%0 Journal Article %J journal of Cross Cultural Gerontology %D Forthcoming %T Comparative Analysis of Gender and Age Patterns in Informal Care Received among Disabled Older Adults: A Cross-National Study across the United States, Mexico, China, and Indonesia. %A Jain, Urvashi %A Sheehan, Connor M %K Cross-country comparisons %K Disability %K Family caregiving %K Informal care %X

This paper examines cross-national differences by gender and age in receipt and sources of help for limitations with activities of daily living or instrumental activities of daily living among older adults in the United States, Mexico, China, and Indonesia. Respondents aged 50 + from the Health and Retirement Study, Mexican Health and Aging Study, China Health and Retirement Longitudinal Study, and Indonesia Family Life Survey are included. Descriptive methods, logistic and multinomial regression analyses are used to examine patterns in any help received and main source of help respectively. After controlling for age, marital status, and co-residence with child(ren), it is found that men in all four countries overwhelmingly relied on their spouse for care, while children are more likely to be the main source of care for women. Children as the main source of care increased with age in each country and among men and women, surpassing spouse in China and Indonesia, and to a lesser extent in Mexico, but not in the United States where spouse was found to be more likely to be main caregiver even among the oldest age groups. Caregiving for the disabled is important for the well-being of the care recipient and for caregivers. Our results shed light on the asymmetric burden of caregiving on female spouses, across four diverse and aging countries.

%B journal of Cross Cultural Gerontology %G eng %R 10.1007/s10823-023-09488-0 %0 Journal Article %J Journal of the American Geriatrics Society %D Forthcoming %T A comprehensive prognostic tool for older adults: Predicting death, ADL disability, and walking disability simultaneously. %A Lee, Alexandra K %A Diaz-Ramirez, L Grisell %A Boscardin, W John %A Smith, Alexander K %A Lee, Sei J %K ADL %K Disability %K Mortality %K predition %X

BACKGROUND: Many clinical and financial decisions for older adults depend on the future risk of disability and mortality. Prognostic tools for long-term disability risk in a general population are lacking. We aimed to create a comprehensive prognostic tool that predicts the risk of mortality, of activities of daily living (ADL) disability, and walking disability simultaneously using the same set of variables.

METHODS: We conducted a longitudinal analysis of the nationally-representative Health and Retirement Study (HRS). We included community-dwelling adults aged ≥70 years who completed a core interview in the 2000 wave of HRS, with follow-up through 2018. We evaluated 40 predictors encompassing demographics, diseases, physical functioning, and instrumental ADLs. We applied novel methods to optimize three models simultaneously while prioritizing variables that take less time to ascertain during backward stepwise elimination. The death prediction model used Cox regression and both the models for walking disability and for ADL disability used Fine and Gray competing-risk regression. We examined calibration plots and generated optimism-corrected statistics of discrimination using bootstrapping. To simulate unavailable patient data, we also evaluated models excluding one or two variables from the final model.

RESULTS: In 6646 HRS participants, 2662 developed walking disability, 3570 developed ADL disability, and 5689 died during a median follow-up of 9.5 years. The final prognostic tool had 16 variables. The optimism-corrected integrated area under the curve (iAUC) was 0.799 for mortality, 0.685 for walking disability, and 0.703 for ADL disability. At each percentile of predicted mortality risk, there was a substantial spread in the predicted risks of walking disability and ADL disability. Discrimination and calibration remained good even when missing one or two predictors from the model. This model is now available on ePrognosis (https://eprognosis.ucsf.edu/alexlee.php) CONCLUSIONS: Given the variability in disability risk for people with similar mortality risks, using individualized risks of disabilities may inform clinical and financial decisions for older adults.

%B Journal of the American Geriatrics Society %G eng %R 10.1111/jgs.17932 %0 Journal Article %J Aging & Mental Health %D Forthcoming %T Hospitalization's association with depression in adults over 50 years old: does living arrangement matter? Findings from the Health and Retirement Study. %A Missell-Gray, Rachel %A Van Orden, Kimberly %A Simning, Adam %K Caregiving %K depression %K Disability %K Living arrangement %K post-acute care %X

OBJECTIVES: To examine how living arrangements are associated with depressive symptoms in late middle-life and older adults following hospitalization within the last two years.

DESIGN: We used the 2016 wave of the Health and Retirement Study (HRS), a nationally representative survey of adults over 50 years old living in the United States.

METHODS: The dependent variable was whether HRS participants screened positive for having depressive symptoms. The primary independent variable was self-reported hospitalization in the prior two years. We stratified bivariate analyses and multivariate logistic regressions by living arrangement to examine hospitalizations' association with depressive symptoms.

RESULTS: Depressive symptoms were less prevalent among participants who were married or partnered and living with a partner (14.0%) compared to those who were not married or partnered and were living with others (31.7%) and were not married or partnered and were living alone (27.8%). In multivariate analyses stratified by living arrangement, however, hospitalization was associated with depressive symptoms for those married or partnered and living with a partner (OR = 1.39, 95% CI: 1.14-1.69) but not for those who were not married and living with other(s) (OR = 0.88, 95% CI: 0.65-1.18) and not married or partnered and living alone (OR = 1.06, 95% CI: 0.82-1.36).

CONCLUSIONS: Late middle-life and older adults residing with spouses or cohabitating appear at risk for having depressive symptoms following a hospitalization. A better understanding of how relationships and living arrangements may affect depression risk in the context of an acute medical illness is needed to identify points of intervention.

%B Aging & Mental Health %G eng %R 10.1080/13607863.2022.2163978 %0 Journal Article %J Sociological Methods & Research %D Forthcoming %T How bad could it be? Worst-case bounds on bias in multistate models due to unobserved transitions %A Christian Dudel %A Daniel C Schneider %K Bias %K Disability %K Identification %K Life Expectancy %K Markov Model %X Multistate models are often used in social research to analyze how individuals move between states. A typical application is the estimation of the lifetime spent in a certain state, like the lifetime spent in employment, or the lifetime spent in good health. Unfortunately, the estimation of such quantities is prone to several biases. In this paper, we study the bias due to the often implicitly used assumption that there are no unobserved transitions between states. This assumption does often not hold for the panel data typically used to estimate multistate models, as the states occupied by individuals are only known at specific points in time, and further transitions between panel waves are not recorded. We present partially identified estimates of the lifetime spent in a state, or worse-case bounds, which show the maximum possible level of bias due to unobserved transitions. We provide two examples studying the lifetime spent in disability (disabled life expectancy; DLE). The first example applies our methods to results on cohort trends in DLE in the U.S. taken from Crimmins et al. (2009). In the second example, we replicate findings from Mehta and Myrskylä (2017), and apply our methods to data from the U.S. Health and Retirement Study (HRS) in order to estimate the effects of health behaviors on DLE. %B Sociological Methods & Research %@ 0049-1241 %G eng %R 10.1177/0049124121995540 %0 Journal Article %J Archives of Gerontology and Geriatrics %D Forthcoming %T Physical activity positively impacts disability outcomes during transition from midlife to early older age irrespective of body mass index. %A Vasilopoulos, Terrie %A Drozda, David %A Vincent, Heather K %K Aging %K Body Mass Index %K Disability %K Obesity %K Physical activity %K trajectory %X

We examined the effects of physical activity (PA) and body mass index (BMI) longitudinal patterns (trajectories) on subjective measures of mobility, function, and disability in adults and assessed whether effects of PA trajectories on function varied due to BMI. Group-based trajectory analyses were used to determine patterns of change in PA and BMI using data from the Health and Retirement Study 1931-1941 birth cohort (n = 10,507). Physical function was assessed by Mobility Limitations (0-5 scale) and Large Muscle Function (0-4 scale) Indexes, as well as with score for activities of daily living (ADLs) and instrumental activities of daily living (IADLs), with higher scores being worse. Our analyses estimated four distinct PA trajectories: decreasing, (2) fluctuating, (3) stable high, and (4) emergent (previously low/sedentary with increased PA over the study period). Worse mobility limitations, large muscle function, ADLs, and IADLs were associated with Decreasing and Fluctuating PA groups. Better outcomes were associated with Emergent and Stable High PA groups. The five BMI trajectories were stable normal/overweight, modest decreasing, fluctuating, steep decreasing, and increasing. No significant interaction existed between PA and BMI trajectories for Mobility Limitations (P= 0.577), Large Muscle Function (P= 0.511), ADLs (P= 0.600), and IADLs (P= 0.152). These findings may empower clinicians to promote messages to midlifers that meaningful changes in PA can improve function in older age.

%B Archives of Gerontology and Geriatrics %V 120 %P 105339 %G eng %1 http://www.ncbi.nlm.nih.gov/pubmed/38340391?dopt=Abstract %R 10.1016/j.archger.2024.105339 %0 Journal Article %J SSM - population health %D 2023 %T Disability and morbidity among US birth cohorts, 1998-2018: A multidimensional test of dynamic equilibrium theory. %A Shen, Tianyu %A Payne, Collin F %K Aging %K Disability %K Dynamic equilibrium %K Health expectancy %K Morbidity %X

A substantial body of prior research has explored patterns of disability-free and morbidity-free life expectancy among older populations. However, these distinct facets of later-life health are almost always studied in isolation, even though they are very likely to be related. Using data from the US Health and Retirement Study and a multistate life table approach, this paper explores the interactions between disability, morbidity, and mortality by sex and education among four successive US birth cohorts, born from 1914 to 1923 to 1944-1953 and compared in the periods 1998-2008 and 2008-2018. We find little compression of disability but a marked expansion of morbidity across cohorts. However, disability-free life expectancy (DFLE) among those living with chronic morbidities has increased, even though at the population-level DFLE is largely unchanged. Broadly, these patterns suggest that successive cohorts of older populations in the US are experiencing a dynamic equilibrium, where the link between chronic morbidities and disability has weakened over successive cohorts. Investigating patterns by educational attainment, we find marked disparities where the least educated individuals not only live significantly fewer years free of disabilities or chronic morbidities but also have experienced an expansion in morbidity and disability. Our findings suggest that the future trajectory of disability-free life expectancy in the US is increasingly contingent on efforts to improve disease management and control the severe consequences of chronic morbidities.

%B SSM - population health %V 24 %P 101528 %G eng %R 10.1016/j.ssmph.2023.101528 %0 Journal Article %J Population Research and Policy Review %D 2023 %T Life, Longevity, and the Pursuit of Happiness: The Role of Disability in Shaping Racial and Sex Disparities in Living a Long and Happy Life %A Bardo,Anthony R. %A Cummings,Jason L. %K Activities of Daily Living %K Black People %K Black white differences %K Black women %K Business And Economics–Economic Situation And Conditions %K Data quality %K Demographers %K Demography %K Disability %K Disadvantaged %K Gender Differences %K Happiness %K health %K Inequality %K Intersectionality %K Life Expectancy %K Life span %K limitations %K Longevity %K Marital Status %K Men %K Older people %K Peers %K Quality of Life %K race %K Racial differences %K Racial inequality %K Retirement %K Severity %K Sex differences %K Subjective well-being %K Wealth %K women %X Disability-free life expectancy is a common measure used by demographers to gauge quantity and quality of life. Yet, the extent to which positive dimensions of quality of life differ by disability status remains unexplored. Using data from the Health and Retirement Study (N = 16,614), we estimated happy life expectancy by age, race, sex, and severe Activities of Daily Living (ADL) limitations. First, results show that happy life expectancy differed substantially by disability status, as older adults with severe ADL limitations experienced 50–60% fewer remaining years of their life happy compared to their more able-bodied peers. Second, healthy Black women and men at age fifty can expect to live five fewer years of their remaining life happy compared to their White peers, but there were no significant race or sex differences among individuals with severe ADL limitations. Finally, the racial gap in Happy Life Expectancy between Black and White women was largely accounted for by group differences in marital status, education, and wealth, but Black men continued to be disadvantaged compared to their White peers. Implications of this study point to a need to critically examine the intersections of race and sex to develop a clearer portrait of the pattern and underlying factors associated with social disparities in longevity and quality of life. Findings highlight the importance of considering positive dimensions of quality of life alongside measures of illness, disability, or disease when determining whether we are adding life to years or just years to life. %B Population Research and Policy Review %V 42 %P 72 %@ 01675923 %G eng %U https://proxy.lib.umich.edu/login?url=https://www.proquest.com/scholarly-journals/life-longevity-pursuit-happiness-role-disability/docview/2849184861/se-2 %0 Journal Article %J Innovation and Aging %D 2023 %T Pain, Physical Demands at Work, and Future Work Expectations Among Older Adults in the United States. %A Andrasfay, Theresa %A Fennell, Gillian %A Crimmins, Eileen %K Disability %K Retirement %K Working Longer %X

BACKGROUND AND OBJECTIVES: In the United States, pain is becoming increasingly prevalent among older adults at the same time as policies are incentivizing work longer. Given that pain and physically demanding jobs are both linked to early retirement and they often go hand-in-hand, it is important to assess how the unique effects of pain and physical work demands may interact in predicting future work expectations.

