Association of Epigenetic Age and Everyday Discrimination With Longitudinal Trajectories of Chronic Health Conditions in Older Adults.

We investigated the strength of the association between baseline epigenetic age, everyday discrimination, and trajectories of chronic health conditions (CHCs) across 3 study waves, among adults 50 years of age and older. We used 2016-2020 data from the Health and Retirement Study (HRS). Data for the PhenoAge and DNAm GrimAge second-generation epigenetic clocks were from the 2016 HRS Venous Blood Study. CHC trajectories were constructed using latent class growth curve models. Multinomial logistic regression models assessed the strength of the association between accelerated epigenetic age, everyday discrimination, and the newly constructed CHC trajectories for participants with complete data (n = 2 893). In the fully adjusted model, accelerated PhenoAge (relative risk ratios [RRR] = 2.53, 95% confidence interval [95% CI] = 1.81, 3.55) and DNAm GrimAge (RRR = 2.79, 95% CI = 1.95, 4.00) were associated with classification into the high CHC trajectory class. Racial disparities were evident, with increased risk of classification into the high trajectory class for Black (PhenoAge: RRR = 1.69, 95% CI = 1.07, 2.68) and reduced risk for Hispanic (PhenoAge: RRR = 0.32, 95% CI = 0.16, 0.64; DNAm GrimAge: RRR = 0.34, 95% CI = 0.17, 0.68), relative to White participants. Everyday discrimination was associated with classification into the medium-high (RRR = 1.28, 95% CI = 1.00, 1.64) and high (RRR = 1.52, 95% CI = 1.07, 2.16) trajectory classes in models assessing DNAm GrimAge. More research is needed to better understand the longitudinal health outcomes of accelerated aging and adverse social exposures. Such research may provide insights into vulnerable adults who may need varied welfare supports earlier than the mandated chronological age for access to federal and state resources.

Stability and change of religiosity among baby boomers in adulthood: Associations with familism over time.

While it is commonly understood that familism is influenced by religiosity, less is known about how religiosity between young adulthood and midlife is related to the trajectory of familism from midlife over the later life course. In this study, we identified a multidimensional typology of religiosity among baby boomers in young adulthood and midlife, explored how membership in this religious typology changed from young adulthood to midlife, and examined how transition patterns of religiosity were associated with familism over time. We used data from a sample of 471 baby boomers (mean age 19 years in 1971) from the Longitudinal Study of Generations (LSOG), Wave-1 (1971) through Wave-8 (2005). Using latent class and latent transition analysis, we identified three latent religiosity classes in Wave-1 (1971) and Wave-3 (1988): strongly religious, weakly religious, and privately religious, and identified nine transition patterns of religiosity from you between these waves from young adulthood to midlife. Using latent growth curve analysis (Wave-3 to Wave-8), we found that respondents who remained strongly or privately religious or whose religiosity increased had higher initial levels of familism (Wave-3) compared to those who stayed in the weakly religious class. However, the gap in familism across religiosity transition patterns decreased over time up to late middle age. Our findings indicate that while religiosity was positively associated with familism, its impact weakened over time possibly due to change in the centrality of family life and societal factors.

Using Community-Based Participatory Research to Develop Care Recommendations for People Aging With HIV.

Background and Objectives: Over 50% of New Yorkers living with human immunodeficiency virus (HIV) are 50 years old or older, and the emotional and physical consequences of being a long-term survivor are significant. This study aimed to identify the practical needs of long-term survivors and older people with HIV (consumers) in New York State and develop recommendations addressing those needs. Research Design and Methods: The HIV + Aging/LTS/Perinatally Diagnosed Subcommittee of the Consumer Advisory and Quality Advisory committees in the New York State AIDS Institute used community-based participatory research (CBPR) methods to design a statewide survey about the care needs of consumers in New York State. This survey, open to consumers, clinicians, and supportive services providers, was launched in June 2021 using Qualtrics. Participants provided demographic data and chose the 3 most important barriers and recommendations from each of 10 categories of issues affecting health care and supportive services. Consumers provided information about their HIV diagnosis and other health conditions. Responses were characterized using basic descriptive statistics. Results: Participants included 124 consumers from 26 counties, 20 clinicians, and 24 supportive service providers. Among consumers, 67% were cisgender men, 27% were African American, and 65% were both long-term survivors and older people with HIV. On average consumers had been diagnosed with HIV for 27 years. Participants were concerned with clinical care coordination, housing needs, cultural representation in mental health services, and financial support of consumers. Discussion and Implications: CBPR is an effective approach to developing consumer-generated recommendations to improve HIV care for long-term survivors and older people with HIV. Town hall formats informed survey design, enabled broad coverage of topics, and ensured that focus remained on priorities most important to consumers. The first quality initiative arising from the study was a routine screening of long-term survivors of HIV to identify functional decline and enhance referral pathways and care linkages.

