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Retirement Study (retirement + study)
Selected AbstractsReduction of quantity smoked predicts future cessation among older smokersADDICTION, Issue 1 2004Tracy Falba ABSTRACT Aim To examine whether smokers who reduce their quantity of cigarettes smoked between two periods are more or less likely to quit subsequently. Study design Data come from the Health and Retirement Study, a nationally representative survey of older Americans aged 51,61 in 1991 followed every 2 years from 1992 to 1998. The 2064 participants smoking at baseline and the first follow-up comprise the main sample. Measurements Smoking cessation by 1996 is examined as the primary outcome. A secondary outcome is relapse by 1998. Spontaneous changes in smoking quantity between the first two waves make up the key predictor variables. Control variables include gender, age, education, race, marital status, alcohol use, psychiatric problems, acute or chronic health problems and smoking quantity. Findings Large (over 50%) and even moderate (25,50%) reductions in quantity smoked between 1992 and 1994 predict prospectively increased likelihood of cessation in 1996 compared to no change in quantity (OR 2.96, P < 0.001 and OR 1.61, P < 0.01, respectively). Additionally, those who reduced and then quit were somewhat less likely to relapse by 1998 than those who did not reduce in the 2 years prior to quitting. Conclusions Reducing successfully the quantity of cigarettes smoked appears to have a beneficial effect on future cessation likelihood, even after controlling for initial smoking level and other variables known to impact smoking cessation. These results indicate that the harm reduction strategy of reduced smoking warrants further study. [source] How Did the Elimination of the US Earnings Test above the Normal Retirement Age Affect Labour Supply Expectations?,FISCAL STUDIES, Issue 2 2008Pierre-Carl Michaud H55; J22 Abstract We look at the effect of the 2000 repeal of the earnings test above the normal retirement age (NRA) on the self-reported probabilities of working full-time after ages 65 and 62 of male workers in the US Health and Retirement Study (HRS). Using administrative records on social security benefit entitlements linked to the HRS survey data, we can distinguish groups of respondents according to the predicted effect of the earnings test before its repeal on their marginal wage rate after the NRA. We use panel data models with fixed and random effects to investigate the effect of the repeal. We find that male workers whose predicted marginal wage rate increased because the earnings test was repealed had the largest increase in the subjective probability of working full-time after age 65. We find no significant effects of the repeal on the subjective probability of working full-time past age 62. [source] The Onset of Health Problems and the Propensity of Workers to Change Employers and OccupationsGROWTH AND CHANGE, Issue 3 2003Jodi Messer Pelkowski Although many studies have investigated how poor health affects hours of work and labor force participation, few have examined the extent to which individuals adapt in order to remain in the labor market. Individuals experiencing health problems may move to different types of work in order to remain in the labor force or to reduce the negative labor market consequences of illness. This paper investigates the movement between employers, and among occupation categories when changing employers, using data from the Health and Retirement Study (HRS). One advantage of the HRS is that its questions on life-cycle employment and health patterns permit a long-term perspective on job mobility that is unavailable in most other datasets. Workers with health problems are more likely than healthy workers to remain with their current employer than to switch employers. But among those who switch employers, those with health problems are more likely to change broad occupational categories than are healthy workers. While many individuals remain with the same employer after the onset of health problems, many do switch employers and occupations, even in the presence of ADA legislation. [source] Proximity to death and participation in the long-term care marketHEALTH ECONOMICS, Issue 8 2009France Weaver Abstract The extent to which increasing longevity increases per capita demand for long-term care depends on the degree to which utilization is concentrated at the end of life. We estimate the marginal effect of proximity to death, measured by being within 2 years of death, on the probabilities of nursing home and formal home care use, and we determine