What Do We Mean by Accumulation? Advancing Conceptual Precision for a Core Idea in Gerontology

Examining the Bidirectional Nature of Loneliness and Anxiety Among Older Adults in Daily Life

OBJECTIVES

Loneliness in later life increases the risk for adverse health outcomes; however, less is known about how loneliness is maintained. Anxiety may play an important role in maintaining loneliness, but little is known about how this connection plays out over time in daily life. This study thus focused on the within-person associations between momentary loneliness and anxiety among older adults.

METHODS

Participants were 317 diverse older adults (40% Black; 13% Hispanic, mean age = 77.45 years, 67% women) systematically recruited from the Bronx, NY, who completed ecological momentary assessments 5 times daily for 14 consecutive days. Multilevel models tested bidirectional contemporaneous, momentary cross-lagged (t - 1), day-level cross-lagged (average day to end of day), and day-to-day cross-lagged associations between loneliness and anxiety. Separate sensitivity analyses controlled for concurrent overall mood valence or depressed state. Gender and mild cognitive impairment (MCI) status were tested as moderators at all timescales.

RESULTS

Significant bidirectional associations between loneliness and anxiety were found at the contemporaneous and momentary cross-lagged (t - 1) timescales. Higher average daily loneliness predicted higher end-of-day anxiety, but not vice versa. Loneliness and anxiety were not significantly associated from day to day. Sensitivity analyses revealed some associations varied depending on inclusion of either concurrent mood valence or depressed state. Neither gender nor MCI status moderated associations at any timescale.

DISCUSSION

Findings shed light on the complex temporal ordering of loneliness and anxiety in daily life and extend contemporary theoretical notions of loneliness, including the possibility of interventions that target key moments in daily life.

Life-course social connectedness: Comparing data-driven and theoretical classifications as predictors of functional limitations in adulthood

A life course perspective on social relationships highlights the importance of specific relationships at specific times in life, but analyses that account for life course trajectories in social relationships are rare. This study compares theoretical and data-driven approaches to classifying life course relationships, including multiple dimensions of social connectedness at different time points across the life course. We examine each approach's ability to predict later-life functional limitations, given that functional impairment is prevalent among middle-aged and older adults. Data were from three waves of the Midlife in the United States (MIDUS) study (n = 6909). Relationship variables (parental affection, parental discipline, social support, social strain, and positive relations with others) were from wave 1 or wave 2. Functional limitations were measured at wave 3. Results showed that the data-driven approach had more predictive power than the theoretical approach. Additionally, results suggested that including only positive relationship features was nearly as robust as including both positive and negative relationship features. Overall, the data-driven approach outperformed the theoretical approach and revealed relationship trajectories consistent with life course cumulative processes.

Occupational social class differences in the impact of COVID-19 related employment disruptions on retirement planning amongst older workers in England

Purpose

This paper aims to examine the impact of COVID-19 related employment disruption on individuals’ retirement planning and whether these experiences differ by occupational social class.

Design/methodology/approach

To explore these issues, this study linked data from those who were employed in wave 9 of the English Longitudinal Study of Ageing (ELSA) main study with wave 1 of the ELSA COVID-19 study (N = 1,797). Multinominal regression analyses were conducted to explore whether the interaction between employment disruption and occupational social class was associated with planning to retire earlier or later than previously planned.

Findings

The results show that stopping work because of COVID-19 is associated with planning to retire earlier. However, there were no statistically significant interactions between occupational social class and employment disruptions on whether respondents planned to retire earlier or later.

Originality/value

This paper’s original contribution is in showing that the pandemic has had an impact on retirement decisions. Given the known negative effects of both involuntary early labour market exit, the findings suggest that the COVID-19 related employment disruptions are likely to exacerbate social inequalities in health, well-being in later life and, consequently, can help anticipate where there will be need for additional support in later life.

