Search

Objectives This study was aimed to describe the interviewer-assessed measures present in the 2015/2016 Round of National Social Life, Health, and Aging Project (NSHAP), outline strengths of interviewer-assessed measures, and explore how interviewer assessments in the domains of home environment and personal characteristics are associated with older adult health. Method Data come from the 2015/2016 Round of the NSHAP. Results We provide descriptive results from the interviewer assessments of personal attributes, indoor home environment, and outdoor residential context. We present an illustrative analysis of reports of falls, a health outcome that might be predicted by characteristics assessed by the interviewer, and we suggest directions for further research. Discussion Interviewer assessments collected in NSHAP are useful as proxy measures and can be used in combination with respondent’s reports and ecological measures to generate insights into healthy aging.

Objectives Our primary objective was to examine the distribution of 3-m usual walk, five repeated chair stands, and three static balance stance performances among age and gender subgroups of adults at least 65 years in two national data sets. We secondarily determined whether demographic–function associations varied across data sets, birth cohorts, or models incorporating data from those “unable to do” tasks. Methods Two nationally representative data sets were used to generate survey weight-adjusted performance distributions: the 2015–2016 National Social Life Health and Aging Project and the 2016 National Health and Aging Trends Study. We then regressed walk and chair stand performance on age, gender, and race/ethnicity, examining differences across data sets, birth cohorts (1920–1947, 1948–1965), and before/after incorporating the “unable to do” performers. Results Findings confirmed the gradual decline in function with age and allowed estimation of “relative” performance within age/gender subgroups. Data set distribution differences were noted, possibly due to recruitment, eligibility, and protocol variations. Demographic associations were similar across data sets but generally weaker among the 1948–1965 cohort and in models including the sizable “unable to do” group. Discussion We present the largest, most current Short Physical Performance Battery reference data in U.S. adults aged 65 or older. Findings support standardization of administration protocols in research and clinical care and differentiating absolute from relative performance.

Objectives In this article, we present the theoretical framework that guided the development of the National Social Life, Health, and Aging Project (NSHAP) including the measures of social health. We discuss the literature that links social measures to other outcomes, and we discuss in detail how researchers might construct common measures of social health, including those that reflect social relationships, sexuality, social networks, social resources, and social participation. Methods The NSHAP includes multiple detailed measures of social health, collected in the rounds of data collection carried out in 2005, 2010, and 2015, allowing for study of changes over time and as people age among a nationally representative sample of the community-dwelling population of older adults in the United States. Results We define indicators of social health, describe measures of each in the 2015 round of NSHAP, and show the distribution of the measures by gender and age. We present scales of dimensions of social health that have been developed elsewhere and describe their properties. Discussion We briefly discuss the distribution of these measures by age and gender in the 2015 round of NSHAP. Simple analyses of these categorized measures reveal differences by age and gender that deserve closer attention in future investigations using the NSHAP data.

Background and Objectives Elder mistreatment victims at risk of poor physical and psychological health may benefit from increased social support. This article identifies mistreatment victims among community-dwelling older Americans and maps their social networks to guide the design of social support interventions. Research Design and Methods Using nationally representative survey data from Wave 3 (2015–2016) of the National Social Life, Health, and Aging Project (N = 2,334) and descriptive, latent class, and regression analyses, we estimate the prevalence of mistreatment since age 60, identify the alleged perpetrators’ relationships to the victims, and examine victims’ social networks. Results Self-reported lifetime prevalence of elder mistreatment is as high as 21%, depending on the mistreatment behavior measured. Latent class analysis reveals two mistreatment classes: 12% of older adults experienced multiple types of mistreatment (polyvictimization), and 6% experienced primarily financial mistreatment. Although alleged perpetrators are unlikely to appear in older adults’ core social networks, the most commonly reported perpetrators are children and relatives. Regression analyses show that experiencing mistreatment since age 60 is associated with having less current social support, more social strain, and fewer kin in the core social network. Older adults reporting polyvictimization also have less-dense core networks. Discussion and Implications Increasing family support should be done cautiously because children and relatives are frequently named as mistreatment perpetrators. Increasing communication across polyvictimization victims’ network members may support their well-being. Providing outside assistance with financial management could benefit financial mistreatment victims.

