Vicki A Freedman
Datos Biográficos
| ID | 82937 |
|---|---|
| NOMBRE | Vicki A Freedman |
| NOMBRES | Vicki A |
| APELLIDO | Freedman |
| FIRMA | FREEDMAN V A |
| AFILIACIONES | University of Michigan |
| ORCID | 0000-0002-4604-4207 |
| VERIFICADO | Sí |
| TOTAL DE OBRAS | 76 |
| TOTAL DE CITAS | 733 |
| TOTAL COMO AUTOR | 69 |
| TOTAL COMO EDITOR | 7 |
| PRIMER AÑO DE PUBLICACIÓN | 1993 |
| AÑO MÁS RECIENTE DE PUBLICACIÓN | 2026 |
| ÍNDICE H | 15 |
The Future Availability of Family Caregivers
Discussions about future care needs of U.S. older adults have frequently called attention to ongoing changes in families as the harbinger of a looming family care shortfall. To explore this premise, we paired estimates from the National Health and Aging Trends Study with projections of kinship patterns by age, sex, race through 2040. We defined care gaps in two complementary ways: the number of older adults with care needs who have (1) no family …
Co-calibration of cognitive performance in the National Health and Aging Trends Study with the Health and Retirement Study's Harmonized Cognitive Assessment Protocol
NHATS and HRS-HCAP both provide reliable cognitive function measures and dementia prevalence estimates for older Americans. Co-calibrated scores based on each study's cognitive test battery provide a valid and feasible approach for comparative US research. Better aligned algorithmic approaches across studies could strengthen opportunities for comparative studies of disparities in the US context using the co-calibration approach
Who’s On Your Team? Classifying Dementia Caregiving Networks and Associations With the Well-being of Caregivers and Care Recipients With Dementia
Objectives While caregivers are typically enmeshed in broad networks of family and friends assisting with care, this network has been neglected in favor of examining a “primary” caregiver. This study examines types of family and unpaid friend networks for individuals with dementia and how one’s network type relates to the well-being of care recipients with dementia and their caregivers. Methods Data are drawn from the nationally representative 20…
Enhancing Dementia Classification for Diverse Demographic Groups
Objectives Alzheimer’s disease and related dementias significantly affect older adults’ quality of life. The clock-drawing test (CDT) is a widely used dementia screening tool due to its ease of administration and effectiveness. However, manual CDT-coding in large-scale studies can be time-intensive and prone to coding errors and is typically limited to ordinal responses. In this study, we developed a continuous CDT score using a deep learning neu…
Beyond Caregiving
Objectives Limited research has explored caregivers’ activities beyond caregiving duties, which may offer positive experiences and counterbalance caregiving stress. This study aimed to (a) identify the most pleasant non-caregiving activities, (b) assess time allocation based on activity categories and pleasantness, and (c) investigate the association between activity pleasantness and duration, considering differences between caregivers to older a…
Work as overload or enhancement for family caregivers of older adults
Objective: This study examines work and care patterns and their association with experienced well-being over the course of the day and tests a moderating effect of gender. Background: Many family and unpaid caregivers to older adults face dual responsibilities of work and caregiving. Yet little is known about how working caregivers sequence responsibilities through the day and their implications for well-being. Method: Sequence and cluster analys…
Caring Together
Study findings highlight the importance of considering unique arrangements in dementia care. Receipt of paid care was not only determined by patient care needs. Creating equitable access to paid care may be a particularly important way to support both persons living with dementia and their family caregivers as care needs grow
Covid-19-Related Changes in Assistance Networks for U.S. Older Adults with and without Dementia
Early in the pandemic, assistance networks of older adults adapted by substituting helpers, by contracting to reduce exposures with more intimate tasks for recipients with dementia, and by reducing transportation assistance. Future research should explore the impact of such changes on the well-being of older adults and their assistance networks
The Impact of Care Intensity and Work on the Mental Health of Family Caregivers
Caregiver interventions that reduce objective demands or support intensive caregivers could reduce or prevent well-being losses and improve the caregiver's relationship with the recipient
The Changing Tides of Caregiving During the Covid-19 Pandemic
Those who changed their care provision during the pandemic predominantly did so to protect their care recipient from COVID-19 exposure. Increasing one's care provision was strongly associated with worse mental health and well-being. Supports for caregivers who take on additional care tasks during the pandemic could have great public health benefit
Late-Life Disability and Care
Recognizing the shifting landscape of late-life disability and care, in 2008 the National Institute on Aging (NIA) funded a new national study of disability trends and dynamics. The National Health and Aging Trends Study (NHATS) is designed to foster a deeper understanding of national trends in late-life functioning, individual trajectories in functioning and accommodation, how these processes differ for various population subgroups, and the cons…
