Center for Demography of Health and Aging (CDHA)

2021. Eric Grodsky. The Nation’s High School Class of 1972 at Retirement: Education and Cognitive Aging Among Mid-Cohort Baby Boomers.

The research team will collect data from the ~14,500 sample members of the precursor to High School and Beyond, the National Longitudinal Study of the High School Class of 1972. Born mainly in 1953-55, sample members are now in their mid to late 60s. This proposed project would collect, analyze and disseminate data about their current cognition and life circumstances as well as their physiological status as indicated by whole blood, plasma, serum, and other biomarkers. The project has four aims:

1. Estimate the effects of education from adolescence forward
2. Assess the role of different aspects of education in producing racial and ethnic disparities in cognitive functioning and impairment in the transition from midlife to older ages
3. Assess the role of different aspects of education in the relationship between physiology and ADRD captured in blood- and saliva-based biomarkers as individuals transition from midlife to older ages
4. Prepare for distribution the resulting database and associated documentation and metadata to facilitate scholarship on the factors that affect cognitive functioning and cognitive impairment.

Priority Research Areas: Cognitive Aging and the Demography of Dementia

2021. Jessica Cao. Post-acute Care Access and Disparities among ACO Medicare Beneficiaries during the COVID-19 Pandemic.

This pilot project aims to gauge the changes and disparities in post-acute care (PAC) access among Medicare beneficiaries in the UW Health system, a local Medicare Accountable Care Organization (ACO), during the COVID-19 pandemic. Results from this pilot project will be used as the baseline for R01- level studies regarding the effects of the pandemic on PAC utilizations, health outcomes and subsequent health care utilizations and costs among Medicare beneficiaries. The ultimate goal is to make recommendations to the local ACO and beyond on how to improve equitable care access and quality of care for older adults.

Priority Research Areas: Health Trends and Disparities

2021. John Eason. Frailty, Aging, and Cancer Survival.

The goal of this project is to investigate the role of frailty/aging at the individual level and community level factors in pancreatic ductal adenocarcinoma survival. In addition to measuring the effect of community disadvantage (e.g. poverty and unemployment), researchers will examine how/if the presence of healthcare organizations in a community mitigate the effect of disadvantage incidence and survival. Eason and colleagues will investigate the role of individual level determinants of health disparities, but will also investigate how access to health care may alleviate cancer survival disparities.

Priority Research Areas: Effects of Interventions on Population Health

2021. Kristen Litzelman. “Jumping through A New Set of Hoops Each Time” – Conceptualization and Assessment of Socioeconomic Disparities in Caregivers’ Access to Resources.

In order to advance research and intervention efforts focused on resource use among caregivers, this project will conceptualize the process of accessing resources and assess socioeconomic disparities in resource use. The researchers will draw on previous theoretical and conceptual models to frame this work. The project’s overarching hypothesis is that service use is driven not only by need, but by caregivers’ existing resources of time, money, and emotional energy, compounded by sequential challenges in the systems navigation process. Conceptualizing this process and assessing how socioeconomic factors are linked to service utilization is a critical first step to understanding disparities in resource allocation and identifying targets for intervention

Priority Research Areas: Health Trends and Disparities

2021. Lauren Schmitz and Valentina Duque (University of Sydney). The Impact of Early Life Exposure to Extreme Weather and Temperature Shocks on Late Life Cardiovascular and Cognitive Health: Evidence from the Longitudinal Aging Study in India (LAS).

This project will contribute to our understanding of how early life conditions affect aging patterns in developing countries. Specifically, since agriculture remains the main source of income for a large fraction of households in these contexts, we will focus on two shocks that largely affect their economic, health, and psychological wellbeing: 1) the occurrence of adverse weather and temperature shocks, and 2) policies aimed at reducing food insecurity, poverty, and promoting economic growth. Understanding life course impacts of extreme weather patterns on aging outcomes is particularly imperative in the modern climate era; the number of record high temperatures and intense rainfall events has been increasing globally and these trends are expected to continue to rise over the next few decades.

Priority Research Areas: Determinants of Health, Well-Being and Longevity

2020. Jason Fletcher. Deploying Machine Learning Tools to Predict Mortality Outcomes in the General Population.

Utilizing machine learning to predict mortality outcomes at the population level has thus far proven a tough nut to crack: the existing small samples sizes too small, the large samples lacking the proper type of data. This project aims to find the middle ground between these extremes by linking large population-based data from the National Longitudinal Mortality Study and the American Community Survey (ACS) to data from the National Death Index (NDI) and Medicare claims. Utilizing these linkages, the researchers will look for interactions that lead to mortality, and create risk scores based off of these interactions.

Priority Research Areas: Determinants of Health, Well-Being and Longevity

2020. Jooyoung Kong. Adverse Childhood Experiences and Physiological, Affective, and Cardiovascular Reactivity to Family Caregiving Stress.

