National Sample Of Older Americans Research Articles

Adverse Neighborhood Environments and Health Behaviors among Older Americans

Maintaining healthy lifestyle, including healthy diet and physical activity, in adverse neighborhood environments may be more difficult for older adults because of changes linked to aging, which make them more vulnerable to their environments. This study aims to investigate the association of neighborhood disorder with diet quality and physical activity in a national sample of older Americans. For this study, we used data from the Health and Retirement Study. Neighborhood disorders include vandalism, boarded houses, abandoned cars, demolished houses, trash, litter, or junk, poorly kept communal areas, homeless people, prostitution, winos or junkies, and drug use or drug dealing near residents’ housing unit (range: 0-11). Diet quality and physical activity were assessed using the Healthy Eating Index 2015 (HEI-2015; range:0-100) and the metabolic (MET) equivalent activity points (range: 0-31 in this sample). Ordinary least squares regression models were estimated to examine an association between neighborhood disorder, diet quality, and physical activity. Neighborhood disorder was associated with poor diet and physical inactivity. For one additional negative neighborhood feature, HEI-2015 scores and MET-equivalent activity points decreased by 0.55 (95% CI: -1.09. -0.01) and 0.69 (95% CI: -1.05, -0.33). Findings of this study suggest that older adults living in adverse neighborhoods are at a greater risk of poor diet and physical inactivity, which are important risk factors for poor health and chronic diseases. Promoting neighborhood environments and perceived neighborhood safety would increase access to health food, encourage healthy diet and physical activity, and support healthy aging.

Diet Quality and Biological Risk in a National Sample of Older Americans.

Objectives: Using comprehensive measures of biological risk, this study aims to investigate the relationship between intake of individual dietary components, overall diet quality, and biological dysregulation. Methods: We analyzed nationally representative data from 3734 older adults who participated in the Health and Retirement Study Venous Blood Study in 2016 and Health Care and Nutrition Survey in 2013. Results: Eleven out of 13 individual dietary components were associated with lower biological risk. Respondents with poor/suboptimal quality diet had higher biological risk than those with good quality diet. Discussion: Findings from this study emphasize the importance of healthy eating in improving health of older adults. Encouraging intake of fruits, greens and beans, whole grains, and fatty acids, while limiting consumption of sodium, added sugar, and saturated fat would improve overall diet quality and contribute to the prevention of chronic diseases and morbidity.

Diet Quality and Biological Risk in a National Sample of Older Americans

Biomarkers are sensitive to current health status and capture aspects of health that may precede the development of disease and other health problems. Using comprehensive measures of biological risk, this study aims to investigate the relationship between intake of individual dietary components, overall diet quality, and biological dysregulation. For the analysis, we used nutrition and biomarker data from 3,641 older adults (over age 50) in the Health and Retirement Study. Eleven out of 13 individual dietary components were associated with lower biological risk. After controlling for SES, health behaviors, and access to health care, a high intake of fruits, greens and beans, whole grains, seafood and plant proteins, and fatty acids and a low intake of sodium and saturated fat were still associated with lower biological risk. Respondents with poor/suboptimal quality diet had higher biological risk than those with good quality diet. After controlling for SES, health behaviors, and access to health care, respondents with poor/suboptimal quality diet continued to exhibit higher biological risk than those with good quality diet, though the differences in biological risk were reduced. Findings from this study emphasize the importance of healthy eating in improving health of older adults. Encouraging intake of fruits, greens and beans, whole grains, seafood and plant proteins, and fatty acids, while limiting consumption of sodium and saturated fat would improve overall diet quality and contribute to the prevention of chronic diseases and morbidity.

