Current Awareness in Aging Research (CAAR) Report #234--April 22, 2004


CAAR (Current Awareness in Aging Research) is a weekly email report produced by the Center for Demography of Health and Aging at the University of Wisconsin-Madison that helps researchers keep up to date with the latest developments in the field. For more information, including an archive of back issues and subscription information see:


I. Reports and articles:

1. _DEMOGRAPHIC RESEARCH_ SPECIAL COLLECTION: Note: _DR_ is "a free, expedited, peer-reviewed journal of the population sciences published by the Max Planck Institute for Demographic Research." "Determinants of Diverging Trends in Mortality" (_Demographic Research_ Special Collection S2, 2004, .pdf format). "The papers in this special collection were presented at the seminar "Determinants of Diverging Trends in Mortality", held at MPIDR, Rostock on 19-21 of June, 2002. The seminar was organized by the Max Planck Institute for Demographic Research and the Committee on Emerging Health Trends of the International Union for the Scientific Study of Population."

Click on "Special Collections" on the left side of the page.

2. CENSUS BUREAU FACTS FOR FEATURES: "Older Americans Month Celebrated in May" (CB04-FF.07. Apr. 20, 2004).

3. CMS News Releases, National Coverage Determinations (NCD):

A. "Medcare Makes Drug Card Enrollment Easier With Autoenrollment and Standard Form" (Apr. 17, 2004).

B. "CMS to Increase Payments to Hospitals Reclassified Under Medicare Reform Law" (Apr. 20, 2004).

C. "NCD for Acupuncture for Fibromyalgia (30.3.1)" (Apr. 16, 2004, HTML or .pdf format, 5p.).

D. "NCD for Acupuncture for Osteoarthritis (30.3.2)" (Apr. 16, 2004, HTML or .pdf format, 5p.).

4. DHHS NEWS RELEASE: "HHS Announces New Initiative to Improve Quality of Care for Medicare Beneficiaries with Chronic Illnesses" (US Department of Health and Human Services, Apr. 20, 2004).

5. AOA NEWSLETTER: "AoA e-News," (US Administration on Aging, April 2004, HTML, .pdf and Microsoft Word format, 8p.).


A. "Council on Family Health Offers Medicine Use Information for Seniors: Educational booklet distributed in cooperation with FDA, AoA" (US Food and Drug Administration, Apr. 14, 2004). Note: The news release links to"Medicines and You: A Guide for Older Adults" (Council on Family Health/US Food and Drug Administration/US Administration on Aging, April 2004, .pdf format, 17p.).

B. "FDA Approves Apokyn for the Acute Treatment of Episodes of Immobility in Parkinsons Patients" (US Food and Drug Administration Talk Paper T04-09, Apr. 21, 2004).

7. BLS REPORT: "National Compensation Survey: Employee Benefits in Private Industry in the United States, March 2003" (April 2004, .pdf format, 16p.).

8. CALIFORNIA HEALTHCARE FOUNDATION GUIDE: "2004 Guide to California Medicare Options," (, April 2004).

9. ASSOCIATION OF SUPERANNUATION FUNDS OF AUSTRALIA REPORT:"Intergenerational modelling for Australian families," (April 2004, .pdf format, 36p.).

10. Brookings Institution Report: "The Saver's Credit: Issues and Options," by William G. Gale, J. Mark Iwry, and Peter R. Orszag (Retirement Security Project, April 2004, .pdf format, 30p.). An extensive abstract, as well as a link to full text, can be found at:

11. HRS BIBLIOGRAPHY UPDATE: The University of Michigan Institute for Social Research Health and Retirement Study has recently updated its bibliography:


Tunceli, K., A Structural Model of the Effect of Retiree Health Insurance on Early Retirement 2003. The Pennsylvania State University.

Journal Articles:

Amirkhanyan, A. A. and Wolf, D. A., Caregiver Stress and Noncaregiver Stress: Exploring the Pathways of Psychiatric Morbidity The Gerontologist, vol. 43, pp. 817-827, 2003.

Hurd, M. D. and McGarry, K., The Predictive Validity of Subjective Probabilities of Survival The Economic Journal, vol. 112, 2002.

Sturm, R., Ringel, J. S., and Andreyeva, T., Increasing Obesity Rates And Disability Trends Health Affairs, vol. 23, pp. 199-205, 2004.

Zelinski, E. M. and Gilewski, M. J., Effects of Demographic and Health Variables on Rasch Scaled Cognitive Scores Journal of Aging and Health, vol. 15, pp. 435-464, 2003.


