Vision impairment and food insecurity in the national health and aging trends study

Introduction

Vision impairment (VI) may further exacerbate older adults' vulnerability to experiencing food insecurity and may be a unique and important target for policies addressing access to nutritional food. The purpose of this study is to determine the association of VI in older adults with food insecurity.

Methods

This is a cross-sectional analysis of round 11 (2021) of the National Health and Aging Trends Study (NHATS), a nationally representative survey of U.S. Medicare beneficiaries ages 65 and older. Participants include 2,815 older adults with complete data on at least one objective measure of vision (distance, near or contrast sensitivity) and food insecurity. Food insecurity was assessed using a previously developed indicator of food insecurity in NHATS. VI was defined as binocular visual acuity (VA) worse than 0.3 logMAR (Snellen equivalent 20/40) at distance or its near equivalent, or contrast sensitivity (CS) worse than 1.55 logUnits. Continuous VI measures included distance and near VA (per 0.1 logMAR), and CS (per 0.1 logCS).

Results

Participants were majority White (82%) and female (55%), and 3% had food insecurity. Older adults with any VI had a greater prevalence of food insecurity than adults without VI (5.0% vs. 2.0%, p < 0.05). In fully adjusted regression analyses, individuals with any VI experienced double the odds of food insecurity than individuals without VI (OR: 2.1, 95% CI: 1.2-3.6). Distance VI (measured continuously) was associated with 1.2 times the odds of food insecurity (OR = 1.2; 95% CI: 1.0-1.3, per 0.1 logMAR). All other vision measures trended towards higher odds of food insecurity, though not statistically significant.

Discussion

Older adults with VI experience higher rates of food insecurity than their peers. Interventions to improve food security should be targeted towards addressing the specific barriers faced by visually impaired older adults.

"Hang Ups, Let Downs, Bad Breaks, Setbacks": Impact of Structural Socioeconomic Racism and Resilience on Cognitive Change Over Time for Persons Racialized as Black

Introduction

Older adults racialized as Black experience higher rates of dementia than those racialized as White. Structural racism produces socioeconomic challenges, described by artist Marvin Gaye as "hang ups, let downs, bad breaks, setbacks" that likely contribute to dementia disparities. Robust dementia literature suggests socioeconomic factors may also be key resiliencies.

Methods

We linked state-level data reflecting the racialized landscape of economic opportunity across the 20th Century from the U.S. Census (1930-2010) with individual-level data on cognitive outcomes from the U.S. Health and Retirement Study participants racialized as Black. A purposive sample of participants born after the Brown v. Board ruling (born 1954-59) were selected who completed the modified Telephone Interview for Cognitive Status between 2010 and 2020 (N=1381). We tested associations of exposure to structural racism and resilience before birth, and during childhood, young-adulthood, and midlife with cognitive trajectories in mid-late life using mixed-effects regression models.

Results

Older adults born in places with higher state-level structural socioeconomic racism experienced a more rapid cognitive decline in later life compared to those with lower levels of exposure. In addition, participants born in places with higher levels of state-level structural socioeconomic resilience experienced slower cognitive change over time than their counterparts.

Discussion

These findings reveal the impact of racist U.S. policies enacted in the past that influence cognitive health over time and dementia risk later in life.

Social Factors and Older Adults' Use of Wearable Activity Trackers: Before and During the First Wave of the COVID-19 Pandemic

Wearable activity trackers (WAT) have shown high potential to improve health in the aging population. Evidence links various social factors with WAT use in older adults, but mainly within small samples and the prevalence of their WAT use during the COVID-19 is unknown. We reported WAT use prevalence before and during the first wave of COVID-19 and examined social factors associated with WAT use frequency using a nationally representative sample of 3302 U.S. older adults. We used Multinomial Logistic Regression to identify social factors associated with WAT use frequency. Only 10.3% of pre-COVID-19 and 10.9% of first-wave subsamples were frequent WAT users. Older adults aged 75 and above and those with low incomes were less likely to frequently use WATs. Our findings suggest socioeconomic and age disparities in WAT use among older Americans. Future studies should focus on enhancing low-income older adults' WAT adoption to enable equal access to WAT-related health benefits.