Background and objectives Although the role of place on health is not new, less is known about how place matters for cognition. By investigating both neighborhood and home as the sociospatial realms of older adults, we explore associations between health and place across multiple contexts. We also distinguish objective and subjective measures of place and disentangle their differential associations with cognition. Research design and methods We analyzed place effects on cognition from the National Social Life, Health, and Aging Project (N = 2,260) linked to neighborhood characteristics and crime data. We measured place in four ways: (a) objective indicators of neighborhood such as police-reported crime rates and interviewer-reported on presence of disordered conditions on the streets; (b) perceptions of neighborhood by respondents (perceived danger and social cohesion); (c) objective conditions of home (interviewer's report on presence of clutters, odor, and messiness); (4) perceived social support, strain, and threat by household members. The MoCA-SA was used to assess cognitive functioning. Results Subjective interpretations appeared to have more direct effects on cognition than did objective indicators of neighborhood or home. When examining these living environments together, we found the association between neighborhood and cognition is partially explained by characteristics of home environment, especially perceived social support. We found a buffering effect of social support on cognition for women, not for men. Discussion and implications Late life living environments are important contexts for aging. Aging-in-Place interventions should address subjective interpretations of place to reduce future risks of cognitive decline.

The classical senses (vision, hearing, touch, taste, and smell) play a key role in social function by allowing interaction and communication. We assessed whether sensory impairment across all 5 modalities (global sensory impairment [GSI]) was associated with social function in older adults. Sensory function was measured in 3,005 home-dwelling older U.S. adults at baseline in the National Social Life, Health, and Aging Project and GSI, a validated measure, was calculated. Social network size and kin composition, number of close friends, and social engagement were assessed at baseline and 5- and 10-year follow-up. Ordinal logistic regression and mixed effects ordinal logistic regression analyzed cross-sectional and longitudinal relationships respectively, controlling for demographics, physical/mental health, disability, and cognitive function (at baseline). Adults with worse GSI had smaller networks (β=-0.159, p=0.021), fewer close friends (β=-0.262, p=0.003) and lower engagement (β=-0.252, p=0.006) at baseline, relationships that persisted at 5 and 10 year follow-up. Men, older people, African-Americans, and those with less education, fewer assets, poor mental health, worse cognitive function, and more disability had worse GSI. Men and those with fewer assets, worse cognitive function, and less education had smaller networks and lower engagement. African-American and Hispanic individuals had smaller networks and fewer close friends, but more engagement. Older respondents also had more engagement. In summary, GSI independently predicts smaller social networks, fewer close friends, and lower social engagement over time, suggesting that sensory decline results in decreased social function. Thus, rehabilitating multisensory impairment may be a strategy to enhance social function as people age.

Has American society become more socially disconnected as Robert Putnam argues in Bowling Alone? Claude Fischer disputes this contention with evidence that Americans remain about as connected to friends and family as in the past. We address this debate with data for older adults from the National Social Life, Health and Aging Study, collected in 2005, 2010, and 2015. We compare social participation as reported at ages 57 to 68 for members of the Silent Generation cohort vs the Baby Boom cohort. We find that the gender gap in social participation evident for the Silent Generation does not exist at all for younger Baby Boomers, only appearing after age 62. These same cohort differences appear for participation in religious services and organized groups. This suggest that the gendered separation of social roles that characterized older generations is becoming less pronounced, with implications for social support and social isolation.

Implementing frailty assessment into routine clinical practice is a priority. Gait speed and performance on 5 repeated chair stands are two measures of frailty. We face a number of clinical implementation challenges: (1) We lack normative data for U.S. older adults and (2) The clinical relevance of change in frailty measures is unclear. The National Social Life, Health and Aging Project dataset allows an examination of the distribution of 3-meter gait and 5-repeated chair stands times as well as 5-year change in these measures in a nationally-representative, community-dwelling older adult sample. Dr. Huisingh-Scheetz will describe demographic predictors of change in these measures as well as determine whether baseline plus 5-year change in these measures predicts loss of independence in activities of daily living (ADLs).

