses of some of the fatigue measurement scales used. This literature review integrates findings about fatigue in chronic illnesses in various aspects, in the population of individuals who are of 65 age or older. The four emerged themes are of value to individuals with similar characteristics as the selected population, as well as to health care providers and researchers who may address the inconsistent findings and provide a strong evidence for best practice.
DIMENSIONS OF SOCIAL SUPPORT AND ASSOCIATIONS WITH HEALTH AMONG OLDER ADULTS
Authors: Asante Samuel , Bang Eun-Jun
Published: November 2019

Social support is fundamental to human survival, and is significantly involved in the attainment and maintenance of good health and wellbeing. Previous studies have often considered social support as a singular, non-dimensional construct. While this is important and enlightening, the method of adding up individual aspects to create a singular, non-dimensional construct has produced little understanding of these aspects/dimensions of social support and their implications for health. This study examined three dimensions or types of social support-affective, confidant, and instrumental support-and their associations with physical and mental health in older adults. Data for this study were obtain from Utah Fertility, Longevity, and Aging (FLAG) study. Participants involved 325 older adults, aged 50 years or older. Results showed a significant, strong positive correlation between affective support and physical and mental health, and weak association between confidant support and physical and mental health. The correlation between instrumental support and physical and mental health was moderate. After controlling for the influence of socio-demographic variables, affective and instrumental support significantly predicted physical and mental health. Confidant support was not a significant predictor of either physical or mental health. The findings suggest both affective and instrumental support might be relatively more important to the health and mental wellbeing of older adults than confidant support, underscoring the relative importance older adults attach to quality rather than confidant support, which essentially is quantity of social ties.
GRANDPARENTAL CAREGIVING AND CO-RESIDENCE, SOCIOECONOMIC STATUS, AND MORTALITY IN RHODE ISLAND CITIES AND TOWNS
Authors: Broccoli Julia , Cohen Steven A , Greaney Mary L
Published: November 2019

Grandparents co-residing with their grandchildren is becoming increasingly more common, with over 1.5 million grandchildren living with their grandchildren in the U.S. Furthermore, the number of grandparents who are primary caregivers for their grandchildren has also increased, which can negatively effects the grandparents’ physical and mental health, and increase social isolation and financial burden. However, the associations between grandparental caregiving and health outcomes are not well understood on a population level. Therefore, the purpose of this study was to assess associations between grandparental caregiving, socioeconomic status, and population health outcomes. Using mortality data (2009-2011) from the Rhode Island (RI) Department of Health and life table methods for each RI city/town, life expectancy at age 65 (LE65) and age-standardized mortality rates (ASMR) were calculated and linked to data from the American Community Survey on grandparental caregiving responsibilities, grandparental living arrangements (co-residence), poverty status, and demographics. Correlations and multivariable linear regression modeling were used to evaluate associations among LE65, ASMR, grandparental caregiving and co-residence, demographics, and poverty. Both LE65 (rho=-0.382, p=0.016) and ASMR (rho=0.327, p=0.042) were associated with the percent of grandparents living with grandchildren. The percent of grandparents as primary caregivers to their grandchildren was not significantly associated with LE65 or ASMR. ASMR was associated with the percent of grandparents living in poverty (rho=0.401, p=0.013) and overall poverty (rho=0.363, p=0.023). These results highlight conditions of community-based living and role of primary caregivers at an older age that should be further explored to improve the health of grandparents, particularly in multi-generational homes.
EARLY-LIFE MILITARY EXPOSURES AND HEALTH AMONG OLDER VETERANS: THE BUFFERING EFFECT OF PSYCHOLOGICAL RESILIENCE
Authors: Taylor Miles G , Ureña Stephanie , Carr Dawn , Min Stella N
Published: November 2019

Objectives Drawing on the life course framework and theoretical concept of resilience, we examine the impact of early-life service-related exposures (SREs) on later-life functional impairment trajectories among older U.S. male veterans. We conceptualize resilience as a psychological resource potentially moderating the lasting negative consequences of traumatic military exposures. Method Using the 2013 Veterans Mail Survey linked to the Health and Retirement Study 2006–2014 Leave Behind Questionnaire and RAND Data File (v.N), we estimate latent growth curve models of functional impairment trajectories. Results SRE to death has a persistent positive effect on functional limitations and activities of daily living limitations. Psychological resilience significantly moderates this association, such that veterans maintaining higher levels of resilience in the face of adverse exposures have considerably less functional impairment over time compared to their counterparts with low levels of resilience. Discussion Our findings point to the importance of psychological resilience in later life, especially within the realm of traumas occurring in early life. We discuss implications for current military training programs, stressing the importance of research considering individual resources and processes that promote adaptation in the face of adverse life events.
MOVING AND GROOVING: ACTIVITY BENEFITS OF SOCIAL INTEGRATION MAY DEPEND ON RELATIONSHIP QUALITY
Authors: Brown Colette J , Rook Karen
Published: November 2019

New evidence indicates that being more socially integrated increases physical and leisure activities (Fingerman et al., 2019), thus reducing the health risks of being sedentary. Yet socially integrated individuals often have both positive (e.g., supportive) and ambivalent (e.g., supportive and conflictual) relationships. The current study investigated whether the two kinds of relationships exhibit comparable associations with activity levels, and in turn, health. In-person interviews conducted with a national sample of adults ages 65 to 91 (N = 916) assessed participants’ social ties, frequency of vigorous physical activity and leisure activities, and functional health limitations. Hierarchical multiple regression analyses structured to test mediation were conducted. Having more social ties (both positive and ambivalent) was associated with more frequent physical and leisure activity. After adjusting for demographic characteristics, both kinds of social ties were related to health limitations, albeit in opposite directions, with positive ties related to fewer limitations and ambivalent ties related to more limitations. Once physical and leisure activities were included, the association between positive ties and health limitations became nonsignificant, whereas the adverse effect of ambivalent ties remained unchanged. These findings reveal that the health benefits of positive, but not ambivalent, social ties may be explained by physical and leisure activities. This ability to get people up and moving has, until recently, been an overlooked benefit of social integration. Further investigation of the quality of social ties will extend knowledge of the pathways by which they affect health.
THE EFFECT OF FINANCIAL DIFFICULTIES ON COGNITIVE FUNCTION IN A JAPANESE ELDERLY POPULATION SAMPLE
Authors: Ishikawa Yumi
Published: November 2019

