Previous healthcare-based studies have reported increasing herpes zoster (HZ) incidence over time; however, this could be an artifact of increased healthcare utilization. This study is a cross-sectional analysis of 15,103 respondents in the 2008 wave of the Health and Retirement Study (HRS) to evaluate changes in HZ incidence from 1940 to 2008. Negative binomial regression is used to model the effect of calendar year, age of onset of HZ, gender and race/ethnicity on HZ incidence. A nonparametric method based on B-spline basis expansion is used to model the effect of calendar year to avoid imposing a predetermined functional form and produce flexible and accurate estimates. This study demonstrates increasing HZ incidence from 1940 to 2008 using self-reported HZ. Although the reason for this increase remains unknown, this study supports the assertion that this trend is real and not an artifact of increasing healthcare utilization for HZ over time.

Background. Research identifies isolation (being alone) as a risk factor for cognitive decline— yet it is possible that subjective dimensions of isolation are more critical. Potential risk factors are loneliness (the distress stemming from feeling alone) and cynical hostility (an attitude of distrust and cynicism). The present study examined the relationship between these factors and cognitive functioning and decline. Methods. Data came from the Health and Retirement Study, a nationally representative longitudinal study of US adults over 50. Loneliness was measured using the Hughes Loneliness Scale; cynical hostility was measured using items from the Cook-Medley Hostility Inventory. Cognitive functioning was indexed by the Telephone Interview for Cognitive Status. Regressions were conducted to examine loneliness and cynical hostility as predictors of cognitive function at baseline as well as cognitive decline over four and six-year periods. Models were adjusted for demographic characteristics, health behaviors, and isolation. Results. Loneliness, [f2=.003, t(52)=-3.75; p<.001] and cynical hostility, [f2=.002, t(52)=-2.98, p=.004] predicted cognitive function at baseline. Loneliness and cynical hostility each predicted cognitive decline over four [f2=.001, t(52)=-2.29; p=.026 f2=.003, t(52)=-3.98; p<.001 respectively] but not six years [t(52)= -.78; p=.439; t(52)= -1.29; p=.203 respectively]. Discussion. Loneliness and cynical hostility are correlates of lower cognitive function and risk factors for cognitive decline over four years. The absence of significant effects of loneliness and cynical hostility over six years could be attributed to low statistical power in these analyses. The effect sizes in this study are small, yet meaningful in the context of the personal and social costs associated with cognitive decline.

Using an analysis of secondary data from the Health and Retirement Survey, this thesis provides the groundwork for understanding factors for nursing home placement using matching techniques to understand the differences between those persons with similar health characteristics who are not residents of nursing homes, and who are temporary residents or permanent residents of nursing homes. / Fisher Institute for Wellness and Gerontology

No description available.

Frailty is a well-established indicator of late-life decline and is accompanied by higher rates of comorbidity and disability. Meanwhile, an estimated 41% of adults over the age of 65 report consuming alcohol – an identified health risk and protective factor depending on dosage. Given that the demographic group of older Americans is projected to double by the year 2050, identification of frailty risk and protective factors is imperative. The goals of this thesis are to: (1) identify how varying levels of alcohol consumption relate to frailty, and (2) elucidate a possible mechanism that accounts for the relationship between alcohol consumption and frailty. A sample of stroke-free participants over the age of 65 was identified from the Health and Retirement Study. Study 1 utilized stepwise logistic regression models to identify predictors of prevalent frailty at baseline (2000), and of incident frailty 4, 8, and 12 years later. For both males and females, significant predictors of frailty at all years included age, depressive symptomatology, and medical burden score. In addition, BMI was a significant predictor of frailty for females at all years. With respect to alcohol use, results revealed that drinking 1-7 drinks per week had a protective effect for females at baseline (OR=0.50) and 12 years later (OR=0.75); however, no such protective effects were found for males. Given that extant research has identified CRP as a mediator between the relationship of moderate alcohol use and cardiovascular health benefits, Study 2 used a cross-sectional sample from the 2008 wave to examine the potential mediating role of CRP between moderate alcohol use and reduced frailty risk. Results from structural equation modeling support the hypothesized model that moderate alcohol is associated with less frailty, and that this relationship is partially mediated by CRP levels. Overall findings suggest that moderate alcohol use confers health benefits for females by reducing frailty risk and that CRP is one mechanism by which alcohol use may confer protective effects for frailty. These results provide a starting place in an effort to better understand the protective effects of moderate alcohol use and can assist in improving prevention and treatment efforts for older adults by preventing or prolonging the onset of age-related diseases. Future research should further examine the relationship between alcohol use and frailty and determine if CRP mediates the relationship between moderate alcohol use and other beneficial health outcomes.

No description available.

No description available.

This study examined the relationship between physical health, social support, and depression in a married, middle-aged/older adult sample in which at least one partner has heart disease. The data was obtained from a national longitudinal study the Health and Retirement Survey (HRS) and is composed of selected respondents and their spouses. The HRS Wave 1 data that was used for these analyses was collected in 1992 and 1993. This study tested a stress buffer model predicting the relationship between physical health, social support, and depression. For study inclusion, participants must have been diagnosed with cardiovascular disease and received treatment in the last year. A heart disease construct was developed by calculating the level of disease by the number of conditions and medical treatments received within the last year. A second health category for other chronic health conditions included diabetes, arthritis, cancer, and chronic pain. These constructs were combined into a total disease construct, which provided a broad measure of health problems typical of an older adult population. Social support was determined by respondents' satisfaction with friends, neighbors, family, their marriage, and enjoyable time spent with their spouse. Social support was subdivided into two constructs separating spousal support from social support sources outside the marriage. The Center for Epidemiological Studies Depression short-form (CES-D) calculated depression scores. Findings support a stress-buffering model among older married adults with chronic diseases. Hierarchical multiple regressions found the following main effects predicted Depression: Total Disease (Beta=. 03, p<. 000), Exercise (Beta=-.11, p<. 000), Smoking (Beta=. 04, p<. 001), General Support (Beta=-.21, p<. 000), Spousal Support (Beta=-.19, p<. 000). The Total Diseases by Spousal Support interaction was a significant predictor of Depression for men and women (Beta= -.04, p<. 000) and Total Disease by Spousal Support was also a significant predictor for men and women (Beta=-.03, plt;. 000). For men with Heart Disease, Total Disease by Spousal Support was a stronger predictor (Beta=-.03) than it was for women with Heart Disease (Beta=-.10). These results may partially explain gender differences in heart disease patients and suggests several psychological interventions that could be beneficial.

Title from first page of PDF document. Includes bibliographical references (p. 20-21).

Thesis (Ph.D.)--Pardee Rand Graduate School, 2006. / Title from PDF cover. Includes bibliographical references. Issued also in print.