TY - JOUR T1 - Age Differences Experiences of Pandemic-related Health and Economic Challenges among Adults Aged 55 and Older. JF - The Gerontologist Y1 - Forthcoming A1 - Wiemers, Emily E A1 - Lin, I-Fen A1 - Wiersma Strauss, Anna A1 - Chin, Janecca A1 - Hotz, V Joseph A1 - Seltzer, Judith A KW - Access to medical care KW - COVID-19 KW - Economic hardship KW - Mental Health AB -

BACKGROUND AND OBJECTIVES: The oldest adults faced the highest risk of death and hospitalization from COVID-19, but less is known about whether they also were the most likely to experience pandemic-related economic, health care, and mental health challenges. Guided by prior research on vulnerability versus resilience among older adults, the current study investigated age differences in economic hardship, delays in medical care, and mental health outcomes among adults aged 55 and older.

RESEARCH DESIGN AND METHODS: Data were from the COVID-19 module and Leave Behind Questionnaire in the 2020 Health and Retirement Study (HRS). We estimated linear probability models to examine differences in experiences of pandemic-related economic and health challenges by age group (55-64, 65-74, 75+) with and without controls for preexisting sociodemographic, social program, health, and economic characteristics from the 2018 HRS. Models accounting for differential mortality also were estimated.

RESULTS: Adults aged 65-74 and 75+ experienced fewer economic and mental health challenges and those aged 75+ were less likely to delay medical care than adults aged 55-64. Age gradients were consistent across a broad range of measures and were robust to including controls. For all age groups, economic challenges were less common than delays in medical care or experiences of loneliness, stress, or being emotionally overwhelmed.

DISCUSSION AND IMPLICATIONS: Even though the oldest adults were at the greatest risk of death and hospitalization from COVID-19, they experienced fewer secondary pandemic-related challenges. Future research should continue to explore the sources of this resilience for older adults.

ER - TY - JOUR T1 - Chronic Disease and Workforce Participation Among Medicaid Enrollees Over 50: The Potential Impact of Medicaid Work Requirements Post-COVID-19 JF - medRxiv Y1 - Forthcoming A1 - Rodlescia S. Sneed A1 - Stubblefield, Alexander A1 - Gardner, Graham A1 - Jordan, Tamara A1 - Briana Mezuk KW - Chronic disease KW - COVID-19 KW - health policy KW - Medicaid AB - As the COVID-19 pandemic wanes, states may reintroduce Medicaid work requirements to reduce enrollment. Using the Health and Retirement Study, we evaluated chronic disease burden among beneficiaries aged >50 (n=1460) who might be impacted by work requirements (i.e. working <20 hours per week). Seven of eight chronic conditions evaluated were associated with reduced workforce participation, including history of stroke (OR: 7.35; 95% CI: 2.98-18.14) and lung disease (OR: 4.39; 95% CI: 2.97-7.47). Those with more severe disease were also more likely to work fewer hours. Medicaid work requirements would likely have great impact on older beneficiaries with significant disease burden.Key PointsChronic disease linked to reduced work among older Medicaid beneficiaries.Work requirements would greatly impact those aged >50 with chronic conditions.Coverage loss would have negative implications for long-term disease management.Competing Interest StatementThe authors have declared no competing interest.Funding StatementThis work was supported by the Robert Wood Johnson Foundation’s (RWJF) Policies for Action program under grant number 77342. This is a secondary analysis that uses data from the Health and Retirement Study, (2016 HRS Core and RAND HRS Longitudinal File 2018), sponsored by the National Institute on Aging under grant number NIA U01AG009740 and conducted by the University of Michigan.Author DeclarationsI confirm all relevant ethical guidelines have been followed, and any necessary IRB and/or ethics committee approvals have been obtained.YesThe details of the IRB/oversight body that provided approval or exemption for the research described are given below:This study involved only openly available human data, which can be obtained from: https://hrsdata.isr.umich.edu/data-products/rand-hrs-longitudinal-file-2018 and https://hrsdata.isr.umich.edu/data-products/2016-hrs-coreI confirm that all necessary patient/participant consent has been obtained and the appropriate institutional forms have been archived, and that any patient/participant/sample identifiers included were not known to anyone (e.g., hospital staff, patients or participants themselves) outside the research group so cannot be used to identify individuals.YesI understand that all clinical trials and any other prospective interventional studies must be registered with an ICMJE-approved registry, such as ClinicalTrials.gov. I confirm that any such study reported in the manuscript has been registered and the trial registration ID is provided (note: if posting a prospective study registered retrospectively, please provide a statement in the trial ID field explaining why the study was not registered in advance).YesI have followed all appropriate research reporting guidelines and uploaded the relevant EQUATOR Network research reporting checklist(s) and other pertinent material as supplementary files, if applicable.YesAll data are available online at: https://hrsdata.isr.umich.edu/data-products/rand-hrs-longitudinal-file-2018 and https://hrsdata.isr.umich.edu/data-products/2016-hrs-core ER - TY - JOUR T1 - The Hidden Role of Racial Wealth Disparities in Older Adults’ Vulnerability to COVID-19 JF - Research Square Y1 - Forthcoming A1 - Ruth Winecoff A1 - Padmaja Ayyagari A1 - Melissa McInerney A1 - Kosali I. Simon A1 - M Kate Bundorf KW - COVID-19 KW - Racial wealth disparities AB - Background: To examine racial and ethnic differences in wealth and other economic, exposure and baseline health-related risks of COVID-19 among older adults in the U.S. Methods: Using rich data on wealth and long-term care use among older Americans unique to the 2016 Health and Retirement Study, we quantify differences in COVID-19 vulnerability among non-Hispanic white, non-Hispanic Black and Hispanic respondents aged 50+. We measure wealth, other economic (insurance, income); exposure (long-term care, employment, telework, household size); and health (chronic conditions, smoking) risk stratified by age (50-64, 65+). Results: Blacks and Hispanics face dramatically greater financial risk that potentially increases exposure to COVID-19, relative to whites; Blacks and Hispanics are four to five times more likely to have no financial wealth. Blacks are also more likely than whites to use long-term care. Blacks and Hispanics also are less likely to have health insurance and face greater risk of exposure to COVID-19 because they are less likely to telework, and Hispanic older adults reside in larger households. Black and Hispanic older adults are also more likely to have a chronic condition associated with worse COVID-19 outcomes. Conclusions: Our results suggest that wealth differences may play a substantial role in contributing to the very large racial and ethnic disparities in the health burden of COVID-19. Racial disparities in long-term care, where COVID-19 risks are higher, contribute to make older Black Americans even more vulnerable to COVID-19. SN - 2693-5015 ER - TY - JOUR T1 - The Impact of Online Services on the COVID-19 Resilience of Korean Older Adults. JF - Asia-Pacific Journal of Public Health Y1 - Forthcoming A1 - Nam, Su-Jung A1 - Yeo, JeongHee KW - COVID-19 KW - korean KW - Older Adults KW - online services KW - Pandemic ER - TY - JOUR T1 - Race-Ethnic Differences in the Effects of COVID-19 on the Work, Stress, and Financial Outcomes of Older Adults. JF - Journal of Aging and Health Y1 - Forthcoming A1 - Jason, Kendra A1 - Carr, Dawn A1 - Chen, Zhao KW - COVID-19 KW - financial KW - psychological resilience KW - race KW - Stress AB -

OBJECTIVES: This study investigates race-ethnic differences among older non-Hispanic Black, non-Hispanic White, and Hispanic adults' financial, employment, and stress consequences of COVID-19.

METHODS: We use data from the Health and Retirement Study, including the 2020 COVID-panel, to evaluate a sample of 2,929 adults using a combination of bivariate tests, OLS regression analysis, and moderation tests.

RESULTS: Hispanic and non-Hispanic Black older adults experienced more financial hardships, higher levels of COVID-19 stress, and higher rates of job loss associated with COVID-19 relative to their Non-Hispanic White counterparts. Non-Hispanic Black and Hispanic adults reported significantly higher levels of COVID-19 resilience resources, yet, these resources were not protective of the consequences of COVID-19.

DISCUSSION: Understanding how the experiences of managing and coping with COVID-19 stressors differ by race-ethnicity can better inform intervention design and support services.

ER - TY - JOUR T1 - Telehealth uptake among middle-aged and older Americans during COVID-19: chronic conditions, social media communication, and race/ethnicity. JF - Aging & Mental Health Y1 - Forthcoming A1 - Choi, Shinae L A1 - Hites, Lisle A1 - Bolland, Anneliese C A1 - Lee, Jiyoung A1 - Payne-Foster, Pamela A1 - Bissell, Kimberly KW - Comorbidity KW - COVID-19 KW - midlife KW - Race/ethnicity KW - social media communication KW - telehealth AB -

OBJECTIVES: This study investigated whether and to what extent constructs of the protection motivation theory of health (PMT)-threat appraisal (perceived vulnerability/severity) and coping appraisal (response efficacy and self-efficacy)-are related to telehealth engagement during the COVID-19 pandemic, and how these associations differ by race/ethnicity among middle-aged and older Americans.

METHODS: Data were from the 2020 Health and Retirement Study. Multivariable ordinary least-squares regression analyses were computed adjusting for health and sociodemographic factors.

RESULTS: Some PMT constructs are useful in understanding telehealth uptake. Perceived vulnerability/severity, particularly comorbidity ( = 0.13, 95% confidence interval (CI) [0.11, 0.15],  < 0.001), and response efficacy, particularly participation in communication via social media ( = 0.24, 95% CI [0.21, 0.27],  < 0.001), were significantly and positively associated with higher telehealth uptake during the COVID-19 pandemic among middle-aged and older Americans. Non-Hispanic Black adults were more likely to engage in telehealth during the pandemic than their non-Hispanic White counterparts ( = 0.20, 95% CI [0.12, 0.28],  < 0.001). Multiple moderation analyses revealed the significant association between comorbidity and telehealth uptake was similar across racial/ethnic groups, whereas the significant association between social media communication and telehealth uptake varied by race/ethnicity. Specifically, the association was significantly less pronounced for Hispanic adults ( = -0.11, 95% CI [-0.19, -0.04],  < 0.01) and non-Hispanic Asian/other races adults ( = -0.13, 95% CI [-0.26, -0.01],  < 0.05) than it was for their non-Hispanic White counterparts.

CONCLUSION: Results suggest the potential of using social media and telehealth to narrow health disparities, particularly serving as a bridge for members of underserved communities to telehealth uptake.

ER - TY - JOUR T1 - Association Between COVID-19 Vaccine Hesitancy and Religiosity Among Elderly with Comorbidities Y1 - 2023 A1 - Kingsley A. Kalu A1 - Ho-Jui Tung KW - comorbidities KW - COVID-19 KW - Elderly KW - Health and Retirement Study KW - Population KW - religiosity KW - vaccine hesitancy AB - Background: Evidence has indicated that COVID-19 vaccines are effective in preventing hospitalizations and deaths. Higher percentages of older adults with chronic conditions are more susceptible to developing severe outcomes when infected with the virus. However, there are studies documenting vaccine hesitancy associated with religiosity. This study tries to examine the association between COVID-19 vaccine hesitancy and religiosity among older adults with comorbidities. Method: This study used secondary data from the Health and Retirement Study (HRS), which is a nationally representative sample of older adults living in the United States. Vaccine hesitancy was measured by the single item, “How likely are you to take the coronavirus vaccine when it becomes available to you? Responses to the item was dichotomized by collapsing the “not at all likely” and “ not very likely” against the “very likely” and “somewhat likely” categories. Religiosity was measured by the weekly frequencies of attending religious services. Results: Logistic regression results showed that HRS participants who attended religious service more than once a week expressed a higher hesitancy (OR=2.02 p<.05) in taking a COVID-19 vaccine if available. Compared to other races, the black participants had higher vaccine hesitancy (OR=2.49; p<.05) with lower odds of taking the COVID-19 vaccine if available. However, there was no association between the number of comorbidities and COVID-19 vaccine hesitancy. Conclusion: The results seem to suggest an association between religiosity and the likelihood of COVID-19 vaccination among older Americans. More research is needed to evaluate religiosity as a social determinant of health for vaccine hesitancy. Keywords Keywords: Religiosity, vaccine hesitancy, Health and Retirement Study, comorbidities, elderly, population, COVID-19. UR - https://digitalcommons.georgiasouthern.edu/gapha-conference/2023/2023/7/ ER - TY - JOUR T1 - Changes in social lives and loneliness during COVID-19 among older adults: a closer look at the sociodemographic differences. JF - International Psychogeriatrics Y1 - 2023 A1 - Choi, Eun Young A1 - Farina, Mateo P A1 - Zhao, Erfei A1 - Jennifer A Ailshire KW - COVID-19 KW - Diversity KW - Pandemic KW - Psychosocial KW - social isolation AB -

OBJECTIVES: The COVID-19 pandemic greatly impacted the social lives of older adults across several areas, leading to concern about an increase in loneliness. This study examines the associations of structural, functional, and quality aspects of social connection with increased loneliness during COVID-19 and how these associations vary by sociodemographic factors.

DESIGN: Secondary data analyses on a nationally representative survey of older US adults.

SETTING: The 2020 Health and Retirement Study (HRS) COVID-19 module.

PARTICIPANTS: The study sample includes 3,804 adults aged 54 or older.

MEASUREMENTS: Increased loneliness was based on respondents' self-report on whether they felt lonelier than before the COVID-19 outbreak.

RESULTS: While 29% felt lonelier after COVID-19, middle-aged adults, women, non-Hispanic Whites, and the most educated were more likely to report increased loneliness. Not having enough in-person contact with people outside the household was associated with increased loneliness (OR = 10.07, < .001). Receiving emotional support less frequently (OR = 2.28, < .05) or more frequently (OR = 2.00, < .001) than before was associated with increased loneliness. Worse quality of family relationships (OR = 1.85, < .05) and worse friend/neighbor relationships (OR = 1.77, < .01) were related to feeling lonelier. Significant interactions indicated stronger effects on loneliness of poor-quality family relationships for women and insufficient in-person contact with non-household people for the middle-aged group and non-Hispanic Whites.

CONCLUSIONS: Our findings show an increase in loneliness during COVID-19 that was partly due to social mitigation efforts, and also uncover how sociodemographic groups were impacted differently, providing implications for recovery and support.

VL - 35 IS - 6 ER - TY - JOUR T1 - Cognitive Decline Before and During COVID-19 Pandemic Among Older People With Multimorbidity: A Longitudinal Study. JF - Journal of the American Medical Directors Association Y1 - 2023 A1 - Li, Chenglong A1 - Hua, Rong A1 - Gao, Darui A1 - Zheng, Fanfan A1 - Xie, Wuxiang KW - Cognition KW - Cognitive Dysfunction KW - COVID-19 KW - Dementia KW - multimorbidity KW - Pandemics AB -

OBJECTIVE: To investigate whether older people living with multimorbidity would suffer an accelerated decline in cognition during the COVID-19 pandemic, compared with prepandemic data.

DESIGN: A 5-year cohort conducting surveys from year 2016 to 2021, with 2016 to 2019 as the control period and 2019 to 2021 the pandemic period.

SETTING AND PARTICIPANTS: In total, 9304 cognitively healthy older participants age ≥50 years were included from the Health and Retirement Study (HRS).

METHODS: Multimorbidity was defined as the concurrent presence of 2 or more chronic diseases. A global cognition z score was calculated using memory (immediate and delayed word recall tests) and executive function (counting backwards and the serial sevens tests). Incident dementia was defined using either the reported physician diagnosis or an alternative approach based on cognition summary score. Linear mixed models were used to assess longitudinal changes, while modified Poisson regression models were used to analyze the risk of incident dementia.

RESULTS: Of the 9304 participants included, 3649 (39.2%) were men, with a mean age of 65.8 ± 10.8 years. Participants with multimorbidity (n = 4375) suffered accelerated declines of 0.08 standard deviation (95% confidence interval 0.03, 0.13, P = .003) in global cognition and an elevated dementia risk (risk ratio 1.66, 95% confidence 1.05 to 2.61, P = .029), compared with individuals without morbidity (n = 1818) during the pandemic period. After further adjusting sociodemographic characteristics and prepandemic cognitive measurements, these differences remained evident. In contrast, no significant differences in cognitive declines were observed during the control period.

