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Opsasnick LA, Zhao W, Schmitz LL, Ratliff SM, Faul JD, Zhou X, Needham BL, Smith JA. Epigenome-wide association study of long-term psychosocial stress in older adults. Epigenetics 2024; 19:2323907. [PMID: 38431869 PMCID: PMC10913704 DOI: 10.1080/15592294.2024.2323907] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/13/2023] [Accepted: 02/21/2024] [Indexed: 03/05/2024] Open
Abstract
Long-term psychosocial stress is strongly associated with negative physical and mental health outcomes, as well as adverse health behaviours; however, little is known about the role that stress plays on the epigenome. One proposed mechanism by which stress affects DNA methylation is through health behaviours. We conducted an epigenome-wide association study (EWAS) of cumulative psychosocial stress (n = 2,689) from the Health and Retirement Study (mean age = 70.4 years), assessing DNA methylation (Illumina Infinium HumanMethylationEPIC Beadchip) at 789,656 CpG sites. For identified CpG sites, we conducted a formal mediation analysis to examine whether smoking, alcohol use, physical activity, and body mass index (BMI) mediate the relationship between stress and DNA methylation. Nine CpG sites were associated with psychosocial stress (all p < 9E-07; FDR q < 0.10). Additionally, health behaviours and/or BMI mediated 9.4% to 21.8% of the relationship between stress and methylation at eight of the nine CpGs. Several of the identified CpGs were in or near genes associated with cardiometabolic traits, psychosocial disorders, inflammation, and smoking. These findings support our hypothesis that psychosocial stress is associated with DNA methylation across the epigenome. Furthermore, specific health behaviours mediate only a modest percentage of this relationship, providing evidence that other mechanisms may link stress and DNA methylation.
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Affiliation(s)
- Lauren A. Opsasnick
- Department of Epidemiology, School of Public Health, University of Michigan, Ann Arbor, MI, USA
| | - Wei Zhao
- Department of Epidemiology, School of Public Health, University of Michigan, Ann Arbor, MI, USA
- Survey Research Center, Institute for Social Research, University of Michigan, Ann Arbor, MI, USA
| | - Lauren L. Schmitz
- Robert M. La Follette School of Public Affairs, University of Wisconsin-Madison, Madison, WI, USA
| | - Scott M. Ratliff
- Department of Epidemiology, School of Public Health, University of Michigan, Ann Arbor, MI, USA
| | - Jessica D. Faul
- Survey Research Center, Institute for Social Research, University of Michigan, Ann Arbor, MI, USA
| | - Xiang Zhou
- Department of Biostatistics, School of Public Health, University of Michigan, Ann Arbor, MI, USA
| | - Belinda L. Needham
- Department of Epidemiology, School of Public Health, University of Michigan, Ann Arbor, MI, USA
| | - Jennifer A. Smith
- Department of Epidemiology, School of Public Health, University of Michigan, Ann Arbor, MI, USA
- Survey Research Center, Institute for Social Research, University of Michigan, Ann Arbor, MI, USA
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Woods SB, Roberson PNE, Booker Q, Wood BL, Booker SQ. Longitudinal Associations of Family Relationship Quality With Chronic Pain Incidence and Persistence Among Aging African Americans. J Gerontol B Psychol Sci Soc Sci 2024; 79:gbae064. [PMID: 38767217 PMCID: PMC11161900 DOI: 10.1093/geronb/gbae064] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/11/2023] [Indexed: 05/22/2024] Open
Abstract
OBJECTIVES This study examines how family relationships convey risk or resilience for pain outcomes for aging African Americans, and to replicate and extend analyses across 2 nationally representative studies of aging health. METHODS African American participants in Midlife in the United States (MIDUS, N = 755) and the Health and Retirement Study (HRS, N = 2,585) self-reported chronic pain status at 2006 waves and then again 10 years later. Logistic regression was used to estimate the odds of pain incidence and persistence explained by family, intimate partner, and parent-child strain and support, as well as average support and average strain across relationships. RESULTS On average, MIDUS participants were younger (M = 52.35, SD = 12.06; 62.1% female) than HRS (M = 66.65, SD = 10.92; 63.7% female). Family support and average support were linked to decreased odds of pain incidence in MIDUS, but only when tested without accounting for strain, whereas parent-child strain was a risk factor for pain incidence in HRS, as was average strain. Family support protected against pain persistence in MIDUS, whereas average support was linked to reduced odds of pain persisting in HRS. DISCUSSION Chronic pain outcomes are worse for African Americans for a number of reasons, but parent-child strain may contribute to the risk of new pain developing over time for older adults. Conversely, family support may offer a protective benefit for pain incidence and persistence among aging African Americans. Findings implicate family relationships as a potential target of pain management interventions.
