Secular Improvements in Cognitive Aging: Contribution of Education, Health, and Routine Activities

Objectives Limited evidence exists regarding the reasons for secular changes in cognitive functioning over historical time. Thus, we examined potential explanatory factors for changes in cognitive speed, a central dimension of cognitive functioning. Methods Population-based data of middle-aged and older adults from Germany ( N = 5443) was used with baseline participants from 2002 to 2014, comparing the time periods 2002–2014. Results Cognitive speed improved in middle-aged adults (40–65) and older adults (66+). In both age groups, increases were partly explained by education, employment status, volunteering status, routine activities, and physical functioning. Changes in education were more important in explaining increases in older than in middle-aged adults, whereas changes in health were more important for explaining increases in middle-aged adults. Conclusions Cognitive speed increased in both age groups over historical time. Education, employment, volunteering, routine activities, and health were all important in explaining these changes, but their importance differed between age groups.

Childhood Disadvantage and Adult Functional Status: Do Early-Life Exposures Jeopardize Healthy Aging?

Objectives To examine whether childhood disadvantage is associated with later-life functional status and identify mediating factors. Methods Unique and additive effects of five childhood domains on functional status were assessed at baseline (2006) and over time (2006–2016) in a sample of 13,894 adults from the Health and Retirement Study (>50 years). Adult health behaviors and socioeconomic status (SES) were tested as mediators. Results Respondents exposed to multiple childhood disadvantages (OR = .694) as well as low childhood SES (OR = .615), chronic diseases (OR = .694), impairments (OR = .599), and risky adolescent behaviors (OR = .608) were less likely to be free of functional disability by baseline. Over time, these unique and additive effects of childhood disadvantage increased the hazard odds of eventually developing functional disability (e.g., additive effect: hOR = 1.261). Adult health behaviors and SES mediated some of these effects. Discussion Given the enduring effects of childhood disadvantage, policies to promote healthy aging should reduce exposure to childhood disadvantage.

Educational Differences in Self-Rated Health Trends Among Middle-Aged and Older Adults Living Alone, 1972–2018

Objectives: This study examines educational differences in living alone and in self-rated health trends among middle-aged and older adults. Methods: We used logistic regression to analyze data from the 1972–2018 National Health Interview Survey ( n = 795,239 aged 40–64; n = 357,974 aged 65–84). Results: Between 1972–1974 and 2015–2018, living alone became more prevalent, particularly among men and at lower levels of education. Self-rated health trends varied by living arrangement and education. We found self-rated health declines among middle-aged adults having no college degree and living alone, but trends in self-rated health were mostly stable or even improved among middle-aged adults living with others. Among older adults, self-rated health improved over time, but for the least-educated older Americans living alone, the probability of reporting fair or poor health increased between 1972–1974 and 2015–2018. Discussion: The findings suggest growing disparities by social class, in living arrangements and in self-rated health.

Experience of Time and Subjective Age When Facing a Limited Lifetime: The Case of Older Adults with Advanced Cancer

Objectives We addressed two questions: (1) Does advanced cancer in later life affect a person’s awareness of time and their subjective age? (2) Are awareness of time and subjective age associated with distress, perceived quality of life, and depression? Methods We assessed patients suffering terminal cancer (OAC, n = 91) and older adults free of any life-threatening disease (OA, n = 89), all subjects being aged 50 years or older. Results Older adults with advanced cancer perceived time more strongly as being a finite resource and felt significantly older than OA controls. Feeling younger was meaningfully related with better quality of life and less distress. In the OA group, feeling younger was also associated to reduced depression. Perceiving time as a finite resource was related to higher quality of life in the OA group. Discussion Major indicators of an older person’s awareness of time and subjective aging differ between those being confronted with advanced cancer versus controls.

The Long-Term Impact of Childhood Disability on Mental Health Trajectories in Mid- to Late-Life

Objectives We draw from the life course and stress process frameworks to examine how experiencing disability in early life influences mental health in adulthood. Methods Data come from the Health and Retirement Study Cross-Wave Childhood Health and Family Aggregated Data file (2008-2018, n = 15,289). Childhood disability status is a retrospective self-report of whether respondents were disabled for six months or more because of a health problem before the age of 16 ( n = 581). We used age-based growth curve models to construct trajectories of depressive symptoms by childhood disability status. Results Respondents who experienced childhood disability exhibit more depressive symptoms at age 50 compared to those who did not experience this stressor. However, there is no difference in the growth of depressive symptoms with age between these groups, suggesting maintained inequality over the late adulthood life course. Discussion Findings suggest that childhood disability has long-term implications for life course mental health.

