@article {11966, title = {Cognitive Function Among Noncustodial Grandparents in China and the United States: A Cross-National Perspective.}, journal = {The International Journal of Aging and Human Development}, volume = {95}, year = {2022}, pages = {18-41}, abstract = {

The current study aimed to investigate the association between grandparenting and cognitive function over time in noncustodial grandparents in China and the United States. Lagged dependent variable (LDV) approach and linear regression models were applied to analyze a sample of 1,411 Chinese and 6,579 American adults aged 65 and above from the China Health and Retirement Longitudinal Study (CHARLS, 2011-2013) and the U.S. Health and Retirement Study (HRS, 2012-2014). Grandparenting involvement was associated with less decline in episodic memory for grandparents and greater level of grandparenting had no negative effect on mental status and global cognitive function in noncustodial grandparents in China and the United States. The impact of grandparenting on cognitive function was conditioned on caregiving intensity, gender, urban/rural residence, and nation. Findings of the study suggest that greater attention on grandparenting facilitation might yield improved research, social support, policy, and interventions on cognitive health for the general older population.

}, keywords = {CHARLS, cognitive function, cross-national studies, grandparenthood, intergenerational relationship}, issn = {1541-3535}, doi = {10.1177/00914150211050877}, author = {Pan, Xi and Luo, Ye and Nicholas J Bishop} } @article {12036, title = {Marital Transitions, Change in Depressive Symptomology, and Quality of Social Relationships in Midlife and Older U.S. Adults: An Analysis of the Health and Retirement Study.}, journal = {The International Journal of Aging and Human Development}, volume = {95}, year = {2022}, pages = {349-371}, abstract = {

Preventing negative health outcomes following marital transitions can promote personal recovery and well-being. We used the Health and Retirement Study (HRS) (2012, 2014) to test whether social relationship quality moderated the association between marital transition and change in depressive symptomology among U.S. adults aged 50 and older (n = 3,705). Marital status transitions between 2012 and 2014 included remained married/partnered, divorced/separated, and widowed. Depressive symptomology was measured using the Center for Epidemiological Studies Depression Scale 8 Short Form (CES-D 8). Social support, social contact, and social strain were indicators of social relationship quality. Change in depressive symptomology was modeled using autoregressive multiple regression. Social relationship quality appeared to influence depressive symptomatology for those experiencing divorce/separation. Compared to individuals who remained married/partnered, depressive symptomatology in those experiencing separation/divorce decreased among those reporting low social support, increased among those reporting high social support, and increased among those who reported low social strain. Limitations and clinical implications are discussed.

}, keywords = {depression, Divorce, marital transitions, Mental Health, Social Support, Widowhood}, issn = {1541-3535}, doi = {10.1177/00914150211066551}, author = {Julia E Tucker and Nicholas J Bishop and Wang, Kaipeng and Phillips, Farya} } @article {12065, title = {Birth Cohort Differences in Multimorbidity Burden Among Aging U.S. Adults }, journal = {Innovation in Aging}, volume = {5}, year = {2021}, pages = {257}, abstract = {Multimorbidity is the co-occurrence of two or more chronic health conditions and affects more than half of the US population aged 65 and older. Recent trends suggest increased risk of poor self-reported health, physical disability, cognitive impairment, and mortality among later born birth cohorts, yet we are unaware of work examining cohort trends in multimorbidity among aging US adults. Observations were drawn from the Health and Retirement Study (2000{\textendash}2018) and included adults aged 51 and older across 7 birth cohorts (1923 and earlier, 1924{\textendash}1930, 1931{\textendash}1941, 1942{\textendash}1947, 1948{\textendash}1953, 1954{\textendash}1959, and 1960{\textendash}1965). Multimorbidity was measured as a count of 9 chronic conditions including heart disease, hypertension, stroke, diabetes, arthritis, lung disease, cancer (excluding skin cancer), depression, and cognitive impairment. General linear models adjusting for repeated measures and covariates including age, sex, race/ethnicity, and education were used to identify whether trends in multimorbidity varied across birth cohort. 31,923 adults contributed 153,940 total observations, grand mean age was 68.0 (SD=10.09), and mean multimorbidity was 2.19 (SD=1.49). In analyses adjusted for age and other covariates, adults born 1948{\textendash}1953 reported .34 more chronic conditions (SE=.03, p<.001), adults born 1954{\textendash}1959 reported .42 more chronic conditions (SE=.03, p<.001), and adults born 1960{\textendash}1965 reported .55 more chronic conditions (SE=.03, p<.001), than those born 1931{\textendash}1941, respectively. Our preliminary results confirm increasing multimorbidity among later birth cohorts of older Americans and should help guide policy to manage impending health declines among older Americans.}, keywords = {birth cohort, multimorbidity}, doi = {https://doi.org/10.1093/geroni/igab046.987}, author = {Nicholas J Bishop and Steven A Haas and Ana R Qui{\~n}ones} } @article {11770, title = {Dietary quality modifies the association between multimorbidity and change in mobility limitations among older Americans.}, journal = {Preventive Medicine}, volume = {153}, year = {2021}, pages = {106721}, abstract = {