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Affiliation(s)
- Sarah B Woods
- Department of Family and Community Medicine, University of Texas Southwestern Medical Center, Dallas, Texas, USA
| | | | - Quiera Booker
- Department of Family and Community Medicine, University of Texas Southwestern Medical Center, Dallas, Texas, USA
| | - Beatrice L Wood
- Departments of Psychiatry and Pediatrics, Jacobs School of Medicine and Biomedical Sciences, University at Buffalo, Buffalo, New York, USA
| | - Staja Q Booker
- Department of Biobehavioral Nursing Science, College of Nursing, University of Florida, Gainesville, Florida, USA
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Shakya S, Silva SG, McConnell ES, McLaughlin SJ, Cary MP. Psychosocial stressors associated with frailty in community-dwelling older adults in the United States. J Am Geriatr Soc 2024; 72:1088-1099. [PMID: 38391046 DOI: 10.1111/jgs.18821] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2023] [Revised: 01/14/2024] [Accepted: 01/21/2024] [Indexed: 02/24/2024]
Abstract
BACKGROUND Frailty is multifactorial; however, psychosocial stressors contributing to frailty are poorly understood. This study aimed to examine whether gender, race/ ethnicity, and education are associated with differential exposure to psychosocial stressors, determine psychosocial stressors contributing to frailty, and explore the mediating psychosocial stressors pathway. METHODS This cross-sectional study involved 7679 community-dwelling older adults (≥65) from the Health and Retirement Study (2006 and 2008 waves). Psychosocial stressors such as loneliness, low subjective social status, financial strain, poor neighborhood cohesion, everyday discrimination, and traumatic life events were measured. Frailty was defined by the Fried phenotype measure. Multivariable logistic regressions were used to examine the association of gender, race/ethnicity, and education with psychosocial stressors, psychosocial stressors associated with frailty, and the mediating psychosocial stressors pathway. RESULTS Females experienced greater financial strain but lower discrimination (both p < 0.05). Older adults who identified as Hispanic, Black, and racially or ethnically minoritized experienced low subjective social status, high financial strain, low neighborhood cohesion, and high discrimination than their White counterparts (all p < 0.05). Those with lower education experienced high loneliness, low subjective social status, high financial strain, low neighborhood cohesion but lower traumatic life events (all p < 0.05). Psychosocial stressors: High loneliness, low subjective social status, high financial strain, and low neighborhood cohesion (all p < 0.05) independently increased the odds of frailty. The mediating pathway of psychosocial stressors was not significant. CONCLUSION: Disparities exist in exposure to psychosocial stressors associated with frailty. Multilevel interventions are needed to reduce the influence of psychosocial stressors on frailty.
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Affiliation(s)
- Shamatree Shakya
- College of Nursing, University of Illinois Chicago, Chicago, Illinois, USA
| | - Susan G Silva
- School of Nursing, Duke University, Durham, North Carolina, USA
| | - Eleanor S McConnell
- Department of Veterans Affairs Medical Center, Geriatric Research, Education and Clinical Center (GRECC), Durham, North Carolina, USA
| | - Sara J McLaughlin
- Department of Sociology and Gerontology, Miami University, Oxford, Ohio, USA
| | - Michael P Cary
- School of Nursing, Duke University, Durham, North Carolina, USA
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Wilson SJ, Novak JR, Yorgason JB, Martire LM, Lyons KS. New Opportunities for Advancing Dyadic Health Science in Gerontology. THE GERONTOLOGIST 2024; 64:gnac187. [PMID: 36534908 PMCID: PMC10733121 DOI: 10.1093/geront/gnac187] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2022] [Indexed: 10/07/2023] Open
Abstract
As dyadic health science enters a golden age, important conceptual, theoretical, and technical challenges remain. This forum review brings together perspectives on the burgeoning dyadic literature from several subdisciplines within aging research. We first define key concepts and terms so that interested researchers can navigate the complex and various ways in which dyadic health research is conducted. We discuss exciting scientific advances and close by identifying crucial challenges and considerations that coincide with important future directions for the field.
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Affiliation(s)
- Stephanie J Wilson
- Department of Psychology, Southern Methodist University, Dallas, Texas, USA
| | - Joshua R Novak
- Department of Human Development and Family Science, Auburn University, Auburn, Alabama, USA
| | | | - Lynn M Martire
- Department of Human Development and Family Studies, The Pennsylvania State University, University Park, Pennsylvania, USA
| | - Karen S Lyons
- Connell School of Nursing, Boston College, Chestnut Hill, Massachusetts, USA
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Brennan PL. Stressors and Pain across the Late-Life Span: Findings from Two Parent Longitudinal Studies of Aging and Health. J Aging Health 2023; 35:677-687. [PMID: 35658697 PMCID: PMC10478334 DOI: 10.1177/08982643221104369] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
OBJECTIVE The objective is to determine associations between stressors and pain across the late-life span. METHOD Multilevel linear modeling was applied separately to harmonized repeated measures data from the Longitudinal Late-Life Health study (LLLH; n = 342; 13-year interval) and the Health and Retirement Study (HRS; n = 2959; 8-year interval). RESULTS In both the LLLH and HRS samples, independent of age, gender, and race, participants with higher average stressor levels experienced more numerous painful conditions and higher pain severity over the study intervals. In the HRS sample, they also experienced higher levels of pain interference. In general, participants' stressor levels did not influence rates of increase in their pain. Gender and race had few moderating effects on associations between stressors and pain. DISCUSSION Stressors and pain are associated across the late-life span. Future research should focus on the mediating mechanisms that account for this association and the moderating factors that affect its strength.
