bluuebunny/crossref_metadata_2025_split huggingface dataset:
EDUCATION AS A MEDIATOR THROUGH THE EFFECT OF AGE AT MIGRATION ON COGNITIVE HEALTH AMONG OLDER IMMIGRANTS IN THE US
Authors: Hong Dongfang , Dong Wuyi 
Published: January 2025

Abstract

Background
Age at immigration is a critical determinant that influences long-term cognitive outcomes among older adults, often through disruptions or enhancements in educational opportunities. Previous research has underscored the importance of educational attainment as a key factor in cognitive resilience and decline. The mediating role of education in the relationship between the timing of immigration and cognitive function remains underexplored. This study addressed whether age at migration is associated with cognition among older immigrants whether education mediates this association?

Methods
Data were taken from the 2020 Health and Retirement Study (N=1,587). Linear regression is employed to examine the direct association between age at migration and cognitive function and the indirect association through years of completed education.

Results
This study revealed a significant association between age at immigration and cognitive function, with immigrants who migrated during young adulthood (ages 18-40) displaying notably lower cognitive function compared to those who migrated at younger ages (before 18). The results also provided evidence for the partial mediation of educational attainment for the association between age at immigration and cognitive function. This indicated that disruptions in education due to migration contribute to cognitive outcomes.

Discussion
This study contributed to our understanding of how immigration timing and educational attainment intersect to affect cognitive function, with implications for policy and intervention strategies aimed at supporting the cognitive health and educational opportunities of immigrant populations. Future research should consider additional mediators, such as socioeconomic status and social support, to further elucidate these relationships
EDUCATION, ADULT LITERACY, AND HEALTH AMONG MIDDLE-AGED AND OLDER IMMIGRANTS IN THE UNITED STATES
Authors: Narine Donnette , Yamashita Takashi , Chidebe Runcie , Cummins Phyllis , Kramer Jenna , Karam Rita 
Published: January 2025

Abstract
The education-health pathway is well-documented whereby greater human capital such as educational attainment can provide health benefits over the life course. However, there is evidence of diminishing health benefits from education for immigrants compared to non-immigrants, partially due to structural factors (e.g., health insurance) limiting health-related benefits among immigrant populations. Older immigrants are more likely to be college-educated compared to their non-immigrant counterparts. However, the decades-old degrees from their home countries, along with English not being their native language, pose a particular concern for older immigrants’ health. As formal educational attainment cannot be easily promoted among older populations, adult literacy proficiency is another useful form of foundational human capital indicator, which is malleable at any life stage. This study examined the mediation effect of adult literacy proficiency on the education-health pathway among middle-aged and older immigrants in the United States. The nationally representative sample of immigrants aged 45 years and older (n = 590) in the 2012/2014/2017 U.S. Program for International Assessment of Adult Competencies (PIAAC) restricted-use file (RUF) data were analyzed. The mediation analysis showed that the association between educational attainment (college vs. less than college degree) [95% Confidence-Interval (CI): Lower-Limit (LL), Upper-Limit (UL) = 0.168, 0.780] and health (good vs. fair/poor) was mediated by adult literacy proficiency scores (0 to 500 points) [95% CI: LL, UL = 0.053, 0.352] among older immigrants in the United States. Findings from this study are informative to future interventions to support the health of older immigrants by way of adult literacy training.
INCREASING CHILDREN’S EDUCATION IMPROVES PARENTAL DEMENTIA RISK AND REDUCES GRADIENTS IN RISK
Authors: Luo Liying , Warren John , Xu Jiahui , Langa Kenneth 
Published: January 2025

Abstract
Recent research suggests that adult children’s education may influence their parents’ health at older ages. The empirical evidence about this upstream influence remains somewhat mixed, however. This is due in part to differing methodological approaches. To account for intergenerational selection and interdependent pathways, we use multilevel marginal structural models and well-defined casual estimands to analyze longitudinal data from the Health and Retirement study. We ask two important questions: (1) At the individual level, for whom does children’s education convey health benefits in older ages? (2) At the population level, what are the implications of increasing education levels among younger generations for (a) the health and well being of their parents’ generation and (b) educational disparities in health and well being? Our analyses suggests that at the individual level, increasing levels of children’s education decreases parents’ dementia risk. At the population level, educational disparities in dementia risk may be reduced as younger generations obtain more education.
LOVE HURTS: MARITAL STATUS AND CHRONIC PAIN
Authors: Choi S Emily , Wagner Brandon 
Published: January 2025

