Pilot Project Awards

Sociodemographic and Neurocognitive Characterization of Mexican-American Bilinguals and Monolinguals Presenting with Typical and Pathological Cognitive Aging
Stephanie Grasso (Assistant Professor, Speech Language and Hearing Sciences, UT  Austin) and Brian Downer, (Associate Professor, Department of Nutrition, Metabolism and Rehabilitation Science, University of Texas Medical Branch)
This study will characterize sociodemographic profile of bilingualism, monolingualism, and language dominance in older Mexican-Americans associated with changes in cognitive function over a 20-year period. It will also examine cross-sectional differences in brain structures in typical cognitive aging, mild cognitive impairment (MCI) and Alzheimer’s dementia (AD).

Contextual Despair and Risk Behaviors in Midlife: Extending Innovative Measures to Add Health
Lauren Gaydosh, (Assistant Professor, Sociology, UT Austin) Tse-Chuan Yang (Associate Professor, Department of Preventive Medicine and Population Health, University of Texas Medical Branch)
This study will investigate contextual factors in decreasing life expectancy via “deaths of despair” (e.g., drug overdose, suicide). The investigators will generate a longitudinal hierarchical dataset with individuals embedded in places over time to distinguish the impacts of individual characteristics (e.g., educational attainment) from community features (i.e., economic decline) leveraging rich data spanning adolescence to middle adulthood in Add Health.

Structural Racism, Discrimination, and Health across the Life Course  
Aprile Benner (Associate Professor, Human Development & Family Sciences, UT Austin)
This study will generate of a publicly available longitudinal national database with geographically and historically coded metrics of structural racism (e.g.,healthcare access, built environment). This data base will situate structural racism in geographic contexts to assess explanatory variables linking racism to health outcomes.

Daily Experiences and Well-being in Late Life: A Longitudinal Examination of Ecologically Valid Assessments of Older Adults’ Daily Experiences
Karen Fingerman (Professor, Human Development & Family Sciences, UT Austin)
This project examines older adults’ daily experiences using ambulatory assessments over 5 days via: Actical assessment of physical activity, Ecological Moment Assessments of socioemotional states, and Electronically Activated Recorders capturing language production throughout the day. Sociodemographic differences in daily experiences may be associated with health disparities over time.

Disability of a Family Member, Caregiving Behavior, and Caregiver Health Outcomes in Middle and Late Adulthood
Sae Han (Assistant Professor, Human Development & Family Sciences, UT Austin)
This project will reconcile contradictory sets of evidence surrounding caregiving and health outcomes. Relying on the Health and Retirement Survey (HRS) to estimate the effect of parental caregiving trajectories on depression, the study will allow causal inference and separate the risk of parental deterioration from possible benefits of providing care.

The Dynamics of Race Differences in Life Course Pathways Associated with the Risk of Alzheimer’s Disease and Related Dementias
Mark Hayward (Professor, Sociology, UT Austin)
This study will evaluate cohort changes in racialized life course pathways of ADRD risk. The study will leverage data from the HRS and its sister studies in Brazil, South Africa, and India to develop a macro comparative approach for understanding dynamics of racialized pathways through a global lens.

Gender disparities in adult mortality and morbidity in India: Understanding variation and investigating mechanisms
Diane Coffey, Assistant Professor, Department of SociologyA large body of research documents health disparities between boys and girls in India.  Gender discrimination leads to skewed sex ratios at birth, and to male-female gaps in child mortality and height that are markedly different from the rest of the world.  Such research highlights the rich complexity of how biology and society interact to produce population-level child health outcomes.  For example, in most countries, girls are more likely to survive childhood and less likely to be stunted than boys (Sawyer, 2012).  Yet, in India, many child health outcomes are similar across sexes, or worse for girls. 

Less research has documented, contextualized, and investigated disparities in morbidity and mortality between adult men and women.  Comparisons of gender differences in life expectancy suggest that the female life expectancy advantage that exists in almost every country is muted in India.  This proposal seeks to understand how and why women in India experience smaller, and sometimes no survival advantages compared to men.  By examining regional variation in gender discrimination, as well as regional variation in gender health gaps, we seek to build a more comprehensive model of disparities in the aging process in India, where one-sixth of people live.