whether this effect differs by availability of informal care , i.e. marital status and co-residence with an adult child. The analysis uses a sample of elderly aged 70+from the 1993,2002 Health and Retirement Study. Simultaneous probit models address the joint decisions to use long-term care and co-reside with an adult child. Overall, proximity to death significantly increases the probability of nursing home use by 50.0% and of formal home care use by 12.4%. Availability of informal support significantly reduces the effect of proximity to death. Among married elderly, proximity to death has no effect on institutionalization. In conclusion, proximity to death is one of the main drivers of long-term care use, but changes in sources of informal support, such as an increase in the proportion of married elderly, may lessen its importance in shaping the demand for long-term care. Copyright © 2008 John Wiley & Sons, Ltd. [source] Depression and Retirement in Late Middle-Aged U.S. WorkersHEALTH SERVICES RESEARCH, Issue 2 2008Jalpa A. Doshi Objective. To determine whether late middle-aged U.S. workers with depression are at an increased risk for retirement. Data Source. Six biennial waves (1992,2002) of the Health and Retirement Study, a nationally representative panel survey of noninstitutionalized 51,61-year-olds and their spouses started in 1992. Study Design. Workers aged 53,58 years in 1994 were followed every 2 years thereafter, through 2002. Depression was coded as lagged time-dependent variables measuring active depression and severity of depression. The main outcome variable was a transition to retirement which was measured using two distinct definitions to capture different stages in the retirement process: (1) Retirement was defined as a transition out of the labor force in the sample of all labor force participants (N=2,853); (2) In addition a transition out of full time work was used as the retirement definition in the subset of labor force participants who were full time workers (N=2,288). Principal Findings. In the sample of all labor force participants, the presence of active depression significantly increased the hazard of retirement in both late middle-aged men (adjusted OR: 1.37 [95 percent CI 1.05, 1.80]) and women (adjusted OR: 1.40 [95 percent CI 1.10, 1.78]). For women, subthreshold depression was also a significant predictor of retirement. In the sample of full time workers, the relationship between depression and retirement was considerably weaker for women yet remained strong for men. Conclusions. Depression and depressive symptoms were significantly associated with retirement in late middle-aged U.S. workers. Policymakers must consider the potentially adverse impact of these labor market outcomes when estimating the cost of untreated depression and evaluating the value of interventions to improve the diagnosis and treatment of depression. [source] Length of Stay for Older Adults Residing in Nursing Homes at the End of LifeJOURNAL OF AMERICAN GERIATRICS SOCIETY, Issue 9 2010Anne Kelly MSW OBJECTIVES: To describe lengths of stay of nursing home decedents. DESIGN: Retrospective cohort study. SETTING: The Health and Retirement Study (HRS), a nationally representative survey of U.S. adults aged 50 and older. PARTICIPANTS: One thousand eight hundred seventeen nursing home residents who died between 1992 and 2006. MEASUREMENTS: The primary outcome was length of stay, defined as the number of months between nursing home admission and date of death. Covariates were demographic, social, and clinical factors drawn from the HRS interview conducted closest to the date of nursing home admission. RESULTS: The mean age of decedents was 83.3±9.0; 59.1% were female, and 81.5% were white. Median and mean length of stay before death were 5 months (interquartile range 1,20) and 13.7±18.4 months, respectively. Fifty-three percent died within 6 months of placement. Large differences in median length of stay were observed according to sex (men, 3 months vs women, 8 months) and net worth (highest quartile, 3 months vs lowest quartile, 9 months) (all P<.001). These differences persisted after adjustment for age, sex, marital status, net worth, geographic region, and diagnosed chronic conditions (cancer, hypertension, diabetes mellitus, lung disease, heart disease, and stroke). CONCLUSION: Nursing home lengths of stay are brief for the majority of decedents. Lengths of stay varied markedly according to factors related to social support. [source] Depressive Symptoms in Middle Age and the Development of Later-Life Functional Limitations: The Long-Term Effect of Depressive SymptomsJOURNAL OF