Aging With Emerging Social Welfare and Disappearing Filial Piety: Chinese Migrant Workers' Pathways Toward Financial Retirement Planning.

This study examines the pathways and mechanisms linking Chinese migrant workers' migration experiences and their financial retirement planning. Using a mixed-methods approach with 1083 surveys and 32 interviews, this study finds that having a good financial status and social support system and maintaining a hopeful attitude toward retirement are direct pathways toward good financial retirement planning. Good health and hope for retirement are further enhanced by a good financial status and social support. Conversely, poor health and negative employment experiences are linked to poor financial retirement planning. The qualitative findings provide a contextual understanding of the pathways identified in the quantitative analyses. Migrant workers often face a dilemma between self-reliance for retirement and relying on filial piety. These findings apply not only to Chinese migrant workers but also to all migrant workers with limited access to healthcare and public pensions for retirement.

Prior incarceration length and edentulism among formerly incarcerated older adults in the United States.

BACKGROUND: This study investigated the association between prior incarceration length and edentulism among US adults 55 years and older. Analyses explored indirect factors such as wealth, smoking status, mental health, and chronic health conditions that may explain this relationship. In addition, the study analyzed how associations between incarceration and edentulism vary by race and ethnicity. METHODS: The authors used data from the 2012-2014 Health and Retirement Study (unweighted N = 11,630; weighted N = 72,872,877) to assess the relationship between incarceration duration and edentulism through multivariable logistic regression. The Karlson-Holm-Breen method evaluated indirect effects, and multiplicative interaction terms examined variations by race and ethnicity. RESULTS: Net of control variables analyses showed a positive association between having been incarcerated for more than 1 month and higher odds of edentulism. However, this association was rendered statistically nonsignificant after accounting for wealth, current smoking status, mental health, and chronic disease. Collectively, wealth and smoking explained approximately 60% of the association between prior incarceration length and edentulism. Racial moderation models indicated that longer incarceration times increased edentulism likelihood in non-Hispanic Whites specifically. CONCLUSIONS: To the authors' knowledge, this is the first study on the association between prior incarceration length and edentulism among older adults. Study findings indicated the relationship between incarceration and edentulism was explained by higher wealth and current smoking status. PRACTICAL IMPLICATIONS: These findings highlight the need for adequate access to oral health care services for formerly incarcerated older adults to improve oral health and enhance their overall health and quality of life.

Golden years happiness: analyzing the nostalgic aspect of leisure.

Retirees face numerous challenges, particularly in countries with lower socio-economic conditions. Perceived social isolation and happiness levels are seen as significant factors that significantly affect the quality of life in old age. Perceived social happiness levels can disrupt the quality of life in old age and contribute to mental disorders. Recent studies on leisure have suggested a direct impact of individuals' leisure attitudes on happiness. In this context, leisure nostalgia stands out in the relationship between leisure attitude and happiness levels among retirees. In this study, structural equation modeling (SEM) was employed to examine the relationship between leisure attitude, leisure nostalgia, and happiness levels in a sample of 210 retirees. The findings revealed that leisure nostalgia fully mediated the relationship between leisure attitude and happiness. It was concluded that previous experiences significantly shape retirement, and leisure attitude offers valuable opportunities for enhancing happiness through effective leisure utilization.

Is being overweight a causal factor in better survival among the oldest old? a Mendelian randomization study.

Overweight, defined by a body mass index (BMI) between 25 and 30, has been associated with enhanced survival among older adults in some studies. However, whether being overweight is causally linked to longevity remains unclear. To investigate this, we conducted a Mendelian randomization (MR) study of lifespan 85+ years, using overweight as an exposure variable and data from the Health and Retirement Study and the Long Life Family Study. An essential aspect of MR involves selecting appropriate single nucleotide polymorphisms (SNPs) as instrumental variables (IVs). This is challenging due to the limited number of SNP candidates within biologically relevant genes that can satisfy all necessary assumptions and criteria. To address this challenge, we employed a novel strategy of creating additional IVs by pairing SNPs between candidate genes. This strategy allowed us to expand the pool of IV candidates with new "composite" SNPs derived from eight candidate obesity genes. Our study found that being overweight between ages 75 and 85, compared to having a normal weight (BMI 18.5-24.9), significantly contributes to improved survival beyond age 85. Results of this MR study thus support a causal relationship between overweight and longevity in older adults.

