Health In Later Life Research Articles

Increased adult child schooling and older parents’ health behaviors in Europe: A quasi-experimental study

There is growing evidence that adult child educational attainment is associated with older parents' physical health and longevity. Scholars have hypothesized that these associations may be driven by health-behavior pathways, whereby adult children with more education may share information about healthy lifestyles, role-model healthier behaviors, and/or have more economic resources to support leisure-based physical activity or the purchase of healthy foods for older parents. However, this relationship has not been comprehensively evaluated with methods capable of addressing the confounding bias expected for observational studies on this topic. We estimated the association between increased adult child schooling and older parents' health behaviors using data from the Survey for Health, Aging and Retirement in Europe (SHARE) (n = 8195). We leveraged changes to compulsory schooling laws that would have impacted respondents' adult children as quasi-experiments and estimated the association between increased schooling among oldest adult children and respondents' (parents') body mass index, obesity, physical inactivity, excessive drinking, and current smoking using two-stage least squares regression. Each year of increased schooling among oldest adult children was associated with a lower risk of current smoking (β: −0.029, 95% CI: −0.056, −0.003), physical inactivity (β: −0.034, 95% confidence interval [CI]: −0.077, 0.009), obesity (β: −0.038, 95% CI: −0.065, −0.011) and lower body mass index (β: −0.37, 95% CI: −0.73, −0.02). The direction of associations with excessive drinking varied by parent gender (β: −0.027, 95% CI: −0.046, −0.007 for mothers; β: 0.068, 95% CI: −0.011, 0.148 for fathers). Increases in adult child schooling may have upward influences on parents' late-life health behaviors, although there may be some differences by parent gender. Findings should be replicated across other global settings and studies should directly evaluate parent health behaviors as mediators of the relationship between increased adult child schooling and older parents’ longevity.

Depression and antidepressant treatment in the development of hypertensive disorders of pregnancy: Results from a prospective cohort study.

Hypertensive disorders of pregnancy are associated with longer term cardiovascular risk. Understanding if depression or antidepressant use in pregnancy is associated with HDP is important in identifying those potentially vulnerable to poorer health in later life. This study examines if depression and antidepressants are associated with HDP. In all, 815 pregnant women were recruited within an Australian pregnancy cohort study at less than 20 weeks of pregnancy, all undertook the Structured Clinical Interview for the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition, and were assigned to four groups for this paper: those with unmedicated depression meeting criteria for current depression (n = 97), those taking selective serotonin reuptake inhibitors in early pregnancy (n = 101), those taking serotonin and noradrenaline reuptake inhibitors in early pregnancy (n = 31), and those without depression or taking antidepressant medication (control; n = 586). Women were then assessed again following birth. Hypertensive disorders of pregnancy were diagnosed according to the Society of Obstetric Medicine in Australia and New Zealand Guidelines. Use of serotonin and noradrenaline reuptake inhibitors (SNRIs) (adjusted risk ratio = 9.10, 95% confidence interval = [3.82, 21.67]) and unmedicated depression (adjusted risk ratio = 3.11, 95% confidence interval = [1.32, 7.35]) were independently associated with significantly higher risk for developing hypertensive disorders of pregnancy compared to controls. Selective serotonin reuptake inhibitors (SSRIs) use did not confer any increased risk. Higher doses of SNRIs, but not selective serotonin reuptake inhibitors, were associated with significantly higher risk for developing HDP (adjusted risk ratio = 4.83, 95% confidence interval = [1.50, 15.58]). Our findings suggest that those with depression in pregnancy and/or on an serotonin and noradrenaline reuptake inhibitor should have closer surveillance for the development of hypertensive disorders of pregnancy. These findings support treatment of depression in pregnancy, however, also the consideration of class of antidepressant.

Elevated blood pressure is associated with advanced brain aging in mid-life: A 30-year follow-up of The CARDIA Study.

