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Tahmassi N, Al Snih S. Walking Activity and Physical Function Among Mexican American Older Adults Over 9 Years of Follow Up. J Phys Act Health 2024; 21:692-697. [PMID: 38626896 DOI: 10.1123/jpah.2023-0266] [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: 06/08/2023] [Revised: 03/05/2024] [Accepted: 03/07/2024] [Indexed: 06/25/2024]
Abstract
BACKGROUND Walking activity has been associated with reduction in the development of chronic disease, cognitive and physical function impairment, disability, and mortality. The objective of this study was to examine the relationship between walking activity and physical function over 9 years of follow-up among Mexican Americans aged 78 years and older. METHODS Participants (N = 998) were from the Hispanic Established Population for the Epidemiologic Study of the Elderly (2007-2016). Measures included walking activity duration and frequency, socio-demographics, body mass index, medical conditions, pain, depressive symptoms, limitation in activities of daily living, and the Mini-Mental State Examination. Low physical function was defined as scoring <7 on the Short Physical Performance Battery. At baseline, participants were grouped into nonwalkers (n = 653), walked <150 minutes/week (n = 144), and walked 150 minutes/week or more (n = 201). A Generalized Estimating Equation model was used to estimate the odds ratio and 95% CI of low physical performance as a function of walking activity status. RESULTS Compared with nonwalkers, participants walking < 150 minutes/week had lower odds (odds ratio = 0.66, 95% CI, 0.51-0.86) of low physical function over time, after controlling for all covariates, as did those walking ≥ 150 minutes/week (odds ratio = 0.54, 95% CI, 0.41-0.71). CONCLUSIONS Mexican American older adults who engage in any walking activity are at reduced risk of low physical function, even those with disability. Interventions at the individual and community level are recommended to reduce physical function impairment, even in those with preexisting medical conditions or disability.
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Affiliation(s)
- Nicholas Tahmassi
- John Sealy School of Medicine, The University of Texas Medical Branch, Galveston, TX, USA
| | - Soham Al Snih
- Department of Population Health and Health Disparities/School of Public and Population Health, The University of Texas Medical Branch, Galveston, TX, USA
- Division of Geriatrics and Palliative Medicine/Department of Internal Medicine, TheUniversity of Texas Medical Branch, Galveston, TX, USA
- Sealy Center on Aging, The University of Texas Medical Branch, Galveston, TX, USA
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Davidson-Turner KJ, Farina MP, Hayward MD. Racial/Ethnic differences in inflammation levels among older adults 56+: an examination of sociodemographic differences across inflammation measure. BIODEMOGRAPHY AND SOCIAL BIOLOGY 2024; 69:75-89. [PMID: 38807566 PMCID: PMC11257156 DOI: 10.1080/19485565.2024.2356672] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/30/2024]
Abstract
OBJECTIVE Chronic inflammation is a key biological risk factor for many widespread adult health conditions. This study examines racial/ethnic differences in inflammation across several inflammatory markers, including selected cytokines that are identified as important for aging and age-related health outcomes. METHODS Data came from the 2016 Venous Blood Collection Subsample of the Health and Retirement Study. Using logistic regression models, we compared high-risk categories of C-reactive protein and cytokine markers (IL-6, IL-10, IL-1RA, TNFR1, and TGF-Beta), across race/ethnicity and whether these differences persisted among men and women. RESULTS The findings provided evidence of significant race/ethnic differences in inflammatory measures, but the patterns differed across marker types. CONCLUSIONS These findings emphasize that race/ethnic differences are not consistently captured across markers of inflammation and that researchers should proceed with caution when using individual markers of inflammation in an effort to not overlook potential racial/ethnic differences in biological risk.