Abstract
While chronic pain is a highly prevalent and costly public health concern among older adults in the United States, longitudinal research on the social determinants of chronic pain, particularly its association with social relationships, has been limited. To address this gap, this study investigates how marital status influences later-life chronic pain with a focus on gender-specific variations. Drawing on the Health and Retirement Study (1998–2016), we estimated fixed effects logit models using an analytic sample of community-dwelling American adults aged 50 and above (N = 19,975). At baseline, women reported moderate-to-severe limiting pain (27.07%) significantly more frequently than did men (19.41%). Among men, unmarried groups, specifically the divorced/separated [OR = 0.72] and the widowed [OR = 0.55], had significantly lower odds of experiencing moderate-to-severe limiting pain compared to married individuals, controlling for demographic characteristics, socioeconomic status, health conditions and health behaviors. Among women, only the widowed had significantly lower odds of experiencing moderate-to-severe limiting pain [OR = 0.72] compared to their married counterparts. These findings suggest that though intimate social relationships may be important risk factors in shaping chronic pain in later life, they do so in perhaps surprising ways.
SOCIAL DETERMINANTS, LONELINESS, DEPRESSION, AND CHRONIC ILLNESS FOR MIDLIFE AND OLDER ADULTS IN APPALACHIA
Authors: Theeke Laurie , Hutto Lashawn , Smith LaTonya 
Published: January 2025

Abstract
Loneliness constitutes a significant health risk among midlife and older adults in Appalachia. This study presents a secondary data analysis exploring relationships among social determinants of health, loneliness, depression, and chronic illness. Common variable data from two prior studies that collected data from adults at a family health center was used for the analysis. The sample of 150 adults (88 women) ranged in age from 46 to 91years (mean 63.5, SD11.16) with mean loneliness score of 39.5 (SD11.13)- indicating high loneliness and averaged 3.2 (SD 1.88) chronic illnesses which increased with age. Over 40% were married with 74% living with others. An associate degree or higher was earned by 46%. Though 69.3% worked full-time, 43.3% reported income below $40,000 annually. Age inversely correlated with loneliness (p =.04) and depression scores (p &lt;.001). Loneliness highly correlated with depression (p,.001) and inversely correlated (p &lt;.01) with emotional, tangible, affective, positive, and total social support. Loneliness correlated with resting heart rate (p &lt;.001) and body mass index (p=.05) but not with blood pressure. Men had higher loneliness (p=.027) and were more frequently diagnosed with hyperlipidemia, heart disease (p=.047), hypertension (p=.049), and stroke (p=.004). Women had higher scores for social support (p=.005) and functional ability. Findings highlight inequities in health for older adults, particularly men, living in Appalachia. Future studies are planned for larger cohort studies to better explicate psychophysiological pathways from loneliness to illness in this population and to examine the effectiveness of LISTEN, an intervention designed to target loneliness that demonstrated effectiveness in this population.
SOCIAL ENGAGEMENT IS ASSOCIATED WITH COGNITION IN OLDER ADULTS FROM UNDERSERVED QUILOMBOLA COMMUNITIES IN BRAZIL
Authors: Simon Sharon Sanz , Cappi Carolina , Junior João Cabral , Alves Gilberto , de Oliveira Bruno Carneiro Alves 
Published: January 2025

Abstract

Quilombos are settlements founded by descendants of runaway slaves in Brazil, typically located in rural areas. Quilombola communities often present poor basic sanitation, high levels of illiteracy, and limited access to social and health services. Although the Quilombola population is socially vulnerable and likely to present an increased risk for dementia, it is underrepresented in aging research. The present study aims to investigate the association between cognition and socio-cultural engagement, potentially protective for dementia. Method: This cross-sectional study was conducted in 11 Quilombola communities in Maranhão, Brazil. The study comprised 221 older adults (60-104 years), selected in partnership with local services and community health workers. Participants completed a health survey and a cognitive screening. Demographics, cardiovascular risk factors (CRF), cognitive performance, and social engagement were described. Regression analysis examined the association between social engagement and cognition, controlling for age, sex, race, education, family income, and cardiovascular risk factors. We also examined moderation effects of sex and age on the regressions.