To identify potentially modifiable risk-factors in the age-related disablement process, we examined the association between change in mobility limitations and multimorbidity and how dietary quality moderates this association. Information from 3320 adults aged 65 and older in 2012 was drawn from the Health and Retirement Study and the Health Care and Nutrition Study. Mobility limitations reported in 2012 and change in mobility limitations from 2012 to 2014 were regressed on multimorbidity measured as number of chronic conditions in 2012, dietary quality measured in 2013 using the Alternative Healthy Eating Index-2010 (AHEI-2010), and their interaction term using Poisson regression. Respondents reported an average of 2.9 (SD, 2.9) mobility limitations in 2012 and 3.1 (SD, 3.0) mobility limitations in 2014, an average of 2.64 (SD, 1.4) chronic conditions in 2012, and mean AHEI-2010 score in 2013 of 57.1 (SD, 10.9). Greater AHEI-2010 scores were associated with fewer mobility limitations at baseline (p~<~.001) and slower progression of mobility limitations over the two-year observational window (p~<~.001). For those with AHEI-2010 scores >=48.4, dietary quality appeared to moderate the association between multimorbidity and change in mobility limitations. These results suggest that improving dietary quality may be an effective means of reducing the progression of mobility limitations among older adults and that dietary quality may modify the effect of multimorbidity on progressive disablement. Our work adds to research supporting dietary quality as a potentially intervenable factor in the reduction of disablement in aging populations.