High blood pressure (BP) is a risk factor for late-life brain health; however, the association of elevated BP with brain health in mid-life is unclear. We identified 661 participants from the Coronary Artery Risk Development in Young Adults Study (age 18-30 at baseline) with 30 years of follow-up and brain magnetic resonance imaging at year 30. Cumulative exposure of BP was estimated by time-weighted averages (TWA). Ideal cardiovascular health was defined as systolic BP<120mm Hg, diastolic BP<80mm Hg. Brain age was calculated using previously validated high dimensional machine learning pattern analyses. Every 5mmHg increment in TWA systolic BP was associated with approximately 1-year greater brain age (95% confidence interval [CI]: 0.50-1.36) Participants with TWA systolic or diastolic BP over the recommended guidelines for ideal cardiovascular health, had on average 3-year greater brain age (95% CI: 1.00-4.67; 95% CI: 1.45-5.13, respectively). Elevated BP from early to mid adulthood, even below clinical cut-offs, is associated with advanced brain aging in mid-life.

In utero exposure to natural disasters and later-life mortality: Evidence from earthquakes in the early twentieth century

A growing body of research explores the effects of prenatal insults caused by natural disasters on life-cycle outcomes. This paper joins the literature by exploring the long-run effects of prenatal exposure to earthquakes on adulthood and old-age mortality. Using Social Security Administration death records (1975–2005) linked with the full-count 1940 US census and implementing a difference-in-difference methodology, I show that exposure during the first trimester is associated with 1.8 months lower longevity, conditional on survival up to age 34. This effect is equivalent to 22 percent of the white-nonwhite gap in the outcome. The results implicate the relevance of the in-utero period and specifically the onset of pregnancy for later-life health outcomes.

A life course epidemiology approach to climate extremes and human health

A life course epidemiology approach to climate extremes and human health

Do different types of war stressors have independent relations with mental health? Findings from the Korean Vietnam Veterans Study.

South Korea had the second largest contingent of soldiers in the Vietnam War, but little is known about their adaptation, especially in later life. Previous work in a different sample found very high rates of posttraumatic stress disorder (PTSD; 41%) among Korean Vietnam veterans (KVVs; Kang, Kim, & Lee, 2014), compared to 19-31% for American Vietnam veterans. We explored possible reasons for this high rate of PTSD, as well as anxiety and depressive symptoms, utilizing both vulnerability factors (e.g., war stressors) and protective factors (optimism, unit cohesion, and homecoming experiences). The sample included 367 male KVVs surveyed by mail (M age = 72, SD = 2.66). Using hierarchical regressions controlling for demographics, we examined the relative contributions of different types of war stressors and then the protective factors. Combat exposure was significantly associated with the three types of negative psychological symptoms, but their associations became nonsignificant when "subjective" war stressors (malevolent environments, perceived threat, and moral injury) were added. In the final models, malevolent environments were the strongest predictor for all three outcomes. In addition, moral injury was independently associated with PTSD symptoms, while perceived threat was marginally associated with depressive and anxiety symptoms. Among psychosocial factors, only optimism was negatively associated with the mental health outcomes. KVVs had very high rates of combat exposure, but malevolent environments played a more important role in their mental health in later life. These findings suggest the importance of considering adverse environmental factors in understanding PTSD in future studies. (PsycInfo Database Record (c) 2022 APA, all rights reserved).

The Experience of Killing and Health in Late Life: Findings from Korean Vietnam War Veterans

Background: The current study aimed to examine the effects of combat exposure and killing on mental and subjective physical health later in life among Korean Vietnam War veterans.Methods: The data were collected from 342 male veterans with a mean age of 72 years (SD=2.57). Veterans were divided based on their histories into three groups: no experience (Group 1), combat exposure only (Group 2), and both killing and combat exposure (Group 3). Analyses of variance (ANOVAs) examined group differences in post-traumatic stress disorder (PTSD) symptoms, anxiety symptoms, hostility, and perceived physical health.Results: The ANOVAs showed that PTSD, anxiety symptoms and hostility were most prevalent among the veterans in Group 3 (both killing and combat exposure). No significant differences were found between Groups 1 and 2. Perceived physical health was highest among the veterans in Group 1 (no experience). There were no differences between Groups 2 and 3. Even after controlling for the impacts of optimism and social support after homecoming, these results were similar.Conclusions: The findings indicate that killing experience and combat exposure should be considered in designing interventions for veterans deployed into active combat zones.