Introduction. The geriatric functional measures and syndromes collected 5 years apart in Waves 1 and 2 of the National Social Life, Health, and Aging Project (NSHAP) data set included: difficulty with activities of daily living and instrumental activities of daily living, the timed up and go, a 3-m timed walk, repeated chair stands, self-reported physical activity, accelerometry-assessed (in)activity, falls, fractures, and frailty. The purpose of this paper was to describe the data collection methods and report preliminary population estimates for each measures. Method. Frequencies, means, or medians were estimated for each measure stratified by age and gender, using the age-eligible samples in Wave 1 ( n = 3,005) and Wave 2 (n = 3,196). An adapted phenotypic frailty scale was constructed in the sample common to both waves ( n = 2,261). Changes over 5 years were reported for four measures common to both waves. Results. The functional measures worsened with age ( p < .001). The syndromes were more prevalent with age except “all fractures” (p value range < .001–.03). Functional measures were worse among females than males except chair stand performance and the accelerometry-assessed (in)activity measures ( p value range < .001–.01). The syndromes were more common among females than males except Wave 2 falls and Wave 2 hip fractures ( p value range < .001–.03). Changes from Wave 1 to 2 revealed 11.5%–25.2% of individuals reported better health and 21.3%–44.7% reported worse health. Discussion. The NSHAP provides a comprehensive assessment of geriatric health. Our findings are consistent with the literature and support the construct of the study measures.

Cognition represents a key component of health, and decrements in cognitive functioning commonly accompany advancing age (Salthouse, 2012; Steinerman, Hall, Sliwinski, & Lipton, 2010). The individual cognitive domains affected (e.g., memory, attention, or executive function) vary within an individual and across a population by age (Salthouse, 2012). The subtler variations in cognitive functioning among community-dwelling older adults may represent relevant and important determinants of overall health status Moreover, the modest changes in cognition that do occur, if they progress, may advance to mild cognitive impairment (MCI; deficits in at least one cognitive domain, characteristically memory, but without clear functional consequences) and/or overt dementia (deficits in at least two cognitive domains of which one is memory with functional consequences) (Ashford, 2008; Petersen et al., 1999). A paucity of evidence exists surrounding the relationship between “normal” cognitive functioning and health in older adults (Alwin & Hofer, 2011). Emergent research suggests variation in cognitive performance in individuals with no known (or subclinical) cognitive impairment is associated with psychological, physical, and social health. For example, one study found that cognitively intact older adults who had lower scores on a measure of global cognitive function reported more depressive symptoms, whereas those with higher cognitive scores reported fewer such symptoms (Santos et al., 2013). Similarly, lower cognitive performance has been associated with physical disability and poorer social engagement compared to persons with better cognitive performance among cognitively intact individuals (Ishizaki et al., 2006; Paulo et al., 2011). Finally, initial studies investigating the relationship between cognitive performance with sleep quality and duration are on-going, with the former appearing more important to function than the latter (Blackwell et al., 2006; Potvin et al., 2012). While most of these studies are cross-sectional, limiting the ability to infer causality, and do not account for treatment effects (e.g., medication use), available studies highlight the importance of integrating multidimensional cognitive measures into population-based epidemiologic research. Epidemiologic studies traditionally incorporate some measure of cognition, although study design (e.g., phone vs in-person interview) or competing priorities within the survey may limit the number and extent of cognitive domains assessed (Herzog & Wallace, 1997). For example, the Health and Retirement Study (HRS) evaluates verbal memory, orientation, numeracy, attention, reasoning ability, vocabulary, verbal fluency, and language, but overlooks visuo-construction and executive function (Wallace & Herzog, 1995). As part of The National Social life, Health and Aging Project (NSHAP)—a population-based, nationally representative, in-home study of community-dwelling older adults—we developed a more comprehensive cognitive function measure as part of Wave 2. After an extensive literature review of available cognitive measures, the Montreal Cognitive Assessment (MoCA) stood out as a promising starting point to build upon in creating a measure, because it assesses key cognitive domains (executive function, visuo-construction skills, naming, memory, attention, language, abstract thinking, and orientation), has been administered in a variety of settings, and does not take an inordinate amount of time to complete (Luis, Keegan, & Mullan, 2009; Nasreddine et al., 2005). Our purpose here is to describe an adaptation of the clinical MoCA for use in a survey setting, the NSHAP, Wave 2, and provide recommendations for its use. This includes pilot testing to revise the instructions and format of the measure to ensure it could be reliably administered by non-medically trained personnel (e.g., field interviewers) in a home setting. Respondent burden was also minimized through elimination of redundant items, the use of an enhanced visual interface to better engage participants, and modification of the item order. These changes helped encourage completion of the measure as well as the remainder of the full 2-hr NSHAP interview. Using a pre-test sample, the measure was further refined for incorporation into Computer-Assisted Personal Interviewing (CAPI) technology for the full survey. With consideration of several guiding principles, outlined below, a final adaption, identified as the Chicago Cognitive Function Measure (CCFM), was constructed and incorporated into the NSHAP, Wave 2 instrument. In addition, a scoring algorithm for the measure was created and applied, yielding the final measure accompanied by recommendations on its use. Finally, the CCFM was successfully incorporated into NSHAP Wave 2 with preliminary results being reported.