Disciplinary Roots of 300 Top-Ranked Scientific Contributors to Gerontology: From Legacy to Enriching Our Discovery

Gerontology is viewed by many as a multidisciplinary field of inquiry, but which disciplines have had the greatest impact on research in the field? Combining data from a composite score incorporating multiple citation indicators with information on the highest degree, we examine the disciplinary origins of the 300 top-ranked scholars in gerontology. Despite efforts for gerontology to be distinct from geriatrics, more than 30 percent of the most influential scholars in gerontology during the past 6 decades hold a degree in medicine. Other fields of the leading contributors to gerontology include psychology, sociology, biology, biochemistry, and genetics. Although the disciplinary origins of gerontology will likely shift in the coming decades, we conclude that biomedical sciences are likely to remain core to the development of gerontology. To build on the scientific contributions of leading scholars in gerontology, future research should reflect conceptual precision and scientific innovation while prioritizing methodological rigor and transparency.

Do workers accumulate resources during continuous employment and lose them during unemployment, and what does that mean for their subjective well-being?

Drawing on cumulative advantage/disadvantage and conservation of resources theories, I investigated changes in economic, social, and personal resources and in subjective well-being (SWB) of workers as they stayed continuously employed or continuously unemployed. I considered age, gender, and SES as potential amplifiers of inequality in resources and SWB. Using 28 yearly waves from the German Socio-Economic Panel (SOEP 1985–2012), I conducted multilevel analysis with observations nested within participants. A longer duration of continuous employment predicted slightly higher economic resources and thereby slightly higher SWB over time. A longer organizational tenure had mixed effects on resources and predicted slight reductions in SWB via lower mastery. A longer duration of continuous unemployment predicted marked reductions mainly in economic but also in social resources, which led to modest SWB decreases. Younger workers, women, and workers with higher SES benefited from longer continuous employment and organizational tenure more. At the between-person level, some evidence for self-selection of less resourceful individuals into long-term or repeated unemployment emerged. The highly regulated German labor market and social security system may both dampen the rewards of a strong labor force attachment and buffer against the losses of long-term unemployment.

Evaluating the Cumulative Impact of Childhood Misfortune: A Structural Equation Modeling Approach

Most studies of the early origins of adult health rely on summing dichotomously measured negative exposures to measure childhood misfortune (CM), neglect, adversity, or trauma. There are several limitations to this approach, including that it assumes each exposure carries the same level of risk for a particular outcome. Further, it often leads researchers to dichotomize continuous measures for the sake of creating an additive variable from similar indicators. We propose an alternative approach within the structural equation modeling (SEM) framework that allows differential weighting of the negative exposures and can incorporate dichotomous and continuous observed variables as well as latent variables. Using the Health and Retirement Study data, our analyses compare the traditional approach (i.e., adding indicators) with alternative models and assess their prognostic validity on adult depressive symptoms. Results reveal that parameter estimates using the conventional model likely underestimate the effects of CM on adult health outcomes. Additionally, while the conventional approach inhibits testing for mediation, our model enables testing mediation of both individual CM variables and the cumulative variable. Further, we test whether cumulative CM is moderated by the accumulation of protective factors, which facilitates theoretical advances in life course and social inequality research. The approach presented here is one way to examine the cumulative effects of early exposures while attending to diversity in the types of exposures experienced. Using the SEM framework, this versatile approach could be used to model the accumulation of risk or reward in many other areas of sociology and the social sciences beyond health.

Early Origins of Body Mass in Later Life: Examining Childhood Risks and Adult Pathways

Prior research reveals that negative early-life experiences play a major role in the development of obesity in later life, but few studies identify mechanisms that alter the lifetime risk of obesity. This study examines the influence of negative childhood experiences on body mass index (BMI) and obesity (BMI ≥30) during older adulthood and the psychosocial and behavioral pathways involved. Using a nationally representative sample, we examine the influence of cumulative misfortune as well as five separate domains of misfortune on BMI and obesity. Results show that four of the five domains are associated with BMI and obesity either directly, indirectly, or both. The influence of cumulative misfortune on the outcomes is mediated by three adult factors: socioeconomic status, depressive symptoms, and physical activity. The mediators identified here provide targets for intervention among older adults to help offset the health risks of excess BMI attributable of early-life exposure to misfortune.

