Representative Sample Of Older Americans Research Articles

Dementia severity at incident diagnosis in a population representative sample of older Americans.

We provide the first analysis of distribution of dementia severity at incident diagnosis for a population representative sample of older Americans. Using data from the Aging, Demographics, and Memory Study (ADAMS), the Health Retirement Study (HRS), and traditional Medicare claims, we estimated the Clinical Dementia Rating Scale for ADAMS respondents and applied parameter estimates to predict dementia severity for HRS respondents with claims-based incident dementia diagnosis. Seventy percent of older adults received a dementia diagnosis of mild cognitive impairment or mild dementia (early stages). Fewer individuals were diagnosed at early stages in years 2000 to 2008 (65%) compared to years 2009 to 2016 (76%). About 72% of non-Hispanic white persons were diagnosed at early stages, compared to 63% non-Hispanic black and 59% Hispanic persons. More males than females were diagnosed at early stages (75%vs 67%). These data linkages allow population surveillance of early and equitable dementia detection in the older US population to assess clinical and policy levers to improve detection. For the US population 70 and older, 30% were diagnosed with dementia at a moderate or severe stage.Fewer were diagnosed at early stages in years 2000 to 2008 compared to 2009 to 2016 (65%vs 76%).A total of 72% of white persons were diagnosed at early stages, compared to 63% black and 59% Hispanic persons.More males than females were diagnosed at early stages (75%vs 67%).High wealth and education level were associated with diagnosis at early stages disease.

Associations of Handgrip Strength Weakness and Asymmetry with Lower Cognitive Function: Results from the National Health and Nutrition Examination Survey (2011-2014).

The joint associations of handgrip strength (HGS) weakness and asymmetry with cognitive decline remain understudied in older adults. To investigate the associations between HGS weakness, asymmetry, and lower cognitive function in a nationally representative sample of older Americans. This cross-sectional study utilized data from the National Health and Nutrition Examination Survey 2011-2014. Weakness was defined as HGS <26 kg for men and <16 kg for women. Asymmetry was determined by calculating the ratio of dominant to non-dominant HGS. Participants with an HGS ratio <0.90 or >1.10 were classified as having any HGS asymmetry. Those with an HGS ratio >1.10 exhibited dominant HGS asymmetry, while those with an HGS ratio <0.90 displayed nondominant HGS asymmetry, respectively. Lower cognitive functioning was defined as global cognitive composite scores more than 1 standard deviation below the mean. Covariate-adjusted logistic regression models were used to analyze the associations between HGS asymmetry/weakness and lower cognitive functioning. Compared to individuals with non-weak and symmetric HGS, those with any HGS asymmetry alone and weakness alone had 1.017 (95% confidence interval [CI]: 0.707-1.463) and 1.391 (95% CI: 0.542-3.571) greater odds for cognitive decline, while co-occurrence of both HGS asymmetry and weakness was associated with 3.724 (95% CI: 1.711-8.107) greater odds for lower cognitive function after controlling for confounders. Individuals exhibiting both diminished and asymmetrical HGS demonstrated an elevated susceptibility to cognitive impairment, thereby implying that the inclusion of HGS asymmetry assessment in conjunction with weakness evaluation may enhance the accuracy of prognosticating cognitive decline.

RACIAL/ETHNIC DIFFERENCES IN IMPACTS OF COVID-19 ON PSYCHOLOGICAL WELL-BEING AMONG OLDER ADULTS

Abstract Covid-19 caused challenges to psychological well-being among older adults, but the impact may differ across various populations. The purpose of this study is to investigate racial/ethnic differences in psychological well-being among older adults during the first year of the pandemic, particularly focusing on mediating effects of different types of social support. Data came from the 2021 Health and Retirement Study (HRS), which includes a nationally representative sample of older Americans. Our sample was restricted to the respondents aged 65+ who participated in the 2021 HRS Perspectives on the Pandemic that focuses on the first-year pandemic experiences (N=4,656). We compared four racial/ethnic groups including white, black, Hispanic, and others. Psychological well-being was measured by the 12 questions on participants’ feeling during the first year of the pandemic (e.g., distressed, afraid, worried). Three distinct groups of help-receiving patterns were identified by latent class analysis: 1) no help, 2) intense help from kids, and 3) moderate help from diverse social relationships. Frequencies of in-person and not-in-person contacts with children or family were also included in our analysis. We found that Hispanic’s psychological well-being was the most negatively impacted by the pandemic (Coef.=0.687, p&amp;lt;.05) even after controlling for socio-demographic characteristics, physical and mental health. Our mediation analysis demonstrated that intense help from kids and less in-person contacts negatively mediated the association between Hispanics and their psychological well-being. This study shows that older Hispanics who had been known for strong family ties and support are at risk due to restricted social contacts during the pandemic.