Weakness May Cause Mortality In Older Americans: A Matched Cohort Analysis

Muscle weakness has been implicated with early mortality; however, quantifying the extent of this association with a carefully matched not weak and strong control will help to better establish the impact of weakness on premature death. PURPOSE: We utilized a propensity cohort analysis in a national sample of older Americans for this study to determine if persons who were weak had a higher risk for early mortality compared to a not weak or strong control group. METHODS: Data from 19,729 Americans aged at least 50 years from 2006-2014 waves of the Health and Retirement Study were analyzed. Handgrip strength was measured with a hand-grip dynamometer. Men with handgrip strength <26 kilograms were considered weak, ≥26 kilograms were considered not weak, and ≥32 kilograms were considered strong. Women with handgrip strength <16 kilograms were classified as weak, ≥16 kilograms were classified as not weak, and ≥20 kilograms were classified as strong. The National Death Index and postmortem interviews determined date of death. The greedy matching algorithm was used to separately match the weak cohort 1:1 to a 1) not weak control cohort, and 2) strong control cohort on several influential covariates. Kaplan-Meier estimators examined survival probabilities and Cox models determined the association between weakness and time to mortality for each of the matched pairs. RESULTS: Of the 1,077 weak and not weak matched pairs, 401 weak (37.2%; mortality rate per 1,000 person years: 90.6) and 296 not weak (27.4%; mortality rate per 1,000 person years: 57.8) older Americans died over an average 4.4±2.5 year follow up. There were 392 weak (37.0%; mortality rate per 1,000 person years: 89.6) and 243 strong (22.9%; mortality rate per 1,000 person years: 46.7) persons that died over a mean 4.5±2.5 year follow up from the 1,057 weak and strong matched pairs. Those in the weak cohort had a 1.40 (95% confidence interval (CI): 1.19-1.64) and 1.54 (CI: 1.30-1.83) higher hazard for mortality relative to older Americans in the not weak and strong control cohorts, respectively. CONCLUSION: Our findings may indicate a causal association between muscle weakness and mortality in older Americans. Healthcare providers should include measures of handgrip strength as part of routine health assessments and discuss the health risks of weakness with their patients.

Sleeping time is associated with functional limitations in a national sample of older Americans.

Engaging in healthy behaviors may help to preserve function during aging; however, it is not well understood how sleeping time is associated with functional capacity in older adults. We sought to determine the association of sleeping time on functional limitation in a national sample of older Americans. The analytical sample included 6020 adults aged at least 65years who participated in the 2007-2016 waves of the National Health and Nutrition Examination Survey. Respondents indicated their hours of sleep/weeknight and were categorized as < 5, 5-6.5, 7-8, 8.5-9, and > 9h of sleep/weeknight. Ability to complete 19 functional tasks including basic activities of daily living, instrumental activities of daily living, leisure and social activities, lower extremity mobility activities, and general physical activities were also self-reported. A covariate-adjusted logistic model analyzed the associations between each sleeping time category and functional limitation. Relative to those reporting 7-8h of sleep/weeknight, older Americans reporting < 5, 5-6.5, 8.5-9, and > 9h of sleep/weeknight had 1.66 [95% confidence interval (CI): 1.05, 2.62], 1.25 (CI: 1.02, 1.52), 1.59 (CI: 1.19, 2.12), and 2.99 (CI: 1.96, 4.56) greater odds for functional limitation, respectively. Sleep should be recognized as a health factor that may reflect functional capacity in older adults. Healthcare providers should discuss the importance of optimal sleep with their older patients and older adults should practice healthy sleeping behaviors for preserving function. Not meeting optimal sleep recommendations is associated with functional limitations in older Americans.

Weakness May Have a Causal Association With Early Mortality in Older Americans: A Matched Cohort Analysis

