Linda J Waite

University of Chicago | UC · Department of Sociology

OBJECTIVES Scholarly, clinical, and policy interest in cognitive function has grown over the last several decades in part due to large increases in Alzheimer’s Disease and related dementias as populations age. However, adequate measures of cognitive function have not been available in many research data sets. We argue that a wealth of previously un...

Objectives: We examine the relationship between social isolation, poor health behaviors, and perceived worsening of older adults' health behaviors following the coronavirus outbreak. We assess the extent to which psychological pathways mediate the relationship between social isolation and worsening health behaviors. Methods: Drawing on data from...

Background: Mobility assessments are commonly used among older adults as risk stratification for falls, preoperative function, frailty, and mortality. We determined if gait speed and self-reported difficulty walking are similarly associated with social isolation and loneliness, which are key markers of social well-being and linked to health outcom...

This study assesses the extent to which changes in mental health among older adults from pre- to during the pandemic varied by cognitive functioning and the role that decreases in social resources played in this association. We use data from the National Social Life, Health, and Aging Project (NSHAP)—a population-based panel study of older U.S. adu...

Nonrespondents generally suffer from worse health outcomes than respondents. Are they unwilling or unable to respond? Our aim was to address this issue. Data (N=3,130) from 2010-2015 waves of National Social Life Health and Aging Project (NSHAP, W2, W3) was used. Four groups of participants were considered based on their response status at W3: aliv...

Objectives: In this article, we seek to provide assistance to those who might want to use data from the National Social Life, Health, and Aging Project (NSHAP) Rounds 1-3 to compare those born in different cohorts. We outline 2 theoretical models that underlie the design of NSHAP-the life course model and the birth cohorts model-and review example...

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 old...

Objectives: Elder mistreatment has negative consequences for older adults' health and well-being. As such, scholars aim to understand its causes, the contexts in which it occurs, how to prevent victimization, and how to design interventions for mistreated older adults. This paper provides a detailed overview of the 2015-2016 National Social Life,...

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 cohort...

Objective: We describe each childhood background measure available in the National Social Life, Health, and Aging Project (NSHAP), report preliminary population estimates for each measure by age and gender, and validate the childhood measures by showing that the associations between the NSHAP childhood measures and later-life health outcomes are c...

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 soc...

Objectives: This report introduces National Social Life, Health, and Aging Project (NSHAP) data users to 2 new measures-one that assesses older adults' resilience, defined as personal attributes that indicate an adaptive reserve that can be drawn on during adversity, and a second that expands on existing measures of social support received from ot...

Objectives This paper examines the association between cognitive impairment, including mild cognitive impairment (MCI) and early dementia (ED), and sexual activity in a large, longitudinal sample of community-dwelling older adults. We focus here on sexual activity, which includes both sexual activity with a partner and masturbation. Methods We ana...

Background Social isolation and loneliness are critical to the health of older adults, but they have not been well‐described at the end of life. Objectives To determine the prevalence and correlates of social isolation and loneliness among older adults in the last years of life. Design Nationally representative, cross‐sectional survey. Setting H...

In this chapter, we review current and foundational research on sexuality in older adulthood. We briefly review neuroendocrine perspectives, sexual script theory, and interdisciplinary biopsychosocial frameworks, as a prelude to summarizing current work on sexual interest, attitudes towards sex, sex as a dyadic phenomenon, health and well-being out...

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...

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 20...

Hearing and vision impairment have been independently linked to accelerated cognitive decline in older adults, however there is limited evidence on the effect of dual sensory impairment (DSI) (both hearing and vision impairment) on cognition. Additionally, the impact of social isolation and loneliness, both correlates of DSI and independent risk fa...

The role of childhood in shaping overall adult health has been well documented, especially for physical and mental health, but much less is known about the impact of early disadvantage on oral health in later life. Using data from the 2006 and 2012 Health and Retirement Study, we investigate the link between childhood financial and psychosocial adv...

Background: Frailty is associated with lower mean activity; however, hourly activity is highly variable among older individuals. We aimed to relate frailty to hourly activity variance beyond frailty's association with mean activity. Methods: Using the 2010-2011 National Social Life, Health and Aging Project wrist accelerometry data (n=647), we e...