Insulin resistance and sarcopenia: a prognostic longitudinal link to stroke risk in middle-aged and elderly Chinese population.

BACKGROUND: Stroke is the leading cause of death in middle-aged and elderly people in China. Insulin resistance (IR) and sarcopenia are both closely associated with metabolic diseases. However, the relationship between these two indicators and stroke has not been fully investigated. The aim of this study was to investigate the relationship between IR and sarcopenia and the risk of new-onset stroke. METHODS: Using longitudinal data from the China Health and Retirement Longitudinal Study (CHARLS) from 2011 to 2018, Cox proportional hazards models were used to determine the association between IR surrogate indicators and sarcopenia status with stroke incidence. RESULTS: In the present study, during a median 7 years of follow-up, we included 7009 middle-aged and elderly residents, of whom 515 presented with stroke incidence. After adjustment for potential confounders, both baseline IR surrogates and sarcopenia independently predicted stroke risk. In addition, co-morbidities had a higher risk of stroke than other groups. The positive association between TyG-WC and sarcopenia on stroke risk was particularly significant [HR (95% CI): 2.03 (1.52, 2.70)]. In subgroups of different ages and sexes, the combination of IR and sarcopenia is associated with the highest risk of stroke. CONCLUSIONS: We found that IR and sarcopenia synergistically increase the incidence of stroke in older adults. This finding provides new perspectives for stroke detection and intervention and highlights the importance of early detection and management of IR and sarcopenia in older adults.

Does subjective life expectancy matter in purchasing life insurance among middle-aged and older adult? Evidence from China.

Population-wide increase in life expectancy is a source of aggregate longevity risk. Life insurance is a natural instrument to manage the risk. Previous studies used chronological age to examine the relationship between aging and life insurance purchase, which ignored the impact of subjective life expectancy-the real perception of remaining time. Therefore, this study aims to fill the lack in this area and to explore in depth the relationship between subjective life expectancy and purchasing life insurance among middle-aged and older adult at micro perspective. This paper utilizes data from the China Health and Retirement Longitudinal Study (CHARLS) over a period of 4 years to construct both Probit and Tobit models. The findings reveal that subjective life expectancy positively affects the likelihood of participation and the extent of life insurance among the middle-aged and older adult population in China. IV model estimation results show good robustness of the results. Meanwhile, there is also heterogeneity in the effect with respect to gender, hukou, education and wealth. The findings provide new perspective to explain the subjective motivation of purchasing life insurance in China.

Association of allostatic load with functional disability in the China Health and Retirement Longitudinal Study.

OBJECTIVES: Allostatic load (AL) is an index that manifests as cumulative wear and tear on multiple physiological systems resulting from repeated adaptation to stressors throughout the life course. Higher AL was found to be associated with increased risk of adverse health outcomes, but studies on functional disability among large Chinese older population were limited. We aimed to investigate the associations of AL with functional disability among Chinese older adults. RESEARCH DESIGN AND METHODS: This prospective cohort study included 5880 older adults who were at least 50 years old and participated in the CHARLS at baseline (2011 wave), with 3 follow-ups (2013, 2015 and 2018 waves). We selected 11 biomarkers from 4 physiological systems to construct AL. AL score was classified into three categories based on tertiles: 0-1 (low burden), 2-3 (medium burden) and 4-11 (high burden). Functional disability was assessed by activities of daily living (ADL) and instrumental activities of daily living (IADL). Multivariable logistic regression models examined the association between baseline AL, transitions of AL burden and incidence of functional disability. RESULTS: In cross-sectional analyses, medium and high AL burden were associated with an increased prevalence of ADL disability, while association was only significant between high AL burden and IADL disability. During the 7-year follow-up, 1102 and 1777 participants incident ADL disability and IADL disability, respectively. Those with medium and high AL burden had an increased risk of new-onset ADL disability than those with low AL burden ("medium": OR = 1.25, 95%CI = 1.01, 1.55; "high": OR = 1.69, 95%CI = 1.32, 2.18). As for IADL disability, association was only significant in "high" group (OR = 1.50, 95% CI = 1.24, 1.83). We also found keep medium/high AL burden in 2011 and 2015 was associated with new-onset ADL (OR = 2.27, 95%CI = 1.50, 3.44) and IADL disability (OR = 1.51, 95%CI = 1.11, 2.05) in 2018. CONCLUSION: These results show that higher AL predicts functional disability among Chinese older adults. Monitoring AL and paying close attention to those with medium/high AL burden may aid prevention of adverse health outcomes, thus giving a healthier ageing experience to a large proportion of the population.

