Research on Aging recent issues

HIV/AIDS and Older Persons: Shifting the Focus From the Infected to the Affected

Williams, N., Knodel, J., Lam, D. — Mon, 23 Nov 2009 14:19:22 PST

The Role of Parents and Family Members in ART Treatment Adherence: Evidence From Thailand

Knodel, J., Kespichayawattana, J., Saengtienchai, C., Wiwatwanich, S. — Mon, 23 Nov 2009 14:19:22 PST

High levels of treatment adherence are crucial for the success of expanding antiretroviral therapy (ART) treatment programs everywhere. Augmenting adherence through treatment supporters is one promising strategy. Most discussions focus on peers, especially members of persons with HIV/AIDS (PHA) groups, for this purpose. Far less attention is given to family members and especially older age parents. Yet ART recipients often live with or nearby parents and other family members who are highly motivated to ensure the treatment’s success. This study examines the extent that family members, especially parents, assist adherence in Thailand. Results indicate that most adult ART patients live with family members and more than half live with or in the same locality as a parent. Family members, including parents, commonly remind ART patients to take medications, especially if coresident. Moreover, parents often remind patients to get resupplies and sometimes accompany them to appointments. Clearly close family members, including parents, should be explicitly incorporated into adherence augmentation programs and provided adequate information to facilitate their role as long-term adherence partners, not only in Thailand but wherever ART recipients are closely linked to family members through living and caregiving arrangements.

The Impact of Caregiving on the Health and Well-being of Kenyan Luo Grandparents

Ice, G. H., Yogo, J., Heh, V., Juma, E. — Mon, 23 Nov 2009 14:19:22 PST

As the HIV/AIDS pandemic progresses in Africa, elders are increasingly responsible for the care of orphans. Several reports suggest that elderly Africans do not have the resources to provide care and are at risk of poor health, but few studies have systematically measured health of caregivers. The Kenyan Grandparents Study is a longitudinal study designed to compare elder Luo caregivers to noncaregiving peers. Several measures of health were collected, including body mass index (BMI), blood pressure, glucose, and hemoglobin. In addition, self-perceived health and mental health were measured using the MOS Short-Form 36 (SF-36). It was hypothesized that caregivers would have poorer health than noncaregivers and that the difference in health would widen over the three waves of the study. Caregiving did not affect physical health but did act to decrease mental health and perceived health over time.

Socioeconomic Differentials Between HIV Caregivers and Noncaregivers: Is There a Selection Effect? A Case of Older People Living in Nairobi City Slums

Chepngeno-Langat, G., Falkingham, J., Madise, N. J., Evandrou, M. — Mon, 23 Nov 2009 14:19:22 PST

This article seeks to investigate the association between caregiving to someone with an HIV-related illness and the socioeconomic status of the caregiver using a population-based survey of 1,587 older people living in Nairobi slums. Findings indicate significant differences in living arrangements, wealth, income, and expenditure between HIV caregivers and noncaregivers. HIV caregivers lived in larger households and were also more likely to live in households with a large number of children younger than the age of 15 years. Whereas a high proportion of HIV caregivers were ranked highly in terms of wealth status, differences in per capita income and expenditure were not significant when household size and other confounders were accounted for. The financial costs associated with caring for someone with a chronic illness and the reliance on family members with financial ability for material support, a common feature of African extended family systems, may account for the relative economic advantage of HIV caregivers.

The Impact of AIDS on Intergenerational Support in South Africa: Evidence From the Cape Area Panel Study

Mon, 23 Nov 2009 14:19:22 PST

This study uses panel data from Cape Town to document the role played by aging parents in caring for grandchildren who lose parents due to illnesses such as AIDS. The authors quantify the probabilities that older adults and their adult children provide financial support to orphaned grandchildren. The authors find significant transfers of public and private funds to older adults caring for orphans. Perhaps because of these transfers the authors find no differences in expenditure patterns between households with orphans and other older adult households. They also find no impact of either the death of a child or taking in orphaned grandchildren on adult well-being as measured by ability to work, depression, or self-reported health. Findings suggest that the combined public and private safety net in South Africa mitigates many of the consequences older adults could suffer when an adult child dies and leaves behind grandchildren needing care.