Hearing impairment impacts fluidity of communication and social interactions and thus may contribute to loneliness. We investigated the cross-sectional association between hearing impairment and loneliness in community-dwelling older U.S. adults using data from the National Social Life, Health, and Aging Project ( N = 3,196). Individuals reporting...

BACKGROUND/OBJECTIVES Prognostic indices rarely include cognition. We determined if a comprehensive cognitive screen or brief individual items were associated with improved mortality predictions of a widely used prognostic index. DESIGN, SETTING, AND PARTICIPANTS The National Social Life Health and Aging Project Wave 2, a nationally representative...

A large number of older adults have physical and/or cognitive challenges and require help to manage everyday activities. Many older adults receive care from a spouse. Over the long term, this has adverse consequences for caregiver health and well-being. Less is known about the outcomes associated with the early transition to becoming a spousal care...

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 contr...

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 Nationa...

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 illnes...

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 regr...

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: U...

Many studies show that disability predicts lower social participation and poorer psychological well-being. However, few have examined how disability, social interaction, and psychological well-being interrelate with one another. We use diary data from World Health Organization's Study on Global AGEing and Adult Health, 2007–2010 (N = 8,771) and med...

Cognitive impairment and decline have been identified as risk factors for elder financial exploitation (EFE), as poor cognition can impact financial management ability. Using NSHAP data, we explore associations between community-dwelling older adults’ cognition, self-reported financial management ability, and self-reported serious financial mistrea...

Background Older adults receive important health benefits from more robust social capital. Yet, the mechanisms behind these associations are not fully understood. Some evidence suggests that higher levels of social capital ultimately affect health through alterations in physical activity (PA), but most of this research has relied on self-reported l...

Sexual activity with one’s partner is an important component of well-being and is linked to physical, emotional, and cognitive health. However, it is unclear why some older adults are more interested in sex and some less so. Their own characteristics, those of their partner, and characteristics of the relationship may all be important. We define se...

Objective To investigate the buffering effects of social support as an effects modifier in the association between depression and inflammation in the elderly. Methods We analyzed the Korean Social Life, Health, and Aging Project (KSHAP) for questionnaire, clinical, and laboratory data of 530 older adults living in a rural community. Multivariate r...

Background: The Montreal Cognitive Assessment (MoCA) has not been administered to a representative national sample, precluding comparison of patient scores to the general population and for risk factor identification. Methods: A validated survey-based adaptation of the MoCA (MoCA-SA) was administered to a probability sample of home-dwelling US a...

This chapter addressed the state of coupled relationships in the low fertility countries that have been affected by changes in the family such as increasing levels of cohabitation and relationship dissolution. Evidence on sexuality in these countries suggests that child-free time due to small numbers of children does not always mean more focus on t...

Background/Objectives Accelerometry measures older adult (in)activity with high resolution. Most studies summarize activity over the entire wear time. We extend prior work by analyzing hourly activity data to determine how frailty and other characteristics relate to activity among older adults. Methods Using wrist accelerometry data collected from...

Social engagement and social support have been associated with disability onset and severity (Mendes De Leon, 2003; Seeman et al., 1996). However, the context in which support is experienced can affect its impact on health outcomes. In married couples, for example, the benefit to health status of support from friends was diminished the greater the...

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...

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...

We respond to Dr. Acierno's concerns about the measurement of elder mistreatment and social support in the National Social Life, Health, and Aging Project. We made our analytic decisions carefully and conducted systematic robustness checks, and believe our findings are theoretically important.

There is an error in the second sentence of the fourth paragraph of the Materials and Methods section under the subheading "Statistical Analysis." The correct sentence is: We examined the within-participant correlation and agreement between the 2- or 3-day and the 7-day average CPM using Lin's concordance correlation coefficient [16, 17] and Bland-...

Lin's concordance correlation coefficients between 2-day (A) and 3-day (B) average percent of time spent in sedentary, light-lifestyle, and moderate-vigorous activity per daily versus 7-day estimate among adults aged 65 and older in National Health and Nutrition Examination Survey 2003±4 and 2005±6 accelerometry sub-study. (TIFF)

Objective Older adults frequently report sleep problems and are at increased risk for cardiometabolic disruption. Experimental sleep restriction of younger adults has suggested that cortisol may be on the pathway between sleep restriction and cardiometabolic disease. We investigated whether the natural variation in sleep among older adults is assoc...

