Differential Aging-In-Place.

Abstract

This three-essay dissertation explores components of aging–in-place among adults living alone aged 65 and older using nationally representative data from the Health and Retirement Study (HRS). Drawing on the Person-Environment Fit and Person-Centered perspectives, the overall goal is to examine the extent to which three dimensions of aging-in-place, namely the environment, the older individual, and individual agency (efficacy), are inter-related in order to enable independent living among this subgroup of older persons. Together, these three components help to characterize the heterogeneity of the life contexts and personal resources of older adults who live alone and are aging-in-place. The first paper explored to what degree the environment and health subgroups are associated with subjective well-being among older adults living alone. Through clustering analysis, the four health subgroups of sensory-cognitive impaired, physically impaired, frail, and healthy were identified. The intersection of these health subgroups with three environmental contexts that reflect different levels of physical and social support were examined. The frail group was more likely to show depressive symptoms if they lived in a physically average and socially unsupported environment. The sensory-cognitive impaired group was more likely to report depressive symptoms when they lived in a physically-unsupported but socially-supported environment. The second paper asked if changes in depressive symptomatology over time are mediated by changes in perceived control. The findings confirm a stronger negative influence of membership in a vulnerable health subgroup on perceived control, which in turn affects depressive symptoms over time. Among the environmental contexts, only greater social support was associated with a decrease in depressive symptoms over time via perceived control. The third paper extended the empirical examination of proposals drawn from the Person-Environment Fit perspective. I asked how much environments moderate the effects of health profiles and low socioeconomic status on mortality risk. The results show that for individuals in the sensory-cognitive impaired and physically impaired groups, broader social network was associated with an increased risk of death. In addition, the study revealed that older adults living alone with low socioeconomic status who live in a senior housing environment had a reduced risk of death.