The Strength of Parent–Adult Child Ties in Biological Families and Stepfamilies
We examine older partnered parents' time spent with adult children in biological and step families, treating time together as an indication of relationship strength. Using a unique national sample of U.S. time diaries from the Panel Study of Income Dynamics, we investigate time with all adult children combined and with each adult child. We find that time together depends on family structure and parent–adult child dyadic relationship type embedded…
Patterns of Caregiving Among Older Adults With and Without Dementia
Care types can help us understand sources of heterogeneity in caregiving and effectively target caregiver support services and interventions
Visual Difficulty, Race and Ethnicity, and Activity Limitation Trajectories Among Older Adults in the United States
Promoting optimal aging for all requires an understanding of the factors that influence disparities in key outcomes. Our study provides evidence from a diverse national sample that visual difficulty appears to disproportionately affect activity limitation trajectories among older adults from minority racial/ethnic groups and particularly among non-Hispanic "Black individuals." Further research is needed to determine whether interventions to promo…
Incident Care Trajectories for Older Adults With and Without Dementia
Information on how family caregiving is likely to evolve over time in terms of care hours may help older adults with and without dementia, the family members, friends, and paid individuals who care for them, as well as their health care providers assess and plan for future care needs
Examining Consequences Related to Unmet Care Needs Across the Long-Term Care Continuum
Older adults receiving paid care face significant and consequential gaps in care, particularly in comparison to those in other care arrangements. More attention is needed to determine how paid care arrangements can be improved and/or expanded to meet the needs of the growing number of older adults receiving paid care in the community
Changes in Older Adults’ Social Contact During the Covid-19 Pandemic
The pandemic revealed the importance of ensuring that communication technologies to maintain social ties are available to and usable by older adults, particularly for those living in residential care settings
Assessing Health Care Use Trajectories After the Onset of Functional Disability
While activity limitations are a strong predictor of health care use among older adults, trajectories of health care use are heterogeneous. Along with clinical characteristics, potentially modifiable household and regional factors shaped health care trajectories, indicating that addressing these factors could potentially shift health care use patterns
Care Received and Unmet Care Needs Among Older Parents in Biological and Step Families
Results illustrate that concerns about the implications of the rising prevalence of step families for care parents receive from their children may be warranted. However, there is a lack of evidence of greater unmet need for care for older parents in step families, as risks of unmet needs are high for older parents regardless of family type
National estimates of kinship size and composition among adults with activity limitations in the United States
BACKGROUND: The number of adults living with limitations in daily activities in the United States is large, and projected to increase. Families, which are becoming more complex, are critical to the wellbeing of this population. OBJECTIVE: We present national estimates of the size and composition of kin networks for adults with activity limitations. METHODS: We use the 2013 Panel Study of Income Dynamics to assess kin relationships of adults aged …
The Association of Comorbid Depression and Anxiety Symptoms With Disability Onset in Older Adults
OBJECTIVE: Despite the high prevalence of late-life depression and anxiety at threshold and subthreshold levels, their joint role in the disablement process remains unclear. This study aims to examine the association of comorbid occurring depression and anxiety across the full spectrum of symptom severity with disability onset in older adults. METHODS: The study included 3663 participants from the 2011 National Health and Aging Trends Study, who …
Change Over Time in Caregiving Networks for Older Adults With and Without Dementia
Findings lend support to the need for caregiver training on managing multiple task domains and-for dementia caregivers in particular-task-sharing skills. More generally, the design of new approaches to better support older adults and their caregivers should consider the complexity, heterogeneity, and change over time in caregiving networks
Do Family Relationships Buffer the Impact of Disability on Older Adults' Daily Mood? An Exploration of Gender and Marital Status Differences
ObjectiveWe evaluate whether non-spousal family support and strain moderate the effect of disability on older adults' daily frustration and happiness, and whether these patterns differ by gender and marital status.BackgroundStress buffering perspectives predict that harmful effects of stress on well-being are buffered by family support, whereas stress proliferation models suggest effects are intensified by family strain. The extent to which famil…
