Self-reported sensory impairment and social participation among Korean older adults: mediating roles of cognitive function and digital technology use.

OBJECTIVES: This study investigates the correlation between self-reported sensory impairment, cognitive function, digital technology use, and social participation among older adults in South Korea. METHOD: Data from the 2020 National Survey of Older Koreans, comprising a nationally representative sample of 7849 individuals aged 65 years or older, were analyzed. A serial mediation analysis (Model = 6) was conducted using the PROCESS macro for SPSS. RESULTS: Following adjustment for covariates, cognitive function and digital technology use serially mediated the relationship between self-reported sensory impairment and social participation among older adults (B = -0.0020, SE = 0.0005, 95% confidence interval [CI] = [-0.0030, -0.0010]). Specifically, self-reported sensory impairment exhibited a negative correlation with cognitive function (B = -0.3277, SE = 0.0753, p < .001), which was positively associated with digital technology use (B = 0.0763, SE = 0.0056, p < .001), subsequently linking to enhanced social participation (B = 0.0784, SE = 0.0037, p < .001). CONCLUSION: Through cross-sectional analysis, this study confirms that self-reported sensory impairment in older adults may precede cognitive decline, hindering digital technology use and reducing social participation. Early diagnosis and treatment are crucial in preventing cognitive decline, while age-friendly digital devices may alleviate cognitive burden and promote social engagement.

Is living alone beneficial to older adults during the COVID-19 pandemic? Examining associations between living arrangements and life satisfaction by gender in Korea.

OBJECTIVES: This study examines associations between living arrangements and life satisfaction and the associated effects of gender among Korean older adults during the pandemic. METHOD: Data were drawn from the 2020 National Survey of Older Koreans-a nationally representative survey. Living arrangements were categorized into four groups: living alone; living with spouse only; living with family and spouse; and living with family without spouse. Logistic regression analyses were used to examine associations between living arrangements and life satisfaction measured as a binary outcome. RESULTS: Older adults living alone were more likely to be satisfied with life compared with those who lived with a spouse only. However, living alone became nonsignificant after controlling for social contact with friends or neighbors and social participation. Interestingly, there was a significant interaction between living arrangements and gender, showing that living alone was beneficial to older women but not to men. Subsample analysis by gender confirmed that older women living alone had a greater likelihood of being satisfied with life than those living with a spouse only, whereas men living alone had lower life satisfaction. CONCLUSION: Findings suggest that living alone is not always deleterious to older adults, particularly women. During the pandemic, older Korean women living with their spouse and/or family might be less satisfied with life due to the dual burden of family care and housework, associated with traditional gendered norms and social context.

Evaluation of changes in lacrimal canaliculi width depending on temperature and viscosity of eye drops using spectral-domain optical coherence tomography in dogs.

OBJECTIVE: To evaluate the changes in the width of the lower lacrimal canaliculi (LC) upon instillation of artificial tears (AT) at different temperatures and viscosities using spectral-domain optical coherence tomography (SD-OCT). ANIMAL STUDIED: Eight eyes of four client-owned adult dogs. PROCEDURES: Imaging of lower LC was performed under general anesthesia. AT at temperatures of 2°C, 20°C, and 38°C, and a high-viscosity tear gel of 20°C, were topically instilled in 100 µL volumes. SD-OCT tracked LC width changes following each instillation. RESULTS: The average baseline width of the LC was 96.38 ± 30.18 µm. The 2°C AT expanded LC width to 183.50 ± 44.11 µm, returning to baseline in 5.00 ± 1.31 min. The 20°C AT resulted in a width of 155.25 ± 35.79 µm, with a 3.88 ± 1.25 min return. The 38°C AT expanded LC width to 131.75 ± 29.49 µm, with a 2.25 ± 0.89 min return. The high-viscosity tear gel expanded LC width to 208.57 ± 56.31 µm, with remained expanded for 10 or more minutes. In temperature comparisons, the 2°C and 20°C AT significantly expanded the LC width more and had longer return times than the 38°C AT (p < .05). Viscosity comparisons showed higher viscosity eye drops significantly expanded LC width more than lower viscosity eye drops (p < .05). CONCLUSIONS: This study found that lower temperature and higher viscosity of eye drops had tendency to result in a wider expansion of the LC width. Additionally, the return time to baseline for LC width tended to be longer with eye drops of lower temperature and higher viscosity. This finding could be helpful in advancing future research on tear dynamics.

