Ruth E. Dunkle

The Relationship Between the Trajectory of Body Mass Index and Health Trajectory Among Older Adults Multilevel Modeling Analyses

Little is known about the cross-sectional or longitudinal relationships between body weight and health at older ages. Using multilevel modeling analyses, this study examined the trajectories of body mass index (BMI), chronic health conditions (CHC), and functional disability (FD); factors associated with the trajectories; and the relationships between the trajectories. The sample of elders aged 65 and older participated in the Americans Changing Lives longitudinal study. Participants showed decreasing BMI and increasing CHCand FD with time. Current smokers presented lowerBMI at Wave 1 and showed a slower decrease inBMIover time than those who never smoked. Obesity was associated with more CHC and greater FDatWave 1 but did not influence their changes. Elders who experienced a slower decrease in BMI showed a slower increase in CHC and FD; the change in health was not related to the change in BMI.

Age-Friendly Environments and Self-Rated Health: An Exploration of Detroit Elders

While a number of organizations and government entities have encouraged the development of more “age-friendly” environments, to date there has been limited research linking these environment features to elder outcomes. Using a representative sample of older adults living in Detroit, this study examined the association between age-friendly environment factors and self-rated health. Results indicated that access to health care, social support, and community engagement were each associated with better self-rated health, while neighborhood problems were associated with poorer self-rated health. Moreover, individual-level income and education no longer predicted self-rated health once age-friendly environment factors were taken into account. These findings highlight the need for more research documenting the effects of age-friendly environments, particularly across diverse contexts and populations.

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

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.

Do Age-Friendly Characteristics Influence the Expectation to Age in Place? A Comparison of Low-Income and Higher Income Detroit Elders

Currently there is limited evidence linking age-friendly characteristics to outcomes in elders. Using a representative sample of 1,376 adults aged 60 and older living in Detroit, this study examined the association between age-friendly social and physical environmental characteristics and the expectation to age in place, and the potential differences between low- and higher-income elders. Based on U.S. Environmental Protection Agency’s (EPA) age-friendly guide, we identified six factors reflecting age-friendly characteristics. Logistic regression models indicated that regardless of income level only neighborhood problems were significantly associated with expecting to age in place. Low-income elders were more likely to expect to age in place than their higher-income counterparts, and it is unclear whether this resulted from a desire to remain in the home or that there is no place else to go. Future research should address the ways in which financial resources affect the choices, expectations, and outcomes of aging in place.

Social network types and well-being among South Korean older adults

Objective: The social networks of older individuals reflect personal life history and cultural factors. Despite these two sources of variation, four similar network types have been identified in Europe, North America, Japan, and China: namely ‘restricted’, ‘family’, ‘friend’, and ‘diverse’. This study identified the social network types of Korean older adults and examined differential associations of the network types with well-being. Method: The analysis used data from the 2008 wave of the Korean Longitudinal Study of Aging (KLoSA: N = 4251, age range 65–108). We used a two-step cluster analytical approach to identify network types from seven indicators of network structure and function. Regression models determined associations between network types and well-being outcomes, including life satisfaction and depressive symptomatology. Results: Cluster analysis of indicators of network structure and function revealed four types, including the restricted, friend, and diverse types. Instead of a family type, we found a couple-focused type. The young–old (age 65–74) were more likely to be in the couple-focused type and more of the oldest old (age 85+) belonged to the restricted type. Compared with the restricted network, older adults in all other networks were more likely to report higher life satisfaction and lower depressive symptomatology. Discussion: Life course and cohort-related factors contribute to similarities across societies in network types and their associations with well-being. Korean-specific life course and socio-historical factors, however, may contribute to our unique findings about network types.

Conceptualizing Age-Friendly Community Characteristics in a Sample of Urban Elders: An Exploratory Factor Analysis

Accurate conceptualization and measurement of age-friendly community characteristics would help to reduce barriers to documenting the effects on elders of interventions to create such communities. This article contributes to the measurement of age-friendly communities through an exploratory factor analysis of items reflecting an existing US Environmental Protection Agency policy framework. From a sample of urban elders (n = 1,376), we identified 6 factors associated with demographic and health characteristics: access to business and leisure, social interaction, access to health care, neighborhood problems, social support, and community engagement. Future research should explore the effects of these factors across contexts and populations.