Introduction to a Supplement on Population Level Trends in Dementia
Fifty Years of the Panel Study of Income Dynamics
The Panel Study of Income Dynamics (PSID) is the world's longest running household panel survey. Since it began in 1968, it has collected data on the same families and their descendants, making it an essential part of America's data infrastructure for empirically based social science research. The PSID arose from the War on Poverty as a tool for evaluating poverty dynamics, and this year (2018) marks 50 years of data collection. Because of its lo…
Family Structure and the Risk of Nursing Home Admission
Given the high costs associated with institutionalization, understanding factors related to nursing home admissions is of considerable interest. The family is particularly relevant to a discussion of nursing home admission, given its critical role in providing care to older disabled persons. Using data from the New Haven EPESE, we examine the relationship between family structure and the risk of first nursing home admission. Family structure is d…
Happy Marriage, Happy Life? Marital Quality and Subjective Well-being in Later Life
The authors examined associations between marital quality and both general life satisfaction and experienced (momentary) well-being among older husbands and wives, the relative importance of own versus spouse's marital appraisals for well-being, and the extent to which the association between own marital appraisals and well-being is moderated by spouse's appraisals. Data are from the 2009 Disability and Use of Time daily diary supplement to the P…
Declines in late-life disability
Resolving inconsistencies in trends in old-age disability
In September 2002, a technical working group met to resolve previously published inconsistencies across national surveys in trends in activity limitations among the older population. The 12-person panel prepared estimates from five national data sets and investigated methodological sources of the inconsistencies among the population aged 70 and older from the early 1980s to 2001. Although the evidence was mixed for the 1980s and it is difficult t…
The Division of Family Labor
We consider the division of caregiving efforts among the children of older, functionally limited parents. Our model of parental care assumes that care decisions are made in the context of an extended family, with each child taking into account not only the parent's needs and the child's own circumstances, but also the characteristics and actual care behavior of siblings. We propose a simultaneous-Tobit statistical framework that embodies these as…
Neighborhoods and disability in later life
Persistent and Growing Socioeconomic Disparities in Disability Among the Elderly
Objective. We sought to determine whether socioeconomic and racial/ethnic disparities in prevalence of disability over age 70 have widened or narrowed during the past 2 decades. Methods. We used data from the 1982–2002 National Health Interview Surveys, which are nationally representative cross-sectional surveys of the noninstitutionalized population of the United States. Participants included 172227 people aged 70 years and older. The primary ou…
Understanding trends in functional limitations among older Americans
OBJECTIVES: This report documents trends in functional limitations among older Americans from 1984 to 1993 and investigates reasons for such trends. METHODS: We applied logistic regression to data for noninstitutionalized Americans aged 50 years and older from the Survey of Income and Program Participation. We focused on 4 functional limitation measures unlikely to be affected by changes in role expectations and living environments: reported diff…
Persistent, Consistent, Widespread, and Robust? Another Look at Recent Trends in Old-Age Disability
Evidence from several surveys using various measures indicates that disability has declined among elderly persons. Determining the causes of the improvements should be a high priority in future research efforts
The role of education in explaining and forecasting trends in functional limitations among older Americans
Using the Survey of Income and Program Participation, we document the importance of education in accounting for declines in functional limitations among older Americans from 1984 to 1993. Of the eight demographic and socioeconomic variables considered, education is most important in accounting for recent trends. The relationship between educational attainment and functioning has not changed measurably, but educational attainment has increased gre…
Marital Quality and Negative Experienced Well-Being
One's own and spouse's marital appraisals play a complex role in shaping negative emotions among older adults. Findings suggest that frustration is a particularly complex emotion and a promising area for further study among older married couples
Trends in Late-Life Activity Limitations in the United States
This article updates trends from five national U.S. surveys to determine whether the prevalence of activity limitations among the older population continued to decline in the first decade of the twenty-first century. Findings across studies suggest that personal care and domestic activity limitations may have continued to decline for those ages 85 and older from 2000 to 2008, but generally were flat since 2000 for those ages 65–84. Modest increas…