Association Between Area Temperature and Severe Vision Impairment in a Nationally Representative Sample of Older Americans

ABSTRACT Purpose Several small studies have associated exposure to elevated average temperature with specific vision problems. However, no large-scale studies have examined the relationship between vision impairment and average area temperature in the general population. We conducted a cross-sectional analysis of a large nationally representative sample of older adults to further explore this relationship. Methods Secondary analysis of the American Community Survey (ACS). The survey was conducted through mail, telephone and in-person interviews. Data from six consecutive years of the cross-sectional survey were analysed (2012–2017). The subsample analysed included community-dwelling and institutionalized older adults aged 65 and older in the coterminous US who lived in the same state in which they were born (n = 1,707,333). The question on severe vision impairment was “Is this person blind or does he/she have serious difficulty seeing even when wearing glasses?”. Average annual temperature data from the National Oceanic and Atmospheric Administration was combined into a 100-year average and mapped to corresponding US Census Bureau’s public use microdata areas from the ACS. Results Higher average temperature is consistently associated with increased odds of severe vision impairment across all cohorts (i.e. age, sex, race, income, and educational attainment cohorts) with the exception of Hispanic older adults. Compared to those who lived in counties with average temperature of < 50 °F (< 10 °C) , the odds of severe vision impairment were 44% higher in counties with average temperature of 60 °F (15.5 °C) or above (OR 1.44; 95% CI 1.42–1.46). Conclusion If the association is found to be causal, the predicted rise in global temperatures could impact the number of older Americans affected by severe vision impairment and the associated health and economic burden.

Epigenetic-based age acceleration in a representative sample of older Americans: Associations with aging-related morbidity and mortality

Biomarkers developed from DNA methylation (DNAm) data are of growing interest as predictors of health outcomes and mortality in older populations. However, it is unknown how epigenetic aging fits within the context of known socioeconomic and behavioral associations with aging-related health outcomes in a large, population-based, and diverse sample. This study uses data from a representative, panel study of US older adults to examine the relationship between DNAm-based age acceleration measures in the prediction of cross-sectional and longitudinal health outcomes and mortality. We examine whether recent improvements to these scores, using principal component (PC)-based measures designed to remove some of the technical noise and unreliability in measurement, improve the predictive capability of these measures. We also examine how well DNAm-based measures perform against well-known predictors of health outcomes such as demographics, SES, and health behaviors. In our sample, age acceleration calculated using "second and third generation clocks," PhenoAge, GrimAge, and DunedinPACE, is consistently a significant predictor of health outcomes including cross-sectional cognitive dysfunction, functional limitations and chronic conditions assessed 2 y after DNAm measurement, and 4-y mortality. PC-based epigenetic age acceleration measures do not significantly change the relationship of DNAm-based age acceleration measures to health outcomes or mortality compared to earlier versions of these measures. While the usefulness of DNAm-based age acceleration as a predictor of later life health outcomes is quite clear, other factors such as demographics, SES, mental health, and health behaviors remain equally, if not more robust, predictors of later life outcomes.

Consistent and robust predictors of Internet Use among older adults over time identified by machine learning

Older adults tend to under-utilize digital technology and online services that can yield substantial benefits to their health and wellbeing. Addressing this problem requires determining robust and consistent predictors of older adults’ Internet use over time. Informed by current models of technology use in aging, the present study took a data-driven approach to determine the predictors of Internet use among older adults. Machine learning was applied to a large, nationally representative sample of older Americans with data for hundreds of variables – both before and after the advent of smartphones and tablets. Machine learning models achieved classification accuracy slightly higher than a theory-driven benchmark model, with results largely supporting current models of aging and technology use. Specifically, data from 2002 and 2016 indicated that age, socioeconomics, and cognitive functions that decline with age (immediate memory, delayed memory, and visuospatial skills) were the most robust and consistent predictors of Internet use among older adults. Machine learning also discovered additional factors that should be considered in models of technology use in aging, such as alcohol use. Taken with prior literature, these results suggest that automaticity should be a high design priority to reduce the age-related cognitive challenges that impact technology use.