Longer life spans have helped advent the “sandwich generation” – middle-aged adults who find themselves caring for their children and their own aging parents. This position, stressful for anyone, may be especially stressful for adults who had Adverse Childhood Experiences (ACEs) while growing up. Primarily using the data from the Midlife in the United States (MIDUS) study, this project will explore how caregiving adults with ACES in their histories respond and react to daily stressors.

Priority Research Areas: Determinants of Health, Well-Being and Longevity

2020. Judith Simcox. Improving Biomarkers of Metabolic Disease in African American Populations.

Studies have shown that the most widely used clinical markers for diabetes — HDL, LDL, and triglycerides — are not accurate predictors of the disease in African-Americans. This pilot project will examine the promise of two potential alternatives in African-American females: C reactive protein and arachidonic acid containing lipids. African Americans are 60% more likely than Caucasians to have diabetes and twice as likely to die from diabetes-related complications. With better diagnostic tools, healthcare professionals have a better chance of bringing about positive health care outcomes.

Priority Research Areas: Biology, Genetics and Demography of Aging

2020. Philipp Koellinger. Understanding Socio-economic Influences on Health and Longevity.

Scientists have already discovered that low socio-economic status (SES) is linked to an array of physical and mental health conditions and reduced longevity, but the mechanisms behind these correlations have proven elusive thus far. If they could be discovered, scientists may be able to predict and prevent some of the poor outcomes associated with low SES. This project will utilize the over 500,000 genomic samples within the UK Biobank to complete analyses.

Priority Research Areas: Determinants of Health, Well-Being and Longevity

2020. ZhengZheng Tang. Investigating the Interactions between Inflammatory Biomarkers and Gut Microbiome in the Wisconsin Longitudinal Study.

Persistent inflammation has emerged as a consistent marker of aging and aging-related diseases. This pilot project seeks to investigate the connection between these inflamed biomarkers and changes in the gut microbiome among older adults, using the Wisconsin Longitudinal Study, a rich longitudinal data source that has tracked individuals from the 1957 high school class throughout Wisconsin.

Priority Research Areas: Biology, Genetics and Demography of Aging

2019. Jason Fletcher. WLS Digitization.

The Wisconsin Longitudinal Study (WLS), which started with a state-wide survey of all 30,000 Wisconsin high school seniors in 1957, has become a premier resource for understanding how events and circumstances throughout life shape economic and health trajectories into older ages and can answer questions that no other data resource in the US can answer.  It merges deep social scientific advances with more recent biological assessments, including genetics and the microbiome.

In this project, we plan to digitize over 20,000 of the original WLS surveys from 1957.  This work will substantially expand the WLS in ways that will allow new research areas to be explored that have not been previously available.  An enhanced WLS can substantially expand our understanding of the connections between early life conditions and experiences and later life outcomes.  Having access to data on the full population of the Wisconsin Class of 1957 seniors thus allows us to contextualize the school and social environments during this time period to a degree not previously available.

The digitization effort will make possible a number of extensions to the WLS that will also expand the reach of the data.  First, the 20,000 newly digitized surveys can be linked to the 1940 Decennial Census in order to add information on early environments, such as family characteristics and geographic location (the survey respondents were born in 1939).  Second, the surveys can be linked to US Mortality records to create an additional “panel” of respondents. Third, eventually, all WLS respondents could be “PIK”ed and linked with Census data projects (e.g. 2000 Decennial Census) inside an FSRDC.

Priority Research Areas: Determinants of Health, Well-Being and Longevity

2019. Michal Engelman. Understanding the long-term relationship between Community Health and Voter Turnout in the Midwest.

Reports of declining life expectancy and rising economic and social anxieties among white Americans (particularly those living outside of major metropolitan areas) captured both popular and scholarly attention in the lead-up to and aftermath of the 2016 election. In attempting to explain the Republican candidate’s victory in a state that had favored Democratic presidential candidates since 1988, early reports stated that white voters – and particularly older, white, working-class voters – were responsible for flipping Wisconsin from blue to red. Subsequent analysis has shown that the story is considerably more complicated, encompassing low voting rates among African Americans (due to unenthusiastic turnout as well as voter ID policies that created barriers for interested voters) and higher-than-predicted support for Trump among white voters of varied socioeconomic backgrounds.

In this study, we will create a unique linkage between the rich sociodemographic and health data available in the Wisconsin Longitudinal Study (WLS), State Voter Files up to 2019, and aggregate data on population health and economic well-being in order to understand voting patterns among older, largely white adults who grew up in Wisconsin. This study will allow us to identify individual and community level predictors of voting patterns, marshaling longitudinal data to assess the extent to which the 2016 election represented continuity with or a break from prior elections. Our aim in creating this linked data set is to enrich the resources available for future research focused on the interaction of socio-demographic and health characteristics with political participation.