BACKGROUND: Reports of insomnia symptoms are common among the elderly. However, little is known about the relationship between insomnia symptoms and objective assessments of sleep in the general population of older adults. We assessed concordance between insomnia symptoms and actigraphic sleep characteristics in a nationally representative sample of older Americans. METHODS: In a national probability sample of 727 adults aged 62-91 years in 2010-2011 from the National Social Life, Health, and Aging Project, respondents were asked how often they (a) feel rested when they wake up, (b) have trouble falling asleep, (c) have trouble with waking up during the night, and (d) have trouble waking up too early and not being able to fall asleep again. Responses to these questions were compared to sleep characteristics estimated from three nights of actigraphy for the same individuals. Statistical analyses were adjusted for age, gender, race and ethnicity, income, assets, and education. RESULTS: Feeling rested (Question (a), above) was not correlated with any actigraphy-estimated sleep characteristics. Questions (b)-(d) each had several significant correlations with the actigraphy metrics, but generally not with the specific objective sleep characteristics that each question intended to reference. In some cases, the associations were not in the expected direction. CONCLUSIONS: Although three of four questions about insomnia symptoms were significantly associated with objectively estimated sleep characteristics, responses seem to be general indicators of sleep quality rather than reports of specific sleep characteristics. Language: en

Objectives To examine the relationships between loneliness, social and health behaviors, health, and mortality among older adults in China. Method Data came from a nationally representative sample of 14,072 adults aged 65 and older from the 2002, 2005, and 2008 waves of the Chinese Longitudinal Healthy Longevity Survey. A cross-lagged model combined with survival analysis was used to assess the relationships between loneliness, behavioral and health outcomes, and risk of mortality. Results About 28% of older Chinese adults reported feeling lonely, and lonely adults faced increased risks of dying over the subsequent years. Some of the effect was explained by social and health behaviors, but most of the effect was explained by health outcomes. Loneliness both affects and is affected by social activities, solitary leisure activities, physical exercise, emotional health, self-rated health, and functional limitations over a 3-year period. Discussion Loneliness is part of a constellation of poor social, emotional, and health outcomes for Chinese older adults. Interventions to increase the social involvement of lonely individuals may improve well-being and lengthen life.

The National Social Life, Health, and Aging Project (NSHAP) is a longitudinal, population-based study that seeks to improve an understanding of the well-being of older, community-dwelling Americans. It accomplishes this by affording researchers a wide range of high quality measures that enable examining interactions among physical health and illness, medication use, cognitive function, emotional health, sensory function, health behaviors, social connectedness, sexuality, and relationship quality. The panelists in this symposium use NSHAP data to shed light on previously un- or underexplored aspects of health during aging. Kaufman et al. use interviewer ratings of respondents’ skin shade along with respondents’ individual experiences of discrimination, neighborhood racial composition, and other factors to characterize heterogeneity in the racial experience and how heterogeneity relates to health inequities. Riley integrates information on respondents’ residential region at birth and in older age to show that older adults who left the South are less healthy than those who stay in the South, and that social embeddedness helps to explain the health benefits for those who stay. Huang et al. take advantage of rich structural and functional social connectedness data to show that self-reported hearing impairment is associated with depth but not breadth of social connections. Huisingh-Scheetz et al. capitalizes on performance measures of gait speed and chair stands obtained at each wave to examine whether repeated measures improve the ability to predict loss of independence in activities of daily living. Discussant will discuss the importance, strengths, and weaknesses of these papers, and consider implications for future research.

