Jennifer A Ailshire

University of Southern California | USC · School of Gerontology

Comparing the aging experience across country contexts offers a unique opportunity to determine whether observed differences in mental and physical health of older adults reflect a universal aging process or if they depend on the unique social and economic contexts in which older adults live. The HRS-family of surveys consists of nationally-represe...

Extreme heat exposure is a major risk factor for cardiovascular diseases and mortality. However, knowledge about the biological ramifications of extreme heat exposure is limited, particularly among older adults who face elevated vulnerability. This study examines the association between heat exposure and epigenetic aging, a key molecular marker of...

Climate change is leading to more extreme heat events, potentially impacting host-parasite dynamics, immunity, and infectious diseases. While animal studies suggest that heat can induce long-lasting immune disorders, its effects on human immune function remain underexplored. This study examines how heat exposure is associated with adaptive immunity...

Physical activity plays an important role in delaying the progression of cognitive and functional decline among people with dementia (PWD). Neighborhood environments can provide key resources or function as critical barriers to promoting physical activity among PWD. However, the specific neighborhood factors that drive this relationship are yet to...

Latin America’s population is aging rapidly. Little is known about disability prevalence among older adults in these countries. We estimate and compare disability prevalence from nationally representative surveys of older adults from Mexico (2015 Mexican Health and Aging Study, MHAS, N=6,699), Brazil (2015 Brazilian Longitudinal Study of Aging, ELS...

Despite the robust link between education and dementia risk, less is known about how state education quality relates to dementia, particularly regarding how it differs by race. Drawing on data from the Health and Retirement Study (2000-2018) of adults aged 55 years and older, linked to historical state school investment records from 1914 to 1959, w...

Despite demographic projections that more men are adopting caregiving roles than ever before, there is a lack of population-level estimates regarding the prevalence of male caregivers over time. It is also unclear which types of caregiving tasks men typically provide. Using data from the Health and Retirement Study (2002-2018), we investigate trend...

Living in neighborhoods with diverse amenity environments, including a variety of facilities and services, may impact the health and well-being of older residents by providing increased access to essential services, fostering social networks, and building social capital within communities. Such environments, however, may not be uniformly experience...

Prior research shows independent associations of exposure to air pollution and heat on epigenetic alterations. However, less is known about the combined effects of long-term air pollution (PM2.5) and acute heat events. We examine joint effects of elevated PM and heat on DNA methylation (DNAm). Data from the 2016 Health and Retirement Study DNAm Sam...

Purpose Pain and depression are linked to higher mortality risk and lower subjective survival probabilities (SSPs). We examine if SSPs for individuals with pain and depression match their actual lifespans. Methods Using data on 12,745 Health and Retirement Study respondents aged 57-89 in 2000 with follow-up through 2018, we assessed whether respon...

Objective Pain is a leading cause of disability and a limiting factor in individuals’ assessments of their own subjective health, however its association with subjective longevity has yet to be explored. Subjective survival probabilities (SSPs), or one’s own perceived chances of living to a given age, can influence individuals’ behavior as they pla...

Colombia’s population is rapidly aging and older adults are living longer, however, we have limited information on the level of disability and number of years older Colombians spend with disability. We estimated age-and-gender specific ADL, IADL and mobility disability prevalence and disabled life expectancy (DLE) and to examined gender differences...

Background Foreign born (FB) adults from Latin America are projected to account for the largest proportion of the aging immigrant population in the United States (U.S.) Migration related stressors may increase vulnerability for impairments of stress regulatory systems that are vital in maintaining brain health. We assessed how subjective social sta...

Social services (e.g., senior centers, adult day care centers) and home health services (e.g., in-home personal care, visiting nurses) have been found to provide numerous benefits, such as opportunities for social interaction, physical activity, cognitive stimulation, as well as personal care and regular medical check-ups for older adults. These se...

There is substantial evidence from the occupational health, psychology, and environmental health literatures to suggest that inflammation is a biologically plausible mechanism through which physical, psychosocial, and environmental occupational characteristics influence risks of several health conditions at older ages. However, there is limited emp...

