Journal of Aging and Health

Williams-Farrelly, Monica M.; Ferraro, Kenneth F.

doi: 10.1177/08982643231185426pmid: 37358912

Objectives: Social relationships are widely regarded as salubrious, but do they mediate the influence of childhood experiences on frailty in later life? Drawing from cumulative inequality theory, we assess the influence of childhood experiences and adult relationships on frailty trajectories. Methods: We analyzed data from the Health and Retirement Study to examine the influence of six domains of childhood experiences and social relationships on frailty trajectories over 8 years. Mediation analyses were completed with structural equation models. Results: Risky adolescent behavior, chronic disease, and impairments during childhood are associated directly with higher risk of initial frailty, but not over time. More social roles and higher social support mediate the relationship between childhood experiences and frailty, and the effect of more social roles continues over time. Discussion: This study provides compelling evidence that supportive social relationships mediate the risk and severity of frailty in later life associated with noxious childhood experiences.

Ickert, Edmund C.; Hughes, Tiffany; Berg-Carramusa, Cara A.; Dudash, Shannon; Kerns, Lucy

doi: 10.1177/08982643231186630pmid: 37358257

Objective: This study examined alignment of subjective balance confidence with Stopping Elderly Accidents, Deaths and Injuries (STEADI) fall risk. Methods: Cross-sectional analysis of 155 community-dwelling adults (60 + y/o) from 2016 to 2018 who completed a STEADI fall assessment. Descriptive statistics, Chi-Square analysis, and biserial point correlations were applied. Results: Adults who overestimate balance confidence, 55.6% (n = 50) reported a fall in the past year, 62.2% (n = 56) were worried about falling, 48.9% (n = 44) felt unsteady when standing/walking, and 70.0% (n = 63) had a score of ≥4 on the Stay Independent Questionnaire (SIQ). Physical performance for these adults were mean TUG score 10.9s (SD = 3.4), mean 30 second chair stands 10.8 (SD = 3.5), and mean 4-stage balance score 3.1 (SD = .76). Discussion: Older adults are more likely to overestimate their subjective balance confidence. Individuals are equally likely to have reported a fall in the past year if they were “at fall risk,” regardless of their subjective balance confidence.

Siltanen, Sini; Keskinen, Kirsi E.; Lahti, Anna-Maria; Rantanen, Taina; von Bonsdorff, Mikaela

doi: 10.1177/08982643231186627pmid: 37376762

ObjectivesLeading an active life in old age underpins positive life experience. This study aimed to compare the levels of active aging in senior housing residents and community-dwelling older people.MethodsWe combined data from the BoAktiv senior house survey (N = 336, 69% women, mean age 83 years) and AGNES cohort study among community-dwelling older adults (N = 1021, 57% women, mean age 79 years). Active aging was assessed with the University of Jyvaskyla Active Aging scale. Data were analyzed with general linear models, and the analyses were stratified by sex.ResultsMen in senior houses demonstrated lower active aging scores in general than community-dwelling men. Women in senior houses showed greater will to be active, but poorer ability and possibilities for activity than community-dwelling women.DiscussionDespite the social and supporting environment, senior housing residents’ possibilities for leading an active life seem to be compromised, potentially leading to an unmet activity need.

Katz, Emma; Edelstein, Barry; Turiano, Nicholas A.

doi: 10.1177/08982643231187104pmid: 37394282

Objectives: Patient trust in physicians is associated with patient satisfaction with healthcare, patients engaging in follow-up care, and positive health-related outcomes. The current study investigated whether age moderated the relation between trust in physicians and four health outcome variables, including patient satisfaction, doctor visits, emergency room visits, and hospital admissions. Methods: 398 English-speaking, community-dwelling adults completed measures of physician trust and important health outcome variables via Amazon Mechanical Turk. Results: Age significantly moderated relations between trust in physicians and hospital admissions, and trust in physicians and patient satisfaction, with both positive relations becoming stronger with increasing age. Discussion: The results highlight the need for a lifespan approach to the study of physician trust and related health outcomes. They offer an avenue for increasing physician trust, engagement with the healthcare system prior to the need for hospitalization, and the reduction of healthcare costs.

Shenk, Marisa; Hicks, Bernadette; Quiñones, Ana; Harrati, Amal

doi: 10.1177/08982643231185689pmid: 37392162

ObjectivesThis paper examines the health, work, and financial experiences of older adults with disabling conditions during the COVID-19 pandemic. It also explores the role of county- and state-level conditions in these experiences.MethodsUsing data from the 2020 Health and Retirement Study, we estimated regression models to assess differences in outcomes between those with and without disabling conditions and by race/ethnicity. We used multilevel modeling to assess whether and how county or state factors might be associated with the differences in these effects.ResultsOlder adults with disabilities were more likely to report experiencing financial hardships, delaying health care, and experiencing effects on work than those without disabilities; these differences are heighted between race and ethnicity. Older adults with disabilities were more likely to live in counties with greater social vulnerability.DiscussionThis work underscores the importance of developing a robust, disability-inclusive public health response that protects older adults.