Childhood experience of parental affection and financial well‐being in later life: Evidence from the Health and Retirement Study

AbstractChildhood experience of parental affection has been shown to be influential in numerous domains of a child's life. Using a nationally representative sample of older Americans, this study examined the association between childhood experience of parental affection and financial well‐being four to five decades later. Consistent with the literature, childhood experience of parental affection was found to be positively related to both objective and subjective financial well‐being, as evidenced by greater total assets and lower total debt, debt‐to‐assets ratio, propensity to experience difficulty paying bills, and financial satisfaction. The results were robust to controlling for early life characteristics of parents and family, as well as addressing potential recall bias in retrospective reports. Our findings suggest that parental affection in childhood exerts a long‐lasting influence on financial well‐being, which persists into later life. Early intervention for those who lack parental affection may complement financial education programs and yield significant lifetime benefits.

Cognition and Diabetes: Examining Sex Differences Using a Longitudinal Sample of Older Adults.

Objectives: This study aims to investigate sex-based differences in the diabetes status and cognition relationship using a representative sample of older Americans. Methods: Using a sample of 19,190 females and 15,580 males from the Health and Retirement Study, we conduct mixed-effects linear regression analyses to examine sex differences in the association between diabetes and cognition over a 20-year follow-up period among older adults in the United States. Main Findings: Females experience slightly steeper declines in cognition that are further exacerbated by diabetes. At age 65, females without diabetes have significantly higher cognition than males; this gap is eliminated by age 85. Among diabetics, there is no initial sex disparity, but females' cognition becomes significantly lower than males' over the following 20years. Principal Conclusions: Relative to males, females are particularly susceptible to diabetes-related declines in cognition with increasing age.

Toxic Psychosocial Stress, Resiliency Resources and Time to Dementia Diagnosis in a Nationally Representative Sample of Older Americans in the Health and Retirement Study from 2006-2016.

Background: Toxic stress (TS), resiliency-promoting factors (RPFs) and their interactions were investigated in relationship to incident dementia in a nationally representative sample (n = 6516) of American adults ≥50 years enrolled in the Health and Retirement Study between 2006 and 2016. Methods: TS included experiences of everyday discrimination and RPF included personal mastery. Race/ethnicity was self-reported as African American, Caucasian, or Other. Multivariable Cox proportional hazards regression models estimated TS-, RPF- and race-associated hazard ratios (HR) for dementia diagnosis and 95% confidence intervals (CIs) with adjustment for comorbidity, lifestyle, and socio-demographic confounders. Results: Discrimination-associated risk of dementia diagnosis on average increased with education level [discrimination x education, p = 0.032; HR = 1.75 (95% CI: 1.01–3.03) if < high school, HR = 5.67 (95% CI: 2.94–10.94) if high school completed and HR = 2.48 (95% CI: 1.53–4.00) if ≥some college education]. Likewise, African American vs. Caucasian race disparity in new-onset dementia was evident (HR = 2.12, 95% CI: 1.42–3.17) among adults with high-mastery while absent (HR = 1.35, 95% CI: 0.75–2.41) among adults with low mastery (Mastery x Race, p = 0.01). Conclusions: TS is a contextual driver of incident dementia that seemingly operates in a race and RPF-dependent fashion among American adults. Association pattern suggests that TS may overwhelm the cognitive reserve benefit of RPF particularly in status-inconsistent contexts including persons subjected to discrimination despite high education and persons of African American descent despite high mastery. Policies that reduce discrimination and promote equitable treatment by race/ethnicity may support cognitive resiliency and reduce the risk of dementia diagnosis in adult Americans.

Delayed Care Related to COVID-19 in a Nationally Representative Sample of Older Americans.

Delayed Care Related to COVID-19 in a Nationally Representative Sample of Older Americans.