CONCLUSIONS AND IMPLICATIONS: During the COVID-19 pandemic, older people with multimorbidity suffered an accelerated decline in cognition and elevated incident dementia risk, while no evident differences in cognitive decline rates were observed before the pandemic. Measures targeting vulnerable older people with multimorbidity could be significant for assisting these individuals to tackle neurocognitive challenges during the pandemic.

VL - 24 IS - 4 ER - TY - JOUR T1 - Factors Associated with Healthcare Delays Among Adults Over 50 During the COVID-19 Pandemic. JF - The Journals of Gerontology, Series A Y1 - 2023 A1 - Chan, Athena C Y A1 - Sneed, Rodlescia S KW - COVID-19 KW - geographical region KW - healthcare delay KW - Race/ethnicity AB -

BACKGROUND: Adults over 50 have high healthcare needs, but also face high coronavirus disease 2019 (COVID-19)-related vulnerability. This may result in reluctance to enter public spaces, including healthcare settings. Here, we examined factors associated with healthcare delays among adults over 50 early in the COVID-19 pandemic.

METHODS: Using data from the 2020 wave of the Health and Retirement Study (N=7615), we evaluated how race/ethnicity, age, geographic region, and pandemic-related factors were associated with healthcare delays.

RESULTS: In our sample, 3 in 10 participants who were interviewed from March 2020 to June 2021 reported delays in medical or dental care in the early stages of the COVID-19 pandemic. Non-Hispanic Whites (OR: 1.37; 95% CI: 1.19-1.58) and those of other racial/ethnic backgrounds (OR: 1.31; 95% CI: 1.02-1.67) delayed care more than Non-Hispanic Blacks. Other factors associated with delayed care included younger age, living in the Midwest or West, knowing someone diagnosed with or who died from COVID-19, and having high COVID-19-related concerns. There were no differences in care delays among adults aged >70; however, among those ≤70, those who knew someone diagnosed with COVID-19 were more likely to delay care than those who did not. Additionally, among those ≤70, Non-Hispanic Whites and those of other racial/ethnic backgrounds delayed care more than Non-Hispanic Blacks and Hispanics.

CONCLUSIONS: There is considerable heterogeneity in care delays among older adults based on age, race/ethnicity, and pandemic-related factors. As the pandemic continues, future studies should examine whether these patterns persist.

ER - TY - JOUR T1 - Financial hardship and change in emotional well-being before to during COVID-19 pandemic among middle-aged and older Americans: Moderating effects of internal coping resources. JF - Social Science & Medicine Y1 - 2023 A1 - Choi, Shinae L A1 - Lee, Yoon G KW - Adaptation KW - COVID-19 KW - financial stress KW - Leave Behind Questionnaire KW - Pandemics KW - Psychological AB -

OBJECTIVE: The purpose of this study was to investigate associations between financial hardship and change in emotional well-being-positive and negative affect-before to during the COVID-19 pandemic among middle-aged and older Americans and to examine the extent to which associations were moderated by internal coping resources-dispositional mastery and optimism.

METHOD: Data derived from the Leave-Behind Questionnaire in the 2016 and 2020 waves of the Health and Retirement Study, a nationally representative longitudinal survey of U.S. adults aged 51 and older (N = 1312). We estimated multivariate ordinary least squares regression models with interaction terms to evaluate prospectively the benefits of mastery and optimism as internal coping resources for middle-aged and older adults.

RESULTS: Dispositional mastery moderated the effects of financial hardship on changes in negative and positive affect, respectively, before to during the COVID-19 pandemic; however, optimism did not significantly moderate the effects of financial hardship on change in negative and positive affect before to during the COVID-19 pandemic.

CONCLUSIONS: Our findings have implications for interventions aimed at improving middle-aged and older adults' emotional well-being by promoting internal coping resources. Specifically, interventions should focus on financial hardship and mastery for vulnerable middle-aged and older adults in the context of public health crises.

VL - 317 ER - TY - JOUR T1 - Online engagement, resilience, and loneliness among older people during the COVID-19 pandemic JF - Social Science & Medicine Y1 - 2023 A1 - Kunyu Zhang A1 - Jeffrey A. Burr A1 - Jan E. Mutchler A1 - Jiehua Lu KW - COVID-19 KW - Digital engagement KW - Internet KW - Loneliness KW - Posttraumatic growth KW - Resilience AB - Background and objectives The COVID-19 pandemic exacerbated the public health concerns of social isolation and loneliness for older people who are vulnerable due to their health conditions and more restrictive social measures. However studies revealed that many older adults demonstrated high resilience and remained emotionally stable during the pandemic, particularly those who had a broad engagement with online technology that could compensate for their isolation. Yet, little empirical research has examined explicitly the association between online engagement and loneliness among older adults, and the role resilience played in this relationship during the pandemic. This study contributed to the literature by addressing these research gaps. Research design and methods This study investigated the relationships between online engagement (sum of involvement in 31 online activities), resilience (sum of positive experiences and personal growth during COVID-19) and loneliness (mean of 11-items from the revised version of the UCLA loneliness scale) among community-dwelling older people (aged 60+), using national survey data from the 2020 Health and Retirement Study (HRS) collected during the COVID-19 pandemic (N = 3,552). Results and conclusion Online engagement was negatively associated with levels of loneliness (β = -0.080, 95% CI [-0.118, -0.047]), and this association was partially mediated by levels of resilience (β = -0.023, 95% CI [-0.031, -0.016]. The findings suggested that a broad integration of online technology into daily-life may have helped older people combat loneliness during the pandemic, and resilience could be one important mechanism that linked this association. VL - 329 ER - TY - JOUR T1 - PCR144 Evaluation of the Association between Self-Perceptions of Aging and Care Deferrals Among US Adults Aged ≥50 Years during the COVID-19 Pandemic Y1 - 2023 A1 - S. Korgaonkar A1 - P. Prajapati A1 - M. Barnard A1 - S. Goswami KW - Aging KW - COVID-19 KW - US adults AB - Objectives Self-perceptions of aging (SPA) have been shown to influence healthcare-seeking behaviors among middle-aged and older adults. Negative SPA may intensify the COVID-19 pandemic-related healthcare disruptions in this population. Therefore, this study seeks to evaluate the association between SPA and care deferrals among community-dwelling adults aged ≥50 years in the US during the COVID-19 pandemic. Go to: Methods A cross-sectional study of the eligible sample was conducted using data from the 2020 wave of the Health and Retirement Study. SPA score was measured using a validated eight-item instrument with higher scores indicating negative SPA. The association between SPA and care deferrals during the COVID-19 pandemic was assessed using multivariable logistic regression adjusted for respondents’ sociodemographic and clinical characteristics, past COVID-19-related experiences, and COVID-19 worry. Go to: Results The final sample consisted of 4,153 community-dwelling adults aged ≥50 years. 30% reported care deferrals during the COVID-19 pandemic. Among respondents who deferred care, the majority were aged 50-64 years (46.6%), females (65.4%), and White (64.5%). Most commonly reported care deferrals were dental appointments (74.5%) and physician visits (56.5%). Care deferrals were mainly due to clinic/office rescheduling or cancelling appointments (57.5%), respondent deciding the care could wait (33.8%), and COVID-19 fear (21.8%). Respondents reporting care deferrals reported higher mean SPA scores, indicating negative aging attitudes, compared those who did not defer care (Mean (SD): 3.24 (1.02) vs. 3.05 (1.04), p<0.001). After accounting for covariates, higher SPA scores were associated with significantly higher odds of care deferrals (aOR: 1.20, 95% CI: 1.11 – 1.30, p<0.001). Go to: Conclusions This study found that negative SPA were associated with care deferrals during the COVID-19 pandemic among community-dwelling adults aged ≥50 years. As healthcare delivery rebounds to pre-pandemic levels, the role of SPA in healthcare-seeking behaviors should be recognized. Health promotion efforts may target positive aging attitudes to encourage timely and proactive use of healthcare. ER - TY - JOUR T1 - Physical Disability, Psychological Resilience and COVID-related Changes in Depressive Symptoms among U.S. Older Adults. JF - J Gerontol B Psychol Sci Soc Sci Y1 - 2023 A1 - Li, Miao A1 - Luo, Ye KW - COVID-19 KW - Depressive symptoms KW - Older Adults KW - Physical disability KW - United States AB -

OBJECTIVES: This study pursued three goals: (1) to determine how depressive symptoms among U.S. older adults changed in 2018-2020, a period transitioning to the first wave of COVID pandemic, compared to in pre-pandemic periods, (2) to determine whether physical disability predicts change in depressive symptoms in 2018-2020, and (3) to assess whether psychological resilience moderates the association between physical disability and change in depressive symptoms in 2018-2020.

METHODS: Based on biennial longitudinal data of the Health and Retirement Study from 2010 to 2020, we used a before-after design and latent change score model to examine whether depressive symptoms change in 2018-2020 represents a continuation or departure from the overall trend of between-wave changes in 2010-2018. We also used physical disability in 2018 and psychological resilience in 2016-2018 to predict depressive symptoms change score in 2018-2020.

RESULTS: In contrast to the relatively stable between-wave change trend in 2010-2018, there was an abrupt elevation in the latent change score of depressive symptoms in 2018-2020, which was primarily driven by increased affective symptoms (e.g., depressed mood, loneliness, unhappiness, and sadness). Increase in depressive symptoms in 2018-2020 was associated positively with physical disability but negatively with psychological resilience. Moderation effect of psychological resilience, however, was not significant.

DISCUSSION: Our findings reveal heavier COVID-related mental health burden for older adults with physical disabilities and the potential benefits of enhancing individual psychological resilience. They also suggest that health interventions addressing the COVID impacts need to particularly focus on the affective aspects of depressive symptoms.

ER - TY - JOUR T1 - Predictors of food insecurity among older adults before and during COVID-19 in the United States. JF - Front Public Health Y1 - 2023 A1 - Nicklett, Emily Joy A1 - Cheng, Greta Jianjia A1 - Morris, Zachary A KW - Aged KW - COVID-19 KW - diet KW - Food insecurity KW - Food Supply KW - Humans KW - Middle Aged KW - Pandemics KW - United States AB -

BACKGROUND: The COVID-19 pandemic has strained the health and wellbeing of older adult populations through increased morbidity, mortality, and social exclusion. However, the impact of COVID-19 on the health of older adults through food security has received relatively little attention, despite the strong impact of diet quality on the health and longevity of older adults.

OBJECTIVE: The objective of this study was to identify sociodemographic and socioeconomic predictors of self-reported food insecurity before and early in the COVID-19 pandemic among community-dwelling older adults in the United States.

METHODS: Using longitudinal data from the Health and Retirement Study, a nationally representative sample of middle-aged and older adults in the United States, we examined the associations between sociodemographic and socioeconomic predictors of self-reported food insecurity between 2018 ( = 2,413) and June 2020 ( = 2,216) using population-weighted multivariate logistic regression models.

RESULTS: The prevalence of food insecurity doubled among participants from 2018 (4.83%) to June 2020 (9.54%). In 2018, non-Hispanic Black and rural residents were more likely to report food insecurity, while individuals with higher education and greater wealth were less likely to report food insecurity in adjusted models. In June 2020, those who were relatively younger, not working due to a disability, and renting were more likely to report food insecurity. Those with an increased number of functional limitations, a recent onset of a work-limiting disability, and those who were no longer homeowners experienced an elevated longitudinal risk for food insecurity.

CONCLUSION: Future research should examine effective policies and interventions to address the disproportionate impacts of COVID-19 on populations at a heightened risk of experiencing food insecurity.

VL - 11 ER - TY - JOUR T1 - Race-Ethnicity and Depressive Symptoms Among U.S. Older Adults in the COVID-19 Pandemic: Uncovering the Counterbalancing Mechanisms. JF - Innovation in Aging Y1 - 2023 A1 - Li, Miao A1 - Luo, Ye KW - Competitive mediation KW - COVID-19 KW - Depressive symptoms KW - race KW - Resilience AB -

BACKGROUND AND OBJECTIVES: Drawing on the counterbalancing framework, this study examined the counteracting roles of coronavirus disease (COVID)-related stressors (i.e., infection threat, family activity disruption, economic impact) and psychological resilience in explaining racial-ethnic disparities in depressive symptoms during the COVID-19 pandemic.

RESEARCH DESIGN AND METHODS: A competitive mediation model was fitted using nationally representative data from the Health and Retirement Study COVID-19 Project, which were collected in June 2020 ( = 1,717). A competitive mediation model was specified within which the associations between race-ethnicity categories and depressive symptoms were mediated by infection threat, family activity disruption, economic impact, and psychological resilience. A list of pre-COVID covariates and pre-COVID depressive symptoms were adjusted for in this model.

RESULTS: Infection threat, family activity disruption, economic impact, and psychological resilience were all higher among non-Hispanic Blacks and Hispanics than among non-Hispanic Whites. Economic impact had a positive whereas psychological resilience had a negative direct effect on depressive symptoms net of pre-COVID covariates and pre-COVID depressive symptoms. Mediation analyses revealed that, compared to non-Hispanic Whites, non-Hispanic Blacks and Hispanics had higher depressive symptoms due to their higher family activity disruption and higher economic impact, but their higher levels of psychological resilience also reduced depressive symptoms. The counteracting indirect effects offset each other, resulting in a null total effect of race-ethnicity on depressive symptoms.

DISCUSSION AND IMPLICATIONS: These findings suggest that interventions addressing the mental health impact of COVID should consider race/ethnicity-specific vulnerabilities and resilience. Future studies need to consider the complex and potentially counterbalancing mechanisms linking race-ethnicity and mental health.

VL - 7 IS - 2 ER - TY - JOUR T1 - Relationships Between Types of Leisure Activities and Mental Health among Older Adults With Diabetes During the COVID-19 Pandemic. JF - Am J Health Behav Y1 - 2023 A1 - Lee, Jungjoo A1 - Han, Areum A1 - Kim, Junhyoung A1 - Park, Se-Hyuk KW - Aged KW - COVID-19 KW - Diabetes Mellitus KW - Humans KW - Leisure activities KW - Mental Health KW - Pandemics AB -

Three types of leisure activities such as sedentary, social, and leisure-time physical activity (LTPA) have been identified as essential factors that influence mental health outcomes among older adults with diabetes. In this study, we aimed to investigate what types of leisure activities are associated with mental health outcomes among older adults with diabetes during the COVID-19 pandemic. We used 2020 Health and Retirement Study (HRS) data. We extracted 310 records from 3266 individuals diagnosed with diabetes and conducted a hierarchical regression analysis to investigate the research question. LTPA was the strongest predictor of reduced loneliness and stress and increased happiness and life satisfaction among older adults with diabetes. Our findings highlight the relationship between different types of leisure activities and mental health for older adults with diabetes during the COVID-19 pandemic. Data suggest that LTPA, social leisure, and sedentary leisure reduce loneliness and stress and improve happiness and life satisfaction.

VL - 47 IS - 2 ER - TY - JOUR T1 - Sex differences in changes of depressive symptoms among older adults before and during the COVID-19 pandemic: evidence from two longitudinal cohorts. JF - BMC Geriatrics Y1 - 2023 A1 - Zheng, Fanfan A1 - Li, Chenglong A1 - Hua, Rong A1 - Liang, Jie A1 - Gao, Darui A1 - Xie, Wuxiang KW - COVID-19 KW - depression KW - ELSA KW - Pandemics KW - Sex Characteristics AB -

BACKGROUND: Major concerns about the adverse mental health impact of the rapidly spread COVID-19 pandemic have been raised. Previous studies on changes of depressive symptoms during the COVID-19 pandemic have yielded inconsistent results regarding the sex differences. Since women have higher depressive symptoms even without the pandemic, it is essential to consider the pre-existing change of depressive symptoms of a similar period to discern the effect of the pandemic on depression. This study aimed to evaluate sex differences in depressive symptoms before and during the pandemic.

