Health And Retirement Survey Research Articles

Disabilities, shared capitalism, and wealth: evidence from health and retirement survey

ABSTRACT Does shared capitalism help to mitigate the economic effects of disability? Employee ownership and profit sharing are linked to higher incomes and wealth for workers, while disability is strongly linked to lower incomes, but there has been no prior research on their overlapping effects. Using household-level panel data from Health and Retirement Survey (HRS) restricted to households with at least one earner, we provide exploratory results on the relationships among disability, shared capitalism, and wealth. We find that: 1) disability households have lower mean and median wealth (one-third to one-half lower than non-disability households using the most comprehensive disability measure); 2) disability households are less likely to participate in shared capitalism (only three-fourths as likely as non-disability households using the most comprehensive disability measure); 3) shared capitalism is linked to a greater increase in wealth for disability households than for non-disability households, but disability wealth gaps remain even when shared capitalism is available. While we cannot make strong causal claims, these findings suggest that shared capitalism may play a positive role in wealth-building for people both with and without disabilities, and help to mitigate some of the economic disadvantages faced by people with disabilities.

Wealth-related inequalities in self-reported health status in the United States and 14 high-income countries.

To examine wealth-related inequalities in self-reported health status among older population in the United States and 14 European countries. We used secondary individual-level data from Health and Retirement Survey (HRS) and the Survey of Health, Ageing, and Retirement in Europe (SHARE) in 2011 and 2019. In this cross-sectional study, we used two waves from HRS (wave 10 and 14) and SHARE (wave 4 and 8) to compare wealth-related health inequality across countries, age groups, and birth cohorts. We estimated Wagstaff concentration indices to measure these inequalities across three age groups (50-59, 60-69, 70-79) and two birth cohorts (1942-1947, 1948-1953) in the US and 14 European countries. We performed secondary analysis of survey data. Focusing on older population, we found evidence of wealth-related inequalities in self-reported health status across several high-income countries, with the US demonstrating higher levels of inequality than its European counterparts. The magnitude of these inequalities with respect to wealth remained unchanged over the study period across all countries. Our findings also suggest that wealth-related health inequalities differ at different stages of workforce engagement, especially in the United States. This could be explained either by potential redistributive effects of retirement or by uneven survivor effect, as less wealthy may drop out of the observations at a greater rate partly due to their poorer health. Wealth-related inequalities in self-reported health status are strong and persistent across countries. Our results suggest that there is meaningful variation across high-income countries in health-wealth dynamics that merits further investigation to better understand whether certain health or welfare systems are more equitable. They also highlight the need to consider social policy and wealth redistribution mechanisms as strategies for improving population health among the less wealthy, in the United States and elsewhere.

The association between incarceration and housing insecurity and advanced immune age during late life

Emerging evidence suggests that psychosocial stress ages the immune system. Accordingly, immune aging may be an important potential mechanism linking psychosocial stress to aging-related decline and disease. Incarceration and housing insecurity represent severe and complex experiences of a multitude of psychosocial stressors, including discrimination, violence, and poverty. In this study, we investigated the association between incarceration and/or housing insecurity and advanced immune age in adults aged 55 and older. Our sample was derived from the Health and Retirement Survey (HRS), with n = 7003 individuals with valid housing insecurity data and n = 7523 with valid incarceration data. From 2016 Venous Blood Study data, we assessed immune aging using a comprehensive set of immune markers including inflammatory markers (IL-6, CRP, s-TNFR1), markers of viral control (CMV IgG antibodies), and ratios of T cell phenotypes (CD8+:CD4+, CD+ Memory: Naïve, CD4+ Memory: Naïve, CD8+ Memory: Naïve ratios). We found that both incarceration and housing insecurity were strongly associated with more advanced immune aging as indicated by increased inflammation, reduced viral control, and reduction in naïve T cells relative to memory T cells. Given that those who experienced incarceration, housing insecurity, and/or are racialized minorities were less likely to be included in this study, our results likely underestimated these associations. Despite these limitations, our study provided strong evidence that experiencing incarceration and/or housing insecurity may accelerate the aging of the immune system.