Life expectancy at birth in China has increased more than 20 years over the past 50 years and is one year higher than in the US in 2021. Whether the rapid improvement in Chinese life expectancy has been accompanied by similar changes in other aspects of the aging process compared to the US remains unclear. In this study, we focus on measured physic...

Exposure to stressful neighborhood environments is a well-established risk factor for health deterioration and premature death. However, the underlying biological underpinnings driving these associations are not fully understood. Epigenetics may function as a key molecular pathway to adverse health outcomes among residents of high-stress neighborho...

Historical redlining disproportionately harmed Black and disadvantaged communities by designating them as less desirable for mortgage lending. Residence in neighborhoods historically designated as less desirable is associated with worse health outcomes, though little research exists on older adults. Redlined neighborhoods often have characteristics...

Intense, frequent extreme weather events pose a significant public health threat, particularly for middle-aged and older adults who may be at elevated health risk. Yet, the social and environmental factors that determine their vulnerability and resilience remain largely unexplored. This study investigates individual and contextual determinants asso...

Neighborhood social cohesion may act as a protective factor against the negative effects of certain stressors associated with dementia status on subjective well-being. The current study aimed to investigate the moderating effect of neighborhood social cohesion on the relationship between dementia status and subjective well-being among older adults....

Research indicates an association between diet quality and cognitive outcomes. However, the association across ethnicities is not well understood. This study identifies differences in diet quality using the Healthy Eating Index (HEI-2015) score by ethnicity and its relationship to cognitive outcomes within ethnic groups. The sample includes 6,845 o...

The number of older adults in Colombia will soon double and it is essential to understand the disease burden in this population. Disease prevalence is often estimated from medical diagnoses, which can underestimate disease in populations with less health care access and low health literacy. We compare differences in diseased life expectancy (DLE) u...

Aging in Latin America is occurring rapidly, in a context of high levels of poverty, low education and limited knowledge on the health conditions of older adults. This symposium is focused on heath-disparities found in some of Latin America’s largest middle-income countries, Mexico, Brazil, Chile, and Colombia. The symposium explores various health...

Compared to only 2% of the total population between ages 65 and 84, 15% of persons with dementia (PWD) transition to nursing homes. This may be due to caregiving challenges associated with the behavioral symptoms PWD exhibit and their reduced capacities to perform daily tasks. Access to neighborhood amenities (e.g., parks, food access, libraries, s...

Marijuana use is increasing in the U.S. population, including among adults 50 and older, but research on population characteristics of marijuana use in middle aged and older adults is limited. We use data from the 2018-2021 Behavioral Risk Factor Surveillance System (BRFSS) surveys, which are representative of U.S. state populations, to estimate pr...

Centenarians are recognized as providing a model of delayed aging. Centenarians are generally healthier throughout their 80s/90s than non-centenarians. However, the extent of the delay in morbidities experienced by centenarians remains unclear as it requires quantifying trajectories of health deterioration with age for both centenarians and their c...

Education’s contribution to Black–White disparities in cognitive function remains unclear due to data limitations that capture systemic educational inequities in the Jim Crow South. We include differential rates of school attendance across race, years, and states in the Jim Crow South. We linked state-level data on school attendance from the 1919 t...

Introduction There is growing interest in accelerating adoptions of vaccines. This study examined factors that differentiate the acceptance and timing of uptake of the first shingles vaccine, Zostavax, among older adults in the U.S. Methods Data from Health and Retirement Study respondents who were aged ≥62 years in 2008 were analyzed to determine...

Background: The aging process is accompanied by decline in kidney functioning. It remains unknown to what extent age-related decline in kidney functioning can be attributed to health indicators, and whether rate of decline differs across sociodemographic groups. Methods: Using data from the Health and Retirement Study from 2006/2008 through 2014...

Background and Objectives Self-perceptions of aging (SPA) are associated with health and well-being later in life. While prior studies have identified individual-level predictors of SPA, the role of neighborhood social context in SPA remains largely unexplored. A neighborhood social environment may act as a critical avenue for older adults to remai...

Objectives The COVID-19 pandemic greatly impacted the social lives of older adults across several areas, leading to concern about an increase in loneliness. This study examines the associations of structural, functional, and quality aspects of social connection with increased loneliness during COVID-19 and how these associations vary by sociodemogr...