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Affiliation(s)
- KJ Davidson-Turner
- Department of Sociology, University of Texas at Austin, Austin, Texas, USA
| | - Mateo P. Farina
- Department of Human Development and Family Sciences, University of Texas at Austin, Austin, Texas, USA
| | - Mark D. Hayward
- Department of Sociology, University of Texas at Austin, Austin, Texas, USA
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Onwudebe C, Al Snih S, Raji MA, Milani SA. Diabetes Complications and Pain Among Mexican Americans Aged 80 and Older. Innov Aging 2023; 7:igad099. [PMID: 38094936 PMCID: PMC10714911 DOI: 10.1093/geroni/igad099] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/13/2023] [Indexed: 02/01/2024] Open
Abstract
Background and Objectives Diabetes is common among Hispanic older adults; however, the association between diabetic complications and pain has not been widely studied in this population. Our objective was to examine the association between diabetes complications and pain over 6 years among Mexican Americans aged 80 years and older. Research Design and Methods We used data from Waves 7 to 9 (2010-2016) of the Hispanic Established Population for the Epidemiologic Study of the Elderly (n = 853). Participants were categorized as having no diabetes, diabetes without complications, and diabetes with complications. Pain was defined as reporting pain when standing or walking (pain on weight-bearing) and having pain that limited daily activities (pain interference). We used generalized estimating equations to estimate the odds of pain over 6 years as a function of diabetes status controlling for socioeconomic and health characteristics. Results At baseline, the mean age was 85.7 (standard deviation = 3.9) years, 65.2% female, 68.5% had no diabetes, 14.7% had diabetes without complications, and 16.9% had diabetes with complications. Those with diabetes without complications had lower odds of reporting pain on weight-bearing and pain interference, compared to those with no diabetes. Among those reporting diabetes (n = 269), those with complications had higher odds of pain on weight-bearing and pain interference, compared to those without complications. Those with both micro and macro complications had over 2 times the odds of pain, compared to those having no complications. Discussion and Implications The lower burden of pain in those with diabetes but no complications may reflect optimal management of diabetes. Routine screening and treatment of pain in patients with diabetes complications can mitigate excess disability and increase the quality of life for patients with diabetes.
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Affiliation(s)
- Chinedu Onwudebe
- John Sealy School of Medicine, University of Texas Medical Branch, Galveston, Texas, USA
| | - Soham Al Snih
- Department of Population Health & Health Disparities, University of Texas Medical Branch, Galveston, Texas, USA
- Sealy Center on Aging, University of Texas Medical Branch, Galveston, Texas, USA
| | - Mukaila A Raji
- Sealy Center on Aging, University of Texas Medical Branch, Galveston, Texas, USA
- Division of Geriatrics and Palliative Medicine, Department of Internal Medicine, University of Texas Medical Branch, Galveston, Texas, USA
| | - Sadaf Arefi Milani
- Sealy Center on Aging, University of Texas Medical Branch, Galveston, Texas, USA
- Department of Epidemiology, University of Texas Medical Branch, Galveston, Texas, USA
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Elias S, Turkson‐Ocran R, Koirala B, Byiringiro S, Baptiste D, Himmelfarb CR, Commodore‐Mensah Y. Heterogeneity in Cardiovascular Disease Risk Factors Among Latino Immigrant Subgroups: Evidence From the 2010 to 2018 National Health Interview Survey. J Am Heart Assoc 2023; 12:e027433. [PMID: 37158060 PMCID: PMC10227289 DOI: 10.1161/jaha.122.027433] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/13/2022] [Accepted: 03/10/2023] [Indexed: 05/10/2023]
Abstract
Background The Latino population is a growing and diverse share of the US population. Previous studies have examined Latino immigrants as a homogenous group. The authors hypothesized that there would be heterogeneity in cardiovascular disease risk factors among Latino immigrant subgroups (from Mexico, Puerto Rico, Cuba, Dominican Republic, Central America, or South America) compared with non-Latino White adults. Methods and Results A cross-sectional analysis of the 2010 to 2018 National Health Interview Survey (NHIS) among 548 739 individuals was performed. Generalized linear models with Poisson distribution were fitted to compare the prevalence of self-reported hypertension, overweight/obesity, diabetes, high cholesterol, physical inactivity, and current smoking, adjusting for known confounders. The authors included 474 968 non-Latino White adults and 73 771 Latino immigrants from Mexico (59%), Puerto Rico (7%), Cuba (6%), Dominican Republic (5%), Central America (15%), and South America (9%). Compared with White adults, Mexican immigrants had the highest prevalence of overweight/obesity (prevalence ratio [PR], 1.17 [95% CI, 1.15-1.19]); Puerto Rican individuals had the highest prevalence of diabetes (PR, 1.63 [95% CI, 1.45-1.83]); individuals from Central America had the highest prevalence of high cholesterol (PR, 1.16 [95% CI, 1.04-1.28]); and individuals from the Dominican Republic had the highest prevalence of physical inactivity (PR, 1.25 [95% CI, 1.18-1.32]). All Latino immigrant subgroups were less likely to be smokers than White adults. Conclusions The authors observed advantages and disparities in cardiovascular disease risk factors among Latino immigrants. Aggregating data on Latino individuals may mask differences in cardiovascular disease risk and hinder efforts to reduce health disparities in this population. Study findings provide Latino group-specific actionable information and targets for improving cardiovascular health.