Priority Research Areas: Determinants of Health, Well-Being and Longevity

2019. Qiongshi Lu. Testing Gene-environment Interactions without Measuring the Environmental Factor.

Gene-environment interaction studies for late-life health outcomes often have limited sample sizes. While the size of genome-wide association studies (GWAS) grows rapidly for almost all complex diseases and traits, most of these studies have very limited measurements on epidemiological risk factors that are of interest in gene-environment interaction analysis. In this research, we explore the possibility of using PGS as a proxy of the epidemiological/ environmental risk factor (we refer to it as E-PGS) in gene-environment interaction analysis.

We will conduct simulations to investigate the validity of using E-PGS as a proxy for the ‘E component’ in gene-environment interaction analysis. Then we will conduct a pilot analysis focusing on three prevalent late-life diseases – coronary artery disease, stroke, and breast cancer. The Wisconsin Longitudinal Study (WLS) will be used as the primary discovery cohort, and we will replicate our findings in the Health and Retirement Study (HRS).

The main goal of the proposed work is to determine the feasibility of identifying gene-environment interactions in late-life health outcomes using E-PGS as a proxy. The successful identification of interactions would provide a strong basis for expanding our analysis to broader phenotypes.

Priority Research Areas: Biology, Genetics and Demography of Aging

2019. Yang Wang. Medicaid Expansions and Formal and Informal Care for the Elderly.

The Affordable Care Act has led to substantial increases in health insurance coverage for individuals in the US, and expansions in Medicaid have played a large role in the increased coverage. We explore how these changes have affected the provision and receipt of informal care, as well as changes in the demand for formal (nursing home) care for the elderly.

We will use the American Time Use Survey (ATUS) and the Health and Retirement Study (HRS). The ATUS provides nationally representative estimates of how, where, and with whom Americans spend their time. The Health and Retirement Study (HRS), focused on providing detailed information on health, health care, work, family and the aging process of Americans, will be used to measure the symmetric informal care receipt by the elderly to validate the results from the ATUS and to measure the effects of Medicaid expansions on actual nursing home use by the elderly.

Priority Research Areas: Effects of Interventions on Population Health

2018. James Raymo. The Demography of Isolation at Older Ages.

This project is designed to generate population-based information about the experience of social isolation at older ages and the complex relationships between health and social isolation. It will identify measures of isolation in the Health and Retirement Study (HRS), National Survey of the Japanese Elderly (NSJE) and Survey of Health, Ageing, and Retirement in Europe (SHARE).  How demographic attributes like age, sex, educational attainment, area of residence, marital status, number of children, and health contribute to the prevalence and duration of isolation at older ages in a cross-country frame work.

Priority Research Areas: Determinants of Health, Well-Being and Longevity

2018. Jason Fletcher. Gene-Environment Interactions Related to Old Age Cognition and Cognitive Decline.

The restricted Health and Retirement Study (HRS) data will be used to examine interactions between specific environment conditions and polygenic scores related to cognition in old age. HRS is a nationally representative longitudinal study of aging of individuals born 1931-1941 and their spouses. It has collected data on the aging process by focusing on health, work, family, and related domains. HRS’ polygenic scores for cognition, Alzheimer’s disease, education, and other related phenotypes can contribute to our investigation on how genetic predispositions interact with early disease environments, various exposure to pollution, and the Great Depression.

Priority Research Areas: Biology, Genetics and Demography of Aging

2018. Lindsay Jacobs. Work and Cognition at Older Ages: Do Occupations Matter.

This pilot will study work patterns on cognition and wellbeing across occupations and over respondents’ life course.  This project plans to connect Job attributes in O*Net data to Wisconsin Longitudinal Study (WLS) respondents’ occupations over the years. WLS is a long-term study of a random sample of 10,317 men and women who graduated from Wisconsin high schools in 1957. The WLS data provides an opportunity to adequately account for selection into occupations earlier in life and any causal effects of occupation on later life outcomes.

Priority Research Areas: Cognitive Aging and the Demography of Dementia

2018. Stephanie Robert. Social Determinants of Health And Wellbeing at Older Ages.

This project will examine how SES, race/ethnicity, and neighborhood context impact the health outcomes of older adults, or of adults over the life course. Will associating them with urban/suburban/rural residence predict health trajectories and transitions out of community residence for older adults? Research will be conducted using restricted data from the National Health and Aging Trends Survey (NHATS), a nationally representative sample of Medicare recipients ages 65 and older, with oversamples of black older adults and the oldest old. NHATS includes both community-dwelling older adults and those living in facilities. We will follow respondents’ transitions into nursing home, assisted living, or remaining in the community. In addition, we will link caregivers’ data in the National Study of Caregiving (NSOC), a complementary study for members in NHATS to look at urban/rural/suburban differences in informal and formal support networks in the community and in non-community residences.