Gender disparity regarding the impact of retirement on marital satisfaction: Evidence from a longitudinal study of older Korean adults.

OBJECTIVE: To investigate the impact of retirement on marital satisfaction by gender on Koreans aged >45 years in a large, nationally representative cohort. METHODS: Retirement status and marital satisfaction data of 5867 individuals were analysed. Marital dissatisfaction was defined as a satisfaction score reduction of more than 10 points versus the previous wave. Lagged generalised estimating equation (GEE) models adjusted for demographics (age, sex, education level and household income), health-related habits (smoking and drinking status) and comorbidities (obesity, hypertension, type 2 diabetes, and depression and frailty) were used to confirm the relationship between retirement and marital dissatisfaction. RESULTS: The final GEE model adjusted for covariates revealed sex-specific differences in marital satisfaction after retirement. Whereas male retirees reported higher satisfaction than non-retired men, female retiree responses revealed lower satisfaction than non-retired women. Furthermore, these trends were consistent regardless of the time elapsed after retirement. CONCLUSIONS: Marital satisfaction should be screened in women during the transition to retirement.

Integrating a Personal Finance Workshop to Enhance Financial Literacy Among Senior Medical Students: A Single Institution's Experience.

Purpose: Graduating medical students frequently start their training burdened with substantial financial debt and minimal savings, especially in comparison to their peers in other professional fields. A lack of financial literacy can result in increased debt, decreased job satisfaction and contribute to physician burnout. Enhancing financial education could improve both the financial stability and emotional well-being of future medical professionals. In this study, a basic personal finance workshop was conducted for 4th year medical students at a single institution. The aim of the study was to determine the impact of the personal finance workshop on improving financial literacy. Methods: An introduction to basic personal finance workshop was open to enrollment for all 4th year medical students at The Alpert Medical School at Brown University. A 40-question survey to evaluate financial literacy was administered to all participants before and 6-months after the workshop. The topics covered included student loan management, basics of retirement accounts, investing, budgeting, saving and consensus surrounding financial topics. The results were analyzed using student paired t-test and Chi-square test of independence. Results: Overall, an improvement in financial literacy was reported 6 months after the personal finance workshop (62% vs 54%, p = 0.004). Students subjectively reported an increase in confidence in their personal finance knowledge (16% vs 44%) and general knowledge regarding retirement savings (7% vs 55%). More than 92% of students agreed or strongly agreed that a basic personal finance education should be included as part of the medical school curriculum. Conclusion: A personal finance workshop for medical students nearing graduation increases awareness and confidence in financial knowledge. The incorporation of basic financial education in the medical school curriculum may help young physicians establish better financial habits that will improve their financial wellbeing.

A Comparative Analysis of Oral Health and Self-Rated Health: 'All of Us Research Program' vs. 'Health and Retirement Study'.

