"Unlinked lives": Elaboration of a concept and its significance for the life course.

This article introduces the concept of "unlinked lives" and illustrates its significance for scholarship on the life course. There are many lessons to be learned about human interdependence by focusing not on relationships that are formed and then maintained, but instead on relationships that are lost or ended by choice or circumstance, such as through changes in institutional affiliations, social status and positions or places. Unlinked lives carry important social meanings, are embedded in complex social processes, and bring consequences for the wellbeing of individuals, families, and societies. To develop this concept, we put forward nine key propositions related to when and how unlinkings happen as processes, as well as some of the consequences of being unlinked as a status or outcome. The coupling of "unlinked lives" with "linked lives" offers a crucial avenue for advancing life course theories and research, integrating scholarship across multiple life periods and transitions, and bridging the two now-distinct traditions of intellectual inquiry on the life course and on social networks.

Networked lives: Probing the influence of social networks on the life course.

Social network research is well-equipped to help life course scholars produce a deeper and more nuanced approach to the principle of "linked lives," one of the cornerstones of the field. In this issue on Networked Lives, nine original articles and two commentaries generate new theories, empirical findings and methodological applications at the intersection of the fields of social networks and life course research. In this introduction, we reflect on these advances, highlighting key findings and challenges that await scholars in building more robust synergy between the two fields. Social networks emerge as key structural forces in life courses, yet there is much to learn about the mechanisms through which their effects on people's lives come about. There is a need to study further how networks evolve through the rhythm of life events, and to analyze broader and more complex networks that capture the roles and influences of relations beyond intimate or family ties. These papers demonstrate that there is much to be gained in probing how individuals are linked to and unlinked from others over time, and in carrying conceptual and methodological advances across social network and life course studies.

Daily Caregiving Appraisals, Future Self-Views, and Physical Activity Goals Among Adult-Daughter Dementia Caregivers.

OBJECTIVES: Caregiving dynamics may shape caregivers' views on their own aging in ways that affect their (de)motivation to improve their current and future health and well-being. In this study, we investigated within-person associations of daily positive and negative caregiving appraisals, future self-views (physical functioning, cognitive, and overall health domains), and physical activity goal pursuit among adult-daughter dementia caregivers. METHODS: Data came from 33 middle-aged caregivers (M = 55.03) who participated in a 30-day microlongitudinal study of caregiving (N of occasions = 855). We used multilevel modeling to analyze within-person associations. RESULTS: Daily positive caregiving appraisals were not associated with daily future self-views. However, on days when caregivers reported higher negative caregiving appraisals, they thought more negatively about their future older selves in all domains. In turn, on days when caregivers thought more negatively about their future older selves in all domains, they reported lower physical activity goal pursuit. Future self-views in all domains mediated the association between negative caregiving appraisals and physical activity goal pursuit. Future self-views did not mediate the association between positive caregiving appraisals and physical activity goal pursuit. However, cognitive future self-views moderated the association between positive caregiving appraisals and physical activity goal pursuit. DISCUSSION: Results suggest that one pathway through which subjective caregiving experiences, especially negative caregiving appraisals, affect caregivers' physical activity goal pursuit is through future self-views. Thus, this study offers a deeper theoretical understanding of caregivers' self-regulatory health behavior and new empirical information on how caregiving might affect life-span developmental motivation.

Studying social change in human lives: a conversation.

This commentary reinforces a central commitment of life course research: to make visible how social change matters in human lives. This paper captures a moderated conversation with four senior scholars about how they came to study the intersection between social change and life experience, why this intersection is so important to life course studies, and theoretical and methodological imperatives and challenges that come with it.

Aging-Related Changes in the Association between Negative Affect and Response Time Inconsistency in Older Adulthood.