Using rapid response system trigger clusters to characterize patterns of clinical deterioration among hospitalized adult patients

BACKGROUND

Many rapid response system (RRS) events are activated using multiple triggers. However, the patterns in which multiple RRS triggers occur together to activate RRS events are unknown. The purpose of this study was to identify these patterns (RRS trigger clusters) and determine their association with outcomes among hospitalized adult patients.

METHODS

RRS events among adult patients from January 2015 to December 2019 in the Get With The Guidelines- Resuscitation registry's MET module were examined (n = 134,406). Cluster analysis methods were performed to identify RRS trigger clusters. Pearson's chi-squared and ANOVA tests were used to examine differences in patient characteristics across RRS trigger clusters. Multilevel logistic regressions were used to examine the associations between RRS trigger clusters and outcomes.

RESULTS

Six RRS trigger clusters were identified. Predominant RRS triggers for each cluster were: tachypnea, new onset difficulty in breathing, decreased oxygen saturation (Cluster 1); tachypnea, decreased oxygen saturation, staff concern (Cluster 2); respiratory depression, decreased oxygen saturation, mental status changes (Cluster 3); tachycardia, staff concern (Cluster 4); mental status changes (Cluster 5); hypotension, staff concern (Cluster 6). Significant differences in patient characteristics were observed across clusters. Patients in Clusters 3 and 6 had an increased likelihood of in-hospital cardiac arrest (p < 0.01). All clusters had an increased risk of mortality (p < 0.01).

CONCLUSIONS

We discovered six novel RRS trigger clusters with differing relationships to adverse patient outcomes. RRS trigger clusters may prove crucial in clarifying the associations between RRS events and adverse outcomes and aiding in clinician decision-making during RRS events.

Self-Reported Vision Impairment and Food Insecurity in the US: National Health Interview Survey, 2011-2018

PURPOSE

To determine if vision impairment (VI) is associated with food insecurity among the United States (US) adults.

METHODS

This is a cross-sectional study of US adults ≥18 years below a threshold of 150% poverty from the National Health Interview Survey (NHIS), years 2011-2018. Outcome measures included food insecurity status, based on response to the NHIS adult (10-item) food insecurity tool, either as a binary (food secure or insecure) or ordinal (high, marginal, low, and very low) variable. VI was defined as self-reported trouble seeing, even when wearing glasses or contact lenses. Multivariable logistic regression analyses adjusted for potential confounders examined associations between VI and food insecurity.

RESULTS

Participants (N = 62075) were majority female (57%), White (62%), and non-Hispanic (74%). Of them, 16% reported VI and 28% were food insecure. In fully adjusted logistic regression models, adults with VI had 216% higher odds (95% CI = 2.01-2.31) of being food insecure than adults without VI. Further, there was a dose-response relationship between VI and food insecurity noted in a multinomial model: VI predicted 159% higher risk of marginal food security (95% CI = 1.44-1.75), 197% higher risk of low food security (95% CI = 1.80-2.16), and 295% higher risk of very low food security (95% CI = 2.69-3.22), as compared to high food security.

CONCLUSION

VI is associated with food insecurity, increasingly so among adults with highest levels of food insecurity in this national sample of low-income US adults. This data highlights the need for targeted interventions to address and reduce the burden of food insecurity among US adults with VI.

Using rapid response system trigger clusters to characterize patterns of clinical deterioration among hospitalized adult patients

Background

Many rapid response system (RRS) events are activated using multiple triggers. However, the patterns in which RRS triggers co-occur to activate the medical emergency team (MET) to respond to RRS events is unknown. The purpose of this study was to identify and describe the patterns (RRS trigger clusters) in which RRS triggers co-occur when used to activate the MET and determine the association of these clusters with outcomes using a sample of hospitalized adult patients.

Methods

RRS events among adult patients from January 2015 to December 2019 in the Get With The Guidelines- Resuscitation registry's MET module were examined (n=134,406). A combination of cluster analyses methods was performed to group patients into RRS trigger clusters based on the triggers used to activate their RRS events. Pearson's chi-squared and ANOVA tests were used to examine differences in patient characteristics across RRS trigger clusters. Multilevel logistic regression was used to examine the associations between RRS trigger clusters and outcomes following RRS events.