Race/Ethnicity and Marital Status in IADL Caregiver Networks

Racial/ethnic variations in instrumental activities of daily living (IADL) caregiver network composition were examined in a nationally representative sample of elders, using task specificity and hierarchical compensatory theoretical perspectives. Logistic regressions tested network differences among White, Black, and Mexican American elders (n = 531 married, n = 800 unmarried). Findings concerning racial/ethnic differences were partially dependent on marital status, differentiation of spouses from other informal helpers among married elders, and which racial/ethnic groups were compared. Networks including formal caregivers did not differentiate married or unmarried Black from White elders but were more common among unmarried Mexican American elders than for comparable White and Black elders. Married Black elders with solely informal networks were more likely than comparable White elders to have informal helpers other than the spouse. Racial/ethnic similarities and differences in caregiver networks are discussed relative to their sociocultural context, including marital status, elder’s and spouse’s health, and financial resources

“Out of Sight” But Not “Out of Mind”: Parent Contact and Worry Among Senior Ranking Male Officers in the Military Who Live Long Distances From Parents

This study explores variables that influence worry and parent contact among senior military officers who face frequent moves, restricted housing, and overseas assignments, and who have been geographically separated from their parents most of their adult lives. Data on predictors of officer worry and parent contacts were collected from 277 senior ranking male officers (40 to 49 years old). A structural equation model of worry and parent contact among male officers showed that previous parental illness, parent’s age, and the tendency among officers to have an angry temperament increased their worry. Conversely, number of siblings and satisfaction with a “parent care plan” decreased worry about parents. Number of siblings also decreased contact with parents. Quality of interpersonal relationships and branch of service (Army and Marine Corps) increased contacts with parents. This research underscores the importance of examining the invisible “anguish” of adult sons who are precluded from visiting their parents by distance or employment situations, lends quantitative support to previous qualitative findings, and indicates that satisfaction with a realistic parent care plan reduces worries about elderly parents.

Worries, psychosocial resources, and depressive symptoms among the South Korean oldest old

Objectives: Few Korean studies have explored factors that influence depressive symptoms, a condition that is likely to increase with age. This study examines how worries, psychosocial resources, specifically family support, are related to depressive symptoms among a sample of the oldest old in South Korea. The buffering effects of psychosocial resources previously identified as reducing the impact of worries on depression in the younger old age group were also examined. Method: Interviews were conducted with 213 community-dwelling oldest old in Seoul, Korea in 2007. 193 of these had children and were included in the analysis. Multiple regression analysis was used to test the hypotheses. Results: Greater worries were significantly related to greater severity of depressive symptoms among South Korean oldest old. Psychosocial resources including mastery, emotional support from adult children, and instrumental support from adult children had main effects on depressive symptoms. Emotional support from adult children had a powerful buffering effect on the relationship between worries and depressive symptoms. Conclusion: Worries and certain aspects of social support are important in understanding the depressive symptoms of South Korean oldest old. Incorporating filial support into the development of services for this age group could be helpful to treating their symptoms of depression.

Does Gender Moderate Factors Associated With Whether Spouses Are the Sole Providers of IADL Care to Their Partners

The authors explored whether gender moderated the influence of other factors on solo spousal caregiving. The subsample (n = 452) from the Asset and Health Dynamics Among the Oldest Old study included elderly care recipients (CRs) receiving assistance with instrumental activities of daily living (IADLs) and their spouses. Logistic regression was used to model the likelihood of solo spousal IADL care. Gender moderation was tested by product terms between CRs’ gender and measures of partners’ health, potential helpers, and sociodemographic characteristics. As numbers of CRs’ IADLs and couples’ proximate daughters increased, wives less often received care solely from their husbands, but husbands’ receipt of care from their wives was unaffected. Age differences between spouses and CRs affected solo spousal caregiving to wives and husbands in opposite ways. Regardless of gender, CRs’ numbers of limitations in activities of daily living and spouses with limitations in IADLs or activities of daily living reduced the likelihood of solo spouse care. Identifying circumstances influencing solo spouse caregiving differently among couples with frail wives and husbands facilitates gender-sensitive services.