Community Reaction to Older Age Parental AIDS Caregivers and Their Families: Evidence From Cambodia

Knodel, J., Williams, N., Kim, S. K., Puch, S., Saengtienchai, C. — Mon, 23 Nov 2009 14:19:22 PST

Accounts of community reactions to persons with HIV/AIDS and their families typically focus only on negative reactions stemming from stigmatization, with little acknowledgement of variation over time and across settings. To usefully guide local interventions, a broader view is needed that also encompasses attitudes and actions stemming from sympathy and friendship. The authors examined community reactions in Cambodia to families from the perspectives of parents of adults who died of AIDS or currently receive antiretroviral therapy. Survey evidence and open-ended interviews revealed a mixture of reactions with respect to social relations, interactions with local officials, gossip, business patronage, funeral participation, and orphaned grandchildren. Positive support was often dominant, and reactions typically improved substantially over time. Misplaced fears of contagion through casual contact underlay most negative reactions. Moral condemnation or blame was not evident as a source of negative reactions. Overall, a sufficiently supportive atmosphere likely exists in many localities to facilitate community-based efforts to mitigate the epidemic’s impact on affected families.

Financial Transfers to Husbands' and Wives' Elderly Mothers in Mexico: Do Couples Exhibit Preferential Treatment by Lineage?

Noel-Miller, C., Tfaily, R. — Wed, 30 Sep 2009 10:35:36 PDT

The aim of this study was to contrast the likelihood that a husband’s elderly mother receives financial assistance from a couple with that of a wife’s mother. Prior U.S.-based research has documented a strong bias toward transfers to wives’ parents.The authors aimed to extend this literature to Mexico, where financial help from adult children is a critical source of support for a rapidly aging population lacking institutional assistance. The authors’ approach to modeling competition between mothers accounted for the nature of their need.The results demonstrate that among mothers of similar financial need, a husband’s mother is twice as likely to receive financial assistance as a wife’s mother. In contrast, when faced with personal care needs, a wife’s mother is disproportionately favored. These results reflect gender differences in Mexican adult children’s responsibility for family members’ financial and physical well-being.The findings uncover new complexity in the patterns by which couples transfer money to parents of different lineage.

Older Adults Seeking Mental Health Counseling in a NORC

Pickard, J. G., Fengyan Tang, — Wed, 30 Sep 2009 10:35:36 PDT

The authors used the Andersen model to compare older adults’ help seeking from clergy to help seeking from other sources of formal mental health services. Data were from the Naturally Occurring Retirement Community Demonstration Project. Multinomial logistic regression was used to compare sources from which help was sought.The results indicate that older adults sought help from clergy more frequently than from other formal sources. Increased stress levels, higher intrinsic religiosity, and being younger were related to seeking help from clergy. Greater stress and attendance at religious services were related to help seeking from other sources. Only greater frequency of attending religious services was associated with a greater likelihood of seeking help from clergy versus other formal providers.The increasing elderly population and the attendant crisis in mental health services might best be addressed through public-private partnerships in which mental health professionals assist clergy in identifying problems and making appropriate referrals.

Stress and Depression Among the Oldest-Old: A Longitudinal Analysis

Jeon, H.-S., Dunkle, R. E. — Wed, 30 Sep 2009 10:35:36 PDT

Stress and psychosocial resources play a crucial role in late-life depression. While most studies focus on predominantly those who are young-old, this study used a sample aged 85 and older.The authors’ study aims to examine three research questions: (1) What are the trajectories of depression and its associated factors such as types of stress and psychosocial resources among the oldest-old? (2) What are the longitudinal relationships among the changes in stress, psychosocial resources, and depressive symptoms? (3) Are the effects of the changes in stress on depression trajectory mediated by changes in psychosocial resources? The study used a convenience sample of 193 community-dwelling elders aged 85 and older with four interviews every six months from 1986 to 1988. Using multilevel modeling analyses, longitudinal results showed that changes in positive life events, daily hassles (worries), and mastery were significantly associated with changes in late-life depression among the oldest-old.