Frailty indices (FI) have been found to predict adverse outcomes, such as, mortality, hospitalization, and institutionalization in older adults. However, traditional FIs often exclude people with dementia (PWD), who may not be able to consent to or complete all of the standard frailty items. While frailty is a known risk factor for onset of dementi...

Although education is a key protective factor against dementia, older U.S. adults experienced vastly different educational contexts. One of the most consequential legal decisions impacting educational contexts was Brown v. Board of Education, which declared ‘separate but equal’ schools unconstitutional. School desegregation in the U.S. South was in...

Loneliness is a public health concern that is associated with poor mental and physical health. Caregiving spouses of community-dwelling older adults often have high levels of caregiving burden, which make them more vulnerable to social isolation and loneliness. There has been a growing interest in third places as mediums for social interaction. Res...

Various neighborhood factors, including greenspace availability and neighborhood socioeconomic disadvantage, are associated with accelerated biological age (aging faster than expected based on chronological age) among older adults. Neighborhoods, however, evolve overtime and historical neighborhood conditions may be influential in the aging process...

There is a common saying that demanding jobs can make workers age faster, but there is little empirical evidence linking occupational characteristics to accelerated biological aging. We examine how occupational category (professional/managerial, sales/clerical, service, and manual) and occupational characteristics (e.g., psychosocial stressors, phy...

Research has documented the increased risk of cognitive impairment among older adults living in socioeconomically disadvantaged neighborhoods. Much less is known about the factors that moderate this risk. We conceptualized self-perception of aging (SPA) as a potential moderator because it reflects core beliefs about the self at older ages but is al...

Cross-national comparative research is a useful tool for identifying common aspects of, and risk factors for, healthy and unhealthy aging across populations and sociocultural contexts. The papers in this symposium use harmonized data from the Gateway to Global Aging to examine a range of topics in aging and provide new insights into long-standing a...

Residence in high poverty states has been associated with increased mortality risk in the United States, but less attention has been paid to the relationship between state-level poverty and mortality in younger to older adults in Latin America. Poorer states in Colombia, one of the most populous and rapidly aging countries in Latin America, tend to...

People who have COVID-19 can experience symptoms for months. Studies on long COVID in the population lack representative samples and longitudinal data focusing on new-onset symptoms occurring with COVID while accounting for pre-infection symptoms. We use a sample representing the U.S. community population from the Understanding America Study COVID-...

The 2006 eldercare facility ordinance of Los Angeles was designed to streamline permitting of senior housing development in the jurisdiction. Using California State Department of Social Services residential care and census place data, this study compares the pre and post effect of the ordinance on the number of large residential care facilities dev...

Chronic pain is a leading cause of disability and is a limiting factor in individuals’ assessments of their own subjective health; however, the association between pain and assessments of one's longevity has not yet been explored. Subjective life expectancy (SLE) predicts health and financial planning through its association with actual mortality a...

Background Motoric Cognitive Risk Syndrome (MCR) is a predementia stage where slow gait speed and subjective memory complaints are present. The purpose of this study was to estimate the prevalence of MCR and assess its relationship with sociodemographic factors and chronic conditions. Methods This is a secondary analysis of the SABE Colombia study...

People who have COVID-19 can experience symptoms for months. Studies on long COVID in the population lack representative samples and longitudinal data focusing on new-onset symptoms occurring with COVID while accounting for pre-infection symptoms. We use a sample representing the U.S. community population from the Understanding America Study COVID-...

Most prior research on caregivers’ mental health focused on individual or household factors, we know much less about the influence of neighborhood factors on mental health of spousal caregivers. The current study fills the gap in our knowledge by examining the association of neighborhood characteristics (i.e., perceived neighborhood disorder and ne...

Prior research has suggested that poor neighborhood and housing conditions can lead to worse psychological wellbeing. Most studies examine either neighborhood or housing conditions, but not both. Since neighborhood and housing conditions may be correlated it raises the question of whether one is a proxy for the other. We use data from the 2006 and...

Increasing attention is being paid to improving care at the end-of-life, including developing a better understanding of where individuals die, and factors related to place of death. The older immigrant population in the United States is increasing rapidly, and while prior research suggests they may differ in their end-of-life experiences, we know r...