Results
Higher social engagement was associated with better cognition (p &lt;.001) above and beyond demographics and CRF. We observed the social activities that mostly drove the results were attending “community meetings” and “religious/faith services”. Age and sex did not moderate the associations.

Conclusion
Social engagement may be a key aspect of cognitive/brain health in Quilombola population. Social engagement may not only provide social/emotional support, but also facilitate access to basic needs. Although the results are limited by the cross-sectional design and survival bias, it may inform strategies in underserved populations.
UNIQUE STRATEGIES AT CEDARS-SINAI TO SCREEN FOR AND ADDRESS SOCIAL DETERMINANTS OF HEALTH IN OLDER ADULTS
Authors: Rosen Sonja , Cohen Emma , Hren Katie , Harris Christina , Green Krystal 
Published: January 2025

Abstract
To effectively address health disparities and bridge systemic gaps between health and social care, healthcare institutions must cohesively address shortcomings in identifying, supporting, and monitoring social determinants of health (SDoH) to better serve communities. In 2021, Cedars-Sinai, a Los Angeles urban Academic Medical Center, launched a robust strategy to address SDoH needs across health system settings. Cedars-Sinai’s SDoH strategy includes a customized 12-domain screener to identify patients unmet social care needs and additional workstreams to support patient and community needs, including an electronic resource referral platform, an inaugural Community Health Worker (CHW) program, and a network of community-based organizations (CBOs) with accountable referral pathways. As one of the largest Medicare providers in the region, and serving more older adults over the age of 80 than any other academic medical center, this SDoH strategy included tailored interventions for older adults such as embedding a CHW within the geriatrics outpatient practice and cultivating community partnerships with CBOs experienced in serving older adults. In the first 2.5 years of Cedars-Sinai’s SDoH strategy, 97,757 older adult patient screenings identified 30,245 unmet HRSN needs; 411 of these older adult patients received CHW support, 61.24% of whom were successfully connected to resources. These systemwide efforts highlighted that older adults experience more nuanced SDoH inequalities fueled by aging-specific structural barriers and succeed with greater dosages of social care interventions. Findings from Cedars-Sinai’s approach to SDoH has demonstrated that healthcare institutions are most effective in addressing SDoH through comprehensive strategies that create population-specific solutions in tandem with screening.
UTILIZING COMMUNITY CONNECTIONS: A SOCIAL DETERMINANTS OF HEALTH SCREENING FOR COMMUNITY-DWELLING OLDER ADULTS
Authors: O’Sullivan Kelly , Weaver Raven , Bolkan Cory , Gotch Chad , Geissal Erik , Swanson Breanne 
Published: January 2025

Abstract
Community-based aging resources, like Area Agencies on Aging (AAA), are often underutilized. Establishing partnerships with healthcare providers can promote better awareness and use of available services/supports. We evaluated a community partnership between a primary care clinic and an AAA; both community partners were committed to reducing adverse health outcomes. This exploratory intervention study assessed social determinants of health (SDH) needs of Medicare-eligible primary care patients (n = 385) during an annual visit (Mage=72.5; 89.6% White) and connected patients to appropriate supportive aging services. There were 284 participants with identified unmet SDH needs, but only 36 participants accepted referral to AAA resources. We analyzed Medicare’s Risk Adjustment Factor (RAF) score at baseline and participants’ use of advanced care (i.e., ER visits/hospital readmissions/institutionalizations), urgent care, and primary care, over a 6-month period. Descriptive, bivariate, and multivariate analyses revealed positive associations between RAF score with age (p&lt; 0.001) and number of SDH needs (p&lt; 0.001), advanced care with SDH needs (p=0.004) and RAF score (p&lt; 0.001), and primary care visits with SDH needs (p=0.003) and RAF score (p&lt; 0.001). The screening revealed that older adults’ SDH needs are often unmet and underrecognized. Cross-sector partnerships between medical and social models of health can reduce risk and meet needs of community-dwelling older adults. Policy provisions that encourage such partnerships are needed to improve community-dwelling older adults’ wellbeing, independence, and ability to age-in-place.
DO LIFE SATISFACTION AND LEVEL OF OPTIMISM IMPACT SUCCESSFUL AGING IN MID AND LATE LIFE?
Authors: Bhattacharyya Kallol Kumar , Molinari Victor , Gupta Debasree Das , Hueluer Gizem 
Published: January 2025