Zhang, Dan

doi: 10.1177/08982643231159709pmid: 37395560

ObjectivesTo examine the associations between perceived neighborhood conditions and older Chinese adults’ sleep problems, and whether these associations are mediated by psychosocial factors and moderated by urban-rural residence.MethodsData were from the World Health Organization Study on global Ageing and Adult Health. We used OLS, binary, and multinomial logistic regression analyses. Karlson–Holm–Breen decomposition method was used to test mediation effects.ResultsPositively perceived neighborhood social cohesion was associated with fewer insomnia symptoms and decreased odds of poor sleep quality, sleepiness, lethargy, and short sleep duration. Positively perceived neighborhood safety was related to decreased risks of poor sleep quality and sleepiness. Depression and perceived control partially mediated the effects of perceived neighborhood on sleep. Furthermore, the protective effects of neighborhood cohesion against sleep problems were more pronounced among older urban adults than their rural counterparts.DiscussionInterventions that make neighborhoods safer and more integrated will improve late-life sleep health.

Sand, Gregor; Bristle, Johanna

doi: 10.1177/08982643221089427pmid: 35713288

ObjectivesBased on protection motivation theory, we investigate how indicators of threat perception (perceived severity, perceived vulnerability, and fear arousal) and coping appraisal (hope) are associated with older people’s motivation to engage in protective behavior after the outbreak of COVID-19.MethodsWe use multivariate regression analyses with a sample of 40,282 individuals from 26 countries participating in the SHARE Corona Survey.ResultsWe find that 15% of all respondents stayed home completely—mainly the oldest and vulnerable people with prior health risk conditions. On average, older Europeans responded strongly to the recommended protective behavior measures (6 out of 7 measures adopted). Among the threat perception indicators, fear arousal is the main motivator for protective behavior, whereas the coping appraisal indicator hope shows an equally strong association.DiscussionGiven the negative health effects of fear, our findings may help evaluate and revise governmental policy responses and communication strategies.

Tuomola, Essi-Mari; Keskinen, Kirsi E.; Viljanen, Anne; Rantanen, Taina; Portegijs, Erja

doi: 10.1177/08982643231191444pmid: 37482698

Objectives: To study cross-sectional and longitudinal associations between objectively assessed neighborhood walkability, walking difficulties, and participation in leisure activities among older people. Methods: Self-reported 2 km walking difficulty (intact, modifications, difficulties) at baseline and participating in organized group, outdoor recreation and cultural activities at baseline and follow-up were studied in community-dwelling persons (N = 848) aged 75–90. A walkability index, calculated using a geographic information system, was categorized into tertiles (lowest, middle, highest). Results: Residence in the highest walkability areas was associated with higher participation in cultural activities and lower participation in outdoor recreation, while the latter was most frequently reported by residents in the lowest walkability areas. Those reporting no difficulties were more likely than those reporting difficulties to participate in all studied activities. Residence in the middle or highest walkability areas predicted higher participation in cultural activities at follow-up. Discussion: Older persons activity profiles associate with neighborhood walkability and walking difficulties.

Shippee, Tetyana Pylypiv; Parikh, Romil R.; Baker, Zachary G.; Bucy, Taylor I.; Ng, Weiwen; Jarosek, Stephanie; Qin, Xuanzi; Woodhouse, Mark; Nkimbeng, Manka; McCarthy, Teresa

doi: 10.1177/08982643231191164pmid: 37493607

Assi, Sahar; Garcia Morales, Emmanuel E.; Du, Eric Y.; Martinez-Amezcua, Pablo; Reed, Nicholas S.

doi: 10.1177/08982643231190983pmid: 37505080

Objective: The purpose of this study was to determine if dual sensory impairment (DSI) is associated with falls and fear of falling among older adults. Methods: Using data from the 2019 Medicare Current Beneficiary Survey (MCBS), we studied the cross-sectional association of self-reported hearing/vision impairment with self-reported history/number of falls over the past year, fear of falling (scale 1–6), and a fall requiring medical help using weighted multivariable regressions adjusted for demographic and clinical covariates. Results: Among 11,089 Medicare beneficiaries (mean age = 74, 55% female, 9% Black), DSI is associated with increased prevalence (prevalence ratio = 1.45 [1.28–1.65]) and incidence (incidence ratio = 2.21 [1.79–2.75]) rate of falls, and greater odds of a higher fear of falling score (odds ratio = 1.38 [1.08–1.77]). Discussion: DSI is associated with falls among older adults. Consideration of DSI as a marker to initiate fall prevention programs and inclusion of sensory interventions in these programs may be valuable.