}, keywords = {diet quality, Health care and nutrition study, Mobility limitations, multimorbidity}, issn = {1096-0260}, doi = {10.1016/j.ypmed.2021.106721}, author = {Nicholas J Bishop and Sarah Ullevig and Wang, Kaipeng and Krystle E Zuniga} } @article {11738, title = {Investigating Racial/Ethnic Disparities in the Association Between AHEI-2010 and Change in Cystatin C in a Representative Sample of Older Americans}, journal = {Current Developments in Nutrition}, volume = {5}, year = {2021}, pages = {1015}, abstract = {Cystatin 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{\textendash}2016 and if this varied by race/ethnicity.Observations 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{\textendash}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.Mean serum Cys C was 1.20 {\textpm} 0.44 mg/L (SD) in 2012 and 1.25 {\textpm} 0.45 mg/L in 2016, and mean AHEI-2010 score was 58.11 {\textpm} 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{\textendash}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.Our 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.No funding.}, keywords = {Cystatin C, Racial Disparities, renal function}, isbn = {2475-2991}, doi = {10.1093/cdn/nzab053_008}, author = {Nicholas J Bishop and Zhu, Jie} } @article {bishop_zuniga_2020, title = {Investigating walnut consumption and cognitive trajectories in a representative sample of older US adults}, journal = {Public Health Nutrition}, volume = {24}, year = {2021}, pages = {1741-1752}, abstract = {Objective: 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. Design: 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{\textperiodcentered}01{\textendash}0{\textperiodcentered}08 1 oz. servings per day) and moderate intake (>0{\textperiodcentered}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. Setting: The USA. Participants: A sample of 3632 US adults aged 65 years and older. Results: Those reporting any walnut consumption had greater cognitive scores at baseline than those not consuming walnuts (low walnut consumption, b = 1{\textperiodcentered}53, se = 0{\textperiodcentered}21, P < 0{\textperiodcentered}001; moderate walnut consumption, b = 2{\textperiodcentered}22, se = 0{\textperiodcentered}27, P < 0{\textperiodcentered}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. Conclusions: 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.}, keywords = {Cognitive decline, Walnuts}, doi = {10.1017/S1368980020001287}, author = {Nicholas J Bishop and Krystle E Zuniga} } @article {zuniga_bishop_turner_2020, title = {Dietary lutein and zeaxanthin are associated with working memory in an older population}, journal = {Public Health Nutrition}, year = {2020}, abstract = {Objective: The purpose of the study was to examine the association between dietary lutein and zeaxanthin (L + Z) intake and immediate word recall (IWR) and delayed word recall (DWR), and to identify the major contributors to dietary L + Z intake in a recent and representative sample of the older US population. Design: In this cross-sectional analysis, multivariate path analytic models estimated the association between L + Z consumption and cognitive performance while adjusting for covariates. Setting: Observations were drawn from the 2014 Health and Retirement Study, a nationally representative panel study of older US adults, and the 2013 Health Care and Nutrition Study, which assessed dietary intake via FFQ in a subsample of respondents. Participants: The analytic sample included 6390 respondents aged >=50 years. Results: L + Z intake was 2{\textperiodcentered}44 {\textpm} 2{\textperiodcentered}32 mg/d on average, and L + Z intake differed significantly across quartiles (P < 0{\textperiodcentered}001). For example, average L + Z intake in Q1 was 0{\textperiodcentered}74 {\textpm} 0{\textperiodcentered}23 mg/d and in Q4 was 5{\textperiodcentered}46 {\textpm} 2{\textperiodcentered}88 mg/d. In covariate adjusted models, older adults in the highest quartiles of L + Z intake had significantly greater IWR and DWR scores than those in the lowest quartile. Leafy vegetables, cruciferous vegetables, dark yellow vegetables, fish and seafood, legumes, eggs and fruit were significant and meaningful predictors of dietary L + Z intake. Conclusion: A high consumption of vegetables, fish and seafood, legumes, eggs and fruit is associated with a higher intake of L + Z and greater word recall among older adults.}, keywords = {Carotenoid, Cognition, Episodic Memory, Lutein, Memory, Older adult, Zeaxanthin}, doi = {10.1017/S1368980019005020}, author = {Krystle E Zuniga and Nicholas J Bishop and Turner, Alexandria S} } @article {10805, title = {Estimating Sample Size Required to Establish an Association Between Walnut Intake and Cognitive Change in Older Adults: An Application of Monte Carlo Power Analysis}, journal = {Current Developments in Nutrition}, volume = {4}, year = {2020}, pages = {10}, abstract = {Objectives Observational studies support a cross-sectional association between walnut intake and cognitive function among older adults, but few of these studies identify walnut intake as a predictor of cognitive change. This project estimates the sample size required to establish a statistically significant association between walnut intake and cognitive change in an observational study using Monte Carlo power analysis. Methods Initial observations were drawn from the 2012, 2014, and 2016 Health and Retirement Study (HRS) and the 2013 Health Care and Nutrition Study (HCNS; age >= 65, n = 3632). Global cognitive function was measured using the Telephone Interview for Cognitive Status and two operationalizations of walnut intake were investigated (none, low intake (.01 {\textendash} .08 servings/day), and moderate intake (> .08 servings/day); no intake vs. any intake). Latent growth models adjusting for covariates and complex sample design were used to estimate age-based developmental trajectories of TICS scores as a function of walnut intake. Parameter estimates from these models were used as starting values in Monte Carlo simulation models replicated for sample sizes from 1000{\textendash}50,000. Results Model estimation required around 1200 hours of processing time. When measured as a trichotomous variable, the observed association between walnut intake and cognitive change was weak (for moderate intake, b = -0.030, SE = .03) and would require at least 42,000 observations to reduce the standard error to a level where 80\% or more of random samples would identify the effect as statistically significant (P < .05). When measured as a dichotomous variable, the observed effect was small (b = -0.013, SE = 0.025) and required a sample size of at least 39,000 observations to identify power above .80. Conclusions Given that the HRS and HCNS are nationally-representative studies, the population size from which an adequate sample would need to be drawn to identify walnut intake as a significant predictor of cognitive decline would exceed the number of adults age 65 and older currently living in the US. Rather than increase sample size of observational studies, researchers should apply quasi-experimental methods and detailed measurement of walnut intake to establish an association between walnut intake and cognitive change.