Abstract
Earlier theoretical frameworks of successful aging (SA) included either objective or subjective evaluations or both. Guided by the Rowe and Kahn model, the current study expands prior work by examining the association of objective and subjective components of SA with individuals’ life satisfaction and level of optimism across adulthood. Data were from waves 2 (2004-05) and 3 (2013-14) of the Midlife in the United States (MIDUS) study. To obtain a multidimensional SA score, we considered successful agers as those with a higher score in cognition, with minimal difficulties in performing physical activities, maintaining active engagement with life, and free of multiple chronic conditions. We used structural equation modeling to examine whether subjective life satisfaction (wave 2) has any effect on a composite measure of SA (wave 3) while controlling for baseline sociodemographic and health factors; we also examined the reverse directional association. Further, we also examined the mediation effects of level of optimism in the above associations. A total of 2,040 individuals (Mage=64±11; women 56%) were included. After controlling for covariates, findings revealed that prior life satisfaction has a positive direct effect (b=0.094; SE=0.019; p&lt; 0.001) on SA; also, this effect is bidirectional. Further, high level of optimism mediates the association between life satisfaction and SA. While SA is often examined in relation to various risk/protective factors in late life, this study identified life satisfaction and level of optimism as having potentially positive impacts on achieving SA in middle-aged and older MIDUS participants.
INVESTIGATING CAUSAL LINK BETWEEN VOLUNTEERING AND BLOOD PRESSURE BY GENDER, RACE, AND COHORT
Authors: Kim Seoyoun , Halvorsen Cal , Shiba Koichiro 
Published: January 2025

Abstract
Given that nearly half of adults 50 and older have hypertension in the United States, public health interventions focus on reducing risk factors. However, population-based approaches that aim to enhance protective factors, such as social engagement, can be applied to larger groups, resulting in a downward shift in the population blood pressure distribution. Further, understanding the potential heterogeneous effects of volunteering frequency by demographic factors help identify the population subgroups in which volunteering is more (or less) protective against hypertension. The current project examines the link between volunteering and changes in systolic and diastolic blood pressure by gender, race/ethnicity, and cohort as potential effect modifiers. Using the Health and Retirement Study (2006-2016, N=18,847), this study assessed the longitudinal relationships between volunteering (2010/2012) and blood pressures (2014/2016) within each stratum of gender, race/ethnicity, and age cohort. The analyses adjusted for pre-volunteering covariates (2006/2008) as well as selection into volunteering using Inverse Probability Treatment Weighting (IPTW). The joint exposure of volunteering and effect modifiers was estimated by the relative excess risk due to interaction (RERI). Results show that individuals volunteering 201+ hours annually had a lower likelihood of clinically high diastolic (PR=0.84, p=0.04) and systolic (PR=0.98, p=0.04) blood pressure. Moderate level of volunteering was predictive of low systolic blood pressure. The combination of volunteering 201+ hours and being female was protective against high diastolic blood pressure (RERI=-0.09, p=0.02). Given the modest effect modification, frequent volunteering has an anti-hypertensive effect for the general population of adults 50 and older.
LONELINESS AND COGNITIVE FUNCTION IN OLDER ADULTS: A LONGITUDINAL ANALYSIS
Authors: Abaei Elnaz , Martin Peter 
Published: January 2025