AMERICAN GERIATRICS SOCIETY, Issue 3 2010Kenneth E. Covinsky MD OBJECTIVES: To determine whether middle-aged persons with depressive symptoms are at higher risk for developing activity of daily living (ADL) and mobility limitations as they advance into older age than those without. DESIGN: Prospective cohort study. SETTING: The Health and Retirement Study (HRS), a nationally representative sample of people aged 50 to 61. PARTICIPANTS: Seven thousand two hundred seven community living participants in the 1992 wave of the HRS. MEASUREMENTS: Depressive symptoms were measured using the 11-item Center for Epidemiologic Studies Depression Scale (CES-D 11), with scores of 9 or more (out of 33) classified as significant depressive symptoms. Difficulty with five ADLs and basic mobility tasks (walking several blocks or up one flight of stairs) was measured every 2 years through 2006. The primary outcome was persistent difficulty with ADLs or mobility, defined as difficulty in two consecutive waves. RESULTS: Eight hundred eighty-seven (12%) subjects scored 9 or higher on the CES-D 11 and were classified as having significant depressive symptoms. Over 12 years of follow-up, subjects with depressive symptoms were more likely to reach the primary outcome measure of persistent difficulty with mobility or difficulty with ADL function (45% vs 23%, Cox hazard ratio (HR)=2.33, 95% confidence interval (CI)=2.06,2.63). After adjusting for age, sex, measures of socioeconomic status, comorbid conditions, high body mass index, smoking, exercise, difficulty jogging 1 mile, and difficulty climbing several flights of stairs, the risk was attenuated but still statistically significant (Cox HR=1.44, 95% CI=1.25,1.66). CONCLUSION: Depressive symptoms independently predict the development of persistent limitations in ADLs and mobility as middle-aged persons advance into later life. Middle-aged persons with depressive symptoms may be at greater risk for losing their functional independence as they age. [source] Association Between Cognitive Function and Social Support with Glycemic Control in Adults with Diabetes MellitusJOURNAL OF AMERICAN GERIATRICS SOCIETY, Issue 10 2009Toru Okura MD OBJECTIVES: To examine whether cognitive impairment in adults with diabetes mellitus is associated with worse glycemic control and to assess whether level of social support for diabetes mellitus care modifies this relationship. DESIGN: Cross-sectional analysis. SETTING: The 2003 Health and Retirement Study (HRS) Mail Survey on Diabetes and the 2004 wave of the HRS. PARTICIPANTS: Adults aged 50 and older with diabetes mellitus in the United States (N=1,097, mean age 69.2). MEASUREMENTS: Glycosylated hemoglobin (HbA1c) level; cognitive function, measured with the 35-point HRS cognitive scale (HRS-cog); sociodemographic variables; duration of diabetes mellitus; depressed mood; social support for diabetes mellitus care; self-reported knowledge of diabetes mellitus; treatments for diabetes mellitus; components of the Total Illness Burden Index related to diabetes mellitus; and functional limitations. RESULTS: In an ordered logistic regression model for the three ordinal levels of HbA1c (<7.0, 7.0,7.9, ,8.0 mg/dL), respondents with HRS-cog scores in the lowest quartile had significantly higher HbA1c levels than those in the highest cognitive quartile (adjusted odds ratio=1.80, 95% confidence interval=1.11,2.92). A high level of social support for diabetes mellitus care modified this association; for respondents in the lowest cognitive quartile, those with high levels of support had significantly lower odds of having higher HbA1c than those with low levels of support (1.11 vs 2.87, P=.02). CONCLUSION: Although cognitive impairment was associated with worse glycemic control, higher levels of social support for diabetes mellitus care ameliorated this negative relationship. Identifying the level of social support available to cognitively impaired adults with diabetes mellitus may help to target interventions for better glycemic control. [source] Functional Limitations, Socioeconomic Status, and All-Cause Mortality in Moderate Alcohol DrinkersJOURNAL OF AMERICAN GERIATRICS SOCIETY, Issue 6 2009Sei J. Lee MD OBJECTIVES: To determine whether the survival benefit associated with moderate alcohol use remains after accounting for nontraditional risk factors such as socioeconomic status (SES) and functional limitations. DESIGN: Prospective cohort. SETTING: The Health and Retirement Study (HRS), a nationally representative study of U.S. adults aged 55 and older. PARTICIPANTS: Twelve thousand five hundred nineteen participants were enrolled in the 2002 wave