Loneliness in older adults is most often attributed to marital and living status, social life factors, and physical health. Hearing impairment, however, is an understudied, potentially modifiable risk factor for loneliness. Older adults with hearing impairment experience difficulties with communication and social functioning, which also could contribute to loneliness. For this analysis, we used data from Wave 2 of the National Social Life, Health, and Aging Project. Participants (N=3,174) were a nationally representative sample of community dwelling older adults aged 62 - 91 years. Poisson regression models with robust variance were used to model the cross-sectional relationship between self-reported hearing impairment and loneliness. We found a dose-response relationship such that individuals reporting very good/good and fair/poor hearing had a 9% [95% CI: 0.93 - 1.28] and 26% [95% CI: 1.10-1.46], respectively, higher prevalence of loneliness compared to individuals reporting excellent hearing, adjusting for chronic conditions, functional and cognitive ability, and demographic factors. Results were robust to exclusion of participants who reported hearing aid use. These findings suggest that self-reported hearing impairment is a strong factor associated with loneliness in older adults. Given the negative implications of loneliness on multiple facets of mental and physical health, functional ability, and premature mortality, efforts to further explore hearing impairment as a causal and modifiable risk factor for loneliness should be undertaken.

Wearable sensors may improve our ability to identify frailty in the community. Frailty has been historically defined, in part, by reduced average activity; however, new analytic methods of aggregate, free-living accelerometry data suggest that frailty may be more fully characterized above and beyond reduced average activity. Using mixed-effect regression models of awake hourly activity from the National Social Life, Health and Aging Project dataset, we have shown that frail adult activity is most reduced in the morning relative to pre- and non-frail adults rather than the afternoon or evening. High residual between- and within-subject activity variance in this model prompted further study of activity variance. A follow-up analysis using a mixed-effect location-scale model of hourly activity data revealed that increasing frailty in older adults is associated with greater between-subject as well as within-subject hourly activity variability, particularly in the morning and afternoon. Study implications and future directions will be discussed.