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Affiliation(s)
- Penny L. Brennan
- Institute for Health & Aging, University of California San Francisco, San Francisco, CA, USA
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Matthews TA, Li J. Adverse Childhood Experiences, Social Isolation, Job Strain, and Cardiovascular Disease Mortality in U.S. Older Employees. MEDICINA (KAUNAS, LITHUANIA) 2023; 59:1304. [PMID: 37512115 PMCID: PMC10383992 DOI: 10.3390/medicina59071304] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/06/2023] [Revised: 07/10/2023] [Accepted: 07/13/2023] [Indexed: 07/30/2023]
Abstract
Stress is a key driver of cardiovascular disease (CVD), yet the contribution of psychosocial stressors to the development of CVD has not been systematically examined in United States (U.S.) populations. The objective of this study was to assess prospective associations of adverse childhood experiences (ACEs), social isolation, and job strain with CVD mortality. Data were from the large, nationally representative, population-based Health and Retirement Study (HRS). ACEs, social isolation and job strain were assessed using validated survey instruments at baseline between 2006-2008, and death information was followed up through 2018. Cox proportional hazards regression models were used to examine prospective associations of ACEs, social isolation, and job strain with CVD mortality among 4046 older employees free from CVD at baseline. During 42,149 person-years of follow-up time, 59 death cases of CVD were reported. After adjustment for covariates, ACEs and job strain were significantly associated with increased risk of CVD mortality (aHR and 95% CI = 3.67 [1.59, 8.48] and 2.24 [1.21, 4.11], respectively), whereas social isolation demonstrated an inflated but nonsignificant association (aHR and 95% CI = 1.62 [0.72, 3.66]). These findings highlight the role of psychosocial exposures as novel and clinically relevant risk factors for CVD.
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Affiliation(s)
- Timothy A Matthews
- Department of Environmental Health Sciences, Fielding School of Public Health, University of California Los Angeles, 650 Charles E. Young Drive South, Los Angeles, CA 90095, USA
| | - Jian Li
- Department of Environmental Health Sciences, Fielding School of Public Health, University of California Los Angeles, 650 Charles E. Young Drive South, Los Angeles, CA 90095, USA
- School of Nursing, University of California Los Angeles, 650 Charles E. Young Drive South, Los Angeles, CA 90095, USA
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Shakya S, Silva SG, McConnell ES, McLaughlin SJ, Cary MP. Does cumulative psychosocial stress explain frailty disparities in community-dwelling older adults? Arch Gerontol Geriatr 2023; 113:105055. [PMID: 37167754 DOI: 10.1016/j.archger.2023.105055] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2023] [Revised: 04/20/2023] [Accepted: 05/02/2023] [Indexed: 05/13/2023]
Abstract
OBJECTIVE Frailty is a leading predictor of adverse outcomes in older adults. Although disparities in frailty are well-documented, it is unclear whether psychosocial stressors explain these disparities. This study aimed to examine the potential mediating role of psychosocial stress. METHODS This cross-sectional study included 7,679 community-dwelling older adults (≥ 65) from Health and Retirement Study in the US (2006 and 2008). We used six dichotomized psychosocial stressors: a) loneliness, b) discrimination, c) financial strain, d) low subjective status, e) poor neighborhood cohesion, and f) traumatic life events to compute cumulative psychosocial stress. The Fried frailty phenotype defined frailty based on three features: slowness, poor strength, weight loss, fatigue, and low physical activity. Multivariable regressions were used to examine the structural determinants (gender, education, race, and ethnicity) frailty relationship and test whether cumulative psychosocial stress has a mediating role. RESULTS The frailty prevalence was 22%. Females, Hispanics, Blacks, and those with less education had higher odds of frailty (p<.01). Race and ethnic minorities and non-college graduates experienced greater cumulative psychosocial stress relative to their White and college graduate counterparts (p<.05), respectively. Greater cumulative psychosocial stress was associated with increased odds of frailty (p < .001); however, it did not mediate the structural determinants and frailty relationship. CONCLUSION Contrary to expectations, cumulative psychosocial stress did not mediate the relationship between structural determinants and frailty. Rather, high cumulative psychosocial stress was independently associated with frailty. Further research should examine other psychosocial mediators to inform interventions to prevent/delay frailty.