}, keywords = {cognitive impairment, Mental Processes, Monte Carlo Method, tic disorder}, issn = {2475-2991}, doi = {10.1093/cdn/nzaa040_010}, author = {Nicholas J Bishop} } @article {10807, title = {Food Insecurity and Dietary Quality in Older Adults: Do Nutrition Assistance Programs Play a Protective Role?}, journal = {Current Developments in Nutrition}, volume = {4}, year = {2020}, pages = {1379}, abstract = {Objectives The emergence of food insecurity as a primary nutrition-related health issue among older adults suggests a need to examine how nutritional assistance programs are related to food insecurity and dietary quality in aging populations. This project examines food insecurity and dietary quality in US adults age 65 and older and the impact of nutrition assistance programs. Methods The sample was drawn from the 2012 Health and Retirement Study and 2013 Health Care and Nutrition Study and included 3779 respondents representing a population of 37,217,566 adults aged 65 and older. Food insecurity was a binary measure based on the USDA six-item US Adult Food Security Survey Module. Two forms of nutritional assistance included receipt of supplemental food from sources such as food banks and Meals-on-Wheels (1 = yes, 0 = no) and reported receipt of SNAP benefits (1 = yes, 0 = no). Dietary quality was measured using the Alternative Healthy Eating Index-2010 based on a food frequency questionnaire. General linear modeling adjusting for covariates and complex sampling design was used to test if nutritional assistance moderated the association between food insecurity and AHEI-2010. Results Around 10\% of the sample was food insecure, 14\% reported receipt of supplemental food, and 6.4\% were SNAP benefit recipients. In covariate-adjusted models, food insecurity and receipt of SNAP benefits were not associated with AHEI-2010, but receipt of supplemental food was (b = -1.39, SE = 0.67, P = 0.038). Receipt of supplemental food moderated the association between AHEI-2010 and food insecurity (P = 0.001). Simple effect estimates suggested that among those not receiving supplemental food, the food insecure had lower AHEI-2010 scores than the food secure (b = -2.15, SE = 0.88, P = 0.014). Among those receiving supplemental food, the food insecure had greater AHEI-2010 scores than the food secure (b = 2.62, SE = 1.25, P = 0.035) and similar AHEI-2010 scores as the food secure not receiving supplemental food. Conclusions Preliminary analysis suggests that receipt of supplemental food appears to be associated with better dietary quality among food-insecure older adults and confirms the importance of food assistance programs in combating the negative effect of food insecurity on dietary quality.}, keywords = {acute hemorrhagic edema of childhood, Aging, diet}, issn = {2475-2991}, doi = {10.1093/cdn/nzaa061_007}, author = {Nicholas J Bishop and Sarah Ullevig and Krystle E Zuniga and Wang, Kaipeng} } @article {11325, title = {Social Support and Depressive Outcomes in Older Adults: An Analysis of the Health and Retirement Study}, journal = {Innovation in Aging}, volume = {4}, year = {2020}, pages = {69}, abstract = {Given population aging and impact of both spousal and social support on the health of older adults, the protective role of social support amongst recently bereaved older adults represents an important area of research. The aim of this study is to identify the relationship between recent widowhood and change in depressive symptoms in older adults, and how social support moderates this association. Utilizing observations from the nationally representative Health and Retirement Study, the analytic sample consisted of 2,890 adults age 50 and over who were partnered or married in 2012. Depression was measured using the Center for Epidemiological Studies Depression scale short form (CESD-8). Positive social support was measured as perceived social support from family, friends, and children. Widowhood was a dichotomous measure indicating mortality of spouse between 2012 and 2014. Autoregressive multiple regression was used to determine if widowhood was associated with change in depression from 2012-2104 and whether positive social support moderated this relationship. Widowhood was associated with an increase in depressive symptoms from 2012-2014 (b=0.967, SE=0.145, p <.001) and social support was negatively associated with change in depression (b=-0.021, SE=0.004, p <.001). Social support appeared to moderate the association between widowhood and change in depression (b=0.068, SE=0.026, p =.010), though widowed older adults with higher social support appear to have more rapid increase in depression than those with lower social support. These preliminary findings and implications for supporting bereaved older adults will be discussed.}, keywords = {depressive outcomes, Social Support}, isbn = {2399-5300}, doi = {10.1093/geroni/igaa057.226}, author = {Julia E Tucker and Nicholas J Bishop} } @article {10151, title = {Egg consumption, multi-domain cognitive performance, and short-term cognitive change in a representative sample of older U.S. adults.}, journal = {Journal of the American College of Nutrition}, volume = {38}, year = {2019}, pages = {537-546}, abstract = { Existing research supports a positive relationship between egg intake and cognitive function in older populations, although the impact of whole egg consumption on multi-domain cognitive function and cognitive decline in representative samples of older adults has not been described. We examined the association between egg consumption, cognitive performance, and cognitive change in a representative sample of U.S. adults aged 65 and older. We drew observations from the 2012 and 2014 Health and Retirement Study and the recently released 2013 Health Care and Nutrition Study. The analytic sample contained 3835 respondents, representing a weighted population of 37,806,082 community-dwelling adults aged 65 and older in 2013. Multivariate path analytic models were used to estimate the association between egg consumption groups (none, <= 1 serving per week, 2-6 servings per week, >= 7 servings per week) and cognitive performance across domains of working memory, executive function, and global mental status. First-order autoregressive models were used to estimate cognitive change over the 2-year observational period. Follow-up analyses examined associations between egg consumption group, dietary patterns, and nutrient intake. On average, older adults consumed 0.34 eggs per day ( = 0.36). Although bivariate analyses suggested that moderate egg consumers had the best cognitive performance at baseline assessment, egg consumption was not associated with cognitive performance or cognitive change when adjusting models for covariates known to have a robust association with cognitive health. Our results suggest that egg consumption does not benefit, nor is detrimental to, the cognitive health of older adults. Further studies of whole egg consumption and cognitive performance would benefit from controlled experimental settings, longer follow-up periods to measure cognitive change, and assessment of both community-dwelling and institutionalized older adults.}, keywords = {Cognitive Ability, Eating habits, HCNS}, issn = {1541-1087}, doi = {10.1080/07315724.2019.1566035}, author = {Nicholas J Bishop and Krystle E Zuniga} } @article {10142, title = {Latent profile analysis of dietary intake in a community-dwelling sample of older Americans.}, journal = {Public Health Nutrition}, year = {2019}, abstract = {