Latinos are often treated as an amalgamated group without respect to Latinos' composition included in sampling designs in different periods. This matters because the Latino population is continuously changing over time with respect to migration patterns, socioeconomic status, sociocultural characteristics, and geographic dispersion across the U.S.,...

An individual’s rate of aging directly impacts one’s functioning, morbidity and mortality. Identifying factors related to accelerated or delayed aging may provide important information for potential areas of intervention. While race/ethnicity, socioeconomic status and behavior characteristics have been linked to biological aging, it is unclear whet...

Despite its importance for health and wellbeing, oral health quality of life (OHQoL) has received little attention in lower-income countries, such as Colombia. This study describes the prevalence of older adults’ OHQoL and variability by socioeconomic status. We use data from the 2015 SABE-Colombia (N=18,700), a nationally representative survey of...

The U.S. is aging, and the older adult population and number of long-term care services are growing but not at corresponding rates and concentrations depending on location. Insufficient research has analyzed residential care at the neighborhood or city level of analysis, where geographical trends in growth often reveal notable patterns of long-term...

Self-perception of aging (SPA), one’s attitude toward one’s own aging, has been associated with health and well-being in later life. Whereas existing literature identifies individual-level predictors of SPA (e.g., education and health), little is known about the role of neighborhood context. The present study examines whether 1) neighborhood social...

Summary Background: Motoric Cognitive Risk Syndrome (MCR) is a predementia stage where slow gait speed and subjective memory complaints are present. The purpose of this study was to estimate the prevalence of MCR and assess its rela- tionship with sociodemographic factors and chronic conditions. Methods: This is a secondary analysis of the SABE C...

The development of residential care has not kept pace with the growth of the older population in many places. We merged the California Department of Social Services residential care for the elderly dataset with census place data to document the growth of facilities and beds per older adults in all of California and in its three largest cities. From...

This literature review provides a framework for understanding the development of residential care in California, including state licensing, federal funding, and state and local planning policies for the development of facilities. It discusses the history, planning, and licensing of residential care as a home and community-based service in Californi...

Background Cardiometabolic risk (CMR) is a key indicator of physiological decline with age; but age-related declines in a nationally representative older U.S. population have not been previously examined. Methods We examined the trajectory of cardiometabolic risk (CMR) over 8 years of aging, from 2006/2008 to 2014/2016, among 3,528 people over age...

BACKGROUND Cognitive impairment and dementia are some of the most important health challenges we face today. Almost 60% of people with dementia live in low-and middle-income countries, such as Colombia. OBJECTIVE The aim of this study was to evaluate the association between access, capacity to use and frequency of using with cognitive impairment a...

Background: Air pollution is linked to worse cognitive function in older adults, but whether differences in this relationship exist by education, a key risk factor for cognitive decline, remains unknown. Objective: To determine if the association between fine particulate matter air pollution (PM2.5) and incident cognitive impairment varies by level...

Objective A suboptimal diet and nutritional deficiencies can have important influences on health with significant impact among older adults. This study aims to assess the presence of suboptimal dietary intake among older Americans and identify risk and protective factors influencing diet quality. Design Cross-sectional secondary analysis Setting...

Objectives In response to the COVID-19 pandemic, older adults are advised to follow social distancing measures to prevent infection. However, such measures may increase the risk of loneliness. The current study aimed to investigate (1) whether social distancing measures, particularly limiting close social interactions, are associated with lonelines...

Objectives Family is largely overlooked in research on factors associated with place of death among older adults. We determine if family caregiving at the end of life is associated with place of death in the United States and Europe. Methods We use the Harmonized End of Life data sets developed by the Gateway to Global Aging Data for the Survey of...

Biomarkers are sensitive to current health status and capture aspects of health that may precede the development of disease and other health problems. Using comprehensive measures of biological risk, this study aims to investigate the relationship between intake of individual dietary components, overall diet quality, and biological dysregulation. F...

In recent decades, the cost of higher education has exceeded the pace of inflation while wages have stagnated or declined. As such, young adult children may increasingly look to their parents and other family members, including grandparents, to help them pay for college. We use data from the National Longitudinal Survey of Youth 1979 to determine w...