Negative affect (NA) and positive affect (PA) are established modifiable psychosocial correlates of cognitive health and have demonstrated capacity for meaningful within-person fluctuations based on person-environment interactions, age, and measurement approach. Previous research has shown NA is associated with increased response time inconsistency (RTI), an early performance-based indicator of cognitive health and aging. It is unclear, however, whether PA is associated with RTI, and whether affect-RTI associations exist within persons over time or change as individuals get older. We utilized data from a measurement burst study (Cognition, Health and Aging Project) to explore within- and between-person associations between affect and RTI in community-dwelling older adults (N=111, M=80.04 years, SD=6.30). Affect and RTI were assessed on six days over a two-week period, every six months for two years. Results revealed a significant association between NA-low arousal and RTI within persons over time. RTI was higher on sessions when NA-low arousal was higher than usual (b=0.21, 95%CI=0.08 to 0.35, p<.01). This association decreased in magnitude over time (b=-0.09, 95%CI=-0.14 to - 0.03, p<.001), ultimately resulting in increased NA-low arousal being associated with decreased RTI two years later (b=-.14, 95%CI=-0.27 to -0.01, p<.05). No PA-RTI associations emerged. The results suggest efforts focused on maximizing resource allocation and personalizing cognitive health efforts should consider for whom and when mitigating NA may be maximally beneficial to daily cognition, whereas additional work is needed to determine influences from PA.

Daily linkages among high and low arousal affect and subjective cognitive complaints.

Objectives: Subjective cognitive complaints may be an early indicator of Alzheimer's disease pathology and related dementias that can be detectable prior to objective, performance-based decline. Negative and positive affective states (NA and PA, respectively) are established psychosocial correlates of cognition in older adulthood and have demonstrated capacity for meaningful within-person fluctuations based on person-environment interactions, age, and measurement approach.Method: We utilized data from a 100-day, microlongitudinal study of 105 community-dwelling older adults (Mage = 63.19, SD = 7.80, Range = 52-88) to explore within- and between-person associations between high and low arousal NA and PA, and memory- and attention-related complaints.Results: For memory-related complaints, those who reported experiencing greater NA-high arousal had increased forgetfulness (OR = 2.23, 95%CI: 1.11-4.49, p < .05). Within persons, reporting more NA-high arousal than usual was associated with increased forgetfulness (OR = 1.01, 95%CI: 1.004-1.018, p < .01). For attention-related complaints, those who reported experiencing greater NA-low arousal had increased trouble staying focused (OR = 2.34, 95%CI: 1.17-4.66, p < .05). Within persons, reporting more NA-low arousal (OR = 1.02, 95%CI: 1.01-1.03, p < .001) and less PA-high arousal (OR = 0.96, 95%CI: 0.95-0.97, p < .001) than usual was associated with increased trouble staying focused. Additionally, reporting more PA-low arousal than usual was associated with decreased trouble staying focused among those with higher levels of conscientiousness (OR = 0.72, 95%CI: 0.57-0.92, p < .01).Conclusion: Results from this study offer a means to maximize resource allocation and personalized cognitive health efforts by pinpointing for whom and on which days boosting PA and/or reducing NA may both serve as pathways to benefit daily subjective cognition.

Understanding the effects of Covid-19 through a life course lens.

The Covid-19 pandemic is shaking fundamental assumptions about the human life course in societies around the world. In this essay, we draw on our collective expertise to illustrate how a life course perspective can make critical contributions to understanding the pandemic's effects on individuals, families, and populations. We explore the pandemic's implications for the organization and experience of life transitions and trajectories within and across central domains: health, personal control and planning, social relationships and family, education, work and careers, and migration and mobility. We consider both the life course implications of being infected by the Covid-19 virus or attached to someone who has; and being affected by the pandemic's social, economic, cultural, and psychological consequences. It is our goal to offer some programmatic observations on which life course research and policies can build as the pandemic's short- and long-term consequences unfold.

Leveraging Public Health Research to Inform State Legislative Policy that Promotes Health for Children and Families.