Animal Naming Test Is Associated With Poor Patient-Reported Outcomes and Frailty in People With and Without Cirrhosis: A Prospective Cohort Study.

INTRODUCTION:Cognitive dysfunction is a major driver of care complexity, poor patient-reported outcomes, and frailty for people with cirrhosis. The performance and clinical associations of the animal naming test (ANT) in the general population are unknown. We evaluated ANT performance in a representative sample of older Americans with and without chronic liver disease (CLD).METHODS:We analyzed 6,661 subjects enrolled in the 2010–2016 Health and Retirement Survey, a representative cohort of >30,000 US adults. Average age of participants was 75 years. We evaluated 3 subject subgroups: (i) without CLD, (ii) noncirrhosis CLD, and (iii) cirrhosis. We determined the association between the ANT (overall) and S-ANT1 <10 (adjusted for age and education) and health status, basic and instrumental activities of daily living, healthcare utilization (care hours received and hospitalizations), and frailty measures (hand grip and walk speed).RESULTS:Overall, 8.2% of the sample had noncirrhotic CLD and 1.3% had cirrhosis. CLD or cirrhosis was not independently associated with ANT. Poor ANT performance was associated with poor health status and frailty overall. An S-ANT <10 was associated with fair-poor self-reported health (odds ratio [OR] 1.37; 95% confidence interval [CI]: 1.20–1.56), care hours received (incidence rate ratio [IRR] 2.39; 95% CI: 1.79–3.19), and hospitalizations (IRR 1.14; 95% CI: 1.03–1.26). S-ANT <10 was also associated with activities of daily living disability (OR 1.31; 95% CI: 1.13–1.51), instrumental activities of daily living disability (OR 1.85; 95% CI: 1.59–2.14), weaker hand grip (IRR 0.94; 95% CI: 0.92–0.96), and time to walk 2.5 m (IRR 1.23; 95% CI: 1.17–1.29).DISCUSSION:ANT performance is not specific to CLD/cirrhosis but is associated with patient-reported outcomes and frailty in a nationally representative sample of elderly subjects with and without CLD.

Temporal trends (2008–2017) in serious hearing loss: Findings from a nationally representative sample of older Americans

BackgroundHearing loss is a source of great public health concern. Previous research showed a decline in the prevalence of hearing loss among older adults. However, it is unclear whether this trend persists in recent years. MethodsThe purpose of this study was to investigate the temporal trend in prevalence of hearing loss among older Americans (age 65+) between 2008 and 2017. To this end, we conducted a secondary analysis of 10 cross-sectional surveys: the 2008–2017 annual American community surveys (ACS). The ACS were conducted by the US Census through mail, internet, phone, and in-person meetings. ACS includes Americans aged 65+ living in the community and in group quarters such as nursing homes (n = 5,359,651). Annual response rates were above 89%. Whether the participant has hearing problems is assessed based on response to the ACS question “Is this person deaf or does he/she have serious difficulty hearing?”. ResultsDuring the decade 2008–2017, the prevalence of serious hearing loss in the older American population (65+) decreased from 16.3 to 14.8% (p < 0.001), indicating an 11% decline after adjustments for sex and race. When age was taken into account, this was attenuated to a 4% decline. Substantial sex differences were observed: Among females aged 65+, the age-race adjusted odds of serious hearing loss declined 10% over the decade, while males experienced a 2% increase. ConclusionsOlder females had a substantial decrease in the prevalence of self-reported serious hearing loss between 2008 and 2017. Future research is needed to understand the cause of this trend.

Investigating Racial/Ethnic Disparities in the Association Between AHEI-2010 and Change in Cystatin C in a Representative Sample of Older Americans