Benitez-Silva, H., Buchinsky, M., Chan, H.-M., Sheidvasser, S., and Rust, J., How Large is the Bias in Self-Reported Disability Status? Jul, 1999. SUNY - Stony Brook, Department of Economics Working Paper #99-02. Stony Book, NY.

Even, W. and Macpherson, D.A., Do Pensions Impede Phased Retirement? 2003.

Even, W. and Macpherson, D.A., When Will the Gender Gap in Retirement Income Narrow? 2003.

Karoly, L.A. and Zissimopoulos, J., Self-Employment and the 50+ Population 2004. AARP Public Policy Institute. Washington, DC.

12. STPP REPORT: "Aging Americans: Stranded Without Options," (Surface Transportation Policy Project, April 2004, .pdf format, 17p.).

Executive Summary excerpt:

The demographics of the United States will change dramatically during the next 25 years as more baby boomers reach their 60s, 70s and beyond. The U.S. Census Bureau projects that the number of Americans age 65 or older will swell from 35 million today to more than 62 million by 2025 - nearly an 80 percent increase. As people grow older, they often become less willing or able to drive, making it necessary to depend on alternative methods of transportation. Unfortunately, the United States is currently ill prepared to provide adequate transportation choices for our rapidly aging population. Alternatives to driving are sparse, particularly in some regions and in rural and small town communities. As the number of older people increases, so too will their mobility needs. How the nation addresses this issue will have significant social and economic ramifications. This report presents new findings based on the National Household Transportation Survey of 2001 and places them in the context of other research on mobility in the aging population.

13. MEDSCAPE ARTICLE: Note: Medscape requires free registration before providing articles: "Alcohol Intake and Risk of Dementia," by Jose A. Luchsinger, Ming-Xin Tang, Maliha Siddiqui, Steven Shea, and Richard Mayeux (_Journal of the American Geriatrics Society_, Vol. 52, No. 4, 2004, p. 540-546, via Medscape).

14. _JAMA_ ARTICLE ABSTRACT: "Lipid-Lowering Therapy With Statins in High-Risk Elderly Patients: The Treatment-Risk Paradox," by Dennis T. Ko, Muhammad Mamdani, and David A. Alter (_Journal of the American Medical Association_, Vol. 291, No. 15, Apr. 21, 2004, p. 1864-1870).

15. AARP PRIME TIME RADIO: The following AARP _Prime Time Radio_ shows, for Mar 22. - Apr. 13 2004, are now available (RealPlayer plug-in or helper application required, audio transcripts run between 24 and 30 minutes).

Apr. 6, 2004: Caregiving: Facing the Challenges


II. Working Papers:


A. "The Effect of Social Security on Divorce and Remarriage Behavior," by Stacy Dickert-Conlin and Cristian Meghea (WP 2004-09, April 2004, .pdf format, 32p.).


This paper investigates the effects of economic incentives on divorce and remarriage behavior. Before December 1977, the Social Security law entitled divorcees to claim auxiliary benefits on their ex-spouses record only if the marriage lasted at least 20 years. One of the 1977 amendments of the Social Security rules shortened the minimum duration of an"eligible" marriage to ten years. Following the passage of the law, we find that the divorce rate at nine years of marriage decreased relative to a control group. However, there is not strong evidence of a corresponding increase in the divorce rate at ten years of marriage. We also find no evidence that the new claim on future Social Security benefits affected divorced womens remarriage probability in the predicted way.

B. "Lifetime Earnings, Social Security Benefits, and the Adequacy of Retirement Wealth Accumulation," by Eric M. Engen, William G. Gale, and Cori Uccello (WP 2004-10, April 2004, .pdf format, 41p.).


This paper provides new evidence on the adequacy of household retirement saving. We depart from much previous research on the adequacy of saving in two key ways. First, our underlying simulation model of optimal wealth accumulation allows for precautionary saving against uncertain future earnings. Second, we employ data on lifetime earnings. Using data from the 1992 Health and Retirement Study, we find that households at the median of the empirical wealth-lifetime earnings distribution are saving as much or more as the underlying model suggests is optimal, and households at the high end of the wealth distribution are saving significantly more than the model indicates. But we also find significant undersaving among the lowest 25 percent of the population. We show that reductions in Social Security benefits could have significant deleterious effects on the adequacy of saving, especially among low-income households. We also show that, controlling for lifetime earnings, households with high current earnings tend to save far more adequately than other households.