Feeling Better? Trends in General Health Status
Declines in proportions reporting poor/fair health among the older population in recent decades mirror declines in disability. Although the younger population has not experienced such progress, its prevalence of poor/fair health is low throughout the 21-year analysis period. Of concern are the growing socioeconomic disparities in health for both younger and older populations
Chronic conditions and the decline in late-life disability
Using data from the 1997–2004 National Health Interview Survey (NHIS), we examine the role of chronic conditions in recent declines in late-life disability prevalence. Building upon prior studies, we decompose disability declines into changes in the prevalence of chronic conditions and in the risk of disability given a condition. In doing so, we extend Kitigawa’s (1955) classical decomposition technique to take advantage of the annual data points…
Health and Functioning Among Baby Boomers Approaching 60
Trends varied by indicator, period, and age. It is surprising that, given the socioeconomic, medical, and public health advantages of Baby Boomers throughout their lives, they are not doing considerably better on all counts
Care Received and Unmet Care Needs Among Older Parents in Biological and Step Families
Results illustrate that concerns about the implications of the rising prevalence of step families for care parents receive from their children may be warranted. However, there is a lack of evidence of greater unmet need for care for older parents in step families, as risks of unmet needs are high for older parents regardless of family type
Disability, participation, and subjective wellbeing among older couples
Change Over Time in Caregiving Networks for Older Adults With and Without Dementia
Findings lend support to the need for caregiver training on managing multiple task domains and-for dementia caregivers in particular-task-sharing skills. More generally, the design of new approaches to better support older adults and their caregivers should consider the complexity, heterogeneity, and change over time in caregiving networks
Changes in Older Adults’ Social Contact During the Covid-19 Pandemic
The pandemic revealed the importance of ensuring that communication technologies to maintain social ties are available to and usable by older adults, particularly for those living in residential care settings
Disability-Free Life Expectancy Over 30 Years
Objectives. To examine changes in active life expectancy in the United States over 30 years for older men and women (aged ≥ 65 years). Methods. We used the 1982 and 2004 National Long Term Care Survey and the 2011 National Health and Aging Trends Study to estimate age-specific mortality and disability rates, the overall chances of survival and of surviving without disability, and years of active life for men and women. Results. For older men, lon…
Neighborhoods and Obesity in Later Life
Objectives. We examined the influence of neighborhood environment on the weight status of adults 55 years and older. Methods. We conducted a 2-level logistic regression analysis of data from the 2002 wave of the Health and Retirement Study. We included 8 neighborhood scales: economic advantage, economic disadvantage, air pollution, crime and segregation, street connectivity, density, immigrant concentration, and residential stability. Results. Wh…
Neighborhoods and Chronic Disease Onset in Later Life
Objectives. To strengthen existing evidence on the role of neighborhoods in chronic disease onset in later life, we investigated associations between multiple neighborhood features and 2-year onset of 6 common conditions using a national sample of older adults. Methods. Neighborhood features for adults aged 55 years or older in the 2002 Health and Retirement Study were measured by use of previously validated scales reflecting the built, social, a…
Is Spousal Caregiving Associated With Enhanced Well-Being? New Evidence From the Panel Study of Income Dynamics
For women, chores such as meal preparation, laundry, and cleaning--but not caregiving per se--are associated with worse experienced well-being than other activities. Findings underscore that there are positive aspects of spousal caregiving for older wives that offset the innately unpleasant nature of household tasks
Aggregate Changes in Severe Cognitive Impairment Among Older Americans
As a group, older persons, especially those well into their 80s, appear to have better cognitive functioning today than they did in the early 1990s
Do Family Relationships Buffer the Impact of Disability on Older Adults' Daily Mood? An Exploration of Gender and Marital Status Differences
ObjectiveWe evaluate whether non-spousal family support and strain moderate the effect of disability on older adults' daily frustration and happiness, and whether these patterns differ by gender and marital status.BackgroundStress buffering perspectives predict that harmful effects of stress on well-being are buffered by family support, whereas stress proliferation models suggest effects are intensified by family strain. The extent to which famil…
Kin and Nursing Home Lengths of Stay