ObjectivesCystatin C (Cys C) is a promising biomarker for early-stage chronic kidney disease. Dietary intake plays an essential role in the prevention of kidney function decline, which has yet to be examined in relation to changes in Cys C among older adults. Our objective was to test whether scores on the Alternative Healthy Eating Index-2010 (AHEI-2010) were associated with change in Cys C from 2012–2016 and if this varied by race/ethnicity. MethodsObservations were drawn from the Health and Retirement Study. Blood spot collection and examination occurred in 2012 and 2016, participant attributes were measured in 2012, and dietary assessment was conducted by a validated dietary frequency questionnaire in 2013. The sample was restricted to respondents aged ≥65 years who were White (n = 789), Black (n = 108), or Hispanic (n = 61) and had biomarkers measured in 2012 and 2016 (n = 958). Serum Cys C (mg/L) was constructed to be equivalent to the 1999–2002 NHANES scale. Dietary quality was measured using AHEI-2010. Autoregressive linear modeling adjusting for covariates and sampling design was used to examine the associations of interest. ResultsMean serum Cys C was 1.20 ± 0.44 mg/L (SD) in 2012 and 1.25 ± 0.45 mg/L in 2016, and mean AHEI-2010 score was 58.11 ± 11.0. Greater AHEI-2010 was associated with lower serum Cys C level at baseline (b = –.004, SE = .013, P = .002) and less rapid increase in the Cys C level from 2012–2016 (b = –.003, SE = .012, P = .024). The association between AHEI-2010 and change in serum Cys C was significantly different for Whites and Hispanics (b = .128, SE = .031, P < .001), but null when comparing Whites and Blacks. AHEI-2010 was negatively associated with change in Cys C for Whites, and positively associated with change in Cys C among Hispanics. Stratified analyses suggested that AHEI-2010 was not significantly different for Whites and Hispanics. Hispanics had significantly lower household income, assets, and educational attainment than Whites, and greater levels of food insecurity. ConclusionsOur results indicate that dietary quality has a divergent association with change in serum Cys C for White and Hispanic older adults. These results suggest the need for examination of how disparities in socioeconomic status may influence the effect of dietary intake on kidney function for older adults from different racial/ethnic backgrounds. Funding SourcesNo funding.

Self-Reported Dementia-Related Diagnosis Underestimates the Prevalence of Older Americans Living with Possible Dementia.

Dementia screening is an important step for appropriate dementia-related referrals to diagnosis and treat possible dementia. We sought to estimate the prevalence of no reported dementia-related diagnosis in a nationally representative sample of older Americans with a cognitive impairment consistent with dementia (CICD). The weighted analytical sample included 6,036,224 Americans aged at least 65 years old that were identified as having a CICD without history of stroke, cancers, neurological conditions, or brain damage who participated in at least one-wave of the 2010-2016 Health and Retirement Study. The adapted Telephone Interview of Cognitive Status assessed cognitive functioning. Those with scores≤6 were considered as having a CICD. Healthcare provider dementia-related diagnosis was self-reported. Age, sex, educational achievement, and race and ethnicity were also self-reported. The overall estimated prevalence of no reported dementia-related diagnosis for older Americans with a CICD was 91.4%(95%confidence interval (CI): 87.7%-94.1%). Persons with a CICD who identified as non-Hispanic black had a high prevalence of no reported dementia-related diagnosis (93.3%; CI: 89.8%-95.6%). The estimated prevalence of no reported dementia-related diagnosis was greater in males with a CICD (99.7%; CI: 99.6%-99.8%) than females (90.2%; CI: 85.6%-93.4%). Moreover, the estimated prevalence of no reported dementia-related diagnosis for non-high school graduates with a CICD was 93.5%(CI: 89.3%-96.1%), but 90.9%(CI: 84.7%-94.7%) for those with at least a high school education. Dementia screening should be encouraged during routine geriatric health assessments. Continued research that evaluates the utility of self-reported dementia-related measures is also warranted.

Dietary Quality Predicts Short-Term Change in Mobility Limitations in Older U.S. Adults

Using a representative sample of older Americans, this project examines the association between dietary quality and short-term change in mobility limitations and whether this association differs for the food insecure or those receiving nutritional assistance. The sample was drawn from the 2012 Health and Retirement Study and 2013 Health Care and Nutrition Study and included 3,779 respondents representing a population of 37,217,566 adults aged 65 and older. Mobility limitations were operationalized as a log-transformed count of 11 indicators of limitation in physical mobility. Dietary quality was measured using the Alternative Healthy Eating Index-2010 (AHEI-2010) based on responses to a food frequency questionnaire. Food insecurity was a binary measure based on the USDA six-item short form. Nutritional assistance included receipt of supplemental food from sources such as food banks and/or reporting receipt of SNAP benefits (1=yes, 0=no). Autoregressive multiple regression was used to test whether AHEI-2010 predicted change in mobility limitations from 2012-2014 and whether food insecurity or receipt of supplemental food moderated this relationship. Around 10.7% of older adults were food insecure, and around 17.5% reported receipt of nutritional assistance. AHEI-2010 was associated with a slower decline in mobility limitations over the 2-year observational window (b=-0.014, SE=.003, p<.001), but food insecurity nor nutritional assistance were associated with changing mobility limitation, either directly or as moderators of the association between progressing limitations and AHEI-2010. These preliminary findings suggest dietary quality may be associated with disablement among older adults regardless of food environment.