Priority Research Areas: Determinants of Health, Well-Being and Longevity

2017. Jenna Nobles. Aging through a Nutrition Transition: The Effects of Early-Life Scarcity on Later-Life Health.

In the last few decades, a dietary shift from locally grown staples to mass-produced, shelf-stable calorically dense foods has increased cardiovascular health risk in aging populations around the world. This project uses data from the Indonesian Family Life Survey (IFLS) to measure childhood nutritional conditions and health-trajectories at older ages. It provides an empirical test on the global nutrition transition and the effects of early life scarcity on later life health.

Priority Research Areas: Determinants of Health, Well-Being and Longevity

2017. Kristen Malecki. The Social Epigenomics of Health Disparities: How Different Dimensions of Disadvantage Get Under the Skin.

This pilot project uses the Survey of the Health of Wisconsin (SHOW) data to study how individual characteristics and neighborhood-level contextual characteristics operate independently and jointly to shape health disparities through epigenetic mechanisms that accelerate biological aging. It employs DNA methylation array data to test the hypothesis that differences in biological aging exist across socio-demographically matched subpopulations.

Priority Research Areas: Biology, Genetics and Demography of Aging

2017. Michal Engelman. Who Enjoys An Immigrant Health Advantage? Nativity, Race/Ethnicity, and Population Health Patterns.

This pilot examines the health of America’s diverse foreign-born population in the context of the nation’s racial/ethnic disparities. The National Health Interview Surveys (NHIS) data is used to study whether and how socioeconomic characteristics, health behaviors, and incorporation experiences of immigrants contribute to their health outcomes.

Priority Research Areas: Determinants of Health, Well-Being and Longevity

2016. Alberto Palloni. Early Conditions, Delayed Effects and Their Impact on Adult Mortality Patterns Summary.

This project will conduct an empirical test on conjectures derived from theories of Developmental Origins of Health and Disease (DOHaD). The Latin American Mortality Database (LAMBdA) and the Human Mortality Database (HMD) will be used to generalize a formal model formulated by Palloni and Beltran Sanchez.

Priority Research Areas: Determinants of Health, Well-Being and Longevity

2016. Federico Rey and Pamela Herd. The Role of Early Life Experiences in Shaping the Gut Microbiome: A Study Incorporating the Microbiome into the Wisconsin Longitudinal Study.

Microbes in the gut, and their associated genes (the microbiome), affect many aspects of our physiology. A growing body of research emphasizes the key role the microbiome plays in shaping human health. This project uses the Wisconsin Longitudinal Study to explore the role of early life conditions’ and the degree of plasticity in the gut microbiome across the life course.

Priority Research Areas: Biology, Genetics and Demography of Aging

2016. James Raymo. Living Arrangements at Older Ages: A Cross-National Comparison.

Living arrangements are closely linked with health, health care, and long-term care in later life. This project will examine transitions in living arrangements among older Europeans, depict their living arrangements as trajectories over a period of nine years. Data will come from the Survey of Health and Retirement in Europe (SHARE), which tracks national samples of men and women 50 years of age or older since 2004 in 20 European countries (and Israel).

Priority Research Areas: Consequences of U.S. and Global Aging

2016. Michal Engelman. Why Does the Immigrant Health Advantage Disappear over the Life Course?.

Population aging and immigration from increasingly diverse origins are dramatically transforming America’s demographic profile. This pilot project uses 2014 California Health Interview Survey (CHIS) to examine social structures, policies, and practices affect the health of immigrant populations.

Priority Research Areas: Determinants of Health, Well-Being and Longevity

2015. Eva Dugof, Michal Engelman, Kevin Look and Amy Kind. Health Trajectories in Older Adults.

Two out of three older adults in the United States are living with two or more chronic conditions. Research shows that as the number of chronic conditions increases, so too does the complexity of care, health care spending, and adverse health outcomes. Few studies have sought to address how the relationship between multimorbidity and health may vary by the combination of conditions. Our project will examine differences in the order in which conditions are accumulated and study the dynamics of multiple chronic conditions among older adults in the Medicare program and the implications of different health trajectories on health spending and life expectancy. We hope to address an urgent need for better information on the consequences of multiple chronic conditions to inform the development of clinically and culturally tailored interventions, clinical trial design, payment models, and health system planning.

Priority Research Areas: Determinants of Health, Well-Being and Longevity

2015. Jason Fletcher. Determinants of Telomere Length in the Health and Retirement Study.

Research findings relating telomere length to longevity and health in general are somewhat contradictory and inconsistent, but most of them are based on small samples of individuals and with limited information. Our project will investigate the relation between telomere length, onset of chronic diseases and mortality in the Health and Retirement Study. This large population study contains rich information on individuals life histories and may help to elucidate aspects that are obscured by inappropriate sample size or ancillary information.