Purpose Engagement in policy is an essential public health service, with state legislatures serving as important arenas for activity on issues affecting children and families. However, a gap in communication often exists between policymakers and public health researchers who have the research knowledge to inform policy issues. We describe one tool for researchers to better leverage public health research to inform state legislative policymaking on issues of relevance to children and families. Description The Oregon Family Impact Seminar (OFIS), adapted from the Policy Institute for Family Impact Seminars, applies a systematic process to bring a synthesis of research findings on public health issues to state legislators using a six-step process: (1) identify candidate topics, (2) recruit legislative champions, (3) select the topic, (4) identify and prepare speakers, (5) host the presentations, and (6) develop and disseminate a research brief as a follow-up contact. Assessment Use of this model in Oregon has produced policy impact; for example, the 2015 presentation, "Two-Generation Approaches to Reduce Poverty," prompted ongoing dialogue culminating in a new statute to increase Earned Income Tax Credit for parents with young children. This approach also has strengthened relationships among researchers and legislators, which serves to streamline the OFIS process. Conclusion This model is an effective vehicle for leveraging public health research findings to inform state-level policy. This model also serves to connect researchers with opportunities to engage with policymakers to address significant public health problems, particularly those addressing social, economic, and environmental determinants of health for children and families.

The inseparability of human agency and linked lives.

The notion that people make choices and take actions that determine the outcomes of their lives - human agency - is a central principle of the life course paradigm. Unfortunately, conceptualizations of agency, like larger developmental and sociological theories, often assume that agency is limited to individuals who are "developmentally normal." We draw upon the thought of social scientists and disability scholars, as well as the life history of a woman with intellectual disability, to address the logical, ethical, and empirical flaws of this assumption. To rectify these problems, life course theory and research should pay greater attention to how agency is interwoven with another central principle of the life course paradigm: linked lives. This principle is that an individual's life cannot be understood in isolation of their interdependencies with other persons. Although human agency and linked lives are discussed as separate principles of the life course, they are not separate in lived experience. We demonstrate that, for all people and at all times in life, human agency is dependent upon interpersonal relationships. It is therefore imperative to examine intersections of agency and linked lives in order to more fully and accurately understand life course dynamics in diverse populations. Human agency is profoundly affected by interpersonal relationships and other social factors. Because agency and linked lives are inseparable, agency cannot be conceptualized as an individual characteristic of 'independent' actors. We conclude by discussing how life course research can more fully attend to the relationship between agency and linked lives.

The life course cube: A tool for studying lives.

This paper proposes a conceptualization of the life course as a set of behavioral processes characterized by interdependencies that cross time, life domains, and levels of analysis. We first discuss the need for a systematized approach to life course theory that integrates parallel and partially redundant concepts developed in a variety of disciplines. We then introduce the 'life course cube,' which graphically defines and illustrates time-domain-level interdependencies and their multiple interactions that are central to understanding life courses. Finally, in an appendix, we offer a formal account of these interactions in a language that can be readily adopted across disciplines. Our aim is to provide a consistent and parsimonious foundation to further develop life course theories and methods and integrate life course scholarship across disciplines.

Precisely Where Are We Going? Charting the New Terrain of Precision Prevention.

In addition to genetic data, precision medicine research gathers information about three factors that modulate gene expression: lifestyles, environments, and communities. The relevant research tools-epidemiology, environmental assessment, and socioeconomic analysis-are those of public health sciences rather than molecular biology. Because these methods are designed to support inferences and interventions addressing population health, the aspirations of this research are expanding from individualized treatment toward precision prevention in public health. The purpose of this review is to explore the emerging goals and challenges of such a shift to help ensure that the genomics community and public policy makers understand the ethical issues at stake in embracing and pursuing precision prevention. Two emerging goals bear special attention in this regard: (a) public health risk reduction strategies, such as screening, and (b) the application of genomic variation studies to understand and reduce health disparities among population groups.

Some Things I Have Learned About Aging by Studying the Life Course.

