ICAA Research Review is published monthly for ICAA members. Complimentary issues are sent periodically to people who register.

In this issue

• Stats: 80% of older Americans can't withstand a financial shock
• Stereotypes about older workers leading to premature retirement
• Emotional wellbeing linked to women's gut health
• Multigenerational attitudes toward technology for healthy aging
• Cost of family caregiving skyrockets
• Tech Talk: Internet usage could halve dementia risk

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Stats: 80% of older Americans can't withstand a financial shock

A recent analysis by the National Council on Aging (NCOA) and the LeadingAge LTSS Center @ UMass Boston found that 80% of older Americans (47 million) continue to be unable to sustain a financial shock such as needing to pay for long-term care services and supports (LTSS) or the loss of income due to divorce or widowhood. This has implications for active-aging organizations looking for new customers, as the report suggests that middle-class older adults are at risk.

The report looks at the total net value of all assets—housing, retirement accounts, income, and savings—of people age 60 and older by income quintiles and compares that with the cost of two years of in-home long-term care services and nursing homes.

Among the findings:

• 20% of older households (approximately 11 million) have no assets to draw upon to withstand a financial shock.
• 21%-80% have modest assets but would still be unable to afford more than two years of nursing home care or four years in an assisted living community, if needed.
• The total net value of household assets is $39,500 for those in the 21%-40% quintile and $150,000 for those in the 41-60% quintile.

Previous research found that over half of adults ages 65 and older will need LTSS for less than two years, and about one in seven will require care for more than five years, according to the report. In 2021, the median yearly cost of a private room in a nursing home was $108,405, and that of a home health care aide was $61,776. [Ed. note: According to SeniorLiving.org, the median annual cost of assisted living in 2021 was $54,000].

Since Medicare does not cover LTSS costs, older adults and their families must shoulder this financial risk or spend down their assets into poverty to qualify for social safety net programs such as Medicaid.

"When you think about these potential costs, and then look at the entire picture of what is available to people in terms of their own resources and government assistance, you realize that the most vulnerable here are middle income Americans, who have the most to lose," said Co-Director of the LeadingAge LTSS Center at UMass Boston Dr. Marc Cohen.

SOURCE: National Council on Aging (April 19, 2023); NCOA (April 10, 2023). The 80%: The Continued Toll of Financial Insecurity in Retirement.
KEYWORDS: Finances, Savings, Long-term care

To read the findings, click here

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Stereotypes about older workers leading to premature retirement

Unproductive, inflexible, and less motivated... these are some of the most common stereotypes about older employees. Even though the stereotypes are usually unfounded, they nevertheless influence how older employees perceive themselves and their status in the workplace. Thus, these stereotypes have become a key factor in many employees’ retirement decisions, according to a recent study by University of Copenhagen researchers. It is one more reason to help your constituents reject stereotypes, particularly if they are still working and would like to continue doing so.

“In our study, we refer to the uncertainty that senior employees feel about their status as ‘the worn-out syndrome,’ which is similar to the well-known imposter syndrome that is associated with a feeling of inadequacy. But there is an important difference: the senior employees we have interviewed are confident about their own skills, and their colleagues are mostly positive about their contribution,” says author and Associate Professor Aske Juul Lassen from the University of Copenhagen.

“Senior employees thus seem to internalize the stereotypes that circulate in the labor market about older employees. In other words, the syndrome does not necessarily have anything to do with what colleagues think about a senior employee but rather with what the senior employee thinks the colleagues think about the senior employee. Combined with a latent fear of future decline, this uncertainty unfortunately leads to premature decisions about retirement,” Lassen adds.

The study’s findings are based on ethnographic fieldwork at small and medium-sized companies in the finance and production industries in Denmark, where Lassen and his colleagues interviewed 92 older workers, managers, union representatives, and HR personnel at eight different companies.

“If we want to combat the stereotypes that inform the worn-out syndrome and senior employees’ untimely retirement decisions, senior employees and their colleagues and managers must find a way of discussing openly the fear and uncertainty that senior employees feel regarding their potential cognitive decline," commented coauthor Marie Gorm Aabo.