Poor oral health can impact overall health. This study assessed the association between dental factors (dentate status and dental utilization) and self-rated health (S-RH) among older adults in two cross-sectional datasets: (1) NIH "All of Us (AoU) Research Program" (May 2018-July 2022 release) and (2) U.S. nationally representative "Health and Retirement Study" (HRS) 2018 wave. Participants aged ≥ 51 years were included in these analyses if (1) from AoU, they had clinical dental and medical data from electronic health records (EHRs) and surveys (n = 5480), and (2) from HRS, they had dental and socio-demographic survey data (n = 14,358). S-RH was dichotomized (fair/poor vs. better) and analyzed with logistic regression. Sample survey weights for HRS and stratification and averaging AoU results used the weighted HRS race-ethnicity and age distribution standardized respective analyses to the U.S. population. Fair/poor S-RH was reported by 32.6% in AoU and 28.6% in HRS. Dentate status information was available from 7.7% of AoU EHRs. In population-standardized analyses, lack of dental service use increased odds of fair/poor S-RH in AoU, OR (95% CI) = 1.28 (1.11-1.48), and in HRS = 1.45 (1.09-1.94), as did having diabetes, less education, and ever being a smoker. Having no natural teeth was not statistically associated with fair/poor S-RH. Lack of dental service was positively associated with fair/poor S-RH in both datasets. More and better oral health information in AoU and HRS are needed.

Elite athletes' subjective wellbeing trajectories throughout the retirement transition: an analysis using Ruthven's (2022) transition model.

AIMS: Utilizing Ruthven's (2022) transition model, we explored how identity, voluntariness, and reason for retirement are related to subjective wellbeing throughout an athlete's retirement. METHODS: 541 participants completed an anonymous, online survey and estimated their wellbeing starting before retirement and up to the present. A set of linear mixed models regressed the seven wellbeing outcomes on the three measures, with education, gender, and time since retirement as covariates. RESULTS: Identity: Athletic Identity wellbeing was significantly and consistently lower than Diversified Identity. Voluntariness: Surprise retirement was significantly more difficult and contributed to a sharper decline on the day of transition. Reason for retirement: Pursue Something Else and Right Time experienced no significant wellbeing changes, while Injury had a significant decline on their transition day. Motivation Loss experienced significantly lower wellbeing prior to retirement, and a significant, gradual rise on the day of and throughout their transition. CONCLUSIONS: There are wellbeing benefits for a diverse identity, voluntary retirement, and retiring due to pursuing something else, or feeling ready to retire. At risk groups include retiring due to injury, low motivation, and loss of eligibility/graduation. Findings support the benefit of utilizing a theoretical model to explain elite athlete outcomes.

The Interplay between nighttime/midday sleep duration and the number of new-onset chronic diseases: A decade-long prospective study in China.

OBJECTIVE: To investigate the interplay between individual nighttime and midday sleep duration and the number of new-onset chronic diseases and determine the optimal sleep duration associated with lowest number of new-onset chronic diseases. METHODS: We used data from the China Health and Retirement Longitudinal Study (CHARLS) covering a decade and involving 10,828 participants. A random intercept cross-lagged model was used to explore the interplay between nighttime/midday sleep durations and new-onset chronic diseases at both the within-individual and between-individual levels, followed by a dose-response analysis at the between-individual level to determine the optimal sleep duration. New-onset chronic diseases include 14 types of self-reported diseases diagnosed by doctors. RESULTS: Within-individual analysis revealed that increased nighttime/midday sleep duration led to a higher number of new-onset chronic diseases, and an increased number of new-onset chronic diseases resulted in decreased nighttime sleep duration. Between nighttime and midday sleep, one type of sleep duration increase was likely to lead to an increase in another type. Between-individual analysis found a nonlinear relationship between the number of new-onset chronic diseases and nighttime sleep duration, identifying the optimal nighttime sleep duration as 7.46 h. CONCLUSIONS: These findings elucidate the interplay between sleep duration and number of new-onset chronic diseases and underscore the need for public awareness and comprehensive interventions. Future studies should focus on refining sleep monitoring and exploring the sleep-chronic diseases nexus in greater depth.

Antecedents of and experiences with voluntary early exit from working life before the expected retirement age in Sweden.

