Medicaid Utilization among Middle-age and Older Adults: A Health and Retirement Study Longitudinal Analysis (1998 to 2014).

With over fifteen million older adults in the United States relying on the means-tested Medicaid program for healthcare coverage, there has been concern over rising Medicaid costs among this rapidly growing age group. Few studies have longitudinally examined trends among older beneficiaries over time to identify factors related to Medicaid utilization and to better understand how potential coverage changes might impact this group. This study used the 1998 to 2014 waves of the Health and Retirement Study (N = 8,162) to analyze a representative sample of those aged 50 and older to ascertain demographic, health, and economic factors associated with Medicaid utilization over a sixteen-year period. The analyses showed stable probabilities of accessing the program over time and observed that the most vulnerable older adults make up the pool of Medicaid beneficiaries. There is no evidence of significant asset divestment in order to qualify for benefits. Multivariate analyses further revealed those who were older, female, minority race/ethnicity, less educated, in poorer health, below the federal poverty line, and with lower net wealth had a higher risk of utilizing Medicaid during the observed time period than their counterparts. Findings highlight the importance of monitoring changes in the documented risk factors over time in terms of their impact on Medicaid utilization and underscore the need to consider how these factors may be interrelated.

Impact of a Web-based Information and Referral Tool on Access to Federal and State Programs for Older Adults.

Federal and state governments provide a plethora of benefits programs intended to help older Americans, but take-up rates for the programs is low. BenefitsCheckUp® is an online tool intended to increase enrollment in these programs. To evaluate the impact of this national online screening tool providing individualized benefit information, we conducted a web survey of individuals who screened potentially eligible for programs including Supplemental Security Income, Medicaid, Medicare Savings Programs, Supplemental Nutrition Assistance Program, and energy assistance. Thirty-six percent of those surveyed applied for at least one benefit at an annualized, estimated average value of $2,865, and 20.5% enrolled, representing about 7% of the approximately 2 million site visitors age 60+. These results indicate that an online screening tool is a promising strategy for increasing benefit take-up rates among older adults with the value of benefits received far exceeding investments.

Age-Related Effects on Memory for Social Stimuli: The Role of Valence, Arousal, and Emotional Responses.

Background/Study Context: Previous research (Hess et al., 2013, Psychology and Aging, 28, 853-863) suggested that age-based positivity effects in memory were attenuated with social stimuli. This research examined the degree to which this generalized across arousal levels associated with social images. Variations in approach and avoidance responses to individual images were also examined, along with age differences in their relationship to memory performance. METHODS: In Experiment 1, young (22-43 years) and older (65-85 years) adults recalled positive and negative social scenes that were high or low in arousal. In Experiment 2, young (20-40 years) and older (65-83 years) adults viewed and recalled the same scenes under instructions designed to alter arousal, and approach and avoidance ratings for each image were recorded. RESULTS: In Experiment 1, age differences in recall were confined to high-arousal, negative images, with young adults exhibiting superior memory relative to older adults. There was no evidence of an age-related positivity effect for low-arousal social scenes. This result was replicated in Experiment 2, but distancing instructions minimized the age difference in recall for high-arousal, negative images. Approach and avoidance ratings differentially predicted recall across age groups, with stronger associations in the young. CONCLUSION: The results are consistent with emerging evidence demonstrating that valence-based biases associated with aging (e.g., positivity effect) are specific to the context and stimulus characteristics. Differences in prediction of recall responses from approach and avoidance ratings across age groups suggested that the observed effects in memory reflected differences in responses to the characteristics of stimuli.

Context influences on the relationship between views of aging and subjective age: The moderating role of culture and domain of functioning.

Subjective age has been shown to reliably predict a variety of psychological and physical health outcomes, yet our understanding of its determinants is still quite limited. Using data from the Aging as Future project, the authors examined the degree to which views of aging influence subjective age and how this influence varies across cultures and domains of everyday functioning. Using data from 1,877 adults aged from 30 to 95 years of age collected in China, Germany, and the United States, they assessed how general attitudes about aging and perceptions of oneself as an older adult influenced subjective age estimates in 8 different domains of functioning. More positive attitudes about aging were associated with older subjective ages, whereas more positive views of self in old age were associated with younger subjective age. It is hypothesized that these effects are reflective of social-comparison processes and self-protective mechanisms. These influences varied considerably over contexts, with views of aging having a greater impact in domains associated with stronger negative stereotypes of aging (e.g., health) compared to those with more positive ones (e.g., family). Culture also moderated the impact of aging views in terms of the strength of prediction, direction of effect, and age of greatest influence, presumably due to cultural differences in the salience and strength of aging-related belief systems across contexts. The results illustrate the contextual sensitivity of subjective age and highlight the role played by an individual's views of old age-both in general and regarding oneself-in determining their own experience of aging. (PsycINFO Database Record

Age differences in the underlying mechanisms of stereotype threat effects.