Racial-Ethnic Differences in Subjective Survival Expectations for the Retirement Years

Roebuck Bulanda, J., Zhenmei Zhang, — Wed, 30 Sep 2009 10:35:36 PDT

Prior research finds a race anomaly in subjective life expectancy such that Blacks expect to live longer than Whites even though their actual life expectancy is lower, but it does not include other racial-ethnic groups. Using data from the 1998 Health and Retirement Study (n = 8,077), the authors find that the race anomaly in subjective survival expectations can be extended to Mexican Americans: Mexican Americans, regardless of their nativity, expect a lower chance of living to ages 75 and 85 than do Whites net of age and gender even though their actual life expectancy is higher. In addition, foreign-born Mexican Americans expect a lower chance of survival to older ages than native-born Mexican Americans, which is also opposite of actual mortality patterns.We also find that education and wealth interact with race-ethnicity to influence subjective survival expectations.

Acknowledgments

Wed, 30 Sep 2009 10:35:36 PDT

The Impact of Late-Life Parental Death on Adult Sibling Relationships: Do Parents' Advance Directives Help or Hurt?

Khodyakov, D., Carr, D. — Fri, 24 Jul 2009 14:34:02 PDT

The authors examined whether the effect of parental death on adults siblings' relationship quality varies on the basis of the presence and perceived effectiveness of a deceased parent's formal preparations for end-of-life care. The authors used data from the Wisconsin Longitudinal Study and focused on the relationship quality of a bereaved adult child and his or her randomly selected sibling. Parental death was associated with a decrease in sibling closeness. The parent's use of advance directives (living will and durable power of attorney for health care) did not have uniformly positive effects on adult siblings' relationship quality. Sibling relationships suffered when the living will was believed to "cause problems," but relationships improved when the deceased parent named someone other than his or her spouse or a child as durable power of attorney for health care. The authors discuss the implications for developing effective end-of-life preparations that benefit both the decedent and surviving kin.

Early Retirement in the Three Types of Welfare States

Kim, J. — Fri, 24 Jul 2009 14:34:02 PDT

The main purpose of this study was to examine the labor force participation rate of 55- to 64-year-olds across countries and by gender on the basis of Esping-Andersen's typology of welfare states. The author investigated the influence of a country's socioeconomic characteristics on work participation using data from nine Organisation for Economic Co-operation and Development countries from 1984 to 2001. The results show that classifying countries according to Esping-Andersen's typology provides insight into how a set of country-level socioeconomic conditions and policies may influence individual work decisions. The results also show that men and women respond differently to economic and demographic changes at the country level. Conclusions imply that policy interventions to reverse patterns of early retirement need to consider country-level economic and demographic characteristics and their interaction, along with policies that would change financial incentives facing individuals.

Bridge Jobs: A Comparison Across Cohorts

Giandrea, M. D., Cahill, K. E., Quinn, J. F. — Fri, 24 Jul 2009 14:34:02 PDT

Are today's retirees following in the footsteps of their older peers with respect to gradual retirement? Recent evidence from the Health and Retirement Study (HRS) suggests that most older Americans with full-time career jobs late in life moved to other jobs prior to complete labor force withdrawal. The authors explored the retirement patterns of two cohorts of individuals from the HRS. One group (the war babies) was born between 1942 and 1947 and therefore aged 59 to 64 years at the time of their fifth biennial HRS interviews in 2006. The others (the original HRS respondents) were aged 59 to 64 in 2000 and therefore 6 years older. The war babies have followed the gradual-retirement trends of their predecessors. Traditional one-step retirement appears to be fading as the effects of changes in the retirement environment continue to unfold.