Is College Completion Associated with Better Cognition in Later Life for People Who Are the Least, or Most, Likely to Obtain a Bachelor's Degree?

OBJECTIVES

Drawing on insights from theorizing on cumulative dis/advantage (CDA), we aimed to advance understanding of educational attainment as a protective factor for later-life cognition by examining whether associations between obtaining a bachelor's degree and later-life cognition differ according to individuals' likelihood of completing college based on characteristics in adolescence.

METHODS

We conducted a propensity score analysis with data from the Wisconsin Longitudinal Study (WLS). Measures to predict college completion were assessed prospectively in adolescence, and a global measure of later-life cognition was based on cognitive assessments at age 65.

RESULTS

College completion by age 25 (vs high school only) was associated with better later-life cognition for both men and women. Among men specifically, associations were stronger for those who were less likely as adolescents to complete college.

DISCUSSION

Results indicate the utility of a CDA perspective for investigating the implications of interconnected early life risk and protective factors for later-life cognition, as well as ways in which college education can both contribute to, as well as mitigate, processes of CDA.

Cumulative Inequality at the End of Life?: Racial Disparities in Impairment in the Time Before Death

OBJECTIVES

Drawing from cumulative inequality (CI) theory, the current study examined racial disparities in impairment as individuals approached death to determine whether proposed mechanisms hypothesized to fuel or diminish racial disparities at late ages were at work at the end of individualized life spans.

METHOD

Black-white disparities were analyzed among decedents using latent growth curves based on the data from the North Carolina Established Populations for Epidemiologic Studies of the Elderly (EPESE) (N = 1,926).

RESULTS

Consistent with previous literature, racial inequalities in functional disparities diminish at late ages. However, significant black-white disparities emerge as older adults approach death, exponentially increasing within the 2 years immediately preceding death. Further, these disparities are not fully mediated by socioeconomic status.

DISCUSSION

The results confirm that CI in health outcomes is observable in late life among individual life spans, suggesting the years surrounding death may be a particularly vulnerable period for health inequality. Future research should examine how advantaged statuses translate to increased access to health-related resources that aid in maintaining greater functional independence until the last stage of life.

Transpersonal Genetic Effects Among Older U.S. Couples: A Longitudinal Study

BACKGROUND

Emerging social genetics research suggests one's genes may influence not just one's own outcomes but also those of close social alters. Health implications, particularly in late life, remain underexplored. Using combined genetic and survey data, this study examined such transpersonal genetic associations among older U.S. couples.

METHOD

Data were from married or cohabiting couples in the 2006-2016 waves of the Health and Retirement Study, nationally representative of U.S. adults over 50. Measures included a polygenic score for educational attainment, and self-rated health. Analysis was through parallel process latent growth models.

RESULTS

Women's and men's genetic scores for education had transpersonal linkages with their partner's health. Such associations were solely with life-course variations and not late-life change in outcomes. Moreover, they were indirect, mediated by educational attainment itself. Evidence also emerged for individual-level genetic effects mediated by the partner's education.

DISCUSSION

In addition to the subject-specific linkages emphasized in extant genetics literature, relational contexts involve multiple transpersonal genetic associations. These appear to have consequences for a partner's and one's own health. Life-course theory indicates that a person is never not embedded in such contexts, suggesting that these patterns may be widespread. Research is needed on their implications for the life-course and gene-environment correlation literature.

The Impact of Military Service Exposures and Psychological Resilience on the Mental Health Trajectories of Older Male Veterans

Objectives: We examine the impact of exposure to the dead, dying, and wounded (DDW) during military service on the later-life depressive symptom trajectories of male United States veterans, using psychological resilience as an internal resource that potentially moderates negative consequences. Methods: The Health and Retirement Study (2006-2014) and linked Veteran Mail Survey were used to estimate latent growth curve models of depressive symptom trajectories, beginning at respondents' first report of resilience. Results: Veterans with higher levels of resilience do not have increased depressive symptoms in later life, despite previous exposure to DDW. Those with lower levels of resilience and previous exposure to DDW experience poorer mental health in later life. Discussion: Psychological resilience is important for later-life mental health, particularly for veterans who endured potentially traumatic experiences. We discuss the importance acknowledging the role individual resources play in shaping adaptation to adverse life events and implications for mental health service needs.