Olfaction in (Social) Context: The Role of Social Complexity in Trajectories of Older Adults' Olfactory Abilities.

Objectives: Olfaction is an important correlate of later-life health, including cognition and mortality risk. Environmental enrichment protects against olfactory decline, yet little research considers the social context as a source of sensory enrichment or stimulation. This study examines how exposure to social complexity (i.e., diversity or novelty in social networks and activities) shapes later-life olfaction. Methods: Cross-sectional and longitudinal ordered logit models analyze data from 1,447 older adults interviewed at Rounds 1 and 2 of the National Social Life, Health, and Aging Project. Results: Exposure to greater social complexity (larger social networks, greater network diversity) is associated with significantly better olfaction at baseline. Increases in network diversity and fewer network losses significantly protect against olfactory decline over time. Discussion: Findings highlight the social context as an important, yet relatively overlooked source of sensory enrichment, and underscore the need for biological applications to integrate social life dynamics into studies of health trajectories.

Life-course income trajectories of men and women in Norway: implications for self-rated health in later life.

BackgroundSocioeconomic inequalities in health are well-established, but studies addressing lagged effects of income or of fluctuations in income over the life course are relatively rare. The current study aims to (i) identify and describe life-course income trajectories for men and women who are currently in later life; and (ii) assess the association of income trajectories with self-rated health in older adults.MethodsThe study sample consisted of 1625 men and 1634 women born between 1937 and 1955 who participated in the third wave of the Norwegian Life course, Ageing and Generation Study. Latent class growth analyses were used to estimate dominant income trajectories from ages 30 through 62 in men and women. Stepwise logistic regression analyses were specified to analyze the association of income trajectories with self-rated health in later life.ResultsFour trajectories in women and three trajectories in men were estimated as dominant patterns of income over the life course. Differences in the level of income were considerable at age 30 and accumulated over time. Continued exposure to low income showed statistically significant higher odds for poor self-rated health in older men and women. This association remained significant after taking differences in educational attainment, working life, family formation and accumulated wealth into account.ConclusionThe findings suggested remarkable rigidity in income groups that had formed by age 30. A significant share of men and women remain mired in relatively low-income status across the life course with negative implications for health in later life.

Leisure Activities and Depressive Symptoms among Older Men and Women in Mexico: Implications of Physical Health.

This study investigated whether the effects of specific types of group and individual leisure activities on depressive symptoms differ for older men and women in Mexico and whether several indicators of physical health can shape the psychological benefits of these activities. This study used data from two waves (2012 and 2015) of the Mexican Health and Aging Study and employed OLS regressions. The association between leisure activities and depressive symptoms among older Mexicans may vary by the type of activity, gender, and physical health. Physical health issues may decrease potential psychological benefits of certain leisure activities. Yet, despite deteriorating physical health, older adults may benefit from involvement in some leisure activities. This study highlights the diversity of experiences related to later-life mental health and emphasizes the importance of investigating psychological implications of specific types of leisure activities among older men and women with different physical health concerns.

Jobless parents, unhealthy children? How past exposure to parental joblessness influences children's future health

RationaleDespite a growing body of work investigating the combined effects of maternal and paternal joblessness for children's outcomes, very little is known about the long-term effects of parental joblessness on children's health, and especially health during adulthood. ObjectiveThe primary objective of this study is to directly test whether exposure to parental joblessness during childhood and early adulthood has adverse consequences for health in later years. This study also explores whether family resources, time inputs and family harmony mediate this relationship. MethodsMultilevel generalized structural equation models describing processes influencing child health outcomes in later life are estimated using longitudinal data from 19 waves of the Household, Income and Labour Dynamics in Australia Survey (N = 2875 individuals and 22,942 person-year observations). ResultsParental joblessness, especially when experienced over a protracted period, is found to impose a penalty on children's mental health in later life, which is mostly not mediated by other variables. A significant negative association with general health is also found, but in this case family income and family harmony play a more important mediating role. ConclusionThe results suggest that it is not parental job loss per se that matters, but parents not being able to quickly find alternative employment. It is only children in families where joblessness is protracted and long-lasting who are at serious risk of long-term health problems. In sum, our results imply that the parental outcome that is most important for children's later health, and especially their mental health, is continuous paid employment. Such findings provide support for a jobs-first policy emphasis.