"Aging" and the "life course" are distinct but complementary phenomena that inform one another. Building on this insight, this essay conveys some lessons the author has learned about aging by studying the life course. These include that (1) age is a salient dimension of individual identity and social organization; (2) a reconfigured life course brings reconfigured aging; (3) old age is a highly precarious phase of life; (4) difference and inequality are not the same, but both can accumulate over time; (5) aging is gendered; (6) aging is interpersonal, and "independence" is an illusion; (7) "choice" and "responsibility" can be dirty words; (8) much of aging is in the mind-it is imagined and anticipated; and (9) history leaves its footprints on aging, and the future of aging is already here. These lessons culminate in a final insight: that to understand personal aging, gerontologists must look beyond the personal, for much of the relevant action is to be found in social experience.

Aging: It's Interpersonal! Reflections From Two Life Course Migrants.

We start with the observation that aging gerontologists often engage in two distinct discourses on aging-one public and one private. This separation entails "othering," which reproduces agism and stigma. Based on personal experience, insight from colleagues and writers, and concepts from symbolic interaction perspectives, we argue that becoming old to some degree involves becoming a stranger. Before reaching old age, both of us have been in the position of strangers due to social experiences that left us "off the line" or "on the margins." Examples are crossing social borders related to nations, class structures, gender, race, health status, and generations. Our stories illustrate how aging is more than personal. It is interpersonal-shaped by social history, policies, interdependence in relationships, and the precariousness of old age. Such phenomena often show sharp contrasts in the interpersonal worlds and social experiences of women and men. Reflecting on our own journeys as life course migrants leaves us acutely aware of both the social problems and potential promises of aging.

From "Personalized" to "Precision" Medicine: The Ethical and Social Implications of Rhetorical Reform in Genomic Medicine.

Since the late 1980s, the human genetics and genomics research community has been promising to usher in a "new paradigm for health care"-one that uses molecular profiling to identify human genetic variants implicated in multifactorial health risks. After the completion of the Human Genome Project in 2003, a wide range of stakeholders became committed to this "paradigm shift," creating a confluence of investment, advocacy, and enthusiasm that bears all the marks of a "scientific/intellectual social movement" within biomedicine. Proponents of this movement usually offer four ways in which their approach to medical diagnosis and health care improves upon current practices, arguing that it is more "personalized," "predictive," "preventive," and "participatory" than the medical status quo. Initially, it was personalization that seemed to best sum up the movement's appeal. By 2012, however, powerful opinion leaders were abandoning "personalized medicine" in favor of a new label: "precision medicine." The new label received a decisive seal of approval when, in January 2015, President Obama unveiled plans for a national "precision medicine initiative" to promote the development and use of genomic tools in health care.

Citizen science or scientific citizenship? Disentangling the uses of public engagement rhetoric in national research initiatives.

BACKGROUND: The language of "participant-driven research," "crowdsourcing" and "citizen science" is increasingly being used to encourage the public to become involved in research ventures as both subjects and scientists. Originally, these labels were invoked by volunteer research efforts propelled by amateurs outside of traditional research institutions and aimed at appealing to those looking for more "democratic," "patient-centric," or "lay" alternatives to the professional science establishment. As mainstream translational biomedical research requires increasingly larger participant pools, however, corporate, academic and governmental research programs are embracing this populist rhetoric to encourage wider public participation. DISCUSSION: We examine the ethical and social implications of this recruitment strategy. We begin by surveying examples of "citizen science" outside of biomedicine, as paradigmatic of the aspirations this democratizing rhetoric was originally meant to embody. Next, we discuss the ways these aspirations become articulated in the biomedical context, with a view to drawing out the multiple and potentially conflicting meanings of "public engagement" when citizens are also the subjects of the science. We then illustrate two uses of public engagement rhetoric to gain public support for national biomedical research efforts: its post-hoc use in the "care.data" project of the National Health Service in England, and its proactive uses in the "Precision Medicine Initiative" of the United States White House. These examples will serve as the basis for a normative analysis, discussing the potential ethical and social ramifications of this rhetoric. We pay particular attention to the implications of government strategies that cultivate the idea that members of the public have a civic duty to participate in government-sponsored research initiatives. We argue that such initiatives should draw from policy frameworks that support normative analysis of the role of citizenry. And, we conclude it is imperative to make visible and clear the full spectrum of meanings of "citizen science," the contexts in which it is used, and its demands with respect to participation, engagement, and governance.