METHODS: Data from the Health and Retirement Study (HRS; waves 13 to 15) and the English Longitudinal Study of Ageing (ELSA; wave 8 to COVID-19 wave 2) were analyzed. Depressive symptoms were assessed by the 8-item Center for Epidemiological Studies Depression (CES-D) scale. According to the time of COVID-19 outbreak in the US and the UK, the intervals from waves 13 to 14 surveys of the HRS and from waves 8 to 9 surveys of the ELSA were employed as pre-pandemic periods to control for the pre-existing depressive symptoms, respectively. Changes of CES-D scores during the pre-pandemic and pandemic periods were assessed by linear mixed models.

RESULTS: Nine thousand, seven hundred thirty-seven participants (mean age: 66.7 ± 10.7 years) from the HRS and 5,098 participants (mean age: 68.7 ± 10.0 years) from the ELSA were included. CES-D scores among women were significantly higher than those among men at all waves in both cohorts. During the pre-pandemic period, no significant sex difference on changes of CES-D scores was detected in either the HRS or the ELSA. During the pandemic period, CES-D scores were increased in both men and women and the sex differences in CES-D increments of the two cohorts were both significant. Enlarged sex differences were demonstrated in increments of CES-D scores during the pandemic period.

CONCLUSIONS: Our results suggest women suffered from worse depressive symptoms in response to the pandemic, although the changes of depression were similar between men and women before the pandemic. These findings underscore the necessity to support the vulnerable populations, especially women, to manage the distress brought by the pandemic and maintain optimal mental health status.

VL - 23 IS - 1 ER - TY - JOUR T1 - Socioeconomic and race/ethnic differences in immunosenescence: Evidence from the Health and Retirement Study. JF - Brain, Behavior, and Immunity Y1 - 2023 A1 - Noppert, Grace A A1 - Stebbins, Rebecca C A1 - Dowd, Jennifer Beam A1 - Aiello, Allison E KW - Academic Success KW - COVID-19 KW - Health Status KW - Pandemics KW - SARS-CoV-2 AB -

BACKGROUND: The COVID-19 pandemic has highlighted the urgent need to understand variation in immunosenescence at the population-level. Thus far, population patterns of immunosenescence have not well described.

METHODS: We characterized measures of immunosenescence from the 2016 Venous Blood Study from the nationally representative U.S Health and Retirement Study (HRS) of individuals ages 50 years and older.

RESULTS: Median values of the CD8+:CD4+, EMRA:Naïve CD4+ and EMRA:Naïve CD8+ ratios were higher among older participants and were lower in those with additional educational attainment. Generally, minoritized race and ethnic groups had immune markers suggestive of a more aged immune profile: Hispanics had a CD8+:CD4+ median value of 0.37 (95 % CI: 0.35, 0.39) compared to 0.30 in non-Hispanic Whites (95 % CI: 0.29, 0.31). Non-Hispanic Blacks had the highest median value of the EMRA:Naïve CD4+ ratio (0.08; 95 % CI: 0.07, 0.09) compared to non-Hispanic Whites (0.03; 95 % CI: 0.028, 0.033). In regression analyses, race/ethnicity and education were associated with large differences in the immune ratio measures after adjustment for age and sex.

CONCLUSIONS: Lower educational attainment and minoritized racial ethnic status were associated with higher levels of immunosenescence. This population variation may have important implications for both risk of age-related disease and vulnerability to emerging pathogens (e.g., SARS-CoV-2).

VL - 107 ER - TY - JOUR T1 - Spending behavior and stimulus transfer use in response to income shocks among older Americans: evidence from the COVID-19 pandemic JF - Applied Economics Letters Y1 - 2023 A1 - Muna Sharma A1 - Patryk Babiarz KW - COVID-19 KW - Income shocks KW - Saving KW - Spending KW - stimulus checks AB - This study examines household behavioural responses to the pandemic-induced income shocks regarding their overall spending and spending out of 2020 CARES stimulus payments. Using data from the 2020 Health and Retirement Study COVID-19 project and restricting our sample to older adults (51 years old and above), we show that the negative income shocks experienced during the COVID-19 pandemic put downward pressure on household spending. Results also reveal that, relative to those who did not experience an income shock, stimulus recipients who experienced income losses were more likely to use the stimulus transfer to increase spending, pay off debt, or for other purposes rather than to save. VL - 30 IS - 12 ER - TY - JOUR T1 - Structural equation model of coping and life satisfaction of community-dwelling older people during the COVID-19 pandemic. JF - J Patient Rep Outcomes Y1 - 2023 A1 - Lalani, Nasreen A1 - Dongjuan, Xu A1 - Cai, Yun A1 - Arling, Greg W KW - Activities of Daily Living KW - Adaptation, Psychological KW - Aged KW - Child KW - COVID-19 KW - Female KW - Frailty KW - Humans KW - Independent Living KW - Male KW - Pandemics KW - Personal Satisfaction AB -

BACKGROUND: COVID-19 put older individuals at high risk for morbidity and mortality, isolation, reduced coping, and lower satisfaction with life. Many older adults experienced social isolation, fear, and anxiety. We hypothesized that successful coping with these stressors would maintain or improve satisfaction with life, a crucial psychological outcome during the pandemic. Our study investigated relationships between older people's coping and life satisfaction during the pandemic and their optimism, sense of mastery, closeness with spouse, family, and friends, and vulnerabilities from frailty, comorbid diseases, memory problems, and dependencies in instrumental activities of daily living (IADL).

METHODS: The study was based on a special COVID-19 sample of 1351 community-dwelling older adults who participated in the 2020 Health and Retirement Survey. A comprehensive structural equation modeling was used to test direct and indirect effects, with life satisfaction as the main outcome and coping as a mediator between the other variables and coping.

RESULTS: Most survey respondents were female and between the ages of 65-74 years. They averaged 1.7 chronic conditions, one in seven was frail, about one-third rated their memory as fair or poor, and about one in seven reported one or more difficulties in IADL. As hypothesized-older people with increased sense of mastery and optimism were better able to cope and had greater life satisfaction. In addition, close relationships with friends and with other family members besides the spouse/partner or children contributed to more successful coping, while the interpersonal closeness of all types contributed directly to greater life satisfaction. Finally, older people with more IADL limitations reported greater difficulty coping and lower life satisfaction, and those older people who were frail or had multiple comorbid diseases reported lower life satisfaction.

CONCLUSIONS: Optimism, sense of mastery and closeness with family/friends promotes coping and life satisfaction, whereas frailty and comorbidities make coping more challenging and lead to lower life satisfaction particularly during a pandemic. Our study improves on prior research because of its nationally representative sample and formal specification and testing of a comprehensive theoretical framework.

VL - 7 IS - 1 ER - TY - ICOMM T1 - Study: Mid-life loneliness serves as risk factor for death later Y1 - 2023 A1 - Fischer, Kristen KW - COVID-19 KW - Life Expectancy KW - Loneliness PB - McKnights UR - https://www.mcknights.com/news/clinical-news/study-mid-life-loneliness-serves-as-risk-factor-for-death-later/ ER - TY - JOUR T1 - Activity Participation and Life Satisfaction of Older Adults During the COVID-19 Pandemic JF - The American Journal of Occupational Therapy Y1 - 2022 A1 - Sherman, David S. A1 - Lindstrom, Debra KW - activity participation KW - COVID-19 KW - Life Satisfaction AB - The study aims to expand support in the literature for the connection between activity participation and life satisfaction by exploring older adults’ experiences during the COVID-19 pandemic. Secondary data from the 2020 Health and Retirement Study COVID-19 Project were analyzed using a cross-sectional descriptive design. Results suggest that individuals with a higher frequency of activity participation reported higher life satisfaction. VL - 76 IS - Supplement_1 ER - TY - JOUR T1 - American older adults in COVID-19 Times: Vulnerability types, aging attitudes and emotional responses JF - Frontiers in Public Health Y1 - 2022 A1 - Fu, Mingqi A1 - Guo, Jing A1 - Chen, Xi A1 - Zhang, Qilin KW - Aging attitudes KW - COVID-19 KW - emotion KW - Vulnerability AB - Background: The coronavirus disease aroused challenges to the emotional well-being of vulnerable older adults in hard-hit areas. This study investigates different vulnerability types among American older adults and how modes of vulnerability are associated with aging attitudes and emotional responses. Methods: Using Latent Class Analysis, we investigated 2003 respondents aged over 50 from HRS. Hierarchical linear regressions with the affective profile as cluster identity were used to examine the relationship between vulnerability type and positive aging attitudes with positive and negative emotional responses. Results: We detected three vulnerability types among American older adults: the slight vulnerability (72%), the healthcare use vulnerability (19%), and the dual vulnerabilities (9%). No significant difference in positive emotions was found between vulnerability types. However, more negative emotions were found among older adults with healthcare use vulnerability (B=0.746 VL - 8 IS - 9 ER - TY - JOUR T1 - Association of Perceived Job Insecurity With Subsequent Memory Function and Decline Among Adults 55 Years or Older in England and the US, 2006 to 2016. JF - JAMA Network Open Y1 - 2022 A1 - Yu, Xuexin A1 - Kenneth M. Langa A1 - Cho, Tsai-Chin A1 - Lindsay C Kobayashi KW - COVID-19 KW - ELSA KW - Employment KW - England KW - Female KW - Male KW - Memory Disorders KW - Pandemics KW - Prospective Studies AB -

Importance: Intensified global economic competition and recent financial crises, including those associated with the COVID-19 pandemic, have contributed to uncertainty about job security. However, little is known about the association of perceived job insecurity with memory function and decline among older adults.

Objectives: To investigate the association between perceived job insecurity and subsequent memory function and rate of memory decline among older adults in the US and England.

Design, Setting, and Participants: This 10-year prospective population-based cohort study used data from the US Health and Retirement Study (HRS) and the English Longitudinal Study of Ageing (ELSA) collected from 2006 to 2016. Participants included 9538 adults 55 years or older. Data were analyzed from August 1 to 31, 2021.

Exposures: Perceived job insecurity (yes vs no) at baseline.

Main Outcomes and Measures: Episodic memory z scores at baseline and rate of decline during the follow-up.

Results: Among the 9538 study participants, the mean (SD) age at baseline was 60.97 (6.06) years, and 4981 (52.22%) were women. A total of 2320 participants (24.32%) reported job insecurity at baseline (1088 of 3949 [27.55%] in England and 1232 of 5589 [22.04%] in the US). Perceived job insecurity after 55 years of age was associated with lower baseline memory z scores in the fully adjusted model (β = -0.04 [95% CI, -0.08 to -0.01]) but not with rate of memory decline (β = 0.01 [95% CI, -0.01 to 0.01]). The association appeared to be stronger in the US than in England (job insecurity × US, β = -0.05 [95% CI, -0.11 to 0.02]), but the estimate was imprecise, potentially owing to low statistical power.

Conclusions and Relevance: The findings of this cohort study suggest that exposure to job insecurity in middle to late life was associated with worse memory function among older adults in the US and England. This association may vary across socioeconomic and social welfare contexts, although future studies with large samples from diverse socioeconomic settings are warranted.

VL - 5 IS - 4 ER - TY - JOUR T1 - Changing relationships between social contact, social support and depressive symptoms during the COVID-19 pandemic. JF - The Journals of Gerontology, Series B Y1 - 2022 A1 - Ang, Shannon KW - COVID-19 KW - Depressive symptoms KW - informal social participation AB -

OBJECTIVES: Given the longstanding consensus that social contact can promote older adult well-being, many have focused on how social contact changed during the pandemic. Less is known, however, about whether the link between social contact and health changed during the pandemic. This study sought to understand how associations between social contact, social support, and depressive symptoms changed during the COVID-19 pandemic.

METHODS: Data from two waves of the Health and Retirement Study were used. Respondents reported both virtual and in-person social contact, as well as perceived positive and negative social support. I use path models to estimate relationships between social contact, social support, and depressive symptoms. Bootstrapping was used to estimate the change in associations between 2016 and 2020.

RESULTS: Estimates show that associations between positive social support and depressive symptoms, as well as between in-person social contact and depressive symptoms, attenuated during the pandemic. Virtual social contact played a relatively minor role in determining outcomes such as social support and depressive symptoms, compared to in-person social contact.

DISCUSSION: Findings suggest that researchers and policymakers should not only focus on the changing quantity of social interactions when events such as the COVID-19 pandemic happen, but also the changing content and efficacy of the social interactions that remain.

VL - 77 IS - 9 ER - TY - JOUR T1 - Characteristics of community-dwelling older individuals who delayed care during the COVID-19 pandemic. JF - Archives of Gerontology and Geriatrics Y1 - 2022 A1 - Na, Ling KW - Community-dwelling KW - COVID-19 KW - delayed care AB -

BACKGROUND: Disruptions and reductions in healthcare services, coupled with infection concerns in the public, have caused widespread delay in health care during the COVID-19 pandemic. Persons with disability were at increased risk for deferred care. This study aimed to examine the extent of delayed care among older US individuals by disability status, identify characteristics associated with delayed care, and explore potential barriers to care during the pandemic.

METHODS: Data were drawn from the Health and Retirement Study (HRS) 2020 Core Early Release. Community-dwelling adults over age 50 (n = 15145) were classified as having ADL (or IADL) impairment versus no impairment. Distributions of demographic, clinical, and psychosocial characteristics, delayed care, and barriers to care were compared between disability groups. Characteristics associated with delayed care were identified with the multivariable logistic regression model with multiple imputation.

RESULTS: 30.7% of older individuals delayed care. ADL/IADL impairment was associated with delayed care overall and in specific domains. Sociodemographic (e.g., younger age and higher socioeconomic status), clinical (e.g., disability, psychiatric conditions, pain, and severe fatigue), and psychosocial (e.g., concerns about the pandemic, perceived financial insecurity, and loneliness) characteristics were associated with delayed care. Financial barrier to care and fear disproportionately affected those with social and clinical vulnerabilities, whereas reductions in healthcare services had a greater impact on those with socioeconomic well-being.

CONCLUSION: Efforts should be directed to increase receipt of needed care among vulnerable older individuals. Both pandemic-induced and long-standing barriers to care among disparate subpopulations should be considered in alternative care delivery models.

VL - 101 ER - TY - ICOMM T1 - COVID-19 Didn’t Change Older Americans’ Retirement Expectations: Study Y1 - 2022 A1 - McCarthy, Ed KW - COVID-19 KW - retirement expectation PB - ThinkAdvisor UR - https://www.thinkadvisor.com/2022/08/26/covid-19-didnt-change-older-americans-retirement-expectations-study/ ER - TY - JOUR T1 - COVID-19 pandemic impact on trajectories in cardiometabolic health, physical activity and functioning among adults from the 2006-2020 Health and Retirement Study. JF - The Journal of Gerontology, Series A Y1 - 2022 A1 - Beydoun, Hind A A1 - Beydoun, May A A1 - Gautam, Rana S A1 - Alemu, Brook T A1 - Weiss, Jordan A1 - Hossain, Sharmin A1 - Zonderman, Alan B KW - Activities of Daily Living KW - COVID-19 KW - lifestyle KW - Obesity KW - Statistical models AB -

BACKGROUND: The aim of this study was to evaluate the impact of the COVID-19 pandemic on trajectories in cardiometabolic health, physical activity and functioning among U.S. older adults, overall and according to selected baseline socio-demographic characteristics.

METHODS: We performed secondary analyses using longitudinal data on 1,372 participants from the 2006-2020 Health and Retirement Study. Pre-post COVID-19 pandemic onset was examined in relation to body mass index (BMI), number of cardiometabolic risk factors and/or chronic conditions, physical activity, Activities of Daily Living (ADL) and Instrumental Activities of Daily Living (IADL) using mixed-effects regression models and group-based trajectory models.

RESULTS: The COVID-19 pandemic was associated with significantly increased BMI (β=1.39, 95% CI: 0.74, 2.03). Furthermore, the odds of having at least one cardiometabolic risk factor and/or chronic disease increased pre-post COVID-19 onset (OR 1.16, 95% CI: 1.00, 1.36), whereas physical functioning worsened pre-post COVID-19 onset (ADL: β=1.11, 95% CI: 0.94, 1.28; IADL: β=0.59, 95% CI: 0.46, 0.73). The pre-post COVID-19 period (2018-2020) showed a stable group of trajectories, with low, medium and high levels of the selected health indicators. Health disparities according to sex, race/ethnicity, educational level, work status and total wealth are highlighted.

