Advance Directives Completion among Older American Couples: A Dyadic Perspective on the Role of Cognitive Function and Other Factors

Health Behavior Patterns and Associated Risk of Memory-Related Disorders Among Middle-Aged and Older Chinese Couples

Objectives: Studies on the interdependence of couples' health behaviors and subsequent cognitive outcomes remain limited. Methods: Longitudinal data from the China Health and Retirement Longitudinal Study (2011-2018) were used (N = 1869 heterosexual couples). Latent class analysis identified the dyadic pattern of health behaviors in 2011 (i.e., alcohol consumption, smoking, and physical inactivity). Stratified Cox models examined the association of latent classes with risk of developing memory-related disorders in 2013-2018. Results: Three classes were identified: class 1 (21.25%, only husband smoke, and both active), class 2 (47.55%, both inactive, neither drink nor smoke), and class 3 (31.20%, both drink and smoke, and both active). Couples' sedentary lifestyle was associated with an increased risk of memory-related disorders among both husbands and wives. Conclusion: Couples were moderately concordant in their physical activity but weakly in smoking and drinking. Couple-based interventions, especially promoting physical activity, may reduce cognitive aging among middle-aged and older Chinese couples.

“Till Death Do Us Part”, Dying Matters, Beyond the Individual: Advance Care Planning Patterns Among Older Couples

Objective

We examined the formal and informal advance care planning (ACP) patterns of older couples and determined how these patterns are associated with individual and spousal characteristics.

Methods

Using data from the 2014 and 2016 Health and Retirement Study, we performed latent class analysis to identify ACP patterns and multinomial regression models to describe characteristics of older couples ( N = 2195 couples).

Results

We identified four ACP patterns: high engaging couple (47%); high engaging husband—low engaging wife (11%); high engaging wife—low engaging husband (11%); and low engaging couple (31%). High engaging couples were more likely to be older, educated, and financially better off, whereas high ACP engagement in discordant ACP patterns was associated with health and wives’ constraints.

Discussion

A couple-based approach was recommended to promote the merits of ACP where spouses were older, had limited resources, or where one or both partners were suffering from poor health.