RESEARCH DESIGN AND METHODS: Using Health and Retirement Study data (1998, 2004, 2010, and 2016 waves), we assess how pain and physical job demands influence future work expectations of 10,358 adults at midlife (ages 51-56), after accounting for sociodemographic, job, health, and financial characteristics.

RESULTS: Compared to men with no pain, activity-interfering pain was associated with low expectations of full-time work past 62 regardless of job demands, while noninterfering pain was associated with 62% higher odds (odds ratio [OR] = 1.62, 95% confidence interval [CI]: 1.35-1.93) of expecting not to work full-time past age 62 only among those with physically demanding jobs. Having both interfering pain and a physically demanding job was associated with increased odds of expecting not to work full-time past age 65 for men (OR = 1.25, 95% CI: 1.06-1.47) and past age 62 for women (OR = 1.18, 95% CI: 1.00-1.39).

DISCUSSION AND IMPLICATIONS: The co-occurrence of physically demanding work with pain-particularly activity-interfering pain-is associated with low expectations of full-time work past ages 62 and 65 for adults at midlife. Working longer may be feasible for older adults whose pain does not interfere with work, but unrealistic for individuals facing both pain and physically demanding work.

%B Innovation and Aging %V 7 %P igad089 %G eng %N 10 %R 10.1093/geroni/igad089 %0 Journal Article %J International Journal of Stress Management %D 2023 %T Stressor appraisals among adults in late middle age and late adulthood in the United States: Applying the intersectionality framework. %A Wang, Kun %A Marbut, Alexander R %A Zheng, Dianhan %A Peet, J. Zak %K Disability %K gender %K Immigration %K intersectionality framework %K Race/ethnicity %K stressor appraisals %X Although the intersectionality framework suggests that social identities may combine to create unique experiences of hardship, few studies have applied it to older adults’ stress appraisals. Thus, in this study, guided by the intersectionality framework, we examined whether older participants with multiple marginalized identities had more negative global stressor appraisals and whether they had specific patterns concerning individual stressor appraisals than those with singular or no marginalized identities. A sample of 6,015 participants aged 50 and older was drawn from the 2016 Health and Retirement Study. Six social identities relevant to age, gender, race/ethnicity, immigration, (dis)ability, and poverty were included. Latent class analysis was conducted to identify marginalized identity patterns. The three-step approach was applied to compare global stressor appraisals and individual stressor appraisals between the intersectional class and other classes. Three marginalized identity classes were identified: the intersectional class consisting of females and individuals living in poverty, the Black, Indigenous, and Other People of Color class, and the older adult class. Compared to the other two classes, the intersectional class reported more negative global stressor appraisals and was more likely to feel upset or very upset about self-health, family health, family substance use, work, financial, housing, and relationship stressors. Caregiving stressor appraisal was not statistically significantly different between the intersectional class and the other two classes. Overall, the findings in this study supported the intersectionality framework as it applies to stress appraisal among older adults. An intersectionality perspective may be needed in future stress research and interventions among older adults. %B International Journal of Stress Management %V 30 %P 47–56 %G eng %N 1 %R 10.1037/str0000283 %0 Journal Article %J The American Journal of Epidemiology %D 2022 %T Changes in life expectancy and disability-free life expectancy in successive birth cohorts of older cancer survivors: a longitudinal modeling analysis of the US Health and Retirement Study. %A Payne, Collin F %A Lindsay C Kobayashi %K Cancer %K Disability %K Life Expectancy %K microsimulation modeling %X

The population of older cancer survivors in the US is rapidly growing. However, little is currently known about how the health of older cancer survivors has changed over time and across successive birth cohorts. Using data from the US Health and Retirement Study, we parameterized a demographic microsimulation model to compare partial cohort life expectancy (LE) and disability-free LE for US men and women without cancer and with prevalent and incident cancer diagnoses for four successive 10-year birth cohorts born 1918-1927 to 1948-1957. Disability was defined as being disabled in ≥1 activity of daily living. These cohorts had mid-point ages of 55-64, 65-74, and 75-84 years during the periods 1998-2008 (the "early" period) and 2008-2018 (the "later" period). Across all cohorts and periods, those with incident cancer had the lowest LE, followed by those with prevalent cancer and cancer-free individuals. We observed declines in partial LE and an expansion of life spent disabled among more recent birth cohorts of prevalent cancer survivors. Our findings suggest that advances in treatments that prolong life for individual cancer patients may have led to population-level declines in conditional LE and disability-free LE across successive cohorts of older cancer survivors.

%B The American Journal of Epidemiology %V 191 %P 104-114 %G eng %N 1 %R 10.1093/aje/kwab241 %0 Book Section %B New Models for Managing Longevity Risk: Public-Private Partnerships %D 2022 %T Disability-free life trends at older ages: Implications for longevity risk management %A Douglas A. Wolf %A Olivia S. Mitchell %K Activities of Daily Living %K Disability %B New Models for Managing Longevity Risk: Public-Private Partnerships %I Oxford University Press %@ 978–0–19–285980–8 %G eng %& 3 %R 10.1093/oso/9780192859808.001.0001 %0 Journal Article %J The Journals of Gerontology, Series B %D 2022 %T The Effect of Physical Limitations on Depressive Symptoms over the Life Course: Is Optimism a Protective Buffer? %A Choi, Shinae L %A Namkung, Eun Ha %A Carr, Deborah %K Depressive symptoms %K Disability %K Functional Limitation %K life course %K Optimism %K Stress %X

OBJECTIVES: We examined the extent to which optimism buffers the effects of physical limitations on depressive symptoms, across four mid- and later-life age groups (ages 40-49, 50-64, 65-74, 75+ at baseline). Analyses are motivated by stress theories, which hold that the protective effects of coping resources are evidenced only at high levels of stress. We further explore whether these purportedly protective effects diminish with age, as health-related stressor(s) intensify and become irreversible.

METHODS: We use data from two waves (2004-06 and 2013-14) of the Health and Retirement Study (HRS, n = 4,515) and Midlife in the United States (MIDUS, n = 2,138). We estimate OLS regression models with three-way interaction terms to examine prospectively the benefits of optimism as a coping resource for persons with physical limitations across four age groups. Physical limitations are assessed with a composite measure encompassing mobility and activity of daily living (ADL) limitations.

RESULTS: In HRS and MIDUS, persons with 3+ limitations reported significantly more depressive symptoms than persons with 0-2 limitations, yet these disparities diminished at higher levels of optimism. Buffering effects of optimism vary by age. For midlife and young-old persons with 3+ limitations, optimism is strongly and inversely related to depressive symptoms at follow-up. Comparable protective effects are not evident among oldest sample members.

DISCUSSION: Stress and coping models should consider more fully factors that limit older adults' capacity to deploy purportedly protective personal resources. Investments in structural or institutional supports may be more effective than interventions to enhance positive thinking.

%B The Journals of Gerontology, Series B %V 77 %P 1661-1673 %G eng %N 9 %R 10.1093/geronb/gbac058 %0 Journal Article %J International Journal of Chronic Obstructive Pulmonary Disease %D 2022 %T Frailty Among Older Individuals with and without COPD: A Cohort Study of Prevalence and Association with Adverse Outcomes %A Roberts, Melissa %A Mapel, Douglas %A Ganvir, Nikhil %A Dodd, Melanie %K Cognition %K Disability %K home health %K peak air flow %K Survival %X Rationale: Frailty prevalence estimates among individuals with COPD have varied widely, and few studies have investigated relationships between frailty and adverse outcomes in a COPD population. Objective(s): Describe frailty prevalence among individuals with and without COPD and examine associations between frailty and mortality and other adverse outcomes in the next two years. Methods: This was an observational cohort study using Health and Retirement Study data (2006– 2018) of community living individuals ages 50– 64 and ≥ 65 with and without COPD (non-COPD). Frailty (Fried phenotype [5 items], and a modified Frailty Index-Comprehensive Geriatric Assessment [Enhanced FI-CGA] [37 items], and debility (modified BODE Index [4 items]) were assessed. Two-year post-assessment outcomes (mortality, ≥ 1 inpatient stay, home health and skilled nursing facility (SNF) use) were reviewed in a population matched 3:1 (non-COPD: COPD) on age, sex, race, and year using univariate and multivariate logistic regression (adjusted for morbidities). Area-under-the-curve (AUC) was used to evaluate regressions. Results: The study included 18,979 survey observations for age 50– 64, and 24,162 age ≥ 65; 7.8% and 12.0% respectively reporting a diagnosis of COPD. Fried phenotype frailty prevalence for age ≥ 65 was 23.1% (COPD) and 9.4% (non-COPD), and for the Enhanced FI-CGA, 45.9% (COPD) and 22.4% (non-COPD). Two-year mortality for COPD was more than double non-COPD for age 50– 64 (95% CI: 3.8– 5.9% vs 0.7– 1.3%) and age ≥ 65 (95% CI: 11.9– 14.3% vs 5.6– 6.6%). Inpatient utilization, home health care use, or at least temporary SNF placement were also more frequent for COPD. Measures were predictive of adverse outcomes. In adjusted models, the Fried phenotype and modified BODE score performed similarly, and both performed better than the Enhanced FI-CGA index. AUC values were higher for morality regressions. Conclusion: Frailty prevalence among individuals with COPD in this national survey is substantially greater than without COPD, even at pre-retirement (50– 64 years). These measures identify patients with increased risk of poor outcomes. %B International Journal of Chronic Obstructive Pulmonary Disease %V Volume 17 %P 701-717 %G eng %R 10.2147/COPD.S348714 %0 Journal Article %J Aging & Mental Health %D 2022 %T Gender-based depression trajectories following heart disease onset: significant predictors and health outcomes. %A Kong, Dexia %A Lu, Peiyi %A Solomon, Phyllis %A Shelley, Mack %K Depression trajectory %K Disability %K gender comparison %K growth mixture model %K Mortality %X

BACKGROUND: Using a nationally representative sample of U.S. older adults (50+), this study investigates gender-based depression trajectories following heart disease onset and associated risk of disability and mortality over an 8-year period.

METHOD: Six waves of longitudinal data from the Health and Retirement Study (2006-2016) were used ( = 1787). Heart disease onset was defined as self-reporting no heart disease at baseline but reporting a positive diagnosis in a subsequent wave. Growth Mixture Modelling identified depression trajectories. Multinomial logistic regression models determined significant predictors of depression trajectories. Cox proportional-hazards models examined the associated disability and mortality risks.

RESULTS: Three distinct depression trajectories were identified, including persistent minimal depression (men: 68.65%; women: 60.17%), moderate depression (women: 29.70%; men: 17.97%), and chronic depression (women: 10.12%) or emerging depression (men: 13.38%). Younger age and depression status at baseline were associated with women's chronic depression and men's emerging depression. Chronic/emerging and moderate depression were associated with higher disability risks than was minimal depression among both women and men (hazard ratios [HR] ranged from 2.12 to 3.92,  < 0.001). Only men's emerging depression was linked to higher mortality risk compared to minimal depression (HR = 2.03,  < 0.001).

CONCLUSION: Longitudinal course of depression following onset of heart disease is heterogeneous in later life. Unfavorable depression trajectories (i.e. moderate, chronic, and emerging) were associated with higher disability risk compared to the minimal depression trajectory. Study findings characterize risk stratification regarding depression after heart disease onset, which can inform the development of interventions to improve health outcomes among older adults with heart conditions.

%B Aging & Mental Health %V 26 %P 754-761 %G eng %N 4 %R 10.1080/13607863.2021.1891202 %0 Journal Article %J Journal of Applied Gerontology %D 2022 %T Handgrip Strength Asymmetry Is Associated With Limitations in Individual Basic Self-Care Tasks. %A Mahoney, Sean J %A Kyle J Hackney %A Donald A Jurivich %A Lindsey J Dahl %A Johnson, Carol %A Ryan P McGrath %K Activities of Daily Living %K Disability %K Frailty %K self-care %X

This investigation sought to determine the associations between handgrip strength (HGS) asymmetries and limitations in individual activities of daily living (ADL). The analytic sample included 18,468 participants from the 2006 to 2016 waves of the Health and Retirement Study. Those with HGS >10% stronger on either hand had any HGS asymmetry. Individuals with HGS >10% stronger on their dominant or non-dominant hand had dominant or non-dominant HGS asymmetry, respectively. ADL abilities were self-reported. Those with any HGS asymmetry had 1.21 (95% confidence interval [CI] = [1.01-1.46]) greater odds for a toileting limitation and 1.25 (CI = [1.03-1.52]) greater odds for a transferring limitation. Individuals with dominant HGS asymmetry had 1.24 (CI = [1.01-1.53]) greater odds for a transferring limitation. Those with non-dominant HGS asymmetry had 1.39 (CI = [1.01-1.93]) and 1.44 (CI = [1.05-1.96]) greater odds for a bathing and toileting limitation, respectively. HGS asymmetries could help to identify future limitations in specific ADLs.