The Association Between Post-Traumatic Stress and Depressive Symptoms Among Older Puerto Ricans in Boston: How Does Loneliness Matter?

Objectives To examine the association between post-traumatic stress and depression and whether such an association differs by level of loneliness among older Puerto Ricans. Methods Data were collected from 304 Puerto Ricans aged 60 and above living in the Greater Boston area who responded to questionnaires. We used ordinary least squares regression to examine the association between post-traumatic stress, loneliness, and depressive symptoms. Results Post-traumatic stress was significantly associated with higher levels of depression. The association between post-traumatic stress and depression was stronger for those experiencing a higher degree of loneliness. Discussion In working with older Puerto Ricans experiencing post-traumatic stress, it is important for mental health professionals to incorporate the assessment of loneliness and to prevent and reduce comorbid depression by addressing loneliness through improving social skills, enhancing social support, and reducing maladaptive social cognition.

Self-Reported Sensory Impairments in Older Adults and their Association with Self-Rated Health and Mortality Outcomes

Objectives This study assessed the relationship between self-reported impairments of vision, hearing, and dual sensory impairment, and change in self-rated health/mortality status over a 5-year period. Methods Data came from the National Health and Aging Trends Study, a nationally representative survey of Medicare beneficiaries ages 65 and older. Analyses consisted of a series of ordinal logistic regressions stratified by sex. Results For both women and men, self-reported sensory impairments were not statistical predictors of self-rated health/mortality, when other dimensions of health, such as physical functioning, participation, and activities of daily living functioning were included in models. Discussion Understanding how self-reported sensory impairments impact self-rated health could assist in targeting rehabilitation strategies to older adults who experience sensory impairments.

The Relationship Between Perceived Age Discrimination in the Healthcare System and Health: An Examination of a Multi-Path Model in a National Sample of Israelis Over the Age of 50

Objectives The present study aims to examine possible pathways that potentially account for the relationship between perceived age discrimination in healthcare settings (as one form of ageism) and health outcomes. Methods We relied on 1570 complete surveys, which constitute a representative national sample of adults aged 50 and above in Israel. Results We found a direct link between perceived age discrimination and health outcomes. This link was partially mediated by self-perceptions of aging and subsequently by health behaviors (e.g., eating vegetables) and preventive health behaviors (e.g., medical check-ups). The link between perceived age discrimination and health behaviors was moderated by age, thus, particularly detrimental for older people over the age of 65 as compared with those between the ages of 50 and 65. Discussion This study adds to the literature as it examines comprehensive mechanisms to account for the path between perceived age discrimination and health status. Our findings point to the unique aspects associated with perceived age discrimination, which potentially make older people more susceptible to its negative effects.

Frailty and Differences in Self-Reported Sexual Functioning Among Older Females and Males in National Social life, Health and Aging Project

Objective To understand the association of frailty with females’ and males’ self-reported sexual functioning. Methods Logistic regression on 5 domains of sexual function by frailty status (robust, pre-frail, frail) were analyzed from 2058 respondents to National Social Life, Health, and Aging Project (2010–2011). Results Females had similar frailty profiles to males, but more often reported low overall sexual functioning (12.9% v. 4.0%). Compared to robust, pre-frail and frail males had higher odds of sexual function-related: anxiety (pre-frail OR 1.91 95% CI [1.33, 2.74]; frail OR 2.13 95% CI [1.03, 4.41]), negative changes (pre-frail: OR 1.40, 95% CI [1.00, 1.96]; frail: OR 2.42, 95% CI [1.51, 3.89]), and erectile dysfunction (pre-frail: OR 1.81, 95% CI [1.23,2.68]; frail: 2.00, 95% CI [1.00,4.02]); frail females had 1.69 times higher odds (95% CI [1.16,2.48]) of negative changes. Discussion Frailty may be a clinical indicator of sexual functioning decline for males more than females.

“It’s Going to be Different for Everyone”: Negotiating Quality of Life and Care Priorities Within Care Convoys

Objective: The overall goal of this analysis was to learn about residents’ quality of life and quality of care in assisted living over time and from multiple viewpoints within support networks. Method: This grounded theory analysis examined qualitative data collected from 50 residents and 169 of their care network members followed over two consecutive 2-year periods in 8 diverse settings. Results: Quality involved a dynamic process of “negotiating priorities,” which refers to working out what is most important for residents’ quality of life and care. Resident and care partner priorities were not always consistent or shared, in part because quality is personal, subjective, dynamic, and situational. Discussion: Communication and collaboration among formal and informal care partners are vital to residents’ ability to age in place with a high quality of life and quality care.