Integration into social networks is an important determinant of health and survival in late adulthood. We first identify different types of non-kin networks among older adults and second, investigate the association of these types with survival rates. Official register information on mortality is combined with data from the Longitudinal Aging Study Amsterdam (LASA). The sample includes 2,440 Dutch respondents aged 54-85 at baseline in 1992 and six follow-ups covering a time span of 20 years. Using latent class analysis, respondents are classified into distinct types of non-kin networks, based on differences in number and variation of non-kin relations, social support received from non-kin, and contact frequency with non-kin. Next, membership in network types is related to mortality in a Cox proportional hazard regression model. There are four latent types of non-kin networks that vary in network size and support. These types differ in their associations with mortality, independent of sociodemographic and health confounders. Older adults integrated into networks high in both number and variation of supportive non-kin contacts have higher chances of survival than older adults embedded in networks low in either amount or variation of support or both. A combination of structural and functional network characteristics should be taken into account when developing intervention programs aiming at increasing social integration outside the family network.

The study aimed to validate Wenger's empirically derived support network typology of responses to the Practitioner Assessment of Network Type (PANT) in an older New Zealander population. The configuration of network types was tested across ethnic groups and in the total sample. Data (N = 872, Mage = 67 years, SDage = 1.56 years) from the 2006 wave of the New Zealand Health, Work and Retirement study were analyzed using latent profile analysis. In addition, demographic differences among the emerging profiles were tested. Competing models were evaluated based on a range of fit criteria, which supported a five-profile solution. The "locally integrated," "community-focused," "local self-contained," "private-restricted," and "friend- and family-dependent" network types were identified as latent profiles underlying the data. There were no differences between Māori and non-Māori in final profile configurations. However, Māori were more likely to report integrated network types. Findings confirm the validity of Wenger's network types. However, the level to which participants endorse accessibility of family, frequency of interactions, and community engagement can be influenced by sample and contextual characteristics. Future research using the PANT items should empirically verify and derive the social support network types, rather than use a predefined scoring system.

This study took an emic multidimensional approach on successful aging and examined what older people consider important to age successfully by asking them about their plans and wishes (PWs). Associations between participants' demographics, health status, working life, social contacts, life satisfaction, and their PWs were investigated. An online questionnaire was completed by 649 older individuals (55-90 years). Conceptual content analysis was performed to identify important categories in PWs. Quantitative analyses were conducted to examine associations between PWs and participants' characteristics. Most mentioned PWs were related to activities, engagement with life, and health. Seventy-four participants (11.4%) expressed no PWs. Multivariate analysis revealed that having PWs was most strongly related to participants' life satisfaction. Older individuals with a higher life satisfaction indicated significantly more often to have PWs than individuals with a lower life satisfaction. The majority of older people desire an active, engaged, and healthy life. PWs were variable and personal, which endorses an emic, multidimensional approach to successful aging. Knowledge on what older individuals find important in their lives and what they want to achieve can assist older individuals in setting and attaining their goals toward aging well.

Recovery from self-reported walking limitation may be a turning point in an individual's health trajectory and may lead to better physical and mental health in the future. This research examines whether recovery from walking limitation is associated with onset of mobility disability, activities of daily living (ADLs) disability, or mortality among a national sample of older Americans. Using Waves 4 through 11 (1998-2012) of the Health and Retirement Study (HRS), discrete-time event history models (N = 12,579 person-intervals) with multiple competing events were estimated using multinomial logistic regression. The risk group was defined as respondents with walking limitation, but free of disability. A lagged measure of recovery was created using 2 adjacent waves, and disability and mortality outcomes were assessed in the subsequent wave (i.e., 2 years later). Recovery from walking limitation (i.e., difficulty walking one or several blocks) was associated with lower odds of mobility disability (i.e., difficulty walking across the room) onset, ADL with mobility disability onset, ADL without mobility disability onset, and mortality. Recovery from walking limitation was not only predictive of mobility-related outcomes, but also nonmobility-related ADLs and mortality-suggesting that the predictive capacity of recovery extends to multiple physical health outcomes. This research suggests that self-reported recovery from walking limitation may be a turning point in the disabling process and signals a meaningful change in an older adult's functional health trajectory.

To examine the trend of health-related Internet use (HRIU) among older adults. We analyzed data from the 2003, 2005, and 2011-2012 iterations of the National Cancer Institute (NCI)-sponsored Health Information National Trends Survey (HINTS). HRIU was measured by 4 online behaviors: seeking health information, buying medicine, connecting with people with similar health problems, and communicating with doctors. Internet use and HRIU among older adults increased substantially from 2003 to 2011 with more significant increases in seeking health information and communicating with doctors online. Overall, the digital health divide between different demographic groups has narrowed, especially in terms of gender, racial/ethnic group, rural/urban residence, and various health statuses; however, age, education, and household income remain persistent predictors of the digital divide. Those in the oldest group (75 or older), those with less than a high school education, and those with very low income (<$25,000/year) continuously lagged behind their counterparts in all aspects of HRIU. Despite an overall increase in HRIU and a narrowed digital divide, significant variations in HRIU in different demographic groups persisted; therefore, we call for more senior-friendly online resources and culturally appropriate interventions to bridge the digital health divide for vulnerable older adults.