%B Journal of Applied Gerontology %V 41 %P 450-454 %G eng %N 2 %R 10.1177/0733464820982409 %0 Journal Article %J The Journals of Gerontology, Series B %D 2022 %T Life Course Stressors and Functional Limitations in Later Life among White, Black, and Hispanic Adults: Deleterious, Hardening, or Benign? %A Sauerteig, Madison R %A Kenneth F Ferraro %A Bauldry, Shawn %K Disability %K Health Disparities %K Racial Disparities %K stress accumulation %K Trauma %K weathering %X

OBJECTIVES: Although striking racial and ethnic disparities in health are manifest during later life, they may be rooted in early-life exposures. Drawing from cumulative inequality theory, we investigate whether life course stressors are associated with risk of later life functional limitations and whether this relationship differs by race and ethnicity.

METHODS: We utilize longitudinal data from the Health and Retirement Study to test whether child and adult stressors predict trajectories of the occurrence and severity of functional limitations among a diverse sample of older adults.

RESULTS: Child and adult stressors are associated with greater occurrence and severity of functional limitations during later life. Mediation analyses reveal the indirect influence of child stressors via adult stressors on occurrence and severity of functional limitations; however, the indirect effects are slightly stronger for Black and Hispanic adults than their White counterparts.

DISCUSSION: Child stressors, in and of themselves, do not increase functional limitations among Black and Hispanic people but are associated with greater adult stress exposure, predisposing them to more functional limitations. Results suggest that childhood stressors are associated with distinct social pathways to functional limitations among Black, White, and Hispanic older adults.

%B The Journals of Gerontology, Series B %V 77 %P 249-259 %G eng %N 1 %R 10.1093/geronb/gbab066 %0 Journal Article %J Social Sciences %D 2022 %T Linked Lives: Does Disability and Marital Quality Influence Risk of Marital Dissolution among Older Couples? %A Kenzie Latham-Mintus %A Holcomb, Jeanne %A Zervos, Andrew P. %K Disability %K marital dissolution %K Marital quality %X Using fourteen waves of data from the Health and Retirement Study (HRS), a longitudinal panel survey with respondents in the United States, this research explores whether marital quality—as measured by reports of enjoyment of time together—influences risk of divorce or separation when either spouse acquires basic care disability. Discrete-time event history models with multiple competing events were estimated using multinomial logistic regression. Respondents were followed until they experienced the focal event (i.e., divorce or separation) or right-hand censoring (i.e., a competing event or were still married at the end of observation). Disability among wives was predictive of divorce/separation in the main effects model. Low levels of marital quality (i.e., enjoy time together) were associated with marital dissolution. An interaction between marital quality and disability yielded a significant association among couples where at least one spouse acquired basic care disability. For couples who acquired disability, those who reported low enjoyment were more likely to divorce/separate than those with high enjoyment; however, the group with the highest predicted probability were couples with low enjoyment, but no acquired disability. %B Social Sciences %V 11 %P 27 %G eng %N 1 %R 10.3390/socsci11010027 %0 Journal Article %J Journal of Aging and Health %D 2022 %T A Longitudinal Examination of the Association Between Loss of Control and Loneliness Among Older Adults Diagnosed with Cancer. %A Morris, Zachary %A Malik, Sana %A Burke, Shanna %A Grudzien, Adrienne %A Cadet, Tamara %K Cancer %K Disability %K Loneliness %K Mental Health %K Social work %X

The objective of this paper is to examine whether feeling a loss of control over one's life is associated with an increased risk for loneliness among those diagnosed with cancer. We draw on data from the Health and Retirement Study to identify three baseline and follow-up cohorts of cancer survivors age 50 and older. Ordinary least squared regression is used to examine predictors for future loneliness. Upon adjusting for other known predictors of loneliness, feelings of loss of control was significantly predictive of loneliness among 4-year cancer survivors. Social workers and other health care practitioners should seek to provide evidence-based interventions to reduce the risk for loneliness for cancer survivors feeling a loss of control.

%B Journal of Aging and Health %V 34 %P 1092-1100 %G eng %N 6-8 %R 10.1177/08982643221092735 %0 Journal Article %J Journal of Aging and Health %D 2022 %T The Long-Term Impact of Childhood Disability on Mental Health Trajectories in Mid- to Late-Life. %A Jessica S West %A Kamis, Christina %K aging with disability %K Disability %K growth curve models %K Mental Health %X

OBJECTIVES: We draw from the life course and stress process frameworks to examine how experiencing disability in early life influences mental health in adulthood.

METHODS: Data come from the Health and Retirement Study Cross-Wave Childhood Health and Family Aggregated Data file (2008-2018, = 15,289). Childhood disability status is a retrospective self-report of whether respondents were disabled for six months or more because of a health problem before the age of 16 ( = 581). We used age-based growth curve models to construct trajectories of depressive symptoms by childhood disability status.

RESULTS: Respondents who experienced childhood disability exhibit more depressive symptoms at age 50 compared to those who did not experience this stressor. However, there is no difference in the growth of depressive symptoms with age between these groups, suggesting maintained inequality over the late adulthood life course.

DISCUSSION: Findings suggest that childhood disability has long-term implications for life course mental health.

%B Journal of Aging and Health %G eng %R 10.1177/08982643211066184 %0 Journal Article %J The Journals of Gerontology, Series B %D 2022 %T Physical Disability and Older Adults' Perceived Food and Economic Insecurity During the COVID-19 Pandemic. %A Choi, Shinae L %A Deborah Carr %A Namkung, Eun Ha %K COVID-19 %K Disability %K Financial hardship %K Food insecurity %K Job insecurity %X

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.

%B The Journals of Gerontology, Series B %V 77 %P e123-e133 %G eng %N 7 %R 10.1093/geronb/gbab162 %0 Journal Article %J Aging Clinical and Experimental Research %D 2022 %T Physical inactivity in older adults with cognitive impairment without dementia: room for improvement. %A Miller, Matthew J %A Irena Cenzer %A Deborah E Barnes %A Kenneth E Covinsky %K cognitive impairment %K Disability %K Physical activity %K Physical function %X

BACKGROUND: Persons with cognitive impairment without dementia are at high risk of adverse health outcomes. Tailored intervention targeting moderate-vigorous physical activity (MVPA) may reduce these risks.

AIMS: To identify the prevalence and predictors of physical inactivity among older adults with cognitive impairment, no dementia (CIND); and estimate the proportion of inactive people with CIND who are capable of greater MVPA.

METHODS: We studied 1875 community dwelling participants (over age 65) with CIND in the Health and Retirement Study. Physical inactivity was defined as MVPA ≤ 1x/week. Associations of physical inactivity with sociodemographic, health, and physical function were examined using chi-square and modified Poisson regression. We considered physically inactive participants capable of greater MVPA if they reported MVPA at least 1-3x/month, no difficulty walking several blocks, or no difficulty climbing several flights of stairs.

RESULTS: Fifty-six percent of participants with CIND were physically inactive. Variables with the highest age, sex, and race/ethnicity adjusted risk ratio (ARR) for physical inactivity were self-rated health (poor [76.9%]vs. excellent [34.2%]; ARR [95% CI] 2.27 [1.56-3.30]), difficulty walking (across the room [86.5%] vs. none [40.5%]; ARR [95% CI] 2.09 [1.87-2.35]), total assets (lowest quartile [62.6%] vs. highest quartile [43.1%]; ARR [95% CI] 1.54 [1.29-1.83]), and lower education attainment (less than high school [59.6%] vs college graduate [42.8%]; ARR [95% CI] 1.46 [1.17-1.83]). Among physically inactive older adults with CIND, 61% were estimated to be capable of greater MVPA.

CONCLUSIONS: Although physical inactivity is prevalent among older adults with CIND, many are capable of greater MVPA. Developing tailored physical activity interventions for this vulnerable population may improve cognitive, health, and quality of life outcomes.

%B Aging Clinical and Experimental Research %V 34 %P 837-845 %G eng %N 4 %R 10.1007/s40520-021-01999-5 %0 Journal Article %J Research on Aging %D 2022 %T Responding to Disability Onset in the Late Working Years: What do Older Workers do? %A Jody Schimmel Hyde %A Wu, April Yanyuan %A Livermore, Gina %K Disability %K Occupations %K Older workers %K Transitions %K work limitations %X

This study uses occupational data from the Health and Retirement Study to document the link between disability onset and occupational transitions among older adults who are working and do not report a disabling condition at age 55. We find that one-quarter of workers go on to experience new disabilities before full-retirement age. Relative to their peers who do not report disabilities, stopping work and significant occupational changes are more common among workers who experience new disabilities. Our results suggest that policies to support labor force attachment might consider the importance of new disability onset and whether employer accommodations might help workers with new disabling conditions remain in the jobs they held when their health began to limit their work.

%B Research on Aging %V 44 %P 643-657 %G eng %N 9-10 %R 10.1177/01640275221074634 %0 Journal Article %D 2022 %T The Role of Physical, Cognitive, and Interpersonal Occupational Requirements and Working Conditions on Disability and Retirement %A Italo Lopez Garcia %A Kathleen J. Mullen %A Jeffrey Wenger %K cognitive %K Disability %K physical %K Retirement %X We examine of the role of physical and mental job requirements, as well as hazardous working conditions, on retirement and disability among older individuals in the United States. By linking occupation-level data on job requirements from the Occupational Requirements Survey (ORS) to individual-level data from the Health and Retirement Study (HRS), we create composite indices for physical activities and the physical work environment, as well as two indices of mental job requirements related to job autonomy and flexibility index, and being supervised and working with the pubic. Using data from the HRS Life History Mail Survey, we merge these indices to the HRS panel using the most important occupation held by the individual in her prime years. We find that a 1 standard deviation (SD) increase in the physical activity and physical work environment indices are associated with a 10 to 13 percentage point (pp) increase in the probability of being retired and a 3 to 5 pp increase in the probability of transitioning into retirement. The associations of these indices with disability outcomes follow the same patterns as retirement, but they are lower in magnitude. A 1 SD increase in job autonomy/flexibility is associated with a 22 pp decrease in the probability of being retired and a 12 pp decrease in retirement transitions, but it does not predict disability outcomes. Finally, the effects of physically demanding and hazardous jobs on labor force exit are concentrated among men and low-educated workers, while delays in retirement predicted by higher job autonomy and flexibility are driven by college-educated workers. %G eng %U https://mrdrc.isr.umich.edu/pubs/the-role-of-physical-cognitive-and-interpersonal-occupational-requirements-and-working-conditions-on-disability-and-retirement/ %0 Web Page %D 2022 %T Study Shows Need for Geriatric Principles in Critical Care Medicine %A Jacobs, Sheila %K Critical Care %K Dementia %K Disability %K Frailty %K multimorbidity %B Critical Care %I Pulmonology Advisor %G eng %U https://www.pulmonologyadvisor.com/home/topics/critical-care/study-shows-need-for-geriatric-principles-in-critical-care-medicine/ %0 Journal Article %J Journal of Applied Gerontology %D 2021 %T A 2-Year Longitudinal Relationship Between Work-Family Conflict and Health Among Older Workers: Can Gardening Help? %A Eunae Cho %A Tuo-Yu Chen %A Megan C Janke %K Chronic conditions %K depression %K Disability %K Leisure activities %K Self-rated health %K Senior workers %K work-family interference %X With the graying workforce worldwide, identifying factors that facilitate older workers' health is critically important. We examined whether gardening mitigates the relationship of work-family conflict with disability, chronic conditions, depressive symptoms, and self-rated health among older workers. We drew a subsample of older workers aged 55 years and above from the Health and Retirement Study (N= 1,598). Our results indicate that the relationships of work-to-family conflict at baseline with disability and with poorer self-rated health at a 2-year follow-up were stronger for those who gardened less than those who gardened more. No significant interaction was found between family-to-work conflict and gardening in predicting the health outcomes. This study is the first to show that gardening may have a protective effect against the adverse impact of work-to-family conflict on older workers' health. %B Journal of Applied Gerontology %V 40 %P 1330-1341 %G eng %N 10 %R 10.1177/0733464820934678 %0 Journal Article %J The Journals of Gerontology: Series B %D 2021 %T Activity Limitations and Depressive Symptoms Among Older Couples: The Moderating Role of Spousal Care. %A Sae Hwang Han %A Kim, Kyungmin %A Jeffrey A Burr %K Activities of Daily Living %K Caregiving %K Disability %K instrumental support %X

OBJECTIVES: Limitations in performing basic daily activities, as well as spousal caregiving that arises from activity limitations, are important factors that have ramifications for mental health among couples. The objective of this study was to investigate the interplay of these factors by focusing on whether the associations between activity limitations and depressive symptoms among coupled-individuals were moderated by receipt and provision of spousal care.