Elevated Risk of Cognitive Impairment Among Older Sexual Minorities: Do Health Conditions, Health Behaviors, and Social Connections Matter?

Little research has examined cognitive health disparities between sexual minority and heterosexual populations. Further, most extant studies rely on subjective measures of cognitive functioning and non-probability samples. This study uses a performance-based cognitive screening tool and a nationally representative sample of older Americans to examine the disparity in cognitive impairment by sexual orientation and the potential mechanisms producing this disparity. Using data from the 2015-2016 National Social Life, Health, and Aging Project (N = 3,567), we analyzed respondents' scores on the survey-adapted Montreal Cognitive Assessment. We estimated ordinal logit regressions to examine the relationship between sexual orientation and cognitive impairment and used the Karlson-Holm-Breen method to assess how mental and physical conditions, health behaviors, and social connections mediate this relationship. The prevalence of cognitive impairment is significantly higher among sexual minority older adults than among heterosexual older adults when sociodemographic factors are adjusted for. Depressive symptoms explain some of this prevalence gap. Although anxiety symptoms, physical comorbidity, health behaviors, and social connections may contribute to cognitive impairment, they do not explain the cognitive disparity by sexual orientation. The findings indicate that depressive symptoms are an important link between minority sexual orientation and cognitive impairment and highlight the importance of studying other potential mechanisms that we could not explore in this study. Future research should further investigate how minority stress processes may unfold to accelerate cognitive decline among sexual minorities over the life course.

Investigating walnut consumption and cognitive trajectories in a representative sample of older US adults.

Existing research suggests walnut intake may be associated with better cognitive function in older adults, yet few studies utilise longitudinal data from observational studies of ageing populations. Our objective was to estimate the association between whole walnut intake and cognitive change in a representative sample of older Americans. Secondary analysis of the Health and Retirement Study and Health Care and Nutrition Study. Walnut consumption was defined as a categorical measure (none, low intake (0·01-0·08 1 oz. servings per day) and moderate intake (>0·08 1 oz. servings per day)) and cognitive function was measured using the Telephone Interview for Cognitive Status. Latent growth modelling estimated the association between walnut consumption and trajectories of cognitive status over a 4-year observational period. Sensitivity analyses assessing non-random dropout and Monte Carlo power analyses were conducted to contextualise results. The USA. A sample of 3632 US adults aged 65 years and older. Those reporting any walnut consumption had greater cognitive scores at baseline than those not consuming walnuts (low walnut consumption, b = 1·53, se = 0·21, P < 0·001; moderate walnut consumption, b = 2·22, se = 0·27, P < 0·001), but walnut consumption was not associated with cognitive change. Walnut consumption was positively associated with socioeconomic status and health behaviours as well as intake of nutrients identified to have neuroprotective benefits. We identified an association between walnut consumption and cognitive function in older adults, although we did not find that walnut consumption was protective against age-related cognitive decline.

Handgrip Strength Asymmetry and Weakness are Differentially Associated with Functional Limitations in Older Americans.

