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Article ; Online: Dried blood spot based biomarkers in the Health and Retirement Study: 2006 to 2016.

Kim, Jung Ki / Faul, Jessica / Weir, David R / Crimmins, Eileen M

American journal of human biology : the official journal of the Human Biology Council

2023 Volume 36, Issue 2, Page(s) e23997

Abstract: Introduction: The Health and Retirement Study (HRS) has collected biomarker data over multiple waves. Such data can help improve our understanding of health changes in individuals and the causal pathways related to health. There are, however, technical ... ...

Abstract	Introduction: The Health and Retirement Study (HRS) has collected biomarker data over multiple waves. Such data can help improve our understanding of health changes in individuals and the causal pathways related to health. There are, however, technical challenges to using the HRS dried blood spots (DBS) biomarker data due to changes over time in assay protocols, platforms, and laboratories. We provide technical and summary information on biological indicators collected as part of the HRS from 2006 to 2016 that should be helpful to users of the data. Methods: We describe the opportunities and challenges provided by the HRS DBS data as well as insights provided by the data. The HRS collected DBS from its nationally representative sample of respondents 51 years of age or older from 2006 to 2016. DBS-based biomarkers were collected from half the sample in 2006, 2010, and 2014, and from the other half of the sample in 2008, 2012, and 2016. These DBS specimens were used to assay total and HDL cholesterol, glycosylated hemoglobin, C-reactive protein, and cystatin C from 2006 to 2016, and Interleukin 6 was added in 2014/2016. Samples included approximately 6000 individuals at each wave, and completion rates ranged from 81% to 90%. HRS transformed DBS values into venous blood equivalents to make them more comparable to those of the whole blood-based assays collected in most other studies and to facilitate longitudinal analysis. Results: Distribution of changes over time by age shows that total cholesterol levels decreased for each age, while HbA1c levels increased. Cystatin C shows a clear age gradient, but a number of other markers do not. Non-Hispanic Black persons and Hispanic respondents have a higher incidence of risk levels of each biomarker except for CRP among non-Hispanic Black older persons. Conclusion: These public-use DBS data provide analysis opportunities that can be used to improve our understanding of health change with age in both populations and among individuals.
MeSH term(s)	Humans ; Aged ; Aged, 80 and over ; Cystatin C ; Retirement ; Dried Blood Spot Testing/methods ; Biomarkers ; C-Reactive Protein/analysis
Chemical Substances	Cystatin C ; Biomarkers ; C-Reactive Protein (9007-41-4)
Language	English
Publishing date	2023-10-06
Publishing country	United States
Document type	Journal Article
ZDB-ID	1025339-7
ISSN	1520-6300 ; 1042-0533
ISSN (online)	1520-6300
ISSN	1042-0533
DOI	10.1002/ajhb.23997
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Article ; Online: Decision Making for Patients With Severe Dementia Versus Normal Cognition Near the End of Life.

Nicholas, Lauren Hersch / Halpern, Scott D / Weir, David R / Baum, Micah Y / Nolan, Marie / Gallo, Joseph / Langa, Kenneth M

Innovation in aging

2023 Volume 7, Issue 7, Page(s) igad081

Abstract: Background and objectives: The clinical progression of severe dementia frequently leads to situations where surrogate decision makers must quickly make choices about potentially burdensome treatments that offer limited clinical benefit. We examined ... ...

Abstract	Background and objectives: The clinical progression of severe dementia frequently leads to situations where surrogate decision makers must quickly make choices about potentially burdensome treatments that offer limited clinical benefit. We examined whether the number of decision makers and their access to advance directives were related to treatment choice for patients with severe dementia in comparison to those with normal cognition. Research design and methods: We retrospectively linked survey responses about end-of-life treatment decisions to Medicare claims for Health and Retirement Study respondents dying between 2002 and 2015 whose next-of-kin reported a need for surrogate decision making. We estimated multivariable logistic regression models to study measures of aggressive care in the last 6 months of life; in-hospital death, burdensome transfers, and burdensome treatments. Results: Compared to patients who were cognitively normal near the end of life ( Discussion and implications: Surrogate decision makers made similar choices around end-of-life care for patients with severe dementia regardless of the number of decision makers and availability of advance directives. However, both advance directives and single decision makers were associated with less aggressive care for cognitively normal decedents.
Language	English
Publishing date	2023-08-01
Publishing country	England
Document type	Journal Article
ISSN	2399-5300
ISSN (online)	2399-5300
DOI	10.1093/geroni/igad081
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Article ; Online: Epigenetic-based age acceleration in a representative sample of older Americans: Associations with aging-related morbidity and mortality.