METHODS: Longitudinal household data from the Health and Retirement Study (2004-2014; dyad N = 6,614) were analyzed to estimate within-person associations between one's own and spousal activity limitations, receipt and provision of spousal care, and depressive symptoms.

RESULTS: Findings showed a consistent link between one's own activity limitations and depressive symptoms for both spouses, whereas spousal activity limitations were associated with depressive symptoms for wives only. We also found moderating effects of spousal care in the link between one's own and spousal activity limitations and depressive symptoms.

DISCUSSION: Receipt and provision of activities of daily living-related assistance may contextualize the association between activity limitations and depressive symptoms among older coupled-individuals in a direction that could alleviate or aggravate the risk of depression.

%B The Journals of Gerontology: Series B %V 76 %P 360-369 %G eng %N 2 %R 10.1093/geronb/gbz161 %0 Journal Article %J American Journal of Epidemiology %D 2021 %T The Association Between Cytomegalovirus and Disability by Race/Ethnicity and Gender: Results from the Health and Retirement Study. %A Kate A Duchowny %A Grace A Noppert %K Activities of Daily Living %K Cytomegalovirus %K Disability %K Health Disparities %K social epidemiology %X

Recent studies have documented a decline in the overall prevalence of disability in the United States, however racial/ethnic and gender disparities continue to persist. Cytomegalovirus (CMV), a socially patterned exposure, may be a key mechanism in understanding these previously documented disparities. Using data from the nationally-representative 2016 Health and Retirement Study, we employed Poisson log-binomial models to estimate the prevalence of disability comparing CMV seropositive versus seronegative adults and investigated effect modification by race/ethnicity and gender. Among the 9,029 participants (55% women, mean age: 67.4), 63% were CMV seropositive and 15% were disabled. CMV seropositivity was highest among non-Hispanic Black (88%) and Hispanic adults (92%) compared to non-Hispanic White adults (57%). We found evidence for effect modification of the CMV-disability by gender but not race/ethnicity. While the confidence intervals in the fully-adjusted models included the null value, compared to seronegative women, our results suggest a greater prevalence of disability among CMV seropositive women (PR= 1.16, 95% CI= 0.97, 1.39) but not among men (PR= 0.85, 95% CI= 0.69, 1.06). Results provide initial support that CMV may be an important determinant of gender disparities in disability.

%B American Journal of Epidemiology %V 190 %P 2314-2322 %G eng %N 11 %R 10.1093/aje/kwab152 %0 Journal Article %J The Journals of Gerontology, Series B %D 2021 %T Chronic Pain and Friendship among Middle-Aged and Older U.S. Adults. %A Yang, Yulin %A Grol-Prokopczyk, Hanna %K Disability %K health %K number of friends %K pain severity %K Social networks %X

OBJECTIVES: This study examines how chronic pain affects friendship in later life. We test whether onset of pain leads to social network activation, as suggested by research on other health conditions (Latham- Mintus, Forth.), or whether pain-an unverifiable and often stigmatizing condition-functions as a "threat to the social self" (Karos et al., 2018).

METHODS: Using longitudinal data from the Health and Retirement Study (HRS; N=4,598; 2006/2008 as Time 1 and 2010/2012 as Time 2), we conducted OLS regressions with the lagged dependent variable approach to assess how new-onset chronic pain predicted (a) respondents' number of close friends and (b) their frequency of in-person meetings with friends, controlling for sociodemographic variables and health conditions.

RESULTS: New-onset severe pain predicted a decrease in number of friends. New-onset moderate pain, in contrast, predicted more friends and more frequent in-person meetings. (Findings were significant or marginally significant depending on model specifications.) Mild pain showed no significant association with either outcome. Pain had a greater effect on men's friendship outcomes than women's.

DISCUSSION: The effects of chronic pain on later-life friendships appear to depend on pain severity, and to differ between men and women. Onset of severe pain serves as a "threat to the social self," while onset of moderate pain contributes to social network activation; both associations are significantly more pronounced among men. These findings highlight the complex associations between health and social outcomes.

%B The Journals of Gerontology, Series B %V 76 %P 2131-2142 %G eng %N 10 %R 10.1093/geronb/gbaa185 %0 Journal Article %J The Journals of Gerontology: Series B %D 2021 %T Does Gender Matter in the Receipt of Informal Care Among Community-dwelling Older Adults? Evidence from a Cross-National Comparative Study across the United States, South Korea, and China %A Kwak, Minyoung %A Kim,, BoRin %A Lee, Hyunjoo %A Jiaan Zhang %K Caregiving %K CHARLS %K Disability %K gender %K KLoSA %K Living arrangement %X This study compares patterns of gender difference in the receipt of informal care among community-dwelling older adults across the United States, Korea, and China where family-oriented systems for providing care to older adults are emphasized.Data came from the 2014 Health and Retirement Study, the 2014 Korea Longitudinal Study of Aging, and the 2015 China Health and Retirement Longitudinal Study. Logistic regression models were used to predict the receipt of informal care by gender. We also examined how the effects of health and living arrangement on the receipt of informal care differ depending on gender.In the United States and China, older women were more likely to receive informal care than men. However, older Korean women were less likely to receive informal care than men. The effects of health and living arrangement on the use of informal care were moderated by gender in different ways across countries.This study provides evidence that patterns of gender differences in the receipt of informal care vary across the three countries. More attention needs to be paid to the design and implementation of long-term supports and services to address the unique patterns of gender difference in care arrangement in each country. %B The Journals of Gerontology: Series B %V 76 %P S64-S75 %G eng %N 1 %R 10.1093/geronb/gbaa018 %0 Web Page %D 2021 %T Family Care Availability And Implications For Informal And Formal Care Used By Adults With Dementia In The US %A National Institute on Aging %K Alzheimer's disease %K Behavioral & Social Research %K Caregiving %K Chronic conditions %K Dementias %K Demography %K Disability %X As dementia worsens, people may gradually lose the ability to prepare meals, bathe, get dressed, and otherwise care for themselves. The likelihood that people living with dementia rely on unpaid care rather than paid care depends on whether a spouse or adult children are available to be primary caregivers, according to an NIA-supported study at the University of Michigan. Conversely, people without family members available to care for them are more likely to require paid help from a long-term care facility. As reported recently in Health Affairs, national estimates suggest that available family members and other unpaid caregivers are an important consideration for how people with dementia can remain outside of a nursing home environment when they need help with everyday activities. %B News & Events %I National Institute on Aging %G eng %U https://www.nia.nih.gov/news/family-member-availability-predicts-likelihood-unpaid-care-people-living-dementia %0 Journal Article %J The Journals of Gerontology: Series B %D 2021 %T Family caregiving and place of death: Insights from cross-national analysis of the Harmonized End of Life Data. %A Jennifer A Ailshire %A Osuna, Margarita %A Wilkens, Jenny %A Jinkook Lee %K Activities of Daily Living %K Aging %K Disability %K family caregivers %K Nursing homes %K SHARE %K spouse %K Terminally Ill %X

OBJECTIVES: Family is largely overlooked in research on factors associated with place of death among older adults. We determine if family caregiving at the end of life is associated with place of death in the United States and Europe.

METHODS: We use the Harmonized End of Life data sets developed by the Gateway to Global Aging Data for the Survey of Health, Ageing and Retirement in Europe (SHARE) and the Health and Retirement Study (HRS). We conducted multinomial logistic regression on 7,113 decedents from 18 European countries and 3,031 decedents from the United States to determine if family caregiving, defined based on assistance with activities of daily living, was associated with death at home versus at a hospital or nursing home.

RESULTS: Family caregiving was associated with reduced odds of dying in a hospital and nursing home, relative to dying at home in both the United States and Europe. Care from a spouse/partner or child/grandchild was both more common and more strongly associated with place of death than care from other relatives. Associations between family caregiving and place of death were generally consistent across European welfare regimes.

DISCUSSION: This cross-national examination of family caregiving indicates that family-based support is universally important in determining where older adults die. In both the United States and in Europe, most care provided during a long-term illness or disability is provided by family caregivers, and it is clear families exert tremendous influence on place of death.

%B The Journals of Gerontology: Series B %V 76 %P S76-S85 %G eng %N Supplement_1 %R 10.1093/geronb/gbaa225 %0 Web Page %D 2021 %T Family member availability predicts likelihood of unpaid care for people living with dementia %A National Institute on Aging %K Alzheimer's disease %K Caregiving %K Chronic conditions %K Dementias %K Demography %K Disability %X As dementia worsens, people may gradually lose the ability to prepare meals, bathe, get dressed, and otherwise care for themselves. The likelihood that people living with dementia rely on unpaid care rather than paid care depends on whether a spouse or adult children are available to be primary caregivers, according to an NIA-supported study at the University of Michigan. Conversely, people without family members available to care for them are more likely to require paid help from a long-term care facility. As reported recently in Health Affairs, national estimates suggest that available family members and other unpaid caregivers are an important consideration for how people with dementia can remain outside of a nursing home environment when they need help with everyday activities. %B Featured Research %I National Institute on Aging %G eng %U https://www.nia.nih.gov/news/family-member-availability-predicts-likelihood-unpaid-care-people-living-dementia %0 Journal Article %J The Journals of Gerontology, Series B %D 2021 %T Increasing Education-Based Disparities in Healthy Life Expectancy Among U.S. Non-Hispanic Whites, 2000-2010. %A Cantu, Phillip A %A Connor M Sheehan %A Sasson, Isaac %A Mark D Hayward %K Disability %K Education %K Healthy life expectancy %K Mortality %X

OBJECTIVES: To examine changes in Healthy Life Expectancy (HLE) against the backdrop of rising mortality among less-educated white Americans during the first decade of the twenty-first century.

METHODS: This study documented changes in HLE by education among U.S. non-Hispanic whites, using data from the U.S. Multiple Cause of Death public-use files, the Integrated Public Use Microdata Sample (IPUMS) of the 2000 Census and the 2010 American Community Survey, and the Health and Retirement Study (HRS). Changes in HLE were decomposed into contributions from: (i) change in age-specific mortality rates; and (ii) change in disability prevalence, measured via Activities of Daily Living (ADL) and Instrumental Activities of Daily Living (IADL).

RESULTS: Between 2000 and 2010, HLE significantly decreased for white men and women with less than 12 years of schooling. In contrast, HLE increased among college-educated white men and women. Declines or stagnation in HLE among less-educated whites reflected increases in disability prevalence over the study period, whereas improvements among the college educated reflected decreases in both age-specific mortality rates and disability prevalence at older ages.

DISCUSSION: Differences in HLE between education groups increased among non-Hispanic whites from 2000 to 2010. In fact, education-based differences in HLE were larger than differences in total life expectancy. Thus, the lives of less-educated whites were not only shorter, on average, compared with their college-educated counterparts, but they were also more burdened with disability.

%B The Journals of Gerontology, Series B %V 76 %P 319-329 %G eng %N 2 %R 10.1093/geronb/gbz145 %0 Journal Article %J Experimental Gerontology %D 2021 %T Muscle weakness is a prognostic indicator of disability and chronic disease multimorbidity. %A Mark D Peterson %A Casten, Kimberly %A Collins, Stacey %A Hassan, Halimah %A García-Hermoso, Antonio %A Jessica Faul %K Aging %K Chronic disease %K Dementia %K Disability %K Grip strength %K weakness %X

BACKGROUND: The objective of this study was to use nationally-representative data on Americans greater than 50 years of age to determine the association between grip strength and inflammation as independent predictors of incident disability, chronic multimorbidity and dementia.

METHODS: Middle age and older adults (n = 12,618) from the 2006-2008 waves of the Health and Retirement Study with 8-years of follow-up were included. Longitudinal modeling was performed to examine the association between baseline grip strength (normalized to body mass: NGS) and high sensitivity C-reactive protein (hs-CRP) (≥3.0 mg/L) with incident physical disabilities (i.e., ≥2 limitations to activities of daily living), chronic multimorbidity (≥2 of chronic conditions), and dementia.

RESULTS: The odds of incident disability were 1.25 (95% CI: 1.20-1.30) and 1.31 (95% CI: 1.26-1.36) for men and women respectively, for each 0.05-unit lower NGS. The odds of incident chronic multimorbidity were 1.14 (95% CI: 1.08-1.20) and 1.14 (95% CI: 1.07-1.21) for men and women respectively for each 0.05-unit lower NGS. The odds of incident dementia were 1.10 for men (95% CI: 1.02-1.20) for each 0.05-unit lower NGS, but there was no significant association for women. Elevated hs-CRP was only associated with chronic multimorbidity among men (OR = 1.29; 95% CI: 1.00-1.73) and women (OR = 1.60; 95% CI: 1.26-2.02).