Intergenerational solidarity and digital communication during the Covid-19 pandemic in South Korea: Implications for dyadic well-being.

Previous research has not considered how digital communication fits with the established intergenerational solidarity paradigm, although the paradigm has undergone other refinements over time. Consequently, less is known about how the use of digital communication creates new types of intergenerational solidarity between parents and adult children, and how they are associated with their well-being. With this foundation, we aimed to identify new dyadic patterns of intergenerational solidarity between parents and adult children during the COVID-19 pandemic in South Korea, with an emphasis on digital communication (texting, video call, and social media interaction), its intersection with other dimensions of solidarity, and its association with parents' and children's well-being (depressive symptoms, self-esteem, and life satisfaction). Using an online survey method, we collected data from 407 parent-adult child dyads between April and June 2022 from the Seoul Metropolitan area in South Korea. Three-step latent class analysis was used for data analysis. We identified four classes describing intergenerational solidarity between parents and adult children (tight-knit, distant-but-digitally-connected, conflictual, and independent). We found that among dyads of parents and adult children who had tight-knit and distant-but-digitally-connected relationships with each other, parents reported better well-being on all three outcomes, and children reported better life satisfaction compared to dyads who had conflictual relationships. Our findings suggest that incorporating digital communication into the intergenerational solidarity paradigm is useful to better understand the multidimensional characteristics of intergenerational relationships between older parents and their adult children.

Intergenerational solidarity with digital communication and psychological well-being among older parents during the COVID-19 pandemic.

We aimed to identify intergenerational solidarity (emotional closeness, in-person contact, phone contact, geographic proximity, consensus, and conflict) with digital communication (texting, video call, and social media interaction) with adult children among older parents during the COVID-19 pandemic. In addition, we aimed to investigate whether intergenerational solidarity with digital communication latent classes were associated with older parents' psychological well-being. We used the 2022 survey of the Longitudinal Study of Generations (LSOG). The sample consisted of 519 older parents who reported about 1245 adult children. Two-level latent class analysis identified six classes at the child level (Level 1: distant but digitally connected, tight-knit and digitally connected, tight-knit traditional, detached, intimate but distant, and sociable). In addition, the analysis identified three classes at the parent level (Level 2: digitally connected, mixed, and intimate but distant). Results of multivariate regression showed that older parents in the digitally connected latent class had better psychological well-being than those in the mixed latent class. Consequently, our finding indicates that digital solidarity with adult children can be beneficial for older parents' psychological well-being during the COVID-19 pandemic.

Intergenerational solidarity of adult children with parents from emerging to established adulthood.

Although researchers have focused on adult children's intergenerational solidarity with their parents following the transition to adulthood, less is known about continuity and change in the multiple dimensions of solidarity as children transition from emerging to established adulthood. Therefore, we focused on reciprocal longitudinal associations between dimensions of latent forms of solidarity (normative and affectual solidarity) and manifest forms of solidarity (associational and functional solidarity) as reported by young adults at three stages from emerging to established adulthood. Data were derived from young adult children participating in the Longitudinal Study of Generations who reported about 260 daughter-mother, 214 son-mother, 244 daughter-father, and 205 son-father relationships in 2000 (18-29 years old), 2005 (23-34 years old), and 2016 (34-45 years old). Multigroup autoregressive cross-lagged models prospectively predicted reciprocal influences among the dimensions of solidarity across four parent-child gender groups. Results showed that young adults' perceived intergenerational solidarity with parents was stable across three-time points. In addition, young adults' perceived associational solidarity with parents in emerging adulthood (2000 survey) predicted functional solidarity with parents (receiving support from parents and providing support to parents) in intermediate young adulthood (2005 survey), and in established adulthood (2016 survey). However, parents' and children's gender differences were not identified in the above associations. The study concludes that frequent contact with parents in emerging adulthood is a key factor in establishing intergenerational solidarity with parents from early-to-middle stage of adulthood regardless of parents' and children's gender. (PsycInfo Database Record (c) 2023 APA, all rights reserved).