CONCLUSIONS: The COVID-19 pandemic onset appears to worsen cardiometabolic health and physical functioning among U.S. older adults, with clusters of individuals defined by selected socio-demographic characteristics experiencing distinct trajectories pre-post COVID-19 pandemic onset.

VL - 77 IS - 7 ER - TY - JOUR T1 - Determinants of COVID-19 Outcome as Predictors of Delayed Healthcare Services among Adults ≥50 Years during the Pandemic: 2006–2020 Health and Retirement Study JF - IJERPH Y1 - 2022 A1 - Beydoun, Hind A. A1 - Beydoun, May A. A1 - Alemu, Brook T. A1 - Weiss, Jordan A1 - Hossain, Sharmin A1 - Gautam, Rana S. A1 - Zonderman, Alan B. KW - cardiometabolic KW - COVID-19 KW - healthcare services KW - lifestyle KW - Machine learning KW - socio-demographic AB - Background: The coronavirus disease 19 (COVID-19) was declared a global pandemic on 11 March 2020. To date, a limited number of studies have examined the impact of this pandemic on healthcare-seeking behaviors of older populations. This longitudinal study examined personal characteristics linked to COVID-19 outcomes as predictors of self-reported delayed healthcare services attributed to this pandemic, among U.S. adults, ≥50 years of age. Methods: Secondary analyses were performed using cross-sectional data (1413 participants) and longitudinal data (2881 participants) from Health and Retirement Study (HRS) (2006–2018) linked to the 2020 HRS COVID-19 Project (57% female, mean age: 68 years). Demographic, socioeconomic, lifestyle and health characteristics were evaluated in relation to delayed overall, surgical and non-surgical healthcare services (“Since March 2020, was there any time when you needed medical or dental care, but delayed getting it, or did not get it at all?” and “What type of care did you delay”) using logistic regression and Ensemble machine learning for cross-sectional data as well as mixed-effects logistic modeling for longitudinal data. Results: Nearly 32.7% delayed healthcare services, 5.8% delayed surgical services and 31.4% delayed non-surgical services. Being female, having a college degree or higher and 1-unit increase in depression score were key predictors of delayed healthcare services. In fully adjusted logistic models, a history of 1 or 2 cardiovascular and/or metabolic conditions (vs. none) was associated with 60–70% greater odds of delays in non-surgical services, with distinct findings for histories of hypertension, cardiovascular disease, diabetes and stroke. Ensemble machine learning predicted surgical better than overall and non-surgical healthcare delays. Conclusion: Among older adults, sex, education and depressive symptoms are key predictors of delayed healthcare services attributed to the COVID-19 pandemic. Delays in surgical and non-surgical healthcare services may have distinct predictors, with non-surgical delays more frequently observed among individuals with a history of 1 or 2 cardiovascular and/or metabolic conditions. VL - 19 UR - https://EconPapers.repec.org/RePEc:gam:jijerp:v:19:y:2022:i:19:p:12059-:d:923426 ER - TY - JOUR T1 - Determinants of COVID-19 testing among late middle-aged and older adults: Applying the health belief model. JF - Aging and Health Research Y1 - 2022 A1 - Sun, Na A1 - Hua, Cassandra L A1 - Qiu, Xiao A1 - Brown, J Scott KW - COVID-19 KW - Health belief model KW - Perceived barriers AB -

Objectives: The purpose of this study was to examine correlates of taking a COVID-19 test among late middle-aged and older adults using nationally representative data.

Methods: Data were obtained from the 2020 Health and Retirement Study midway release COVID-19 module. Our sample was representative of community residing adults aged 51 and over in the United States ( = 2,870).

Measurements: We regressed taking a COVID-19 test on demographic characteristics, medical comorbidities, and measures related to the health belief model (i.e., perceived severity, perceived susceptibility, cues to action, and perceived barriers) using logistic regression, stratifying the model by 10-year age categories.

Results: Concern about the pandemic was associated with an increase in the likelihood of taking a test among late middle-aged adults. Knowing someone who was diagnosed with COVID-19 was associated with taking a test in most age categories. Financial barriers and knowing someone who died of COVID-19 were not associated with taking a test.

Conclusions: How late middle-aged and older adults perceive the COVID-19 pandemic may significantly influence their likelihood of taking a COVID-19 test.

VL - 2 IS - 2 ER - TY - JOUR T1 - The Devastating Economic Impact of COVID-19 on Older Black and Latinx Adults: Implications for Health and Well-Being. JF - The Journals of Gerontology, Series B Y1 - 2022 A1 - Garcia, Marc A A1 - Amy D Thierry A1 - Pendergrast, Claire B KW - COVID-19 KW - economic inequality KW - Health Disparities AB -

OBJECTIVES: While disparities in COVID-19 infections and mortality have been documented for older Black and Latinx populations, pandemic-related economic impacts have been less studied for these groups. Minoritized older adults may be particularly vulnerable to financial hardships given their precarious socioeconomic positions. Thus, we aim to highlight the devastating economic impact of the ongoing COVID-19 pandemic and subsequent economic recession on older Black and Latinx adults, with a particular focus on the foreign-born population.

METHODS: This study used data from the 2020 COVID-19 module of the Health and Retirement Study. The sample included adults >50 years of age who were U.S.-born non-Latinx White and Black, U.S.-born Latinx, and foreign-born Latinx (n=2,803). We estimated age-standardized prevalence and means of variables indicating financial impact and economic hardship during the pandemic. We further examined differences in these measures across racial/ethnic and nativity groups.

RESULTS: Our findings document stark racial/ethnic inequalities in the pandemic's economic impact on older adults. Results show the pandemic has negatively affected older Black and Latinx adults across a host of economic factors (e.g., paying bills, affording health-related needs, or purchasing food), with foreign-born Latinx experiencing greater economic hardships relative to other groups.

DISCUSSION: During the COVID-19 pandemic, older Black and Latinx adults are experiencing disparate economic effects, including lacking money to cover basic needs, compared to older White adults. The implications of the economic shocks of the pandemic for the health and well-being of older Black and Latinx adults warrant policy-oriented action towards promoting equity.

VL - 77 IS - 8 ER - TY - JOUR T1 - Different Levels of Leisure-time Physical Activity, Coping, and Mental Health among Older Adults with Diabetes during the COVID-19 Pandemic. JF - American Journal of Health Behavior Y1 - 2022 A1 - Kim, Junhyoung A1 - Han, Sua KW - Adaptation KW - COVID-19 KW - Cross-Sectional Studies KW - Diabetes Mellitus KW - Exercise KW - Leisure activities KW - Mental Health KW - Pandemics KW - Psychological AB -

The COVID-19 has led public health researchers to try to improve mental health among older adults with diabetes. Leisure-time physical activity (LTPA) has emerged as a means of coping with mental health difficulties in the pandemic. We extracted 301 respondents from the Health and Retirement Study (HRS) based on the following criteria: over 50 years old and the onset of diabetes. We used multiple questionnaire items to assess mental health (ie, loneliness, happiness, and positive and negative affect) for older adults with diabetes. We used multivariate analysis of variance to investigate the relationships between the fixed variable (ie, LTPA) and outcome variables (ie, mental health). We categorized LTPA participation into 3 groups (ie, low, mid, and high) and examined mental health following various levels of LTPA participation. LTPA participation showed a significant group mean differences for loneliness, happiness, and positive affect, but not for negative affect. High-LTPA respondents presented lower loneliness and higher happiness than low-LTPA respondents. High-LTPA and mid-LTPA respondents indicated higher positive affect than low-LTPA respondents. This study provides evidence of the benefits of LTPA on mental health for older adults with diabetes and suggests that high-LPTA involvement can be effective in promoting mental health among older adults with diabetes in the COVID-19 era.

VL - 46 IS - 2 ER - TY - JOUR T1 - Difficulty and help with activities of daily living among older adults living alone during the COVID-19 pandemic: a multi-country population-based study. JF - BMC Geriatrics Y1 - 2022 A1 - Chen, Shanquan A1 - Jones, Linda A A1 - Jiang, Shan A1 - Jin, Huajie A1 - Dong, Dong A1 - Chen, Xi A1 - Wang, Dan A1 - Zhang, Yun A1 - Xiang, Li A1 - Zhu, Anna A1 - Cardinal, Rudolf N KW - Activities of Daily Living KW - COVID-19 KW - Domiciliary care KW - Living Alone AB -

BACKGROUND: Older adults who live alone and have difficulties in activities of daily living (ADLs) may have been more vulnerable during the COVID-19 pandemic. However, little is known about pandemic-related changes in ADL assistance (such as home care, domiciliary care) and its international variation. We examined international patterns and changes in provision of ADL assistance, and related these to country-level measures including national income and health service expenditure.

METHODS: We analysed data covering 29 countries from three longitudinal cohort studies (Health and Retirement Study, English Longitudinal Study of Aging, and Survey of Health, Ageing and Retirement in Europe). Eligible people were aged ≥50 years and living alone. Outcomes included ADL difficulty status (assessed via six basic ADLs and five instrumental ADLs) and receipt of ADL assistance. Wealth-related inequality and need-related inequity in ADL assistance were measured using Erreygers' corrected concentration index (ECI). Correlations were estimated between prevalence/inequality/inequity in ADL assistance and national health-related indicators. We hypothesized these measures would be associated with health system factors such as affordability and availability of ADL assistance, as well as active ageing awareness.

RESULTS: During COVID-19, 18.4% of older adults living alone reported ADL difficulties (ranging from 8.8% in Switzerland to 29.2% in the USA) and 56.8% of those reporting difficulties received ADL assistance (ranging from 38.7% in the UK to 79.8% in Lithuania). Females were more likely to receive ADL assistance than males in 16/29 countries; the sex gap increased further during the pandemic. Wealth-related ECIs indicated socioeconomic equality in ADL assistance within 24/39 countries before the pandemic, and significant favouring of the less wealthy in 18/29 countries during the pandemic. Needs-related ECIs indicated less equity in assistance with ADLs during the pandemic than before. Our hypotheses on the association between ADL provision measures and health system factors were confirmed before COVID-19, but unexpectedly disconfirmed during COVID-19.

CONCLUSION: This study revealed an unequal (and in some countries, partly needs-mismatched) response from countries to older adults living alone during the COVID-19 pandemic. The findings might inform future research about, and policies for, older adults living alone, particularly regarding social protection responses during crises.

VL - 22 IS - 1 ER - TY - JOUR T1 - Disparities in Mental Health and Well-Being between Heterosexual and Sexual Minority Older Adults during the COVID-19 Pandemic. JF - Journal of Aging and Health Y1 - 2022 A1 - Chen, Jen-Hao KW - Coronavirus impact KW - COVID-19 KW - Health Inequality KW - LGBTQ KW - minority experience KW - psychosocial health AB -

This study examines disparities in older adults' mental health and well-being during the pandemic by sexual minority status. This study analyzed data on older adults from the Health and Retirement Study's COVID-19 Module (N = 3142 for heterosexuals and N = 75 for sexual minorities). Weighted regressions linked concern about COVID-19, depression, pandemic emotional stress, and changes in loneliness, in-person contacts, income, and work to sexual minority status, controlling for sociodemographic characteristics. Compared to heterosexuals, sexual minority older adults had more concern about the pandemic and emotional stress and showed a decrease in in-person contact during the pandemic-these differences were not explained by sociodemographic characteristics. Sexual minority older adults were also more likely to have changes in income and work during the pandemic, but these differences were explained by sociodemographic characteristics. Sexual minority older adults have experienced worse mental health outcomes than heterosexuals during the COVID-19 pandemic, which merits intervention.

VL - 34 IS - 6-8 ER - TY - JOUR T1 - Experiences of Older Adults During the 2020 COVID-19 Pandemic in the United States: An Initial Exploration of Nationally Representative Data at the Intersection of Gender and Race. JF - Journal of Applied Gerontology Y1 - 2022 A1 - Takashi Yamashita A1 - Punksungka, Wonmai A1 - Van Vleet, Samuel A1 - Helsinger, Abigail A1 - Cummins, Phyllis KW - COVID-19 KW - gender KW - Intersectionality KW - race AB -

Little is known about the overall experiences and feelings of diverse older populations during the 2020 COVID-19 pandemic. To provide the baseline information for future research and policy, this study analyzed the 2020 Health and Retirement Study COVID-19 project data ( = 1782). More than 70% of older adults reported the following activities: watching TV (98%), reading (90%), using a computer and the internet (83%), gardening (82%), walking (75%), baking and cooking (73%), and praying (73%). Volunteering and attending community groups, which are known to benefit well-being, were unpopular (less than 8%). During the pandemic, older adults were generally satisfied with their lives, but more than half of them were concerned about their own health, family's health, and future prospects. Our study also showed the differences in the experiences and feelings by gender and race as well as the intersection of gender and race in the United States.

VL - 41 IS - 619-627 ER - TY - JOUR T1 - Financial Hardship and Psychological Resilience during COVID-19: Differences by Race/Ethnicity. JF - The Journals of Gerontology, Series B Y1 - 2022 A1 - Taylor, Miles G A1 - Carr, Dawn C A1 - Jason, Kendra KW - COVID-19 KW - Health Disparities KW - Income KW - Race/ethnicity KW - Successful aging KW - Wellbeing AB -

OBJECTIVES: Research on the impact of COVID-19 among older adults has primarily focused on relatively acute virus outcomes, but it is likely financial hardships during this time have eroded the adaptive capacity of older adults. It is also possible these impacts vary by race and ethnicity. We examine changes in psychological resilience (PR) among older adults before and during the pandemic to determine whether financial hardships and other stressors have altered this resource for White, Black, and Hispanic older adults.

METHOD: Using the COVID module released by the HRS (n=735), we examined changes in PR between 2016 and 2020 related to financial hardships during COVID. We tested interactions to determine whether the effects were patterned by race and ethnicity.

RESULTS: Consistent with previous literature, resilience was relatively stable during this time on average. Financial hardship during COVID-19 diminished resilience, but this effect was concentrated primarily among White Americans.

DISCUSSION: The results suggest that PR is a relatively stable resource in later life, even during the pandemic. However, this resource may be impacted in the face of specific challenges in later life. Policies related to financial hardship during the pandemic should be seen as supporting the capacity for older adults to adapt to current as well as future challenges.

