Abstract Objectives This longitudinal study examined the relationship between objective visual acuity and subjective vision over a six-month period. Specifically, it investigated the moderating role of internalized ageist attitudes in shaping how objective vision relates to perceived sensory vision difficulties over time. Methods A sample of 139 community-dwelling participants (M=70.25, SD=5.57) underwent objective vision assessments (distance and near visual acuity, and contrast sensitivity) and completed the Fraboni Scale of Ageism at baseline (T1). Subjective vision assessments were conducted at T1 and six months later (T2). Hierarchical regression analyses were used to predict T2 subjective vision, controlling for baseline subjective vision, age, sex, relationship status, and self-rated health. Results No direct main effect of T1 objective vision on T2 subjective vision was found. However, higher baseline ageist attitudes significantly predicted poorer subjective vision at T2 (β=.14, p=.041). Crucially, a significant interaction emerged (β=.16, p=.018); objective vision at T1 predicted poorer subjective vision at T2 only among individuals with high levels of ageist attitudes. For those with low ageist attitudes, this association was non-significant. Discussion These findings support Stereotype Embodiment Theory, suggesting that internalized ageist stereotypes asct as a cognitive lens through which individuals interpret biological sensory cues. The results indicate that subjective vision is not merely a reflection of physical decline but is significantly shaped by psychological frameworks. Clinical interventions aimed at reducing internalized ageist attitudes may mitigate the negative subjective experience of vision loss, potentially reducing functional vulnerabilities and enhancing overall well-being.
Objectives Recent trends of increasing midlife morbidity and mortality and widening educational disparities in the United States are concerning. This study documented the age pattern and educational disparities in health in the National Longitudinal Study of Adolescent to Adult Health (Add Health) cohort as they enter midlife, and situates the cohort relative to preceding, similar, and following cohorts in the National Health and Nutrition Examination Survey (NHANES).Methods Using data from Add Health and NHANES on 6 birth cohorts observed from adolescence to middle age, we characterized age patterns in general health, mental health, health behaviors, and chronic conditions within and across cohorts. We documented disparities by educational attainment, focusing on those with and without a 4-year college degree, and how such disparities emerge and evolve across the life course.Results Analysis showed that general health, mental health, and chronic disease deteriorated for the Add Health cohort as they aged into midlife, while health behaviors improved. Compared to the NHANES cohorts, the Add Health cohort had worse health than older cohorts, generally worse health compared to the same birth cohort, with some exceptions, and mixed health compared to younger cohorts. Educational gradients were relatively stable across age, with some evidence of increases, while educational gradients generally increased across cohorts.Discussion The worsening health of the Add Health cohort with age and relative to previous cohorts has important implications for aging, as this currently midlife cohort of U.S. adults will enter old age in worse health than their predecessors.
Objectives The goal of the Add Health Cognitive Assessment, Physical, and Sensory Function (Add CAPS) protocol was to establish a comprehensive, nationally representative assessment of cognitive, physical, and sensory function in early midlife to support longitudinal and life course Alzheimer's disease risk research. We developed the Add CAPS, a comprehensive and multidimensional assessment battery in Wave VI of the National Longitudinal Study of Adolescent to Adult Health (Add Health).Methods We describe protocol implementation and examine the distribution of cognitive, physical, and sensory measures by age, sex, and educational attainment in Add Health Wave VI.Results Among participants who completed the survey, response rates were approximately 85% for digital cognitive assessments and 94% for interviewer-administered cognitive, physical, and hearing measures. Participants with complete Add CAPS data had a mean age of 44.2 years. Cognitive performance varied by age, education, and sex. Younger participants and those with higher educational attainment had better cognitive performance scores across assessments. Participants who were male, older, and had lower educational attainment had poorer hearing. There were no age differences in grip strength, but it did vary by educational attainment. Survey-reported cognitive and physical challenges were common.Discussion The Add CAPS Protocol fills a critical gap by providing robust measures of cognitive, physical, and sensory function earlier in the adult life course than most nationally representative aging studies. These data will support future research on aging trajectories and health in the U.S. population.
Objectives Mental health is a central concern for aging and well-being over the life course. This study examined ethno-racial patterns of depressive symptoms and loneliness among a diverse cohort of U.S. midlife adults to illuminate why some individuals age more successfully than others. Drawing on the Stress Process Model, we investigated whether these patterns persist after accounting for socioeconomic and relational stressors and social support resources.Methods We used new Wave VI data from the National Longitudinal Study of Adolescent to Adult Health (Add Health). Descriptive statistics and negative binomial regression were employed to document ethno-racial variation in depressive symptoms and loneliness among this cohort of midlife U.S. adults (N = 11,435; ages 39-50).Results Multiracial adults initially reported slightly higher depressive symptoms and loneliness relative to White adults, but these differences were attenuated with adjustment for stressors and social support. Black adults exhibited poorer mental health than White adults descriptively, but better outcomes after adjusting for stressors and social support. Hispanic adults reported lower levels of depressive symptoms and loneliness than White adults net of sociodemographic covariates. Asian adults demonstrated no statistically significant differences from White adults.Discussion Ethno-racial groups each display unique mental health patterns in midlife, possibly reflecting differences in how ethno-racial groups perceive and cultivate resources in response to stressors and adverse structural conditions. Future studies should continue to investigate the complex set of factors which shape the mental well-being and aging of the U.S. population.
Objectives This study aims to better understand the effect of social disconnection on cognitive aging regarding its life course variation, temporal dynamics, and multidimensionality.Methods We conducted coordinated data analysis of three large U.S. population-based longitudinal cohort panels (Add Health I-VI, MIDUS 1-3, and HRS 2006-2020) consisting of 18,553 individuals aged 11+. We harmonized measures of longitudinal patterns of social isolation and loneliness (never/transient/persistent), episodic memory (word recalls), and working memory (backward digit span and serial 7's) across datasets. We estimated growth curve models to assess prospective associations of social isolation and loneliness with subsequent memory trajectories from adolescence to old adulthood.Results We found strong detrimental effects of social isolation in both young and older adulthood and loneliness in older adulthood on memory function. Longer (particularly persistent) exposures to isolation and loneliness predicted poorer memory test scores. These effects were attenuated but largely remained significant after adjusting for sociodemographic, behavioral, and health risk factors. Social isolation and loneliness show weaker and less consistent associations with the rate of memory decline across the life course samples.Discussion Comparative life course research helped to elucidate the complex relationship between social disconnection and memory change and inform the timing and duration of cognitive impacts of objective and subjective social disconnection. Interventions to promote healthy aging should focus on reducing the chronicity of isolation starting early in life and feelings of loneliness in later life. Future research should include additional longitudinal data to further investigate links between cognition, social disconnection, and underlying mechanisms.