SOURCES: University of Copenhagen (March 29, 2023); A MG, et al. PLOS ONE. Published March 29, 2023; https://doi.org/10.1371/journal.pone.0282905
KEYWORDS: Stereotypes, Retirement, Older workers

To read the full study, click here

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Emotional wellbeing linked to women's gut health

A recent study linked bacteria in our gut to positive emotions like happiness and hopefulness and healthier emotion management skills. “The gut contains trillions of microorganisms collectively known as the gut microbiome. Many studies have shown that disturbance in the gut microbiome can affect the gut-brain axis and lead to various health problems, including anxiety, depression, and even neurological disorders,” said coauthor Yang-Yu Liu, PhD, an associate scientist in the Brigham and Women's Hospital's Channing Division of Network Medicine and an associate professor of Medicine at the Harvard Medical School.

“This interaction likely flows both ways — the brain can impact the gut, and the gut can impact the brain. The emotions that we have and how we manage them could affect the gut microbiome, and the microbiome may also influence how we feel," added first author Shanlin Ke, PhD. The gut-brain axis might affect physical health, as well.

The study included more than 200 women from the Mind-Body Study, a sub-study of the Nurses’ Health Study II. These middle-aged, mostly white women filled out a survey that asked about their feelings in the last 30 days – i.e., positive (feeling happy or hopeful about the future) or negative (feeling sad, afraid, worried, restless, hopeless, depressed, or lonely) emotions.

The survey also assessed how they handled their emotions - reframing the situation to see it in a more positive light (cognitive reappraisal) or holding back from expressing their negative emotions (suppression).

Three months after answering the survey, the women provided stool samples. The team compared the results from the microbial analysis to the survey responses about emotions and ways of managing them to look for connections.

“Some of the species that popped up in the analysis were previously linked with poor health outcomes, including schizophrenia and cardiovascular diseases,” Guimond said. ”These links between emotion regulation and the gut microbiome could affect physical health outcomes and explain how emotions influence health.”

People who suppressed their emotions had a less diverse gut microbiome, and those who reported happier feelings had lower levels of Firmicutes bacterium CAG 94 and Ruminococcaceae bacterium D16. On the other hand, people who had more negative emotions had more of these bacteria, as well as fewer metabolism-related actions in the gut.

While the study does not prove cause and effect, the connection provides one more reason to encourage healthy eating and help constituents with gut problems to choose an appropriate diet. Referral to a nutrition specialist may be advisable in some cases.

SOURCES: Brigham and Women’s Hospital (April 27, 2023); Ke S et al. Psychological medicine, 1-10. March 21. 2023, doi:10.1017/S0033291723000612
KEYWORDS: Gut, Microbiome, Emotional wellness, Women’s health

To read the full article, click here

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Multigenerational attitudes toward technology for healthy aging

A recent article presents an overview of the GenerationTech survey, and describes attitudes and acceptance related to technology in general and as a means to support active and healthy aging. It’s a fascinating read with messages for active-aging organizations, and the full text is available for downloading.

The survey was conducted with a random sample of 2,121 men and women from three generations (30–39, 50–59 and 70–79-year-olds) in Sweden. The generations had in common some attitudes toward and acceptance of technologies for active and healthy aging. However, the kinds of technologies preferred to support active and healthy aging and the reasons for using them differed by generation. According to the authors, the findings could help guide the development and implementation of technologies for active and healthy aging throughout the aging process.

To support active and healthy aging, overall, respondents preferred using household devices, home entertainment, exercise devices and assistive devices. Notably, the oldest (70–79 years) generation was significantly less interested in using activity sensors, exercise devices, personal health sensors, medical technologies, smart homes, welfare technologies, home and social robots, Internet shopping and Internet services to support active and healthy aging. The youngest (30–39 years) generation was significantly less interested in using household devices, home entertainment, motorized vehicles and social media to support active and healthy aging. The middle-aged (50–59 years) generation compared to the oldest generation was significantly more interested in using assistive devices, personal emergency response systems and social media to support active and healthy aging.

Overall, the main reasons for wanting to use technologies were to be independent, remain in contact with friends and family, be physically active and notify someone in case of a fall or illness. The oldest generation compared to the other generations was significantly less interested in using technologies to save time, feel safe, monitor health, control home entertainment, access services, for pleasure and entertainment or shopping. The middle-aged generation compared to the youngest generation was significantly less interested in using technologies to save time.