We used the convoy model and the network type construct to identify the relationship quality profiles found among older gay men and to examine how they define a satisfactory network. We used a network mapping strategy and in-depth qualitative interviews with 20 participants in Atlanta. During the interviews, all network members were discussed, regardless of relationship or map position. For participants, having people in their lives with whom they could fully be "out" as gay men (authenticity) was at the root of a quality network. This allowed them to develop emotional closeness (intimacy), which, in part, provided a foundation of social support. Participants' discussion of network quality, which reflected authenticity, intimacy, and social support, revealed high, moderate, and low quality network types. Our findings diversify knowledge of the network type construct, provide a deeper understanding of its qualitative features, and give voice to this often-invisible group, situating meaning within their social-historical context. The findings suggest that the meaning of a quality network is contextual and culturally specific, varying across groups of older adults.

To estimate the impact of Medicare Part D on cost-related prescription nonadherence and health outcomes among the newly covered medicare beneficiaries. Difference-in-differences analyses of data from a balanced panel of Medicare beneficiaries observed in each wave of the Health and Retirement Study from 2000 to 2010 were carried out. The differences in the pre- and post-Part D changes in these outcomes are calculated for previously uncovered Part D enrollees and a comparison group of previously covered Medicare beneficiaries. The results from this analysis indicate that Part D reduced cost-related nonadherence rates among the newly covered by 7 percentage points and that this decline was sustained through 2010. Part D was also associated with a 5 percentage points increase in the likelihood that a newly covered enrollee reported to be in good or better health and a 4-percentage point decline in the likelihood of being diagnosed with high blood pressure. These improvements were also sustained through 2010 but were only evident among those newly covered beneficiaries who remained enrolled in a Part D plan through 2010. However, there is insufficient evidence to conclude that Part D improved the blood pressure of newly covered, hypertensive beneficiaries. Part D has had a sustained impact on cost-related nonadherence rates and the health status of newly covered beneficiaries. However, the change in health status is conditional on remaining enrolled in a Part D plan over time.

Our study examines cross-national variations in intergenerational relations of partnered parents aged 50 and older with adult non-coresident children by family structure (intact vs stepfamilies) and parent-child relationship type (biological tie vs steprelation). We focus on three European countries-France, Germany, and Russia-which have in common a relatively large proportion of stepfamilies, but differ with regard to contextual characteristics potentially impacting the stepfamily-intergenerational-relations nexus. The analysis is based on data from the Generations and Gender Survey (Wave 1). Our pooled analytical sample consists of 14,309 parent-child relationships derived from responses by 6,590 surveyed parents with adult children living outside the parental household. We consider two core dimensions of intergenerational solidarity as dependent variables, namely frequency of contact and emotional closeness. Our results support the notion of commonly weaker intergenerational relations in stepfamilies. We also observe differences between biological parent-child ties and steprelations. Compared with their French and German counterparts, there is a weaker association between having a steprelation and parent-child contact frequency as well as a stronger negative correlation between having a steprelation and emotional closeness among Russian respondents. The observed cross-national differences are proposed to result from different economic incentives to form a stepfamily, translating into a stronger "functional" basis of stepfamily intergenerational relations in the Russian context.

Visual impairment is the leading cause of age-related disability, but the social patterning of loss of vision in older people has received little attention. This study's objective was to assess the association between social position and onset of visual impairment, to empirically evidence health inequalities in later life. Visual impairment was measured in 2 ways: self-reporting fair vision or worse (moderate) and self-reporting poor vision or blindness (severe). Correspondingly, 2 samples were drawn from the English Longitudinal Study on Ageing (ELSA). First, 7,483 respondents who had good vision or better at Wave 1; second, 8,487 respondents who had fair vision or better at Wave 1. Survival techniques were used. Cox proportional hazards models showed wealth and subjective social status (SSS) were significant risk factors associated with the onset of visual impairment. The risk of onset of moderate visual impairment was significantly higher for the lowest and second lowest wealth quintiles, whereas the risk of onset of severe visual impairment was significantly higher for the lowest, second, and even middle wealth quintiles, compared with the highest wealth quintile. Independently, lower SSS was associated with increased risk of onset of visual impairment (both measures), particularly so for those placing themselves on the lowest rungs of the social ladder. The high costs of visual impairment are disproportionately felt by the worst off elderly. Both low wealth and low SSS significantly increase the risk of onset of visual impairment.

We document the prevalence and sociodemographic correlates of older adults with three generations of living kin and examine the patterns of transfers among this group compared with those with fewer generations of kin available. We use the Health and Retirement Study (1998-2010) to estimate kin availability and intergenerational transfers among respondents in their 50s, 60s, and 70s. It is far more common for older adults to have aging parents, children, and grandchildren than to have just two generations of kin (parents and children). Forty percent of adults in their 50s, 30% of those in their 60s, and 7.5% of those in their 70s have three generations of kin available. Hispanics and the least educated are more likely to have this generational configuration. The vast majority provides financial or in-kind transfers to at least one generation, and a large minority provides support to both older and younger generations. Although there has been much concern about the strains among those sandwiched between parents and children, it is far more common among older adults to also have grandchildren, and many of these adults are transferring resources both upward and downward to multiple generations.