Racial and ethnic differences in lifetime Medicare expenditures for dementia patients

AbstractBackgroundResearch on racial and ethnic disparities in lifetime dementia costs is sparse. We analyzed lifetime Medicare expenditures for dementia patients to identify when during the course of care costs are the highest, and whether these costs differ by race and ethnicity.MethodWe analyzed data from the 2000‐2016 Health and Retirement Survey (HRS) linked with corresponding Medicare claims to estimate total Medicare expenditures for four “phases”: 1) the year before dementia diagnosis; 2) the first year following a dementia diagnosis; 3) ongoing care for dementia after the first year; and 4) the last year of life. We then estimated each patient’s phase‐specific and lifetime Medicare expenditures by using a race‐specific survival model and monthly expenditures adjusted for demographics, socio‐economic status, year of dementia diagnosis, nursing home status, functional limitations, cognitive impairment, comorbidities, and Medicaid eligibility status.ResultAdjusted mean lifetime Medicare expenditures for non‐Hispanic Blacks ($166,548) and Hispanics with dementia ($163,425) exceeded corresponding expenditures for non‐Hispanic whites ($135,648) (Figure). In the year preceding and immediately following an initial dementia diagnosis, mean Medicare expenditures for non‐Hispanic Blacks ($26,384 and $20,824) exceeded expenditures for Hispanics and non‐Hispanic whites (ranging $21,340‐23,379 and 17,382‐18,085). Ongoing care costs for non‐Hispanic Blacks with dementia (mean $1,734/month) exceeded costs for Hispanics ($1,538/month) and non‐Hispanic whites ($1,424/month). Of the four phases, the last year of life was responsible for the greatest cost contribution: $52,003 for non‐Hispanic Blacks, $48,377 for Hispanics, and $39,648 for non‐Hispanic whites.ConclusionsTotal mean Medicare expenditures for non‐Hispanic Black and Hispanic beneficiaries with dementia exceeded corresponding expenditures for non‐Hispanic whites. Expenditures were highest for non‐Hispanic Blacks with dementia in every phase of care. Compared to non‐Hispanic whites, Hispanics had lower expenditures in the first year following dementia diagnosis and similar monthly ongoing care expenditures but much higher expenditures during their last year of life. Research should identify factors contributing to the disparities identified here so that policy makers can address problems adversely affecting disadvantaged populations. Figure: Estimated mean lifetime Medicare expenditures for beneficiaries newly diagnosed with dementia, by phase of care and by race and ethnicity (adjusted)

Blood inflammatory markers and mortality in the US population: A Health and Retirement Survey (HRS) analysis.

A potential direct correlation between systemic inflammation and physiological aging has been suggested, along with whether there is a higher expression of inflammatory markers in otherwise healthy older adults. Cross-sectional data were extracted from the publicly available 2016 Health and Retirement Survey, a nationally representative survey of older adults in the United States. A subset of participants (n = 9934) consented to a blood draw at the time of recruitment and were measured for high sensitivity C-reactive protein (hs-CRP), Interleukin (IL-6, IL-10, IL-1RA), soluble tumor necrosis factor receptor (sTNFR-1) and transforming growth factor beta 1 (TGF-β1). We included 9,188 participants, representative of 83,939,225 nationally. After adjusting for sex and the number of comorbidities, there remained a significant positive correlation between age and ln (log adjusted) IL-6, and ln sTNFR-1, and a significant inverse correlation between age and ln IL-1RA, ln TGF-β1, and ln hs-CRP. Among the subset of participants who reported none of the available comorbidities (n = 971), there remained an independent correlation of age with ln IL-6 and ln sTNFR-1. After adjusting for age, sex, and number of reported comorbidities, there was a statistically significant correlation between increased ln IL-6, ln IL-10, ln sTNFR-1, and ln hs-CRP with death. This study highlights the existence of a correlation between serum biomarkers of inflammation and aging, not only in the whole population, but also in the smaller subset who reported no comorbidities, confirming the existence of a presence of low-grade inflammation in aging, even in healthy elders. We also highlight the existence of a correlation between inflammatory markers and overall mortality. Future studies should address a possible threshold of systemic inflammation where mortality significantly increases, as well as explore the effectiveness of anti-inflammatory treatments on morbidity and mortality in healthy aging subjects.