Results

Six RRS trigger clusters were identified in the study sample. The RRS triggers that predominantly identified each cluster were as follows: tachypnea, new onset difficulty in breathing, and decreased oxygen saturation (Cluster 1); tachypnea, decreased oxygen saturation, and staff concern (Cluster 2); respiratory depression, decreased oxygen saturation, and mental status changes (Cluster 3); tachycardia and staff concern (Cluster 4); mental status changes (Cluster 5); hypotension and staff concern (Cluster 6). Significant differences in patient characteristics were observed across RRS trigger clusters. Patients in Clusters 3 and 6 were associated with an increased likelihood of in-hospital cardiac arrest (IHCA [p<0.01]), while Cluster 4 was associated with a decreased likelihood of IHCA (p<0.01). All clusters were associated with an increased risk of mortality (p<0.01).

Conclusions

We discovered six novel RRS trigger clusters with differing relationships to adverse patient outcomes following RRS events. RRS trigger clusters may prove crucial in clarifying the associations between RRS events and adverse outcomes and may aid in clinician decision-making during RRS events.

RACIAL DISPARITIES IN THE ASSOCIATION BETWEEN VISION IMPAIRMENT AND FOOD INSECURITY IN THE US

We examined racial disparities in household food insecurity among low-income Americans with and without vision impairment in the National Health Interview Survey, years 2011-2018. Among 257,620 U.S. adults below a threshold of 150% poverty, 15% of White, 16% of Black, and 8% of Asian Americans, and 18% of American Indians and Inuits reported vision impairment. In analyses adjusted for sociodemographic variables, vision impairment was associated with >100% greater odds (95% CI=2.01-2.31) of 30-day food insecurity, as compared to no vision impairment. Further, odds of household food insecurity were higher among Black Americans (OR=1.37, 95% CI=1.29-1.47), and American Indians and Inuits (OR=1.38, 95% CI=1.15-1.66) than White Americans, while Asians had lower odds (OR=0.45, 95 %CI=0.36-0.57). These findings highlight that low-income adults with vision impairment and racial minorities experience food disparities and dietary inadequacy, an area of disadvantage that can influence overall health, in a nationally representative sample in the U.S.

RJ, Crews D, Samuel L. FOOD INSECURITY AND COGNITIVE TRAJECTORIES IN COMMUNITY-DWELLING OLDER ADULTS

Food insecurity, defined as limited access to nutritionally adequate and safe foods due to social and economic conditions, has adverse effects on physical health and well-being. However, it remains unclear whether food insecurity accelerates cognitive decline in older adults. This study examined the association of food insecurity with cognitive decline. We analyzed data from 4,508 community-dwelling participants in the National Health and Aging Trends Study (NHATS) collected from 2011 to 2020, a prospective cohort study of a nationally representative sample of Medicare beneficiaries ages 65 years and older. Food insecurity was measured using 5 items within functional, social support, and financial limitations domains. Immediate and delayed recall were assessed by a 10-item word-list memory task (range: 0—10). Executive function was evaluated by the Clock Drawing Test (range: 0—5). Each year’s cognitive functions were linked to the prior year’s food insecurity values. Weighted linear mixed effect models were fitted. Prevalence of food insecurity at baseline was 3.5% (95% CI: 2.9 — 4.3). Persons with food insecurity were more likely to have Black race or Hispanic ethnicity, low income, and less than high school education. Food insecurity was associated with faster decline in executive function accounting for demographic and socioeconomic characteristics: the average difference, over 1-year, in executive function score between people exposed to and not exposed to food insecurity was 0.038 points (95% CI: -0.072 — -0.003). Food assistance programs or increasing healthy food access may reduce food insecurity and delay cognitive aging in community-dwelling older adults.