ObjectivesQuantifying the association between muscle weakness and mortality with carefully matched cohorts will help to better establish the impact of weakness on premature death. We used a matched cohort analysis in a national sample of older Americans to determine if those who were weak had a higher risk for mortality compared with control groups with incrementally higher strength capacities. DesignLongitudinal panel. SettingDetailed interviews that included physical measures were conducted in person, whereas core interviews were often performed over the telephone. ParticipantsData from 19,729 Americans aged at least 50 years from the 2006-2014 waves of the Health and Retirement Study were analyzed. MeasuresA handgrip dynamometer was used to assess handgrip strength (HGS) in each participant. Men with HGS <26 kg were considered weak, ≥26 kg were considered not weak, and ≥32 kg were considered strong. Women with HGS <16 kg were classified as weak, ≥16 kg were classified as not-weak, and ≥20 kg were classified as strong. The National Death Index and postmortem interviews determined the date of death. The greedy matching algorithm was used to match cohorts. ResultsOf the 1077 weak and not-weak matched pairs, 401 weak (37.2%) and 296 not-weak (27.4%) older Americans died over an average 4.4 ± 2.5-year follow-up. There were 392 weak (37.0%) and 243 strong (22.9%) persons who died over a mean 4.5 ± 2.5-year follow-up from the 1057 weak and strong matched pairs. Those in the weak cohort had a 1.40 [95% confidence interval (CI) 1.19, 1.64] and 1.54 (CI 1.30, 1.83) higher hazard for mortality relative to persons in the not-weak and strong control cohorts, respectively. Conclusions and ImplicationsOur findings may indicate a causal association between muscle weakness and mortality in older Americans. Health care providers should include measures of HGS as part of routine health assessments and discuss the health risks of muscle weakness with their patients.

Daily Protein Intake and Distribution of Daily Protein Consumed Decreases Odds for Functional Disability in Older Americans.

Objective: We sought to determine whether daily protein intake and protein distribution across eating occasions were associated with functional disability in a national sample of older Americans. Methods: Data from 8,070 adults aged ≥60 years from the 2007-2016 waves of the National Health and Nutrition Examination Survey were included. Protein intake and functional capacity was self-reported. A daily protein recommendation of ≥1.0 g/kg/day was utilized. The daily protein recommendation was then spread-out across four meals, whereby a ≥0.25 g/kg/meal threshold was used. Results: Those meeting the daily protein recommendation had 0.78 (95% confidence interval [CI] = [0.65, 0.93]) decreased odds for functional disability. Persons meeting the protein intake threshold per eating occasion for one, two, three, and four occasions had 0.60 (CI = [0.38, 0.95]), 0.48 (CI = [0.30, 0.77]), 0.47 (CI = [0.29, 0.77]), and 0.39 (CI = [0.20, 0.75]) decreased odds for functional disability, respectively. Discussion: Protein consumption seems to be important for preserving function in older Americans.

Trajectories of allostatic load among older Americans and Britons: longitudinal cohort studies

BackgroundDifference in life expectancy between males and females has been suggested to rest on sex difference in physiological dysregulation. But allostatic load, a physiological index, has not been carefully examined for an extended period beyond middle age. We aim to draw longitudinal trajectories of allostatic load in a national sample of older Americans and Britons; also to examine sex-based trajectories and factors behind their differences.MethodsWe studied men and women aged ≥50 years participating in the Health and Retirement Study Waves 8–11, 2006–2012 (N = 15,583 person-years) and the English Longitudinal Study of Ageing Waves 2, 4 and 6, 2004–2012 (N = 14,765 person-years). Because of the difference in provenance, we included different number of biomarkers to calculate allostatic load in HRS and ELSA. In HRS we used 8 biomarkers (systolic and diastolic blood pressure, haemoglobin A1c, high-density lipoprotein, total cholesterol, waist circumference, cystatin C, and C-reactive protein), while ELSA allostatic load was constructed from 10 biomarkers (systolic and diastolic blood pressure, haemoglobin A1c, high-density lipoprotein, total cholesterol, waist circumference, BMI, triglyceride, fibrinogen and C-reactive protein). A growth curve model was fitted to repeated observations of allostatic load, demographic characteristics, socioeconomic position, comorbidities and health behaviours (smoking, drinking, and physical exercise). To account for attrition, a joint model was applied.ResultsThe analysis showed that allostatic load increases linearly with age in the U.S. However, there are different levels for males and females. In England allostatic load follows such different paths that their trajectories cross in later life.ConclusionsSex-based trajectories of allostatic load showed distinct female advantage and are mostly consistent with female advantage in life expectancy.