This project has three aims: 1) to identify gaps in the literature about gender disparities in health in India and compare how these gaps match with NIA funding priorities; 20 to identify how data on adult health and morbidity can be used to fill gaps in the literature; 3) to prepare preliminary analyses to be used in an NIA proposal and prepare a proposal. 

Health Disparities among Aging Parents of Adult Children with Serious Conditions
Robert Crosnoe, Associate Dean of Liberal Arts and Rapoport Centennial Professor of Sociology & Deborah Cohen, Assistant Professor, Department of Psychiatry and Behavioral Sciences, Dell Medical School, UT AustinThis project will involve preliminary analyses and pilot data collection for a R01 proposal to NIA. The parent project—which will go through the NIH review cycle twice over the next year—is a large mixed-methods study investigating the physical and mental health toll on aging parents of children with serious conditions who have reached adulthood and how this toll can be buffered by resources in the family ecology related to marriage/partnership and by resources in the community related to the availability of health and human services. The pilot project’s goals are to conduct preliminary statistical modeling of a nationally representative data set that incorporates community-level measures from outside sources (e.g., Health Resources and Services Administration, National Center for Charitable Statistics), demonstrates feasibility, confirms power, and produces potential results supporting the proposed plan of quantitative analyses; to conduct a small number of pilot semi-structured interviews with local parents that allow refinement and expansion of the proposed qualitative sampling and data collection procedures and experimentation with the proposed textual and grounded theory analytical techniques; and to address, when possible, any suggestions and critiques that arise during the NIH review process related to data and analyses.

Biological Aging Among Older Sexual and Gender Minority Adults in the US South
Lauren Gaydosh, Assistant Professor, Department of Sociology & Tara McKay, Assistant Professor, Health Policy, Center for Medicine, Health, and Society, Vanderbilt UniversityOlder sexual minorities constitute approximately 3 million Americans, a number expected to double by 2030. Moreover, 35% of SGM adults in the US reside in the South, yet many studies focus on SGM samples in coastal metropolitan cities. Sexual and gender minority (SGM) populations experience significantly worse morbidity, mental health, physical disability, and unmet healthcare needs compared with their heterosexual and cisgender counterparts. With smaller kin networks, SGM are also more likely to experience social isolation. These health and social disparities have been exacerbated by the current COVID-19 pandemic. The Vanderbilt University Social Networks, Aging, and Policy Study (VUSNAPS) investigates the health and aging of older SGM residing in four states in the US South (Alabama, Georgia, North Carolina, and Tennessee). This pilot project will collect innovative in-home self-collected blood samples for measurement of biomarkers of aging in a subsample (n=150) of the VUSNAPS cohort. We aim to assess the feasibility of this self-collection technology both in terms of acceptability in our study population and quality of the resulting biomarker measurements. We will construct biomarker-based measures of biological aging and examine variation by sexual orientation and gender identity. Finally, we will investigate the relationship between social isolation and biological age, testing state-level variation. This project will contribute to the fields of biodemography, public health, minority health disparities, and gerontology, all of which will benefit from expanding access to biomarker data among a high-need and understudied population. The collection of biomarkers of aging among this population will be a major advancement in the measurement and study of health inequalities across gender identity and sexual orientation, especially in older age. The study will enable preliminary investigation into the disproportionate burden and lasting implications of the pandemic on health and aging in this vulnerable population.

How Spouses Influence Each Other’s Health in Same- and Different-Sex Marriages: A Dyadic and Longitudinal Assessment from Mid to Later Life
Debra Umberson, Professor of Sociology and Director of the Center on Aging and Population Sciences (CAPS) & Stephen Russell, Department Chair, Human Development and Family Sciences, Director, School of Human Ecology

Decades of population research show that married Americans are in better health and live longer than their unmarried peers and that there are gender differences in how spouses influence each other’s health. Until recently, however, this research was entirely based on marriages between women and men. In 2015, with NIA support (R21 AG0445850), we collected dyadic data to conduct the first in-depth analysis of marital processes and health comparing legally married midlife spouses in same-sex and different-sex marriages. Findings have highlighted differences in health-related marital dynamics for women and men in same- and different-sex unions. These dynamics likely impact both spouses’ long-term health, but due to a lack of longitudinal and dyadic data, scientists know little about how they do so. The major aim of this pilot project is to design and launch collection of Wave 2 data to construct a longitudinal, dyadic data set that will allow us to examine how same-sex partners influence each other’s health behaviors and mental and physical health over time, and in comparison to different-sex partners.