of the HRS. MEASUREMENTS: Participants were asked about their alcohol use, functional limitations (activities of daily living, instrumental activities of daily living, and mobility), SES (education, income, and wealth), psychosocial factors (depressive symptoms, social support, and the importance of religion), age, sex, race and ethnicity, smoking, obesity, and comorbidities. Death by December 31, 2006, was the outcome measure. RESULTS: Moderate drinkers (1 drink/d) had a markedly more-favorable risk factor profile, with higher SES and fewer functional limitations. After adjusting for demographic factors, moderate drinking (vs no drinking) was strongly associated with less mortality (odds ratio (OR)=0.50, 95% confidence interval (CI)=0.40,0.62). When traditional risk factors (smoking, obesity, and comorbidities) were also adjusted for, the protective effect was slightly attenuated (OR=0.57, 95% CI=0.46,0.72). When all risk factors including functional status and SES were adjusted for, the protective effect was markedly attenuated but still statistically significant (OR=0.72, 95% CI=0.57,0.91). CONCLUSION: Moderate drinkers have better risk factor profiles than nondrinkers, including higher SES and fewer functional limitations. Although these factors explain much of the survival advantage associated with moderate alcohol use, moderate drinkers maintain their survival advantage even after adjustment for these factors. [source] The Co-Occurrence of Chronic Diseases and Geriatric Syndromes: The Health and Retirement StudyJOURNAL OF AMERICAN GERIATRICS SOCIETY, Issue 3 2009Pearl G. Lee MD OBJECTIVES: To analyze the co-occurrence, in adults aged 65 and older, of five conditions that are highly prevalent, lead to substantial morbidity, and have evidence-based guidelines for management and well-developed measures of medical care quality. DESIGN: Secondary data analysis of the 2004 wave of the Health and Retirement Study (HRS). SETTING: Nationally representative health interview survey. PARTICIPANTS: Respondents in the 2004 wave of the HRS aged 65 and older. MEASUREMENTS: Self-reported presence of five index conditions (three chronic diseases (coronary artery disease, congestive heart failure, and diabetes mellitus) and two geriatric syndromes (urinary incontinence and injurious falls)) and demographic information (age, sex, race, living situation, net worth, and education). RESULTS: Eleven thousand one hundred thirteen adults, representing 37.1 million Americans aged 65 and older, were interviewed. Forty-five percent were aged 76 and older, 58% were female, 8% were African American, and 4% resided in a nursing home. Respondents with more conditions were older and more likely to be female, single, and residing in a nursing home (all P<.001). Fifty-six percent had at least one of the five index conditions, and 23% had two or more. Of respondents with one condition, 20% to 55% (depending on the index condition) had two or more additional conditions. CONCLUSION: Five common conditions (3 chronic diseases, 2 geriatric syndromes) often co-occur in older adults, suggesting that coordinated management of comorbid conditions, both diseases and geriatric syndromes, is important. Care guidelines and quality indicators, rather than considering one condition at a time, should be developed to address comprehensive and coordinated management of co-occurring diseases and geriatric syndromes. [source] The Relationship Between Self-Rated Health and Mortality in Older Black and White AmericansJOURNAL OF AMERICAN GERIATRICS SOCIETY, Issue 10 2007Sei J. Lee MD OBJECTIVES: To determine whether the association between self-rated health (SRH) and 4-year mortality differs between black and white Americans and whether education affects this relationship. DESIGN: Prospective cohort. SETTING: Communities in the United States. PARTICIPANTS: Sixteen thousand four hundred thirty-two subjects (14,004 white, 2,428 black) enrolled in the 1998 wave of the Health and Retirement Study (HRS), a population-based study of community-dwelling U.S. adults aged 50 and older. MEASUREMENTS: Subjects were asked to self-identify their race and their overall health by answering the question, "Would you say your health is excellent, very good, good, fair, or poor?" Death was determined according to the National Death Index. RESULTS: SRH is a much stronger predictor of mortality in whites than blacks (c -statistic 0.71 vs 0.62). In whites, poor SRH resulted in a markedly higher risk of mortality than excellent SRH (odds ratio (OR)=10.4, 95% confidence interval (CI)=8.0,13.6). In blacks, poor RSH resulted in a much smaller increased risk of mortality (OR=2.9, 95% CI=1.5,5.5). SRH was a stronger predictor of death in white and black subjects with higher levels of education, but differences in education could not account for the observed race differences in the prognostic effect of SRH. CONCLUSION: This population-based study found that the relationship between SRH and mortality is stronger in white Americans and in subjects with higher levels of education. Because the association between SRH and mortality appears weakest in traditionally disadvantaged groups, SRH may not be the best measure to identify vulnerable older subjects. [source] Setting Eligibility Criteria for a Care-Coordination BenefitJOURNAL OF AMERICAN GERIATRICS SOCIETY, Issue 12 2005Christine T. Cigolle MD Objectives: To examine different clinically relevant eligibility criteria sets to determine how they differ in numbers and characteristics of individuals served. Design: Cross-sectional analysis of the 2000 wave of the Health and Retirement Study (HRS), a nationally representative longitudinal health interview survey of adults aged 50 and older. Setting: Population-based cohort of community-dwelling older adults, subset of an ongoing longitudinal health interview survey. Participants: Adults aged 65 and older who were respondents in the 2000 wave of the HRS (n=10,640, representing approximately 33.6 million Medicare beneficiaries). Measurements: Three clinical criteria sets were examined that included different combinations of medical conditions, cognitive impairment, and activity of daily living/instrumental activity of daily living (ADL/IADL) dependency. Results: A small portion of Medicare beneficiaries (1.3,5.8%) would be eligible for care coordination, depending on the criteria set chosen. A criteria set recently proposed by Congress (at least four severe complex medical conditions and one ADL or IADL dependency) would apply to 427,000 adults aged 65 and older in the United States. Criteria emphasizing cognitive impairment would serve an older population. Conclusion: Several criteria sets for a Medicare care-coordination benefit are clinically reasonable, but different definitions of eligibility would serve different numbers and population groups of older adults. [source] Selection correction and sensitivity analysis for ordered treatment effect on count responseJOURNAL OF APPLIED ECONOMETRICS, Issue 3 2004Myoung-Jae Lee In estimating the effect of an ordered treatment , on a count response y with an observational data where , is self-selected (not randomized), observed variables x and unobserved variables , can be unbalanced across the control group (, = 0) and the treatment groups (, = 1, ,, J). While the imbalance in x causes ,overt bias' which can be removed by controlling for x, the imbalance in , causes ,covert (hidden or selection) bias' which cannot be easily removed. This paper makes three contributions. First, a proper counter-factual causal framework for ordered treatment effect on count response is set up. Second, with no plausible instrument available for ,, a selection correction approach is proposed for the hidden bias. Third, a nonparametric sensitivity analysis is proposed where the treatment effect is nonparametrically estimated under no hidden bias first, and then a sensitivity analysis is conducted to see how sensitive the nonparametric estimate is to the assumption of no hidden bias. The analytic framework is applied to data from the Health and Retirement Study: the treatment is ordered exercise levels in five categories and the response is doctor office visits per year. The selection correction approach yields very large effects, which are however ruled out by the nonparametric sensitivity analysis. This finding suggests a good deal of caution in using selection correction approaches. Copyright © 2004 John Wiley & Sons, Ltd. [source] Consequences of Parental Divorce for Adult Children's Support of Their Frail ParentsJOURNAL OF MARRIAGE AND FAMILY, Issue 1 2008I-Fen Lin Using three waves of data from the Health and Retirement Study, I examined the association of parental divorce and remarriage with the odds that biological, adult children give personal care and financial assistance to their frail parents. The analysis included 5,099 adult children in the mother sample and 4,029 children in the father sample. Results indicate that adult children of divorced parents are just as likely as adult children of widowed parents to give care and money to their mothers, but the former are less likely than the latter to care for their fathers. The findings suggest that divorced fathers are prone to be the population most in need of formal support in