A longitudinal study examining the adoption of exercise in older adults with and without heart disease

Abstract Funding Acknowledgements Type of funding sources: None. Background/Introduction Exercise is an important factor in the primary and secondary prevention of cardiovascular disease (CVD). However, few data are available on predictors of adopting exercise (AE) in older adults, especially the impact of a new and remote heart disease diagnosis (NHDD and RHDD, respectively) on AE. Purpose The purpose of this study was to examine predictors of AE in older adults using the Health and Retirement Survey (HRS), a prospective, nationally representative household survey examining retirement and health among older persons in the United States that is repeated every two years. Methods Data from respondents who were age 55 or older in 1998 were examined using three waves of the HRS (1998, 2000, and 2002) which provided three distinct person-wave observations for each respondent from which exercise wave changes and AE in older adults with and without CVD was determined resulting in a total of 8,975 respondents for subsequent analyses. The mean age±SD of the respondents was 69±9 years with 56% being female. Logistic regression models were developed to examine predictors of AE while controlling for a variety of demographic and health related variables. Results AE in respondents with and without CVD was relatively similar after the baseline time period, but a significantly (p<0.05) smaller percentage of respondents with CVD were observed AE compared to respondents without CVD (12% versus 20%). Significant predictors of AE included age, gender, household wealth, body mass index (BMI), medical conditions, mobility and instrumental activities of daily living (IADL) limitations, perceived health status, smoking, a new CVD event, and marriage with only marriage and household wealth positively associated with AE (odds ratio=1.133, p<0.05 and odds ratio=1.076, p<0.01, respectively). Respondents who were older, female, who had a greater BMI, had a greater number of medical conditions, had greater mobility and IADL limitations, poorer perceived health, smoked, and who experienced a new CVD event were less likely in AE. Neither a NHDD or RHDD was a significant positive predictor of AE in older adults (odds ratio=.489, p<0.001 and odds ratio=.915, p>0.05, respectively). Conclusions A smaller percentage of older adults with CVD were found AE compared to older adults without CVD. The finding that marriage was the strongest significant positive predictor of AE is important and highlights the role of spousal support. The finding that neither a NHDD or RHDD was a significant predictor of AE highlights the important role of cardiac rehabilitation in older adults. Long-term programming for AE and maintenance of exercise in older persons with a NHDD and RHDD is particularly important and requires further investigation. Examination of spousal or similar support while attending cardiac rehabilitation and modifying negative predictors of AE appears warranted and may facilitate older adults AE.

164 Characterizing Aging-Related Health in Women who have Criminal-Legal System Involvement (CHARMS)

OBJECTIVES/GOALS: To build a multi-function health profile for older adult (>50 years) women with a history of incarceration; explore group differences by age [45-54, 55-64, 65+], race, and length of incarceration; compare with age-matched control with no history of incarceration; and identify relative contribution of life course risk and asset factors. METHODS/STUDY POPULATION: We will analyze data from the Health and Retirement Survey (HRS) (UMichigan Institute of Social Research). The sample: women >50 years who took the leave-behind psychosocial questionnaire. The sample includes women with history of incarceration (n = 118; 2.93%) and (n = 115; 2.55%), respectively, and in the control n = 4,021 women (2012) and n = 4,114 women (2014). We will use descriptive statistics to profile physical, functional, cognitive, and social health; bivariable tests to compare groups on age-related morbidity, multimorbidity, frailty, and 4-year mortality risk; measure within group differences by age strata and race; estimate GLMs for effects of life course risk on dependent variables in and between groups; and if data permit, test direct mediation by life course risks and indirect by life course assets. RESULTS/ANTICIPATED RESULTS: Our results will characterize health in 4 health domains of women over 50 who have a history of incarceration. In bivariable analysis, we expect significant differences between groups on the dependent variables. Based on previous study using this data set, life course and accumulated stress theory, and our own previous research, we hypothesize that women with incarceration history will have more and earlier cardiovascular disease, stroke, and multimorbidity, higher 4-year mortality risk, and more and earlier cognitive impairment. We anticipate significant contributors to aging-related health outcomes to include childhood challenge and trauma history and, for Black women, perceived racial discrimination. We anticipate education and social support will partially mediate relationships. DISCUSSION/SIGNIFICANCE: The CHARMS findings, based on large-sample, representative, longitudinal HRS survey data, will contribute a profile of multi-function health status, risk, and assets in older women with CLS involvement. The much-needed characterization of aging in the group will set the stage for future interventional study to guide shifts in clinical practice.