TikTok: a far-reaching opportunity for health professionals to address weight loss

OBJECTIVES

Recent behavioral research indicates that social media may be successfully integrated into weight loss interventions to mitigate the obesity epidemic that has been linked with type two diabetes, cardiovascular diseases, cancers, as well as poor psychological health. This study aimed to examine the content and characteristics of 100 most trending TikTok videos related to weight loss.

STUDY DESIGN

This was a cross-sectional, descriptive study.

METHODS

Videos were analyzed for source, predominant theme, and inclusion of specific content. Independent two-tailed t-tests assessed the effect of content on number of comments, likes, and forwards garnered by the videos.

RESULTS

More than 90% of the videos were consumer generated, indicating a missed opportunity by health professionals to use social media to provide accurate information regarding weight loss. Less than one-fifth of the videos were informational but significantly influenced the number of comments (P < .001) and likes (P = .002). Videos mentioning benefits ((P < .001) and speed of weight loss (P = .003) significantly influenced the number of forwards, whereas those that mentioned recipes (P = .005) and how to lose weight (P = .003) significantly affected the number of comments.

CONCLUSION

The results underscore the need for further research to elucidate the effectiveness of social media in impacting weight loss, as well as how they may supplement traditional health promotion and behavior interventions for weight loss.

Quantifying Older Black Americans' Exposure to Structural Racial Discrimination: How Can We Measure the Water In Which We Swim?

The USA was built on legalized racism that started with enslavement and continues in the form of structural racial discrimination. This discrimination is difficult to measure because its many manifestations are hard to observe and dynamic. A useful tool would measure across settings, institutions, time periods in a person's life and the country's history. The purpose of this study was to design a measure of structural racial discrimination that meets those criteria and can be used in large national datasets. To do this, we started with an exploratory mixed-methods instrument design, including qualitative interviews with 15 older Black adults and focus groups with 38 discrimination researchers and other key stakeholders. We then identified 27 indicators of structural racial discrimination across nine theorized discrimination contexts. We matched these with historical administrative data sets to develop an instrument that could quantify older Black Americans' exposure to structural racial discrimination across contexts, the life course, and geographies. These can be mapped to the life course of structural discrimination based on the home addresses of those surveyed. Linking these to available indicators is a promising approach. It is a low burden for participants and enables increasingly multifaceted and focused measurement as more national datasets become available. A flexible, feasible comprehensive measure of structural discrimination could allow not only more thorough documentation of inequities but also allow informed decision making about policies and programs intended to promote racial equity. SIGNIFICANCE STATEMENT: To our knowledge, this is the first study that presents a framework for assessing structural racial discrimination across contexts, life course, and geography that is grounded in theory and in the lived experience of intended participants. Leading researchers and policy makers have called for improved measures of structural racism and discrimination and specifically for a lifecourse approach to measurement. This study is a step in that direction. CLASSIFICATION: Social Sciences.

Access to food and health care during the COVID-19 pandemic by disability status in the United States

BACKGROUND

The COVID-19 pandemic has impacted people's access to food and health care. People with disabilities may be disproportionately affected by these outcomes due to structural and social barriers.

OBJECTIVE/HYPOTHESIS

To examine the relative prevalence of food insufficiency and unmet health care needs among the U.S. residents by vision, hearing, cognition, and mobility disability.

METHODS

We used data from the Household Pulse Survey wave conducted from April 14 to April 26, 2021, when questions about functional disability were first included. Participants were asked about difficulty seeing, hearing, remembering or concentrating, and walking or climbing stairs. The outcomes of interest were food insufficiency, delaying needed medical care and not getting needed medical care. Poisson regression models with robust variance adjusted for potential confounders were used to examine the prevalence ratio of each of these outcomes by disability status in separate models for each type of disability.

RESULTS

During April 14-26, 2021, 39.5% adults in the U.S. reported cognitive disability, 30.8% reported vision disability, 23.2% reported mobility disability, and 14.9% reported hearing disability. Adults with any type of disability were more likely than those without to experience food insufficiency (range of prevalence rate ratios [PRR]: 1.67-1.96), and delay (range of PRR: 1.48-1.87) or not get (range of PRR: 1.60-2.07) needed medical care.

