Residential Relocation of Community-Dwelling Older Adults: The Role of Physical Function and the Housing Environment.

Objective: Most older adults in the United States (U.S.) prefer to remain in their current housing as they age, but difficulty with mobility (e.

Metro-Nonmetro Differences in Adverse Events in Residential Care Communities: Results From the National Post-Acute and Long-Term Care Study.

More than 1 in 5 older Americans live in rural areas (10.6 million of the 46.2 million aged 65 and older).

The Changing Demography of Late-Life Family Caregiving: A Research Agenda to Understand Future Care Networks for an Aging U.S. Population.

Repeated claims that a dwindling supply of potential caregivers is creating a crisis in care for the U.S. aging population have not been well-grounded in empirical research.

Disability Measurement in the Health and Retirement Study.

The Health and Retirement Study (HRS) has provided extensive and detailed national data on disability since it began in 1992, and has been used extensively in studies of disability trends and trajectories. We summarize conceptual frameworks used to characterize disability and review the HRS measures of functioning, work disability, and employer accommodations. HRS survey questions have experienced changes in wording, skip logic, or other design features over the life of the study, and we comment on the analytic challenges posed by those changes.

Social Changes in Women's Roles, Families, and Generational Ties.

There has been much speculation around the aging of the Baby Boom Generation because they were at the forefront of turbulent social changes in women's roles, marriage, and childbearing. This article addresses the ways in which population aging is intertwined with family change, and how intergenerational relations in later life are being transformed by social and demographic changes. Increasing diversity of family types and potentially weaker family ties raise the possibility of challenges to come in the next century.

Disaster Preparedness Among Older Japanese Adults With Long-Term Care Needs and Their Family Caregivers.

Objective: In the 2011 Great East Japan Earthquake, as in Hurricanes Katrina and Rita in the United States, older individuals were at the greatest risk of mortality. Much concern has been raised about developing plans to reduce these risks, but little information has been provided about preparedness, and the key role played by caregivers has been largely unexplored. The aims of this study were thus to examine the preparedness of family caregivers of older adults with long-term care needs and to identify the characteristics of older adults and their caregivers that are associated with poor preparedness and greater concern about disasters.

"It's got to be on this page": age and cognitive style in a study of online health information seeking.

Background: The extensive availability of online health information offers the public opportunities to become independently informed about their care, but what affects the successful retrieval and understanding of accurate and detailed information? We have limited knowledge about the ways individuals use the Internet and the personal characteristics that affect online health literacy.

Objective: This study examined the extent to which age and cognitive style predicted success in searching for online health information, controlling for differences in education, daily Internet use, and general health literacy.

Methods: The Online Health Study (OHS) was conducted at Johns Hopkins School of Public Health and Stanford University School of Medicine from April 2009 to June 2010.

Why do lifespan variability trends for the young and old diverge? A perturbation analysis.

Background: Variation in lifespan has followed strikingly different trends for the young and old: while total lifespan variability has decreased as life expectancy at birth has risen, the variability conditional on survival to older ages has increased. These diverging trends reflect changes in the underlying demographic parameters determining age-specific mortality.

Objective: We ask why the variation in the ages at death after survival to adult ages has followed a different trend than the variation at younger ages, and aim to explain the divergence in terms of the age pattern of historical mortality changes.

The potential for technology to enhance independence for those aging with a disability.

Technologies of all kinds can sustain and accelerate improvements in health and quality of life for an aging population, and enhance the independence of persons with disabilities. Assistive technologies are widely used to promote independent functioning, but the aging of users and their devices produces unique challenges to individuals, their families, and the health care system. The emergence of new "smart" technologies that integrate information technology with assistive technologies has opened a portal to the development of increasingly powerful, individualized tools to assist individuals with disabilities to meet their needs.

Behavioral adaptation and late-life disability: a new spectrum for assessing public health impacts.

Objectives: To inform public health efforts to promote independent functioning among older adults, we have provided new national estimates of late-life disability that explicitly recognize behavioral adaptations.