C. "Valuing Assets in Retirement Saving Accounts," by James M. Poterba (WP 2004-11, April 2004, .pdf format, 37p.).


Assets in retirement saving plans have become an important component of net worth for many households. While many studies compare household balances in tax-deferred retirement accounts such as 401(k) plans with the financial assets held outside these accounts, these different asset components are not directly comparable. Taxes and in some cases penalties are due when assets are withdrawn from some retirement saving plans. These factors can make a dollar held inside a retirement account less valuable than a dollar held in a similar asset outside these accounts, particularly for those who are considering withdrawing assets from the tax-deferred accounts in the near future. For younger households who do not plan to withdraw tax deferred assets for many years, the opportunity for tax-free compound returns in retirement accounts can make a dollar inside such an account more valuable than a dollar outside such accounts from the standpoint of providing retirement resources, even though the principal from the retirement account will be taxed at the time of distribution, while the principal outside such accounts is untaxed. This paper illustrates the potential differences in the value of a dollar of invested in a bond, or in corporate stock, inside and outside tax-deferred accounts. It draws on a range of data sources to calibrate the value of the tax burden, and the benefit of compound growth, for assets held in retirement accounts, and describes the differences in relative valuation for households of different ages.

D. "The Effects of Health Insurance and Self-Insurance on Retirement Behavior," by Eric French and John Bailey Jones (WP 2004-12, April 2004, .pdf format, 76p.).


Using the first estimable dynamic programming model of retirement behavior that accounts for both savings and uncertain medical expenses, we assess the importance of employer-provided health insurance and Medicare in determining retirement behavior. Including both of these features allows us to determine whether workers value employer-provided health insurance because the subsidy contained in the insurance lowers their average medical expenses, or because health insurance also reduces their medical expense risk. Using data from the Health and Retirement Study, we find that the reduction in expected medical expenses explains about 60% of a typical individuals valuation of health insurance, with the reduction in volatility explaining the remaining 40%. We find that for workers whose insurance is tied to their job, shifting the Medicare eligibility age to 67 will significantly delay retirement. However, we find that the plan to shift the Social Security normal retirement age to 67 will cause an even larger delay.

17. NBER: "Social Security and Trust Fund Management," by Takashi Oshio (w10444, April 2004, .pdf format, 42p.).


In this paper we investigate why and to what extent the government should have a social security trust fund, and how it should manage the fund in the face of demographic shocks, based on a simple overlapping-generations model. We show that, given an aging population, a trust fund in some form could achieve the (modified) golden rule or to offset the negative income effect of a PAYGO system. Besides, in a closed economy where factor-prices effects dominate, using the trust fund as a buffer for demographic shocks could lead to a widening of intergenerational inequality. We also the discuss policy implications of our analysis on the social security reform debate in Japan, including the fixed tax method and the use of the trust fund in the face of a rapidly aging population.

Click on "PDF" or submit your email address at the bottom of the page for full text.

18. CESifo: "Are Family Allowances and Fertility-related pensions Siamese Twins?" by Robert Fenge and Volker Meier (Center for Economic Studies and the Ifo Institute for Economic Research [University of Munich, Germany] Working Paper 1157, March 2004, .pdf format, 30p.).


This paper discusses alternative ways to deal with the positive externalities of having children in a pay-as-you-go pension system. Family allowances are compared to introducing a fertility-related component into the pension formula. In an endogenous labor supply setting, both instruments are shown to be equivalent if general pensions are of the Bismarckian contribution-related type. In contrast, if general pensions are of the Beveridgean flat-rate type, making pensions contingent on the number of children is generally preferable to family allowances because the latter creates a larger tax load on labor supply.

Click on "Download PDF" at the bottom of the abstract for full text.

19. SEDAP (SOCIAL AND ECONOMIC DIMENSIONS OF AN AGING POPULATION) [McMaster University, Hamilton, Ontario, Canada]: "The Impact of Differential Cost Sharing of Non-Steroidal Anti-Inflammatory Agents on the Use and Costs of Analgesic Drugs," by Paul V. Grootendorst, John K. Marshall, Anne M. Holbrook, Lisa R. Dolovich, Bernie J. O'Brien, and Adrian R. Levy (Working Paper 115, April 2004, .pdf format, 36p.).


OBJECTIVE: To estimate the effect of differential cost sharing (DCS) schemes for non-steroidal anti-inflammatory drugs (NSAIDs) on drug subsidy program and beneficiary expenditures.

DATA SOURCES/STUDY SETTING: Monthly aggregate claims data from Pharmacare, the public drug subsidy program for seniors in British Columbia, Canada over the period 1989-11 to 2001-06.