CONCLUSIONS: Our findings indicate a robust inverse association between NGS and disability and chronic, multimorbidity in older men and women, and dementia in men. Elevated hs-CRP was only associated with chronic multimorbidity in men and women. Healthcare providers should implement measures of grip strength in routine health assessments and discuss the potential dangers of weakness as well as interventions to improve strength with their patients.

%B Experimental Gerontology %V 152 %P 111462 %G eng %R 10.1016/j.exger.2021.111462 %0 Journal Article %J Journal of Applied Gerontology %D 2021 %T Physical Activity and Falls Among a National Cohort of Older Veterans %A Dan Marciniak %A Neil B. Alexander %A Geoffrey J Hoffman %K Aging %K Disability %K Falls %K Physical activity %K Veterans %X The more than 20 million U.S. veterans have a history of physical activity engagement but face increasing disability as they age. Falls are common among older adults, but there is little evidence on veterans’ fall risk. We conducted a retrospective cohort study using 48,643 observations from 14,831 older (≥65 years) Americans from the 2006–2014 waves of the Health and Retirement Study. Veterans reported more noninjurious falls (26.6% vs. 24.0%, p < .002), but fewer fall-related injuries (8.9% vs. 12.3%, p < .001) than nonveterans. In adjusted analyses, for each 5-year increase in age, the odds of a noninjurious fall were greater for veterans (odds ratio [OR] = 1.05, 95% confidence interval [CI] = [1.01, 1.10]) and, among those with regular physical activity, the odds were lower for veterans compared with nonveterans (OR = 0.89; 95% CI = [0.81, 0.99]). For veterans, physical activity engagement may prove a particularly effective mechanism for reducing the aging-related risks associated with falls and fall injuries. %B Journal of Applied Gerontology %V 40 %P 310-319 %G eng %N 3 %R 10.1177/0733464820915807 %0 Report %D 2021 %T The Relationship Between Adverse Experiences Over the Life Course and Early Retirement Due to Disability %A Amanda Sonnega %A Helppie-McFall, Brooke %K Adversity %K Disability %K Early retirement %X A growing body of research implicates life span adversity in later-life outcomes. We use data from the Life History Mail Survey (LHMS) with data from the Health and Retirement Study (HRS) core surveys to examine the relationship between adverse experiences over the life course and retirement due to disability. We employ 31 measures of childhood and adulthood adversities in both the financial and social domains. We create three measures of retirement due to disability based on survey responses to questions about health as a reason for retiring and the extent to which health limits work ability. For each measure of early retirement due to disability, we perform competing risk survival analysis modeling these outcomes relative to continued work or retirement for any other reason. We conduct these analyses in four samples depending on the component of the survey the data from which the data derived, with the sample including LHMS information being the most restricted but including the greatest number of adversities. Cumulative life adversity was associated with all outcomes examined, including the most conservative specification of disability retirement (i.e., retirement in the context of a health problem that completely limits work) and across all samples. We also found that childhood financial adversity and adult social adversity were most consistently associated with an increased hazard of retirement due to disability in our analysis, which balances the greatest number of adversities with a reasonably large sample (Sample 3). %B Working Paper %I Retirement and Disability Research Center, University of Michigan %C Ann Arbor %G eng %U https://hdl.handle.net/2027.42/171806 %0 Journal Article %J Social Science & Medicine %D 2021 %T Take a Sad Song and Make it Better: Spousal Activity Limitations, Caregiving, and Depressive Symptoms Among Couples %A Sae Hwang Han %A Kim, Kyungmin %A Jeffrey A Burr %K agency %K Caregivers %K caregiving system model %K depression %K Disability %K linked lives %K Transitions %X ObjectivesFramed around key concepts of the life course perspective, we examined the linkages between spousal activity limitations, caregiving transitions, and depression among married couples. The key study objectives were 1) to demonstrate how the caregiving-depression link widely reported in earlier research may have been over-stated, and 2) to investigate whether caregiving yields mental health benefits by weakening the link between spousal activity limitations and depressive symptoms.MethodsWe used longitudinal data from the Health and Retirement Study (2004–2016) to examine a national sample of coupled individuals (6,475 couples; 57,844 person-wave observations). A series of longitudinal actor-partner interdependence models were used to estimate within-person associations between spousal activity limitations, caregiving transitions, and depressive symptoms among coupled individuals.ResultsFindings demonstrated that spousal activity limitations function as a confounder for the association between caregiving transitions and depressive symptoms. Results further provided evidence that transitioning into a caregiving role in the context of spousal activity limitations alleviated symptoms of depression for the caregiver.ConclusionOur findings provide an explanation for the extended longevity benefit reaped by caregivers increasingly reported in recent population studies. Implications for policy, practice, and future research are discussed. %B Social Science & Medicine %V 281 %P 114081 %@ 0277-9536 %G eng %R 10.1016/j.socscimed.2021.114081 %0 Report %D 2021 %T Wealth Trajectories Across Key Milestones: Longitudinal Evidence from Life-Course Transitions %A Gopi Shah Goda %A Streeter, Jialu L. %K childbirth %K Disability %K Divorce %K health shock %K Homeownership %K Marriage %K Retirement %K Wealth %K Widowhood %X Wealth varies considerably across the population and changes significantly over the lifecycle. In this paper, we trace out trajectories of wealth across several key life milestones, including marriage, homeownership, childbirth, divorce, disability, health shocks, retirement and widowhood using multiple decades of longitudinal panel data. We estimate both changes over the ten-year period before and after each milestone and assess whether those changes occur gradually or sharply after the milestone. We find evidence of significant long-run increases in wealth associated with homeownership and retirement, and significant long-run reductions in wealth associated with divorce, health shocks, and disability. In general, these changes appear to occur gradually rather than immediately after the milestone. Our results also indicate a large degree of heterogeneity across demographics, socioeconomic status and risk protection from insurance. In particular, those with lower levels of socioeconomic status and those without access to risk protection experience smaller wealth gains (or larger wealth losses) following life-course transitions. These results identify populations and life stages where individuals are most vulnerable to large reductions in wealth. %B NBER Working Paper %I National Bureau of Economic Research %C Cambridge, MA %G eng %R 10.3386/w28329 %0 Report %D 2021 %T Wealth Trajectories Across Key Milestones: Longitudinal Evidence from Life-Course Transitions %A Gopi Shah Goda %A Streeter, Jialu L. %K Disability %K Divorce %K Health Shocks %K Homeownership %K Marriage %K Retirement %K wealth trajectory %K Widowhood %X Wealth varies considerably across the population and changes significantly over the lifecycle. In this paper, we trace out trajectories of wealth across several key life milestones, including marriage, homeownership, childbirth, divorce, disability, health shocks, retirement and widowhood using multiple decades of longitudinal panel data. We estimate both changes over the ten-year period before and after each milestone and assess whether those changes occur gradually or sharply after the milestone. We find evidence of significant long-run increases in wealth associated with homeownership and retirement, and significant long-run reductions in wealth associated with divorce, health shocks, and disability. In general, these changes appear to occur gradually rather than immediately after the milestone. Our results also indicate a large degree of heterogeneity across demographics, socioeconomic status and risk protection from insurance. In particular, those with lower levels of socioeconomic status and those without access to risk protection experience smaller wealth gains (or larger wealth losses) following life-course transitions. These results identify populations and life stages where individuals are most vulnerable to large reductions in wealth. %B NBER Working Paper %I National Bureau of Economic Research %C Cambridge, MA %G eng %R 10.3386/w28329 %0 Journal Article %J Innovation in Aging %D 2020 %T The Association of Sensory Impairment With Incident Disability-Related Cessation of Employment in Older Adults %A Ahmed F Shakarchi %A Morales, Emmanuel Garcia %A Nicholas S. Reed %A Bonnielin K Swenor %K Disability %K Employment %K sensory impairment %X Sensory impairment (SI) is common among older adults, and it is an increasingly important public health challenge as the population ages. We evaluated the association between SI and incident disability-related cessation of employment in older adults using the population-based Health and Retirement Study. Participants employed in 2006 completed biennial interviews until self-reported incident disability-related cessation of employment. Participants were censored at loss to follow-up, retirement, or 2018. Participants rated their vision and hearing, using eyeglasses or hearing aids if applicable, on a Likert scale (poor, fair, good, very good, excellent). SI was defined as poor or fair ability, and SI was categorized as neither SI (NSI), vision impairment alone (VI), hearing impairment alone (HI), and dual SI (DSI). Cox proportional hazard regression assessed the association between SI and incident disability-related cessation of employment, adjusting for demographic and health covariates. Overall, 4726 participants were included: 421 (8.9%) were with VI, 487 (10.3) with HI, and 203 (4.3%) with DSI. Mean age was 61.0 ± 6.8 years, 2488 (52.6%) were women, and 918 (19.4) were non-White. In the fully adjusted model, incident disability-related cessation of employment over the 12-year follow-up period was higher in VI (Hazard Ratio (HR)=1.30, 95% confidence interval (CI)=0.92, 1.85), HI (HR=1.60, CI=1.16, 2.22), and DSI (HR=2.02, CI=1.38, 2.96). These findings indicate that employed older adults with SI are at increased risk of incident disability-related cessation of employment, and that older adults with DSI are particularly vulnerable. Addressing SI in older adults may lengthen their contribution to the workforce. %B Innovation in Aging %V 4 %P 216 %@ 2399-5300 %G eng %N Suppl 1 %R 10.1093/geroni/igaa057.697 %0 Journal Article %J Alzheimer's & DementiaAlzheimer's & DementiaAlzheimer's Dement. %D 2020 %T Difficulty and help with activities of daily living among older adults living alone with cognitive impairment %A Ryan D. Edwards %A Willa D Brenowitz %A Portacolone, Elena %A Kenneth E Covinsky %A Bindman, Andrew %A M. Maria Glymour %A Jacqueline M Torres %K Activities of Daily Living %K Aging in place %K CIND %K Dementia %K Disability %K limitations %K Living arrangement %K population-based study %K service gaps %X Abstract Introduction There is limited research on difficulties with activities of daily living (I/ADLs) among older adults living alone with cognitive impairment, including differences by race/ethnicity. Methods For U.S. Health and Retirement Study (2000?2014) participants aged 55+ living alone with cognitive impairment (4,666 individuals; 9,091 observations), we evaluated I/ADL difficulty and help. Results Among 4.3 million adults aged 55+ living alone with cognitive impairment, an estimated 46% reported an I/ADL difficulty; 72% reported not receiving help with an I/ADL. Women reported more difficulty than men. Compared to white women, black women were 22% more likely to report a difficulty without help, and Latina women were 36% more likely to report a difficulty with help. Among men, racial/ethnic differences in outcomes were not significant. Patterns of difficulty without help by race/ethnicity were similar among Medicaid beneficiaries. Discussion Findings call for targeted efforts to support older adults living alone with cognitive impairment. %B Alzheimer's & DementiaAlzheimer's & DementiaAlzheimer's Dement. %8 2020/06/26 %@ 1552-5260 %G eng %R 10.1002/alz.12102 %0 Report %D 2020 %T Disability and Wealth: Exploring the Liquid Asset Trajectories of SSI and SSDI Applicants %A L'Esperance, Madelaine %K Disability %K Household Savings %K Social Security Disability Insurance %K Supplemental Security Income %K Wealth %X Social safety net programs provide benefits that insure against disability, poor health, unemployment, and old age. These programs stabilize the financial lives of beneficiaries. In this study, I investigate whether the disability programs Social Security Disability Insurance (SSDI) and Supplemental Security Income (SSI) protect household wealth, including household savings and liquid assets. Using longitudinal data from the 1992–2016 waves of the Health and Retirement Study (HRS), I examine the liquid wealth trajectories of disability program applicants by application timing and decision. I also examine how these trajectories differ by net worth for SSI applicants subject to asset tests. In addition to this descriptive evidence, I employ a panel events study design to examine the effect of application timing on savings net of fixed year and individual effects as well as observed time-varying characteristics. I do not find evidence that disability application timing significantly affects liquid assets. %B Center for Financial Security Working Paper %I University of Wisconsin-Madison %C Madison,WI %G eng %U https://cfsrdrc.wisc.edu/files/working-papers/WI19_JSIT_03_lesperance_revised-(1).pdf %0 Journal Article %J Journal of Health Economics %D 2020 %T A double safety net? Understanding interactions between disability benefits, formal assistance, and family support %A Stephanie Rennane %K Crowd out %K Disability %K Family transfers %K Informal assistance %X While the main insurance sources for individuals with disability are understood, less is known about how family support interacts with federal disability benefits. Using the Health and Retirement Study matched to administrative records, I examine how disability benefits affect family support by comparing accepted and rejected disability applicants before and after benefit receipt. Receipt of disability insurance increases the probability of receiving any assistance from children by 18 percent and more than doubles the amount of in-kind assistance. Disability insurance also increases the probability that children are paid for their help and reduces children's labor supply. These findings are largest for low-income beneficiaries and those who recently lost a spouse, suggesting that child assistance complements income provided by disability insurance, and substitutes for other family assistance. Receipt of disability benefits allows the family to re-optimize how they provide support, and disability insurance is shared within the family in complementary ways. %B Journal of Health Economics %V 69 %G eng %U http://www.sciencedirect.com/science/article/pii/S0167629619303868 %9 Journal %R https://doi.org/10.1016/j.jhealeco.2019.102248 %0 Thesis %B Economics %D 2020 %T Essays on Disability, Public Assistance Programs and Employment %A Zhu, Xiaoqi %K Disability %K Employment %K public assistance programs %X This dissertation explores the relationship between disability, public assistance programs and employment. The first chapter investigates the impact of chronic pain on the labor market participation decisions of people nearing retirement age. The results from estimating a random effect discrete-time hazard model suggest that chronic pain greatly enlarges the hazard of exiting labor market even after controlling for many diseases that contribute to pain, and this effect increases with the severity of pain level. I further estimate a discrete-time competing risks model to explore the association between chronic pain and labor market exits due to different reasons. The finding indicates that chronic pain plays a more important role in the labor market exit decisions of those who are disabled, rather than those who retire normally, implying that chronic pain is a good measure of health-related work capacity. The second chapter examines a potentially important spillover effect of raising the minimum wages. I estimate the impact of minimum wage increases on SSI program participation and employment outcomes among non-elderly adults with disability. Working age adults with disability are at the margin of being affected by the wage floor. On the one hand, a large portion of this population may not have the capacity to work. On the other hand, this is the group that may be paid exactly at the minimum wage rate, on the premise that their health conditions do not completely stop them from working. Using the variation in minimum wages across states during the period 2004-2013, the findings suggest that higher minimum wages may cutback SSI program participation through the channel of employment effect for younger adults with disability. No discernible effect is found on the program participation or the employment outcome of adults aged 50 and older. The last two chapters examine the effects of a policy change in the Medicaid eligibility rule on various individual outcomes, including Medicaid coverage, employment, earnings and household savings. The third chapter estimates the effects of eliminating Medicaid asset tests on Medicaid enrollment and labor market outcomes of non-elderly, low-income parents using a Difference-in-Difference method. The identification strategy exploits the exogenous variation in the timing of asset tests removal among states. The finding indicates that removing Medicaid asset tests only play an important role in mothers’ outcomes. Asset test removal is associated with a 4.4 percentage point increase in the probability of Medicaid enrollment for mothers, but the expanded access to Medicaid slightly lowers their earned income, and decreases the probability of full-time employment and any employment by 2.3 and 2.8 percentage points respectively. The last chapter assesses the effect of eliminating Medicaid asset tests for low-income families on household saving behavior. I use Difference-in-Difference method and data on loweducated household heads with children from the Survey of Income and Program Participation (SIPP) to estimate the elimination effects. The findings indicate a strong positive impact of eliminating asset tests on household holdings of liquid assets, and the effects are greater for states with stricter lower asset limit levels before the elimination. However, the effect is not robust to the inclusion of state specific time trends in the model, which may imply that the elimination of Medicaid asset tests correlates with other trends in state level output, and it may not be possible to disentangle the causal effect of the asset test removal from these underlying trends. This study finds no evidence of the elimination effect on non-liquid assets or household net worth (excluding the value of primary residence and first car). %B Economics %I University at Albany, State University of New York %C Albany, NY %V Doctor of Philosophy %G eng %U https://search.proquest.com/openview/b96b0b5d9ca8e9d6d833afadc2552d90/1?pq-origsite=gscholar&cbl=18750&diss=y %0 Report %D 2020 %T Household responses to disability shocks: Spousal labor supply, caregiving, and disability insurance %A Siha Lee %K Caregiving %K Disability %K Social Security %K spousal labor supply %X This paper examines married women’s time allocation to market hours and spousal care in the event of their husbands’ disability and its implications for evaluating the insurance value of the Social Security Disability Insurance (SSDI) program. First, I find that while spousal labor supply responses to husbands’ disability are small, wives spend a sizable amount of time in spousal care after their husbands become disabled. Motivated by these facts, I develop a dynamic model of married households that incorporates husbands’ disability status, wives’ time allocation choices, health state dependent utility, and the institutional features of SSDI. Counterfactual experiments indicate that caregiving needs substantially attenuate spousal labor supply responses and increase the insurance value of SSDI relative to its costs. Furthermore, policy reforms such as supplementary caregiving benefits can improve social welfare. %B Canadian Labour Economics Forum Working Paper Series %I University of Waterloo %C Waterloo, Ontario %G eng %U https://www.econstor.eu/bitstream/10419/215772/1/169428462X.pdf %9 Report %0 Journal Article %J Annals of Behavioral Medicine %D 2020 %T Individual-Level and Couple-Level Discordant Chronic Conditions: Longitudinal Links to Functional Disability %A Courtney A Polenick %A Kira S. Birditt %A Turkelson, Angela %A Helen C Kales %K Chronic illness %K Disability %K multimorbidity %K Spouses %X Multiple chronic conditions may erode physical functioning, particularly in the context of complex self-management demands and depressive symptoms. Yet, little is known about how discordant conditions (i.e., those with management requirements that are not directly related and increase care complexity) among couples are linked to functional disability.We evaluated own and partner individual-level discordant conditions (i.e., discordant conditions within individuals) and couple-level discordant conditions (i.e., discordant conditions between spouses), and their links to levels of and change in functional disability.The U.S. sample included 3,991 couples drawn from nine waves (1998–2014) of the Health and Retirement Study. Dyadic growth curve models determined how individual-level and couple-level discordant conditions were linked to functional disability over time, and whether depressive symptoms moderated these links. Models controlled for age, minority status, education, each partner’s baseline depressive symptoms, and each partner’s number of chronic conditions across waves.Wives and husbands had higher initial disability when they had their own discordant conditions and when there were couple-level discordant conditions. Husbands also reported higher initial disability when wives had discordant conditions. Wives had a slower rate of increase in disability when there were couple-level discordant conditions. Depressive symptoms moderated links between disability and discordant conditions at the individual and couple levels.Discordant chronic conditions within couples have enduring links to disability that partly vary by gender and depressive symptoms. These findings generate valuable information for interventions to maintain the well-being of couples managing complex health challenges. %B Annals of Behavioral Medicine %V 54 %P 455 - 469 %@ 0883-6612 %G eng %N 7 %R 10.1093/abm/kaz061 %0 Journal Article %J European Journal of Public Health %D 2020 %T Life-course risk factors are associated with activity of daily living disability in older adults. %A Macinko, James %A Vaz de Melo Mambrini, Juliana %A Bof de Andrade, Fabíola %A Drumond Andrade, Flavia Cristina %A Lazalde, Gabriela E %A Lima-Costa, Maria Fernanda %K Activities of Daily Living %K Aging %K Child %K Disability %K Educational Status %K human development index %K multimorbidity %K Older adult %K Socioeconomic factors %X