The Role of Purpose in Life in the Relationship Between Widowhood and Cognitive Decline Among Older Adults in the U.S.

OBJECTIVES: The objective of this study was to examine the role of purpose in life in the relationship between widowhood and cognitive decline. METHODS: This study used a sample of 12,856 respondents (20,408 observations) collected from a national panel survey, the 2006-2014 waves of the Health and Retirement Study (HRS), that sampled older adults aged 50 or older. The study estimated growth-curve models with years since spousal death, purpose in life, and interaction between the two to predict cognition using three measures-total cognition, fluid, and crystallized intelligence scores. We also estimated growth-curve models by sex, race/ethnicity, and education. RESULTS: While years since spousal death negatively correlated with cognition, purpose in life positively correlated with cognition. Furthermore, purpose in life had a moderating effect on the relationship between years since spousal death and cognition. This effect was found by using total cognition (coef. = 0.0515; z = 2.64; p < 0.01) and fluid intelligence scores (coef. = 0.0576; z = 3.23; p < 0.05). The same effects were salient among females (coef. = 0.0556; z = 2.19; p < 0.05), Whites (coef. = 0.0526; z = 2.52; p < 0.05), and older adults with more education (coef. = 0.0635; z = 2.10; p < 0.05). CONCLUSION: Higher purpose in life relates to the negative correlations between widowhood and cognition of older adults. Educational programs improving purpose in life are a possible avenue for reducing the adverse effect of widowhood on cognition and warrant future exploration.

Racial/Ethnic Differences in the Longitudinal Effects of Fear of Falling on Falls.

INTRODUCTION: Recent evidence suggests that the effects of fear of falling on falls may differ by race/ethnicity. This study investigated whether race/ethnicity (white, black, and Hispanic) moderated the longitudinal effects of fear of falling on the incidence of falling and having a repeated fall among community-dwelling older adults. METHODS: We used data from 2011 to 2018 of the National Health and Aging Trends Study (NHATS). These included a total of 19,516 person-intervals from 5,113 respondents. Any self-reported fall in the past year was the outcome variable with baseline fear of falling as the predictor and race/ethnicity as the moderator. Covariates included self-reported sociodemographic information, probable depression, chronic conditions, functional impairment, pain, insomnia symptoms, the Clock Drawing Test, the Short Physical Performance Battery, and grip strength. RESULTS: Among respondents who had no experience of falling at baseline, baseline fear of falling increased the odds of having a new onset of fall at 1-year follow-up significantly among blacks, compared to whites (odds ratio [OR] = 1.85, 95% confidence interval [CI] = 1.44-2.38). No significant difference was found for Hispanics. Among respondents who already fell at baseline, baseline fear of falling increased the odds of having a repeated fall at 1-year follow-up significantly among Hispanics, compared to whites (OR = 1.91, 95% CI = 1.06-3.44). No significant difference was found for blacks. CONCLUSIONS: Clear evidence of racial/ethnic differences was found in the relationship between fear of falling and falls among community-dwelling older adults in the USA. Special attention should be paid to black older adults with a fear of falling but have not fallen down recently and Hispanics with fear of falling and have fallen in the past year. Readily available educational programs should be actively advertised to older adults to reduce the fear of falling, and at the same time, culturally tailored educational programs should be developed for older adults from racial/ethnic minority backgrounds.

Digital technology use and depressive symptoms among older adults in Korea: beneficial for those who have fewer social interactions?

OBJECTIVES: Our study examines the relationship between digital technology use and depressive symptoms among older Koreans and whether social interaction moderates the relationship. METHODS: The data were drawn from the 2017 Survey of Living Conditions and Welfare Needs of Korean Older Persons, a nationally representative survey. Digital technology use was measured by the number of digital functions that respondents perform with their electronic devices. Social interactions were measured by the frequencies of face-to-face and remote connections with friends or neighbors. Relationships were estimated with multiple regression analyses. RESULTS: Digital technology use was inversely associated with depressive symptoms even after adjusting for covariates including cognitive function. Both remote and face-to-face connections with friends or neighbors were associated with fewer depressive symptoms. An interaction between digital technology use and remote contact also was detected: the effect of digital technology use on depressive symptoms was more beneficial for older adults with infrequent remote contact with friends or neighbors than for those with frequent remote contact. CONCLUSION: Findings suggest that digital technology use can reduce depressive symptoms of older adults, especially those who have fewer social interactions. Educating older adults to increase their digital literacy level and use of remote interactions may improve their psychological wellbeing, perhaps even during times of a viral pandemic.