Health among workers retiring after the state pension age: a longitudinal and comparative study

BackgroundIn recent decades, many countries have observed increasing labor force participation beyond the state pension age (SPA). However, there is a lack of research on employment beyond SPA and how it relates to older workers’ health. Moreover, there is a need to better understand how institutional factors affect the relationship between older workers’ employment and health. In this study, we examine simultaneous employment and health trajectories over 11 years in 12 countries from Europe and the Americas, and study how these trajectories differ by welfare state regime and level of old-age pension redistribution.MethodsWe used a harmonized pooled-country dataset of 3699 older workers based on four representative panel surveys: the Survey of Health, Ageing and Retirement in Europe (SHARE), the English Longitudinal Study of Ageing (ELSA), the Health and Retirement Survey (HRS), and the Chilean Social Protection Survey (EPS). We conducted multichannel sequence analysis to estimate the types of simultaneous employment–health trajectories, and multinomial regression analysis to examine the relationship between trajectory types and institutional factors.ResultsWe found that late retirement was equally associated with poor and good health. There is also a higher prevalence of late retirement trajectories in combination with poor health in liberal welfare regimes and in countries with lower levels of old-age pension redistribution.ConclusionOur study indicates that nonliberal welfare regimes and redistributive old-age pension policies may be better suited to protect vulnerable workers while providing those in good health with the opportunity to work beyond the SPA.

The devil's in the details: Variation in estimates of late-life activity limitations across national cohort studies.

Assessing activity limitations is central to aging research. However, assessments of activity limitations vary, and this may have implications for the populations identified. We aim to compare measures of activities of daily living (ADLs) and their resulting prevalence and mortality across three nationally-representative cohort studies: the National Health and Aging Trends Study (NHATS), the Health and Retirement Survey (HRS), and the Medicare Current Beneficiary Survey (MCBS). We compared the phrasing and context of questions around help and difficulty with six self-care activities: eating, bathing, toileting, dressing, walking inside, and transferring. We then compared the prevalence and 1-year mortality for difficulty and help with eating and dressing. NHATS, HRS, and MCBS varied widely in phrasing and framing of questions around activity limitations, impacting the proportion of the population found to experience difficulty or receive help. For example, in NHATS 12.4% [95% confidence interval (CI) 11.5%-13.4%] of the cohort received help with dressing, while in HRS this figure was 6.4% [95% CI 5.7%-7.2%] and MCBS 5.3% [95% CI 4.7%-5.8%]. When combined with variation in sampling frame and survey approach of each survey, such differences resulted in large variation in estimates of the older population of older adults with ADL disability. In order to take late-life activity limitations seriously, we must clearly define the measures we use. Further, researchers and clinicians seeking to understand the experience of older adults with activity limitations should be careful to interpret findings in light of the framing of the question asked.

Impact of a new and remote diagnosis of heart disease on exercise behavior in older adults