old age. [source] Dental care coverage and retirementJOURNAL OF PUBLIC HEALTH DENTISTRY, Issue 1 2010Richard J. Manski DDS Abstract Objectives: To examine the convergence of an aging population and a decreased availability of dental care coverage using data from the Health and Retirement Study (HRS). Methods: We calculate national estimates of the number and characteristics of those persons age 51 years and above covered by dental insurance by labor force, retirement status, and source of coverage. We also estimate a multivariate model controlling for potentially confounding variables. Results: We show that being in the labor force is a strong predictor of having dental coverage. For older retired adults not in the labor force, the only source for dental coverage is either a postretirement health benefit or spousal coverage. Conclusions: Dental care, generally not covered in Medicare, is an important factor in the decision to seek dental care. It is important to understand the relationship between retirement and dental coverage in order to identify the best ways of improving oral health and access to care among older Americans. [source] Mortality Heterogeneity and the Distributional Consequences of Mandatory AnnuitizationJOURNAL OF RISK AND INSURANCE, Issue 4 2008Guan Gong This article investigates the distributional consequences of mandatory annuitization. Using Health and Retirement Study (HRS) data and accounting for longevity risk pooling within marriage and preannuitized wealth, we find substantial redistribution away from disadvantaged groups in expected utility terms. Using HRS data on subjective survival probabilities, we construct a subjective life table for each individual in the HRS. We calculate the value each household would place on annuitization, based on the husband and wife's subjective life tables, and the household's degree of risk aversion and proportion of preannuitized wealth. A significant minority would perceive themselves as suffering a loss from mandatory annuitization. [source] Effects of Alcohol Consumption on Disability among the Near Elderly: A Longitudinal AnalysisTHE MILBANK QUARTERLY, Issue 4 2001Jan Ostermann Data from four waves of the Health and Retirement Study are used to analyze the effects of alcohol use on disability, mortality, and income transfers from public programs. Cross-sectional analysis reveals a complex relationship, with a history of problem drinking clearly leading to higher rates of limitations, and a nonmonotonic relationship between current drinking and disability. In longitudinal analysis, problem drinking was predictive of disability onset, but not of transfer receipt or mortality. Heavy drinkers and problem drinkers, if anything, were less likely to receive public income support than abstainers or moderate drinkers. The likelihood that heavy drinkers received public transfers did not decrease relative to others following statutory changes in 1996 that sought to limit eligibility of alcoholics and drug abusers. [source] Subjective mortality expectations and consumption and saving behaviours among the elderlyCANADIAN JOURNAL OF ECONOMICS, Issue 3 2010Martin Salm Abstract Life expectancy is an important factor that individuals have to take into account for saving and consumption choices. The life-cycle model of consumption and saving behaviour predicts that consumption growth should decrease with higher mortality rates. The aim of this study is to test this hypothesis based on data about subjective longevity expectations from the Health and Retirement Study merged with detailed consumption data from two waves of the Consumption and Activities Mail Survey. This study finds that an increase in subjective mortality by 1% corresponds to an annual decrease in consumption of non-durable goods of around 1.8%. L'espérance de vie est un facteur important dont les personnes doivent tenir compte dans leurs choix de consommation et d'épargne. Le modèle de comportement de consommation et d'épargne au cours du cycle de vie prédit que la croissance de la consommation devrait décroître à mesure que le taux de mortalité augmente. Cette étude met au test cette hypothèse à l'aide de données sur l'espérance de vie subjective tirées des résultats d'une étude sur la santé et la retraite arrimés aux résultats de deux vagues d'enquêtes postales sur la consommation et les activités qui ont produit des données détaillées sur la consommation. Cette étude montre qu'un accroissement de un pour cent dans l'anticipation subjective de mortalité correspond à un déclin d'à peu près 1.8% dans la consommation annuelle de biens non durables. [source] | ||||||||||||||||