CONCLUSIONS

These disparities suggest there is an urgent need to address the negative impact of the COVID-19 pandemic on people with disabilities. The prioritization of disability data collection is key in achieving that goal.

Improvements of Disability Outcomes in CAPABLE Older Adults Differ by Financial Strain Status

The Community Aging in Place-Advancing Better Living for Elders (CAPABLE) program reduces disability in low-income older adults. In this study, we used CAPABLE baseline and 5-month data to examine whether its effects in reducing activities of daily living (ADLs) and instrumental ADLs (IADLs) difficulties differed by participants' financial strain status. At baseline, participants with financial strain were more likely to report higher scores on depression (p < .001), have low energy (p < .001), and usually feel tired (p = .004) compared with participants without financial strain, but did not differ in ADL/IADL scores. Participants with financial strain benefited from the program in reducing ADL (relative risk [RR]: 0.61, 95% confidence interval [CI]: 0.43, 0.86) and IADL disabilities (RR: 0.69, 95% CI: 0.54, 0.87), compared with those with financial strain receiving attention control. Individuals with financial strain benefited more from a home-based intervention on measures of disability than those without financial strain. Interventions that improve disability may be beneficial for financially strained older adults.

Loneliness and Behavioral Changes During the COVID-19 Pandemic

Concerns for the health impact of loneliness, a risk factor for morbidity and mortality, have risen amid the COVID-19 pandemic. However, relationships between loneliness and behavioral changes remains unclear. Utilizing data from the National Health and Aging Trends Study COVID-19 Supplement, we examine the cross-sectional relationship between loneliness and self-reported increase in each of the following behaviors during the pandemic (n=2,924): walking, vigorous activity, eating, use of alcohol and tobacco, watching television and sleeping. Adjusting for age, race, education, activity of daily living limitations, and chronic conditions, loneliness was significantly associated with a higher odds of more eating (odds ratio- OR: 1.42, confidence intervals-CI: 1.24,1.62), sleeping (OR: 1.35, CI: 1.18,1.56), and watching television (OR: 1.45, CI: 1.30,1.61). These results indicate that during stressful times like our current pandemic, loneliness may lead to morbidity and mortality through sedentary behaviors.

Factors Associated With Deficient Housing Among Community-Living Older Adults in the United States

Housing quality is a recognized social determinant of health. Qualitative evidence suggests the ability of older adults to maintain their homes is affected by the domains of financial resources, social environment, and functional abilities, but this conceptualization has not been tested quantitatively. This cross-sectional study examined associations between financial resources (indicated by socioeconomic characteristics: education, racial-status, annual income, financial hardship, Medicaid eligibility), social environment (living arrangement, social integration), and functional abilities (lower extremity performance, self-care disability, independent-living disability, homebound-status, dementia, depression) with deficient housing among 6,489 community-living adults ≥ 65 years participating in the nationally representative 2015 National Health and Aging Trends Study. Sampling weights accounted for study design and non-response. An estimated 9.2% (3.2 million) older Americans lived in housing with ≥1 deficiency (any peeling paint, evidence of pests, flooring in disrepair, broken windows, crumbling foundation, missing siding, or roof problems). In bivariate logistic regressions, factors from all three domains were associated with deficient housing. In a multivariable model that included all variables above and adjusted for age and sex, indicators of financial resources and social environment remained associated with deficient housing (including financial hardship, adjusted odds ratio (aOR)=1.48, 95% confidence interval (CI): 1.10,1.98; and living with non-spousal others versus alone, aOR=1.48; 95% CI:1.09, 2.03), whereas indicators of functional abilities did not. To ensure quality housing for all community-dwelling older adults, efforts that increase financial resources and further examine the role of social environment in deficient housing are needed.