Priority Research Areas: Biology, Genetics and Demography of Aging

2015. Jennifer Dykema, Dana Garbarski, Nora Cate Schaeffer and Kenneth D. Croes. Uncovering the Relationship between Interviewer-Respondent Interaction and Compliance in the Collection of Anthropometric Measures and Physical Performance AssessmentsUncovering the Relationship between Interviewer-Respondent Interaction and Compliance in the Collection of Anthropometric Measures and Physical Performance Assessments.

While biomeasures, including anthropometric measures, physical performance assessments, biological materials, and genetic measures, are increasingly collected along with survey responses in household surveys, more research is needed to determine respondents’ willingness to provide these measures, what factors influence participation, and what barriers impeded successful collection. This study aims to understand how the interviewer influences both consent to participate in anthropometric measurement tasks and the mechanisms by which interviewer effects are introduced into the resulting measures. In addition, interaction during the request and the measurement task will be examined to predict compliance with subsequent requests.

Priority Research Areas: methodology

2014. Barbara Wolfe, Jason Fletcher, Jan S. Greenburg, and Marsha Mailick. Disrupted Family Dynamics: How Children Are Affected by Sibling Death, and Disability.

There is a large literature on the family determinants of child achievement, development, and life outcomes. One aspect of family determinants that has been the subject of only limited research is the influence of siblings particularly non-normative sibling relationships, such as when a sibling is disabled or dies during childhood. Our project focuses on non-normative sibling relationships by exploring the family as a complex, dynamic, social, and reciprocal setting in which children (and parents) develop. We further explore how family disadvantage may moderate or exacerbate the impacts of sibling relationships and how these sibling relationships affect future family disadvantage.

2014. Craig Atwood. Veteran Health in the WLS.

The veteran population is exposed to cognitive impacts including post-traumatic stress disorder (PTSD) and traumatic brain injury (TBI; shell-shock). Although these disorders may resolve following return to civilian life, there is little data on the long-term effects of these exposures to cognitive and affective performance with aging in veterans. The central objective of this proposal is therefore to determine if there are disparities in cognitive and affective disorders between the aged veteran population and civilian population within the WLS cohort. In addition, this dataset will be tested for association with genetic and environmental factors. Identification of differences in cognitive and affective disorders in the veteran population would allow better allocation of resources for treatment of veterans at VA hospitals, while identification of genetic and environmental correlates might allow for the development of prognostic/diagnostic tests and the initiation of preventive strategies.

2014. Jason Fletcher. Gene-Environment Interactions in the Health and Retirement Study.

This pilot project will set up and begin to implement gene-environment interaction research using the restricted (geographic and genetic) Health and Retirement Study (HRS) data. HRS began in 1992 as a nationally representative longitudinal study of aging of individuals born 1931-1941 and their spouses. There are now >10,000 individual with genetic data collected. We plan to use these genetic data in exploring the potential interactions between health policies and genotype in predicting health behaviors. Genetic variants will be examined as potential explanations of heterogeneity in the main effects of environmental effects. In addition, this pilot can help study the potential differences in gene frequency of population stratified by health behaviors.

2014. Katherine Curtis, James Raymo, andJun Zhu. Aging and Place: New Methods to Identify Optimal Spatial Units for Health Outcomes among the Older Population.

Researchers are becoming increasingly interested in the role of place in shaping various social and health outcomes. Individual characteristics such as age and marital status have strong effects on health, yet researchers argue that health outcomes are also shaped by contextual factors such as local social and economic circumstances and the built environment. Research incorporating contextual factors most often relies on multilevel modeling strategies. While a step in the right direction, such approaches are limited in two important ways. First, existing approaches do not offer an empirically-based test of whether contextual factors are measured at the appropriate spatial scale. Second, existing approaches do not account for the possibility that the effect of contextual factors is not the same in all places. Our project will begin to address these limitations. Our goal is to develop new methods to identify optimal spatial units for the study of health outcomes among the older population.

2014. Leonelo Bautista and Alberto Palloni. Chronic Psychosocial Stress, and Risk of Metabolic Syndrome.

This project will examine the role of socioeconomic status (SES) on the risk of metabolic syndrome (MetS). SES is a source of chronic psychosocial stress (CPS), which may increase the risk of MetS by increasing blood levels of cortisol. Unfortunately, the roles of SES and CPS are uncertain partly because standard markers of stress (serum, salivary, and urinary cortisol) provide single point in time levels that are subject to major physiological variations. Hair cortisol could be a better biological marker of CPS, as it reflects average blood levels over a period of months. We will assess the usefulness of hair cortisol as a marker of CPS, by quantifying its association with self-reported stress, individual and neighborhood SES, and components of the MetS. Data from this study will be used to design of a cohort study of the effects of SES on CPS and MetS in the Survey of the Health of Wisconsin (SHOW).