Abstract
Only a few studies have confirmed cognition as a predictor of loneliness. This study investigated the dynamic relationship between loneliness and cognitive performance in older adults through a random intercept cross-lagged panel model. Data from 8,443 individuals aged 65 years and older, drawn from Waves 9–14 of the Health and Retirement Study (HRS), were analyzed. Loneliness was assessed using the UCLA Loneliness Scale, and cognitive function was measured using delayed memory recall. Age, gender, and education were included as covariates. We combined waves 9-10, waves 11-12, and waves 13-14 to include all participants. Bivariate correlations revealed that older age was negatively correlated with cognitive function, loneliness was positively correlated with older age, and male gender and higher education were positively correlated with cognitive function, and negatively correlated with loneliness. Cognition and loneliness were negatively associated. Using Mplus, we computed an unconditional random intercept cross-lagged panel model (RI-CLPM) with no exogenous predictors (X2=.186, df=1, p=0.67, RMSEA=0.000 [.000,.018], CFI=1.0, TLI=1.0) and a conditional model (X2=13.431, df=7, p&lt;.06, RMSEA=0.009 [.000,.015], CFI=.999, TLI=.997) including age, gender, and education as predictors. Results indicated individuals reporting higher loneliness exhibited lower cognitive functioning scores and older age. Male gender and higher education were negatively associated with loneliness and positively with cognitive function. This study underscores the link between loneliness and cognitive decline in older adults, emphasizing the need to address loneliness to potentially reduce cognitive decline. Insights into demographic predictors of loneliness and cognitive function could inform targeted interventions for promoting successful aging.
PREDICTORS OF CONTINUED ENGAGEMENT IN ONE’S FAVORITE ACTIVITY DURING THE COVID-19 PANDEMIC
Authors: Kim Jeehoon , Lee Ji Hyun 
Published: January 2025

Abstract
Active engagement is one of the important pillars in successful aging (Rowe & Kahn, 1997), however less is known about one’s favorite activity, a key source of enjoyment and meaning, in later life. In the context of higher constraints imposed during the pandemic, continuing one’s favorite activity can play a pivotal role in maintaining well-being for older adults. The current study aimed to examine which factors are associated with sustaining engagement in one’s favorite activity in 2020. Data comes from Round 10 of National Health and Aging Trends Study. Participants (n= 4,389, Age M(SD)=78(6), 55% female, 83 % White) answered, during last year, whether they were able to participate in their favorite activity previously reported at Round 5 (84% yes). Survey weighted logistic regression models were performed stratified by gender. We found that women who reported health better (OR= 1.28, p=.018) and engaged in vigorous physical activity (OR=1.96, p =.007) were more likely to continue their favorite activity. For men, younger age (OR=.97, p=.017), social engagement (OR=1.22, p =.011) and physical activity participation (walking OR=1.91, p=.014; vigorous OR=2.07, p=.001) were positively, but depressive symptoms (mild OR=.57, p =.006; major OR=.50, p=.028) were negatively linked to continuing in favorite activities. The findings show that engagement in physical activity supports continued enjoyment of one’s favorite activity; social engagement and mental health are also protective factors for men. Implications for how to support older women and men’s continued activity engagement will be discussed.
SUPPORT FROM FRIENDS, BUT NOT CHILDREN, BUFFERS AGAINST DEPRESSION AMONG LEFT-BEHIND OLDER ADULTS
Authors: Wang Suyi , Lu Minjie , Fung Helene H 
Published: January 2025

Abstract
As adult children migrate, old parents are facing the choice of migrating with their children or remaining in their hometowns (being left-behind). Being left-behind is associated with deteriorating psychological well-being among older adults (Adhikari et al., 2011; Song, 2016; Song, 2017; Zhang, 2016). This study aims to examine whether support from children and friends may benefit the well-being of left-behind older adults. The study recruited 52 left-behind older adults (30 females, Mage = 64.96, SD = 5.291), 69 older adults migrated with their children (54 females, Mage = 64.78, SD = 4.465), and 64 older adults who were currently living with their children in the city they grew up (34 females, Mage = 66.28, SD = 5.072, local group). Consistent with previous findings, the results showed that left-behind older adults reported a higher depression level compared to the local group, and the migration group was in-between. In addition, perceived support from children was negatively associated with depression level among the migration group and the local group, but not among the left-behind group. However, only among the left-behind older adults was perceived support from friends living in the same city negatively associated with depression level. The difference in depression level between the left-behind group and the local group was mitigated among participants who perceived strong support from friends. These results highlight the salutary effect of support, especially from friends, on buffering against depression among left-behind older adults.