Early Social Origins of Biological Risks for Men and Women in Later Life

We investigate whether childhood exposures influence adult chronic inflammation and mortality risk via adult health characteristics and socioeconomic status (SES) and whether gender moderates these relationships. Analyzing a longitudinal national sample of 9,310 men and women over age 50, we found that childhood SES, parental behaviors, and adolescent behaviors were associated with adult chronic inflammation via health characteristics and SES in adulthood. The process of disadvantage initiated by low childhood SES (i.e., adult health risk factors, socioeconomic disadvantage, and chronic inflammation) subsequently raised mortality risk. In addition, gender moderated the mediating influence of childhood SES via unhealthy behaviors and parental behaviors via adult SES. Demonstrating how social forces shape biological health through multiple mechanisms informs health policies by identifying multiple points of intervention in an effort to reduce the lasting consequences of childhood disadvantage.

Working conditions mediate the association between social class and physical function in older age in Sweden: a prospective cohort study

Background

Global demographics are changing as societies all over the world are aging. This puts focus on maintaining functional ability and independence into older age. Individuals from lower social classes are at greater risk of developing limitations in physical function later in life. In this study, we investigated the mediating role of working conditions in the association between occupation-based social class and physical function measured as self-reported mobility limitations and objectively measured physical impairment in older age.

Methods

Two Swedish surveys, linked at the individual level, were used (n = 676–814 depending on the outcome). Follow-up time was 20–24 years. Multiple logistic regression analyses were performed with adjustments for age, sex, level of education, mobility, and health problems at baseline. This was followed by analyses of the size of the mediating effect of working conditions.

Results

Working conditions seem to mediate 35–74% of the association between social class and physical impairment in older age. The pattern of mediation was primarily driven by passive jobs, i.e., low psychological demands and low control, among blue-collar workers. Working conditions did not mediate the association between social class and self-reported mobility limitations in older age.

Conclusions

The results of this study indicate that working conditions are important in combating the social gradient in healthy aging, contributing to the evidence regarding the magnitude of impact exerted by both the physical and psychosocial work environment separately and in conjunction.

Childhood Misfortune and Late-Life Stroke Incidence, 2004-2014

BACKGROUND AND OBJECTIVES

Although most strokes occur in later life, recent studies reveal that negative exposures decades earlier are associated with stroke risk. The purpose of this study was to examine whether accumulated and/or specific domains of early misfortune are related to stroke incidence in later life.

RESEARCH DESIGN AND METHODS

A decade of longitudinal data from stroke-free participants 50 years or older in the Health and Retirement Study were analyzed (N = 12,473). Incident stroke was defined as either self-reported first incident stroke or death due to stroke between 2004 and 2014.

RESULTS

Analyses revealed that accumulated misfortune was associated with increased stroke risk, but the relationship was moderated by wealth. Examining specific domains of childhood misfortune revealed that stroke incidence was greater for persons with behavioral/psychological risks, but that this relationship also was moderated by higher wealth for those with only one behavioral/psychological risk.

DISCUSSION AND IMPLICATIONS

Accumulated childhood misfortune and adolescent depression heighten the risk of stroke in later life, but the influence is remediable through adult wealth. Reducing poverty in later life may decrease stroke incidence for persons exposed to negative childhood exposures.

Institutional and Individual Factors Affecting Health and Employment for Low-Income Women With Chronic Health Conditions

OBJECTIVES

This qualitative study explored risk and protective factors affecting employment and health among low-income older women with chronic health conditions or physical disabilities.

METHODS

The authors conducted a secondary data analysis of 14 intensive interviews with low-income older women with chronic health conditions who had participated in a federally funded training and employment program for workers aged 55 and older. Qualitative data were analyzed using thematic analysis.