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Affiliation(s)
| | | | - Eleanor S McConnell
- Geriatric Research, Education and Clinical Center (GRECC), Department of Veterans Affairs Medical Center, Durham, NC, USA
| | - Sara J McLaughlin
- Department of Sociology and Gerontology, Miami University, Oxford, OH, USA
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Iob E, Ajnakina O, Steptoe A. The interactive association of adverse childhood experiences and polygenic susceptibility with depressive symptoms and chronic inflammation in older adults: a prospective cohort study. Psychol Med 2023; 53:1426-1436. [PMID: 37010219 DOI: 10.1017/s0033291721003007] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
BACKGROUND Adverse childhood experiences (ACEs) and genetic liability are important risk factors for depression and inflammation. However, little is known about the gene-environment (G × E) mechanisms underlying their aetiology. For the first time, we tested the independent and interactive associations of ACEs and polygenic scores of major depressive disorder (MDD-PGS) and C-reactive protein (CRP-PGS) with longitudinal trajectories of depression and chronic inflammation in older adults. METHODS Data were drawn from the English longitudinal study of ageing (N~3400). Retrospective information on ACEs was collected in wave3 (2006/07). We calculated a cumulative risk score of ACEs and also assessed distinct dimensions separately. Depressive symptoms were ascertained on eight occasions, from wave1 (2002/03) to wave8 (2016/17). CRP was measured in wave2 (2004/05), wave4 (2008/09), and wave6 (2012/13). The associations of the risk factors with group-based depressive-symptom trajectories and repeated exposure to high CRP (i.e. ⩾3 mg/L) were tested using multinomial and ordinal logistic regression. RESULTS All types of ACEs were independently associated with high depressive-symptom trajectories (OR 1.44, 95% CI 1.30-1.60) and inflammation (OR 1.08, 95% CI 1.07-1.09). The risk of high depressive-symptom trajectories (OR 1.47, 95% CI 1.28-1.70) and inflammation (OR 1.03, 95% CI 1.01-1.04) was also higher for participants with higher MDD-PGS. G×E analyses revealed that the associations between ACEs and depressive symptoms were larger among participants with higher MDD-PGS (OR 1.13, 95% CI 1.04-1.23). ACEs were also more strongly related to inflammation in participants with higher CRP-PGS (OR 1.02, 95% CI 1.01-1.03). CONCLUSIONS ACEs and polygenic susceptibility were independently and interactively associated with elevated depressive symptoms and chronic inflammation, highlighting the clinical importance of assessing both ACEs and genetic risk factors to design more targeted interventions.
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Affiliation(s)
- Eleonora Iob
- Research Department of Behavioural Science and Health, Institute of Epidemiology and Healthcare, University College London, London, UK
| | - Olesya Ajnakina
- Research Department of Behavioural Science and Health, Institute of Epidemiology and Healthcare, University College London, London, UK
- Department of Biostatistics & Health Informatics, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
| | - Andrew Steptoe
- Research Department of Behavioural Science and Health, Institute of Epidemiology and Healthcare, University College London, London, UK
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Spector AL, Quinn KG, Wang I, Gliedt JA, Fillingim RB, Cruz-Almeida Y. More Problems, More Pain: The Role of Chronic Life Stressors and Racial/Ethnic Identity on Chronic Pain Among Middle-Aged and Older Adults in the United States. CHRONIC STRESS (THOUSAND OAKS, CALIF.) 2023; 7:24705470231208281. [PMID: 37881639 PMCID: PMC10594967 DOI: 10.1177/24705470231208281] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/16/2023] [Accepted: 10/03/2023] [Indexed: 10/27/2023]
Abstract
There is a high prevalence of chronic pain among middle-aged and older adults in the United States. Chronic life stressors have been shown to have detrimental consequences for myriad health conditions, including chronic pain. However, there is limited evidence on the types of chronic life stressors that affect middle-aged and older adults and how these stressors influence the chronic pain burden in this population. Moreover, the interaction between chronic life stressors and racial/ethnic identity remains poorly understood as it relates to chronic pain. The current analysis used the 2018 Health and Retirement Study to investigate relationships between chronic life stressors and odds to experience any chronic pain and high-impact chronic pain. Chronic life stressors were characterized, overall and by racial/ethnic identity, and the main and interaction effects were calculated to evaluate relationships between chronic life stressors, racial/ethnic identity, and odds of experiencing any chronic pain and high-impact chronic pain. Results indicate that in 2018, the most common chronic life stressor among middle-aged and older adults was dealing with their own health problems (68%), followed by dealing with the physical or emotional issues affecting a spouse or child (46%). Adjusted analyses showed that a higher total of chronic life stressors increased the odds of middle-aged and older adults experiencing any chronic pain and high-impact chronic pain. There were no significant interactions between the overall chronic life stress burden and racial/ethnic identity as a predictor of odds to experience any chronic pain or high-impact chronic pain, but significant interaction effects were found related to specific chronic life stressors. Findings underscore the significant impact of chronic life stressors on the chronic pain burden among middle-aged and older adults in the United States, which cut across racial/ethnic identity.