Late mortality after acute hypoxic respiratory failure

BackgroundAcute hypoxic respiratory failure (AHRF) is associated with significant acute mortality. It is unclear whether later mortality is predominantly driven by pre-existing comorbid disease, the acute inciting event or is...

Serum Vitamin Status Profile and Cognitive Function in a National Sample of Older Americans

Serum Vitamin Status Profile and Cognitive Function in a National Sample of Older Americans

The Role of Neighborhood Safety in Recovery from Mobility Limitations: Findings from a National Sample of Older Americans (1996-2008).

Prior research has documented a link between perceived neighborhood safety and functional limitations including incident mobility limitation, yet no research has explored the association between perceived neighborhood safety and recovery from functional limitations. This study investigates whether perceived neighborhood safety independently predicts recovery. Using longitudinal data from the Health and Retirement Study (HRS) (1996-2008), discrete-time event history models with multiple competing events were estimated using multinomial logistic regression. Robust standard errors were used to adjust for clustering. In the unadjusted model, the odds ratio for recovery from mobility limitations was 1.22 (CI: 1.17, 1.27) for respondents reporting greater neighborhood safety, while, in the fully adjusted model, the odds ratio was 1.11 (CI: 1.05, 1.17). Even after controlling for sociodemographic characteristics and numerous health risk factors, perceived neighborhood safety was a robust predictor of mobility limitation recovery. This research provides further evidence that environmental factors shape functional health outcomes including recovery.

P3‐153: Serum folate, homocysteine and memory in a national sample of older Americans

P3‐153: Serum folate, homocysteine and memory in a national sample of older Americans

P3‐154: Vitamin status profile and cognitive function in a national sample of older Americans

P3‐154: Vitamin status profile and cognitive function in a national sample of older Americans

Social Network Type and Subjective Well-being in a National Sample of Older Americans

The study considers the social networks of older Americans, a population for whom there have been few studies of social network type. It also examines associations between network types and well-being indicators: loneliness, anxiety, and happiness. A subsample of persons aged 65 years and older from the first wave of the National Social Life, Health, and Aging Project was employed (N = 1,462). We applied K-means cluster analysis to derive social network types using 7 criterion variables. In the multivariate stage, the well-being outcomes were regressed on the network type construct and on background and health characteristics by means of logistic regression. Five social network types were derived: "diverse," "friend," "congregant," "family," and "restricted." Social network type was found to be associated with each of the well-being indicators after adjusting for demographic and health confounders. Respondents embedded in network types characterized by greater social capital tended to exhibit better well-being in terms of less loneliness, less anxiety, and greater happiness. Knowledge about differing network types should make gerontological practitioners more aware of the varying interpersonal milieus in which older people function. Adopting network type assessment as an integral part of intake procedures and tracing network shifts over time can serve as a basis for risk assessment as well as a means for determining the efficacy of interventions.

Trading Years for Perfect Health: Results From the Health and Retirement Study

To evaluate the preferences of an ethnically diverse national sample of older Americans regarding length of life versus health quality. A time trade-off task administered as part of the 2002 wave of the Health and Retirement Study. Respondents equated 6.86 (SD = 3.46) years of perfect health with 10 years of life in imperfect health. Women and those who ranked their health less favorably were more likely to give up years of life for perfect health. Relative to Whites, Blacks were more willing to live longer in imperfect health. Those of lower levels of education were more likely to prefer 10 years of life in imperfect health. There is wide variability in responses to the time trade-off task that is partially associated with self-rated health, gender, ethnicity, and education.

Attitudes toward and use of subsequent nursing home services among a national sample of older adults.

This study was designed to examine the relationship between attitudes toward nursing homes and subsequent nursing home utilization, and assess the impact of prior nursing home utilization on subsequent attitudes among a national sample of older Americans. Multivariate estimation procedures for complex survey designs were performed on the National Long-Term Care Survey data set. Although prior nursing home use did not directly affect subsequent attitudes toward nursing homes, having favorable attitudes about nursing homes increased the odds of using subsequent nursing home services by 1.5 and increased the total nursing home length of stay by 17%. Implications of this research for public policy and long-term care treatment planning are discussed.