Sexuality is a key component of health and functioning that changes with age. Although most sexual activity takes place with a partner, the majority of research on sexuality has focused on individuals. In this paper, we focused on the sexual dyad. We proposed and tested a conceptual model of the predictors of partnered sexual activity in older adul...

Introduction Accelerometers are increasingly used in research. Four to 7 days of monitoring is preferred to estimate average activity but may be burdensome for older adults. We aimed to investigate: 1) 7-day accelerometry protocol adherence, 2) demographic predictors of adherence, 3) day of the week effect, and 4) average activity calculated from 7...

Multivariable Ordinal Logistic Regression Model of Number of Valid Accelerometer Wear Days in the Accelerometry Sub-Study Participants aged ≥ 65 (n = 2208) in NHANES 2003 to 2006. (DOCX)

Average daily counts per minute and 95% confidence intervals by gender (A) and employment status (B) among adults aged 65 and older in National Health and Nutrition Examination Survey 2003–4 and 2005–6 accelerometry sub-study. (TIFF)

Correlation and Lin’s concordance correlation coefficients between 2-day (A) and 3-day (B) average percent of time spent in sedentary, light-lifestyle, and moderate-vigorous activity per daily versus 7-day estimate among adults aged 65 and older in National Health and Nutrition Examination Survey 2003–4 and 2005–6 accelerometry sub-study. (TIFF)

Stress process theory predicts that elder mistreatment leads to declines in health, and that social support buffers its ill effects. We test this theory using nationally representative, longitudinal data from 2,261 older adults in the National Social Life Health and Aging Project. We regress psychological and physical health in 2010/2011 on verbal...

Working from a social relationship and life course perspective, we provide generalizable population-based evidence on partnered sexuality linked to cardiovascular risk in later life using national longitudinal data from the National Social Life, Health and Aging Project (NSHAP) (N = 2,204). We consider characteristics of partnered sexuality of olde...

The World Health Organization (WHO) has, since 1946, defined health as “a state of complete physical, mental and social well-being and not merely the absence of disease or infirmity.” The Medical or Biophysical framework of health includes physical organ system diseases or conditions Our Comprehensive framework of health includes additional dimen...

Objectives: We assess the association between marital quality and both the risk of developing diabetes and the management of diabetes after its onset in later life. Method: We use data from the first two waves of the National Social Life, Health, and Aging Project to estimate regression models with lagged dependent variables. The sample includes 1...

Significance Health has long been conceived as not just the absence of disease but also the presence of physical, psychological, and social well-being. Nonetheless, the traditional medical model focuses on specific organ system diseases. This representative study of US older adults living in their homes amassed not only comprehensive medical inform...

BACKGROUND An early sign of cognitive decline in older adults is often a disruption in social function, but our understanding of this association is limited. OBJECTIVE We aimed to determine whether those screening positive for early stages of cognitive impairment have differences across multiple dimensions of social function and whether association...

Marriage is linked to improved colorectal cancer-related health, likely in part through preventive health behaviors, but it is unclear what role spouses play in colorectal cancer screening. We therefore determine whether self-reported colonoscopy rates are correlated within married couples and the characteristics of spouses associated with colonosc...

This article focuses on the development of sexuality during childhood and how it is transformed over the life course. We discuss relevant findings from research on sexuality in childhood, through young adulthood and midlife, to older adulthood. We point to sexual scripts, the socially learned set of sexual desires and conduct, as a lens for underst...

Background: Cohort studies have found that short and long sleep are both associated with worse outcomes, compared with intermediate sleep times. While demonstrated biological mechanisms could explain health effects for short sleep, long-sleep risk is puzzling. Most studies reporting the U shape use a single question about sleep duration, a measure...

Sleep complaints are common among older adults, and poor sleep has been found to predict chronic diseases and mortality. Many studies suggest that social participation benefits healthy aging. We examined the relationships between older adults' social participation and their sleep using two waves (2005-2006, 2010-2011) of data from the National Soci...

Objective: This analysis assessed the extent to which: (1) wrist accelerometer measures were associated with difficulty performing specific activities of daily living and instrumental activities of daily living and (2) these measures contributed important information about disability beyond a typical self-reported vigorous activity frequency quest...