Age Discrimination and Suicidal Ideation Among Korean Older Adults.

OBJECTIVE: We examined the role of age discrimination in suicidal ideation among community-dwelling older adults in South Korea. METHODS: We analyzed adults aged 65 or older residing in Korea drawn from the 2014 Survey of Living Conditions and Welfare Needs of Korean Older Persons (total unweighted n = 10,279; total weighted N = 6,280,588). Data were analyzed using chi-square, t tests, and logistic regression analyses. RESULTS: Results from logistic regression analysis showed that after adjusting for covariates, Korean elders who experienced age discrimination had 2.26 times higher odds of having suicidal ideation than those who did not. CONCLUSIONS: The experience of age discrimination increased the risk of suicidal ideation among Korean elders. Identifying ways to reduce age discrimination may be an effective means of reducing suicidal ideation, which would, in turn, potentially decrease suicide rates among older adults. There may be cross-cultural clinical implications and variations due to belief systems surrounding respect for older adults.

Body mass index and trajectories of cognitive decline among older Korean adults.

Objectives: This study examined the relationship between body mass index (BMI) and trajectories of cognitive decline among older Korean adults.Methods: Participants were a nationally representative sample of 5126 Korean adults aged 60 or older from the Korean Longitudinal Study of Aging (KLoSA: 2006-2014). The main outcome variable, cognitive function, was measured with the Korean Mini-Mental State Examination (K-MMSE). According to the BMI values, respondents were divided into four groups at each wave: underweight (<18.5 kg/m2), healthy weight (18.5-22.9 kg/m2), overweight (23.0-24.9 kg/m2), and obese (≥25.0 kg/m2). Growth curve modeling was used to analyze the relationship of interest.Results: The growth curve modeling revealed that, regardless of BMI values, cognitive functioning declined as participants aged, and the rate of cognitive decline accelerated with age. After adjusting for all covariates, older Korean adults who were underweight displayed steeper declines in cognitive functioning, compared to those with a healthy weight. Conversely, overweight or obese older adults showed a much slower cognitive decline as they aged, after adjusting for covariates.Conclusion: Compared to people with a healthy BMI, people with a low BMI may be at risk for cognitive dysfunction, whereas a high BMI could function as a protective factor for cognitive dysfunction in older adulthood. Future research examining the mechanism for these trajectories are needed. Implications for research and clinical practice are discussed.

The association between the number of chronic health conditions and advance care planning varies by race/ethnicity.

Objectives: Although a national consensus exists on the need to increase the rates of advance care planning (ACP) for all adults, racial/ethnic differences in ACP have been consistently observed. This study investigated the intersection of racial/ethnic differences and the number of chronic health conditions on ACP among middle-aged and older adults in the United States.Method: Responses from 8,926 adults from the 2014 wave of the Health and Retirement Study were entered into multilevel hierarchical logistic regression analyses with generalized linear mixed models to predict ACP focused on assigning a durable power of attorney for healthcare (DPOAHC) and having a written living will after adjusting for covariates.Results: We found a significant positive relationship between the number of chronic health conditions and ACP. Non-Hispanic Blacks/African Americans and Hispanics were less likely to engage in ACP than non-Hispanic Whites/Caucasians. Racial/ethnic disparities were even starker for completing a living will. The number of chronic health conditions had a greater effect for Hispanics than non-Hispanic Whites/Caucasians on ACP through assigning a DPOAHC and having a living will. The initial disparity in ACP among Hispanics with no chronic health conditions decreased as the number of chronic health conditions increased.Conclusion: Our findings suggest that more chronic health conditions increase the likelihood that Hispanics will complete ACP documents. These ACP differences should be highlighted to researchers, policymakers, and healthcare professionals to reduce stark racial/ethnic disparities in ACP. A comprehensive and culturally caring decision-making approach should be considered when individuals and families engage in ACP.

The Relationship between Physical-Mental Comorbidity and Subjective Well-Being among Older Adults.