OBJECTIVES: The goals of the present study were to (a) examine whether age differences exist in the mechanisms underlying stereotype threat effects on cognitive performance and (b) examine whether emotion regulation abilities may buffer against threat effects on performance. METHOD: Older and younger adults were exposed to positive or negative age-relevant stereotypes, allowing us to examine the impact of threat on regulatory focus and working memory. Self-reported emotion regulation measures were completed prior to the session. RESULTS: Older adults' performance under threat suggested a prevention-focused approach to the task, indexed by increased accuracy and reduced speed. The same pattern was observed in younger adults, but the effects were not as strong. Age differences emerged when examining the availability of working memory resources under threat, with young adults showing decrements, whereas older adults did not. Emotion regulation abilities moderated threat effects in young adults but not in older adults. CONCLUSIONS: The results provide support for the notion that stereotype threat may lead to underperformance through somewhat different pathways in older and younger adults. Future research should further examine whether the underlying reason for this age difference is rooted in age-related improvements in emotion regulation.

Information content moderates positivity and negativity biases in memory.

Two experiments examined the impact of encoding conditions and information content in memory for positive, neutral, and negative pictures. We examined the hypotheses that the positivity effect in memory (i.e., a bias in favor of positive or against negative information in later life) would be reduced when (a) pictures were viewed under structured as opposed to unstructured conditions, and (b) contained social as opposed to nonsocial content. Both experiments found that the positivity effect observed with nonsocial stimuli was absent with social stimuli. In addition, little evidence was obtained that encoding conditions affected the strength of the positivity effect. We argue that some types of social stimuli may engage different types of processing than nonsocial stimuli, perhaps encouraging self-referential processing that engages attention and supports memory. This processing may then conflict with the goal-driven, top-down processing that is hypothesized to drive the positivity effect. Thus, our results identify further boundary conditions associated with the positivity effect in memory, arguing that stimulus factors as well as situational goals may affect its occurrence. Further research awaits to determine if this effect is specific to all social stimuli or specific subsets.

Mood, motivation, and misinformation: aging and affective state influences on memory.

Normative age differences in memory have typically been attributed to declines in basic cognitive and cortical mechanisms. The present study examined the degree to which dominant everyday affect might also be associated with age-related memory errors using the misinformation paradigm. Younger and older adults viewed a positive and a negative event, and then were exposed to misinformation about each event. Older adults exhibited a higher likelihood than young adults of falsely identifying misinformation as having occurred in the events. Consistent with expectations, strength of the misinformation effect was positively associated with dominant mood, and controlling for mood eliminated any age effects. Also, motivation to engage in complex cognitive activity was negatively associated with susceptibility to misinformation, and susceptibility was stronger for negative than for positive events. We argue that motivational processes underlie all of the observed effects, and that such processes are useful in understanding age differences in memory performance.

Ageism and risk-taking in young adults: evidence for a link between death anxiety and ageism.

The authors investigated the relationship between ageism and risk-taking in young adults. They hypothesized that young adults may attempt to distance themselves from their future older selves and from an awareness of their mortality by seeking out experiences that make them feel strong, energetic, and invulnerable (i.e., experiences involving risk-taking). We report a study whose results confirmed the hypothesis. Our study involved 408 undergraduates (226 women, 182 men) who completed the Centers for Disease Control's 2007 State and Local Youth Risk Behavior Survey and measures of 2 distinct aspects of ageism: (a) ageist attitudes and (b) ageist behaviors. Both ageist attitudes and behaviors correlated positively with risk-taking (i.e., sexual behavior, alcohol use, cigarette use, and drug use). The results are consistent with terror management theory's view of ageism as a buffer against death anxiety.