Marital History, Race, and Social Security Spouse and Widow Benefit Eligibility in the United States

Tamborini, C. R., Iams, H. M., Whitman, K. — Fri, 24 Jul 2009 14:34:02 PDT

Large-scale changes in American family structures over the past decades have important implications for the retirement experiences of women. In this study, the authors use a restricted-use file of the Marital History Module of the U.S. Census Bureau's Survey of Income and Program Participation to investigate changes in the marital histories of women aged 40 to 69 years between 1990 and 2004, with a focus on outcomes relevant for Social Security spouse and widow benefit eligibility. Multinomial and binary logistic regression analyses show significant changes in women's marital patterns since 1990, with more substantial shifts occurring among recent cohorts. Due to downward trends in marriage, the authors find a modest decline in Social Security spouse and widow benefit eligibility in 2004, particularly among Black women born toward the end of the baby boom generation.

The Lifelong Mortality Risks of World War II Experiences

Elder, G. H., Clipp, E. C., Brown, J. S., Martin, L. R., Friedman, H. S. — Tue, 02 Jun 2009 14:31:00 PDT

In this longitudinal study of American veterans, the authors investigated the mortality risks of five World War II military experiences (e.g., combat exposure) and their variation among veterans in the postwar years. The male subjects (n = 854) were members of the Stanford-Terman study, and 38% served in World War II. Cox models (proportional-hazards regressions) were used to compare the relative mortality risk associated with each military experience. Overseas duty, service in the Pacific theater, and exposure to combat significantly increased the mortality risks of veterans in the study. Individual differences in education, mental health in 1950, and age at entry into the military, as well as personality factors, made no difference in these results. In conclusion, a gradient was observed such that active duty on the home front, followed by overseas duty, service in the Pacific, and combat exposure, markedly increased the risk for relatively early mortality. Potential linking mechanisms include heavy drinking.

Old-Age Wealth in Mexico: The Role of Reproductive, Human Capital, and Employment Decisions

Wong, R., DeGraff, D. S. — Tue, 02 Jun 2009 14:31:00 PDT

The authors examined relationships between the wealth of older adults and their early-life decisions regarding investment in human capital, family formation, and work activities in Mexico, using the 2001 Mexican Health and Aging Study. The authors examined correlates of accumulated financial wealth by gender and across three age cohorts: 50 to 59, 60 to 69, and 70 years or older. The authors outline the changing context these cohorts experienced during their lifetimes; describe patterns of net financial worth by main covariates across groups defined by age, sex, and marital status; and present the results of multivariate models of net worth. Simulations were conducted to illustrate patterns of net worth associated with alternative scenarios depicting differing representative combinations of life-course characteristics by age cohort. The findings suggest that old-age financial wealth in Mexico is more closely associated with family formation and human capital decisions than with employment decisions over the lifetime.

Organizational Religious Behavior Among Older African Americans: Findings From the National Survey of American Life

Tue, 02 Jun 2009 14:31:00 PDT

The authors used data from the older African American subsample of the National Survey of American Life (n = 837) to examine the sociodemographic and denominational correlates of organizational religious involvement among older African Americans. Six measures of organizational religious participation were used, including two measures of time allocation for organized religious pursuits. Significant gender, regional, marital status, and denominational differences in organizational religiosity were found. Of particular note, although older Black women generally displayed higher levels of religious participation, older Black men spent more hours per week in other activities at their places of worship. The findings are discussed in relation to prior work in the area of religious involvement among older adults. New directions for research on religious time allocation are outlined.

Do Older Adults Know Their Spouses' End-of-Life Treatment Preferences?

Moorman, S. M., Hauser, R. M., Carr, D. — Tue, 02 Jun 2009 14:31:00 PDT

When terminally ill patients become mentally incapacitated, their surrogates often make treatment decisions in collaboration with health care providers. The authors examined how surrogates' errors in reporting their spouses' preferences are affected by their gender, status as durable power of attorney for health care (DPAHC), whether they and their spouses discussed end-of-life preferences, and their spouses' health status. Structural equation models were applied to data from married couples in their mid-60s from the 2004 wave of the Wisconsin Longitudinal Study. Surrogates reported their spouses' preferences incorrectly 13% and 26% of the time in end-of-life scenarios involving cognitive impairment and physical pain, respectively. Surrogates projected their own preferences onto their spouses'. Similar patterns emerged regardless of surrogate gender and status as DPAHC, marital discussions about end-of-life preferences, or spousal health status. Implications for the process of surrogate decision making and for future research are discussed.