OBJECTIVES: The present study examined the relationship between types and severity of physical-mental comorbidity and subjective well-being (SWB) among older adults. METHODS: The sample was drawn from the National Health and Aging Trends Study (NHATS) collected in 2011. A total of 6,945 older adults aged 65 to 105 were categorized into four groups using 16 common physical health conditions and two mental health problems: no chronic health condition (n = 562, referent), physical health condition (n = 4,946), mental health problem (n = 56), and physical-mental comorbidity (n = 1,380). Outcome variable was self-reported SWB measured with 11 items. Analyses of covariance (ANCOVAs) were used to assess the relationship between types and severity of physical-mental comorbidity and SWB. RESULTS: After adjusting for covariates, older adults with a mental health problem or physical-mental comorbidity reported lower SWB compared to the no chronic health condition group. Physical-mental comorbidity was associated with lower SWB compared to the physical health condition group. Higher severity level of physical-mental comorbidity was associated with decreased SWB. DISCUSSION: Findings suggest that mental health problem and physical-mental comorbidity negatively associated with SWB among older adults. CLINICAL IMPLICATIONS: Integrative interventions should be developed to target mental health issues and comorbid physical-mental health conditions in the older populations.

Purpose in Life Protects Against Cognitive Decline Among Older Adults.

OBJECTIVE: This study examined whether having a sense of purpose in life protects against cognitive decline among older adults and whether purpose in life moderates the relationship between selected risk factors (age, sex, and race/ethnicity) and cognitive abilities. METHODS: This was a longitudinal analysis of existing secondary data of adults (N = 11,557) aged 50 or older using the 2006-2012 waves of the Health and Retirement Study. The study measured purpose in life, cognitive functioning score, and various covariates. RESULTS: Growth curve modeling revealed that, after adjusting for covariates, purpose in life was positively associated with participants' total cognition scores. Purpose in life significantly moderated the relationship between age and race/ethnicity and cognitive decline. Further, purpose in life was a protective factor against cognitive decline for those who were older and black. There was no significant interaction between purpose in life and sex. CONCLUSION: Having a purposeful life protects against cognitive decline in older adults, and the associations varied by age and race/ethnicity, but not by sex. Potential ways to increase purpose in life are discussed in a clinical context.

Trajectories of cognitive decline by widowhood status among Korean older adults.

OBJECTIVES: Given the limited evidence regarding the longitudinal impact of widowhood on cognitive function in later life, the present study aimed to investigate the longitudinal effect of widowhood status on cognitive change among Korean older adults. METHODS: The study sample was drawn from a nationally representative data set, the Korean Longitudinal Study of Ageing (KLoSA); it consisted of 3,660 Korean adults aged 60 and over who were married at baseline. Our dependent variable, cognitive function, was measured by the Korean version of the Mini-Mental State Examination (K-MMSE). Widowhood status was measured with the combination of widowhood status and duration. Growth curve models were constructed using five waves of the KLoSA (2006-2014) to examine the longitudinal trajectories of cognitive changes. RESULTS: In the unadjusted model, widowed older adults had significantly lower cognitive function than their nonwidowed counterparts regardless of widowhood duration. Adjusting for covariates, results from the growth curve models showed that widowed older adults with widowhood duration 4 to 6 years had a significantly steeper decline in cognitive function than nonwidowed older adults (P < 0.05). CONCLUSIONS: These findings suggest that widowhood is detrimental for late-life cognitive function. Further research is required to understand the mechanisms underlying this relationship. Policy and practice implications are discussed according to the cultural context.

Regional and racial/ethnic variations in alcohol consumption among older adults.

Objectives: This paper sought to examine the role of region and race/ethnicity in alcohol consumption among older adults. Methods: Data were obtained from the 2010 Behavioral Risk Factor Surveillance System (BRFSS). Participants aged 60 and older were included (n = 185, 190). Analyses of covariance (ANCOVAs) were conducted to examine the effects of region and race/ethnicity on alcohol consumption among older adults. Results: Results indicate that region and race/ethnicity are significantly related to the alcohol consumption of older adults. More specifically, results suggest that White older adults consume significantly more alcohol than other racial/ethnic groups among older adults. Regarding regional effects, results suggest that older adults in the West consume significantly more alcohol than older adults in the Midwest and South. Additionally, results suggest regional variation in alcohol consumption patterns by race/ethnicity. Conclusion: Findings provide additional insight into how and where alcohol is being used among older adults in the United States. Further, findings highlight the importance of taking race/ethnicity and geography into consideration when investigating the health behaviors of older adults.

Geographic Disparities in the Relation between English Proficiency and Health Insurance Status among Older Latino and Asian Immigrants.