2014. Nora Cate Schaeffer. Standardization and Motivation to Provide DNA Samples: Rapport and Motivation in the Standardized Interview.

The interviewing methods of standardization were developed to support obtaining reliable measurement in large population studies conducted by production interviewers. In addition to the requirements of measurement, contemporary researchers also confront the challenge of motivating respondents to provide the sensitive biological information, such as DNA samples, that forms the foundation of an ambitious research agenda. In this project we examine whether interviewers working under the constraints of standardization introduce responsive behaviors that engage respondents and increase their motivation to comply with sensitive requests. Using pairs of survey respondents matched on their propensity to provide a saliva sample for study of their DNA in response to a request made some time after the interview was completed, we test whether interviews in which behaviors that signal responsiveness by the interviewer and engagement on the part of the respondent increase the odds of complying with the request for a DNA sample.

2013. Corinne Engelman. Identification of Gene Environment Interactions in Cognitive Decline.

The specific aim of this proposal is to use random forest, a machine learning approach that has worked particularly well in our past research, to identify potential interactions between social and behavioral factors, biomarkers, and genetic variants influencing cognitive decline in the WRAP cohort. We hypothesize that interactions in three main pathways will influence cognitive decline:

(a) Cholesterol metabolism: interaction between physical activity, obesity, lipids, and the cholesterol metabolism genes. (b) Insulin resistance: interaction between physical activity, obesity, HOMA (a blood measure of insulin resistance), and genetic variants in type 2 diabetes-related genes. (c) Inflammation: interaction between social activity, social support, stress, inflammatory biomarkers, and genetic variants related to immune system function.

The data for this project comes from the Wisconsin Registry of Alzheimer’s Prevention (WRAP), one of the few studies in the world that is focusing on this preclinical phase in middle-aged adults enriched for parental history of AD. WRAP is a longitudinal study with detailed information on socio-demographic and behavioral factors, biomarkers, and genetic variants.

This rich dataset is especially important because, as of yet, the only well-established risk factors for AD are increasing age, lower education, family history of AD, the APOE 4 allele, most of which are not modifiable. Nine additional genes of very small effect have recently been confirmed and additional suspected factors include cardiovascular disease risk factors (e.g., high cholesterol and hypertension in midlife and diabetes) and social and cognitive engagement [Alzheimer’s Association].

2013. Donald Moynihan, Barry Burden, and Jason Fletcher. Political Participation of Older Americans: the Role of Social and Genetic Factors.

We propose to identify how three factors (genetics, personality, and health) each affect the political participation of older Americans. We plan to pursue these questions by using an expanded version of the Wisconsin Longitudinal Survey. The survey already includes self-reported items on voting, plus other variables we hope to explore, including measures of health, political ideology, personality, socioeconomic status, biomarkers, and other important contextual predictors of voting. We plan to draw on three additional sources that will offer a more reliable and comprehensive account of the political participation of older Americans. First, we will add in individual registration and voting histories for approximately the last 10 years. This will be provided by a private firm that collects such data from state records. Second, we will add campaign contribution data from the state of Wisconsin and the federal government. These public files report on campaign contributions made to candidates, parties, and groups in recent election cycles. Third, we will add a list of Wisconsin residents who signed petitions to recall the governor in 2011. This public document records the name, address, and signing date for each person who added their name to the recall petition.

Priority Research Areas: Biology, Genetics and Demography of Aging

2013. F. Javier Nieto and Alberto Palloni. The Impact of the Economic Recession on the Health and Wellbeing of Elderly Adults.

This proposal leverages resources from the Survey of the Health of Wisconsin (SHOW), established in 2008 by a University of Wisconsin endowment as a statewide geographically-linked examination survey and biorepository. With funding from an NHLBI Grand Opportunities (RC2) grant, the Network for Health Equity in Wisconsin (NHEW) was established, linking SHOW with contextual data on the social, built-in, and health care environments, while developing strong partnerships with community organizations engaged in multi-modal health improvement initiatives. We propose to use the entire cross-sectional data set collected from 2008 to 2011 (N~2479) plus the (new, not yet released) data corresponding to 2012 to assess the effects of the economic recession on older adults’ behaviors and health markers, health care behaviors, residential patterns, and intra-family transfers as well as on the differential impacts by race and migration status. The two main goal of the pilot project are:

1. To assess the effects that drastic shifts in economic conditions induced by the 2008 economic recession influence markers and determinants of health status, including self-reported health and conditions; indicators of mental health and cognitive impairment, body mass and biomarkers including cortisol levels, blood pressure, CRP and other markers of inflammation; and, finally, mortality.
2. To estimate the degree to which the magnitude of the influence of the recession varies across social groups, particularly among disadvantaged groups, including low income, ethnic minorities and immigrants.