Abstract Funding Acknowledgements Type of funding sources: None. Background/Introduction Exercise is an important factor in the primary and secondary prevention of heart disease. However, few data are available on predictors of exercise in older adults, especially the impact of a new and remote diagnosis of heart disease (NHDD and RHDD, respectively) on exercise behavior. It is possible that the motivational impact of a NHDD may be more powerful than a RHDD in promoting exercise in older persons. Purpose The purpose of this study was to examine predictors of exercise in older adults using the Health and Retirement Survey (HRS), a prospective, nationally representative household survey examining retirement and health among older persons in the United States that is repeated every two years. We hypothesized that older persons with a NHDD and RHDD will be more likely to exercise. Methods Data from respondents who were age 55 or older in 1998 were grouped using three waves of the HRS (1998, 2000, and 2002) which provided three distinct person-wave observations for each respondent, yielding 38,634 respondent person-wave observations (9,629 with RHDD and 1,689 with NHDD) with a mean age of 70±9 years (55% female). Logistic regression models were developed to examine the predictors of exercise while controlling for a variety of demographic and health related variables. Results A NHDD was the strongest positive predictor (odds ratio=1.195, p<0.01; 95% CI=1.054-1.355) while a RHDD was not a significant predictor of exercise in older adults (odds ratio=1.034, p=0.31; 95% CI=.969-1.105). No significant difference in demographic, co-morbid conditions, or perceived health was observed between older adults with a NHDD and RHDD. Conclusions A NHDD was a strong positive predictor of exercise in older adults. A RHDD was not a significant predictor of exercise, suggesting that the motivation impact of a heart disease diagnosis lessens over time and secondary prevention efforts such as cardiac rehabilitation continue to be of importance. Long-term programming for maintenance of exercise in older persons with a RHDD appears to be particularly important and requires further investigation.

Does an increase in working hours affect mortality risk? The relationship between working hours and mortality among the older population.

Population aging, caused by an increase in life expectancy and decrease in fertility rates, has created changes and challenges in various spheres, including the labor market. Though health deteriorates with age, more and more older adults choose to stay in the labor force and work into late life. Understanding the effects of various work conditions on the health of older workers is crucial for designing policies and interventions to ensure healthy late life and maintain a productive workforce. To contribute to this endeavor, this study investigates the relationship between long working hours (LWH) and mortality among older populations. The study uses the Cox proportional hazards regression model to investigate data from the Health and Retirement Survey (HRS) between the years 1992-2016, a longitudinal nationally representative dataset from the United States. The results indicate that working 50 hours or more per week is not associated with an increased risk of mortality, for the full sample (1.45 [95% CI: 0.86, 2.45]), for both genders (females 0.51 [95% CI: 0.06, 4.28], males 1.45 [95% CI: 0.81, 2.61]), and for immigrants (female immigrants 0.55 [95% CI: 0.06, 4.75], male immigrants 1.44 [95% CI: 0.79, 2.62]). This analysis confirms and extends the findings of earlier studies by taking into consideration the potential impact of many demographic, socioeconomic, work-related and health-related factors.

American Older Adults in COVID-19 Times: Vulnerability Types, Aging Attitudes, and Emotional Responses.

The Coronavirus Disease (COVID) pandemic has aroused challenges to emotional well-being of the individuals. With 1,582 respondents from the Health and Retirement Survey (HRS), this study investigates the heterogeneity in older adults' vulnerability and examines the relationship between vulnerability types, aging attitudes, and emotional responses. International Positive and Negative Affect Schedule Short-form (I-PANAS-SF) and Attitudes toward own aging (ATOT) were used to assess the emotional experiences and aging attitudes, and 14 kinds of pandemic-related deprivations evaluated vulnerability of individuals. Latent class analysis (LCA) was used to explore the vulnerability types, and weighted linear regressions examined the relationship between vulnerability, aging attitudes, and emotional responses. The results showed that the proportion for individuals with mild vulnerability (MV), healthcare use vulnerability (HV), and dual vulnerability in healthcare use and financial sustainment (DVs) was 67, 22, and 11%, respectively. Older adults aged below 65, Hispanics and non-Hispanic Blacks, and those not eligible for Medicaid were more likely to have HV or DVs. The relationship between vulnerability and positive emotions (PAs) was non-significant, yet individuals with HV (beta = 0.10, standard error [SE] = 0.16) or DVs (beta = 0.09, SE = 0.28) were likely to have more negative emotions (NAs) than their mildly vulnerable counterparts. Furthermore, aging attitudes moderated the relationship between vulnerability and emotions. The salutary effect of positive aging attitudes on emotional well-being was more significant among people with DVs than those with MV (beta = 0.20, SE = 0.04 for positive responses; beta = −0.15, SE = 0.04 for negative responses). Thus, we urge more attention for vulnerable older adults in a pandemic context. Meanwhile, encouraging positive aging attitudes might be helpful for older adults to have better emotional well-being, especially for those with DVs.