There are numerous hypotheses about the role played by kin in decreasing the length of elderly persons' nursing home stays, yet few studies have explicitly examined the relationship between kin and episode length. Here we use backward recurrence time data from the Current Resident File of the 1985 National Nursing Home Survey to estimate models in which the hazard of leaving a nursing home depends upon covariates . Women admitted at age 65 or old…
Near and Far
In this paper we distinguish between two measures of contact between children and their non-residential fathers: whether or not the children have seen their father in the previous year, and how many weeks the children stayed with their father. The distinction between the two is important because there are many aspects of a parent-child relationship, some of which may be met during shorter contacts, and others which may be nurtured during an exten…
Family networks
Despite the importance of kin in caring for older relatives, few studies have examined the relationship between the family network and the risk of nursing home placement. Data from a cohort of noninstitutionalized elderly persons living in New Haven in 1982 were used to predict nursing home admission through 1985. Logistic regression analyses show that older persons who have regular contact with kin have a lower risk of institutionalization. For …
A Case Study on the Use of Multiple Imputation
Multiple imputation is a relatively new technique for dealing with missing values on items from survey data. Rather than deleting observations for which a value is missing, or assigning a single value to incomplete observations, one replaces each missing item with two or more values. Inferences then can be made with the complete data set. This paper presents an application of multiple imputation using the 1987–1988 National Survey of Families and…
Family Structure and the Risk of Nursing Home Admission
Given the high costs associated with institutionalization, understanding factors related to nursing home admissions is of considerable interest. The family is particularly relevant to a discussion of nursing home admission, given its critical role in providing care to older disabled persons. Using data from the New Haven EPESE, we examine the relationship between family structure and the risk of first nursing home admission. Family structure is d…
The Division of Family Labor
We consider the division of caregiving efforts among the children of older, functionally limited parents. Our model of parental care assumes that care decisions are made in the context of an extended family, with each child taking into account not only the parent's needs and the child's own circumstances, but also the characteristics and actual care behavior of siblings. We propose a simultaneous-Tobit statistical framework that embodies these as…
Understanding trends in functional limitations among older Americans
OBJECTIVES: This report documents trends in functional limitations among older Americans from 1984 to 1993 and investigates reasons for such trends. METHODS: We applied logistic regression to data for noninstitutionalized Americans aged 50 years and older from the Survey of Income and Program Participation. We focused on 4 functional limitation measures unlikely to be affected by changes in role expectations and living environments: reported diff…
The role of education in explaining and forecasting trends in functional limitations among older Americans
Using the Survey of Income and Program Participation, we document the importance of education in accounting for declines in functional limitations among older Americans from 1984 to 1993. Of the eight demographic and socioeconomic variables considered, education is most important in accounting for recent trends. The relationship between educational attainment and functioning has not changed measurably, but educational attainment has increased gre…
Incorporating Assistive Devices into Community-Based Long-Term Care
Technology has the potential to confer quality of life enhancements for older persons and their caregivers and cost savings for payers
Implications of Asking "Ambiguous" Difficulty Questions
Analysts should be aware that (a) ambiguously worded questions appear to be a better proxy for underlying than for residual difficulty, (b) discrepancies seem to be lower for separate activities than for summary variables indicating difficulty with one or more activities, and (c) being Hispanic and receiving help may affect reporting discrepancies
Aggregate Changes in Severe Cognitive Impairment Among Older Americans
As a group, older persons, especially those well into their 80s, appear to have better cognitive functioning today than they did in the early 1990s
Persistent, Consistent, Widespread, and Robust? Another Look at Recent Trends in Old-Age Disability
Evidence from several surveys using various measures indicates that disability has declined among elderly persons. Determining the causes of the improvements should be a high priority in future research efforts
Recent Trends in Disability and Functioning Among Older Adults in the United States
CONTEXT: Several well-publicized recent studies have suggested that disability among older Americans has declined in the last decade. OBJECTIVES: To assess the quality, quantity, and consistency of recent evidence on US trends in the prevalence of self-rated old age disability and physical, cognitive, and sensory limitations during the late 1980s and 1990s and to evaluate the evidence on trends in disparities by major demographic groups. DATA SOU…
Another Look at Aggregate Changes in Severe Cognitive Impairment