The Association Between Older Adult Technology Use and Mental Health During the COVID-19 Pandemic

Drama therapy is a widely acknowledged way to explore life-stories in late life. This presentation will describe a new model for creative interventions, based on the results of four studies that provide multiple perspectives on the integration of life-review and drama therapy for community dwelling older adults. The results of two quantitative studies (n=55, aged 62-93; n=78, aged 63-96) suggest that the drama therapy interventions have robust therapeutic potential to enhance mental health while aging. The findings of two qualitative studies with therapists (n=8), participants (n=27; aged 63-96) and staff (n=13) provide a better understanding of the process, and support the mechanisms that lead to positive effects on mental health. Combining the results yielded a multidimensional model which points to three potential transformative routes: the evolution of the life-story, the evolution of improvised dramatic expression, and the expansion of social engagement.

Hopefulness During COVID-19: Associations With Function, Sleep, and Loneliness in the NHATS

The transition to residential care facility may symbolize the joining into the 'community of older people'. This may influence the ways men in late life construct their identities and the intersection of aging and masculinity. Due to some barriers, this experience may be difficult to express explicitly. Bibliotherapy aims to bridge this gap by using literature to address diverse issues in the form of reading and writing activities. In this presentation we will present "The Literary Parliament" project, in which bibliotherapy and poetry groups of men in late life were conducted in residential care facilities in Israel. We will present findings of a qualitative research which explored poems written by group participants, and the way these helped participants to express their perceptions and feelings of ageing and masculinity in the context of residential care. The use of bibliotherapy to encourage psychological discourse among men in late life will be discussed.

Predicting Technology Use Among Older Adults During the COVID-19 Pandemic With Community Participation

The social isolation imposed by the Covid-19 pandemic has significantly affected older adults, and has impacted both their physical and mental health. The pandemic has led to an increase in ageism associated with poorer mental health and a lower sense of dignity, self-esteem and contribution to society. This cross-cultural study involved 24 participants from Italy and Israel aged 79 to 92. The aim was to develop a brief art-based online intervention to enhance the participants’ sense of dignity and sense of meaning in life during this time of crisis. The process focused on the creation of digital photo-collages that captured the participants’ values through three perspectives: their past experiences, legacy, and future perspectives. It employed an arts-based research methodology to explore the participants’ experiences by analysing their relationship with the artistic expression, the photo collage, and its creative process.

Financial Changes and Health During COVID-19 in the National Health and Aging Trends Study

This study tested associations between income decline and financial difficulty with mental health (lack of feeling anxious/depressed, recurring thoughts/nightmares, avoiding activities/thoughts, feeling jumpy/on guard) and sleep quality during COVID-19 among a national sample of 3,188 older adults. Approximately 8% of US older adults reported income decline and 6% reported financial difficulty. Although income decline and financial difficulty rates were both statistically significantly higher among those financially strained before COVID-19 (19% and 34%, respectively), income decline was more common among those with incomes ≥200% of the poverty threshold (9%) whereas financial difficulty was more common among those with incomes &lt;200% poverty (10%). Adjusting for sociodemographic, health and depressive symptoms before COVID-19, financial difficulty was associated with worse mental health (b= -2.39, p&lt;0.001) and sleep quality (b=-0.820, p&lt;0.001), but income loss was not (b= -0.685, p=0.092 and b= -0.405, p=0.082, respectively). Timely interventions are needed for older adults reporting COVID-19 financial difficulty.

Correlation Of Pcr Ct Values With Symptom Onset Across Diagnostic Platforms For Sars-Cov-2

Introduction/Objective

Following the definition of SARS-CoV2 outbreak as a pandemic by WHO, FDA gave EUA approval to the CDC real time polymerase chain reaction (PCR) assay and soon to other vendors to increase test availability. Most of testing platforms are PCR based, which test for multiple gene targets. We aimed to compare distribution of crossing threshold (cT) values of Diasorin (DIA), NeuMoDX (NDX) and Cepheid GenXpert (GX) for symptomatic and asymptomatic patients and assess performance of individual gene targets within the assays. We also correlated cT values with time from symptom onset.

Methods/Case Report

Retrospective review of medical and laboratory records of patients who tested positive for SARS-CoV2 between 08/01/2020 and 10/10/2020 on DIA, NDX, and GX platforms.