VL - 77 IS - 7 ER - TY - ICOMM T1 - Has COVID Created a Retirement Confidence Conundrum? Y1 - 2022 A1 - Nevin E. Adams KW - COVID-19 KW - Retirement PB - National Association of Plan Advisors UR - https://www.napa-net.org/news-info/daily-news/has-covid-created-retirement-confidence-conundrum ER - TY - ICOMM T1 - How did COVID-19 impact Social Security claiming compared to the Great Recession? Y1 - 2022 A1 - Alicia H. Munnell KW - COVID-19 KW - Great Recession KW - Social Security claiming PB - MarketWatch UR - https://www.marketwatch.com/story/how-did-covid-19-impact-social-security-claiming-compared-to-the-great-recession-11666632791?mod=mw_latestnews ER - TY - RPRT T1 - How Does COVID-Induced Early Retirement Compare to the Great Recession? Y1 - 2022 A1 - Chen, Anqi A1 - Liu, Siyan A1 - Alicia H. Munnell KW - COVID-19 KW - Early retirement KW - Great Recession KW - Pandemic AB - In early 2020, the COVID Recession seemed like it would result in an increase in early Social Security claiming, similar to the Great Recession. However, pretty quickly the COVID Recession turned out to be quite different. It was spurred by a health crisis, potentially increasing the likelihood of early claiming among older workers and accompanied by a quick recovery in the stock market followed by rapidly-rising prices that could enable many with assets to retire early. On the other hand, the unprecedented expansion and generosity of unemployment insurance (UI) offered a way for lower-paid workers to stay in the labor force. The following analysis, using data from the Health and Retirement Study (HRS), compares how the claiming pattern changed in the recession years 2008-2010 from the expansion years 2004-2006 with how the pattern changed in the recession year 2020 from the expansion years 2016-2018. JF - Working Papers PB - Center for Retirement Research at Boston College CY - Newton, MA UR - https://crr.bc.edu/working-papers/how-does-covid-induced-early-retirement-compare-to-the-great-recession/ ER - TY - JOUR T1 - The Impact of COVID-19 on Depressive Symptoms and Loneliness for Middle-Aged and Older Adults JF - Sustainability Y1 - 2022 A1 - Curl, Angela L. A1 - Wolf, Katie E. KW - COVID-19 KW - Depressive symptoms KW - Loneliness AB - This study examines the impact of the COVID-19 pandemic on depressive symptoms and loneliness in older adults, using the Protection Motivation Theory Framework. Using data collected between March 2020 and May 2021 as part of the Health and Retirement Study (N = 2145 adults over age 50), the roles of threat and coping appraisals as predictors of protective health behaviors and, ultimately, mental health outcomes, were analyzed using structural equation modeling. Being at high risk for COVID-19 complications and death was associated with more depressive symptoms and loneliness. Higher levels of concern about COVID-19 were associated with more depressive symptoms while knowing someone who had died of the coronavirus was associated with less loneliness. Lower scores for perceived control over one’s health and social life were associated with more depressive symptoms and higher loneliness. These results suggest that moving forward, mental health assessments should consider the impact of the pandemic and include measures specifically asking about COVID-19 concerns and experiences (e.g., death of close friends or family due to COVID-19, protective health measures). Additionally, future responses to this pandemic and other public health emergencies should consider the influence that self-efficacy has on health behaviors and mental health. The pandemic has raised public awareness of the negative consequences of social isolation and acted to destigmatize mental illness, and this greater awareness could encourage middle-aged and older adults to seek various treatments for depression and loneliness. VL - 14 ER - TY - JOUR T1 - The Impact of the COVID-19 Pandemic on Business Ownership Across Racial/Ethnic Groups and Gender. JF - Journal of Economics, Race, and Policy Y1 - 2022 A1 - Choi, Shinae L A1 - Harrell, Erin R A1 - Watkins, Kimberly KW - COVID-19 KW - Entrepreneurship KW - gender KW - Race/ethnicity AB -

This study examined the economic impact of the COVID-19 pandemic on US older entrepreneurs' businesses using the Health and Retirement Study. We estimated logistic regression models to document the odds of experiencing economic impact. The COVID-19 pandemic has affected nearly 76% of US older entrepreneurs but has disproportionately impacted the businesses of Black, Hispanic, Asian/other races, and women entrepreneurs. Older Black entrepreneurs had significantly higher odds of facing business closure (OR = 2.31,  < .01), implementing new procedures (OR = 2.44,  < .01), workers quitting (OR = 2.95,  < .001), and difficulty paying regular bills (OR = 2.88,  < .001) than their White counterparts. Older Hispanic entrepreneurs also had significantly higher odds of instituting new procedures (OR = 2.27,  < .05), workers quitting (OR = 2.26,  < .01), and difficulty paying regular bills (OR = 2.35,  < .01) than their White counterparts. Similarly, older Asian/other races entrepreneurs were significantly more likely to report difficulty paying regular bills since the start of the pandemic than their White counterparts (OR = 3.11,  < .01). Women entrepreneurs were significantly more likely to close their businesses than their male counterparts (OR = 2.11,  < .001). These significant associations persisted after controlling for confounders. Support for underserved racial/ethnic groups and older women entrepreneurs should focus on accessibility to financial services, capital, and support packages as well as legislative support for ensuring business continuity and success.

VL - 5 IS - 4 ER - TY - JOUR T1 - The inequitable burden of the COVID-19 pandemic among marginalized older workers in the United States: an intersectional approach. JF - The Journals of Gerontology, Series B Y1 - 2022 A1 - Andrea, Sarah B A1 - Eisenberg-Guyot, Jerzy A1 - Blaikie, Kieran J A1 - Owens, Shanise A1 - Oddo, Vanessa M A1 - Peckham, Trevor A1 - Minh, Anita A1 - Hajat, Anjum KW - COVID-19 KW - Employment KW - Inequities KW - Intersectionality AB -

OBJECTIVES: The COVID-19 pandemic has profoundly affected the lives of people globally, widening longstanding inequities. We examined the COVID-19 pandemic's impact on employment conditions by race/ethnicity, gender, and educational attainment and the association between such conditions and well-being in older adults in the United States.

METHODS: Using data from the Health and Retirement Study respondents interviewed between May 2020 and May 2021 when they were ≥55 years of age, we examined intersectional patterns in COVID-19-related changes in employment conditions among 4,107 participants working for pay at the start of the pandemic. We also examined the compounding nature of changes in employment conditions and their association with financial hardship, food insecurity, and poor self-rated health.

RESULTS: Relative to non-Hispanic White men with greater than high school education (>HS), Black and Latinx men and women were more likely to experience job loss irrespective of education; among those who did not experience job loss, men with ≤HS reporting Black, Latinx, or "other" race were >90% less likely to transition to remote work. Participants who experienced job loss with decreased income or continued in-person employment with decreased income/shift changes had greater prevalence of financial hardship, food insecurity, and poor/fair self-rated health than others.

DISCUSSION: The impact of COVID-19 on employment conditions is inequitably patterned and is associated with financial hardship, food insecurity, and adverse health in older adults. Policies to improve employment quality and expand social insurance programs among this group are needed to reduce growing inequities in well-being later in life.

VL - 77 IS - 10 ER - TY - ICOMM T1 - Is inflation taking a summer vacation? Y1 - 2022 A1 - Goodkind, Nicole KW - COVID-19 KW - Finances KW - inflation KW - Retirement JF - Business PB - CNN UR - https://us.cnn.com/2022/08/09/investing/premarket-stocks-trading/index.html ER - TY - JOUR T1 - Level of Concern, Spending, and External Support Related to COVID-19: A Comparison between Working and Non-Working Older Adults. JF - International Journal of Environmental Research and Public Health Y1 - 2022 A1 - Yu, Zuojin A1 - Le, Aurora B A1 - Doerr, Alexa A1 - Smith, Todd D KW - COVID-19 KW - Logistic Models KW - Pandemics KW - Retirement AB -

This study compared levels of concern, spending, and use of external support by working status among older adults in the U.S. during the COVID-19 pandemic. It assessed whether work influences these variables related to wellness. Data from 2489 older adults from the 2020 U.S. Health and Retirement Study were analyzed using multiple linear and logistic regression. Older adults who worked had lower concerns about the pandemic (β = -0.28, = 0.048), were less likely to increase their spending (OR = 0.74, = 0.041), and were less likely to use external support (OR = 0.50, < 0.001). Use of external support increased with age (OR = 1.04, < 0.001) and increased spending (OR = 1.32, = 0.019). Married older adults were less likely to increase spending (OR = 0.75, = 0.007) and had lower concerns toward COVID-19 (β = -0.28, = 0.011). Higher levels of concern were reported among women (β = 0.31, = 0.005) and participants who had friends or family members diagnosed with COVID-19 (β = 0.51, < 0.001). Women were more likely to use support (OR = 1.80, < 0.001). Work appears to bolster older adult wellness outcomes.

VL - 19 IS - 18 ER - TY - JOUR T1 - Lonely older adults are more likely to delay or avoid medical care during the coronavirus disease 2019 pandemic. JF - International Journal of Geriatric Psychiatry Y1 - 2022 A1 - Li, Yue A1 - Cheng, Zijing A1 - Cai, Xueya A1 - Holloway, Melissa A1 - Maeng, Daniel A1 - Simning, Adam KW - Aged KW - COVID-19 KW - Humans KW - Independent Living KW - Loneliness KW - Pandemics KW - SARS-CoV-2 AB -

OBJECTIVES: To examine the relationship between loneliness and self-reported delay or avoidance of medical care among community-dwelling older adults during the coronavirus disease 2019 (COVID-19) pandemic.

METHODS: Analyses of data from a nationally representative survey administered in June of 2020, in COVID-19 module of the Health and Retirement Study. Bivariate and multivariable analyses determined associations of loneliness with the likelihood of, reasons for, and types of care delay or avoidance.

RESULTS: The rate of care delay or avoidance since March of 2020 was 29.1% among all respondents (n = 1997), and 10.1% higher for lonely (n = 1,150%, 57.6%) versus non-lonely respondents (33.5% vs. 23.4%; odds ratio = 1.59, p = 0.003 after covariate adjustment). The differences were considerably larger among several subgroups such as those with emotional/psychiatric problems. Lonely older adults were more likely to cite "Decided it could wait," "Was afraid to go," and "Couldn't afford it" as reasons for delayed or avoided care. Both groups reported dental care and doctor's visit as the two most common care delayed or avoided.

CONCLUSIONS: Loneliness is associated with a higher likelihood of delaying or avoiding medical care among older adults during the pandemic.

VL - 37 IS - 3 ER - TY - JOUR T1 - A National Study of Racial-Ethnic Differences in COVID-19 Concerns among Older Americans: Evidence from the Health and Retirement Study. JF - The Journal of Gerontology, Series B Y1 - 2022 A1 - Lin, Zhiyong A1 - Liu, Hui KW - COVID-19 KW - Health Disparities KW - Minority aging KW - race-ethnicity AB -

OBJECTIVES: Concerns about COVID-19 is an important emotional reaction to the pandemic and represents a key pandemic-related mental health outcome. We provide the first population-based evidence of racial-ethnic differences in COVID-19 concerns among older Americans during the COVID-19 outbreak.

METHODS: We analyzed data from the 2020 Health and Retirement Study COVID-19 project. The sample included 2,879 respondents (aged 50 and older) who were interviewed from June to September 2020 and had completed measures on COVID-19 concerns and other key covariates. Ordinary least squares regression models were estimated to assess racial-ethnic differences in COVID-19 concerns. Formal mediation analysis was conducted to test potential mediating roles of exposures to COVID-19 risks, preexisting health status, and socioeconomic resources in accounting for racial-ethnic differences in COVID-19 concerns.

RESULTS: Non-Hispanic Black and Hispanic Americans showed significantly greater concerns about the COVID-19 pandemic than non-Hispanic White Americans. Racial-ethnic minority older adults also had higher proportions of knowing someone who had contracted or died from COVID-19 than White older adults. Unequal exposures to COVID-19 risks by race-ethnicity and, to a lesser degree, preexisting health inequalities accounted for only part of the racial-ethnic differences in COVID-19 concerns.

DISCUSSION: Our findings call for more research and policy interventions to lessen the disproportionate burden of COVID-19 experienced by older adults of racial-ethnic minority groups.

VL - 77 IS - 7 ER - TY - ICOMM T1 - Older Workers’ Retirement Expectations Remain Intact Despite COVID Y1 - 2022 A1 - NAPA Net Staff KW - COVID-19 KW - Older workers KW - retirement expectations PB - National Association of Plan Advisors UR - https://www.napa-net.org/news-info/daily-news/older-workers%E2%80%99-retirement-expectations-remain-intact-despite-covid ER - TY - ICOMM T1 - Panel examines COVID-19 impact on retirement expectations Y1 - 2022 A1 - Mseka, Ayo KW - COVID-19 KW - Retirement PB - Insurance News UR - https://insurancenewsnet.com/innarticle/panel-examines-covid-19-impact-on-retirement-expectations ER - TY - ICOMM T1 - Perceived Control During the COVID-19 Pandemic Depends on Personality Traits Y1 - 2022 A1 - Nye, Jessica KW - COVID-19 KW - perceived control KW - Personality Traits PB - Psychiatry Advisor UR - https://www.psychiatryadvisor.com/home/topics/general-psychiatry/perceived-control-during-the-covid-19-pandemic-depends-on-personality-traits/ ER - TY - JOUR T1 - Personal control and financial well-being among the elderly: Moderating role of the big five JF - Personality and Individual Differences Y1 - 2022 A1 - Chhatwani, Malvika KW - Big Five personality traits KW - COVID-19 KW - Financial well-being KW - Personal control AB - The increasing financial worry among retirees is a major concern for the government. To address this concern, we examine the linkage between a sense of personal control and financial well-being among the elderly during COVID-19 using nationally representative data of 934 respondents. Based on personal control theory, we find a positive relationship between personal control and financial well-being. We also investigate whether the big five personality traits moderate the given relationship and find that openness to experience and conscientiousness positively, whereas neuroticism negatively moderates this linkage. The implications for the theory and practice are discussed. VL - 184 SN - 0191-8869 ER - TY - JOUR T1 - Personality and change in perceived control during the acute stage of the coronavirus pandemic. JF - Personality and Individual Differences Y1 - 2022 A1 - Sesker, Amanda A A1 - Lee, Ji Hyun A1 - Luchetti, Martina A1 - Damaris Aschwanden A1 - Stephan, Yannick A1 - Terracciano, Antonio A1 - Sutin, Angelina R KW - COVID-19 KW - perceived control KW - Personality Traits AB -

Lower perceived control (PC) is related to maladaptive psychological responses to stressful events, yet it is unclear whether longer-term situations are associated with PC change over time. This study examined PC change during the beginning of the coronavirus pandemic and whether trajectories varied by age and personality. Personality was assessed in 2455 U.S. adults (18-100 years) from an online study conducted January-February 2020. PC was assessed across three follow-ups (March-July 2020). Latent growth curves modeled PC change. In controlled models, PC decreased (β = -0.107,  = .005). Older adults had higher PC than younger adults (β = 0.012,  = .001), and experienced less PC decline (β = 0.012,  < .001). All personality traits but Openness were related to PC at baseline (βs ranged from -0.912 to 0.543, ps < .001). Conscientiousness (β = 0.155,  = .002), Extraversion (β = 0.128,  = .008), and Agreeableness (β = 0.099,  = .044) were associated with less PC decline. Employment (β = 0.160,  = .022), health (β = 0.133,  = .002), and disease burden (β = -0.056,  = .014) were also associated with PC change. These results were largely driven by the financial dimension of PC. This study provides evidence for PC change during the COVID-19 pandemic and identifies sociodemographic, personality, and health moderators of PC trajectory.

VL - 192 ER - TY - JOUR T1 - Personality and compliance with COVID-19 protective measures among older Americans: Moderating effects of age, gender, and race/ethnicity. JF - Personality and Individual Difference Y1 - 2022 A1 - Choi, Shinae L A1 - Peter Martin A1 - Cho, Jinmyoung A1 - Ryou, Yeon Ji A1 - Heinz, Melinda KW - COVID-19 KW - gender KW - Personality KW - Prevention KW - Race/ethnicity AB -

Following the growing evidence that personality is related to various health behaviors, we examined whether personality traits were related to compliance with COVID-19 protective measures and evaluated the extent to which associations were moderated by age, gender, or race/ethnicity among older adults during a summer 2020 surge of COVID-19 cases in the United States. Data were from the 2020 Health and Retirement Study COVID-19 module. Multivariate ordinary least squares regression analyses were computed adjusting for health, psychosocial, and sociodemographic factors. Results indicated the significant associations between personality traits and compliance with COVID-19 measures varied by age, gender, and race/ethnicity. Specifically, the associations of agreeableness with wearing a mask and frequent handwashing were less pronounced among older compared with younger individuals. The association between extraversion and wearing masks was stronger for men than for women. The associations of agreeableness with handwashing and physical distancing were weaker for Hispanic older adults, whereas the associations of extraversion with physical distancing and using sanitizers were stronger for Hispanic older adults than for their non-Hispanic White counterparts. Implications regarding behavioral science underlying the current pandemic and future public health crises are discussed.

VL - 189 ER - TY - JOUR T1 - Physical Disability and Older Adults' Perceived Food and Economic Insecurity During the COVID-19 Pandemic. JF - The Journals of Gerontology, Series B Y1 - 2022 A1 - Choi, Shinae L A1 - Deborah Carr A1 - Namkung, Eun Ha KW - COVID-19 KW - Disability KW - Financial hardship KW - Food insecurity KW - Job insecurity AB -

OBJECTIVES: We examined whether older adults with physical disability were vulnerable to three types of perceived economic insecurity (difficulty paying regular bills, difficulty paying medical bills, income loss) and two types of perceived food insecurity (economic obstacles, logistical obstacles) during the early months of the COVID-19 pandemic. We evaluated the extent to which associations are moderated by three personal characteristics (age, sex, race/ethnicity) and two pandemic-specific risk factors (job loss, COVID-19 diagnosis).