BACKGROUND: In most Western countries, senior workers have increased their participation in the workforce. However, at the same time, early retirement also increases. The reasons behind this early exit from the workforce are still unclear. OBJECTIVE: This qualitative study aims to explore the antecedents of and experiences with a voluntary exit from working life before the expected retirement age of 65 in Sweden. METHODS: Data consist of semi-structured interviews with 18 participants who exited working life between the ages of 61-63. In Sweden, these ages are considered as an early exit from working life since, for many years, the expected retirement age has been 65. Qualitative content analysis with an abductive approach was utilized. RESULTS: The analysis revealed four sub-themes: 1) Health benefits with an early exit from working life (with the categories: own health status, the possibility for recovery time, and avoidance of strain); 2) Having economic conditions that enable an early exit from working life (with the categories: offers from the employer and financial compromises); 3) Social benefits with an early exit from working life (with the categories: enabling more time with my social network and avoidance of unsatisfying social work environment); 4) Self-fulfillment activities during the senior years (with the categories: enabling time for activities beyond work and avoidance of decreased job satisfaction. CONCLUSION: This variety of antecedents of and experiences with a voluntary early exit from working life before the expected retirement age highlights that the ongoing increased statutory retirement age also increases the risk for extended inequalities among the aging population.

Race, College Graduation, and Time of Retirement in the United States: A Thirty-Year Longitudinal Cohort of Middle-Aged and Older Adults.

Introduction: College education is typically associated with the ability to work in less physically demanding occupations, allowing for a later retirement age. However, research indicates that highly educated Black individuals often work in more demanding occupations, which affects their retirement age. Aim: Building on the Minorities' Diminished Returns (MDRs) literature, we tested whether the benefit of college education on delaying the time of retirement is weaker for Black compared to White middle-aged and older adults. Methods: We utilized data from the Health and Retirement Study (HRS), which includes a 30-year longitudinal follow-up of a nationally representative sample of middle-aged and older adults in the United States. Education levels at baseline were categorized as less than college graduate (some high school, GED, high school diploma, or some college) and college graduate. The outcome was the time to retirement, measured from wave 2 to wave 15 (baseline to 30 years later). We graphed survival curves and used independent samples t-tests to assess associations between college graduation and time of retirement, overall and by race. Results: Our analysis included 6,803 White and Black participants who were employed at baseline and followed for up to 30 years. Overall, there was a positive association between college graduation and retirement timing, with individuals with higher education retiring later. However, we found significant racial differences in the retirement age of college graduates, indicating notable racial disparities in the effects of college graduation on retirement timing, disadvantaging Black college-educated individuals. Specifically, among Whites, but not Blacks, college education was associated with later retirement. Conclusion: Consistent with Minorities' Diminished Returns theory, the positive effect of college education on retirement timing are weaker for Black than for White middle-aged and older Americans. To address racial disparities, it is insufficient to focus solely on economic disparities. While closing the educational gap is important, we must also work to equalize labor market experiences for Black and White individuals with similar educational credentials. Structural factors contributing to the diminished returns of college education for Black populations must be addressed to effectively close racial disparities.

Associations between sensory impairment and functional limitations among older Chinese adults: mediating roles of social isolation and cognition.

BACKGROUND: The high prevalence of sensory impairment and functional limitations in older adults is a significant concern, yet there is limited understanding of the relationship between these two conditions. Therefore, the objective of this study was to investigate the pathways connecting sensory impairment and functional limitations by examining serial multiple mediating effects of social isolation and cognition in older adults. METHODS: Using the China Health and Retirement Longitudinal Study dataset, a sample of 4871 older adults was selected. The study variables included sensory impairment, functional limitations, social isolation and cognition, and other covariates. A hierarchical multiple linear regression model was used to assess the association between sensory impairment and functional limitations. Mediation analysis was conducted to explore the sequential multiple mediating effects of social isolation and cognitive function in the relationship between sensory impairment and functional limitations. RESULTS: Our findings revealed a significant and positive association between sensory impairment and functional limitations (B = 0.615, 95% CI: 0.397, 0.834). After adjusting for social isolation and cognitive function, the impact of sensory impairment on functional limitations accounted for 87.19% of the total effect. Additionally, approximately 12.81% of the significant relationship between dual sensory impairment and functional limitations was mediated by social isolation and cognitive function. A serial multiple mediating pathway (sensory impairment → social isolation → cognition → functional limitations) was identified, with a coefficient of 0.013 (95% CI: 0.006, 0.020). CONCLUSIONS: Our study provides evidence for the mediating effects of social isolation and cognition in the relationship between sensory impairment and functional limitations. Given the prevalence of functional limitations among older adults with sensory impairment, it is crucial to consider social isolation and cognitive function in efforts to reduce the burden of disability care. Future validation of these findings through longitudinal studies is necessary.