Results (if a Case Study enter NA)

We included 212 patients in our study. Days since symptom onset included 1 to 16 days. For DIA, mean Ct values for 46 symptomatic patients were 21.75 (S gene) and 22.74 (ORF1 gene); whereas 23.49 (S gene) and 25.49 (ORF1 gene) for 12 asymptomatic patients. Similarly, on NDX mean was 22.21 (N gene) and 23.13 (NSP2 gene) for 69 symptomatic, though 28.09 (N gene) and 28.61 (NSP2 gene) for 35 asymptomatic patients. GX manifested mean Ct value of 27.13 (E gene) and 31.22 (N2 gene) for 19 symptomatic; while 33.85 (E gene) and 36.42 (N2 gene) for 31 asymptomatic patients. Correlation coefficient for cT values versus days since symptom onset are DIA (r2 0.19), NDX (r2 0.22), and GX (r2 0.02).

Conclusion

The difference in cT values was statistically significant for symptomatic versus asymptomatic patients. There was positive correlation between days since symptom onset and cT values for DIA and NDX but not for GX, which may be due to difference in population tested in these platforms. These observations may be used to predict viral load and thus infectivity of patients who test positive for SARS-CoV2.

The Home, Block, and Community Environments and Biomarkers of Aging in the National Health and Aging Trends Study

Prior studies have linked household and community conditions to the health and functioning of older adults. However, few studies have investigated associations between household, block, and community environmental conditions with biomarkers of aging. This study used NHATS Round 7 (2017) data on 3,283 community-dwelling older adults to test cross-sectional associations between interior and exterior household disorder, block disorder, community social cohesion, and four biomarkers: C-reactive protein, hemoglobin A1c, cytomegalovirus, and interleukin-6. Survey-weighted models adjusted for age, sex, race/ethnicity, income, education, homeownership, housing type, and metropolitan area; HbA1c was stratified by diabetes diagnosis. Greater interior household disorder was associated with higher IL-6 (β=0.06, SE=0.025, p=0.014) and, among diabetics, greater block disorder was associated with higher HbA1c (β=0.11, SE=0.05, p=0.046). These results link home and block environmental characteristics with biomarkers of aging, suggesting that modifiable aspects of older adults’ living environments may be related to disease and disability risk via physiologic dysregulation.

Greater Subjective Well-Being Associated With Lower Inflammatory Proteins in an Older Adult Sample From the NHATS

Subjective well-being (SWB), comprised of cognitive and affective evaluations of life, is associated with better health outcomes and lower mortality, but mechanisms are poorly understood. We examine the associations between SWB and its subscales with two biomarkers: Interleukin-6 (IL-6) and C-Reactive Protein (CRP), both common inflammatory indicators associated with mortality and increased cardiovascular disease. Dried blood spot data collected from 4,648 older adults NHATS participants in 2017 was used. After adjustment for age, sex, race/ethnicity, education, tobacco, body mass index and chronic disease, we found greater SWB and greater scores on subscales including positive affect, self-realization and personal mastery were all significantly associated with decreased IL-6 and CRP. Conversely, increases in negative affect was significantly associated with increased IL-6 and CRP values. This study adds evidence of a potential mechanistic mind-body connection pathway.

Financial Resources and Biomarkers of Aging in the National Health and Aging Trends Study

Lower income and financial strain (i.e. difficulty making ends meet) are associated with worse aging biomarkers, but evidence among nationally representative samples is limited. This cross-sectional study tested whether income to poverty ratio (analyzed separately for those <500% vs. ≥500% poverty threshold) and financial strain are associated with biomarkers of aging among NHATS participants aged ≥65 years (n=4,648), adjusting for age, race/ethnicity, gender, smoking, BMI, and diabetes diagnosis for hemoglobin A1c. Sampling weights were applied. Among those with incomes <500% poverty, higher income was associated with lower hemoglobin A1c (b= -0.0196, p=0.007), CMV (b= -0.0689, p<0.001) and CRP (b= -0.0428, p=0.012). Among those with incomes ≥500%, higher income was associated with lower IL-6 (b= -0.0001, p=0.023) and lower CMV (b= -0.0001, p<0.001). Financial strain was not associated with biomarkers. Income is more strongly associated with biomarkers among the lower income group, calling for special attention to this vulnerable population.