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Affiliation(s)
- Antoinette L. Spector
- Department of Rehabilitation Sciences and Technology, University of Wisconsin-Milwaukee, Milwaukee, WI, USA
| | - Katherine G. Quinn
- Department of Psychiatry and Behavioral Medicine, Center for AIDS Intervention Research, Medical College of Wisconsin, Milwaukee, WI, USA
| | - Inga Wang
- Department of Rehabilitation Sciences and Technology, University of Wisconsin-Milwaukee, Milwaukee, WI, USA
| | - Jordan A. Gliedt
- Department of Neurosurgery, Medical College of Wisconsin, Milwaukee, WI, USA
| | - Roger B. Fillingim
- Pain Research and Intervention Center of Excellence (PRICE), University of Florida, Gainesville, FL, USA
- Department of Community Dentistry and Behavioral Science, University of Florida, Gainesville, FL, USA
| | - Yenisel Cruz-Almeida
- Pain Research and Intervention Center of Excellence (PRICE), University of Florida, Gainesville, FL, USA
- Department of Community Dentistry and Behavioral Science, University of Florida, Gainesville, FL, USA
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Dupre ME, Farmer HR, Xu H, Navar AM, Nanna MG, George LK, Peterson ED. The Cumulative Impact of Chronic Stressors on Risks of Myocardial Infarction in US Older Adults. Psychosom Med 2021; 83:987-994. [PMID: 34297011 PMCID: PMC8578196 DOI: 10.1097/psy.0000000000000976] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
OBJECTIVE This study aimed to investigate the association between cumulative exposure to chronic stressors and the incidence of myocardial infarction (MI) in US older adults. METHODS Nationally representative prospective cohort data of adults 45 years and older (n = 15,109) were used to investigate the association between the cumulative number of chronic stressors and the incidence of MI in US older adults. Proportional hazards models adjusted for confounding risk factors and differences by sex, race/ethnicity, and history of MI were assessed. RESULTS The median age of participants was 65 years, 714 (4.7%) had a prior MI, and 557 (3.7%) had an MI during follow-up. Approximately 84% of participants reported at least one chronic stressor at baseline, and more than half reported two or more stressors. Multivariable models showed that risks of MI increased incrementally from one chronic stressor (hazard ratio [HR] = 1.28, 95% confidence interval [CI] = 1.20-1.37) to four or more chronic stressors (HR = 2.71, 95% CI = 2.08-3.53) compared with those who reported no stressors. These risks were only partly reduced after adjustments for multiple demographic, socioeconomic, psychosocial, behavioral, and clinical risk factors. In adults who had a prior MI (p value for interaction = .038), we found that risks of a recurrent event increased substantially from one chronic stressor (HR = 1.30, 95% CI = 1.09-1.54) to four or more chronic stressors (HR = 2.85, 95% CI = 1.43-5.69). CONCLUSIONS Chronic life stressors are significant independent risk factors for cardiovascular events in US older adults. The risks associated with multiple chronic stressors were especially high in adults with a previous MI.
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Affiliation(s)
- Matthew E. Dupre
- Department of Population Health Sciences, Duke University, Durham, NC
- Duke Clinical Research Institute, Duke University, Durham, NC
- Department of Sociology, Duke University, Durham, NC
- Center for the Study of Aging and Human Development, Duke University, Durham, NC
| | - Heather R. Farmer
- Department of Human Development and Family Sciences, University of Delaware, DE
| | - Hanzhang Xu
- Department of Family Medicine and Community Health, Duke University, Durham, NC
- Duke School of Nursing, Duke University, Durham, NC
| | - Ann Marie Navar
- Division of Cardiology, Department of Medicine, University of Texas Southwestern, TX
| | - Michael G. Nanna
- Duke Clinical Research Institute, Duke University, Durham, NC
- Division of Cardiology, Department of Medicine, Duke University Medical Center, Durham, NC
| | - Linda K. George
- Department of Sociology, Duke University, Durham, NC
- Center for the Study of Aging and Human Development, Duke University, Durham, NC
- Department of Psychology and Neuroscience, Duke University, Durham, NC
| | - Eric D. Peterson
- Division of Cardiology, Department of Medicine, University of Texas Southwestern, TX
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Luo J, Zhang B, Willroth EC, Mroczek DK, Roberts BW. The Roles of General and Domain-Specific Perceived Stress in Healthy Aging. J Gerontol B Psychol Sci Soc Sci 2021; 77:536-549. [PMID: 34265038 DOI: 10.1093/geronb/gbab134] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2021] [Indexed: 11/14/2022] Open
Abstract
OBJECTIVES Theoretical and empirical evidence suggests the existence of a general perceived stress factor overarching different life domains. The present study investigated the general perceived stress relative to domain-specific perceived stress as predictors of 26 diverse health outcomes, including mental and physical health, health behaviors, cognitive functioning, and physiological indicators of health. METHOD A bifactor exploratory structural equational modelling (BiESEM) approach was adopted in two aging samples from the Health and Retirement Study (HRS; N = 8325 in Sample 1, N = 7408 in Sample 2). RESULTS Across the two samples, perceived stress was well-represented by a bifactor structure where there was a robust general perceived stress factor representing a general propensity towards stress perception. Meanwhile, after controlling for the general perceived stress factor, specific factors that represent perceived stress in different life domains were still clearly present. Results also suggested age, sex, race, education, personality traits, and past and recent stressor exposure as possible factors underlying individual differences in the general perceived stress factor. The general perceived stress factor was the most robust predictor of the majority of health outcomes, as well as changes in mental health outcomes. The specific factor of perceived neighborhood stress demonstrated incremental predictive effects across different types of health outcomes. DISCUSSION The current study provides strong evidence for the existence of a general perceived stress factor that captures variance shared among stress across life domains, and the general perceived stress factor demonstrated substantial prospective predictive effects on diverse health outcomes in older adulthood.