Use of a "baby bottle" to allow a "better-than-nothing" death in older adults infected by COVID-19 in Quebec retirement homes - A case study.

The COVID-19 pandemic has brought to the forefront profound questions surrounding dying and the concept of a "good death". This qualitative case study, conducted in a health center in Quebec, Canada, severely affected by outbreaks during the pandemic's first wave, explores end-of-life care for older adults in retirement homes. Through thirty interviews with healthcare practitioners, researchers, and managers, we investigate the critical role of a pharmacological device referred to as the "baby bottle" in providing end-of-life care to older adults infected with COVID-19 in their homes. Drawing upon the boundary object framework, we examine the ambiguities surrounding the use of this device and explores its agency. In this unprecedented context, we argue that the device facilitated a form of death that could be described as "better than nothing", embodying practitioners' efforts to provide some dignity to the dying person, by minimally controlling the distress and ensuring a connection between the dying person and the care team. Additionally, it served as a means of coping with the pandemic's intolerable aspects, such as the exclusion of frail older adults for the supposed common good. This study raises questions about the legitimacy and normalization of such compensatory measure within under-resourced healthcare systems for older people experiencing a loss of autonomy.

Nursing Staff's Perspectives of Care Robots for Assisted Living Facilities: Systematic Literature Review.

BACKGROUND: Care robots have been proposed in response to nursing shortages in assisted living facilities (ALFs) and the growing population of older adults. While the use of care robots may improve the general health and well-being of older adults, their introduction changes the work of nursing staff fundamentally, and it has implications for the entire health care system. In developing such technology, it is important to include end users, but so far, the nursing staff's perspectives have largely been ignored. OBJECTIVE: This study aims to examine the literature on nursing staff's attitudes, needs, and preferences related to the use of care robots in ALFs, in order to discover gaps in the literature and guide future research. METHODS: This review follows the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) 2020 protocol. On May 12, 2023, we searched PubMed, CINAHL Plus with Full Text, PsycINFO, the IEEE Xplore Digital Library, and the ACM Digital Library using predetermined search terms. Included publications, written in English, focused on the predevelopment phase, in which information was gathered on nursing staff's attitudes, needs, and preferences regarding care robots for ALFs. Publications were excluded if they did not provide peer-reviewed empirical data. The studies' findings were summarized, coded, and analyzed into major themes using thematic analysis and narrative synthesis. Their quality was assessed using McGill University's Mixed Methods Appraisal Tool and the Joanna Briggs Institute's critical appraisal tools. RESULTS: The final sample included 15 studies. Most of the studies (n=11, 73%) were rated as good quality; however, there was a general lack of reporting on important methodological decisions and sample characteristics. Nursing staff desired care robots that could assist with physically demanding tasks and reduce their workload but had mixed feelings on whether robots could or should assist with social tasks. In addition, nursing staff are concerned about the ethics of care robots, as well as about their safety, accessibility, and operability. The nursing staff's culture, qualification, and role in the facility may influence their perspectives of care robots. The studies lacked theory-driven designs and large sample sizes. Eight (53%) studies mentioned using a participatory design approach, but a lack of established criteria for what constitutes participatory design leads to varying degrees of methodological quality. CONCLUSIONS: There was consensus among nursing staff that care robots should serve as nursing assistants to reduce workload. Whether robots could or should assist with social tasks remains a question. Further research is needed to mitigate nursing staff's concerns and understand the socioecological factors that influence their perspectives of care robots and their adoption in ALFs. In addition, theory-driven and large sample size study designs are necessary, as well as work to develop clear criteria for related participatory design research.