Does religiosity in early adulthood predict change in filial eldercare norms after midlife among baby boomers?

This study investigated whether patterns of religious change from early to middle adulthood is associated with patterns of change in filial norms from midlife to later life. Tracking change across 45 years of the adult life span, we link developmental processes occurring at two stages of life using midlife as the point of inflection. Respondents consisted of 436 individuals in the Baby Boom generation who participated in the Longitudinal Study of Generations from Waves 1 (1971) to 9 (2016). We conducted latent class and latent transition analysis to identify religious classes and their transitions over several decades, and latent growth curve modeling to identify change in filial norms. We identified three religiosity classes in Waves 1 and 5-strongly religious, weakly religious, and moderately religious-and five patterns of religious transitions. These transitions were then used to predict change in filial norms between Waves 5 and 9. Respondents who remained weakly religious from early to mid-adulthood reported weaker filial norms in midlife, compared to those who became more religious, and declined more rapidly in their strength of filial norms after middle age. Those who stayed weakly religious also declined more rapidly post-middle age. Our findings link dynamics in religiosity and filial norms across disparate stages of the adult life span and suggest that religious orientations earlier in adulthood are linked to filial norms at time of life when responsibilities for eldercare become a concern for one's parents as well as oneself. (PsycInfo Database Record (c) 2023 APA, all rights reserved).

Psychiatric history and later-life cognitive change: effect modification by sex, race and ethnicity.

Objective: We explored associations between psychiatric history and cognitive functioning, and differences by sex and race/ethnicity (SRE) in 20,155 Health and Retirement Study (1995-2014) participants aged 65 or older.Methods: Multi-level growth curve models examined cognition scores and their trajectories over time by SRE.Results: A history of psychiatric, emotional, or nervous problems was significantly related to cognition scores and rates of decline. Hispanic and Black participants had significantly lower cognition scores at age 75 and steeper rates of decline than White females, and Black race and the Hispanic race/ethnicity-sex interaction erased the protective effects of being female.Conclusions: Future research should include specific psychiatric diagnoses. Population level findings as reported here, along with aggregate findings from similar studies, can inform interventions and policies regarding support for populations that are vulnerable to mental illness and to subsequent cognitive decline.

Intergenerational Solidarity With Grandparents in Emerging Adulthood: Associations With Providing Support to Older Parents in Established Adulthood.

We examined the link between types of intergenerational solidarity with grandparents among young adults in emerging adulthood and whether they provided instrumental and emotional support to their older parents in established adulthood. We used the 2000 and 2016 waves of the longitudinal study of generations and a sample of 229 grandmother-child and 175 grandfather-child dyads. Latent class analysis identified three classes describing intergenerational solidarity with grandparents (tight-knit, detached, and intimate-but-geographically distant) in grandmother-child and grandfather-child dyads in emerging adulthood. Path analyses showed that young adults who had a tight-knit relationship with their grandparents in emerging adulthood provided more instrumental and emotional support to their parents in established adulthood, compared with those who had a detached relationship with their grandparents in emerging adulthood. Results are interpreted in contexts of multigenerational interdependence within families and the sensitivity of young adults to the needs of older parents through their earlier connection to grandparents.

Religiosity of Baby-Boomers in Young Adulthood: Associations with Psychological Well-Being over the Life Course.

Although several studies have discovered positive relationships between religion and various aspects of mental health, less is known about longitudinal associations between religiosity and psychological well-being over the life course. We examined how religious latent classes during the transition to adulthood are associated with trajectories of psychological well-being over 45 years. We selected 798 young-adults baby-boomers from the 1971 wave of the Longitudinal Study of Generation (mean age: 19 years) and tracked their psychological well-being over nine waves up to the 2016 wave (mean age: 64 years). Latent class analysis focused on four religiosity domains (religious service attendance, religious intensity, civic value of religion, literal beliefs) identified four distinct latent religious classes: strongly religious, weakly religious, liberally religious, and privately religious. Results of latent growth curve modeling showed that strongly religious baby-boomers during the transition to adulthood generally reported better psychological well-being than weakly religious baby-boomers at the same stage in life. In addition, psychological well-being in strongly, liberally, and privately religious baby-boomers followed a consistently upward trend across the life course, whereas among weakly religious baby-boomers psychological well-being followed an inverted u-curve (increased until mid-40s and decreased thereafter). Findings suggest that earlier religiosity may serve as a significant predictor affecting psychological well-being throughout the adult life course.