Faul, Jessica D / Kim, Jung Ki / Levine, Morgan E / Thyagarajan, Bharat / Weir, David R / Crimmins, Eileen M

Proceedings of the National Academy of Sciences of the United States of America

2023 Volume 120, Issue 9, Page(s) e2215840120

Abstract: Biomarkers developed from DNA methylation (DNAm) data are of growing interest as predictors of health outcomes and mortality in older populations. However, it is unknown how epigenetic aging fits within the context of known socioeconomic and behavioral ... ...

Abstract	Biomarkers developed from DNA methylation (DNAm) data are of growing interest as predictors of health outcomes and mortality in older populations. However, it is unknown how epigenetic aging fits within the context of known socioeconomic and behavioral associations with aging-related health outcomes in a large, population-based, and diverse sample. This study uses data from a representative, panel study of US older adults to examine the relationship between DNAm-based age acceleration measures in the prediction of cross-sectional and longitudinal health outcomes and mortality. We examine whether recent improvements to these scores, using principal component (PC)-based measures designed to remove some of the technical noise and unreliability in measurement, improve the predictive capability of these measures. We also examine how well DNAm-based measures perform against well-known predictors of health outcomes such as demographics, SES, and health behaviors. In our sample, age acceleration calculated using "second and third generation clocks," PhenoAge, GrimAge, and DunedinPACE, is consistently a significant predictor of health outcomes including cross-sectional cognitive dysfunction, functional limitations and chronic conditions assessed 2 y after DNAm measurement, and 4-y mortality. PC-based epigenetic age acceleration measures do not significantly change the relationship of DNAm-based age acceleration measures to health outcomes or mortality compared to earlier versions of these measures. While the usefulness of DNAm-based age acceleration as a predictor of later life health outcomes is quite clear, other factors such as demographics, SES, mental health, and health behaviors remain equally, if not more robust, predictors of later life outcomes.
MeSH term(s)	Humans ; Aged ; Epigenesis, Genetic ; Cross-Sectional Studies ; Aging/genetics ; DNA Methylation ; Biomarkers ; Acceleration
Chemical Substances	Biomarkers
Language	English
Publishing date	2023-02-21
Publishing country	United States
Document type	Journal Article ; Research Support, N.I.H., Extramural ; Research Support, Non-U.S. Gov't
ZDB-ID	209104-5
ISSN	1091-6490 ; 0027-8424
ISSN (online)	1091-6490
ISSN	0027-8424
DOI	10.1073/pnas.2215840120
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Article ; Online: The Mode Effect of Web-Based Surveying on the 2018 U.S. Health and Retirement Study Measure of Cognitive Functioning.

Domingue, Benjamin W / McCammon, Ryan J / West, Brady T / Langa, Kenneth M / Weir, David R / Faul, Jessica

The journals of gerontology. Series B, Psychological sciences and social sciences

2023 Volume 78, Issue 9, Page(s) 1466–1473

Abstract: Objectives: Measuring cognition in an aging populabtion is a public health priority. A move towards survey measurement via the web (as opposed to phone or in-person) is cost-effective but challenging as it may induce bias in cognitive measures. We ... ...

Abstract	Objectives: Measuring cognition in an aging populabtion is a public health priority. A move towards survey measurement via the web (as opposed to phone or in-person) is cost-effective but challenging as it may induce bias in cognitive measures. We examine this possibility using an experiment embedded in the 2018 wave of data collection for the U.S. Health and Retirement Study (HRS). Methods: We utilize techniques from multiple group item response theory to assess the effect of survey mode on performance on the HRS cognitive measure. We also study the problem of attrition by attempting to predict dropout and via approaches meant to minimize bias in subsequent inferences due to attrition. Results: We find evidence of an increase in scores for HRS respondents who are randomly assigned to the web-based mode of data collection in 2018. Web-based respondents score higher in 2018 than experimentally matched phone-based respondents, and they show much larger gains relative to 2016 performance and subsequently larger declines in 2020. The differential in favor of web-based responding is observed across all items, but is most pronounced for the Serial 7 task and numeracy items. Due to the relative ease of the web-based mode, we suggest a cutscore of 12 being used to indicate CIND (cognitively impaired but not demented) status when using the web-based version rather than 11. Discussion: The difference in mode may be nonignorable for many uses of the HRS cognitive measure. In particular, it may require reconsideration of some cutscore-based approaches to identify impairment.
MeSH term(s)	Humans ; Retirement ; Surveys and Questionnaires ; Aging/psychology ; Cognition ; Internet
Language	English
Publishing date	2023-01-04
Publishing country	United States
Document type	Journal Article ; Research Support, Non-U.S. Gov't ; Research Support, N.I.H., Extramural
ZDB-ID	1223664-0
ISSN	1758-5368 ; 1079-5014
ISSN (online)	1758-5368
ISSN	1079-5014
DOI	10.1093/geronb/gbad068
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Article ; Online: Educational Attainment and Later-Life Cognitive Function in High- and Middle-Income Countries: Evidence From the Harmonized Cognitive Assessment Protocol.