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Affiliation(s)
| | - Ruth‐Alma Turkson‐Ocran
- Division of General MedicineBeth Israel Deaconess Medical Center and Harvard Medical SchoolBostonMA
| | | | | | | | - Cheryl R. Himmelfarb
- Johns Hopkins School of NursingBaltimoreMD
- Johns Hopkins Bloomberg School of Public HealthBaltimoreMD
- Johns Hopkins School of MedicineBaltimoreMD
| | - Yvonne Commodore‐Mensah
- Johns Hopkins School of NursingBaltimoreMD
- Johns Hopkins Bloomberg School of Public HealthBaltimoreMD
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Ventura J, Downer B, Li CY, Snih SA. Nativity differences in the relationship between handgrip strength and cognitive impairment in older Mexican Americans over 20 years of follow-up. Arch Gerontol Geriatr 2023; 107:104903. [PMID: 36584560 PMCID: PMC9974812 DOI: 10.1016/j.archger.2022.104903] [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: 09/14/2022] [Revised: 12/01/2022] [Accepted: 12/12/2022] [Indexed: 12/15/2022]
Abstract
PURPOSE To examine nativity differences in the relationship between handgrip strength (HGS) and cognitive impairment among Mexican Americans aged ≥ 65 years with normal or high cognitive function at baseline over a 20-year period. METHODS Prospective cohort study of 2,155 non-institutionalized Mexican Americans aged ≥ 65 years from the Hispanic Established Population for the Epidemiological Study of the Elderly) who scored ≥ 21 in the Mini Mental State Examination (MMSE) at baseline. Measures included socio-demographics, body mass index, medical conditions, depressive symptoms, physical function, disability, HGS quartiles (sex-adjusted), and MMSE. We used generalized estimating equation models to estimate the odds ratio (OR) and 95% Confidence Interval (CI) of cognitive impairment (MMSE < 21) as a function of HGS quartile by nativity and adjusted for covariates. RESULTS US-born and foreign-born participants in the 4th quartile (highest) of HGS at baseline had lower odds of cognitive impairment over time compared with those in the 1st (lowest) HGS quartile (OR=0.95, 95% CI=0.90-0.99 and OR=0.93, 95% CI=0.89-0.98, respectively), after controlling for all covariates. When we analyzed HGS quartiles as time-varying, we found that US-born participants in the 3rd and 4th HGS quartile had 25% and 30% lower odds of cognitive impairment, respectively, while foreign-born participants in the 3rd and 4th HGS quartile had 27% and 49% lower odds of cognitive impairment over time, respectively, after controlling for all covariates. CONCLUSION Foreign-born older Mexican Americans who performed high in HGS experienced 7% lower odds of cognitive impairment over time compared with US-born older Mexican Americans.
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Affiliation(s)
- Juan Ventura
- John Sealy School of Medicine, University of Texas Medical Branch, Galveston, TX, USA
| | - Brian Downer
- Department of Population Health and Health Disparities/School of Public and Population Health, University of Texas Medical Branch, Galveston, TX, USA
| | - Chih-Ying Li
- Department of Occupational Therapy/School of Health Professions, University of Texas Medical Branch, Galveston, TX, USA
| | - Soham Al Snih
- Department of Population Health and Health Disparities/School of Public and Population Health, University of Texas Medical Branch, Galveston, TX, USA; Division of Geriatrics & Palliative Medicine/Department of Internal Medicine, University of Texas Medical Branch, Galveston, TX, USA; Sealy Center on Aging, University of Texas Medical Branch, Galveston, TX, USA.