Stressors and Pain across the Late-Life Span: Findings from Two Parent Longitudinal Studies of Aging and Health.

The objective is to determine associations between stressors and pain across the late-life span. Multilevel linear modeling was applied separately to harmonized repeated measures data from the Longitudinal Late-Life Health study (LLLH; n = 342; 13-year interval) and the Health and Retirement Study (HRS; n = 2959; 8-year interval). In both the LLLH and HRS samples, independent of age, gender, and race, participants with higher average stressor levels experienced more numerous painful conditions and higher pain severity over the study intervals. In the HRS sample, they also experienced higher levels of pain interference. In general, participants' stressor levels did not influence rates of increase in their pain. Gender and race had few moderating effects on associations between stressors and pain. Stressors and pain are associated across the late-life span. Future research should focus on the mediating mechanisms that account for this association and the moderating factors that affect its strength.

PROTOCOL: The association between marital transitions and physical and mental health in late life: A systematic review.

This is the protocol for a Campbell systematic review. The objectives are as follows: What is the association between marital transitions and physical health among people older than 60? What is the association between marital transitions and mental health among people older than 60? What is the role of gender, age, and education on the association between marital transitions and health among people older than 60? What is the influence of geographical region, housing, neighborhood, and social support on the association between marital transitions and health status among people older than 60?

Does Childbearing Affect Cognitive Health in Later Life? Evidence From an Instrumental Variable Approach.

Cognitive decline is a widespread concern as populations grow older. However, population aging is partly driven by a decrease in fertility, and family size may influence cognitive functioning in later life. Prior studies have shown that fertility history is associated with late-life cognition, but whether the relationship is causal remains unclear. We use an instrumental variable approach and data from the Survey of Health, Ageing, and Retirement in Europe to examine whether having three or more versus two children affects late-life cognition. Parents often prefer to have at least one son and one daughter. We thus exploit the sex composition of the first two children as a source of exogenous variation in the probability of having three or more children. Results indicate that having three or more versus two children has a negative effect on late-life cognition. This effect is strongest in Northern Europe, perhaps because higher fertility decreases financial resources yet does not improve social resources in this region. Future studies should address the potential effects of childlessness or having one child on late-life cognition and explore the mediating mechanisms.

Expansion, Compression, Neither, Both? Divergent Patterns in Healthy, Disability-Free, and Morbidity-Free Life Expectancy Across U.S. Birth Cohorts, 1998-2016.

This article explores how patterns of health, morbidity, and disability have changed across successive generations of older adults in the United States. Using a novel method for comparing state-specific partial life expectancies-that is, total life expectancy (LE), and health expectancies (HEs) in different health states, bounded between two ages-I explore changes in healthy life expectancy across successive birth cohorts of the U.S. population. Results show that little compression of disability is occurring across cohorts, LE with chronic morbidities has expanded considerably, and self-rated health is improving across cohorts, but only at ages 70+. These findings suggest that successive cohorts in the U.S. population may be on divergent paths in terms of late-life health and well-being. Exploring heterogeneity in these patterns, I find that less educated individuals have substantially lower partial LE and disability-free LE than those with more schooling, and that disability-free life is declining among those with less than a high school diploma. Differences in HEs are pervasive across racial and ethnic groups, and both disabled LE and unhealthy LE are expanding in some disadvantaged subgroups. The continued increases in partial LE with morbidities across successive cohorts, and the broad stagnation of disability-free and healthy LE, present a broad view of a U.S. population in which successive generations are not living healthier lives.