Religious Transitions Among Baby Boomers From Young Adulthood to Later Life: Associations with Psychological Well-Being Over 45 Years.

We used classification analysis to examine change in religiosity among baby boomers from young adulthood to early old age and how religiosity transition patterns are associated with psychological well-being in later life. In addition, we tested the gender difference in the above association. We applied latent class and latent transition analysis to 392 baby boomers who participated in the Longitudinal Study of Generations in Wave-1 (1971) and Wave-9 (2016). We identified three classes describing religiosity at each wave (strongly religious, doctrinally religious, and weakly religious), and considered five types of change or stability in religious class membership from Wave-1 to Wave-9. Multiple regression with gender interactions revealed that men who stayed strongly religious over the period reported better psychological well-being compared to men who declined in their religiosity; no such pattern was found for women. Our findings suggest that maintaining strong religiosity over the life course was beneficial for baby boom men in later life.

Are filial eldercare norms related to intergenerational solidarity with older parents? A typological developmental approach.

Intergenerational solidarity is multidimensional in nature, but the role of filial eldecare norms in structuring intergenerational solidarity is less understood. We examine how filial eldercare norms expressed in early adulthood and midlife are associated with intergenerational solidarity with older parents and how this association varies across parent-child gender combinations. We used data from 1985 to 2005 waves of the Longitudinal Study of Generation when the generation of interest was 32 and 52 years of age, respectively. A three-step latent class approach, culminating with a multinomial logistic regression, was conducted on a sample of 198 mother-son, 279 mother-daughter, 155 father-son, and 209 father-daughter dyads. A tight-knit intergenerational type was uniquely identified in mother-daughter relations, and a social unsupportive type was uniquely identified in father-son and father-daughter relations. Daughters expressing stronger filial norms in early adulthood were more likely in middle adulthood to belong to a tight-knit relational type with mothers and a social unsupportive and intimate but distant relational type with fathers, compared to a detached relational type; these effects were mediated by contemporaneously measured filial norms. Our study complements previous studies on the relationship between filial eldercare norms and intergenerational solidarity with older parents by showing that these norms exert an influence by virtue of being stable in adult daughters over 20 years into middle age. These findings demonstrate that eldercare norms expressed by daughters prior to their parents' transition to old age structure intergenerational relationships in later life, suggesting that such norms are better considered as long-term endowments than as situational in their origins. (PsycInfo Database Record (c) 2022 APA, all rights reserved).

Reciprocal associations between affectual, associational, and normative solidarity with parents during children's early to established adulthood.

Intergenerational solidarity has become increasingly important to understand, as close family members mobilize the provision of social support across generations and contribute to family wellbeing. However, less is known about continuity and change in normative (eldercare norms), affectual, and associational solidarity with mothers and fathers as children emerge into full or established adulthood. Therefore, we focused on reciprocal associations between three dimensions of intergenerational solidarity (normative, affectual, and associational) as reported by young-adult children from their early twenties to late thirties. Data were derived from respondents in the Longitudinal Study of Generations: daughters reported about relationships with 291 mother-father pairs and sons reported about relationships with 309 mother-father pairs in 2000, 2005, and 2016. Autoregressive cross-lagged models prospectively predicted mutual influences among the three dimensions of solidarity across daughter-parent and son-parent relationships. In addition, multiple group analysis was conducted to examine the children's gender difference. We found that normative solidarity and emotional closeness with mothers were mutually reinforcing in daughters' and sons' parental relationships. However, normative solidarity predicted emotional closeness with fathers in both daughter-parent and son-parent relationships. The study concludes that sons and daughters establish eldercare norms based on emotional components of solidarity with mothers, and suggest that filial duty is a key reason why mother-child relations become close over the family life course.