Methods: We analyzed the 2011 National Health and Aging Trends Study, a study of Medicare enrollees aged 65 years and older (n = 8077). For 7 mobility and self-care activities we identified 5 hierarchical stages--fully able, successful accommodation with devices, activity reduction, difficulty despite accommodations, and receipt of help--and explored disparities and associations with quality of life measures.

Reliability and validity of self-care and mobility accommodations measures in the National Health and Aging Trends Study.

Purpose Of The Study: Comprehensive measures of disability accommodations have been lacking in national health and aging studies. This article introduces measures of accommodations developed for the National Health and Aging Trends Study, evaluates their reliability, and explores the validity and reliability of hierarchical classification schemes derived from these measures.

Design And Methods: We examined test-retest reliability for questions about assistive device use, doing activities less often, and getting help from another person with both percentage agreement and kappa (N = 111).

Assistive devices in context: cross-sectional association between challenges in the home environment and use of assistive devices for mobility.

Purpose: A primary goal for aging policy is to optimize independence in later life. We estimate the cross-sectional association between physical and social challenge in the home environment and use of assistive devices (AD) for mobility in the home, controlling for lower extremity physical performance (short physical performance battery [SPPB]) and other factors.

Design And Methods: Data are from the Women's Health and Aging Study I, a prospective study of the factors related to physical disability in a sample of moderately to severely disabled older women.

Gender and Material Transfers between Older Parents and Children in Ismailia, Egypt.

In Egypt, kin relations have been governed by a patriarchal contract, which defines expectations for intergenerational support along gendered lines. Social changes may be disrupting these customs and bringing attention to the ways gender may influence intergenerational support in rapidly changing contexts. Using data from 4,465 parent-child dyads in Ismailia, Egypt, we examined whether intergenerational material transfers favored women over men and whether gaps in needs and endowments accounted for gender differences in transfers.

Effects of home, outside leisure, social, and peer activity on psychological health among Japanese family caregivers.

Objective: Previous research has indicated that informal caregivers' personal activities are disrupted by their caregiving role, leading to psychological stress and lower life satisfaction. However, the extent to which engagement in personal activities affects caregivers' psychological health remains unclear. This study examines the relationship between different types and frequencies of activities and both positive and negative parameters of the psychological health of caregivers.

A quality-of-life scale for assistive technology: results of a pilot study of aging and technology.

Background: In an aging society, it is increasingly important to understand how assistive devices can be used by older people to maintain quality of life despite chronic disabilities. Assistive technology is a mainstay of physical therapist practice, but the potential for device use to affect psychosocial well-being is not yet understood at the population level.

Objective: The objective of this study was to develop a parsimonious indicator that can be used in population-based surveys to represent the effect of assistive technologies on quality of life for older people, separate from personal assistance.

Validation of new measures of disability and functioning in the National Health and Aging Trends Study.

Background: Measurement gaps continue to hamper fuller understanding of late-life disability trends and dynamics. This article reports findings that validate the self-reported components of the disability protocol to be used in the new National Health and Aging Trends Study. The protocol was designed to redress existing measures by attending to environmental aspects of disability, capturing a broader range of capacity to perform tasks and including participation restriction items.

The implications of increased survivorship for mortality variation in aging populations.

The remarkable growth in life expectancy during the twentieth century inspired predictions of a future in which all people, not just a fortunate few, will live long lives ending at or near the maximum human life span. We show that increased longevity has been accompanied by less variation in ages at death, but survivors to the oldest ages have grown increasingly heterogeneous in their mortality risks. These trends are consistent across countries, and apply even to populations with record-low variability in the length of life.

Propositional density and cognitive function in later life: findings from the Precursors Study.

Objectives: We used longitudinal data from the Johns Hopkins Precursors Study to test the hypothesis that written propositional density measured early in life is lower for people who develop dementia categorized as Alzheimer's disease (AD). This association was reported in 1996 for the Nun Study, and the Precursors Study offered an unprecedented chance to reexamine it among respondents with different gender, education, and occupation profiles.