OBJECTIVE: To estimate latent dietary profiles in a community-dwelling sample of older Americans and identify associations between dietary profile membership and individual demographic, socio-economic and health characteristics.

DESIGN: Secondary analysis of the 2012 Health and Retirement Study (HRS) and linked 2013 Health Care and Nutrition Study (HCNS). Latent profile analysis identified mutually exclusive subgroups of dietary intake and bivariate analyses examined associations between dietary profile membership, participant characteristics and nutrient intakes.

SETTING: USA.

PARTICIPANTS: An analytic sample of 3558 adults aged 65 years or older.

RESULTS: Four dietary profiles were identified with 15{\textperiodcentered}5 \% of the sample having a {\textquoteright}Healthy{\textquoteright} diet, 42{\textperiodcentered}0 \% consuming a {\textquoteright}Western{\textquoteright} diet, 29{\textperiodcentered}7 \% having a diet consisting of high intake of all food groups and 12{\textperiodcentered}7 \% reporting relatively low intake of all food groups. Members of the {\textquoteright}Healthy{\textquoteright} profile reported the greatest socio-economic resources and health, and members of the {\textquoteright}Low Intake{\textquoteright} profile had the fewest resources and worst health outcomes. Macronutrient and micronutrient intakes varied across profile although inadequate and excessive intakes of selected nutrients were observed for all profiles.