This study examines whether English proficiency and geographic context explain health insurance status among older Latino and Asian immigrants in the U.S. Drawn from the 2010-2012 ACS PUMS, 57,936 Latino and 47,742 Asian immigrants aged 65 and older were selected. Logistic regression analysis was conducted for the U.S. as a whole and separately by geographic region. In the entire U.S., having limited English proficiency (LEP) and being proficient in English (EP) increased odds of being uninsured among Latino immigrants, whereas LEP and EP decreased odds of being uninsured among Asian immigrants. In the stratified analyses for geographic regions, there were significant ethnic differences in the directionality of the relation between English proficiency and uninsured status. Regional institutions should take care to expand access to information on health care and insurance coverage to racial/ethnic minorities, taking into account the characteristics of these groups at the local level.

Widowhood Status as a Risk Factor for Cognitive Decline among Older Adults.

OBJECTIVES: This study investigated whether widowhood status has an effect on cognitive decline among older adults in the United States. DESIGN: Longitudinal analysis of existing secondary data. SETTING: The 1996-2012 waves of the Health and Retirement Study. PARTICIPANTS: A total of 6,766 individuals (28,420 observations) aged 50 years and older who responded to all questions. MEASUREMENTS: Widow/widower status, cognitive functioning score, and various covariates. RESULTS: Growth-curve models show that after controlling for covariates, widowhood status was related to cognitive decline (95% CI: -0.8090, -0.4674). We also found a linear relationship between time since spousal loss and cognitive decline. Conditional upon spousal bereavement status, higher education and having at least one living sibling were found to be protective factors against cognitive decline. CONCLUSIONS: Widowhood status accelerated cognitive decline over time among widowed older adults. Findings suggest that extra support is needed to monitor cognitive functioning for those experiencing widowhood.

Impact of comorbid mental health needs on racial/ethnic disparities in general medical care utilization among older adults.

OBJECTIVE: The objective is to apply the Institute of Medicine definition of healthcare disparities in order to compare (1) racial/ethnic disparities in general medical care use among older adults with and without comorbid mental health need and (2) racial/ethnic disparities in general medical care use within the group with comorbid mental health need. METHODS: Data were obtained from the Medical Expenditure Panel Survey (years 2004-2012). The sample included 21,263 participants aged 65+ years (14,973 non-Latino Caucasians, 3530 African-Americans, and 2760 Latinos). Physical illness was determined by having one of the 11 priority chronic health illnesses. Comorbid mental health need was defined as having one of the chronic illnesses plus a Kessler-6 Scale >12, or two-item Patient Health Questionnaire >2. General medical care use refers to receipt of non-mental health specialty care. Two-part generalized linear models were used to estimate and compare general medical care use and expenditures among older adults with and without a comorbid mental health need. RESULTS: Racial/ethnic disparities in general medical care expenditures were greater among those with comorbid mental health need compared with those without. Among those with comorbid mental health need, non-Latino Caucasians had significantly greater expenditures on prescription drug use than African-Americans and Latinos. CONCLUSIONS: Expenditure disparities reflect differences in the amount of resources provided to African-Americans and Latinos compared with non-Latino Caucasians. This is not equivalent to disparities in quality of care. Interventions and policies are needed to ensure that racial/ethnic minority older adults receive equitable services that enable them to manage effectively their comorbid mental and physical health needs. Copyright © 2016 John Wiley & Sons, Ltd.

Geographic variation in mental health care disparities among racially/ethnically diverse adults with psychiatric disorders.

PURPOSE: The main purpose of this paper is to examine geographic variation in unmet need for mental health care among racially/ethnically diverse adults with psychiatric disorders in the US. METHODS: Drawn from the Collaborative Psychiatric Epidemiology Surveys (CPES; 2001-2003), adults with any past year psychiatric disorder diagnosis (n = 3211) from diverse racial/ethnic backgrounds were selected for analyses. Using weighted data, descriptive analyses and logistic regression analyses were conducted. RESULTS: Two-thirds of the total sample had unmet mental health care need, which differed significantly by race/ethnicity (p < .001). Logistic regression analyses show regional variation of the effect of race/ethnicity in unmet need: after adjusting for covariates, Latinos in the South, Blacks and Latinos in the Midwest, and Latinos and Asians in the West had higher unmet need than non-Hispanic Whites, whereas no significant racial/ethnic effects were found in the Northeast. CONCLUSIONS: Findings suggest that geographic region plays an important role in the sufficient use of mental health services among racial/ethnic minorities. Further research should elucidate reasons for geographic disparities in mental health care among racial/ethnic minority adults to reduce disparities.