BACKGROUND: Multiple risk factors accumulate over the life-course and contribute to higher rates of disability at older ages. This study investigates whether three life-course risk factors (low educational attainment, poor health in childhood and multimorbidity) are associated with increased risk of disability [defined as any limitation in basic activities of daily living (BADL)] in older adults and whether this relationship is moderated by the national socioeconomic context, measured by the Human Development Index (HDI).

METHODS: Data include 100 062 adults (aged 50 and over) participating in longitudinal studies of aging conducted in 19 countries. Analyses include multivariable Poisson models with robust standard errors to assess the associations between HDI, life-course risk factors and other individual-level control variables (sex and age) with any BADL disability.

RESULTS: In country-specific analyses, both educational attainment and multimorbidity are independently associated with disability in nearly every country. The interaction between these risk factors further increases the magnitude of this association. In pooled regression analyses, the relationship between life-course risk factors and disability is moderated by a country's HDI. For individuals with all three life-course risk factors, the predicted probability of disability ranged from 36.7% in the lowest HDI country to 21.8% in the highest HDI country.

CONCLUSIONS: Social and health system policies directed toward reducing the development of life-course risk factors are essential to reduce disability in all countries, but are even more urgently needed in those with lower levels of socioeconomic development.

%B European Journal of Public Health %G eng %R 10.1093/eurpub/ckaa156 %0 Journal Article %J The Journals of Gerontology: Series A %D 2020 %T Living Longer, With or Without Disability? A Global and Longitudinal Perspective %A Jinkook Lee %A Lau, Samuel %A Erik Meijer %A Hu, Peifeng %K Activities of Daily Living %K CHARLS %K Cross-country comparison %K Disability %K ELSA %K KLoSA %K MHAS %K SHARE %K Trends %X Background Significant gains in life expectancy have been achieved, but living longer does not necessarily mean the years gained are productive and healthy. Different theories predict different patterns of time trends in old-age disability prevalence. Methods Using the Gateway to Global Aging Data, which provides internationally harmonized longitudinal data from the Health and Retirement Study and its sister surveys, we compare time trends (from 2004 to 2014) in disability prevalence across countries. Results Disability prevalence varies greatly across countries, and divergent time trends are observed across countries. For countries such as Belgium, Czechia, and Mexico, we observe an increase of disability prevalence, whereas in countries such as Denmark, England, Greece, Korea, Poland, and Sweden, we observe a substantial decrease in disability prevalence. Looking further into the severity of disability, we often observe differential trends in prevalence, but there is no evidence supporting the dynamic equilibrium hypothesis that predicts increased prevalence of modest disability but a decrease in severe disability prevalence. Conclusions Significant gains in life expectancy have translated into different gains in healthy years of life across different countries. Diverse time trends in disability prevalence across countries reaffirm that the expansion of late-life disability is not inevitable. %B The Journals of Gerontology: Series A %V 75 %P 162-167 %G eng %U https://pubmed.ncbi.nlm.nih.gov/30629214/ %N 1 %R 10.1093/gerona/glz007 %0 Journal Article %J The Journals of Gerontology: Series A %D 2020 %T Socioeconomic Inequalities in Disability-free Life Expectancy in Older People from England and the United States: A Cross-national Population-Based Study %A Zaninotto, Paola %A G David Batty %A Stenholm, Sari %A Ichiro Kawachi %A Hyde, Martin %A Goldberg, Marcel %A Westerlund, Hugo %A Vahtera, Jussi %A Head, Jenny %K Cross-National %K Disability %K Healthy life expectancy %K socioeconomic status %X We examined socioeconomic inequalities in disability-free life expectancy in older men and women from England and the United States and explored whether people in England can expect to live longer and healthier lives than those in the United States.We used harmonized data from the Gateway to Global Aging Data on 14,803 individuals aged 50+ from the U.S. Health and Retirement Study (HRS) and 10,754 from the English Longitudinal Study of Ageing (ELSA). Disability was measured in terms of impaired activities and instrumental activities of daily living. We used discrete-time multistate life table models to estimate total life expectancy and life expectancy free of disability.Socioeconomic inequalities in disability-free life expectancy were of a similar magnitude (in absolute terms) in England and the United States. The socioeconomic disadvantage in disability-free life expectancy was largest for wealth, in both countries: people in the poorest group could expect to live seven to nine fewer years without disability than those in the richest group at the age of 50.Inequalities in healthy life expectancy exist in both countries and are of similar magnitude. In both countries, efforts in reducing health inequalities should target people from disadvantaged socioeconomic groups. %B The Journals of Gerontology: Series A %V 75 %P 906-913 %8 01 %G eng %N 5 %R 10.1093/gerona/glz266 %0 Journal Article %J Innovation in Aging %D 2020 %T Trends in Disability Among Adults 55-64 in the United States and England From 2002 to 2016 %A Choi, Hwajung %A Robert F. Schoeni %A Cho, Tsai-Chin %A Kenneth M. Langa %K Disability %K ELSA %X The paper’s goal is to assess whether and, if so, the extent to which prevalence in disability of adults near retirement ages in the US increased over time compared to their peers in England and examine income group differences in the relative trends. This study uses 2002-2016 Health and Retirement Study (HRS) and English Longitudinal Study of Ageing (ELSA) focusing on adults aged 55-64. Annual percent changes over the period of 2002-2016 for limitations in instrumental activities of daily living (IADL) and activities of daily living (ADL) are estimated for each survey (HRS and ELSA) using multivariable logistic regressions to adjust for individual-level characteristics While disability prevalence of adults ages 55-64 in England improved over the years of 2002-2016 (annual % change= -2.01 for IADL; - 2.53 for ADL), disability prevalence of US adults has not improved and in fact even worsened in terms of IADL (annual % change= +1.35). There are substantial variations in the IADL/ADL trends by income groups. In the US, the adverse trends in disability were more pronounced among the lowest income groups (annual % change in IADL=1.76 for bottom 20% vs. -2.08 for top 20%; annual % change in ADL=1.08 for bottom 20% vs. -2.08 for top 20%). In England, the disability status improved over time for all but the lowest income group. We will examine further to identify specific factors contributing to divergent/convergent trends in disability between the US and England. %B Innovation in Aging %V 4 %P 303 %@ 2399-5300 %G eng %N Suppl 1 %R 10.1093/geroni/igaa057.970 %0 Report %D 2020 %T Working and disability expectancies at old ages: The role of childhood circumstances and education %A Angelo Lorenti %A Christian Dudel %A Jo Mhairi Hale %A Mikko Myrskylä %K Disability %K early childhood %K Education %K length of working life %K Markov chains %K Race/ethnicity %K USA %X The ability to work at older ages depends on health and education. Both accumulate starting very early in life. We assess how childhood disadvantages combine with education to affect working and health trajectories. Applying multistate period life tables to data from the Health and Retirement Study (HRS) for the period 2008-2014, we estimate how the residual life expectancy at age 50 is distributed in number of years of work and disability, by number of childhood disadvantages, gender, and race/ethnicity. Our findings indicate that number of childhood disadvantages is negatively associated with work and positively with disability, irrespective of gender and race/ethnicity. Childhood disadvantages intersect with low education resulting in shorter lives, and redistributing life years from work to disability. Among the highly educated, health and work differences between groups of childhood disadvantage are small. Combining multistate models and inverse probability weighting, we show that the return of high education is greater among the most disadvantaged. %B MPIDR Working Papers %I Max Planck Institute for Demographic Research %C Rostock, Germany %G eng %R 10.4054/MPIDR-WP-2020-006 %0 Journal Article %J Medicine %D 2019 %T The burden of health conditions across race and ethnicity for aging Americans: Disability-adjusted life years. %A Ryan P McGrath %A Soham Al Snih %A Kyriakos S Markides %A Jessica Faul %A Brenda Vincent %A Orman T Hall %A Mark D Peterson %K Disability %K health conditions %K race %X