Trends in Geriatric Conditions Among Older Adults Admitted to US ICUs Between 1998 and 2015

Older adults are increasingly admitted to the ICU, and those with disabilities, dementia, frailty, and multimorbidity are vulnerable to adverse outcomes. Little is known about how pre-existing geriatric conditions have changed over time. How have changes in disability, dementia, frailty, and multimorbidity in older adults admitted to the ICU changed from 1998 through 2015? Medicare-linked Health and Retirement Survey (HRS) data identifying patients 65 years of age and older admitted to an ICU between 1998 and 2015. ICU admission was the unit of analysis. Year of ICU admission was the exposure. Disability, dementia, frailty, and multimorbidity were identified based on responses to HRS surveys before ICU admission. Disability represented the need for assistance with≥ 1 activity of daily living. Dementia used cognitive and functional measures. Frailty included deficits in≥ 2 domains (physical, nutritive, cognitive, or sensory function). Multimorbidity represented≥ 3 self-reported chronic diseases. Time trends in geriatric conditions were modeled as a function of year of ICU admission and were adjusted for age, sex, race or ethnicity, and proxy interview status. Across 6,084 ICU patients, age at admission increased from 77.6 years (95%CI, 76.7-78.4 years) in 1998 to 78.7 years (95%CI, 77.5-79.8 years) in 2015 (P< .001 for trend). The adjusted proportion of ICU admissions with pre-existing disability rose from 15.5%(95%CI, 12.1%-18.8%) in 1998 to 24.0%(95%CI, 18.5%-29.6%) in 2015 (P= .001). Rates of dementia did not change significantly (P= .21). Frailty increased from 36.6%(95%CI, 30.9%-42.3%) in 1998 to 45.0%(95%CI, 39.7%-50.2%) in 2015 (P= .04); multimorbidity rose from 54.4%(95%CI, 49.2%-59.7%) in 1998 to 71.8%(95%CI, 66.3%-77.2%) in 2015 (P< .001). Rates of pre-existing disability, frailty, and multimorbidity in older adults admitted to ICUs increased over time. Geriatric principles need to be deeply integrated into the ICU setting.

Generalized linear modeling of a panel mobility index with correlated multivariate categorical responses

Data with multivariate, longitudual categorical responses often occur in applications. It can be difficult to analyze and model such data while simultaneously taking into account explanatory variables and correlations between the responses over time. We take a generalized linear model approach to this problem in analyzing panel data from the Health and Retirement Survey (HRS) that includes older Americans’ mobility over several years as a response. We provide a general formula for the likelihood of such data and apply it to the case when there are three binary responses. This approach can be taken, with computational limits, for data with multivariate, categorical responses with any number of categories. We consider, simultaneously, interpretations of coefficients, dependence of responses and goodness-of-fit in reduced models for parsimony while taking into account explanatory data. The gradient of the objective function is provided for use in gradient descent and the coded optimization algorithm is tested with a Monte Carlo simulation. Dependence of responses in mobility is shown before taking explanatory variables into account, and dependence is shown in a Markov logistic regression model and in the generalized linear model taking into account race, age, gender and interactions between them.

Binge Drinking, Depressive Symptoms, and Sleep Health in Middle-Aged and Older Adults