Parenting styles and health in mid- and late life: evidence from the China health and retirement longitudinal study

BackgroundsThe impact of relationships in early childhood may be long-lasting and reaching to mid to late life. Limited studies have investigated the associations between parenting style and different aspects of well-being beyond adolescence. The current study aims to examine the association between parenting styles and multiple dimensions of functioning in mid-and later-life adults.MethodsWe used data from China Health and Retirement Longitudinal Study (CHARLS). Generalized Estimating Equation (GEE) was applied to examine the association between retrospective parenting styles/behaviors in childhood and health outcome.ResultsCompared with authoritative style, authoritarian style predicted worse self-rated health (coefficient = − 0.13, P < 0.001), cognitive function (− 0.23, P < 0.05) and depressive symptom (0.87, P < 0.001). Paternal affection was associated with more health outcome in mid- and late life than maternal affection. Only paternal affection was a significant predictor of mid- and late life health among male adults, while both paternal and maternal affection were strong predictors among female adults. Authoritative style was associated more positive health outcomes in mid- and late life among adults with literate parents than those with illiterate parents.ConclusionThis study provides evidence for the link between parenting behaviors in early life stage and physical and psychological functioning in mid- to late adulthood. Authoritative style, and the memory of parental affection, particularly from father and educated parents, could have long-lasting positive influence on children’s physical and mental well-being, which further support the life-course perspective on human development.

Loneliness among older adults in Europe: The relative importance of early and later life conditions.

The aim of this paper is to study the association between childhood circumstances and loneliness in older adults in Europe. Based on rich information collected by the Survey on Health, Ageing, and Retirement in Europe (SHARE) on childhood characteristics and individual characteristics at age 50+, the study is able to control for personality traits, socioeconomic and demographic factors, social support and health in later life, and country-specific characteristics. The analyses show strong correlations between life circumstances in childhood and feeling lonely in older age; these correlations remain significant after adjusting for covariates. While ill health is the main factor correlated with loneliness at 50+, as expected, the analysis of the relative importance of the determinants reveals that personality traits account for more than 10% of the explained variance and that life circumstances during childhood account for 7%. Social support at older ages is the second highest category of factors, accounting for 27%—with, interestingly, support at home and social network characteristics contributing about 10% each, engaging in activities and computer skills accounting for 7% of the explained variance. Demographic and socioeconomic factors account for 6% and country-level characteristics contribute 5%. This paper points out the relevance of early life interventions to tackling loneliness in older age, and it shows that early interventions and interventions aiming at increasing social support in later life need to be adapted to all personality types. Thus, the role of childhood circumstances and the mechanisms explaining the association between loneliness in childhood and loneliness in later life deserve more attention in future research.

Centers for Disease Control and Prevention Investments in Adverse Childhood Experience Prevention Efforts

Centers for Disease Control and Prevention Investments in Adverse Childhood Experience Prevention Efforts

20th Century Puerto Rico and Later-Life Health: The Association Between Multigenerational Education and Chronic Conditions in Island-Dwelling Older Adults.

Previous research on the association between education and older adult health in the U.S. has not included Puerto Rico. We investigated the effects of multigenerational educational attainment and chronic conditions among older Puerto Ricans residing on the archipelago's main island. Data were from the longitudinal Puerto Rican Elderly Health Conditions Project. Generalized Poisson regression models were used to examine if multigenerational educational attainment was associated with chronic disease. Findings show that parental educational attainment was associated with fewer chronic conditions among females at baseline but not at follow-up, suggesting that the effects of parental education on health over time are less pronounced. For males, educational attainment across the three generations was not significantly associated with chronic disease at baseline or follow-up. Multigenerational education is an important determinant of older adult health that continues to be relevant in Puerto Rico and the Latin American and Hispanic-Caribbean region.

Investing in Late-Life Brain Capital.

Within many societies and cultures around the world, older adults are too often undervalued and underappreciated. This exacerbates many key challenges that older adults may face. It also undermines the many positive aspects of late life that are of tremendous value at both an individual and societal level. We propose a new approach to elevate health and well-being in late life by optimizing late-life Brain Capital. This form of capital prioritizes brain skills and brain health in a brain economy, which the challenges and opportunities of the 21st-century demands. This approach incorporates investing in late-life Brain Capital, developing initiatives focused on building late-life Brain Capital.