Neighborhood Socioeconomic Status Affects Patient-Reported Outcome 2 Years After ACL Reconstruction.

Background: Lower socioeconomic status (SES) is associated with worse patient-reported outcome (PRO) after orthopaedic procedures. In patients with anterior cruciate ligament (ACL) reconstruction, evaluating SES by use of traditional measures such as years of education or occupation is problematic because this group has a large proportion of younger patients. We hypothesized that lower education level and lower values for SES would predict worse PRO at 2 years after ACL reconstruction and that the effect of education level would vary with patient age.

The "Good Times" Cohort in Later-Life.

Race differences in midlife circumstances explain much of the disability gap in older adulthood, but questions remain about whether early life selection processes are race invariant. To address this, we (1) isolate the 1930s cohort to explore potential race-specific life courses and (2) utilize a two-stage estimation procedure to examine the role of early-to-midlife selection in shaping later-life functional limitations. Using data on Black and White adults born 1931-1941 from the Health and Retirement Study (W2-W9), we estimate trajectories of later-life functional limitations after modeling midlife income and comorbidity as a function of early life factors.

Intraindividual Variability in Late-Life Functional Limitations Among White, Black, and Hispanic Older Adults.

Consistent with the weathering hypothesis, many studies have captured racial/ethnic disparities in average functional health trajectories. The same mechanisms of social inequality that contribute to worse average health among minority adults may also contribute to greater fluctuations in their physical function at upper ages. Using panel data from the Health and Retirement Study, we examine patterns of intraindividual variability over time in trajectories of functional limitations for White, Black, and Hispanic older adults.

The Continued Eclipse of Heterogeneity in Gerontological Research.

Objectives: After a long history of neglect, diversity among older people and increasing heterogeneity with age are now familiar ideas in gerontological discourse. We take up the question of whether this increased attention is translating into the domain of empirical research. We replicate Nelson and Dannefer's (1992) review of the treatment of age-based variability in gerontological research, the most recent known assessment of the issue.

Do Local Social Hierarchies Matter for Mental Health? A Study of Neighborhood Social Status and Depressive Symptoms in Older Adults.

Objectives: Despite a well-established association between relative social position and health, stratification at smaller levels of social organization has received scant attention. Neighborhood is a localized context that has increasing relevance for adults as they age, thus one's relative position within this type of mesolevel group may have an effect on mental health, independent of absolute level of social and economic resources. We examine the relationship between an older adult's relative rank within their neighborhoods on two criteria and depressive symptoms.

From Noise to Signal: The Age and Social Patterning of Intra-Individual Variability in Late-Life Health.

Objectives: Despite a long tradition of attending to issues of intra-individual variability in the gerontological literature, large-scale panel studies on late-life health disparities have primarily relied on average health trajectories, relegating intra-individual variability over time to random error terms, or "noise." This article reintegrates the systematic study of intra-individual variability back into standard growth curve modeling and investigates the age and social patterning of intra-individual variability in health trajectories.

Method: Using panel data from the Health and Retirement Study, we estimate multilevel growth curves of functional limitations and cognitive impairment and examine whether intra-individual variability in these two health outcomes varies by age, gender, race/ethnicity, and socioeconomic status, using level-1 residuals extracted from the adjusted growth curve models.

The social context of disablement among older adults: does marital quality matter for loneliness?

Prior research has not adequately considered that disablement occurs within a web of relationships that provides socioemotional resources to and/or places demands on older adults. Drawing on the stress process and life course perspectives, we considered the social context of disablement by examining the influence of marital quality on the association between disability and loneliness among married older adults. Using data from the National Social Life, Health, and Aging Project, we found (1) functional limitations were associated with higher levels of loneliness; (2) neither positive nor negative marital quality mediated this association, contrary to the stress-deterioration hypothesis; and (3) positive (but not negative) marital quality moderated this association, consistent with the stress-buffering hypothesis.

Proactive aging: a longitudinal study of stress, resources, agency, and well-being in late life.