METHODS: Data are from a random 25 percent subsample of Health and Retirement Study (HRS) participants who completed a COVID-19 module introduced in June 2020. We estimated logistic regression models to predict each of five self-reported hardships during the pandemic.

RESULTS: Bivariate analyses showed that persons with three or more functional limitations were more likely to report both types of food insecurity, and difficulty paying regular and medical bills since the start of the pandemic, relative to those with no limitations. After controlling for health conditions, effects were no longer significant for paying medical bills, and attenuated yet remained statistically significant for other outcomes. Patterns did not differ significantly on the basis of the moderator variables. Job loss substantially increased the risk of economic insecurity but not food insecurity.

DISCUSSION: Older adults with more functional limitations were vulnerable to economic and food insecurity during the pandemic, potentially exacerbating the physical and emotional health threats imposed by COVID-19. Supports for older adults with disability should focus on logistical as well as financial support for ensuring their food security.

VL - 77 IS - 7 ER - TY - JOUR T1 - POSITIVE SELF-PERCEPTIONS OF AGING AS PREDICTORS OF COVID-RELATED PREVENTIVE BEHAVIOR AND RESILIENCE JF - Innovation in Aging Y1 - 2022 A1 - Hannah L. Giasson A1 - Chopik, William A1 - Carrillo, Alejandro KW - COVID-19 KW - positive self-perceptions of aging AB - Individuals have faced extraordinary challenges throughout the COVID-19 pandemic. Psychosocial strengths may promote individuals’ resilience during this time. Positive self-perceptions of aging (SPA) have been found to predict a variety of health and well-being indicators. We examined SPA as a predictor of COVID-19-related behavior, adaptation, and resilience in a sample of 3,620 adults (Mage=65.88; 61.1% women; 65.4% white) from the 2016 and 2020 waves of the Health and Retirement Study. Linear regression results revealed that more positive SPA in 2016 was associated with more preventative health behavior (β=.03, p=.04), a higher likelihood of staying at home (β=.07, p<.001), less worry (β=-.27, p<.001), less stress (β=-.24, p<.001), less loneliness (β=-.27, p<.001), and greater resilience (β=.20, p<.001) during the first year of the pandemic (2020). Associations held after controlling for demographic covariates. Findings support SPA theories, suggesting linkages between SPA and adaptive behaviors and outcomes in the face of external challenges. VL - 6 IS - Suppl 1 ER - TY - JOUR T1 - Predictors of Covid-19 level of concern among older adults from the health and retirement study. JF - Scientific Reports Y1 - 2022 A1 - Beydoun, Hind A A1 - Beydoun, May A A1 - Weiss, Jordan A1 - Gautam, Rana S A1 - Hossain, Sharmin A1 - Alemu, Brook T A1 - Zonderman, Alan B KW - COVID-19 KW - Female KW - Life Style KW - Retirement KW - Risk Factors AB -

The purpose of this longitudinal study is to construct a prediction model for Covid-19 level of concern using established Covid-19 socio-demographic, lifestyle and health risk characteristics and to examine specific contributions of obesity-related cardiometabolic health characteristics as predictors of Covid-19 level of concern among a representative sample of U.S. older adults. We performed secondary analyses of existing data on 2872 2006-2020 Health and Retirement Study participants and examined 19 characteristics in relation to the outcome of interest using logistic regression and machine learning algorithms. In mixed-effects ordinal logistic regression models, a history of diabetes, stroke as well as 1-2 cardiometabolic risk factors and/or chronic conditions were associated with greater Covid-19 level of concern, after controlling for confounders. Female sex, birth cohort, minority race, Hispanic ethnicity and total wealth as well as depressive symptoms were associated with higher level of Covid-19 concern, and education was associated with lower level of Covid-19 concern in fully adjusted mixed-effects ordinal logistic regression models. The selected socio-demographic, lifestyle and health characteristics accounted for < 70% of the variability in Covid-19 level of concern based on machine learning algorithms. Independent risk factors for Covid-19 level of concern among U.S. older adults include socio-demographic characteristics and depressive symptoms. Advanced research is needed to identify relevant predictors and elucidate underlying mechanisms of observed relationships.

VL - 12 IS - 1 ER - TY - RPRT T1 - Racial Disparities in COVID-19 Experiences among Older Adults with Disabling Conditions Y1 - 2022 A1 - Marisa Paige Reed Shenk A1 - Harrati, Amal A1 - Hicks, Bernadette A1 - Quiñones, Ana KW - COVID-19 KW - Disabilities KW - Racial Disparities AB - This paper examines the experiences of older adults with disabling conditions during the COVID-19 pandemic using data from the 2020 Health and Retirement Study. It documents the negative health, work, and financial experiences of older adults by disability status, race, and ethnicity. It also explores the intersectionality of race and ethnicity with disability and the role of contextual factors affecting the environments in which people live (e.g., health and economic conditions) using county- and state-level data. JF - Working Papers PB - Center for Retirement Research at Boston College UR - https://crr.bc.edu/working-papers/racial-disparities-in-covid-19-experiences-among-older-adults-with-disabling-conditions/ ER - TY - JOUR T1 - The Relationship between Pain and Psychological Distress during the COVID-19 Pandemic: Is Social Technology Use Protective? JF - Pain Medicine Y1 - 2022 A1 - Yang, Yulin A1 - Grol-Prokopczyk, Hanna A1 - Reid, M Carrington A1 - Pillemer, Karl KW - Anxiety KW - COVID-19 KW - depression KW - Loneliness KW - technology use for social purpose AB -

OBJECTIVES: The COVID-19 pandemic and resulting shelter-in-place orders have profoundly changed the everyday social environment. This study examines the relationship between pain and psychological distress (depression, anxiety, and loneliness) among US adults ages 54+ during the pandemic. We also test whether use of technology for social purposes moderates the association between pain severity and psychological distress.

METHODS: Using cross-sectional data on 1,014 adults ages 54 + (pain-free, n = 637; mild pain, n = 106; moderate pain, n = 227; and severe pain, n = 64) from the 2020 Health and Retirement Study COVID-19 Project (Early, Version 1.0), we conducted regression analyses to test the association between pain severity and psychological outcomes, and to assess social technology use frequency as a moderator.

RESULTS: Compared to their pain-free peers, participants with mild-to-moderate pain reported more depressive symptoms and greater loneliness; those with severe pain reported higher levels of depression, anxiety, and loneliness. Social technology use was associated with lower levels of depression and loneliness. However, interaction analyses show that social technology use predicted an increase in depression for individuals with pain, but a decrease in depression among pain-free individuals. For anxiety and loneliness, no significant effects of social technology use were observed.

CONCLUSION: Older adults with pain are at high risk of depression, anxiety, and loneliness during the pandemic. Although social technologies have become a common alternative to face-to-face interactions during the COVID-19 crisis, and overall they can provide mental health benefits, our results suggest that social technologies can be detrimental to psychological well-being among people with pain. These findings can inform technology-based interventions aiming to promote well-being among older adults with pain.

VL - 23 IS - 2 ER - TY - ICOMM T1 - Researchers Say Retirement Plans Unperturbed by COVID Y1 - 2022 A1 - Iekel, John KW - COVID-19 KW - retirement plans PB - American Society of Pension Professionals & Actuaries UR - https://www.asppa-net.org/news/researchers-say-retirement-plans-unperturbed-covid ER - TY - JOUR T1 - Rural-urban differences in food insecurity and associated cognitive impairment among older adults: findings from a nationally representative survey. JF - BMC Geriatrics Y1 - 2022 A1 - Srivastava, Shobhit A1 - Muhammad, T KW - Aged KW - Cognitive Dysfunction KW - COVID-19 KW - Cross-Sectional Studies KW - Food insecurity KW - Food Supply KW - Humans KW - Pandemics AB -

INTRODUCTION: Due to rapid urbanization, Covid-19 pandemic and increasing food prices, a higher rate of food insecurity has been observed in recent years in India. Thus, we aim to study the prevalence of food insecurity among older Indian adults and the association of food insecurity as a modifiable risk factor with late-life cognitive impairment.

METHOD: Data for this study were obtained from the recent release of the Longitudinal Ageing Study in India (2017-18). The total sample size for the study was 31,464 older adults aged 60 years and above. Cognitive functioning was measured through five broad domains (memory, orientation, arithmetic function, executive function, and object naming) adapted from the cognitive module of the US Health and Retirement Study (HRS). Descriptive statistics along with cross-tabulation were presented in the study. Additionally, multivariable logistic regression analysis was used to fulfil the objectives of the study.

RESULTS: It was found that 7.7% of older adults in rural areas reduced their size of meals due to unavailability (urban, 3.2%), 41.2% of them did not eat enough food of their choice (urban, 38.3%), 6.9% were hungry but did not eat food (urban, 2.6%), 5.0% did not eat for whole day (urban, 2.2%), and 6.9% lost weight due to lack of food in their household (urban, 2.9%). It was found that older adults who did not have enough food of their choice had significantly higher odds [AOR: 1.24; CI: 1.14, 1.35] of suffering from cognitive impairment in reference to their counterparts. Similarly, the older adults who were hungry but did not eat were 30% [AOR: 1.30; CI: 1.02, 1.73] more likely to suffer from cognitive impairment in reference to their counterparts. Interaction model revealed that older adults who had food insecurity in rural areas had higher odds of cognitive impairment than older adults who had food insecurity in urban areas.

CONCLUSION: The findings of the study highlight that the food security status in older adults may bring about greater challenges due to their limited economic resources. Interventions focusing on food security may have unintended positive impacts on late-life mental wellbeing as the older age is associated with higher cognitive deficits.

VL - 22 IS - 1 ER - TY - JOUR T1 - Social isolation and loneliness before and during the COVID-19 pandemic: a longitudinal study of US Adults over 50. JF - The Journals of Gerontology, Series B Y1 - 2022 A1 - Peng, Siyun A1 - Roth, Adam R KW - COVID-19 KW - Digital isolation KW - Mental Health KW - Social Relationships KW - Social Support AB -

OBJECTIVES: The potential impact of social distancing policies during the COVID-19 pandemic on social isolation and loneliness is of increasing global concern. Although many studies focus primarily on loneliness, patterns of social isolation-particularly physical and digital isolation-are understudied. We examined changes in social isolation, physical isolation, digital isolation, and loneliness in US adults over 50 before and during the lockdown.

METHODS: Two waves of the Health and Retirement Study, a national panel sample of US adults over 50 years old, were used. Fixed-effects regression models were fitted to identify within-person change from 2016 to 2020 to examine the impact of social distancing policies during the pandemic.

RESULTS: There was an increase in physical isolation and social isolation among respondents during the COVID-19 social distancing policies. However, respondents experienced no change in digital isolation or loneliness. The increase in physical isolation was only present for people with high COVID-19 concern whereas people with low concern experienced no change in physical isolation.

DISCUSSION: Despite an increase in physical isolation due to the social distancing policies, US adults aged over 50 stayed connected through digital contact and were resilient in protecting themselves from loneliness.

VL - 77 IS - 7 ER - TY - RPRT T1 - Social Security Claiming: COVID-19 vs. Great Recession Y1 - 2022 A1 - Chen, Anqi A1 - Liu, Siyan A1 - Alicia H. Munnell KW - COVID-19 KW - Great Recession KW - Social Security claiming AB - In early 2020, many thought the COVID crisis – like the Great Recession – might force many workers to claim Social Security early.But the COVID economy turned out very different, with robust growth in the stock market and substantial unemployment relief. The analysis compared the relative impacts of the two recessions on early claiming by earnings group and found that: During COVID, the booming stock market induced early claiming among workers with retirement assets ;while the generous unemployment benefits decreased early claiming for many lower-paid workers. Overall, the latter effect more than cancelled out the former, so COVID actually led to a slight decline in early claiming. JF - Briefs PB - Center for Retirement Research at Boston College CY - Newton, MA UR - https://crr.bc.edu/briefs/social-security-claiming-covid-19-vs-great-recession/ ER - TY - RPRT T1 - Social Security Claiming: COVID-19 vs. Great Recession. Y1 - 2022 A1 - Alicia H. Munnell A1 - Chen, Anqi A1 - Liu, Siyan KW - COVID-19 KW - Great Recession KW - Social Security claiming AB - The brief’s key findings are: In early 2020, many thought the COVID crisis – like the Great Recession – might force many workers to claim Social Security early. But the COVID economy turned out very different, with robust growth in the stock market and substantial unemployment relief. The analysis compared the relative impacts of the two recessions on early claiming by earnings group and found that: During COVID, the booming stock market induced early claiming among workers with retirement assets; while the generous unemployment benefits decreased early claiming for many lower-paid workers. Overall, the latter effect more than cancelled out the former, so COVID actually led to a slight decline in early claiming. JF - Issue in Brief PB - Center for Retirement Research at Boston College CY - Chestnut Hill, MA UR - https://crr.bc.edu/briefs-social-security/social-security-claiming-covid-19-vs-great-recession/ ER - TY - JOUR T1 - Sociodemographic and health status differences in delaying medical care during the COVID-19 pandemic among older adults: findings from the Health and Retirement Study. JF - BMC Public Health Y1 - 2022 A1 - Farina, Mateo P A1 - Jennifer A Ailshire KW - COVID-19 KW - Health Status KW - Health Status Disparities KW - Pandemics KW - Retirement AB -

BACKGROUND: During the COVID-19 Pandemic, adults in the United States reported delaying medical care, which may be tied risk of infection and local policies limiting appointment. Some populations may have been more likely to delay care than others, leading to other forms of health inequality during this period. To-date there is little research on delayed care among U.S. older adult. We determine the prevalence of delayed medical care among older adults and investigate sociodemographic and health status inequalities in delaying health care.

METHOD: We used data from the first public release of the nationally representative Health and Retirement Study COVID-19 Subsample (N = 3006). Using logistic regression, we assessed whether differences in delaying health care varied by age, sex, race/ethnicity, education, self-rated health (SRH), and having any Activity of Daily Living (ADL) limitation. We also conducted additional analysis that evaluated differences in delaying care by two care subtypes: doctor and dental care visits.

RESULTS: About 30% of U.S. older adults reported delaying care with the most common types of delayed care being dental or doctor visits. Adults ages 75 and older were less likely to delay care, while women, college educated, and those with poor SRH, and any ADL limitations were more likely to delay care.

CONCLUSIONS: Nearly one-third of older adults delayed care during the COVID-19 pandemic. The increased likelihood of delayed care among people with worse health suggests that there may be longer-term impacts on the health care system and population health from the COVID-19 pandemic, and may contribute to health inequalities in the near future.

VL - 22 IS - 1 ER - TY - JOUR T1 - Socio-demographic, lifestyle and health characteristics as predictors of self-reported Covid-19 history among older adults: 2006-2020 Health and Retirement Study. JF - American Journal of Infection Control Y1 - 2022 A1 - Beydoun, Hind A A1 - Beydoun, May A A1 - Hossain, Sharmin A1 - Alemu, Brook T A1 - Gautam, Rana S A1 - Weiss, Jordan A1 - Zonderman, Alan B KW - Cardiovascular Diseases KW - Chronic disease KW - COVID-19 KW - ethnicity KW - Female KW - Life Style KW - Retirement KW - Self Report AB -

BACKGROUND: To identify key socio-demographic, lifestyle, and health predictors of self-reported coronavirus disease 2019 (Covid-19) history, examine cardiometabolic health characteristics as predictors of self-reported Covid-19 history and compare groups with and without a history of Covid-19 on trajectories in cardiometabolic health and blood pressure measurements over time, among United States (U.S.) older adults.

METHODS: Nationally representative longitudinal data on U.S. older adults from the 2006-2020 Health and Retirement Study were analyzed using logistic and mixed-effects logistic regression models.