RESULTS

The physical nature of the work and discrimination were risk factors, with unaccommodating work environments, ageism, and/or ableism, and internalized ageism identified as subthemes of discrimination. Protective factors, namely institutional supports (e.g., access to retraining, time management flexibility) enhanced health and self-confidence. Occupational demands matched with the capacity of the individual resulted in continued employment and improved health.

DISCUSSION

Working conditions can degrade health through exposure to mental and physical health risks, or support health through access to financial and interpersonal resources. Institutional supports such as workplace flexibility and retraining are crucial to obtaining a good fit between occupational demands and the capacity of individuals, enabling a positive relationship between employment and health. Legislation designed to prevent discrimination, enhance opportunities for lifelong learning, and encourage flexible work arrangements among low-income women with chronic health conditions may facilitate healthier working lives.

School Context in Adolescence and Cognitive Functioning 50 Years Later

To advance understanding of how social inequalities from childhood might contribute to cognitive aging, we examined the extent to which school context in adolescence was associated with individuals' cognitive performance more than 50 years later. Using data from 3,012 participants in the Wisconsin Longitudinal Study (WLS), we created an aggregate measure of school-level structural advantage, with indicators such as the proportion of teachers who had at least five years of teaching experience and spending per pupil. Multilevel models indicated that secondary school advantage was associated with small benefits in language/executive function at age 65 among older adults who had lower academic achievement in secondary school. Findings suggest that school advantage is a developmental context of adolescence that has modest implications for intracohort differences in aspects of later life cognition.

The long arm of childhood experiences on longevity: Testing midlife vulnerability and resilience pathways

Adverse early experiences have been associated with higher mortality risk, but evidence varies by type of experiences, and relatively little is known about the role of favorable early experiences on health in later life. This study evaluated the independent contributions to longevity of favorable and unfavorable early experiences, including psychosocial stressors, childhood socioeconomic status (SES), and close relationships. We also examined 4 midlife psychosocial factors as vulnerability and resilience pathways potentially mediating these associations. The sample included 1,042 men from the VA Normative Aging Study. Early experiences were assessed retrospectively in 1961-1970 and 1995. Midlife psychosocial factors were measured in 1985-1991 and included stressful life events (SLEs), negative affect, life satisfaction, and optimism. Mortality was assessed through 2016. In multiple mediator structural equation models, which account for the overlap among pathways, higher number of SLEs in midlife mediated the association of having more childhood psychosocial stressors to reduced longevity, supporting stress continuity as a vulnerability pathway. Higher optimism in midlife also mediated the association of higher childhood SES to greater longevity. In single mediator models, higher life satisfaction in midlife transmitted the benefits of higher childhood SES and presence of close relationships onto longevity. Higher optimism also mediated the association of fewer childhood psychosocial stressors to longevity. However, these indirect effects were attenuated when accounting for shared variance among mediators, suggesting overlapping pathways. Findings offer novel evidence on unique and shared pathways linking specific dimensions of early experiences to longevity. (PsycINFO Database Record (c) 2019 APA, all rights reserved).

Childhood Misfortune, Personality, and Heart Attack: Does Personality Mediate Risk of Myocardial Infarction?

Objective

Previous research has revealed a link between childhood experiences and adult health, but the mechanisms underlying this relationship are less clear. To elucidate this relationship, we investigated the pathway from childhood misfortune to nonfatal myocardial infarction (MI) via individual differences in personality.

Method

Longitudinal data were drawn from the National Survey of Midlife Development in the United States, which sampled 3,032 men and women aged 25-74 years at baseline. Big 5 personality traits and multiple measures of childhood misfortune were used to assess whether personality mediated the effect of childhood misfortune on MI risk.

Results

A series of proportional hazards models revealed that neuroticism mediated the effect of additive childhood misfortune on adult MI risk.

Discussion

Childhood misfortune may be formative in the development of personality, which, subsequently, can be consequential to health. These findings highlight the salient roles of early-life experiences and personality to shape health and aging.