La solidaridad intergeneracional se ha vuelto cada vez más importante de comprender, ya que los familiares cercanos movilizan el apoyo social entre las generaciones y contribuyen al bienestar familiar. Sin embargo, se sabe poco acerca de la continuidad y el cambio en la solidaridad normativa (las normas de cuidado de los adultos mayores), afectiva y asociativa con las madres y los padres a medida que los hijos entran en la adultez completa o definitiva. Por lo tanto, nos centramos en las asociaciones recíprocas entre las tres dimensiones de solidaridad intergeneracional (normativa, afectiva y asociativa) según lo informado por los hijos jóvenes-adultos desde sus veinte hasta sus cuarenta años. Los datos se tomaron de personas encuestadas en el Estudio Longitudinal de Generaciones: las hijas informaron acerca de las relaciones con 291 pares de madres y padres y los hijos informaron acerca de las relaciones con 309 pares de madres y padres en los años 2000, 2005 y 2016. Los modelos autorregresivos de retardo cruzado predijeron prospectivamente influencias mutuas entre las tres dimensiones de solidaridad en las relaciones entre la hija y el padre/la madre y las relaciones entre el hijo y el padre/la madre. Además, se realizaron análisis multigrupo para analizar la diferencia de género de los hijos. Descubrimos que la solidaridad normativa y la cercanía emocional con las madres se reforzaron mutuamente en las relaciones parentales de las hijas y los hijos. Sin embargo, la solidaridad normativa predijo la cercanía emocional con los padres tanto en las relaciones entre la hija y el padre/la madre como en las relaciones entre el hijo y el padre/la madre. En el estudio se llega a la conclusión de que los hijos y las hijas establecen normas de cuidado de los adultos mayores basándose en los componentes emocionales de la solidaridad con las madres, y se sugiere que el deber filial es un motivo clave por el cual las relaciones entre madre e hijos se vuelven cercanas durante el transcurso de la vida familiar.

Risk of Nursing Home Use Among Older Americans: The Impact of Psychiatric History and Trajectories of Cognitive Function.

OBJECTIVES: Mental illness and cognitive functioning may be independently associated with nursing home use. We investigated the strength of the association between baseline (1998) psychiatric history, 8-year cognitive function trajectories, and prospective incidence of nursing home use over a 10-year period while accounting for relevant covariates in U.S. adults aged 65 and older. We hypothesized that self-reported baseline history of psychiatric, emotional, or nervous problems would be associated with a greater risk of nursing home use and that cognition trajectories with the greatest decline would be associated with a subsequent higher risk of nursing home use. METHODS: We used 8 waves (1998-2016) of Health and Retirement Study data for adults aged 65 years and older. Latent class mixture modeling identified 4 distinct cognitive function trajectory classes (1998-2006): low-declining, medium-declining, medium-stable, and high-declining. Participants from the 1998 wave (N = 5,628) were classified into these 4 classes. Competing risks regression analysis modeled the subhazard ratio of nursing home use between 2006 and 2016 as a function of baseline psychiatric history and cognitive function trajectories. RESULTS: Psychiatric history was independently associated with greater risk of nursing home use (subhazard ratio [SHR] 1.26, 95% confidence interval [CI] 1.06-1.51, p < .01), net the effects of life course variables. Furthermore, "low-declining" (SHR 2.255, 95% CI 1.70-2.99, p < .001) and "medium-declining" (2.103, 95% CI 1.69-2.61, p < .001) trajectories predicted increased risk of nursing home use. DISCUSSION: Evidence of these associations can be used to educate policymakers and providers about the need for appropriate psychiatric training for staff in community-based and residential long-term care programs.

Is the Relationship Between Religiosity and Filial Elder-Care Norms Declining? A Comparison Between Two Middle-Aged Generations.

We investigated whether religiosity among middle-aged adults in the Baby Boom generation and Generation-X was associated with filial elder-care norms. The sample consisted of 720 Baby Boom and 520 Gen-X respondents participating in the Longitudinal Study of Generations. A cohort-comparative model was devised using data from Baby Boomers in 1994 and Gen-Xers in 2016, when they were 42 and 40 years old, respectively. A three-step latent class modeling technique identified three religious classes in both generations: strongly religious, weakly religious, and doctrinally religious. Weakly religious Baby Boomers and Gen-Xers reported weaker filial elder-care norms than the strongly religious in each generation. No difference in these effects were detected by generation. However, only among Baby Boomers did the doctrinally religious express stronger filial norms, suggesting cross-cohort weakening in how beliefs translate into filial responsibility in the absence of congregational practice. This research opens lines of inquiry that examine long-term effects of adult children's religiosity on the actual provision of assistance to older parents when they face health difficulties.