Despite evidence suggesting race and ethnicity are important factors in responses to environmental exposures, drug therapies, and disease risk, few studies focus on the health needs of racially- and ethnically-diverse aging adults.The objective of this study was to determine the burden of 10 health conditions across race and ethnicity for a nationally-representative sample of aging Americans.Data from the 1998 to 2014 waves of the Health and Retirement Study, an ongoing longitudinal-panel study, were analyzed.Those aged over 50 years who identified as Black, Hispanic, or White were included. There were 5510 Blacks, 3423 Hispanics, and 21,168 Whites in the study.At each wave, participants reported if they had cancer, chronic obstructive pulmonary disease, congestive heart failure, diabetes, back pain, hypertension, a fractured hip, myocardial infarction, rheumatism or arthritis, and a stroke. Disability-adjusted life years (DALYs) were calculated for each health condition by race and ethnicity. Ranked DALYs determined how race and ethnicity was differentially impacted by the burden of each health condition. Sample weights were utilized to make DALY estimates nationally-representative.Weighted DALY estimates (in thousands) ranged from 1405 to 55,631 for Blacks, 931 to 28,442 for Hispanics, and 15,313 to 295,623 for Whites. Although the health conditions affected each race and ethnicity differently, hypertension had the largest number of DALYs, and hip fractures had the fewest across race and ethnicity. In total, there were an estimated 198,621, 101,462, and 1,187,725 DALYs for older Black, Hispanic, and White aging adults.Our findings indicate that race and ethnicity may be influential on health and disease for aging adults in the United States. Monitoring DALYs may help guide the flow of health-related expenditures, improve the impact of health interventions, advance inclusive health care for diverse aging adult populations, and prepare healthcare providers for serving the health needs of aging adults.

%B Medicine %V 98 %P e17964 %G eng %N 46 %R 10.1097/MD.0000000000017964 %0 Journal Article %J BMC geriatrics %D 2019 %T Disability incidence and functional decline among older adults with major chronic diseases %A Joelle H Fong %K Chronic Diseases %K Disability %K functional decline %X BACKGROUND: More than 80% of elderly Americans have at least one chronic disease. While past studies have shown that hierarchical patterns of functional loss may differ by gender and institutional settings, little is known about whether such patterns differ in relation to chronic health condition. The aim of this study is to investigate the pattern of functional loss among older adults with major chronic illnesses, and to compare their onset and ordering of incident ADL disability with those of persons without such conditions. METHODS: We use a nationally representative sample of persons aged 80+ from the 1998-2014 Asset and Health Dynamics of the Oldest Old survey. The group with major noncommunicable diseases (including cardiovascular disease, cancer, chronic respiratory disease, and diabetes) comprises 3,514,052 subjects, while the comparison group comprises 1,073,263 subjects. Self-reports of having difficulty with six distinct ADLs are used to estimate disability incidence rate. Nonparametric statistical methods are used to derive median onset ages and ADL loss sequence separately for each group. RESULTS: Older adults with major chronic diseases have higher rates of incident disability across all ADL items. Estimated median onset ages of ADL disabilities for the full sample range from 91.5 to 95.6. Disability occurs earlier for chronically ill persons (onset ages 91.1-95.0) than for those in the comparison group (onset ages 93.5-98.1). Among those with major chronic diseases, the ADL loss sequence ordered by median ages of disability onset is bathing, walking, dressing, toileting, transferring and eating. The activities are also distinctly separated into an early-loss cluster and a late-loss cluster. Although the loss sequence derived for the comparison group is largely similar, disability progression for those with major chronic diseases is compressed within a shorter timeframe and the timing gaps between adjacent disabilities are smaller. CONCLUSIONS: Older Americans with major noncommunicable diseases face an earlier and steeper slope of functional decline. Chronic care delivery programs should adapt to dynamic changes in older patients' functional status. Health interventions to help patients delay disability onset and optimize functional autonomy within emerging models of chronic care should especially target early-loss activities such as bathing, dressing, and walking. %B BMC geriatrics %V 19 %P 323 %G eng %U https://www.ncbi.nlm.nih.gov/pubmed/31752701 %R 10.1186/s12877-019-1348-z %0 Journal Article %J The National Bureau of Economic Research %D 2019 %T Disability Insurance: Error Rates and Gender Differences %A Low, Hamish %A Pistaferri, Luigi %K Disability %K disability insurance %K gender %K Insurance %X We show the extent of errors made in the award of disability insurance using matched survey-administrative data. False rejections (Type I errors) are widespread, and there are large gender differences in these type I error rates. Women with a severe, work-limiting, permanent impairment are 20 percentage points more likely to be rejected than men, controlling for the type of health condition, occupation, and a host of demographic characteristics. We investigate whether these gender differences in Type I errors are due to women being in better health than men, to women having lower pain thresholds, or to women applying more readily for disability insurance. None of these explanations are consistent with the data. We use evidence from disability vignettes to suggest that there are different acceptance thresholds for men and women. The differences by gender arise because women are more likely to be assessed as being able to find other work than observationally equivalent men. Despite this, after rejection, women with a self-reported work limitation do not return to work, compared to rejected women without a work limitation. %B The National Bureau of Economic Research %V Working Paper No. 26513 %8 11/2019 %G eng %U http://www.nber.org/papers/w26513 %R 10.3386/w26513 %0 Journal Article %J JOURNALS OF GERONTOLOGY SERIES B-PSYCHOLOGICAL SCIENCES AND SOCIAL SCIENCES %D 2019 %T Gendered Expectations Distort Male-Female Differences in Instrumental Activities of Daily Living in Later Adulthood %A Connor M Sheehan %A Elliot M Tucker-Drob %K Disability %K gender %K Independent Living %K Measurement %X Objectives: The ability of older adults to live independently is often assessed with a battery of questions known as Instrumental Activities of Daily Living (IADLs). Many of these questions query the difficulty conducting household activities that have been predominantly conducted by women (e.g., the ability to prepare a meal), especially for cohorts now in old age. Although previous research has documented gender differences in IADL limitations, it has not been documented whether IADLs equivalently measure the same latent construct for men and women. Methods: We apply psychometric tests of measurement invariance to data from the 1998 Health and Retirement Study. We then estimate corrected models that account for violations of measurement invariance across genders. Results: We find that IADLs do not equivalently measure same latent construct for men and women. We find that men are more likely not to do the IADL activities for reasons unrelated to health limitations, which may reflect gendered expectations regarding household activities. Accounting for this we still find that women report greater health-related IADL limitations than men. Discussion: Researchers should be cautious making gender comparisons for IADLs without attending to the gender-specific measurement properties of many of the items of which the IADL is comprised. %B JOURNALS OF GERONTOLOGY SERIES B-PSYCHOLOGICAL SCIENCES AND SOCIAL SCIENCES %V 74 %P 715-723 %8 MAY %G eng %R 10.1093/geronb/gbw209 %0 Journal Article %J Social Science Research %D 2019 %T The growing American health penalty: International trends in the employment of older workers with poor health %A Ben Baumberg Geiger %A René Böheim %A Thomas Leoni %K Disability %K Employment %K health %K Panel data %K Social Security %K Welfare %X Many countries have reduced the generosity of sickness and disability programs while making them more activating – yet few studies have examined how employment rates have subsequently changed. We present estimates of how employment rates of older workers with poor health in 13 high-income countries changed 2004–7 to 2012–15 using HRS/SHARE/ELSA data. We find that those in poor health in the USA have experienced a unique deterioration: they have not only seen a widening gap to the employment rates of those with good health, but their employment rates fell per se. We find only for Sweden (and possibly England) signs that the health employment gap shrank, with rising employment but stable gaps elsewhere. We then examine possible explanations for the development in the USA: we find no evidence it links to labor market trends, but possible links to the USA's lack of disability benefit reform and wider economic trends. %B Social Science Research %V 82 %P 18 - 32 %G eng %U http://www.sciencedirect.com/science/article/pii/S0049089X1830560X %R https://doi.org/10.1016/j.ssresearch.2019.03.008 %0 Journal Article %J J Aging Health %D 2019 %T Impact of Diabetes and Disease Duration on Work Status Among U.S. Older Adults. %A Mutambudzi, Miriam %A César González-González %A Rebeca Wong %K Aging Workforce %K Diabetes %K Disability %K Retirement %X

OBJECTIVES: To examine the effects of diabetes and disease duration on work status over a 9-year period.

METHOD: Multinomial logistic regression models examined the probability of retirement and disability impeding work, using data from the Health and Retirement Study ( n = 5,576).

RESULTS: Among participants who had retired in 2012, almost 14% had incident diabetes (4.91 mean years with diabetes, 95% confidence interval [CI] = [4.67, 5.15]). Approximately 22% of participants who reported a disability impeded labor force participation had prevalent diabetes (17.1 mean years with diabetes, 95%CI = [16.41, 17.71]). Only prevalent diabetes that indicated longer disease duration was associated with disability (relative risk ratio [RRR] = 1.83, 95% CI = [1.30, 2.57]). There was evidence of effect modification among Hispanics only ( p = .02).

DISCUSSION: Diabetes increased risk of exiting the workforce due to disability, and mean disease duration was associated with changes. Disease management and workplace interventions may enable older adults to continue being productive should they choose to remain in the workforce.