Unhealthy alcohol consumption such as binge drinking and depression are common problems among adults. The combined effect of binge drinking and depression might contribute to negative health outcomes, such as accidents, addiction, or sleep problems. Previous evidence has indicated that alcohol consumption differs by age. However, little is known about the association between binge drinking, depression, and sleep health, and how age might play a role in this association. This study aimed to examine the association between binge drinking, depressive symptoms, and sleep health in middle-aged and older adults and characterize any age differences. A total of 5191 middle-aged and older adults from the 2014 Core Survey of the Health and Retirement Survey (HRS) data aged 50 to 80 were included for this study. Binge drinking was defined as the consumption of 5 or more drinks (men) and 4 or more drinks (women) per drinking day. Depressive symptoms were measured using a validated 8-item Center for Epidemiologic Studies Depression Scale. Sleep health was assessed using a composite measure. Age was grouped into middle-aged (50-64.9 years) and older (65-79.9 years) adults. Multiple linear regression analysis was used to examine the associations between variables of interest. Our findings indicated that binge drinking and depressive symptoms negatively influenced sleep health among middle-aged adults, however this relationship was not found in older adults. Clinicians should simultaneously assess problematic alcohol consumption, depressive symptoms, and sleep health. Future research can develop and test age-specific interventions to reduce unhealthy drinking behaviors in middle-aged adults.

Group Differences in Patterns of Retirement and Social Security Benefits Receipt in the United States

Extended working lives are a clear phenomenon in the U.S. However, the Social Security benefits and old-fashioned retirement concept has not changed by the new trend. This study is to examine 1) whether retirement and Social Security benefits simultaneously happen as Social Security was planned, and 2) differences in groups based on the trajectories in retirement and Social Security benefits. This study used data from the Health and Retirement Survey (HRS) 2000-2016. The sample consisted of respondents the ages of 54 or older who worked for pay without receiving Social Security benefits in 2000 (N=1,924). A Latent Class Growth Analysis was conducted to classify the number of groups based on individuals’ trajectories in retirement and Social Security. The bivariate analysis tested group members’ characteristics. The final model included four groups: 1) ‘delayed retirement and Social Security,’ 2) ‘early Social Security but re-entry of the labor market after early retirement,’ 3) ‘delayed retirement but early Social Security,’ and 4) ‘retirement and Social Security at the same time point.’ The bivariate analysis demonstrated significant differences between groups in retirement age, Social Security age, education, health, and income. The result indicated that Group 2, with lower health status, education level, and income, was vulnerable in retirement. The group retired and received Social Security comparatively earlier, whereas they finally retired at the oldest age after reentering the labor market. This finding suggests that Social Security and retirement do not happen simultaneously, and Social Security is not enough for some people’s living.

A mutation associated with stress resistance in mice is associated with human grip strength and mortality

ABSTRACT Hand grip strength (GS) is a valid and reliable predictor of future morbidity and mortality and is considered a useful indicator of aging. In this paper, we use results from the genetic analysis in animal studies to evaluate associations for GS, frailty, and subsequent mortality among humans. Specifically, we use data from the Health and Retirement Survey (HRS) to investigate the association between three polymorphisms in a candidate frailty gene (Tiam1) and GS. Results suggest that the A allele in rs724561 significantly reduces GS among older adults in the US (b = −0.340; p < .006) and is significantly associated with self-reported weakness (b = 0.221; p = .036). This same polymorphism was weakly associated (one-tailed) with an increased risk of mortality (b = 1.091; p < .093) and adjustments for GS rendered this association statistically non-significant (b = 1.048; p < .361). Overall, our results provide tentative evidence that the Tiam1 gene may be associated with frailty development, but we encourage further studies.