Zhang, Yuan S / O'Shea, Brendan / Yu, Xuexin / Cho, Tsai-Chin / Zhang, Kelvin Pengyuan / Kler, Jasdeep / Langa, Kenneth M / Weir, David R / Gross, Alden L / Kobayashi, Lindsay C

The journals of gerontology. Series B, Psychological sciences and social sciences

2024 Volume 79, Issue 5

Abstract: Objectives: Identifying social policies that can promote cognitive health is crucial for reducing the global burden of dementia. We evaluated the importance of educational attainment for later-life cognitive function in various social and geographic ... ...

Abstract	Objectives: Identifying social policies that can promote cognitive health is crucial for reducing the global burden of dementia. We evaluated the importance of educational attainment for later-life cognitive function in various social and geographic settings. Methods: Using harmonized data for individuals aged ≥65 years from the United States Health and Retirement Study (HRS) and its international partner studies in England, Mexico, China, and India, and each study's respective Harmonized Cognitive Assessment Protocol (HCAP), we conducted a cross-national comparative study to examine the role of educational attainment in later-life cognitive function across countries (n = 14,980, 2016-2019). We used multivariable-adjusted regression to estimate associations between educational attainment and harmonized global cognitive function scores. Results: In Mexico, China, and India, the general cognitive function scores on average are approximately one standard deviation of the HRS-HCAP cognitive function score distribution lower compared to the United States and England, paralleling patterns of educational attainment across countries. In all countries, higher educational attainment was associated with progressively higher later-life cognitive function scores. Population-level differences in educational attainment explained about 50%-90% of the observed differences in cognitive function scores across countries. Discussion: The relationship between education and later-life cognitive function across social and geographic contexts underscores the crucial role of education to promote cognitive health and reduce dementia risk. Continual improvement of educational attainment in low- and middle-income settings may yield a significant pay-off in later-life cognitive health.
MeSH term(s)	Humans ; United States/epidemiology ; Developing Countries ; Educational Status ; Cognition ; Academic Success ; Dementia/diagnosis
Language	English
Publishing date	2024-01-29
Publishing country	United States
Document type	Journal Article
ZDB-ID	1223664-0
ISSN	1758-5368 ; 1079-5014
ISSN (online)	1758-5368
ISSN	1079-5014
DOI	10.1093/geronb/gbae005
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Article ; Online: Associations of Age, Sex, Race/Ethnicity, and Education With 13 Epigenetic Clocks in a Nationally Representative U.S. Sample: The Health and Retirement Study.

Crimmins, Eileen M / Thyagarajan, Bharat / Levine, Morgan E / Weir, David R / Faul, Jessica

The journals of gerontology. Series A, Biological sciences and medical sciences

2020 Volume 76, Issue 6, Page(s) 1117–1123

Abstract: Background: Many DNA methylation-based indicators have been developed as summary measures of epigenetic aging. We examine the associations between 13 epigenetic clocks, including 4 second generation clocks, as well as the links of the clocks to social, ... ...