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Affiliation(s)
- Jing Luo
- Department of Medical Social Sciences, Feinberg School of Medicine, Northwestern University, Chicago, IL, USA
| | - Bo Zhang
- Department of Psychological and Brain Sciences, Texas A&M University, TAMU, College Station, TX, USA
| | - Emily C Willroth
- Department of Medical Social Sciences, Feinberg School of Medicine, Northwestern University, Chicago, IL, USA
| | - Daniel K Mroczek
- Department of Medical Social Sciences, Feinberg School of Medicine, Northwestern University, Chicago, IL, USA
| | - Brent W Roberts
- Department of Psychology, University of Illinois at Urbana-Champaign, 603 E. Daniel St., Champaign, IL, USA
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Zhang Z, Chen W. Longitudinal Associations Between Physical Activity and Purpose in Life Among Older Adults: A Cross-Lagged Panel Analysis. J Aging Health 2021; 33:941-952. [PMID: 34002652 DOI: 10.1177/08982643211019508] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Objective: The purpose of the current study was to examine the bidirectional relationship between physical activity (PA) and purpose in life in an older adult sample using longitudinal data. Method: Data were collected from three waves (2006, 2010, and 2014) of the Health and Retirement Study. A total of 4591 participants who had complete information of PA and purpose in life at baseline were included in the current study. A series of cross-lagged models were tested separately for vigorous-intensity PA, moderate-intensity PA, and light-intensity PA. Results: While higher levels of purpose in life were associated with more frequent engagement in future vigorous-intensity PA, moderate-intensity PA, and light-intensity PA, none of the PA variables predicted subsequent purpose in life. Discussion: The results did not support a reciprocal relationship between PA and purpose in life in older adults. It is more likely that purpose in life predicts PA, rather than vice versa.
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Affiliation(s)
- Zhanjia Zhang
- Department of Physical Education, 1259Peking University, Beijing, China.,School of Kinesiology, 1259University of Michigan, Ann Arbor, MI, USA
| | - Weiyun Chen
- School of Kinesiology, 1259University of Michigan, Ann Arbor, MI, USA
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13
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Luo J, Zhang B, Roberts BW. Sensitization or inoculation: Investigating the effects of early adversity on personality traits and stress experiences in adulthood. PLoS One 2021; 16:e0248822. [PMID: 33793582 PMCID: PMC8016298 DOI: 10.1371/journal.pone.0248822] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/18/2020] [Accepted: 03/07/2021] [Indexed: 12/05/2022] Open
Abstract
Cumulative evidence has been found for the associations between personality traits and stress experiences in adulthood. However, less is known about the moderating mechanisms underlying these associations. The present study tested whether the stress sensitization and stress inoculation hypotheses could be applied to the relationship between early adversity and personality in adulthood. Specifically, we tested the linear and curvilinear relations between early adversity (measured retrospectively) and adulthood personality traits, as well as the linear and curvilinear moderating effects of early adversity on the associations between adulthood stress and personality traits. Samples of older adults from the Health and Retirement Study (HRS; N = 6098) and middle-aged adults from the Midlife in the United States Survey (MIDUS; N = 6186) were used. Across the two samples, positive linear associations were found between retrospective early adversity and neuroticism. The results also suggested significant linear effects of early adversity on the association between ongoing chronic stressors and neuroticism such that individuals with moderate exposure to early adversity showed stronger associations between ongoing chronic stressors and neuroticism. Results from the current research were more in line with the stress sensitization model. No support was found for the stress inoculation effects on personality.
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Affiliation(s)
- Jing Luo
- Department of Medical Social Sciences, Feinberg School of Medicine, Northwestern University, Chicago, IL, United States of America
| | - Bo Zhang
- Department of Brain and Psychological Sciences, Texas A & M University, College Station, TX, United States of America
| | - Brent W. Roberts
- Department of Psychology, University of Illinois at Urbana-Champaign, Champaign, IL, United States of America
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Bürgin D, Boonmann C, Schmeck K, Schmid M, Tripp P, Nishimi K, O’Donovan A. Compounding Stress: Childhood Adversity as a Risk Factor for Adulthood Trauma Exposure in the Health and Retirement Study. J Trauma Stress 2021; 34:124-136. [PMID: 33200440 PMCID: PMC7887022 DOI: 10.1002/jts.22617] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/27/2020] [Revised: 08/10/2020] [Accepted: 09/07/2020] [Indexed: 12/21/2022]
Abstract
Childhood adversity (CA) and adulthood traumatic experiences (ATEs) are common and unequally distributed in the general population. Early stressors may beget later stressors and alter life-course trajectories of stressor exposure. Gender differences exist regarding the risk of specific stressors. However, few studies have examined the associations between specific types of CA and ATEs. Using a large-scale sample of older adults, we aimed to (a) determine if specific or cumulative CA increased the risk for specific or cumulative ATEs and (b) examine whether these associations were moderated by gender. In a sample from the U.S. Health and Retirement Study (N = 15,717; Mage = 67.57 years, SD = 10.54), cross-sectional Poisson and logistic regression models were fitted to assess the specific and cumulative associations between CA and ATEs. Overall, cumulative CA was associated with a larger risk ratio of ATEs, adjusted for covariates: aRRRs = 1.28, 1.63, and 1.97 for 1, 2, and 3-4 adverse events in childhood, respectively. Cumulative CA was particularly strongly associated with adulthood physical attacks, aOR = 5.66, and having a substance-abusing spouse or child, aOR = 4.00. Childhood physical abuse was the strongest independent risk factor for cumulative ATEs, aRRR = 1.49, and most strongly associated with adulthood physical attacks, aOR = 3.41. Gender moderated the association between cumulative CA and cumulative ATEs, with slightly stronger associations between cumulative CA and ATEs for women than men. Given that CA and ATEs perpetuate health disparities worldwide, reducing their incidence and effects should be major priorities for public health.
