@article {12300, title = {Childhood Stressors, Relationship Quality, and Cognitive Health in Later Life.}, journal = {The Journals of Gerontology, Series B }, year = {Forthcoming}, abstract = {

OBJECTIVES: The rising prevalence of cognitive impairment, Alzheimer{\textquoteright}s disease, and related disorders signals the need for a better understanding of how social factors may affect cognitive health for millions of Americans. Drawing from cumulative inequality theory, we aim to understand the implications of a stressful childhood on social relationships and cognitive health in later life.

METHODS: This study utilizes longitudinal data (2006-2016) from the Health and Retirement Study to examine pathways, both direct and indirect through social relationships in adulthood, from childhood stressors to cognitive health trajectories over time.

RESULTS: Respondents reporting a greater number of stressors in childhood had worse cognitive health over time, but those negative effects were not as steep as time progressed. Early-life stressors are also associated with less social support and more social strain in adulthood which, in turn, are associated with initial cognitive health. Finally, pathway analyses confirm that childhood stressors are indirectly associated with initial cognitive health through social strain and social support.

DISCUSSION: Findings reveal that a stressful childhood creates chains of risks that have lifelong implications for cognitive health, both directly and indirectly by creating obstacles for developing healthy and supportive social relationships.

}, keywords = {cognitive impairment, Early-Life Stressors, Social Relationships}, issn = {1758-5368}, doi = {10.1093/geronb/gbac007}, author = {Thomas, Patricia A and Williams-Farrelly, Monica M and Sauerteig, Madison R and Ferraro, Kenneth F} } @article {13167, title = {Racial-Ethnic Disparities in Dual-Function Life Expectancy.}, journal = {J Gerontol A Biol Sci Med Sci}, year = {2023}, month = {2023 Feb 17}, abstract = {

BACKGROUND: This study develops a new concept, dual functionality, that integrates physical and cognitive function. We use the concept to define a measure of dual-function life expectancy and assess racial-ethnic inequalities in aging.

METHODS: Drawing on data from the National Health Interview Study Linked Mortality Files and the Health and Retirement Study, we define dual functionality as having no limitations in activities of daily living and being free of dementia. We use this measure and Sullivan life tables to estimate age-50 total life expectancy and age-50 dual-function life expectancy (2FLE) for women and men across four racial-ethnic and nativity groups.

RESULTS: At ages 50 to 54, between 79.0\% (95\% CI: 73.5, 84.5) and 87.6\% (95\% CI: 84.0, 91.2) of (non-Hispanic) Black, foreign-born Hispanic, and US-born Hispanic women and men remain dual functional as compared with 90.4\% (95\% CI: 89.3, 91.4) and 91.4\% (95\% CI: 90.2, 92.5) of (non-Hispanic) White women and men respectively. These and corresponding racial-ethnic disparities in dual functionality through ages 85 and older translate into substantial inequalities in 2FLE. For instance, the Black-White gap in age-50 2FLE is 6.9 years (95\% CI: -7.5, -6.4) for women and 6.0 years (95\% CI: -6.6, -5.4) for men.

CONCLUSIONS: Black, foreign-born Hispanic, and US-born Hispanic older adults are estimated to live a smaller percentage of their remaining years with dual functionality than White older adults. These results reveal stark racial-ethnic inequalities in aging that have significant implications for quality of life, caregiving, and health needs.

}, keywords = {Life Expectancy}, issn = {1758-535X}, doi = {10.1093/gerona/glad059}, author = {Bauldry, Shawn and Thomas, Patricia A and Sauerteig-Rolston, Madison R and Ferraro, Kenneth F} } @article {12506, title = {Subjective Memory Decline Predicts Incident Cognitive Impairment among White-but Not Black or Hispanic-Older Adults.}, journal = {The Gerontologist}, year = {2023}, abstract = {

BACKGROUND AND OBJECTIVES: This study investigates whether subjective memory decline in a racially diverse sample of older adults without cognitive impairment at baseline is associated with incident cognitive impairment during a 12-year follow-up period.

RESEARCH DESIGN AND METHODS: With panel data from a national sample (N=9,244) of cognitively-intact Black, White, and Hispanic Americans 65 years or older in 2004, we examine if subjective memory decline is associated with the loss of normal cognition by 2016. Cognitive status was assessed every two years with a modified version of the Telephone Interview for Cognitive Status to identify the transition from normal cognition to cognitive impairment.

RESULTS: Estimates from Weibull accelerated failure-time models reveal that subjective memory decline is associated with earlier incident cognitive impairment (time ratio = 0.96, p<.05). In subsequent models stratified by race-ethnicity, this association was evident among White respondents (time ratio = 0.95, p<.01) but not among Black, US-born Hispanic, or foreign-born Hispanic respondents.

DISCUSSION AND IMPLICATIONS: Given that the prognostic validity of subjective memory decline differs by race and ethnicity, caution is warranted when using it as a screening or clinical tool in diverse populations.