Abstract	Background: Many DNA methylation-based indicators have been developed as summary measures of epigenetic aging. We examine the associations between 13 epigenetic clocks, including 4 second generation clocks, as well as the links of the clocks to social, demographic, and behavioral factors known to be related to health outcomes: sex, race/ethnicity, socioeconomic status, obesity, and lifetime smoking pack-years. Methods: The Health and Retirement Study is the data source which is a nationally representative sample of Americans over age 50. Assessment of DNA methylation was based on the EPIC chip and epigenetic clocks were developed based on existing literature. Results: The clocks vary in the strength of their relationships with age, with each other and with independent variables. Second generation clocks trained on health-related characteristics tend to relate more strongly to the sociodemographic and health behaviors known to be associated with health outcomes in this age group. Conclusions: Users of this publicly available data set should be aware that epigenetic clocks vary in their relationships to age and to variables known to be related to the process of health change with age.
MeSH term(s)	Age Factors ; Aged ; Aging/genetics ; Biological Clocks/genetics ; DNA Methylation ; Educational Status ; Epigenesis, Genetic ; Female ; Health Behavior ; Humans ; Male ; Obesity/complications ; Racial Groups/statistics & numerical data ; Sex Factors ; Smoking/adverse effects ; Socioeconomic Factors ; United States
Language	English
Publishing date	2020-12-30
Publishing country	United States
Document type	Journal Article ; Research Support, N.I.H., Extramural
ZDB-ID	1223643-3
ISSN	1758-535X ; 1079-5006
ISSN (online)	1758-535X
ISSN	1079-5006
DOI	10.1093/gerona/glab016
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Article ; Online: Could the Adoption of Unleaded Gasoline in the 1970s Play a Role in the Precipitous Decline in Dementia Prevalence?-Reply.

Langa, Kenneth M / Larson, Eric B / Weir, David R

JAMA internal medicine

2017 Volume 177, Issue 6, Page(s) 893

MeSH term(s)	Dementia ; Gasoline ; Humans ; Prevalence
Chemical Substances	Gasoline
Language	English
Publishing date	2017-06-18
Publishing country	United States
Document type	Journal Article ; Comment
ZDB-ID	2699338-7
ISSN	2168-6114 ; 2168-6106
ISSN (online)	2168-6114
ISSN	2168-6106
DOI	10.1001/jamainternmed.2017.1083
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Article ; Online: Contemporaneous Social Environment and the Architecture of Late-Life Gene Expression Profiles.

Levine, Morgan E / Crimmins, Eileen M / Weir, David R / Cole, Steve W

American journal of epidemiology

2017 Volume 186, Issue 5, Page(s) 503–509

Abstract: Environmental or social challenges can stimulate a cascade of coordinated physiological changes in stress response systems. Unfortunately, chronic activation of these adaptations under conditions such as low socioeconomic status (SES) can have negative ... ...

Abstract	Environmental or social challenges can stimulate a cascade of coordinated physiological changes in stress response systems. Unfortunately, chronic activation of these adaptations under conditions such as low socioeconomic status (SES) can have negative consequences for long-term health. While there is substantial evidence tying low SES to increased disease risk and reduced life expectancy, the underlying biology remains poorly understood. Using pilot data on 120 older adults from the Health and Retirement Study (United States, 2002-2010), we examined the associations between SES and gene expression levels in adulthood, with particular focus on a gene expression program known as the conserved transcriptional response to adversity. We also used a bioinformatics-based approach to assess the activity of specific gene regulation pathways involved in inflammation, antiviral responses, and stress-related neuroendocrine signaling. We found that low SES was related to increased expression of conserved transcriptional response to adversity genes and distinct patterns of proinflammatory, antiviral, and stress signaling (e.g., sympathetic nervous system and hypothalamic-pituitary-adrenal axis) transcription factor activation.
MeSH term(s)	Aged ; Aged, 80 and over ; Chronic Disease/epidemiology ; Female ; Gene Expression Profiling ; Humans ; Inflammation/genetics ; Leukocytes ; Life Expectancy ; Male ; Middle Aged ; Pilot Projects ; Poverty ; Social Class ; Social Environment ; Stress, Psychological/genetics ; Time ; United States/epidemiology
Language	English
Publishing date	2017-09-14
Publishing country	United States
Document type	Journal Article
ZDB-ID	2937-3
ISSN	1476-6256 ; 0002-9262
ISSN (online)	1476-6256
ISSN	0002-9262
DOI	10.1093/aje/kwx147
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Article ; Online: A cultural neuropsychological approach to harmonization of cognitive data across culturally and linguistically diverse older adult populations.

Briceño, Emily M / Arce Rentería, Miguel / Gross, Alden L / Jones, Richard N / Gonzalez, Christopher / Wong, Rebeca / Weir, David R / Langa, Kenneth M / Manly, Jennifer J

Neuropsychology

2022 Volume 37, Issue 3, Page(s) 247–257

Abstract: Objective: To describe a cultural neuropsychological approach to prestatistical harmonization of cognitive data across the United States (U.S.) and Mexico with the Harmonized Cognitive Assessment Protocol (HCAP).: Method: We performed a comprehensive ...