Older people who live alone may benefit more from using electronic communication than those who live with others. Although living alone has been linked to a higher risk of depression and social isolation, few studies examined the effect of using electronic communication separately by living arrangements. The current study examines the effect of ele...

Stress is a risk factor for shingles. Empirical evidence of how stress affects getting shingles is lacking for the older population. This paper examines how chronic stress and stressful events are associated with incident shingles in a nationally representative sample of the population over age 50, the Health and Retirement Study. Using data for 20...

With rapid population ageing, providing better end-of-life care (EOLC) is becoming a source of social demand and financial pressure for public and private budgets in many countries. This paper uses data from harmonized end-of-life interviews in the HRS family of studies to assesses variation in health care utilization across different income groups...

In response to the COVID-19 pandemic, older adults are advised to follow social distancing measures to prevent infection. However, such measures may increase the risk of loneliness. The current study aimed to investigate (1) whether social distancing measures, particularly limiting close social interactions, are associated with loneliness among old...

The deterioration of the cardiovascular system is a process associated with aging. Most of the prior works have examined changes in cardiometabolic risk (CMR) while aging at the population level using cross-sectional data, but we study within-person changes for total CMR and separate risk factors, including pulse pressure, resting heart rate, C-rea...

A suboptimal diet and nutritional deficiencies can have important influences on health with significant impact among older adults. This study aims to assess the presence of suboptimal dietary intake among older Americans and identify risk and protective factors influencing diet quality. For this study, data from a nationally representative sample o...

Deterioration in kidney functioning is associated with aging and is a major risk factor for mortality and other poor health outcomes. Medicare expenses for poor kidney functioning are about 100 billion dollars every year. High Cystatin-C is an indicator of poor kidney functioning. We do not know if cystatin-C increases gradually as an individual ag...

The spatial distribution of Latinos in U.S. neighborhoods is highly patterned due to a complex set of social, cultural, and economic forces, which leads to the differential distribution of and exposure of resources and opportunities across space. However, less is known about the types of neighborhoods older Latinos live in and how it impacts their...

Military service and exposure to war may influence the development of depression, leading to disparities in the condition among veterans and non-veterans. This study included 10,512 older men from the 1996 to 2014 waves of the Health and Retirement Study (HRS). We estimated Center for Epidemiology Depression (CESD) score trajectories among veterans...

Life expectancy has increased rapidly in Colombia but it is unclear whether these added years of life are healthy years. The objective of this paper is to estimate gender differences in disability life expectancy for older adults. We use data from the first nationally representative survey of adults ages 60 and over in Colombia, the 2015 Survey of...

Physical conditions of living environments can impact risk of falls, however, prior work has focused typically on one domain at a time—either neighborhood or home, capturing limited environmental boundaries of older adults. We extend prior work by considering both neighborhood and home as important residential contexts and examine their impact on t...

Researchers consistently find adverse long-term health outcomes among renters as compared with homeowners, yet more proximal health measures are needed to understand whether there is a direct link between tenure and health. In this paper, we compare cardiometabolic risk (CMR) levels among older renters and homeowners, and ask whether this health di...

Background: Air pollution is linked to worse cognitive function in older adults, but whether differences in this relationship exist by education, a key risk factor for cognitive decline, remains unknown. Objective: To determine if the association between fine particulate matter air pollution (PM2.5) and incident cognitive impairment varies by le...

Introduction: The COVID-19 pandemic is an unprecedented public health crisis. It is becoming increasingly clear that people’s behavioural responses in the USA during this fast-changing pandemic are associated with their preferred media sources. The polarisation of US media has been reflected in politically motivated messaging around the coronavirus...

Telomere length (TL) is a biomarker that can be used to characterize variability in aging and may explain race/ethnic differences in aging. Yet, it remains unclear if TL is related to aging-associated health risks in multi-ethnic populations or if it explains race/ethnic differences in health. We examine whether salivary TL (STL) explains any of th...

The social, economic, and physical environments in which older adults live play a vital role in healthy, active, and engaged lives. But older adults live in unequal environments. Low-income older adults and older racial-ethnic minorities are more likely to live in neighborhoods characterized by poverty, disorder, lack of social cohesion, and pollut...