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Farina MP, Kim JK, Crimmins EM. Racial/Ethnic Differences in Biological Aging and Their Life Course Socioeconomic Determinants: The 2016 Health and Retirement Study. J Aging Health 2023; 35:209-220. [PMID: 35984401 PMCID: PMC9898094 DOI: 10.1177/08982643221120743] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
Objectives: This study examined differences in accelerated biological aging among non-Hispanic Blacks, Hispanics, and non-Hispanic Whites in the United States and assessed whether including life course socioeconomic conditions attenuated observed racial/ethnic differences. Methods: Data came from the Venous Blood Collection Subsample of the Health and Retirement Study. We used a comprehensive summary measure of biological age (BA-22). We determined whether key lifetime socioeconomic conditions contributed to racial/ethnic differences in biological aging. Results: Findings indicated that non-Hispanic Blacks and Hispanics have accelerated aging, and non-Hispanic Whites have decelerated aging. Racial/ethnic differences were strongly tied to educational attainment. We also observed a significant difference by birthplace for Hispanics. US-born Hispanics had accelerated biological aging, whereas foreign-born Hispanics did not. In age-stratified analyses, these racial/ethnic differences were found for adults aged 56-74, but not for adults aged 75+. Conclusions: These findings provide insight into biological differences underlying racial/ethnic disparities in health.
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Affiliation(s)
- Mateo P Farina
- Andrus Gerontology Center, University of Southern California, Los Angeles, CA, USA
| | - Jung Ki Kim
- Andrus Gerontology Center, University of Southern California, Los Angeles, CA, USA
| | - Eileen M. Crimmins
- Andrus Gerontology Center, University of Southern California, Los Angeles, CA, USA
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Afunugo WE, Li CY, Chou LN, Ward F, Snih SA. Pain, obesity, and physical function in Mexican American older adults during 20 years of follow-up. PM R 2023; 15:331-341. [PMID: 35322569 PMCID: PMC9500111 DOI: 10.1002/pmrj.12805] [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: 09/09/2021] [Revised: 02/18/2022] [Accepted: 03/16/2022] [Indexed: 11/10/2022]
Abstract
INTRODUCTION Pain remains largely undertreated in older adults irrespective of health care setting. Mexican American adults in the United States have a high age-adjusted prevalence of obesity. However, the association of pain and obesity with physical function is understudied in this population. OBJECTIVE To examine the association of co-occurring pain and obesity with physical function over 20 years of follow-up in a cohort of older Mexican Americans who scored ≥7 (moderate to high) in the Short Physical Performance Battery (SPPB) test and were nondisabled at baseline. DESIGN Longitudinal population-based study. SETTING Community-dwelling older adults from Southwestern United States. PARTICIPANTS Mexican American adults age 65 years and older. INTERVENTIONS Not Applicable. MAIN OUTCOME MEASURES Physical function was assessed with the SPPB test (standing balance, timed 8-ft walk, and five repeated timed chair stands). Participants at baseline were divided into four groups: no pain-no obesity (n = 869), obesity only (n = 282), pain only (n = 216), and pain-obesity (n = 159). Generalized Estimating Equation models were used to estimate the odds ratio (OR) and 95% confidence interval (CI) of lower performance in physical function over 20 years as a function of pain-obesity grouping. RESULTS Participants with pain only (OR = 1.61, 95% CI = 1.34-1.95) and with co-occurring pain and obesity (OR = 2.32, 95% CI = 1.83-2.95) had significantly greater odds of physical function impairment over those with no pain-no obesity or obesity only, after controlling for all covariates. CONCLUSION Older Mexican American adults were at high risk for physical function impairment over time if they had pain or co-occurring pain and obesity. Early assessment and proper pain management as well as maintaining a healthy weight may reduce declines in physical function in older Mexican American adults.