RESULTS: Based on logistic regression, number of household members (OR=1.26, 95% CI: 1.05, 1.52), depressive symptoms score (OR = 1.21, 95% CI: 1.04, 1.42) and number of cardiometabolic risk factors or chronic conditions ("1-2" vs "0") (OR = 0.27, 95% CI: 0.11, 0.67) were significant predictors of self-reported Covid-19 history. Based on mixed-effects logistic regression, several statistically significant predictors of Covid-19 history were identified, including female sex (OR = 3.06, 95% CI: 1.57, 5.96), other race (OR = 5.85, 95% CI: 2.37, 14.43), Hispanic ethnicity (OR = 2.66, 95% CI: 1.15, 6.17), number of household members (OR = 1.25, 95% CI: 1.10, 1.42), moderate-to-vigorous physical activity (1-4 times per month vs never) (OR = 0.38, 95% CI: 0.18, 0.78) and number of cardiometabolic risk factors or chronic conditions ("1-2" vs "0") (OR = 0.34, 95% CI: 0.19, 0.60).

CONCLUSIONS: Number of household members, depressive symptoms and number of cardiometabolic risk factors or chronic conditions may be key predictors for self-reported Covid-19 history among U.S. older adults. In-depth analyses are needed to confirm preliminary findings.

VL - 50 IS - 5 ER - TY - JOUR T1 - Staying Optimistic: Older Americans’ Retirement Expectations Remain Uninterrupted Despite COVID-19 Impact JF - EBRI Issue Brief Y1 - 2022 A1 - Liu, Zhikun KW - COVID-19 KW - retirement expectations AB - Employees’ retirement expectations have played important roles in predicting retirement decisions, making policy proposals, and designing financial products and services to help American workers better plan for their future retirement. From stochastic retirement readiness model design to Social Security benefits projection estimations and from defined contribution (DC) plan saving strategy to Monte Carlo retirement goals success rate calculations, people’s expected retirement age is a crucial factor for industry advisors, academics, and financial planners to design retirement services and projection models, study decision behaviors, and make sound advice for their clients. In this Issue Brief, we focus on investigating the potential influence of COVID-19 on the participants’ working and financial situations in 2020, as well as their decisions regarding retirement and Social Security claiming ages. VL - no. 565 UR - www.ebri.org/docs/default-source/ebri-issue-brief/ebri_ib_565_covidret-4aug22.pdf?sfvrsn=b548382f_6 ER - TY - ICOMM T1 - Study Evaluates Link Between Chronic Stress and Insomnia in Aging Population Y1 - 2022 A1 - Grossi, Giuliana KW - Chronic stress KW - COVID-19 KW - insomnia PB - HCP Live Network UR - https://www.hcplive.com/view/study-evaluates-link-between-chronic-stress-insomnia-aging-population ER - TY - RPRT T1 - Understanding the Increased Financial Hardship Experienced by Older Adults with Disabilities during the COVID-19 Pandemic Y1 - 2022 A1 - Zachary A Morris KW - COVID-19 KW - Disabilities KW - Financial hardship AB - The objective of this paper is to analyze why older adults with disabilities experienced greater financial hardship during the COVID-19 pandemic. It is hypothesized that increased household spending during the pandemic due to increased disability-related costs, and not job loss, mediated the relationship between disability and financial insecurity. The paper analyzes data for adults ages 51 and older from the U.S. Health and Retirement Study (HRS) 2020 survey, which was carried out from March 2020 to May 2021 (N=13,083). The paper found that: Adults with disabilities were significantly more likely to experience financial hardships compared to those without disabilities, net sociodemographic and health controls.The report of increased household spending during the pandemic significantly mediated the relationship between disability and financial hardship. Job-loss and income loss had no statistically significant indirect effect. The policy implications of the findings are: More research is needed to understand the changes in the costs of disability-related goods and services during the pandemic and their impact on people with disabilities.Such research can provide policymakers with key information on potential items to subsidize, compensate for, or provide in future disaster events in order to protect the financial security of people with disabilities. JF - Working Papers PB - Center for Retirement Research at Boston College CY - Newton, MA UR - https://crr.bc.edu/working-papers/understanding-the-increased-financial-hardship-experienced-by-older-adults-with-disabilities-during-the-covid-19-pandemic/ ER - TY - RPRT T1 - Will Survivors of the First Year of the COVID-19 Pandemic Have Lower Mortality? Y1 - 2022 A1 - Gal Wettstein A1 - Gok, Nilufer A1 - Anqi Chen A1 - Alicia H. Munnell KW - COVID-19 KW - Mortality AB - The mortality burden of the COVID-19 pandemic was particularly heavy among older adults, racial and ethnic minorities, and those with underlying health conditions. These groups are known to have higher mortality rates than others even in the absence of COVID. Using data from the 2019 American Community Survey, the 2018 Health and Retirement Study, and the 2020 National Vital Statistics System, this paper estimates how much lower the overall mortality rate will be for those who lived through the acute phase of the early pandemic after accounting for this selection effect of those who died from COVID. Such selection may have implications for life insurance and annuity premiums, as well as assessments of the financial standing of Social Security – if the selection is large enough to substantially alter projected survivor mortality. The paper found that: 10-year mortality rates, absent direct COVID deaths and long COVID, will likely be lower in 2021 than anticipated in 2019.However, these differences are small, ranging from a decline of 0.4 percentage points for people in their 60s to 1 percentage point for those in their 90s.The small difference is in spite of the fact that COVID mortality was, indeed, very selective, with mortality declines exceeding half the maximum possible declines, holding total COVID deaths constant, for every age group. The policy implications of the findings are: That declines in mortality due to COVID selection likely will not impact overall population mortality substantially enough to affect Social Security cost projections.Any impact of selection effects on Social Security costs will likely be swamped by ongoing mortality increases directly attributable to acute and long COVID. JF - Working Papers PB - Center for Retirement Research at Boston College CY - Newton, MA UR - https://crr.bc.edu/working-papers/will-survivors-of-the-first-year-of-the-covid-19-pandemic-have-lower-mortality/ ER - TY - JOUR T1 - The 2020 report of The Lancet Countdown on health and climate change: responding to converging crises. JF - Lancet Y1 - 2021 A1 - Watts, Nick A1 - Amann, Markus A1 - Arnell, Nigel A1 - Ayeb-Karlsson, Sonja A1 - Beagley, Jessica A1 - Belesova, Kristine A1 - Boykoff, Maxwell A1 - Byass, Peter A1 - Cai, Wenjia A1 - Campbell-Lendrum, Diarmid A1 - Capstick, Stuart A1 - Chambers, Jonathan A1 - Coleman, Samantha A1 - Dalin, Carole A1 - Daly, Meaghan A1 - Dasandi, Niheer A1 - Dasgupta, Shouro A1 - Davies, Michael A1 - Di Napoli, Claudia A1 - Dominguez-Salas, Paula A1 - Drummond, Paul A1 - Dubrow, Robert A1 - Ebi, Kristie L A1 - Eckelman, Matthew A1 - Ekins, Paul A1 - Escobar, Luis E A1 - Georgeson, Lucien A1 - Golder, Su A1 - Grace, Delia A1 - Graham, Hilary A1 - Haggar, Paul A1 - Hamilton, Ian A1 - Hartinger, Stella A1 - Hess, Jeremy A1 - Hsu, Shih-Che A1 - Hughes, Nick A1 - Jankin Mikhaylov, Slava A1 - Marcia P Jimenez A1 - Kelman, Ilan A1 - Kennard, Harry A1 - Kiesewetter, Gregor A1 - Kinney, Patrick L A1 - Kjellstrom, Tord A1 - Kniveton, Dominic A1 - Lampard, Pete A1 - Lemke, Bruno A1 - Liu, Yang A1 - Liu, Zhao A1 - Lott, Melissa A1 - Lowe, Rachel A1 - Martinez-Urtaza, Jaime A1 - Maslin, Mark A1 - McAllister, Lucy A1 - McGushin, Alice A1 - McMichael, Celia A1 - Milner, James A1 - Moradi-Lakeh, Maziar A1 - Morrissey, Karyn A1 - Munzert, Simon A1 - Murray, Kris A A1 - Neville, Tara A1 - Nilsson, Maria A1 - Sewe, Maquins Odhiambo A1 - Oreszczyn, Tadj A1 - Otto, Matthias A1 - Owfi, Fereidoon A1 - Pearman, Olivia A1 - Pencheon, David A1 - Quinn, Ruth A1 - Rabbaniha, Mahnaz A1 - Robinson, Elizabeth A1 - Rocklöv, Joacim A1 - Romanello, Marina A1 - Semenza, Jan C A1 - Sherman, Jodi A1 - Shi, Liuhua A1 - Springmann, Marco A1 - Tabatabaei, Meisam A1 - Taylor, Jonathon A1 - Triñanes, Joaquin A1 - Shumake-Guillemot, Joy A1 - Vu, Bryan A1 - Wilkinson, Paul A1 - Winning, Matthew A1 - Gong, Peng A1 - Montgomery, Hugh A1 - Costello, Anthony KW - Climate Change KW - Conservation of Natural Resources KW - COVID-19 KW - Extreme Weather KW - Global Health KW - health policy KW - Humans KW - International Cooperation KW - Pandemics KW - SARS-CoV-2 VL - 397 IS - 10269 ER - TY - JOUR T1 - Acknowledging Systemic Discrimination in the Context of a Pandemic: Advancing an Anti-Racist and Anti-Ageist Movement. JF - Journal of Gerontological Social Work Y1 - 2021 A1 - Gonzales, Ernest A1 - Gordon, Stacey A1 - Whetung, Cliff A1 - Connaught, Gerri A1 - Collazo, Jasmin A1 - Hinton, Jill KW - COVID-19 KW - Health Disparities KW - systemic racism AB -

This commentary draws together the confluence of current events - COVID-19 pandemic and racial injustice. Vulnerability to COVID-19 cannot be understood by age alone but within the context of inequity. We first review how COVID-19 has disproportionately affected Black and Latinx populations across the life span with the latest data from New York City Department of Health. We then discuss critical race theory and analyze longstanding inequities in health, economic, and social conditions that heighten the risk for vulnerability. We conclude with a discussion for the social work profession on the issues of defunding the police to undoing stereotypes.

VL - 64 IS - 3 ER - TY - CONF T1 - Assessing the Economic Impact Payment in the Older Population T2 - Retirement and Disability Research Consortium 23rd Annual Meeting Y1 - 2021 A1 - Kezdi, Gabor A1 - David R Weir KW - COVID-19 KW - economic impact KW - Stimulus effects AB - The COVID-19 pandemic is the greatest threat to the health and well-being of the older population in at least a century. The economic consequences of public health policies to mitigate that threat are also of serious concern. This project proposes to study one part of the policy response. We will use data collected by the Health and Retirement Study in its 2020 wave to study awareness and impact of the Economic Impact Payment (EIP) stimulus on different groups of older Americans during the coronavirus pandemic. The EIP was authorized as part of the Coronavirus Aid, Relief, and Economic Security (CARES) Act passed in late March 2020. It provides for a direct stimulus payment to individuals, similar to stimulus programs in previous economic downturns in 2001 and 2008. The great advantage to studying the impact of the EIP in HRS is the volume of other information that can be used to understand differentials in eligibility, awareness, and disposition. From the 2020 survey we will know about the impact of COVID-19 on work and health, as well as the usual measures of income and wealth. JF - Retirement and Disability Research Consortium 23rd Annual Meeting PB - Center for Financial Security, University of Wisconsin-Madison CY - Virtual Event UR - https://cfsrdrc.wisc.edu/files/2021-RDRC-Meeting-Booklet.pdf#page=7 ER - TY - JOUR T1 - The Association of Delayed Care With Depression Among US Middle-Aged and Older Adults During the COVID-19 Pandemic: Cross-sectional Analysis. JF - JMIR Aging Y1 - 2021 A1 - Luo, Yan KW - COVID-19 KW - delayed care KW - depression AB -

BACKGROUND: During the Coronavirus Disease 2019 (COVID-19) pandemic, the depression level among US adults has significantly increased. Age disparity in depression during the pandemic was also reported in recent studies. Delay or avoidance of medical care is one of the collateral damages caused by the COVID-19 pandemic and it can lead to increased morbidity and mortality.

OBJECTIVE: The present study aims to assess the prevalence of depression and delayed care among US middle-aged adults and older adults during the pandemic, as well as investigate the association of delayed care with depression among those two age groups.

METHODS: This cross-sectional study used the 2020 Health and Retirement Study (HRS) COVID-19 Project (Early, Version 1.0) data. Univariate analyses, bivariate analyses, and binary logistic regression were applied. US adults older than 46 years old were included. Depression was measured by Composite International Diagnostic Interview Short Form (CIDI-SF). Delayed care was measured by four items: delayed surgery, delayed seeing a doctor, delayed dental care, and other delayed care.

RESULTS: More than half of participants were older than 65 years old (58.23%) and 274 participants (8.75%) had depression during the pandemic. Delayed dental care was positively associated with depression among both middle-aged adults (OR=2.05, 95%CI=1.04-4.03, P<0.05) and older adults (OR=3.08, 95%CI=1.07-8.87, P<0.05). Delayed surgery was positively associated with depression among older adults (OR=3.69, 95%CI=1.06-12.90, P<0.05). Self-reported pain was positively related to depression among both age groups. Middle-aged adults who reported higher education level (some college of above) or worse self-reported health had higher likelihood to have depression. While perceived more loneliness was positively associated with depression among older adults, financial difficulty was positively associated with depression among middle-aged adults.

CONCLUSIONS: This study found that depression among middle-aged and older adults during the pandemic was also prevalent. The study highlighted the collateral damage of the COVID-19 pandemic by identifying the association of delayed surgery and dental care with depression during the pandemic. Although surgery and dental care cannot be delivered by telehealth, telehealth services can still be provided to address patients' concern on delayed surgery and dental care. Moreover, the implementation of tele-mental health services is also needed to address mental health symptoms among US middle-aged and older adults during the pandemic. Future research that uses more comprehensive measurements for delayed care is needed to decipher the path through which delayed care is associated with depression.