Objectives: Exposure to stressors is differentially distributed by race/ethnicity with minority groups reporting a higher stress burden than their white counterparts. However, to really understand the extent to which some groups bear a disproportionate stress burden we need to consider race/ethnic differences in stress appraisal, specifically how...

A growing number of studies have found a link between outdoor air pollution and cognitive function among older adults. Psychosocial stress is considered an important factor determining differential susceptibility to environmental hazards and older adults living in stressful neighborhoods may be particularly vulnerable to the adverse health effects...

Objectives: This study investigates education differences in levels and change in sense of control and hopelessness among older adults. Method: We used data from the Health and Retirement Study, an ongoing biennial survey of a nationally representative sample of older Americans, to examine education differences in sense of control (e.g., mastery...

Background: Little is known about the health and functioning of individuals who become centenarians in the years prior to reaching age 100. We examined long-term trajectories of disease, disability, and cognitive function in a sample of U.S. centenarians to determine how their aging experience differs from their nonsurviving cohort counterparts, a...

Many studies rely on self-reports to capture population trends and trajectories in weight gain over adulthood, but the validity of self-reports is often considered a limitation. The purpose of this work was to examine long-term trajectories of self-reporting bias in a national sample of American youth. With 3 waves of data from the National Longitu...

Objectives: There is growing interest in understanding how exposures in the residential environment relate to cognitive function in older adults. The goal of this study is to determine if neighborhood-level exposure to fine particulate matter air pollution (PM2.5) is associated with cognitive function in a diverse, national sample of older U.S. ad...

Two research traditions have evolved to assess links between recessions and health, with seemingly divergent findings. Aggregate-level studies generally find that mortality rates decline during recessionary periods. By contrast, individual-level studies generally find that events that frequently occur during recessions, like job loss, unemployment,...

Although racial/ethnic disparities in health have been well-characterized in biomedical, public health, and social science research, the determinants of these disparities are still not well-understood. Chronic psychosocial stress related specifically to the American experience of institutional and interpersonal racial discrimination may be an impor...

Given the well-established benefits of social integration for physical and mental health, studies have begun to explore how access to social ties and social support may be shaped by the residential context in which people live. As a critical health exposure, social integration may be one important mechanism by which places affect health. This paper...

Do women really sleep more than men? Biomedical and social scientific studies show longer sleep durations for women, a surprising finding given sociological research showing women have more unpaid work and less high-quality leisure time compared to men. We assess explanations for gender differences in time for sleep, including compositional differe...

Purpose of the study: The aim of this study was to investigate heterogeneity in body weight trajectories among older adults and their association with mortality risks. Design and methods: Information on body mass index (BMI) and survival come from nine waves of the Health and Retirement Study, a 16-year survey of adults aged 51-61 at baseline (N...

Sleep is essential for health and daily functioning, and social relationships may be a key social factor influencing sleep, yet sleep has been understudied in the literature on social relationships and health. This study used data from the National Survey of Midlife Development in the United States to examine associations between troubled sleep and...

The implications of recent weight gain trends for widening social disparities in body weight in the United States are unclear. Using an intersectional approach to studying inequality, and the longitudinal and nationally representative American's Changing Lives study (19862001/2002), we examine social disparities in body mass index trajectories duri...

To characterize the social characteristics and physical, functional, mental, and cognitive health of exceptional survivors in the United States and how the experience of exceptional longevity differs according to social status. Nationally representative longitudinal study of older Americans. United States. One thousand six hundred forty-nine men an...

Objectives: Race/ethnicity and education are among the strongest social determinants of body mass index (BMI) throughout the life course, yet we know relatively little about how these social factors both independently and interactively contribute to the rate at which BMI changes from adolescence to midlife. The purpose of this study is to (1) exam...

Increasing attention is being paid to the importance of built environment characteristics for participation, especially among people with various levels of impairment or activity limitations. The purpose of this research was to examine the role of specific characteristics in the urban environment as they interact with underlying impairments and act...

Existing research has found a positive association between cognitive function and residence in a socioeconomically advantaged neighbourhood. Yet, the mechanisms underlying this relationship have not been empirically investigated. To test the hypothesis that neighbourhood socioeconomic structure is related to cognitive function partly through the av...