Assessing the Feasibility of Panel Data Collection Among Adult Refugees in Costa Rica
Abigail Weitzman, Assistant Professor, Department of Sociology & Arodys Robles, Professor, University of Costa Rica & Gilbert Brenes-Camacho, Professor of Statistics, University of Costa Rica

The proposed project aims to collect pilot longitudinal data among refugees and other migrants in need of protection (MNP) who have relocated to Costa Rica to evade an imminent threat to their survival. To do so, the project will first conduct a baseline phone survey with MNP from various different Latin American countries who are ages 18 to 95 years and currently residing in Costa Rica. Following, it will then send these same MNP a series of standardized follow-up surveys to complete online either daily, weekly, or monthly. Analyses of the resultant data will provide new information about how the retention of MNP in panel surveys varies as a function of trauma history, age, and other personal characteristics. In addition, they will reveal: (1) how much variation exists in MNPs’ health, wellbeing, and hardship on a daily, weekly, and monthly basis; (2) how trauma histories and former ecological contexts (e.g. country of origin) sort refugees and other MNP onto different health trajectories; and (3) how trauma, age, country of origin, family structure, and attributes of personal networks predict MNP health and hardship on average. The findings promise to advance research and theory on trauma, aging, and international displacement by generating pilot data for an R01 project, adapting methods to track and describe the social and health circumstances of internationally displaced populations, and examining relationships between pre- and post-flight experiences, family dynamics, social incorporation, and MNP health and wellbeing across the adult life course.

Neighborhood Characteristics Throughout Life and Midlife Cognitive Functioning
Elizabeth Munoz, Assistant Professor, Human Development & Family Sciences

Cognitive impairment, from mild impairment to dementia, has profound implications for older adults’ health and well-being and poses a significant burden on the U.S. health care system. Efforts to identify early and modifiable risk factors of cognitive impairment are therefore imperative for the early identification and prevention of cognitive decline in our aging population. Early-life disadvantage and stress have been theorized to be linked with cognitive impairment later in life—with some empirical evidence supporting this association. Most evidence in this area relies on associations between subjective retrospective reports and concurrent neighborhood characteristics with cognitive health, but research has yet to examine whether residential history—in particular, disadvantage in individuals’ earlier-life neighborhoods—influences cognitive functioning. Further, because cognitive decline may begin long before old age, understanding its antecedents requires mapping changes in cognition before old age, during midlife. The primary objective of this pilot project is to establish a coding system of historical residential address data for neighborhood resources and deprivation from childhood to midlife and to determine whether these indices are associated with cognitive function and variability. This proof of concept will allow the PI to pursue an R21 proposal to carry out these efforts in larger data sets with available historical address data, such as that available from the Life History Mail Survey from the Health and Retirement Study.

Trajectories of Mothers’ Breadwinning Responsibilities Over the Life Course
Jennifer Glass & Kelly Raley, Professors. Joanna Pippin, Assistant Professor, Sociology

Mothers provide the bulk of daily care for minor children; they also now frequently work for pay and increasingly provide the majority of the earnings needed to support their households. But scholars know little about when and why mothers become primary household earners, and how long mothers in different demographic groups spend in that status across their life course. We know even less about the cumulative health consequences of being the primary source of household earnings, as distinct from labor force participation or earnings per se. Breadwinning is a status that makes labor force participation obligatory rather than optional for mothers, alongside the caregiving obligations mothers still fulfill that breadwinning fathers typically do not. Yet prior work on premature aging suggests that precisely those groups likely to have the strongest risk of becoming breadwinning mothers show significant health declines by midlife (early age at first birth, nonmarital birth, low education, African-American ancestry, etc.). Evidence strongly suggests that a crucial pathway to premature aging may be the combined burden of both heavy financial and heavy care responsibility for children over long periods of time early in the life course. The primary goal of this project is to concatenate sources of longitudinal information on the share of household earnings from mothers in households with children under 18 to document US mothers’ lifetime incidence and duration as the primary economic support for their children. Cross-sectional estimates indicate that mothers provide primary support for nearly 40% of children under 18 at any given point in time, but lifetime risk and average duration in status have not been estimated, nor have variations in risk by marital status, age at first birth, race or education level. Such data are essential to understand the aggregate impact of mothers’ increasing financial responsibility for children on their health and successful aging.