Addressing elder abuse: service provider perspectives on the potential of restorative processes.

Older adults often rely on family and friends for care and support. Individuals providing support can take advantage of their vulnerabilities, resulting in neglect, physical, emotional, or sexual abuse, or financial exploitation. Conventional approaches, which older adults are often reluctant to pursue, utilize social service interventions, criminal justice responses, civil litigation, and case review multi-disciplinary teams. This project explored providers' perspectives on using restorative processes, alternative approaches that bring together the person harmed, the person committing the harm, and the community to address the harm and repair relationships. Researchers recruited and interviewed providers working with abused older adults, as referred by a community-based elder justice working group. Providers perceived that restorative processes have the potential to address and prevent social isolation, which often leads to elder abuse. We recommend providers explore restorative processes to address elder abuse, paying attention to implementation barriers and identifying appropriate methods for supporting and maintaining outcomes.

Breaking bad news of a breast cancer diagnosis over the telephone: an emerging trend.

PURPOSE: This study evaluated how breast cancer diagnoses were shared with patients. METHODS: Current members of the Dr. Susan Love Research Foundation's Army of Women cohort were sent one email with a link to a survey assessing how their breast cancer diagnosis was communicated, a description of their support system during treatment, basic demographic information, and breast cancer diagnosis details. RESULTS: Participants (n = 2896) were more likely to be given their diagnosis over the telephone in more recent years (OR 1.07, 95% CI 1.06-1.08). Up until about 10 years ago (1967-2006), breast cancer diagnoses were communicated in person more often than by telephone. Since 2006, more than half of participants learned about their diagnosis over the telephone. From 2015 to 2017, almost 60% of participants learned about their diagnosis over the telephone. Among those who heard the news in person, a steady 40% were alone. Characteristics of those who received the news over the telephone included having identified support members, heterosexual identity, and a diagnosis of in situ breast cancer. CONCLUSIONS: Receiving a telephone call about breast cancer diagnosis may be the norm rather than the exception in health care today. Trends in practice, as well as current best practices based primarily on expert opinion, may not provide optimal care for women diagnosed with breast cancer. Patient outcome research to guide future practice, such as the impact of modes of delivery of bad news, is urgently needed to determine appropriate patient-centered approaches for notification of breast cancer diagnoses.

Veteran status and men's later-life cognitive trajectories: evidence from the health and retirement study.

OBJECTIVE: The aim of this study is to determine the extent to which men's later-life cognitive trajectories vary by veteran status. METHOD: We use Health and Retirement Study (HRS) data to estimate growth curve models examining men's later-life cognitive trajectories by veteran status, war service status, and period of service. Analyses control for early-life characteristics that influence selection into military service and later-life cognition, and mid- to late-life characteristics that potentially mediate the relationship between military service and later-life cognition. RESULTS: Veterans have higher cognition scores relative to nonveterans around retirement age, but their cognition scores decline more rapidly with increasing age, such that cognition scores are similar in both groups among the oldest old. Veterans who served during the Korean War have lower cognition scores around retirement age, but less steep age-related declines, than veterans who served during World War II. DISCUSSION: Findings are discussed in relation to the extant literature, future research, potential service needs, and study limitations.

Same-sex sexual relationships in the national social life, health and aging project: making a case for data collection.

This study describes the previously unexplored subsample of respondents who reported at least 1 same-sex sexual relationship (SSSR) in the National Social Life, Health, and Aging Project (NSHAP). The NSHAP collected data from 3,005 adults (aged 57-85). Approximately 4% (n = 102) of respondents reported at least one SSSR. These sexual minority elders were younger, more educated, were more likely to be working, had fewer social supports, and better physical health. Results may indicate crisis competence in sexual minority elders. Collecting sexual orientation and gender identity data in larger, US-based probability samples would inform the development of appropriate community-based services and supports.