Visions of the Life Course: Risks, Resources, and Vulnerability

Life course studies have ushered in unprecedented scientific interest not only in specific periods of human lives but also in the long-term processes associated with growing older. Studies that link periods of the life course have identified important sources of continuity and discontinuity and highlighted the antecedents of misfortune. Theories and conceptual frameworks have emerged to help scholars splice pieces of the life course together, but the need for conceptual clarity remains. Concepts such as vulnerability and disadvantage are important but used in many different ways by researchers. We pose questions to enhance clarity of these and related terms and call for greater attention to temporal referents in studying the life course. The attention to chronological time-manifest in the identification of age, period, and cohort-is excellent but greater attention to perceptions of time also is needed to better integrate human agency and historical context in studies of life course processes.

Diverse Aging and Health Inequality by Race and Ethnicity

Although gerontologists have long embraced the concept of heterogeneity in theories and models of aging, recent research reveals the importance of racial and ethnic diversity on life course processes leading to health inequality. This article examines research on health inequality by race and ethnicity and identifies theoretical and methodological innovations that are transforming the study of health disparities. Drawing from cumulative inequality theory, we propose greater use of life course analysis, more attention to variability within racial and ethnic groups, and better integration of environmental context into the study of accumulation processes leading to health disparities.

What is new with old? What old age teaches us about inequality and stratification

Aging is remarkably unequal. Who survives to grow old in America and the circumstances they face once there reflect durable racial, socioeconomic, and gender inequalities that structure our lives from birth. Yet within the field of social stratification and mainstream sociology proper, examinations of the rapidly growing population of older Americans are often relegated to a "gerontological" periphery. This essay posits that the failure to place aging as a core concern in stratification and inequality is a missed opportunity. We argue for the importance of reintegrating studies on the stratification of aging and explain why such a move is necessary. Specifically, we posit that (a) examining the aging population is necessary for understanding American inequality because aging is an outcome that is ubiquitous yet highly stratified; (b) aging and being seen as "old" in a youth-focused society are stratifying processes in their own right; and (c) later life provides for analytical comparisons that are illustrative of how key mechanisms of inequality structure and stratify. After examining insights provided by a new wave of research on the aging U.S. population, we revisit the implications for understanding inequality and stratification in a graying and unequal America.

Early Origins of Adult Cancer Risk Among Men and Women: Influence of Childhood Misfortune?

OBJECTIVE

To examine the effect of five childhood misfortune domains-parental behavior, socioeconomic status, infectious diseases, chronic diseases, and impairments-on all-site and selected site-specific cancer prevalence and all-site cancer incidence.

METHOD

Panel data from the Health and Retirement Study (2004-2012) were used to investigate cancer risk among adults above the age of 50.

RESULTS

Risky parental behavior and impairment in childhood were associated with higher odds of all-site cancer prevalence, and childhood chronic disease was associated with prostate cancer, even after adjusting for adult health and socioeconomic factors. Moreover, having one infectious disease in childhood lowered the odds of colon cancer. Cancer trends varied by race and ethnicity, most notably, higher prostate cancer prevalence among Black men and lower all-site cancer among Hispanic adults.

DISCUSSION

These findings underscore the importance of examining multiple domains of misfortune because the type and amount of misfortune influence cancer risk in different ways.

Childhood Disadvantage and Health Problems in Middle and Later Life: Early Imprints on Physical Health?

Drawing from cumulative inequality theory, we examine the relationship between childhood disadvantage and health problems in adulthood. Using two waves of data from Midlife Development in the United States, we investigate whether childhood disadvantage is associated with adult disadvantage, including fewer social resources, and the effect of lifelong disadvantage on health problems measured at the baseline survey and a 10-year follow-up. Findings reveal that childhood socioeconomic disadvantage and frequent abuse by parents are generally associated with fewer adult social resources and more lifestyle risks. Health problems, in turn, are affected by childhood disadvantage and by lifestyle risks, especially smoking and obesity. Not only was early disadvantage related to health problems at the baseline survey, but childhood socioeconomic disadvantage and frequent abuse also were related to the development of new health problems at the follow-up survey. These findings reveal the imprint of early disadvantage on health decades later and suggest greater attention to resources, even during midlife, can interrupt the chain of risks.