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Affiliation(s)
- David Bürgin
- Child and Adolescent Psychiatric Research Department, University Psychiatric Hospitals, University of Basel, Basel, Switzerland
- Department of Psychiatry and Weill Institute for Neurosciences, University of California San Francisco, San Francisco, USA
- Mental Health Service, San Francisco Veterans Affairs Medical Center, San Francisco, California, USA
| | - Cyril Boonmann
- Child and Adolescent Psychiatric Research Department, University Psychiatric Hospitals, University of Basel, Basel, Switzerland
| | - Klaus Schmeck
- Child and Adolescent Psychiatric Research Department, University Psychiatric Hospitals, University of Basel, Basel, Switzerland
| | - Marc Schmid
- Child and Adolescent Psychiatric Research Department, University Psychiatric Hospitals, University of Basel, Basel, Switzerland
| | - Paige Tripp
- Department of Psychiatry and Weill Institute for Neurosciences, University of California San Francisco, San Francisco, USA
- Mental Health Service, San Francisco Veterans Affairs Medical Center, San Francisco, California, USA
| | - Kristen Nishimi
- Department of Psychiatry and Weill Institute for Neurosciences, University of California San Francisco, San Francisco, USA
- Mental Health Service, San Francisco Veterans Affairs Medical Center, San Francisco, California, USA
| | - Aoife O’Donovan
- Department of Psychiatry and Weill Institute for Neurosciences, University of California San Francisco, San Francisco, USA
- Mental Health Service, San Francisco Veterans Affairs Medical Center, San Francisco, California, USA
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15
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Brennan PL. Life Stressors: Elevations and Disparities Among Older Adults with Pain. PAIN MEDICINE (MALDEN, MASS.) 2020; 21:2123-2136. [PMID: 32955090 PMCID: PMC7593801 DOI: 10.1093/pm/pnaa189] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/30/2023]
Abstract
OBJECTIVE To examine stressor elevations among older adults with pain, and gender and race disparities in the dual burdens of late-life pain and stressors. DESIGN Cross-sectional. SETTING Community. SUBJECTS Participants in the Longitudinal Late-Life Health study (LLLH; N = 1,884) and the Health and Retirement Study (HRS; N = 7,704). METHODS Pain and stressor measures were harmonized across the LLLH and HRS samples. Analyses of covariance were conducted to determine the effects of older adults' pain, gender, race, and interactions between these factors, on their stressors in nine separate life domains, and in stressors overall. RESULTS In both the LLLH and HRS samples, older adults with painful conditions (joint, back, headache, chest pain), more numerous painful conditions, more severe pain, and more pain interference had elevated stressors in all life domains, compared with older adults without or with less serious pain. Pain was more prevalent among women and nonwhites than men and whites. Stressor exposure was higher for men than women in most life domains; it was higher for nonwhites than whites in all life domains. For certain types of pain and life domains, pain and gender, as well as pain and race, interacted to predict stressor elevations. CONCLUSIONS Late-life pain is associated with elevations in stressors, and there are gender and race disparities in the dual burdens of heightened pain and elevated stressors in later life. Pain and stressors are not consistently more strongly linked among older women than older men, or among older nonwhite than older white persons.
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Affiliation(s)
- Penny L Brennan
- Institute for Health & Aging, University of California, San Francisco, San Francisco, California, USA
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16
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Comparative Dynamics of Individual Ageing among the Investigative Type of Professionals Living in Russia and Russian Migrants to the EU Countries. Eur J Investig Health Psychol Educ 2020; 10:749-762. [PMID: 34542509 PMCID: PMC8314298 DOI: 10.3390/ejihpe10030055] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2020] [Revised: 07/22/2020] [Accepted: 07/24/2020] [Indexed: 12/22/2022] Open
Abstract
The goal of this study was to uncover the influence of professional activity, migration, and gender on dynamics of subjective age and ageing biomarkers. We examined the representatives of investigative types of professions (ITP), 30–75 years old in Russia, (101/62 women), and Russian migrants to the European Union, (101/56 women). ITPs appeared to be ageing slower than statistical standards; men age faster than women; the pre-retirement group (51–65 years old) showed acceleration of relative biological ageing in the Russian sample (women +4.5 years, men +10.7 years) against the EU sample, suggesting a boost of pre-retirement stress in Russia; subjectively, Russian people (51–65 years old) feel close to their chronological age, while EU people perceive themselves far below their calendar age (men—lower by 20.4, women—lower by 10.9 years). The subjective ageing depends on the country of residence, while biological ageing depends on occupation, gender, and negative expectations of retirement.