CONCLUSIONS: We identified dietary patterns among older Americans typified by either selective intake of foods or overall quantity of foods consumed, with those described as {\textquoteright}Low Intake{\textquoteright} reporting the fewest socio-economic resources, greatest risk of food insecurity and the worst health outcomes. Limitations including the presence of measurement error in dietary questionnaires are discussed. The causes and consequences of limited dietary intake among older Americans require further study and can be facilitated by the HRS and HCNS.

}, keywords = {Community-dwelling, Dieting, HCNS}, issn = {1475-2727}, doi = {10.1017/S1368980019001496}, author = {Nicholas J Bishop and Krystle E Zuniga and Christina M Ramirez} } @article {10199, title = {Social support and monetary resources as protective factors against food insecurity among older Americans: findings from a health and retirement study}, journal = {Food Security}, volume = {11}, year = {2019}, month = {08/2019}, pages = {929{\textendash}939}, abstract = {We examined the association between social support, monetary resources, and food insecurity among a nationally representative sample of older Americans. Analyses included 1164 Americans aged 65 and above from the 2012 Health and Retirement Study and the 2013 Health Care and Nutrition Study. Logistic regression analyses were used to estimate the likelihood of food insecurity as a function of social support (including social contact, emotional support, and social strain), monetary resources (including household income and household assets), and covariates. We found older adults with greater social strain and lower emotional support were at increased risk of food insecurity. Greater monetary resources were associated with lower risk of food insecurity. Select indicators of social support appeared to moderate the effect of monetary resources on food insecurity, with increasing social strain reducing the protective benefits of greater household assets, and low emotional support reducing the protective effect of increased household income to non-significance. Emotional support and social strain are aspects of social relationships that may play important roles in the relationship between monetary resources and food insecurity. Interventions seeking to reduce the burden of food insecurity should consider the quality and quantity of social relationships as potential risk factors.}, keywords = {Assets, Emotional support, Food insecurity, Income, Social strain}, url = {https://link.springer.com/article/10.1007/s12571-019-00945-8}, author = {Nicholas J Bishop and Wang, Kaipeng} } @article {9816, title = {Food insecurity, comorbidity, and mobility limitations among older U.S. adults: Findings from the Health and Retirement Study and Health Care and Nutrition Study.}, journal = {Preventative Med}, volume = {114}, year = {2018}, month = {09/2018}, pages = {180-187}, abstract = {Both food insecurity and comorbidity have been identified as precursors to functional limitation in older adults, yet whether food insecurity modifies the progression from chronic disease to disability has not been assessed. We examined 5986 respondents age 50 and older drawn from the 2012-2014 Health and Retirement Study (HRS) and 2013 Health Care and Nutrition Study (HCNS). Mobility limitations reported in 2014 and change in mobility limitations from 2012 to 2014 were regressed on measures of food insecurity, number of chronic conditions, and their interaction terms using Poisson regression. Around 17.3\% of the sample was identified as food insecure. In 2012, respondents reported an average of 1.9 (SD = 1.5) chronic conditions and 2.4 mobility limitations (SD = 3.0). In 2014, individuals reported an average of 2.5 (SD = 3.1) mobility limitations. Food insecurity was associated with a greater number of mobility limitations (IRR = 1.20, 95\% CI: 1.11-1.29, p < .001) and more rapid increase in mobility limitations over the two-year observational period (IRR = 1.06, 95\% CI: 1.00-1.11, p = .047). Food security status also modified the association between comorbidity and both mobility limitation outcomes, with the food secure exhibiting a stronger positive association between chronic conditions and mobility limitations than the food insecure. The food insecure tended to have more mobility limitations than the food secure when few chronic conditions were reported. Our results suggest that food insecurity is associated with prevalence and change in mobility limitations among older adults.}, keywords = {Comorbidity, Disabilities, Food insecurity}, issn = {1096-0260}, doi = {10.1016/j.ypmed.2018.07.001}, author = {Nicholas J Bishop and Wang, Kaipeng} } @article {9769, title = {Latent Profiles of Macronutrient Density and their Association with Mobility Limitations in an Observational Longitudinal Study of Older U.S. Adults.}, journal = {The Journal of Nutrition, Health and Aging}, volume = {22}, year = {2018}, pages = {645-654}, abstract = {

OBJECTIVES: Our first objective was to estimate empirically-derived subgroups (latent profiles) of observed carbohydrate, protein, and fat intake density in a nationally representative sample of older U.S. adults. Our second objective was to determine whether membership in these groups was associated with levels of, and short term change in, physical mobility limitations.