“The responses show that price, technology allowing flexible use and standard rather than extra functions matter when choosing new products,” the authors note. “Overall, respondents [learned] new products easily and had no problems keeping up with technology development. The oldest generation especially considered environmental sustainability important when adopting new technologies. Always wanting the latest was not considered an important factor when adopting new technologies for most respondents.”

SOURCE: Offerman J, et al. Nature Aging (April 6, 2023).
KEYWORDS: Multigenerational, healthy aging, Technology

To read the full article, click here

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Cost of family caregiving skyrockets

The unpaid work provided by family caregivers is valued at an estimated $600 billion, according to the latest report in AARP’s "Valuing the Invaluable" series. This is a $130 billion increase in unpaid contributions from family caregivers since the last report was released in 2019. The economic impact of $600 billion is more than all out-of-pocket spending on healthcare in the US in 2021 and highlights the need for organizations to engage with and support family caregivers.

This report presents trends in family caregiving, explores the scope and complexity of family caregiving, and discusses actions needed to address the financial, social, and emotional challenges of caring for parents, spouses, and others.

The share of available family caregivers is projected to continue shrinking relative to the number of older adults who will potentially need long-term care, according to the report. In addition, family caregivers will continue to face the dual demands of employment and caregiving responsibilities, which often include caring for an older adult and children simultaneously.

The estimated economic value of $600 billion is based on about 38 million caregivers providing an average of 18 hours of care per week for a total of 36 billion hours of care, at an average value of $16.59 per hour.

The report provides a wealth of additional data as well as a look at the impact of the pandemic on family caregivers; issues of concern to individual family caregivers and to society; and suggested strategies to support family caregivers at work and elsewhere. It's an important read for active-aging organizations.

SOURCES: AARP (March 8, 2023); Reinhard S, et al. (March 2023). Valuing the invaluable 2023 update: Strengthening supports for family caregivers. AARP Public Policy Institute.
KEYWORDS: Caregivers, Unpaid care, Long-term care

To download the full report, click here

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Tech Talk: Internet usage could halve dementia risk

Researchers recently found a link between regular internet use and a lower risk of dementia, though there was a suggestion that excessive internet use could have the opposite effect. “Online engagement may help to develop and maintain cognitive reserve, which can in turn compensate for brain aging and reduce the risk of dementia,” said co-author Virginia W. Chang, MD, PhD, of New York University.

Overall, the study suggests that organizations should be encouraging internet use among constituents as one more possible hedge against dementia.

Investigators followed 18,154 dementia-free adults ages 50 to 65 for a median of 8 years and a maximum of 17 years. During follow-up, 4.68% of participants were diagnosed with dementia.

Various analyses showed that regular internet usage was associated with approximately half the risk of dementia compared with non-regular usage. The association remained regardless of an individual's educational attainment, race-ethnicity, sex, or generation.

The authors note, "A digital divide may exist in the cognitive health of US older-age adults. Regular internet users experienced approximately half the risk of dementia compared to non-regular users. Moreover, longer periods of regular internet usage in late adulthood were associated with lower risks of subsequent dementia incidence."

However, they note, "using the internet excessively may negatively affect the risk of dementia in older adults," as their estimates of daily hours of usage suggested a U-shaped relationship with dementia incidence, meaning that too many hours - an as-yet undefined quantity - could raise the risk.

"Future research may identify different patterns of internet usage associated with the cognitively healthy lifespan while being mindful of the potential side effects of excessive usage," the authors conclude.

SOURCES: Wiley (May 3, 2023); Cho G, et al. (May 3, 2023). Journal of the American Geriatrics Society. https://doi.org/10.1111/jgs.18394
KEYWORDS: Technology, Internet, Dementia

To read the abstract, click here

--reported by Marilynn Larkin

Suggestions? Email mlarkin@icaa.cc

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Disclaimer

ICAA Research Review shares knowledge and information. The newsletter is not intended to replace a one-on-one relationship with a qualified health care professional and is not medical advice. The ICAA encourages you to make health and business decisions based upon your own research and in partnership with a qualified professional.