Abstract	Objective: To describe a cultural neuropsychological approach to prestatistical harmonization of cognitive data across the United States (U.S.) and Mexico with the Harmonized Cognitive Assessment Protocol (HCAP). Method: We performed a comprehensive review of the administration, scoring, and coding procedures for each cognitive test item administered across the English and Spanish versions of the HCAP in the Health and Retirement Study (HRS) in the U.S. and the Ancillary Study on Cognitive Aging in Mexico (Mex-Cog). For items that were potentially equivalent across studies, we compared each cognitive test item for linguistic and cultural equivalence and classified items as confident or tentative linking items, based on the degree of confidence in their comparability across cohorts and language groups. We evaluated these classifications using differential item functioning techniques. Results: We evaluated 132 test items among 21 cognitive instruments in the HCAP across the HRS and Mex-Cog. We identified 72 confident linking items, 46 tentative linking items, and 14 items that were not comparable across cohorts. Measurement invariance analysis revealed that 64% of the confident linking items and 83% of the tentative linking items showed statistical evidence of measurement differences across cohorts. Conclusions: Prestatistical harmonization of cognitive data, performed by a multidisciplinary and multilingual team including cultural neuropsychologists, can identify differences in cognitive construct measurement across languages and cultures that may not be identified by statistical procedures alone. (PsycInfo Database Record (c) 2023 APA, all rights reserved).
MeSH term(s)	Aged ; Humans ; Cognition ; Language ; Multilingualism ; Neuropsychological Tests
Language	English
Publishing date	2022-04-28
Publishing country	United States
Document type	Review ; Journal Article
ZDB-ID	1042412-x
ISSN	1931-1559 ; 0894-4105
ISSN (online)	1931-1559
ISSN	0894-4105
DOI	10.1037/neu0000816
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Article ; Online: Recruitment and retention of minority participants in the health and retirement study.

Ofstedal, Mary B / Weir, David R

The Gerontologist

2011 Volume 51 Suppl 1, Page(s) S8–20

Abstract: Purpose: Minority oversamples of African Americans and Hispanics have been a key feature of the Health and Retirement Study (HRS) design from its origins in 1992. The objective of this article was to assess the quality of the HRS with respect to the ... ...

Abstract	Purpose: Minority oversamples of African Americans and Hispanics have been a key feature of the Health and Retirement Study (HRS) design from its origins in 1992. The objective of this article was to assess the quality of the HRS with respect to the recruitment and retention of minority respondents. Design and methods: To evaluate minority recruitment efforts, we examine baseline response rates for the early baby boom cohort that was added in the 2004 wave and the representativeness of this cohort with regard to demographic, socioeconomic, and health characteristics. To evaluate retention, we focus on minority differentials in 2008 interview, nonresponse and mortality outcomes for the full HRS sample. We also examine minority differentials in participation in supplemental components of the HRS. Results: Minority response rates at baseline and in longitudinal follow-ups for the main HRS interview have been equal to or better than that of majority Whites. Conversely, response rates to some specific supplemental components have been lower for minority sample members. Implications: The oversample strategies that the HRS has employed have been successful at identifying and recruiting minority participants at response rates very comparable with that of Whites and others. Minority differentials in participation in supplemental components have been overcome to some extent through interviewer training and targeted follow-up strategies. The HRS experience suggests that well-trained interviewers can overcome most if not all of whatever race and ethnic differentials exist in willingness to participate in surveys, including those involving biological data collection.
MeSH term(s)	African Americans/statistics & numerical data ; Aged ; Biomarkers/blood ; Female ; Health Promotion ; Health Surveys ; Hispanic Americans/statistics & numerical data ; Humans ; Male ; Middle Aged ; Minority Groups/statistics & numerical data ; Minority Health ; National Health Programs ; Patient Dropouts ; Patient Selection ; Retirement ; Sampling Studies ; Surveys and Questionnaires ; United States/epidemiology
Chemical Substances	Biomarkers
Language	English
Publishing date	2011-05-11
Publishing country	United States
Document type	Comparative Study ; Journal Article ; Research Support, N.I.H., Extramural
ZDB-ID	216760-8
ISSN	1758-5341 ; 0016-9013
ISSN (online)	1758-5341
ISSN	0016-9013
DOI	10.1093/geront/gnq100
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