STUDY DESIGN: DCS limits insurance reimbursement of a group of therapeutically similar drugs to the cost of the lowest priced drugs, with beneficiaries responsible for costs above the reimbursement limit. Pharmacare introduced two different forms of DCS, generic substitution (GS) and reference pricing (RP), in April 1994 and November 1995, respectively, to the NSAIDs. Under GS, generic and brand versions of the same NSAID are considered interchangeable, whereas under RP different NSAIDs are. We extrapolated average reimbursement per day of NSAID therapy over the months before GS and RP to estimate what expenditures would have been without the policies. These counterfactual predictions were compared to actual values to estimate the impact of the policies; the estimated impacts on reimbursement rates were multiplied by the post-policy volume of NSAIDS dispensed, which appeared unaffected by the policies, to estimate expenditure changes.

DATA COLLECTION: The cleaned NSAID claims data, obtained from Pharmacares databases, were aggregated by month and by their reimbursement status under the GS and RP policies.

PRINCIPAL FINDINGS: After RP, program expenditures declined by $22.7 million, or $4 million annually, cutting expenditure by half. Most savings accrued from the substitution of low cost NSAIDs for more costly alternatives. About 20% of savings represented expenditures by seniors who elected to pay for partially-reimbursed drugs. GS produced one quarter the savings of RP.

CONCLUSIONS: RP of NSAIDs achieved its goal of reducing drug expenditures and was more effective than GS. The effects of RP on patient health and associated health care costs remain to be investigated.


III. Journal Tables of Contents (check your library for availability):

20. Experimental Aging Research (Vol. 30, No. 2, April 2004). Note: Full electronic text of this journal is available in EBSCO Host Academic Search Elite Database. Check your library for the availability of this database and this issue.

21. INGENTA Tables of Contents: INGENTA provides fee based document delivery services for selected journals.

A. Point your browser to:

B. click on "browse by publication"
C. Click the "fax/ariel" radio button, type the Journal Name in the "by words in the title" search box and click "search".
D. View the table of contents for the issue noted.

Educational Gerontology (Vol. 30, No. 5, May 2004). Note: Full electronic text of this journal is available in EBSCO Host Academic Search Elite Database. Check your library for the availability of this database and this issue.

Journal of Elder Abuse and Neglect (Vol. 14, No. 2/3, 2002).

Omega: Journal of Death and Dying (Vol. 47, No. 3, 2003)

22. AMEDEO MEDICAL LITERATURE: Note: "AMEDEO has been created to serve the needs of healthcare professionals, including physicians, nurses, pharmacists, administrators, other members of the health professions, and patients and their friends. They can easily access timely, relevant information within their respective fields... All AMEDEO services are free of charge. This policy was made possible thanks to generous unrestricted educational grants provided by AMGEN, Berlex, Eisai, Glaxo Wellcome, Novartis, Pfizer, Roche, and Schering AG."

A. Osteoporosis: Literature for the week of Apr. 21, 2004:

B. Alzheimer's Disease: Literature for the week of Apr. 21, 2004:

C. Parkinson's Disease: Literature for the week of Apr. 21, 2004:

D. Prostate Cancer: Literature for the week of Apr. 21, 2004:

AMADEO Literature Guide:


IV. Funding Opportunities:

23. NIH:

A. "NIA (US National Institute on Aging) Announcement: New Policy for Program Project Applications" (US National Institutes of Health, NOT-AG-04-005, Apr. 15, 2004).

B. "Additional Genotyping For the Human Haplotype Map" (US National Institutes of Health, National Institute on Aging, in conjunction with several other agencies, RFA-HG-04-005, Apr. 16, 2004). For more information see:

C. "Long-Term Weight Maintenance: Basic and Clinical Studies" (US National Institutes of Health, National Institute on Aging, in conjunction with several other agencies, PA-04-092, Apr. 13, 2004). For more information see:


V. Conferences:

24. CENTER FOR AGEING AND PASTORAL STUDIES [BARTON, AUSTRALIA]: "Ageing, Spirituality and Palliative Care," a conference to be held Sep. 27-Oct. 1, 2004 in Adelaide, Australia. For more information, see:

More information on CAPS:

VI. Legislation Information Updates:

25. UK HOUSE OF COMMONS HEALTH COMMITTEE REPORT: "Elder Abuse," (HC-111-I, April 2004, .pdf and HTML format, 61p.).



Jack Solock
Data Librarian--Center for Demography and Ecology and Center for
Demography of Health and Aging
4470 Social Science
University of Wisconsin-Madison
Madison, WI 53706