Racial-ethnic differences in the associations between functional disabilities and subsequent depression among community-dwelling midlife and older adults in the US.

BACKGROUND: The intersection of race/ethnicity with disability is a critical dimension of mental health outcomes in later ages that remains under-investigated. OBJECTIVE: We examined the role of race-ethnicity in moderating the associations between functional disabilities and subsequent depression among Americans 51 and older and stratified into the two age-groups of midlife (51-64) and older adults (≥65). METHODS: Using a nationally representative sample of community-dwelling Americans (≥51; n = 7475) in the 2016-2018 Health and Retirement Study, we conducted bivariate and multivariable regression analyses. Racial-ethnic groups included non-Hispanic (NH) Black, Hispanic, and NH White and a binary (0/1) outcome defined subsequent depression in 2018. The total number of difficulties on the Nagi, Lawton, and Katz disability scales represented baseline (2016) functional disabilities with a secondary four-level (no/mild/severe with assistance/severe without assistance) disability indicator incorporated to examine the role of assistance with daily living. RESULTS: Across age-groups, subsequent depression was significantly more prevalent among NH Whites with functional disabilities compared to counterparts reporting no disabilities. Compared to NH Black and Hispanic counterparts, midlife NH Whites were three times more likely to report subsequent depression with each unit increase in the functional disability score, after adjusting for covariates. However, we observed no such racial-ethnic differences among older adults. Among the 51+ severe with no assistance group, adjusted odds of subsequent depression among NH Whites was 2.5 times higher than minority counterparts. CONCLUSION: Health programs and environmental adaptations supporting functional care needs in later ages could be beneficial for improving mental health of adults with disabilities.

Employment status of older nursing staff aged 55 years and older in care facilities: A nationwide cross-sectional study in Japan.

An aging nursing workforce requires addressing shortages due to retirement. This nationwide descriptive cross-sectional study in Japan clarified the employment status of older nursing staff aged ≥ 55 years by facility type during January-March 2022. Questionnaires were sent to 8,000 nursing directors, with 1,658 valid responses (response rate: 20.7%). Descriptive statistics and Kruskal-Wallis or χ2 tests analyzed inter-facility differences. A violin plot depicted the proportion of older nursing staff across facilities by age group, and generalized estimating equation (GEE) models examined associated factors at the facility level. Older nursing staff's distribution differed significantly across age groups (p < 0.01), from 0% to 100% within the same facility type. Some facilities had high percentages of staff working beyond retirement age. GEE results showed higher percentages of full-time employees and nurses were negatively associated with the percentage of older nursing staff across most facility types (p < 0.05). For those aged ≥ 65 years, the total population was positively associated with employment in bedded clinics (coef. = 0.07, 95% CI: 0.01 to 0.14, p = 0.03), but negatively associated with the total population (coef. = -0.06, 95% CI: -0.10 to -0.01, p = 0.02) and percentage of the population aged ≥ 65 (coef. = -0.76, 95% CI: -1.43 to -0.08, p = 0.03) in long-term care insurance facilities. Working conditions and environments should be improvement to potentially retain older nursing staff. Job seekers should be matched with managers' needs in facilities with a higher proportion of older nursing staff to ensure a sustainable workforce.

Dyadic Appraisals of Family Decisions and Health Tasks in Midlife-Older Couples.

Shared appraisals and collaboration within couples play important roles in optimizing health. Less is known about concordance regarding collaboration, factors associated with concordance, and implications for health. Data from 2,761 couples from the Health and Retirement Study (2014/2016 and 2016/2018 waves) were examined to determine within-couple concordance in completion of two tasks (family decisions and medical forms). The majority of couples were concordant regarding who makes family decisions (69.7%) and who completes medical forms (64.4%); 62% agreed they make family decisions collaboratively versus 25.5% completing medical forms collaboratively. Concordance was significantly associated with greater marital support and longer marital duration. Concordance was not significantly associated with depressive symptoms 2 years later, but the link between concordance in making major family decisions and self-rated health differed by age and gender. Future research at the intersection of concordance and collaboration may shed important light on how older couples navigate tasks and decisions.