Effects of Nativity, Length of Residence, and County-Level Foreign-Born Density on Mental Health Among Older Adults in the U.S.

Using the 2004-2007 Medical Expenditure Panel Survey data that are linked to county-level data from the Area Health Resources Files, this study examined whether the healthy immigrant effect applies to mental health of foreign-born older adults. Additionally, testing a protective ethnic density effect on older foreign-born individuals' mental health, this study examined how the percentage of foreign-born population in the county affected the relationship between older adults' immigration status (U.S.-nativity and length of residence in the U.S.) and their mental health status. The sample included 29,011 individuals (level-1) from 920 counties (level-2) across 50 states and D.C. Using the Mental Component Summary of the Short-Form 12, the Kessler Index (K-6), and the Patient Health Questionnaire (PHQ-2), U.S.-born individuals (n = 24,225), earlier immigrants (≥15 years in the U.S.; n = 3866), and recent immigrants (<15 years in the U.S.; n = 920) were compared. The results indicate that recent immigrants showed worse mental health on all three measures compared with U.S.-born individuals and on the K-6 and PHQ-2 compared with earlier immigrants. Higher county-level foreign-born densities were associated with worse mental health status of individuals. However, the significant interactions found in the full conditional multilevel models indicated that the high foreign-born density functioned as a risk factor for worse mental health only among recent immigrants but not among the U.S.-born. In conclusion, the results revealed the vulnerability of older recent immigrants, especially those living in the counties with high foreign-born densities.

Racial/ethnic variations in the relation between body mass index and cognitive function among older adults.

OBJECTIVES: The present study examines racial/ethnic variations in the relation between body mass index (BMI) and cognitive function among older adults. DESIGN: Cross-sectional study of secondary data. SETTING: Data were obtained from the 2010 Health and Retirement Study. PARTICIPANTS: Racial/ethnic groups analyzed were black (n = 546), Hispanic (n = 110), and non-Hispanic white (n = 4,104). MEASUREMENTS: BMI was calculated based on self-reported height and weight. Cognitive function was measured based on Telephone Interview for Cognitive Status-Health and Retirement Study version scores. RESULTS: Significant main effects were found for both BMI and race/ethnicity, indicating that cognitive function varies significantly by both. The BMI × race/ethnicity interaction was also found to be significant. The interaction revealed that among the white sample cognitive function scores tended to increase as BMI increased whereas the opposite relation was observed in the Hispanic sample. The black sample displayed a similar pattern as the white sample, although a decrease was observed in cognitive function scores once BMI reached obesity. CONCLUSION: The results suggest that the relation between BMI and cognitive function does vary by race ethnicity. Therefore, it can be concluded that high or low BMI may vary as a risk or protective factor for cognitive dysfunction among older adults by race/ethnicity. Implications for research and clinical work are discussed.

The relation between body mass index and self-rated mental health among older adults: do racial/ethnic differences exist?

OBJECTIVES: To examine racial and ethnic differences in the relation between body mass index (BMI) and self-rated mental health (SRMH) among community-dwelling older adults. DESIGN: Cross-sectional analyses of nationally representative data from the Collaborative Psychiatric Epidemiology Surveys. SETTING: In-person household interviews. PARTICIPANTS: Older adults aged 60 and older (N = 2,017), including non-Hispanic white (N = 547), black (N = 814), Hispanic (N = 401), and Asian (N = 255) patients. MEASUREMENTS: SRMH was measured with a single item, "How would you rate your own mental health?" BMI categories were underweight (<18.5 kg/m(2)), healthy weight (18.5-24.9 kg/m(2)), overweight (25.0-29.9 kg/m(2)), and obese (≥30.0 kg/m(2)). RESULTS: A two-way analysis of covariance showed that after controlling for covariates, there was a significant main effect of race/ethnicity on SRMH, but the main effect of BMI was not significant. A significant interaction between BMI and race/ethnicity on SRMH was also found. The linear contrasts showed that white adults had a significant trend showing that SRMH decreased with increases in BMI, whereas black adults had a significant trend showing that SRMH increased with increases in BMI. The linear trends for Hispanic and Asian adults were not significant. CONCLUSIONS: There were significant racial/ethnic differences in the relation between BMI and SRMH. Understanding the role of race/ethnicity as a moderator of the relation between BMI and mental health may help improve treatment for older adults with unhealthy weights. Clinical implications are also discussed.