0854 Exploration Of Sleep Health Among Middle-aged And Older Adults

Abstract Introduction Sleep health, a construct introduced to characterize the multidimensional attributes of sleep, has been explored in a variety of populations; however has not been adequately examined for middle-aged and older adults. As attributes of sleep may change with age, the dimensional structure of sleep health may differ in this population. This study aimed to validate a composite measure of sleep health among middle-aged and older adults using data from the Health and Retirement Survey (HRS). Methods Data from the 2014 Core survey of the HRS was used to create a composite measure of Sleep Health including sleep efficiency, duration, timing, satisfaction, and alertness. We standardized and averaged the original variables before transforming to T scores. Sleep Health T scores (ranging 0-100, higher scores indicating better sleep health) were examined using exploratory and confirmatory factor analysis (EFA; CFA). Results Our sample included 6,095 adults with mean age of 68 years (SD=10.1; range 50-99 years). The majority were female (59.7%), white (77%), with high school education (53.9%). Sleep Health T scores ranged from 27-61 (mean=50; SD=6.7). EFA identified one factor. Timing was removed due to low factor loading (&amp;lt;0.4). The revised four-dimension composite Sleep Health measure had acceptable reliability (Cronbach’s alpha 0.6). CFA showed a well-adjusted model (REMSA=0.097; NFI=0.964; RMR=0.035; GFI=0.990; AGFI=0.951). Conclusion These results suggest that the composite measure was valid for assessing sleep health among middle-aged and older adults. Limitations include the use of secondary data, as sleep health dimensions were based on variables not created specifically for our research question. Future research should further examine the role of sleep timing in overall sleep health among middle-aged and older adults. Support This study was supported by the University at Buffalo Clinical and Translational Science Institute (CTSI) funded by the National Institutes of Health (Lorenz, PI).

PHYSICAL ACTIVITY MEDIATES THE EFFECTS OF DEPRESSIVE SYMPTOMS ON THE COGNITIVE FUNCTION OF OLDER ADULTS

Evidence suggests that depressive symptoms among older adults were associated with cognitive impairment and affect cognitive decline over time, while physical activity was associated with lower risk of cognitive decline or have positive effect on cognitive function. The purpose of this study is to examine whether physical activity could mediate the effects of depressive symptoms on the cognitive function of older adults. Data from the 2014 Health and Retirement Survey (HRS) of older adults ≥ 60 years (N=9,753) were used. Hierarchical regression was conducted to examine the relationship between depressive symptoms, physical activity, and cognitive function. Mediation analysis was used to examine whether physical activity could mediate the effects of depressive symptoms on cognitive function. Regression results indicated that increased depressive symptoms was associated with poorer cognitive function, while increased moderate and mild physical activity were associated with better cognitive function. Mediation analysis indicated that the direct effect of depressive symptoms on cognitive function was significant. The indirect effect of depressive symptoms on cognitive function mediated by moderate and mild physical activity were also significant. Findings suggest that physical activity could potentially improve the cognitive function of older adults who have depressive symptoms. Moderate and mild physical activity could benefit older adults with depressive symptoms and reduce the risk of cognitive decline. Frail, disabled or chronically ill older adults are less likely to participate in vigorous physical activity, but they could benefit from moderate or mild physical activity and have better cognitive health.

1470-P: EHR-Based vs. Population-Based CVD Risk Predictions for Diabetes Patients

Electronic health records (EHR) are an increasingly common data source for studying disease risks, having large sample sizes and frequently sampled clinical predictors/outcomes. In contrast to population-based cohorts, EHRs are not population-representative random samples, as subjects tend to be sicker, with higher healthcare utilization. We compared risk predictions of the same outcome (time to incident CVD) in the same population of interest (DM2 patients &amp;gt;50 years) using 2 data sources: waves 1993-2014 of the nationally representative Health and Retirement Survey (HRS) and 2009-2017 New Langone Health Epic data. In each dataset, we estimated the incidence rate (IR) of subsequent CVD in DM2 patients and adjusted hazard ratios (HR) of CVD risk factors using the Cox-regression model. The HRS sample included 2,739, of whom 423 developed CVD. The NYU-Epic sample included 9,179, of whom 1,264 developed CVD. The estimated subsequent CVD IRs were 28.5 (95% CI: 25.9-31.3) (HRS) and 67.1 (95% CI: 63.5-90.9) (NYU-Epic) per 1,000 person-years since DM2 onset. HR estimates were comparable between the datasets for most demographic covariates/biomarkers (Table). Our findings showed that the EHR sample was enriched with a higher proportion of sicker DM2 patients. Our study supports EHR use in DM2 research: EHR-based HR estimates of CVD risk factors have promise to be population-generalizable despite higher CVD IRs in the EHR samples. Disclosure J. Zhong: None. C. Blaum: None. J. Yu: None. R. Ferris: None. J. Ha: None. Y. Xia: None. M. Kabeto: None. C. Cigolle: None. Funding National Institute on Aging