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Smith T, Fletcher J, Lister S. Lived experiences of informal caregivers of people with chronic musculoskeletal pain: a systematic review and meta-ethnography. Br J Pain 2020; 15:187-198. [PMID: 34055340 DOI: 10.1177/2049463720925110] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
Background People with chronic pain often seek support from friends and family for everyday tasks. These individuals are termed informal caregivers. There remains uncertainty regarding the lived experiences of these people who care for individuals with chronic musculoskeletal pain. The aim of this article is to synthase the evidence on the lived experiences of informal caregivers providing care to people with chronic musculoskeletal pain. Methods A systematic literature review was undertaken of published and unpublished literature databases including EMBASE, MEDLINE, CINAHL, PubMed, the WHO International Clinical Trial Registry and ClinicalTrials.gov registry (to September 2019). Qualitative studies exploring the lived experiences of informal caregivers of people with chronic musculoskeletal pain were included. Data were synthesised using a meta-ethnography approach. Evidence was evaluated using the Critical Appraisal Skills Programme qualitative appraisal tool. Results From 534 citations, 10 studies were eligible (360 participants: 171 informal caregivers of 189 care recipients). The evidence was moderate quality. Seven themes arose: the relationship of caregivers to healthcare professionals; role reversal with care recipients; acting the confidant to the care recipient; a constant burden in caregiving; legitimising care recipient's condition; knowledge and skills to provide caregiving; and the perception of other family members and wider society to the caregiver/care recipient dyad. Conclusion The lived experiences of caregivers of people with chronic musculoskeletal pain is complex and dynamic. There is an inter-connected relationship between caregivers, care recipients and healthcare professionals. Exploring how these experiences can be modified to improve a caregiving dyad's lived experience is now warranted.
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Affiliation(s)
- Toby Smith
- Nuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Sciences, University of Oxford, Oxford, UK.,Faculty of Medicine and Health Sciences, University of East Anglia, Norwich, UK
| | - Jessica Fletcher
- Nuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Sciences, University of Oxford, Oxford, UK.,Physiotherapy Department, Connect Health, Milton Keynes, UK
| | - Sarah Lister
- Physiotherapy Department, Norfolk and Norwich University Hospital NHS Foundation Trust, Norwich, UK
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18
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Demakakos P, Lewer D, Jackson SE, Hayward AC. Lifetime prevalence of homelessness in housed people aged 55-79 years in England: its childhood correlates and association with mortality over 10 years of follow-up. Public Health 2020; 182:131-138. [PMID: 32298843 PMCID: PMC7294219 DOI: 10.1016/j.puhe.2019.12.017] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/07/2019] [Revised: 12/06/2019] [Accepted: 12/20/2019] [Indexed: 11/19/2022]
Abstract
OBJECTIVES Since 2010, the number of homeless people in the UK has increased, and homelessness in its different types has become a major public health problem. Housed older people with past experience of homelessness are an understudied population that can provide valuable insight into this problem. For this reason, we examined the lifetime prevalence of homelessness and its associations with childhood adversity and mortality in a national sample of older people. STUDY DESIGN This is a longitudinal cohort study. METHODS We studied 6649 housed individuals aged 55-79 years in 2007 from the English Longitudinal Study of Ageing (ELSA). We used logistic regression to model the association between adverse childhood experiences (ACE) and lifetime experience of homelessness (ever been homeless for ≥1 months) and Cox proportional hazards regression to model the prospective association between lifetime experience of homelessness and mortality. RESULTS We identified 107 participants with lifetime experience of homelessness. We found a strong graded association between the number of ACE and lifetime experience of homelessness; participants with two ACE had 5.35 (95% confidence interval [CI]: 3.17-9.05) times greater odds of having experienced homelessness than those reporting none. Most ACE were individually associated with lifetime homelessness, but fewer remained so in the mutually adjusted model. Participants with lifetime experience of homelessness had 1.55 (95% CI: 1.01-2.37) times greater risk of mortality over a 10-year follow-up and after adjustment for covariates. CONCLUSIONS Exposure to childhood adversity is associated with increased risk of experiencing homelessness. Older housed people with past experience of homelessness are at increased risk of mortality.
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Affiliation(s)
- P Demakakos
- Department of Epidemiology and Public Health, Institute of Epidemiology and Health Care, University College London, London, WC1E 6BT, UK.
| | - D Lewer
- Department of Epidemiology and Public Health, Institute of Epidemiology and Health Care, University College London, London, WC1E 6BT, UK; Collaborative Centre for Inclusion Health, University College London, London, NW1 2DA, UK
| | - S E Jackson
- Department of Behavioural Science and Health, Institute of Epidemiology and Health Care, University College London, London, WC1E 6BT, UK
| | - A C Hayward
- Department of Epidemiology and Public Health, Institute of Epidemiology and Health Care, University College London, London, WC1E 6BT, UK; Collaborative Centre for Inclusion Health, University College London, London, NW1 2DA, UK
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