Methods: Eighteen individuals classified as AD patients (average age at diagnosis: 74) were assigned 2 sex-and-age matched controls, and propositional density in medical school admission essays (average age at writing: 22) was assessed via Computerized Propositional Idea Density Rater 3 linguistic analysis software.

Childhood Hib vaccination and pneumonia and influenza burden in US seniors.

This analysis examines the potential for the elderly to receive indirect protection from pneumonia and influenza (P&I) from vaccination of children. Using data from the Centers for Medicare and Medicaid Services, the National Immunization Survey, and the Behavioral Risk Factor Surveillance System, mixed-effects models were used to assess associations between vaccination coverage and P&I on the state level overall and by urbanicity and income. As vaccination coverage in children increased, the state-level P&I rates in seniors decreased (beta=-0.

Parity and parents' health in later life: the gendered case of Ismailia, Egypt.

We investigate the relationship between reproduction and functional health in later life among women and men in the resource-poor and gender-stratified setting of Ismailia governorate, Egypt. Analyses of survey data collected in 2003 show a statistically significant positive association between parity and difficulty with activities of daily living (ADLs), controlling for demographic and socio-economic factors and other co-morbid conditions. We also find that the number of daughters (but not sons) is associated with worse physical functioning, and this association is more pronounced for older fathers than for older mothers.

Grandparental caregiving, income inequality and respiratory infections in elderly US individuals.

Background: Pneumonia and influenza (P&I) is a major cause of morbidity and mortality in the USA, particularly in elderly people. Recent research indicates that P&I may be linked to socioeconomic conditions associated with interactions of children with vulnerable elderly people that may proliferate the spread of disease. This study assessed the associations between four sociodemographic characteristics--median county income, Gini index, youth dependency ratio and proportion of co-residential caregiver grandparents--and P&I on the county level overall and by age group.

Unhealthy lifestyles among older adults: exploring transitions in Mexico and the US.

Lifestyle risk factors are important precursors of old age disease and disability, and the population level impact of these factors likely differs across countries that vary in their economic growth and the attributes of the populations that adopt and abandon unhealthy lifestyles. This paper describes the stage of "lifestyle transition" among older adults in two countries with vastly different trajectories of socio-economic development. A series of hypotheses are proposed on the socioeconomic patterns of health risk factors that would be expected in the two countries, given their economic circumstances and the historical timing of policy interventions that were initiated to mitigate lifestyle risks in these populations.

Self-selected walking speed was consistent when recorded while using a cane.

Objective: To assess whether loss of consistency or systematic measurement error is introduced by allowing older individuals to use a cane during measurement of self-selected walking speed (SSWS).

Study Design And Setting: Observational study of women aged 65+ (Women's Health and Aging Study I, n=1,002).

Results: Of individuals who use a cane in daily life, 201 (50.

Fertility decline, family structure, and support for older persons in Latin America and Asia.

Objective: To compare family structures and support for older persons in two Asian countries (Taiwan and the Philippines) and six urban areas in Latin America (Buenos Aires, São Paulo, Havana, Santiago, Mexico City, and Montevideo).

Methods: Using the 1999 Survey of Health and Living Status of the Elderly in Taiwan, the 2000 Philippine Survey of the Near Elderly and Elderly, and the 2001 Pan American Health Organisation surveys on Salud, Bienestar y Envejecimiento en América Latina y el Caribe, descriptive tables show variations across countries in family structure, proximity, and transfers of support by the timing of the fertility transition in each location.

Results: Older people in settings with earlier transitions had fewer children and more childlessness, higher levels of solitary living, and lower levels of co-residence with children.

Trends in the use of assistive technology and personal care for late-life disability, 1992-2001.

We describe national trends during the 1990s in late-life difficulty and assistance with self-care activities. Among older Americans living in the community and experiencing difficulty with self-care activities, assistive-technology use increased substantially whereas use of personal care declined. Using a decomposition technique, we demonstrate that these shifts in assistance toward technology account for half the decline in the number of people dependent on personal care.