Background: Studies have been investigating the effect of financial difficulties on cognitive function especially in the US and Australia. However, there is still a discrepancy regarding the results. This study aims to estimate the effect of financial difficulties on cognitive function in a Japanese elderly population sample. It is rewarding to focus on the Japanese setting, which has the highest proportion of elderly in the world. Method: This study uses a longitudinal panel dataset which include randomly selected elderly Japanese citizens aged 60 and over; the National Survey of the Japanese Elderly. It is a panel dataset containing income and cognitive function. It is ideal dataset to capture the probability of onset of cognitive impairment as it focuses on the elderly. We estimate the effect of participants’ equivalent income on the probability of onset of cognitive impairment at a following survey point using random-effect probit model. Result: The first main result is there is a significant negative effect from financial difficulties on cognitive function. The results indicate that when participants’ equivalent income drops by 1%, they are 2.2% more likely to develop cognitive impairment. The second result is that this negative effect is heterogeneous, depending on their income level. Specifically, this negative effect is observed only at low income level, but not at high income level. That is, the deteriorating effect by impoverishment would be severe when the financially needy people faced income drops. Discussion: Income support plays an important role in improving recipients’ cognitive function, especially among the poor.
SOCIOECONOMIC STATUS AND THE GENDER GAPS IN LATE AGE SELF-REPORTED HEALTH IN TAIWAN
Authors: White Robert , Huang Fang-Yi
Published: November 2019

The socio-economic status (SES) are the fundamental causes of gendered health disparity. However, how the gender gap in self-reported health (SRH) mediate by SES at old age over time is still unresolved. Some argue the SES measures play more and more important role to explain the gender gap in SRH at later age because the feminization of poverty and female’s longer widowhood increased the gap over life course through cumulative disadvantage approach. But others SES-SRH gradients in gender gap keep convergent by age since the effects of SES on health for male has declined and make the gender gap in health disparity vanish over time. Our results show for every age, increasing SES is associated with declining risk of reporting poor health and the effects can explain much more for women than men, especially for the younger old below age 70. The effects of SES and marriage on the magnitude of the gender gap are substantial approximately 40 percent among seventy year olds to the full gender gap among 55-64 year olds in 2006.
EDUCATION, LITERACY, NUMERACY AND HEALTH INFORMATION SEEKING IN LATER LIFE
Authors: Yamashita Takashi , Bardo Anthony R , Millar Roberto J , Sahoo Shalini , Cummins Phyllis , Liu Darren
Published: November 2019

Health information plays a critical role for health promotion and maintenance in later life. While health information seeking is primarily driven by need (e.g., health), significantly less is known about the roles of education and health-literacy. Thus, we examine complex pathways that link health information seeking behaviors with education and health literacy (decomposed into general literacy and numeracy), and how these pathways differ by health status among a nationally representative sample of Americans age 50 and older (n = 2,750). Data come from the 2012/2014 Program for International Assessment of Adult Competencies. Multi-group structural equation models were used to examine the use of eight health information sources (newspapers, magazines, internet, radio, TV, books, friends/family, and health professionals) by health status (good vs. poor). Findings showed that literacy and numeracy are significant mediators of the relationship between education and health professional as an information source. Additionally, the mediation effects on health professionals by literacy status [indirect-effect (good vs. poor health) = 0.48 vs. 2.13, p < 0.05] and numeracy [indirect-effect (good vs. poor health) = -0.47 vs. -1.81, p < 0.05] were significantly moderated by health. At the same time, no moderated mediation effect was observed in the use of any other information sources. This study provides some of the first nationally representative evidence regarding how education functions through health literacy components to shape health information seeking behaviors by health status. Explanations and implications for differing effects of education, literacy, and numeracy on health information seeking in later life were evaluated.
THE EDUCATION-HEALTH GRADIENT AND PATHWAYS TO MORTALITY
Authors: Kiel Justin J , Soh Yenee , Guo Muqi , Canning David
Published: November 2019

Large and widening educational gaps in life expectancy exist in the United States, but the mechanisms behind the education-health gradient are not well understood. We aim to study the different pathways of mortality by education group and decompose the life expectancy gap at age 50 into three components: differences in initial health at age 50, differences in transition rates to poor health states, and differences in mortality rates, given the health state. We use 11 waves of the Health and Retirement Survey and model the evolution of mortality, and health states (measured by self-rated health, limitation on any activity of daily living, and ever diagnosed with a range of health conditions). We estimate Markov models of transitions between health states and mortality over two year periods and use these transition matrices to simulate how a cohort’s health changes as they age. We find a 6-year gap in life expectancy between the highest and lowest education groups. Initial health states account for one-third of the gap in life expectancy, primarily from differences in objective health measures. The gap has widened over time, explained by comparatively better health status changes for the higher educated group, compared to the other education groups. The lower education groups have high rates of transition to poor health states, but not differential mortality rates conditional on their health state. These results suggest that educational gaps in life expectancy are due to the onset of ill health at earlier ages, and not different mortality outcomes after disease diagnoses.