DESIGN AND SETTING: Measures of macronutrient density were taken from the 2013 Health Care and Nutrition Study, an off-year supplement to the Health and Retirement Study, which provided indicators of physical mobility limitations and sociodemographic and health-related covariates.

PARTICIPANTS: 3,914 community-dwelling adults age 65 years and older.

MEASUREMENTS: Percent of daily calories from carbohydrate, protein, and fat were calculated based on responses to a modified Harvard food frequency questionnaire. Latent profile analysis was used to describe unobserved heterogeneity in measures of carbohydrate, protein, and fat density. Mobility limitation counts were based on responses to 11 items indicating physical limitations. Poisson regression models with autoregressive controls were used to identify associations between macronutrient density profile membership and mobility limitations. Sociodemographic and health-related covariates were included in all Poisson regression models.

RESULTS: Four latent subgroups of macronutrient density were identified: "High Carbohydrate", "Moderate with Fat", "Moderate", and "Low Carbohydrate/High Fat". Older adults with the lowest percentage of daily calories coming from carbohydrate and the greatest percentage coming from fat ("Low Carbohydrate/High Fat") were found to have greater reported mobility limitations in 2014 than those identified as having moderate macronutrient density, and more rapid two-year increases in mobility limitations than those identified as "Moderate with Fat" or "Moderate".

CONCLUSION: Older adults identified as having the lowest carbohydrate and highest fat energy density were more likely to report a greater number of mobility limitations and experience greater increases in these limitations than those identified as having moderate macronutrient density. These results suggest that the interrelation of macronutrients must be considered by those seeking to reduce functional limitations among older adults through dietary interventions.