Background: Handgrip strength (HGS) is a convent measure of strength capacity and associated with several age-related health conditions such as functional disability. Asymmetric strength between limbs has been linked to diminished function. Therefore, both HGS asymmetry and weakness could be associated with functional disability. We examined the associations of HGS asymmetry and weakness on functional limitations in a nationally representative sample of older Americans. Methods: Data were analyzed from 2689 adults ≥ 60 years who participated in the 2011–2012 and 2013–2014 waves of the National Health and Nutrition Examination Survey. Weakness was defined as HGS < 26 kg for men and < 16 kg for women. Asymmetry was determined from the ratio of the dominant and non-dominant HGS. Those with HGS ratio 0.9–1.1 were considered as having HGS symmetry, and those outside this range had asymmetry. Results: Compared to those with symmetric HGS and were not weak, those with weakness alone, and both weakness and HGS asymmetry had 2.47 (95% confidence interval [CI]: 1.14–5.35) and 3.93 (CI: 1.18–13.07) greater odds for functional limitations, respectively. However, HGS asymmetry alone was not associated with functional limitations (odds ratio: 0.80; CI: 0.62–1.03). Conclusion: The use of HGS asymmetry in protocols could improve the prognostic value of handgrip dynamometers.

Loneliness is Associated with the Symptom Cluster of Pain, Fatigue, and Depression in Older Americans (S724)

•Examine the prevalence of the symptom cluster of pain, fatigue, and depression in a large representative sample of American adults 50 years of age and older from 2006 to 2014.•Describe the relationship between loneliness and the symptom cluster of pain, fatigue, and depression in a large representative sample of American adults 50 years of age and older. The prevalence of chronic pain is increasing over time. Loneliness is an internal experience of isolation and lack of connection. Prior research has linked loneliness with multiple negative health outcomes, including mood disorders and overall mortality. The relationship between loneliness and chronic pain has not been investigated in a representative sample of older adults. To determine the prevalence of the symptom cluster of pain, fatigue, and depression in a large representative sample of older Americans and to explore the relationship between loneliness and the symptom cluster. We conducted a cross-sectional study of adults ≥50 years old using nationally representative data from 2006–2014 obtained from the Health and Retirement Study (HRS). We analyzed the prevalence of pain, fatigue, depression as well the symptom cluster from 2006–2014. We then used adjusted logistic regression models to evaluate the relationship between loneliness and the symptom cluster. From 2006 to 2014, the prevalence of frequent moderate to severe pain causing interference with daily activities increased from 17.9% to 19.4%; fatigue increased from 17.8% to 21.4%; depressive symptoms decreased from 15.0% to 13.4%. From 2008 to 2012, symptom cluster prevalence increased slightly from 4.4% to 4.7%. Loneliness predicted the presence of pain (OR 1.88 – 2.61, 95% CI 1.61– 2.46), fatigue (OR 2.51 – 3.04, 95%CI 1.79 – 3.53), depression (OR 4.69 – 6.01, 95%CI 4.37 - 7.30), and the symptom cluster (OR 5.62 – 6.54, 95%CI 3.08 – 10.25). Recently, more older Americans report pain and fatigue while slightly fewer report depressive symptoms. The symptom cluster, a proxy for chronic pain, increased slightly. Lonely individuals were much more likely to report the symptom cluster.

LIVING ALONE, HAVING CHILDREN AND FRIENDS NEARBY, AND DAILY FRUIT AND VEGETABLE CONSUMPTION

Fruit and vegetable consumption is associated with lower risk of chronic diseases and mortality. Despite the numerous health benefits, fruit and vegetable consumption of most older adults are below the daily recommendation. This paper aimed to investigate whether living alone and having children and friends nearby are associated with older adults’ daily fruit and vegetable consumption using a nationally representative sample of older Americans. Daily fruit and vegetable consumption was measured using (1) daily serving and (2) daily recommendation (2 or more servings for fruits; 3 or more servings for vegetables). Poisson and logistic regression models were estimated using the HRS Health Care and Nutrition Study. The sample included 6,915 community-dwelling older adults. Older adults who were living alone had lower fruit and vegetable consumption and less likely to meet daily recommendation for vegetables, compared to those who were living with someone. Having friends nearby was positively associated with the outcomes, while having children nearby was associated with meeting daily recommendation for vegetables only among older adults living alone. Based on the findings, older adults who are living alone and do not have children and friends nearby may be at the risk of poor nutrition due to low levels of social support. Provision of help with grocery shopping (e.g., transportation, Supplemental Nutrition Assistance Program) and meal preparation (e.g., home-delivered meals) as well as more social opportunities that can improve social support network and encourage healthy eating (e.g., congregate meals) may increase daily fruit and vegetable consumption of older adults.