Journal of Aging and Health

Objectives: Numerous studies have examined the association between body mass index (BMI) and mortality. The precise shape of their association, however, has not been established. We use nonparametric methods to determine the relationship between BMI and mortality. Method: Data from the National Health Interview Survey-Linked Mortality Files 1986-2006 for adults aged 50 to 80 are analyzed using a Poisson approach to survival modeling within the generalized additive model (GAM) framework. Results: The BMI-mortality association is more V shaped than U shaped, with the odds of dying rising steeply from the lowest risk point at BMIs of 23 to 26. The association varies considerably by time since interview and cause of death. For instance, the association has an inverted J shape for respiratory causes but is monotonically increasing for diabetes deaths. Discussion: Our findings have implications for interpreting results from BMI-mortality studies and suggest caution in translating the findings into public health messages.

Objective: To investigate the association between physical activity and quality of life in a sample of Brazilian older adults. Method: The Portuguese version of the World Health Organization Quality of Life Instrument-Older Adults Module and International Physical Activity Questionnaire was administered to 1,204 subjects (645 women and 559 men) aged ≥ 60 years. Results: Older adults of both genders who reported to be more physically active attributed higher scores to the sensory ability, autonomy, and intimacy domains, in addition to presenting significantly higher overall quality of life, irrespectively of age, marital status, educational level, and socioeconomic status. Specifically in women, the scores obtained for the social participation domain were significantly higher in the strata of active and very active subjects when compared to sedentary subjects. Discussion: The results indicate that increases in the levels of physical activity can contribute to improvements in quality of life of older adults.

Objective: Researchers argue that people may encounter difficulty finding productive roles in late life. The purpose of this study is to see whether older people who have found that fellow church members value their life experience encounter fewer symptoms of depression. Methods: The data are from an ongoing nationwide survey (N = 501). Results: Support is obtained for the following relationships: (a) Older people who go to church more often are more likely to feel fellow church members value their life experience, (b) having others value their life experience helps older people feel they belong in their congregation, (c) older individuals who feel they belong in their congregation are likely to have greater feelings of self-worth, and (d) greater self-worth is associated with a fewer symptoms of depression over time. Discussion: The findings identify one way in which religion may help older people find a meaningful role to play in late life.

Objectives: To investigate whether older adults participating in social activities are more likely to maintain or achieve recommended waist circumference (WC) levels. Method: A total of 4,280 older adults who participated in Wave 2 (baseline) and Wave 4 (follow-up) of the English Longitudinal Study of Ageing. WC was measured by a nurse in both study waves. Results: Participation in education, arts, music groups, evening classes, and in charitable associations was associated with maintaining recommended WC only in those men whose WC was in the recommended range at baseline. Participation in social activities was not associated with achieving recommended WC in women or men with initially large waist. Discussion: Participation in cultural and charitable activities may help in maintaining a recommended level of WC in older men with WC originally in the recommended range.

Objectives: To examine the role of medication use and other factors in predicting activity restriction due to a fear of falling (AR/FF). Methods: Older adults were assessed twice with the interRAI Community Health Assessment and the Berg Balance Scale (BBS). The main outcome was limiting going outdoors due to an AR/FF. Medications were recorded by trained assessors. Results: Participants (n = 441) had a mean age of 80.3 (SD = 7.1) years, most were aged 65+ (96.8%) and 29.3% reported activity restriction. Taking nervous system active or cardiovascular medications was associated with AR/FF. In a multivariate model, the main predictors were having 3+ comorbid health conditions, lower (i.e., worse) scores on the BBS, having difficulty with climbing stairs, and having a visual impairment. Discussion: Modifiable risk factors, related to functional impairments, such as difficulties with balance and vision, appear to be more important predictors than medications.

Objective: To determine self-reported physical activity barriers, behaviors, and beliefs about exercise of a representative sample and to identify associated sociodemographic factors. Method: Face-to-face interviews conducted between September and December 2008, using a random stratified sampling technique. Results: Barriers injury and illness were associated with being older, single, and not engaged in full-time work; lack of time was associated with being married, younger, female, and working full-time; and lack of motivation and cost were associated with being younger than 65 years. Advancing age was significantly associated (p < .001) with reduced physical activity. Factors including age, education, marital status, and area of residence were all associated with preferences for environment to exercise in, while all age groups (74%) felt that walking was the most important type of exercise for older adults. Discussion Barriers to physical activity participation are multifaceted with different sociodemographic factors associated with different barriers. A better understanding of these factors may improve uptake of and adherence to exercise programs across the ages.

Objectives: To examine contributions of self-reported vision impairment to disability by persons 65 years and older. Method: We used data from the National Health and Nutrition Examination Survey (NHANES IV; 1999-2008; weighted N = 6,550). The four-staged Nagi model of the disability process, incorporating biomarkers, disease, and physical functioning, was used as a framework to guide variable selection. An unadjusted ordinal logistic regression model testing effects of vision on daily-life activities was compared with models that controlled covariates associated with each stage of the disability model. Results For older adults with vision impairments, effects of poor vision in predicting disability were substantially reduced or eliminated when other health covariates were controlled. Where significant effects of poor vision remained, the strongest effect was found for doing leisure activities at home (OR = 5.29; 95% CI [3.14, 8.90]). Discussion: Results suggest the importance of considering multiple health factors when formulating comprehensive vision rehabilitation interventions.

Objectives: We examine (a) how breast cancer onset and survival are affected by various dimensions of early-life socioeconomic status (SES) and (b) the extent to which women’s characteristics in adulthood mediate the associations between early-life conditions and breast cancer. Method: We apply Cox regression models and a decomposition analysis to the data from the 4,275 women in the Wisconsin Longitudinal Study. Results: Higher levels of mothers’ education and early-life family income were associated with a greater risk of breast cancer incidence. The effect of mothers’ education was mediated by women’s adult SES and reproductive behaviors. Fathers’ education was related negatively to breast cancer mortality, yet this effect was fully mediated by women’s own education. Discussion: This study identifies mechanisms linking early-life social environment to breast cancer onset and mortality. The findings emphasize the role of social factors in breast cancer incidence and survival.

Objectives: The structural aging of the population and withdrawal of older people from the labor force have become common themes within Western social policy discourse and have particular relevance to policy development around health and aging. The current study examines whether particular occupation types are associated with both poor health and an increased likelihood of labor force exit. Methods: Longitudinal data are used to examine workforce participation among older Australians (aged between 55 and 64, in 2002). Results: Older workers in trades, labor, and production occupations, the majority of whom are men, have poorer general health than their counterparts in other occupations and are also the most likely to exit the workforce. Discussion: These findings suggest that a number of older men in Australia (and, indeed, elsewhere) may face both poor health and limited employment opportunities in areas that match their abilities and experience. These individuals may experience a number of years out of the labor force, highlighting a role for targeted policies and programs.

Bertrand, R. M., Saczynski, J. S., Mezzacappa, C., Hulse, M., Ensrud, K., & Fredman, L. (2012). Caregiving and cognitive function in older women: Evidence for the healthy caregiver hypothesis. Journal of Aging and Health, 24(1), 48-66. (Original DOI: 10.1177/0898264311421367)