In particular we will focus on the following health outcomes: self-reported health, self-reported conditions (from health histories including CVD, diabetes, stroke), cognitive function and depression, dental health, sleep habits and sleep problems, respiratory function, blood pressure, obesity and weight gain (loss). In addition we will examine behaviors such as physical activity, diet, smoking and alcohol consumption prevention and prevention and safety habits. Finally, we will investigate adherence to treatment and preventative behaviors.

Priority Research Areas: Population, Economic and Health Forecasting

2013. Hiram Beltrán-Sánchez. Biological Risk Profiles in the Elderly Mexican Population at the Turn of the 21st Century.

The main goal of this study is to examine the association between socioeconomic factors associate and biological indicators of health within the elderly Mexican population. We expect differences in the physiological profile of the Mexican population to vary by age, gender, education, and rural residence. We also conjecture that older persons will have experienced suboptimal development as evidenced by their being shorter in total height and having more stunting resulting from worse levels of infection and nutrition while growing up. Due to likely increases in over-nutrition across all ages due to recent changes in nutrition we also expect differences in the cardiovascular and lipid profiles by age with a larger number of high-risk factors among the old. We will use data from all three waves of MHAS, the Mexican Health and Aging Survey. The third wave includes clinically relevant health indicators estimated from blood samples which were collected on fasting individuals We will study four sets of indicators representing physiological dysregulation: a) physical development and nutrition; b) indicators of metabolic dysregulation; c) indicators of cardiovascular dysregulation; and d) a summary risk indicator.

Priority Research Areas: Biology, Genetics and Demography of Aging

2013. Marsha Mailick. Genotype-Phenotype Associations and Genetic Risk of Aging: Health, Reproductive, Mental Health and Cognitive Phenotypes.

The proposed project will use WLS genetic biomarkers to provide an unbiased assessment of the phenotype of the “premutation” condition of the disorder known as Fragile X-Associated Disorder (FXS), an inherited form of intellectual disability that results from large expansions of a trinucleotide (CGG) repeat in the 5 unstranslated region of the FMR1 gene. This is a highly prevalent but undiagnosed condition. The goal of this new project is to conduct a deep phenotyping analysis to ascertain whether clinical observations of the symptoms associated with the permutation are in fact evident in an unbiased population sample. We will study the physical, reproductive and mental health as well as cognitive phenotypes associated with gray zone and permutation alleles in WLS respondents and determine whether or not the CGG repeat pattern influences the effects of stressful life events on the physical and mental health and cognitive functioning of respondents.

Priority Research Areas: Biology, Genetics and Demography of Aging

2012. Alberto Palloni. Trends and Determinants of Mortality Disparities between the U.S. and Other High-Income Countries: 1980-2010.

A 2011 National Research Council report offers compelling evidence supporting the idea that the US life expectancy at age 50 has fallen behind levels attained by peer countries in Western Europe and North America, both among males and females. The most important contributors to the gap between the US and other countries are associated with mortality due to very specific chronic conditions, including cancers and cardiovascular diseases. In turn, the ultimate determinants of these are less associated with medical technology and health care than with concrete individual behaviors, such as smoking, diet and exercise. This project has two objectives. The first is purely descriptive and entails to estimate the size of mortality gaps at various ages between the US and selected peer countries for the period 1975 and 2010. The second objective is to identify determinants of time trends in the gap between the US and other high-income countries. Results from this project on health status across the life cycle appear in chapter 2 of this study called, “U.S. Health in International Perspective: Shorter Lives, Poorer Health”. This study has received extensive media coverage in The New York Times, USA Today, and National Public Radio among other outlets. Alberto Palloni and graduate student Jay Yonker gathered and analyzed the information in Chapter 2 and wrote sections on health status across the life cycle. This study can be downloaded at this National Academy Press site.

Priority Research Areas: Health Trends and Disparities

2012. Felix Elwert. Proximity to Kin in Old Age and Ill Health.

Kin continues to be the primary caregivers of elderly and chronically ill Americans. Spouses, children, siblings, and parents offer support with the activities of daily living, maintain contact with healthcare professionals and the wider community, and execute nursing tasks for post-operative home care, disability, or long-term terminal illness. Kin caregiving, especially for long-term support, is greatly aided by physical proximity. Greater physical distance between kin likely hampers kin caregiving and may lead to increased health care expenses as the elderly and infirm are forced to contract caregiving on the open market. This project investigates the determinants of proximity to kin in old age and ill health. It draws on newly geocoded and network-coded data from the Framingham Heart Study (FHS) to examine the determinants of proximity over time.