Objectives: To date, there has been no evidence about objectively measured sleep characteristics from a representative national probability sample of adults in the United States. We used actigraphy to measure the sleep characteristics of older Americans. Design: Cross-sectional study. Setting: Sleep sub-study within Wave 2 (2010-2011) of the o...

Sleep is a restorative behavior essential for health. Poor sleep has been linked to adverse health outcomes among older adults; however, we know little about the social processes that affect sleep. Using innovative actigraphy data from the National Social Life, Health, and Aging Project (N = 727), we considered the role of marriage, positive marita...

The availability of social and financial resources has profound implications for health and well-being in later life. Older adults often share resources with others who live with them, sometimes in households including relatives or friends. We examine differences in social support, social connections, money, and the household environment across typ...

Social relationships in older adulthood have strong connections to health and wellbeing. Connections with social network members and with spouses and long-term partners in particular, have an especially important impact on health. We highlight recent research from the National Social Life, Health, and Aging Project (NSHAP), a nationally representat...

Working from a life course perspective, we develop hypotheses about age and gender differences in the link between marital quality and cardiovascular risk and test them using data from the first two waves of the National Social Life, Health, and Aging Project. The analytic sample includes 459 married women and 739 married men (aged 57-85 in the fir...

Most measures of cognitive function used in large-scale surveys of older adults have limited ability to detect subtle differences across cognitive domains, and standard clinical instruments are impractical to administer in general surveys. The Montreal Cognitive Assessment (MoCA) can address this need, but has limitations in a survey context. There...

Objectives: Provide recommendations for researchers on the use of the Big Five personality battery in the National Social Life, Health, and Aging Project (NSHAP), and ensure that the battery does proxy the Big Five. Also, describe the levels of Big Five traits across gender and age. Method: We used an Exploratory Structural Equation Model (ESEM)...

Objective: The goals of this paper were: (a) to promote research using the National Social Life, Health and Aging Project (NSHAP) Wave 2 data by providing relevant background information for a broad range of chronic conditions and (b) to provide a framework for combining these chronic conditions into informative comorbidity indices. Method: The...

Introduction: Wave 2 of the National Social Life, Health, and Aging Project (NSHAP) includes new measures of sexual interest and behavior, as well as new measures of the context of sexual experience and the frequency and appeal of physical contact. This is the first time many of these constructs have been measured in a nationally representative sa...

Objectives: To describe the development of a multidimensional test of cognition for the National Social life, Health and Aging Project (NSHAP), the Chicago Cognitive Function Measure (CCFM). Method: CCFM development included 3 steps: (a) A pilot test of the Montreal Cognitive Assessment (MoCA) to create a standard protocol, choose specific items...

Objectives: The relationship of sleep to health has been an active area of research in recent years, and the National Social Life, Health, and Aging Project (NSHAP) expanded sleep data collection in Wave 2 with enhanced core questions and a novel sleep module that included an objective measure of sleep duration and quality. Method: A randomly se...

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 p...

Background This paper has two objectives. Firstly, it provides an overview of the social network module, data collection procedures, and measurement of ego-centric and complete-network properties in the Korean Social Life, Health, and Aging Project (KSHAP). Secondly, it directly compares the KSHAP structure and results to the ego-centric network st...

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...

Objectives: This paper introduces scales on shared activity and relationship quality for married and partnered older adults using multiple indicators from the second wave of National Social Life, Health, and Aging Project. Method: We assessed the reliability of the scales using Cronbach's alpha and the item-total correlation. We conducted explor...

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...

Objectives.The pathways linking spousal health to marital quality in later life have been little examined at the population level. We develop a conceptual model that links married older adults' physical health and that of their spouse to positive and negative dimensions of marital quality via psychological well-being of both partners and their sexu...

This chapter presents an analysis of the influence of changes in family size and complexity of living relationships on a family's economic well-being during the Great Recession. The analysis reveals that the average size of households did not change markedly following the Great Recession. However, the stable average conceals considerable churning w...

Lifecycle Events and Their Consequences: Job Loss, Family Change, and Declines in Health brings together leading scholars to study the impact of unexpected life course events on economic welfare. The contributions in this volume explore how job loss, the onset of health limitations, and changes in household structure can have a pronounced influence...