Previous research has identified social isolation as a risk factor for physical and mental health problems (e.g., Berkman, 1995; Cacioppo & Hawkley, 2003; Cacioppo, Hughes, Waite, Hawkley, & Thisted, 2006; House, 2001). Socially disconnected and lonely individuals tend to suffer higher rates of morbidity and mortality (Taylor, Repetti, & Seeman, 1997; Thoits, 1995) as well as infection (Cohen, Doyle, Skoner, Rabin, & Gwaltney, 1997; Pressman et al., 2005), depression (Heikkinen & Kauppinen, 2004), and cognitive decline (Wilson et al., 2007). The mere presence of another individual can alleviate stress (Cohen & Williamson, 1991; Thoits), whereas feelings of loneliness may exacerbate the physiological effects of stress, resulting in elevated cortisol levels (Hawkley, Burleson, Berntson, & Cacioppo, 2003; Steptoe, Owen, Kunz-Ebrecht, & Brydon, 2004) and blood pressure (Hawkley et al). The purpose of this article is to demonstrate the development of scales capturing social disconnectedness and perceived isolation using data from the National Social Life, Health, and Aging Project (NSHAP). We use procedures of scale construction to combine multiple indicators of isolation into a scale assessing social disconnectedness and a scale capturing perceived isolation. We then examine the relationship between disconnectedness and perceived isolation and assess their distributions across age, gender, and self-rated health among older adults. Our aim is not to present these scales as definitive measures but to encourage further work toward elucidating the concept, causes, and consequences of social isolation among older adults. Social Isolation Among Older Adults The examination of social isolation among older adults is particularly important for a number of reasons. First, there is some evidence that social isolation may become more common with increasing age. Older adults tend to have smaller social networks (McPherson, Smith-Lovin, & Brashears, 2006) and are more likely to experience feelings of loneliness (Dykstra, van Tilburg, & de Jong Gierveld, 2005). This may be due, in part, to older adults’ experiences of bereavement and their greater likelihood of living alone (Kramarow, 1995; Li & Ferraro, 2005). The correspondence of these conditions has led to the assumption that diminishing social networks result in lower levels of perceived social support and increased loneliness. However, recent research suggests that changes across the life course in social connectedness and satisfaction may be heterogeneous. For example, data from NSHAP indicate that the oldest old have greater participation than the young old (Cornwell, Laumann, & Schumm, 2008), and other research suggests that loneliness may peak in middle age (Carstensen, Isaacowitz, & Charles, 1999). Accordingly, social connectedness, support, and loneliness may not be inextricably linked, especially among older adults. In the face of shrinking social networks, older adults may develop closer relationships and shift expectations so that decreasing connectedness does not necessarily result in the perception of isolation (Lang & Carstensen, 1994; Schnittker, 2007). Finally, to the extent that social isolation is associated with worse health, it may pose a particularly severe risk for older adults. Older adults are more likely to experience bereavement and develop health problems, both of which may increase their need for social support and companionship. As a result, social isolation may be particularly deleterious for older adults. Indeed, research indicates that older adults who experience one or another aspect of isolation have been found to be at greater risk for all-cause mortality, increased morbidity, depression, and cognitive decline (Brummett et al., 2001; Cacioppo & Hawkley, 2003; House, Landis, & Umberson, 1988; Sherbourne, Meredith, Rogers, & Ware, 1992; Tomaka, Thompson, & Palacios, 2006). Measuring Social Isolation The variety of indicators of isolation and loneliness used across research in different disciplines is both a blessing and a curse. This work has captured an enormous number of facets of individuals’ everyday social worlds. Indicators of isolation in previous research include living alone (Dean, Kolody, Wood, & Matt, 1992; Hughes & Gove, 1981; Waite & Hughes, 1999), being unmarried (Lillard & Waite, 1995; Ross, 1995), having a small social network (Berkman & Syme, 1979; Seeman, Berkman, Blazer, & Rowe, 1994), infrequent contact with network members (Brummett et al., 2001), a lack of social network diversity (Barefoot, Gronbaek, Jensen, Schnohr, & Prescott, 2005), a perceived lack of social support (Blazer, 1982; Krause, 1987; Lin, Ye, & Ensel, 1999; Wethington & Kessler, 1986), low participation in social activities (Benjamins, 2004; Ellison & George, 1994; Thoits & Hewitt, 2001), emotionally distant relationships (Uno, Uchino, & Smith, 2002), and feelings of loneliness or not belonging (Cacioppo et al., 2006; Hawkley et al., 2003). However, most of this work has been limited to the examination of only one or two indicators of isolation (or connectedness), or it has focused on only one conceptual area, such as support, participation, or loneliness. As a result, it is difficult to discern whether multiple features of isolation might combine to create particularly severe situations of social isolation among the oldest old. It is also unclear whether feelings of loneliness and a lack of social support do, in fact, follow the loss of social network ties or if more subjective appraisals of isolation are separate from objective features of isolation. In efforts to consolidate multiple measures of social isolation, several authors have previously identified central components of isolation. For example, van Baarsen, Snijders, Smit, and van Duijn (2001) distinguish between social loneliness, as the lack of integration and companionship, and emotional loneliness, as the lack of an attachment figure. De Jong Gierveld and Hagestad (2006) similarly contrast isolation (as the opposite of integration) with loneliness (as the opposite of embeddedness). Following these distinctions and building from the disciplinary approaches of both sociology and psychology, we suggest two distinct aspects of social isolation. Social disconnectedness can be characterized by a lack of contact with others and indicated by situational factors, such as a small social network, infrequent interaction, and a lack of participation in social activities and groups. Perceived isolation, on the other hand, can be characterized by the subjective experience of a shortfall in one’s social resources such as companionship and support. Individuals who are socially disconnected may have small social networks, interact with network members infrequently, and rarely participate in social activities. On the other hand, individuals who perceive themselves to be isolated may report feelings of loneliness and perceive a lack of social support from friends and family members. Social disconnectedness and perceived isolation are related, but we hypothesize that they are distinct. Some research indicates, for example, that feelings of loneliness are responsive to changes in network size, but other findings indicate only a modest correlation between disconnectedness and perceived isolation (Hawkley et al., 2003; Hughes, Waite, Hawkley, & Cacioppo, 2004; Schnittker, 2007). Although physical separation from others and feelings of loneliness may go hand-in-hand for some individuals, infrequent social interaction may not lead to feelings of loneliness for others. Alternatively, people who are socially active and embedded within an expansive social network may feel socially isolated if their relationships lack emotional closeness and support.