Sources of Variation in Private Insurance Coverage Among Medicare Beneficiaries: Decomposing Place-Based and Person-Based Factors
Marika Cabral, Associate Professor, Economics

A key aspect of Medicare is the growing importance of private insurers in the provision of Medicare coverage. The share of Medicare beneficiaries enrolled in private Medicare Advantage (MA) coverage has doubled from 16% in 2006 to one-third in 2017 (Jacobson et al., 2017). However, the uptake of MA varies dramatically across markets, with fewer than 1% of Alaskan beneficiaries in private plans while 56% of Minnesotans receive their Medicare benefits via an MA plan (Jacobson et al., 2017). The decision to take-up MA instead of Traditional Medicare can have important implications for treatment patterns, healthcare spending, and ultimately patient health. For instance, prior work suggests that MA insurers engage in extensive utilization management, leading to substantially lower per-beneficiary utilization of both “low-value” and “high-value” services when compared to comparable Traditional Medicare beneficiaries (Curto et. al., 2019). Despite the importance of understanding MA take-up patterns, very little is known about what drives the large disparities in insurance sources across regions or the substantial increase in the prevalence of MA coverage over time. The primary goal of this project is to examine explanations for both the cross-sectional and longitudinal variation in the prevalence of Medicare beneficiaries opting for private MA coverage. This research expands on the PIs prior work on Medicare supplemental insurance (Cabral and Mahoney, 2019) and builds a foundation for a broader, long-term research agenda exploring the interaction between private and public insurance within the Medicare population.

Education and Financial Resilience During Economic Recession for Healthy Aging: Record Linkage of High School Education Longitudinal Studies to Consumer Credit Data
Chandra Muller & Mark Hayward, Professors, Sociology

Education is among the most important determinants of cognitive functioning and impairment in later life. Over the life course, education leads to better cognitive functioning and healthier aging through access to better jobs, health care, residential neighborhood, wealth accumulation, economic security. Yet, research on how and why early-life educational processes impact cognitive functioning in later life has been severely limited by a lack of prospective longitudinal data. We do not have data sufficient to identify the specific (and potentially malleable) aspects of education that shape cognitive functioning, or to understand the complex pathways through which education protects individuals as they age. The proposed project takes advantage of a unique opportunity to fill these gaps by matching identifying information from sample members of the US Department of Education, National Center for Education Statistics (NCES) Secondary Longitudinal Studies Program (SLSP) to Experian consumer credit records from 2004-2021, the period that covers two major economic shocks: the Great Recession and the recent recession resulting from the COVID-19 pandemic. The linked data will provide vital information to advance our understanding of cognitive aging.  

Large-Scale Genomic Analysis of Aging-Related Cognitive Declines
Elliot Tucker-Drob, Professor, Psychology

Aging-related cognitive declines substantially affect daily living, forecast the onset of clinically severe levels of cognitive impairment and dementia, and predict declines in physical health and eventual mortality. To date, the molecular processes underlying the neurodegeneration and cognitive decline remain poorly understood. Recent developments in genome wide association study (GWAS) provide promising avenues for identifying genetic variants associated with cognitive declines beyond those characterized by polymorphisms within the well-known APOE gene. However, a major challenge to progress in aging research is that that contemporary methods used to index cognitive aging in epidemiological research often rely on cognitive assessments or clinical rating at a single point in time, which are confounded by substantial variation in peak levels of cognitive function in early adulthood. Particularly when peak levels of cognitive function are high, cognitive declines may go undetected for decades before individuals present with impaired levels of functioning. Indeed, it has now become clear that by the time dementia diagnoses are made, neuropathology and trajectories of accelerated cognitive decline have accumulated extensively, during a so-called “silent period.” These issues both dilute and bias genetic associations in conventional designs. The primary goal of the pilot project is to develop novel methods needed conduct the first large-scale consortium-based GWAS of longitudinal rates of aging-related cognitive change, and to assemble a consortium of longitudinal population-based genetic studies of adult cognitive function. The result will set the stage for an R01 proposal to lead the first major effort to: investigate the genome-wide architecture of cognitive aging, produce improved genome-wide polygenic scores that can be used to enhance assessment of risk of cognitive decline, and to identify intersecting connections between genetic and social risk factors for cognitive aging.

 

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