Objectives: Using the Proactivity Model of Successful Aging, we examined how internal and external resources contribute to the maintenance of psychological well-being and social activities among older adults who experience normative stressors of aging. Outcome variables in this study are collectively referred to as quality of life (QOL). We also examined the mediating role of proactive adaptations between internal and external resources and QOL indicators.

Toward advocacy in cancer care for older adults: survivors have cautious personal actions but bold advice for others.

Objectives: To examine narratives of personal coping with the cancer experience and compare them with narratives of advice offered to other cancer patients by community-dwelling elderly cancer survivors.

Design: Qualitative and quantitative mixed methods.

Setting: Community.

The color of hospitalization over the adult life course: cumulative disadvantage in black and white?

Objectives: Drawing from cumulative disadvantage theory, this research addresses the following questions: Do hospital admission and discharge rates differ for White and Black adults? If yes, do the differences amplify in later life?

Methods: This study made use of hospital records abstracted from a long-term prospective study of adults in the National Health and Nutrition Examination Survey I: Epidemiologic Follow-up Study (N = 6,833). Semi-Markov models were specified to examine the likelihood of hospital admission and discharge for Black and White adults aged 25 to 74 years old at baseline.

Results: Black adults were less likely than White adults to be admitted to the hospital, but they had longer lengths of stay.

Assessing racial health inequality in older adulthood: comparisons from mixed-mode panel interviews.

Objectives: Estimates of the extent of health disparities among Black and White older adults are not consistent across studies. The purpose of this study was to systematically compare responses from Black and White older adults in telephone and face-to-face interviews in order to determine whether estimates of racial health inequality vary by survey interview mode.

Methods: By using data from a mixed-mode panel study, I compared estimates of changing health inequality for Black and White older adults collected from face-to-face and telephone interviews.

When do older adults become "disabled"? Social and health antecedents of perceived disability in a panel study of the oldest old.

Disability carries negative social meaning, and little is known about when (or if), in the process of health decline, persons identify themselves as "disabled." We examine the social and health criteria that older adults use to subjectively rate their own disability status. Using a panel study of older adults (ages 72+), we estimate ordered probit and growth curve models of perceived disability over time.

A 3-D model of health decline: disease, disability, and depression among Black and White older adults.

Much of the research on health decline in older adulthood has specified a single causal direction between two health domains, often measured at the same time point, making it difficult to disentangle the mechanisms of health decline over time. Using three waves of data over seven years from older residents of North Carolina, a 3-D model is used to examine the temporal ordering of general health decline and the pathways of influence across three health domains (disease, disability, and depression). In addition, we test whether the 3-D model of health decline is similar for Black and White older adults.

The black/white disability gap: persistent inequality in later life?

Objectives: Previous research on differences between Black and White older adults has produced inconsistent results on whether a gap in disability exists and whether it persists over time. The present research identifies several reasons for the inconsistent results to date and examines Black/White differences in disability trajectories over 6 years.

Methods: Data from the North Carolina Established Populations for the Epidemiologic Studies of the Elderly (1986-1992) are used to estimate the disability gap and trajectory over time for both Black and White older adults.

Cumulative Disadvantage and Health: Long-Term Consequences of Obesity?

Drawing from cumulative disadvantage theory, the health consequences of obesity are considered in light of the accumulation of risk factors over the life course. Two forms of compensation are also examined to determine if the risk due to obesity is persistent or modifiable. Analyses make use of data from a national survey to examine the consequences of obesity on disability among respondents 45 years of age or older, tracked across 20 years (N = 4,106).

A half century of longitudinal methods in social gerontology: evidence of change in the journal.

Objectives: With a focus on the use of longitudinal data, this study reviews trends in the quantitative analysis of social science data on aging during the past half century.

Methods: A content analysis was performed on 227 articles from 12 volumes that were systematically sampled from the Journal of Gerontology: Social Sciences to examine change in the type of data and quantitative methods used (1946-2000).

Results: Cross-sectional analysis remains the single most frequent type of study, but the publication of analyses based on longitudinal panel data increased appreciably over the five decades studied.