R. WAITE, S. JACKSON AND H. THOMPSON. 2003. Aims: To investigate the occurrence of oxytetracycline (OTC) resistance in Melissococcus plutonius, which causesEuropean foulbrood in honeybee colonies.Methods and Results: Strains of M. plutonius were isolated from diseased colonies in England and Wales andtested for resistance to OTC. The minimum inhibitory concentration (MIC) of OTC was also determined forselected isolates. No resistance to the antibiotic was found in any isolate and the average MIC was found to be3AE9 lgml )1 . Melissococcus plutonius was found to be susceptible to both chlortetracycline and tetracycline.Conclusions: No resistance to OTC was found in M. plutonius.Significance and Impact of the Study: This study demonstrated that OTC can continue to be used to treatEuropean foulbrood and that resistance may not explain why some treatments fail.Keywords: Apis mellifera L., European foulbrood, Melissococcus plutonius, oxytetracycline resistance. INTRODUCTIONHoneybees suffer from relatively few diseases, but those thatdo occur are often very serious. One of the major diseasesaffecting larvae is European foulbrood (EFB). The conditionis thought to be caused by a bacterial pathogen, Melissococcusplutonius (formerly M. pluton), which is ingested by thelarva during feeding by adults (Bailey and Locher 1968;Bailey 1983). The bacterium resides in the gut andcompetes with the larva for food. If food is plentiful, bothlarva and bacteria will survive. However, when food is lessavailable, the bacteria will scavenge the food, causing thelarva to starve and die (Bailey 1960). The aetiology isfurther complicated as there are several other bacteriaassociated with the disease, including Paenibacillus alvei,Brevibacillus laterosporus and Enterococcus faecalis. These arethought to be secondary saprophytes that multiply on thedead larva, rather than actual pathogens (Bailey 1963;Alippi 1991). However, the progression of the disease is notfully understood and these bacteria may play a further role.If the infection is light, affecting few larvae within acolony, the disease can be treated with the bacteriostaticantibiotic oxytetracycline (OTC), which prevents multipli-cation of the bacteria. This antibiotic has been used in theUK since the late 1960s to treat EFB and, in some countries,is used against another honeybee disease, American foul-brood (AFB), caused by P. larvae subsp. larvae. Despite thesimilarity of their names, the two diseases are not related.Katznelson et al. (1952) found that OTC was effective intreating colonies with EFB. American beekeepers have usedthe antibiotic as a treatment and prophylactic measureagainst both foulbrood diseases since the 1950s (Moeller1978; Lehnert and Shimanuki 1980; Hoopingarner andNelson 1987; Kochansky 2000). Resistance of P. larvaesubsp. larvae to OTC has recently been reported inArgentina and the USA (Alippi 2000; Miyagi et al. 2000).In the UK, colonies with AFB are destroyed as the disease ishighly virulent and treatment can mask signs of EFB(Thompson and Brown 1999). Since M. plutonius has beenexposed to OTC for a long period, it might be expected that

Background. Sedentary behavior is a risk factor for and marker of poor health, independent of activity participation. Older adults spend the majority of time sedentary making this behavior a critical target for successful aging. The purpose of this study is to provide older adult normative data for sedentary behavior by age and gender, identifying the least and most sedentary patterns for each group as a reference to gauge risk.

IN middle through early older ages, people live in diverse family structures (Siegel, 1993). A large proportion of adults in their 50s and 60s are “empty nesters,” living only with their spouses. Others live with their children—some with their spouses and children, some with their children only, and some in complex households including their spouses, children, and other relatives. A sizeable minority of persons in this age group lives alone; a smaller minority lives with a cohabiting partner. Finally, a modest but significant number live without spouse or children in complex households. As in other stages of the life course, these patterns differ by race and ethnicity. Single-parent families and multigenerational households are both more common among older Blacks and Hispanics than among older Whites (Himes, Hogan, & Eggebeen, 1996). The various household structures make very different demands on the adults in them and offer very different levels and types of resources. These differences may have implications for the well-being of adults at the threshold of old age. Although most middle-aged adults remain healthy and continue to function at high levels, in late middle age some people begin to experience functional limitations associated with aging (Jette, 1996). Impaired functioning among those living independently—or those on whom others are dependent—points to an increased risk of transition to disability and suggests a potential unmet need for support. In this article, we consider the household as a specific and important context in which functional limitations may create problems for older adults. Using the Health and Retirement Study, we examine the cross-sectional relationship between household structure and levels of physical, emotional, and cognitive functioning for a group of adults poised to become young-old.

We measured beta-lipoprotein in 232 cord sera by rate nephelometry and compared the results with those obtained by electroimmunoassay. The mean (mean +/- two standard deviations) was 544 (293-1009) mg/L by rate nephelometry and 503 (265-955) mg/L by electroimmunoassay. The between-assay correlation coefficient was 0.891. Between-run coefficients of variation were 3.5-4.4% for nephelometry and 11-14% for electroimmunoassay. Nephelometry was faster, more precise, and less labor intensive than electroimmunoassay. For these reasons, rate nephelometry appears to be a more suitable assay system for mass screening, should detection of familial hypercholesterolemia prove feasible and desirable.