Objectives. This study explored whether previously reported declines in severe cognitive impairment were robust to cumulative effects of potentially confounding survey design issues
Freedman and Martin Respond
We thank Wang and Badley for their comments, but we believe that the issues they raise as methodological concerns are better interpreted as differences in disciplinary approaches and that the validity of our analysis remains intact. Their main concern is that we did not translate decomposition results into population attributable risk estimates, a concept long used in epidemiology. Yet demographers have a tradition of using decomposition techniqu…
Asking Neutral Versus Leading Questions
The authors conclude that, because they minimize survey time without compromising validity and reliability, items that explicitly capture degree of difficulty by asking "How much difficulty do you have..." may be the optimal approach for survey designers
Factors Influencing the Use of Mobility Technology in Community-Based Long-Term Care
Research on the dynamic acquisition process, with attention to age and trajectories of disability severity, is needed to fully understand the integration of technology and personal care
Disability and Home Care Dynamics Among Older Unmarried Americans
Disability and care are not static constructs in old age. Older unmarried persons experience worsening, stabilizing, and recovery of function, and their care hours change accordingly. Evaluations of home care programs must be cognizant of such dynamic realities
Use of Preventive Services by Men Enrolled in Medicare+Choice Plans
Objectives. We examined the effect of demographic and socioeconomic factors on use of preventive services (prostate-specific antigen testing, colorectal cancer screening, and influenza vaccination) among elderly men enrolled in 2 Medicare+Choice health plans. Methods. Data were derived from administrative files and a survey of 1915 male enrollees. We used multivariate logistic regression to assess the effects of enrollee characteristics on preven…
Resolving inconsistencies in trends in old-age disability
In September 2002, a technical working group met to resolve previously published inconsistencies across national surveys in trends in activity limitations among the older population. The 12-person panel prepared estimates from five national data sets and investigated methodological sources of the inconsistencies among the population aged 70 and older from the early 1980s to 2001. Although the evidence was mixed for the 1980s and it is difficult t…
Persistent and Growing Socioeconomic Disparities in Disability Among the Elderly
Objective. We sought to determine whether socioeconomic and racial/ethnic disparities in prevalence of disability over age 70 have widened or narrowed during the past 2 decades. Methods. We used data from the 1982–2002 National Health Interview Surveys, which are nationally representative cross-sectional surveys of the noninstitutionalized population of the United States. Participants included 172227 people aged 70 years and older. The primary ou…
Feeling Better? Trends in General Health Status
Declines in proportions reporting poor/fair health among the older population in recent decades mirror declines in disability. Although the younger population has not experienced such progress, its prevalence of poor/fair health is low throughout the 21-year analysis period. Of concern are the growing socioeconomic disparities in health for both younger and older populations
Chronic conditions and the decline in late-life disability
Using data from the 1997–2004 National Health Interview Survey (NHIS), we examine the role of chronic conditions in recent declines in late-life disability prevalence. Building upon prior studies, we decompose disability declines into changes in the prevalence of chronic conditions and in the risk of disability given a condition. In doing so, we extend Kitigawa’s (1955) classical decomposition technique to take advantage of the annual data points…
Why Is Late‐Life Disability Declining?
Context: Late‐life disability has been declining in the United States since the 1980s. This study provides the first comprehensive investigation into the reasons for this trend. Methods: The study draws on evidence from two sources: original data analyses and reviews of existing studies. The original analyses include trend models of data on the need for help with daily activities and self‐reported causes of such limitations for the population age…
Socioeconomic Disparities in Medical Provider Visits among Medicare Managed Care Enrollees
This study examined socioeconomic disparities in medical provider visits for elderly people enrolled in two Medicare managed care plans. Controlling for health and demographic differences, elderly people of lower income had fewer primary care visits and those with lower education had fewer specialist visits. The number of emergency room visits was not significantly related to socioeconomic status (SES). People of low SES reported having more fina…
Medicine (60 obras) · Psychology (57 obras) · Gerontology (49 obras) · Health disparities and outcomes (42 obras) · Intergenerational Family Dynamics and Caregiving (30 obras) · Geriatric Care and Nursing Homes (23 obras) · Gerontology (22 obras) · Population (20 obras) · Developmental psychology (19 obras) · Demography (17 obras)