Long-term Outcomes of Military Service in Aging and the Life Course: A Positive Re-envisioning.

Most research on military service focuses on its short-term negative consequences, especially the mental and physical injuries of those deployed in warzones. However, studies of long-term outcomes reveal surprisingly positive effects of military service--both those early in adulthood that grow over time and others that can emerge later in life. These multidomain effects have been found in veterans of World War II and the Korean War and are now being seen in veterans of the Vietnam War. Although some are directly attributable to public policies such as the GI Bill, which facilitate educational and economic gains, there are personal developmental gains as well, including autonomy, emotional maturity and resilience, mastery, and leadership skills, that lead to better health and well-being in later life. These long-term effects vary across persons, change over time within persons, and often reflect processes of cumulative advantage and disadvantage. We propose a life-span model of the effects of military service that provides a perspective for probing both long-term positive and negative outcomes for aging veterans. We further explicate the model by focusing on both sociocultural dynamics and individual processes. We identify public-use data that can be examined to evaluate this model, and offer a set of questions that can be used to assess military service. Finally, we outline an agenda for dedicated inquiry into such effects and consider policy implications for the health and well-being of aging veterans in later life.

Responses to Financial Loss During the Great Recession: An Examination of Sense of Control in Late Midlife.

OBJECTIVES: The "Great Recession" shocked the primary institutions that help individuals and families meet their needs and plan for the future. This study examines middle-aged adults' experiences of financial loss and considers how socioeconomic and interpersonal resources facilitate or hinder maintaining a sense of control in the face of economic uncertainty. METHOD: Using the 2006 and 2010 waves of the Health and Retirement Study, change in income and wealth, giving help to and receiving help from others, household complexity, and sense of control were measured among middle-aged adults (n = 3,850; age = 51-60 years). RESULTS: Socioeconomic resources predicted both the level of and change in the engagement of interpersonal resources prior to and during the Great Recession. Experiences of financial loss were associated with increased engagement of interpersonal resources and decreased sense of control. The effect of financial loss was dampened by education. Sense of control increased with giving help and decreased with household complexity. DISCUSSION: Findings suggest that, across socioeconomic strata, proportional loss in financial resources resulted in a loss in sense of control. However, responses to financial loss differed by socioeconomic status, which differentiated the ability to maintain a sense of control following financial loss.

Bioidentical hormones, menopausal women, and the lure of the "natural" in U.S. anti-aging medicine.

In 2002, the Women's Health Initiative, a large-scale study of the safety of hormone replacement therapy (HRT) for women conducted in the United States, released results suggesting that use of postmenopausal HRT increased women's risks of stroke and breast cancer. In the years that followed, as rates of HRT prescription fell, another hormonal therapy rose in its wake: bioidentical hormone replacement therapy (BHRT). Anti-aging clinicians, the primary prescribers of BHRT, tout it as a safe and effective alternative to treat menopausal symptoms and, moreover, as a preventative therapy for age-related diseases and ailments. Through in-depth interviews with 31 U.S.-based anti-aging clinicians and 25 female anti-aging patients, we analyze attitudes towards BHRT. We illustrate how these attitudes reveal broader contemporary values, discourses, and discomforts with menopause, aging, and biomedicine. The attraction to and promise of BHRT is rooted in the idea that it is a "natural" therapy. BHRT is given both biomedical and embodied legitimacy by clinicians and patients because of its purported ability to become part of the body's "natural" processes. The normative assumption that "natural" is inherently "good" not only places BHRT beyond reproach, but transforms its use into a health benefit. The clinical approach of anti-aging providers also plays a role by validating patients' embodied experiences and offering a "holistic" solution to their symptoms, which anti-aging patients see as a striking contrast to their experiences with conventional biomedical health care. The perceived virtues of BHRT shed light on the rhetoric of anti-aging medicine and a deeply complicated relationship between conventional biomedicine, hormonal technologies, and women's bodies.