}, keywords = {cognitive function, Disparities, Racial-ethnic differences, Self-reported memory}, issn = {1758-5341}, doi = {10.1093/geront/gnac086}, author = {Ferraro, Kenneth F and Sauerteig-Rolston, Madison R and Barnes, Lisa L and Friedman, Elliot and Sands, Laura P and Thomas, Patricia A} } @article {13357, title = {A Time of Healing: Can Social Engagement after Bereavement Reduce Trajectories of Depression after the Death of a Child?}, journal = {J Gerontol B Psychol Sci Soc Sci}, year = {2023}, abstract = {

OBJECTIVES: We work from a stress and life course perspective to examine the mental health of parents who experienced the death of their child. We examine whether mental health eventually returns to pre-bereavement levels and how social engagement after bereavement may shape the recovery process of depressive symptoms.

METHODS: We analyze discontinuous growth curve models to assess the association between a child{\textquoteright}s death and trajectories of parents{\textquoteright} depressive symptoms from the 1998-2016 Health and Retirement Study. The sample includes 16,182 parents aged 50 years and older.

RESULTS: Those who transitioned to bereavement experience an elevation in depressive symptoms and a relatively long recovery time (e.g., seven years) to their pre-bereavement mental health in our findings. However, when engaging in volunteer work after their loss, depressive symptoms reduce more quickly to their pre-bereavement levels. Volunteering offsets up to three years of the negative consequences of child loss.

DISCUSSION: The death of a child is a traumatic event with extensive health consequences, but research should more fully examine the dynamic nature and potential mitigation of these health consequences over time. Our findings expand the temporal lens to encompass healing processes after bereavement, incorporating the importance of social engagement.

}, issn = {1758-5368}, doi = {10.1093/geronb/gbad094}, author = {Cha, Hyungmin and Thomas, Patricia A} } @article {11942, title = {Do Early-Life Social, Behavioral, and Health Exposures Increase Later-Life Arthritis Incidence?}, journal = {Research on Aging}, volume = {44}, year = {2022}, pages = {479-493}, abstract = {

OBJECTIVES: This study investigates direct and indirect influences of childhood social, behavioral, and health exposures on later-life osteoarthritis and rheumatoid arthritis development.

METHODS: Drawing from cumulative inequality theory and six waves of the Health and Retirement Study (2004-2014), we estimate structural equation modeling-based discrete-time survival analysis of the association between six childhood exposure domains and both osteoarthritis and rheumatoid arthritis incidence for men ( = 2720) and women ( = 2974). Using the delta method to test for mediation, we examine indirect effects via selected health-related risks and resources.

RESULTS: Risky adolescent behavior is associated with rheumatoid arthritis incidence for women (h.O.R. = 1.883, 95\% C.I. [1.016, 3.490]), whereas several types of childhood exposures are associated with later-life osteoarthritis development for both men and women. Experiencing two or more childhood socioeconomic disadvantages is indirectly associated with osteoarthritis (men: coef. = 0.024, 95\% C.I. [0.003, 0.045]; women: coef. = 0.111, 95\% C.I. [0.071, 0.150]) and rheumatoid arthritis (men: coef. = 0.037, 95\% C.I. [0.000, 0.074]; women: coef. = 0.097, 95\% C.I. [0.035, 0.159]) development through adult body mass index.

DISCUSSION: Findings highlight the importance of childhood contexts in understanding the development of later-life osteoarthritis and rheumatoid arthritis.

}, keywords = {Adverse Childhood Experiences, Body Mass Index, Cumulative inequality theory, Osteoarthritis, rheumatoid arthritis}, issn = {1552-7573}, doi = {10.1177/01640275211044979}, author = {Blakelee R Kemp and Kenneth F Ferraro and Patricia M Morton and Thomas, Patricia A and Sarah A Mustillo and Eileen M. Crimmins} } @article {11950, title = {Sibling Deaths, Racial/Ethnic Disadvantage, and Dementia in Later Life.}, journal = {The Journals of Gerontology, Series B }, volume = {77}, year = {2022}, pages = {1539-1549}, abstract = {

OBJECTIVES: Sibling loss is understudied in the bereavement and health literature. The present study considers whether experiencing the death of siblings in mid-to-late life is associated with subsequent dementia risk and how differential exposure to sibling losses by race/ethnicity may contribute to racial/ethnic disparities in dementia risk.

METHODS: We use discrete-time hazard regression models, a formal mediation test, and a counterfactual simulation to reveal how sibling loss in mid-to-late life affects dementia incidence and whether unequal exposures by race/ethnicity mediate the racial/ethnic disparities in dementia. We analyze data from the Health and Retirement Study (2000-2016). The sample includes 13,589 respondents (10,607 non-Hispanic White, 1,761 non-Hispanic Black, and 1,158 Hispanic adults) aged 65 years and older in 2000 who show no evidence of dementia at baseline.

RESULTS: Discrete-time hazard regression results show that sibling loss in mid-to-late life is associated with up to 54\% higher risk for dementia. Sibling loss contributes to Black-White disparities in dementia risk. In addition, a simulation analysis shows that dementia rates would be 14\% lower for Black adults if they experienced the lower rates of sibling loss experienced by White adults. This pattern was not observed among Hispanic adults.

DISCUSSION: The death of a sibling in mid-to-late life is a stressor that is associated with increased dementia risk. Black adults are disadvantaged in that they are more likely than Whites to experience the death of siblings, and such losses contribute to the already substantial racial/ethnic disadvantage in dementia.

}, keywords = {Bereavement, Dementia, Minority aging, Race/ethnicity, Stress}, issn = {1758-5368}, doi = {10.1093/geronb/gbab202}, author = {Hyungmin Cha and Thomas, Patricia A and Debra Umberson} }