Priority Research Areas: Determinants of Health, Well-Being and Longevity

2012. John D. DeLamater. Is There a Hormonal Component to Sexual Functioning in Later Life.

There have been occasional studies of the relationship between levels of hormones and sexual desire and sexual behavior in men and women. The hormones most frequently studied have been dehydroepiandrosterone (DHEA and DHEA-S), estradiol, progesterone, and testosterone. The results of these studies have been mixed, due in part to the use of small samples and variation in the measurement protocols for the hormonal assays. Few studies have analyzed hormonal levels and sexual functioning in later life. Pollet, et al., (2011) reported that, among persons over 57 years of age, testosterone was significantly associated with lifetime number of partners among men but not women. Spark (2002) suggested, based on limited data, that DHEAS levels are associated with libido and sexual satisfaction in women over 60.
The National Social Life, Health and Aging Project (NSHAP) provides for the first time the opportunity to analyze these relationships in a large, representative sample of older Americans. The sample includes 3005 men and women ages 57 to 85. The face-to-face interview obtained data on current sexual expression and relationship status, as well as retrospective relation and sexual history data. The interviewer requested that each participant provide a salivary specimen; 2, 721 agreed, and 2,640 were able to produce one. Salivary testing was carried out according to accepted protocols (Waite, et al., nd). The samples were assayed for cotinine, DHEA, estradiol, progesterone and testosterone.
I will begin by looking at correlations between hormone levels and measures of sexual desire, frequency of kissing and hugging, frequency of “sex” (broadly defined by NSHAP), frequency of vaginal intercourse, and frequency of oral sex. These analyses will be carried out separately by gender, race/ethnicity, and age group; in the case of age, various groupings or “cut-offs” have been used in prior work. We will progress to the use of more complex statistical analyses which will enable us to control for various potentially confounding factors. An important one appears to be relationship status and quality.

Priority Research Areas: Biology, Genetics and Demography of Aging

2012. Pamela Herd. Veteran Status and Later-Life Health: Evidence from Sibling Fixed-Effects Models.

There are numerous reasons to posit that veteran status is associated with health in later life. However, very few longitudinal studies of health or military service and health are able to disentangle age, period, and cohort effects or follow cohort members over very long periods of time. This pilot project plans to use data from the Wisconsin Longitudinal Study (WLS) to estimate sibling fixed-effects models of the association between veteran status and various mid- and later-life health outcomes among men, as well as among their spouses and children. We plan to expand this pilot project for a R01 grant application to NIA.

Priority Research Areas: Determinants of Health, Well-Being and Longevity

2011. Alberto Palloni. Early Childhood Conditions, Reproduction of Socioeconomic Inequalities and the Persistence of Health Disparities.

This project assesses the influence that early life conditions exert on adult outcomes and on adult health disparities. It opens up two new avenues of research, one substantive and the other methodological. On the substantive front we are attempting to account for the education health gradient using information on early childhood. The second path of research is purely methodological: we are utilizing combined data sets (WLS, NLSY-C, ECLS-K, NCDS58 and British Cohort 197) to carry out a fully comparative, cross country analysis.

Priority Research Areas: Determinants of Health, Well-Being and Longevity

2011. James R. Walker. Meta–Analysis of the Effect of Education on Mortality.

Abstract: For at least four reasons education is commonly used to proxy for socioeconomic status. First, education is an omnibus variable that influences alternative measures of socioeconomic status such as income, wealth, and occupation. Second, education is determined early into adulthood and before the onset of most chronic diseases. Therefore, education is less susceptible to problems of reverse causality as are income and wealth. Third, educational attainment is easier to measure than are say occupation or concepts such as social status or prestige. Fourth, there is an array of public policies designed to increase educational attainment. Consequently, identifying link between education and health and mortality offers direct, concrete and constructive guidance on beneficial public interventions to increase health or longevity. Nevertheless, education is heterogeneous and many different measures appear in the literature. This project will use a meta analysis of the educational gradient of mortality over the life course. The protective effects of education on health and the inverse relationship between education and (the timing of) mortality are among the most stable and most common findings in the broad literature investigating the relationship between socioeconomic status and mortality. The meta analysis will summarize effects of the quantity of education and of the effects of quality of education. There is a burgeoning literature on the effect of early life investments and adult health outcomes. Understanding and assessing these studies will be an important part of the meta analysis.

Priority Research Areas: Methodology

2011. Whitney P. Witt. The Impact of Preconception Health, Social Support, and Stress on Pregnancy and Birth Outcomes.

There is a dearth of research examining the effects of health, social support, and stress prior to pregnancy and subsequent obstetric outcomes. The purpose of this study will be to evaluate the impact of preconception health, social support, and stress on pregnancy and birth outcomes among a nationally-representative sample of women and their babies. Multivariate logistic regression models will be developed to examine obstetric outcomes using the Early Childhood Longitudinal Study-Birth Cohort (ECLS-B).

Priority Research Areas: Determinants of Health, Well-Being and Longevity