}, keywords = {Activities of Daily Living, Nutrition, Physical limitations}, issn = {1760-4788}, doi = {10.1007/s12603-017-0986-0}, author = {Nicholas J Bishop and Krystle E Zuniga and Lucht, A. L.} } @article {9409, title = {Recent cancer treatment and memory decline in older adults: An analysis of the 2002{\textendash}2012 Health and Retirement Study}, journal = {Journal of Geriatric Oncology}, volume = {9}, year = {2018}, pages = {186-193}, abstract = {Objective: Few studies have examined the impact of cancer treatment on cognitive trajectories in the growing population of older adults diagnosed with and surviving cancer. This study examined whether recent cancer and its treatment accelerated memory decline in older adults.: Materials and Methods: We conducted a secondary analysis of observations drawn from the Health and Retirement Study (2002-2012), a population-based sample of older adults in the United States. Changes in immediate (IWR) and delayed word recall (DWR) scores were estimated by latent growth modeling in individuals who never had cancer (n = 10,939) or had been diagnosed with cancer between 2000 and 2002 and received treatment with some combination of radiation and/or surgery (n = 240), chemotherapy only (n = 34), or chemotherapy and some combination of radiation and/or surgery (n = 64).: Results: In the period immediately following treatment, individuals reporting a recent cancer treated with chemotherapy and surgery/radiation experienced significantly more rapid decline in IWR (b = -0.34, SE = 0.17, p = 0.047) and DWR (b = -0.38, SE = 0.19, p = 0.049) than the non-cancer group. Sensitivity analyses addressing mortality selection and memory-related disease at baseline attenuated the strength of these associations. There were no other statistically significant differences in estimated linear or quadratic slope by cancer status or treatment.: Conclusion: Our results support a potential association between recent cancer treatment and trajectories of memory decline in older adults and provide guidance on the interpretation of statistical estimates from panel studies of health and aging.}, keywords = {Cancer screenings, Cognitive Ability, Memory}, issn = {18794068}, doi = {10.1016/j.jgo.2017.10.004}, url = {http://linkinghub.elsevier.com/retrieve/pii/S1879406817302291http://api.elsevier.com/content/article/PII:S1879406817302291?httpAccept=text/xmlhttp://api.elsevier.com/content/article/PII:S1879406817302291?httpAccept=text/plain}, author = {Krystle E Zuniga and Nicholas J Bishop} } @article {8360, title = {Estimating the Co-Development of Cognitive Decline and Physical Mobility Limitations in Older US Adults}, journal = {Demography}, volume = {53}, year = {2016}, note = {Times Cited: 0 0}, pages = {337-364}, publisher = {53}, abstract = {This study examines the co-development of cognitive and physical function in older Americans using an age-heterogeneous sample drawn from the Health and Retirement Study (1998-2008). We used multiple-group parallel process latent growth models to estimate the association between trajectories of cognitive function as measured by immediate word recall scores, and limitations in physical function as measured as an index of functional mobility limitations. Nested model fit testing was used to assess model fit for the separate trajectories followed by estimation of an unconditional parallel process model. Controls for demographic characteristics, socioeconomic status, and chronic health conditions were added to the best-fitting parallel process model. Pattern mixture models were used to assess the sensitivity of the parameter estimates to the effect of selective attrition. Results indicated that favorable cognitive health and mobility at initial measurement were associated with faster decline in the alternate functional domain. The cross-process associations remained significant when we adjusted estimates for the influence of covariates and selective attrition. Demographic and socioeconomic characteristics were consistently associated with initial cognitive and physical health but had few relations with change in these measures.}, keywords = {Health Conditions and Status}, doi = {10.1007/s13524-016-0458-x}, author = {Nicholas J Bishop and Eggum-Wilkens, Natalie D. and Steven A Haas and Jennie J. Kronenfeld} } @mastersthesis {6223, title = {Socioeconomic and Racial/Ethnic Disparities in Cognitive Trajectories among the Oldest Old: The Role of Vascular and Functional Health}, volume = {Doctor of Philosophy}, year = {2012}, note = {ISBN 9781124275345Dissertation Abstracts International, A: The Humanities and Social Sciences, vol. 72, no. 09, pp. 3523 0419-4209 9781124701622}, pages = {164}, school = {Arizona State University}, address = {Tempe, AZ}, abstract = {Identifying modifiable causes of chronic disease is essential to prepare for the needs of an aging population. Cognitive decline is a precursor to the development of Alzheimer{\textquoteright}s and other dementing diseases, representing some of the most prevalent and least understood sources of morbidity and mortality associated with aging. To contribute to the literature on cognitive aging, this work focuses on the role of vascular and physical health in the development of cognitive trajectories while accounting for the socioeconomic context where health disparities are developed. The Assets and Health Dynamics among the Oldest-Old study provided a nationally-representative sample of non-institutionalized adults age 65 and over in 1998, with biennial follow-up continuing until 2008. Latent growth models with adjustment for non-random missing data were used to assess vascular, physical, and social predictors of cognitive change. A core aim of this project was examining socioeconomic and racial/ethnic variation in vascular predictors of cognitive trajectories. Results indicated that diabetes and heart problems were directly related to an increased rate of memory decline in whites, where these risk factors were only associated with baseline word-recall for blacks when conditioned on gender and household assets. These results support the vascular hypotheses of cognitive aging and attest to the significance of socioeconomic and racial/ethnic variation in vascular influences on cognitive health. The second substantive portion of this dissertation used parallel process latent growth models to examine the co-development of cognitive and functional health. Initial word-recall scores were consistently associated with later functional limitations, but baseline functional limitations were not consistently associated with later word-recall scores. Gender and household income moderated this relationship, and indicators of lifecourse SES were better equipped to explain variation in initial cognitive and functional status than change in these measures over time. Overall, this work suggests that research examining associations between cognitive decline, chronic disease, and disability must account for the social context where individuals and their health develop. Also, these findings advocate that reducing socioeconomic and racial/ethnic disparities in cognitive health among the aging requires interventions early in the lifecourse, as disparities in cognitive trajectories were solidified prior to late old age.}, keywords = {Demographics, Health Conditions and Status}, url = {https://repository.asu.edu/attachments/56828/content/Bishop_asu_0010E_10795.pdf}, author = {Nicholas J Bishop} }