%B J Aging Health %V 32 %G eng %U https://pubmed.ncbi.nlm.nih.gov/30767603/ %N 5-6 %1 http://www.ncbi.nlm.nih.gov/pubmed/30767603?dopt=Abstract %& 432-440 %R 10.1177/0898264318822897 %0 Report %D 2019 %T New Work-Limiting Health Events and Occupational Transitions Among Older Workers %A Jody Schimmel Hyde %A April Yanyuan Wu %K Disability %K Occupations %K Transitions %K work limitations %X In this study, we use the Health and Retirement Study linked to detailed occupational data to descriptively examine whether the occupational path of older workers who report a new work-limiting health condition in the years before retirement differs from that of workers who remain limitation-free. %I Mathematica Policy Research %G eng %U https://ideas.repec.org/p/mpr/mprres/0d12254d6aa542e09156584e8db851ba.html %0 Journal Article %J GeroScience %D 2019 %T Polygenic risk score for disability and insights into disability-related molecular mechanisms %A Alexander M Kulminski %A Kang, Chansuk %A Kolpakov, Stanislav A. %A Loika, Yury %A Nazarian, Alireza %A Anatoliy Yashin %A Stallard, Eric %A Culminskaya, Irina %K Disabilities %K Disability %K Polygenic risk score %X Late life disability is a highly devastating condition affecting 20% or more of persons aged 65 years and older in the USA; it is an important determinant of acute medical and long-term care costs which represent a growing burden on national economies. Disability is a multifactorial trait that contributes substantially to decline of health/wellbeing. Accordingly, gaining insights into the genetics of disability could help in identifying molecular mechanisms of this devastating condition and age-related processes contributing to a large fraction of specific geriatric conditions, concordantly with geroscience. We performed a genome-wide association study of disability in a sample of 24,068 subjects from five studies with 12,550 disabled individuals. We identified 30 promising disability-associated polymorphisms in 19 loci at p < 10−4; four of them attained suggestive significance, p < 10−5. In contrast, polygenic risk scores aggregating effects of minor alleles of independent SNPs that were adversely or beneficially associated with disability showed highly significant associations in meta-analysi %B GeroScience %8 Nov %G eng %U https://doi.org/10.1007/s11357-019-00125-8 %R 10.1007/s11357-019-00125-8 %0 Journal Article %J AEA Papers and Proceedings %D 2018 %T The Effect of the Disability Insurance Application Decision on the Employment of Denied Applicants %A Khan, Mashfiqur R. %K Disability %K disability insurance %X Social Security Disability Insurance (SSDI) affects the labor supply of applicants through its work discouragement and through human capital deterioration regardless of the ultimate acceptance or denial of the claim. In this paper, I provide an estimate of the causal effect of SSDI application on denied applicants using non-applicants as a comparison group. Exploiting instrumental variable approach, I find that the SSDI causes a 36 percentage point reduction in employment of the denied applicants of ages 50 to 58 in the short run. The loss of potential employment of the denied SSDI applicants is a welfare loss to the society. %B AEA Papers and Proceedings %V 108 %P 267-71 %8 May %G eng %U https://www.aeaweb.org/articles?id=10.1257/pandp.20181046 %R 10.1257/pandp.20181046 %0 Conference Paper %B 6th Annual Meeting of the Disability Research Consortium %D 2018 %T Occupational Changes Following Disability Onset in the Late Working Years %A April Yanyuan Wu %A Jody Schimmel Hyde %K Disabilities %K Disability %K Disability onset %K Occupation %K Occupational choice %X The onset of a work-limiting health condition in the years approaching retirement significantly reduces earnings and income, and leads to a sustained increase in the risk for poverty in both the late working years and into retirement. Schimmel and Stapleton (2012) found that earnings among older workers two years after the onset of a work-limiting health condition were 50 percent lower on average, and poverty rates were nearly double the rates for individuals who did not report a work-limiting health condition. Wu and Schimmel Hyde (forthcoming) reported that the likelihood of poverty in retirement was significantly higher for Social Security Disability Insurance (SSDI) beneficiaries and denied applicants—both groups who had substantial medical conditions—relative to older adults who had never sought SSDI before retirement—and who were presumably healthier than the two SSDI groups. %B 6th Annual Meeting of the Disability Research Consortium %I Mathematica Policy Research %G eng %U https://www.mathematica.org/-/media/internet/conferences/2018/drc-annual-meeting/summaries/occupational-changes-following-disability-onset-in-the-late-working-years-summary.pdf %0 Journal Article %J Journal of Disability Policy Studies %D 2018 %T The Postretirement Well-Being of Workers With Disabilities %A April Yanyuan Wu %A Jody Schimmel Hyde %K Disabilities %K Disability %K Retirement %K Well-being %X Older workers who develop significant limitations in health or functioning face declines in income and consumption and an increased likelihood of poverty in the years prior to retirement. We assess the extent to which those differences persist after reaching retirement age. We use the Health and Retirement Study (HRS) linked to Social Security Administration (SSA) records to compare the postretirement financial well-being of workers who experienced disability onset during their working years with those who did not, based on their claiming behavior for Social Security disability and retirement benefits. We find that even after full retirement age, gaps that emerged prior to retirement persist; those who experienced disability prior to retirement had lower incomes, were more likely to be in poverty, and had significantly lower wealth. Workers with disabilities who claimed Social Security Disability Insurance (DI) fared better than those who were rejected for such benefits, yet both groups were worse off than those who delayed claiming benefits until they were eligible for Social Security Old Age and Survivors Insurance (OASI) benefits. Our findings indicate that any changes to the Social Security benefit structure must be mindful of the short- and longer term implications for already-vulnerable groups of workers. %B Journal of Disability Policy Studies %V 30 %P 46 - 55 %8 2019/06/01 %@ 1044-2073 %G eng %U https://doi.org/10.1177/1044207318793161 %N 1 %! Journal of Disability Policy Studies %0 Thesis %B Social Work %D 2018 %T Religion/Spirituality and Disability in Older Adults %A Cantin,Alyssa %K 0201:Disability studies %K 0318:Religion %K 0347:Mental health %K depression %K Disability %K Disability studies %K Health and environmental sciences %K Mental Health %K Philosophy %K Religion %K religion and theology %K Stress %X A secondary data analysis was conducted using data from the Health and Retirement Study (HRS) to explore the relationships between physical disability, religion/spirituality (R/S), and mental health outcomes. The sample consisted of older adults randomly sampled from the United States. Ordinary least square regressions were done to test the proposed hypotheses that severity of disability would be associated with more R/S, more depression and more stress, and that R/S would be associated with less depression and less stress. The main effects were significant, and a mediation regression analysis was completed to determine if R/S significantly mediates the relationship of disability severity with depression and stress. The mediated effect was small but statistically significant, indicating that R/S potentially protects against negative mental health outcomes like depression and stress, as disabilities become more severe. Such findings have important research and practice implications in the treatment of older adults. %B Social Work %I Fordham University %V PhD %P 52 %@ 9780355877892 %G eng %U https://fordham.bepress.com/dissertations/AAI10807818/ %9 phd %0 Report %D 2017 %T The Financial Vulnerability of Former Disability Beneficiaries in Retirement %A Jody Schimmel Hyde %A April Yanyuan Wu %K Disabilities %K Disability %K disability discrimination %K disability finance %K Finance %K Retirement %X By their early 60s, one in four workers has experienced the onset of a work-limiting health condition (Johnson et al. 2007), and nearly four in five adults in this age group have experienced the onset of a chronic health condition (Smith 2003). Older workers who develop significant medical conditions or impairments face declines in earnings, income, and consumption and an increase in poverty (Schimmel and Stapleton 2012; Meyer and Mok 2014). In addition to these effects, leaving the labor force during peak earning years may have a lasting impact on financial security after retirement. In this brief, we consider the post-retirement financial well-being of workers based on whether they received Social Security Disability Insurance (DI). We compare their experiences to other workers who did not receive DI but claimed Old Age and Survivors’ Insurance (OASI) program. %I Mathematica Policy Research %G eng %U https://mathematica.org/publications/the-financial-vulnerability-of-former-disability-beneficiaries-in-retirement %0 Conference Paper %B Population Association of America 2017 %D 2017 %T Neighborhood Socioeconomic Status and Within-Individual Variation in Functional Health %A Katherine Ann Morris %K Disability %K functional health %K socioeconomic status %X Neighborhood socioeconomic disadvantage is a key risk factor for disability, but research on this association is contradictory and limited by cross-sectional analyses and an inattention to within-individual variation in disability. I draw individual-level data from Waves 4 through 10 of the Health and Retirement Study, a nationally-representative sample of community-dwelling older adults, and neighborhood socioeconomic data from the 2000 U.S. Decennial Census. Using multilevel linear growth curve models, I find baseline neighborhood disadvantage is associated with a higher rate of disablement over time, but is weakly associated with a higher initial level of disability. I also find that residents of disadvantaged neighborhoods have larger level-1 residual variance across time, suggesting they have greater temporal fluctuation in their level of disability. These findings reiterate the importance of longitudinal perspectives of disablement and underscore research on physical and social instability within disadvantaged neighborhoods. %B Population Association of America 2017 %G eng %U https://paa.confex.com/paa/2017/webprogrampreliminary/Paper15980.html %0 Generic %D 2016 %T Disability Measurement in the Health and Retirement Study %A Emily M. Agree %A Douglas A. Wolf %K Disability %I National Institute on Aging %C Bethesda, MD %0 Generic %D 2016 %T Using the Health and Retirement Study for Disability Policy Research: A Review %A Jody Schimmel Hyde %A David Stapleton %K Disability %K Policy %K Workers %X The Health and Retirement Study (HRS) is a preeminent data source for research related to the experiences of workers nearing retirement, including the large share of those workers who experience a health shock or disability onset after age 50. In this article, we highlight key information collected from HRS respondents that benefits disability policy research and the body of knowledge that has resulted from this information. Our main goal is to identify from this research experience potential improvements in data collection and documentation that would further strengthen the HRS as a data source for disability policy researchers. %I National Institute on Aging %C Bethesda, MD %0 Thesis %D 2011 %T Partial Benefits in the Social Security Disability Insurance Program: A Policy Alternative to Foster Work among People with Disability %A Yin, Na %K Disability %K Social Security Benefits %X The current U.S. Social Security Disability Insurance program is an all-or-nothing system that has been criticized for creating strong work disincentives. In an empirically grounded and calibrated life-cycle model, I simulate behavioral responses to a partial disability benefit system, a policy alternative to the current program, which allows individuals to claim partial disability and combine earnings with disability benefits. The appeal of this policy hinges on the possibility of inducing applicants to selfselect themselves into a given disability level, while maintaining those with some work capacity in the labor force, and therefore keep them contributing through their labor taxes to the Social Security system, easing the budgetary pressures of the overall Social Security system. The current dichotomous definition of disability can result in relatively productive individuals dropping from the labor force to receive benefits in order to have access to a total income high enough to make ends meet. Instead, the new system will establish a culture of continuous attachment to the labor force in the wake of health limitations. The simulation results show that there will be significant increases in both DI applications and DI rolls under the partial DI system; however, most of the increases are due to increases in applications for partial benefits and awards to partial benefits. In fact, full DI benefits applications and full DI benefit rolls will drop substantially. The mean duration spent on DI program will decrease dramatically. Our budgetary and welfare calculations show that a partial DI system, under some conditions, could result in financial savings for the program as well as individuals' welfare improvements. %G eng %U https://www.researchgate.net/profile/Na_Yin7/publication/241248671_Partial_Benefits_in_the_Social_Security_Disability_Insurance_Program_A_Policy_Alternative_to_Foster_Work_among_People_with_Disability/links/5ea91eae299bf18b95845d1d/Partial-Benefits-in-the %0 Report %D 2010 %T Measuring the Spillover to Disability Insurance Due to the Rise in the Full Retirement Age %A Norma B Coe %A Haverstick, Kelly %K Disability %K disability insurance %K Retirement Age %X The increase in the full retirement age in the Social Security program provides exogenous variation in the generosity in the Social Security Disability Insurance (SSDI) program, based only on birth year. We exploit this variation to estimate how responsive SSDI applications are to the financial incentive to apply. We find that a 1-percentage-point decrease in the retirement-to-disability benefit ratio leads to a 0.25-percentage-point increase in the SSDI application rate for the sample, which represents an 8-percent increase in applications per two years. When weighted to account for sampling design, we estimate that this change in the financial incentive accounted for about 5 percent of the SSDI applications in 2009. However, we do not find a corresponding increase in SSDI receipt based on the financial incentives… %I Center for Retirement Research at Boston College %G eng %U https://crr.bc.edu/working-papers/measuring-the-spillover-to-disability-insurance-due-to-the-rise-in-the-full-retirement-age/ %0 Journal Article %J The Journal of Human Resources %D 1999 %T The Importance of Accommodation on the Timing of Disability Insurance Applications: Results from the Survey of Disability and Work and the Health and Retirement Study %A R.V. Burkhauser %A Butler, J. S. %A Kim, Yang-Woo %A Weathers, Robert R. %K Disabilities %K Disability %K disability insurance %K Work %K work conditions %K work environment %X [Using data from the 1978 Survey of Disability and Work and the 1992 Health and Retirement Study, we test the importance of accommodation and other policy variables on the timing of application for Social Security Disability Insurance benefits following the onset of a work-limiting condition. We correct for choice-based sampling in the Survey of Disability and Work by extending the Manski and Lerman (1977) correction to the likelihood function of our continuous time hazard model, we find that this correction significantly affects the results. Similar findings emerge from these two data sets. Accommodation significantly reduces the speed of application and more generous benefits increase the speed of applying for SSDI.] %B The Journal of Human Resources %V 34 %P - 611589 %8 1999 %@ 0022166X %G eng %U http://www.jstor.org/stable/146381 %N 3