CLINICALTRIAL:

VL - 4 IS - 4 ER - TY - RPRT T1 - COVID-19 Has Had Devastating Economic Impacts on Older Black and Latinx Adults Y1 - 2021 A1 - Pendergrast, Claire B A1 - Amy D Thierry A1 - Garcia, Marc A KW - COVID-19 KW - economic impact KW - race disparity AB - Key findings: Compared to older White and Black adults, a greater proportion of older U.S.-born and foreign-born Latinx adults reported that their income decreased during the pandemic. • A larger portion of older Black adults reported increased household spending compared to other racial/ethnic and groups. • Latinx adults were disproportionately affected by economic hardships, with 56% of foreignborn Latinx adults and 49% of U.S.-born Latinx adults reporting at least one economic hardship. • Foreign-born Latinx adults were more likely to report missing a rent or mortgage payment, not being able to pay medical bills, and lacking money for food than other racial/ethnic groups. PB - Center for Aging and Policy Studies UR - https://surface.syr.edu/cgi/viewcontent.cgi?article=1162&context=lerner ER - TY - JOUR T1 - COVID-19, Inter-household Contact and Mental Well-being among Older Adults in the US and the UK JF - Frontiers in Sociology Y1 - 2021 A1 - Hu, Yang A1 - Qian, Yue KW - COVID-19 KW - Inter-household contact KW - Mental Health KW - Virtual interaction AB - Interacting with family members and friends from other households is a key part of everyday life and is crucial to people’s mental well-being. The COVID-19 pandemic severely curtailed face-to-face contact between households, particularly for older adults (aged 60 and above), due to their high risk of developing severe illness if infected by COVID-19. In-person contact, where possible, was largely replaced by virtual interaction during the pandemic. This article examines how inter-household contact in face-to-face and virtual forms, as well as combinations of the two forms of contact, related to older adults’ mental well-being during the pandemic. Data from two national longitudinal surveys, collected from the same respondents before (2018–2019) and during (June 2020) the pandemic, were comparatively analysed: the Health and Retirement Study in the US and Understanding Society in the UK. The findings showed a notable increase in loneliness in the US and a decline in general mental well-being in the UK following the outbreak of COVID-19. In both countries, more frequent inter-household face-to-face contact during the pandemic was associated with better general mental well-being, but inter-household virtual contact, via means such as telephone and digital media, was not associated with general mental well-being in either the US or the UK. In the US, older adults who engaged more frequently in virtual contact were more likely to feel lonely during the pandemic, particularly if their face-to-face contact was limited. In both countries, the increase in loneliness following the outbreak of the pandemic was greater for older adults who reported more virtual contact. The findings suggest that household-centred crisis management during the COVID-19 pandemic had unintended mental health implications in both the US and the UK, despite contextual differences between the two countries. Although face-to-face contact between households helped to sustain older adults’ mental well-being, virtual contact was not a qualitatively equivalent alternative. The findings also provide an important evidence base for informing policy developments and for supporting the mental health of older people during the COVID-19 pandemic and in the longer term. VL - 6 ER - TY - ICOMM T1 - COVID-19 pandemic shortens aggregate US life expectancy by more than 9 million years Y1 - 2021 A1 - Miller, Janel KW - aggregate life expectancy KW - COVID-19 KW - race disparity AB - Researchers estimated that the COVID-19 pandemic shortened aggregate U.S. life expectancy by more than 9 million years, and Black and Hispanic individuals lost more than twice as many quality-adjusted life years per capita than white individuals. JF - Infectious Diseases PB - Healio UR - https://www.healio.com/news/primary-care/20210920/covid19-pandemic-shortens-aggregate-us-life-expectancy-by-more-than-9-million-years ER - TY - Generic T1 - The Effect Habitual Exercise on Older Adults Mental Health During the COVID-19 Pandemic. T2 - American College of Sports Medicine, Mid-Atlantic Chapter Y1 - 2021 A1 - Resnick, Stephanie A1 - Fridley, Echo A1 - Mutambudzi, Miriam A1 - Heffernan, Kevin KW - COVID-19 KW - Exercise KW - Mental Health AB - The COVID-19 pandemic increased existing social isolation challenges in older adults due to quarantine and social distancing policies. Social isolation can be associated with an increase in mental health conditions such as anxiety and depression. Due to social isolation, many older adults had limited access to exercise opportunities. This is important because exercise can also affect mental health. PURPOSE: To consider the impact of exercise habits on older adults’ mental health during the COVID-19 pandemic. METHODS: The data used were from the Health and Retirement Study, a longitudinal study interviewing a representative sample of older adults biennially about physical and mental health, employment, and daily activities. In 2020, additional questions were added relating to COVID-19 and distributed to a subset of participants. Participants completed a physical activity questionnaire, the Beck Anxiety Inventory (n=1920) and the Center for Epidemiological Studies Depression questionnaire (n=2909). We ran logistic regression models. Model one had anxiety as the outcome of interest, and model 2 depressive symptoms. The independent variable was engaging in moderate exercise at least twice a week. All analyses were adjusted for covariates including the number of chronic health conditions, race/ethnicity, financial hardship during the pandemic, education, and alcohol use. RESULTS: Approximately 47% of this sample reported exercising 1 or less times per week (mean age 70±11 years, 49% female) compared to 53% reporting that they exercise 2 or more times per week (mean age 67±11 years, 51% female). Compared to older adults who exercised 2 or more times a week, those who exercised 1 or fewer times per week were found to be at increased risk for having elevated anxiety (OR = 1.41, 95% CI= .695 -2.92) and depressive symptomology (OR =1.98,95% CI =1.51-2.59). CONCLUSIONS: Exercising one or fewer times a week during the COVID-19 pandemic was associated with higher odds of anxiety and depressive symptoms in older adults. Older individuals who exercise less may be at increased risk for mental health symptoms during times of high psychosocial stress. With the emergence of new variants and uncertainty of the pandemic, it is important that older adults are encouraged to exercise to reduce odds of poor mental health outcomes. JF - American College of Sports Medicine, Mid-Atlantic Chapter PB - International Journal of Exercise Science VL - 10 UR - https://digitalcommons.wku.edu/cgi/viewcontent.cgi?article=5500&context=ijesab N1 - Issue 9, Volume 10 ER - TY - RPRT T1 - The Elderly and the COVID Pandemic: Early Findings on the Impact on Health, Mental Well-Being, and Financial Situation Y1 - 2021 A1 - Zahra Ebrahimi KW - COVID-19 KW - Finances KW - health KW - Well-being AB - Using early releases of data from the Health and Retirement Study (HRS) COVID-19 Project survey, the Employee Benefit Research Institute (EBRI) examines the various impacts of the pandemic on older Americans’ health, mental well-being, and financial situation. The bottom line is that the responses within the HRS depict an older population that was clearly impacted by the pandemic but that was — overall — remarkably resilient. However, the data also identify key areas of concern as well, including lower wealth and those near or early in retireme JF - EBRI Issue Brief PB - Employee Benefit Research Institute CY - Washington, D.C. UR - https://www.ebri.org/content/the-elderly-and-the-covid-pandemic-early-findings-on-the-impact-on-health-mental-well-being-and-financial-situation ER - TY - JOUR T1 - Financial hardship and depression experienced by pre-retirees during the COVID-19 pandemic: the mitigating role of stimulus payments JF - Applied Economics Letters Y1 - 2021 A1 - Liu, Yingyi A1 - Zhang, Yu A1 - Chatterjee, Swarn KW - COVID-19 KW - depression KW - Financial hardship KW - pre-retirees KW - stimulus checks AB - This study examines the association between financial hardship and depression among pre-retirees (ages 50 to 65) using the Health and Retirement Study (HRS) and its 2020 COVID-19 supplement. We find a negative association between the amount of stimulus received and financial hardship experienced by respondents during the pandemic. Additionally, the results indicate that African American households were less likely to increase spending, Hispanic households were more likely to increase savings, and households with lower educational attainment were more likely to pay down debt using their stimulus money. Financial wealth was negatively associated with the perception of feeling depressed. Overall, the findings from this study underscore the important role that the stimulus checks and other financial resources played in buffering the economic shock experienced by American households during the COVID-19 pandemic. SN - 1350-4851 ER - TY - JOUR T1 - Food Insecurity Associated with Higher COVID-19 Infection in Households with Older Adults JF - Public Health Y1 - 2021 A1 - Shinae L. Choi A1 - Fei Men KW - COVID-19 KW - Food insecurity KW - Health Disparities AB - ABSTRACT Objectives As a well-documented social determinant of health, food insecurity may be associated with COVID infection in households with older adults. We examined whether older adults were vulnerable to COVID infection during the early pandemic if they were food insecure versus food secure. Study design Cross-sectional study using a nationally representative population-based survey of US older adults. Methods We used a random subsample of Health and Retirement Study (HRS) drawn in June 2020 (N = 3,212). We compared the odds of reporting COVID infection in a household, COVID infection and mortality among acquaintances, and respondent’s perceived fair or poor health across household food insecurity status resulted from financial or nonfinancial barriers. Baseline health and socioeconomic circumstances were adjusted in the models. Results Results showed higher COVID infection rate among food-insecure households than among their food-secure counterparts during the pandemic. Food insecurity due to nonfinancial obstacles was associated with greater likelihood of COVID infection both within respondents’ households (adjusted odds ratio [aOR] = 1.73, 95% confidence interval [CI]: 1.03–2.90) and among their acquaintances (aOR = 1.32, 95% CI: 1.05–1.65). Food insecurity caused by both nonfinancial and financial constraints was associated with twice the likelihood of knowing someone who died from COVID than their food-secure counterparts (aOR = 2.14, 95% CI: 1.27–3.61). Conclusions Food insecurity driven by nonfinancial constraints played an important role in the ongoing pandemic among US older adults. Policies addressing COVID need to recognize the vulnerability of food-insecure older adults beyond lack of monetary resources. VL - 200 ER - TY - JOUR T1 - Measuring the COVID-19 Mortality Burden in the United States : A Microsimulation Study. JF - Annals of Internal Medicine Y1 - 2021 A1 - Julian Reif A1 - Heun-Johnson, Hanke A1 - Tysinger, Bryan A1 - Darius Lakdawalla KW - COVID-19 KW - mortality burden AB -

BACKGROUND: Fully assessing the mortality burden of the COVID-19 pandemic requires measuring years of life lost (YLLs) and accounting for quality-of-life differences.

OBJECTIVE: To measure YLLs and quality-adjusted life-years (QALYs) lost from the COVID-19 pandemic, by age, sex, race/ethnicity, and comorbidity.

DESIGN: State-transition microsimulation model.

DATA SOURCES: Health and Retirement Study, Panel Study of Income Dynamics, data on excess deaths from the Centers for Disease Control and Prevention, and nursing home death counts from the Centers for Medicare & Medicaid Services.

TARGET POPULATION: U.S. population aged 25 years and older.

TIME HORIZON: Lifetime.

PERSPECTIVE: Individual.

INTERVENTION: COVID-19 pandemic through 13 March 2021.

OUTCOME MEASURES: YLLs and QALYs lost per 10 000 persons in the population. The estimates account for the age, sex, and race/ethnicity of decedents, along with obesity, smoking behavior, lung disease, heart disease, diabetes, cancer, stroke, hypertension, dementia, and nursing home residence.

RESULTS OF BASE-CASE ANALYSIS: The COVID-19 pandemic resulted in 6.62 million QALYs lost (9.08 million YLLs) through 13 March 2021, with 3.6 million (54%) lost by those aged 25 to 64 years. The greatest toll was on Black and Hispanic communities, especially among men aged 65 years or older, who lost 1138 and 1371 QALYs, respectively, per 10 000 persons. Absent the pandemic, 38% of decedents would have had average or above-average life expectancies for their subgroup defined by age, sex, and race/ethnicity.

RESULTS OF SENSITIVITY ANALYSIS: Accounting for uncertainty in risk factors for death from COVID-19 yielded similar results.

LIMITATION: Estimates may vary depending on assumptions about mortality and quality-of-life projections.

CONCLUSION: Beyond excess deaths alone, the COVID-19 pandemic imposed a greater life expectancy burden on persons aged 25 to 64 years, including those with average or above-average life expectancies, and a disproportionate burden on Black and Hispanic communities.

PRIMARY FUNDING SOURCE: National Institute on Aging.

VL - 174 IS - 12 ER - TY - JOUR T1 - Patterns of Material Hardship and Food Insecurity Among Older Adults During the COVID-19 Pandemic. JF - Journal of General Internal Medicine Y1 - 2021 A1 - Claire K. Ankuda A1 - Fogel, Joyce A1 - Amy Kelley A1 - Byhoff, Elena KW - COVID-19 KW - Food insecurity KW - material hardship KW - race AB - The coronavirus (COVID-19) pandemic has major economic consequences across the USA.1 Along with heightened risk for severe COVID-19,2 older adults have less digital access which may be a barrier to mobilizing supports including grocery delivery.3,4 While people with lower incomes and from racial and ethnic minoritized groups have faced high levels of material hardship due to COVID-19,1 little is known about the experience of older adults. We aim to assess the prevalence and risk factors for material hardship and food insecurity among older adults in the USA. VL - 36 IS - 11 ER - TY - NEWS T1 - They Didn’t Expect to Retire Early. The Pandemic Changed Their Plans. T2 - The New York Times Y1 - 2021 A1 - Schwartz, Nelson D. A1 - Coral Murphy Marcos KW - COVID-19 KW - Early retirement KW - involuntary retirement KW - Retirement AB - After years in which Americans worked later in life, the latest economic disruption has driven many out of the work force prematurely. JF - The New York Times CY - New York, New York UR - https://www.nytimes.com/2021/07/02/business/economy/retire-early-pandemic-social-security.html?action=click&module=Spotlight&pgtype=Homepage ER - TY - JOUR T1 - Verbal memory is associated with adherence to COVID-19 protective behaviors in community dwelling older adults. JF - Aging Clinical and Experimental Research Y1 - 2021 A1 - O'Shea, Deirdre M A1 - Davis, Jennifer D A1 - Tremont, Geoffrey KW - Adherence KW - Aging KW - community living KW - COVID-19 KW - Memory AB -

BACKGROUND: Adherence to protective behaviors is central to limiting the spread of COVID-19 and associated risk of serious illness and mortality in older populations. Whether cognition predicts adherence to protective behaviors has not been examined in older adults.

AIMS: To examine whether specific cognitive abilities predict adherence to COVID-19 protective behaviors in older adults, independent of other relevant factors.

METHODS: Data from 431 older adults (i.e., ≥ 65 years) who took part in the COVID-19 module of the Health and Retirement Study were included in the present study. Separate binary logistic regression models were used to examine whether performance on measures of immediate and delayed recall and working memory predicted adherence to COVID-19 protective behaviors, controlling for demographics, level of COVID-19 concern, depressive symptoms, and medical conditions.

RESULTS: For every unit increase in immediate and delayed recall, the probability of adhering to COVID-19 protective behaviors increased by 47% and 69%, respectively. There was no association between the measure of working memory and adherence.

DISCUSSION: It is of public interest to understand the factors that reduce adherence to protective behaviors so that we can better protect those most vulnerable and limit community spread. Our findings demonstrate that reduced memory predicts non-adherence to COVID-19 protective behaviors, independent of virus concern, and other relevant demographic and health factors.

CONCLUSIONS: Public health strategies aimed at increasing adherence to COVID-19 protective behaviors in community dwelling older adults, should account for the role of reduced cognitive function in limiting adherence.

VL - 33 IS - 7 ER - TY - JOUR T1 - Age-Related Vulnerability to Coronavirus Disease 2019 (COVID-19): Biological, Contextual, and Policy-Related Factors. JF - Public Policy and Aging Report Y1 - 2020 A1 - Eileen M. Crimmins KW - COVID-19 KW - Immunosenescence KW - Mortality KW - Nursing homes AB - The detailed facts surrounding the coronavirus disease 2019 (COVID-19) pandemic are still evolving; however, one of the most shocking aspects of the COVID-19 pandemic is how lethal this condition is for the older population (Dowd et al., 2020). The risk for death and severe illness with COVID-19 is best predicted by age. The likelihood of death increases exponentially with age among those who contract the virus in all countries where this has been examined (Figure 1). Figure 1 shows the percent of confirmed cases ending in mortality, by age, for five countries near the beginning of June. In every country, the percent dying increases sharply after age 50, and the highest rates occur among the oldest persons. The age pattern is clear across the countries even though the mortality levels are quite different; the United States has had a much greater number of cases and deaths than the other countries in this figure, but the mortality level was higher in Italy. This difference in levels could be influenced by the proportion of diagnosed cases, which depends on testing, treatment of cases, and whether COVID-19 deaths include only those confirmed with a diagnostic test or include both confirmed and probable deaths (Sung & Kaplan, 2020). Even with these differences, the pattern of an exponential increase in death with age is clear. VL - 30 IS - 4 ER - TY - ICOMM T1 - How the Affordable Care Act Is Helping Fight the Coronavirus Outbreak Y1 - 2020 A1 - Marc A Cohen A1 - Jane Tavares KW - Affordable Care Act KW - Coronavirus KW - COVID-19 KW - depression KW - Health Insurance KW - Medicare KW - Pandemic AB - Ten years after the passage of the Affordable Care Act, the Trump administration is now asking the Supreme Court to overturn it. Yet it’s now clear that the ACA has brought significant improvements to the lives of millions of Americans. Today, they enjoy more health care coverage, with greater access, better outcomes and less cost. JF - The Conversation: Health PB - The Conversation CY - Boston UR - https://theconversation.com/obamacares-unexpected-bonus-how-the-affordable-care-act-is-helping-middle-aged-americans-during-the-pandemic-139267 ER - TY - JOUR T1 - Who are the Most At-Risk Older Adults in the COVID-19 Era? It’s Not Just Those in Nursing Homes JF - Journal of Aging & Social Policy Y1 - 2020 A1 - Marc A Cohen A1 - Jane Tavares KW - COVID-19 KW - home care workers KW - respiratory illnesses KW - seniors KW - social isolation AB - ABSTRACTCOVID-19 has taken a terrible toll on the nursing home population. Yet, there are five times the number of seniors living in the community who are also extremely vulnerable because they suffer from respiratory illnesses. Using the 2018 wave of the Health and Retirement Study we analyze this group of roughly 7 million seniors living in the community and find that they have multiple risk factors that make them particularly exposed. We also show how current strategies for protecting this population may be exacerbating risks and suggest concrete steps for better protecting this group. N1 - PMID: 32418475 ER -