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Affiliation(s)
- Wilma E. Afunugo
- School of Medicine. The University of Texas Medical Branch, Galveston, TX, USA
| | - Chih-Ying Li
- Department of Occupational Therapy. The University of Texas Medical Branch, Galveston, TX, USA
| | - Lin-Na Chou
- Department of Preventive Medicine and Population Health. The University of Texas Medical Branch, Galveston, TX, USA
| | - Frank Ward
- Department of Nutrition, Metabolism, and Rehabilitation Sciences. The University of Texas Medical Branch, Galveston, TX, USA
| | - Soham Al Snih
- Department of Nutrition, Metabolism, and Rehabilitation Sciences. The University of Texas Medical Branch, Galveston, TX, USA
- Division of Geriatrics & Palliative Medicine/Department of Internal Medicine. The University of Texas Medical Branch, Galveston, TX, USA
- Sealy Center on Aging. The University of Texas Medical Branch, Galveston, TX, USA
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Choi YJ, Ailshire JA, Kim JK, Crimmins EM. Diet Quality and Biological Risk in a National Sample of Older Americans. J Aging Health 2022; 34:539-549. [PMID: 34779298 PMCID: PMC9098695 DOI: 10.1177/08982643211046818] [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
Objectives: Using comprehensive measures of biological risk, this study aims to investigate the relationship between intake of individual dietary components, overall diet quality, and biological dysregulation. Methods: We analyzed nationally representative data from 3734 older adults who participated in the Health and Retirement Study Venous Blood Study in 2016 and Health Care and Nutrition Survey in 2013. Results: Eleven out of 13 individual dietary components were associated with lower biological risk. Respondents with poor/suboptimal quality diet had higher biological risk than those with good quality diet. Discussion: Findings from this study emphasize the importance of healthy eating in improving health of older adults. Encouraging intake of fruits, greens and beans, whole grains, and fatty acids, while limiting consumption of sodium, added sugar, and saturated fat would improve overall diet quality and contribute to the prevention of chronic diseases and morbidity.
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Affiliation(s)
- Yeon Jin Choi
- University of Southern California, Los Angeles, CA, USA
| | | | - Jung Ki Kim
- University of Southern California, Los Angeles, CA, USA
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Milani SA, Raji MA, Kuo YF, Lopez DS, Markides KS, Al Snih S. Multimorbidity Is Associated With Pain Over 6 Years Among Community-Dwelling Mexican Americans Aged 80 and Older. FRONTIERS IN PAIN RESEARCH 2022; 3:830308. [PMID: 35399155 PMCID: PMC8983931 DOI: 10.3389/fpain.2022.830308] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2021] [Accepted: 02/24/2022] [Indexed: 11/13/2022] Open
Abstract
Introduction Multimorbidity, the co-occurrence of two or more chronic conditions, is common among older adults and is associated with decreased quality of life, greater disability, and increased mortality. Yet, the association of multimorbidity with pain, another significant contributor to decreased quality of life, has not been widely studied. This is especially understudied among very old (aged ≥ 80) Mexican Americans, a fast-growing segment of the United States (US) population. Objective To assess the association of multimorbidity with pain in very old Mexican Americans, over six years of follow-up. Methods We used data from Waves 7 (2010/2011) to 9 (2015/2016) of the Hispanic Established Populations for the Epidemiologic Study of the Elderly, a longitudinal study of older Mexican Americans residing in the Southwestern US. Multimorbidity was defined as reporting two or more chronic health conditions. Pain was defined as (1) pain on weight-bearing, (2) pain in back, hips, knees, ankles/feet, legs, entire body, or two or more locations, and (3) pain that limits daily activities. We use generalized estimation equations to estimate the odds ratio of pain as a function of multimorbidity over 6 years. Results At baseline (n = 841), 77.3% of participants had multimorbidity. Those with multimorbidity had greater odds [2.27, 95% confidence interval (CI): 1.74, 2.95] of reporting pain on weight-bearing over time, compared to those without multimorbidity. Also, those with multimorbidity had 2.12 times the odds of reporting pain that limited their daily activities (95% CI: 1.61, 2.78) compared to those without multimorbidity. Lastly, those with multimorbidity had higher odds of reporting pain in their back, knee, ankles/feet, legs, hips, entire body, or two or more locations, compared to those without multimorbidity. Conclusions Those with multimorbidity consistently had higher odds of all types of pain, highlighting the need for early management of pain among those with multiple chronic conditions and complex health needs. This is especially important among very old Mexican Americans, who have a high burden of chronic health conditions.
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Affiliation(s)
- Sadaf Arefi Milani
- Division of Geriatrics and Palliative Medicine, Department of Internal Medicine, University of Texas Medical Branch, Galveston, TX, United States
- Sealy Center on Aging, University of Texas Medical Branch, Galveston, TX, United States
- Center for Interdisciplinary Research in Women's Health, University of Texas Medical Branch, Galveston, TX, United States
| | - Mukaila A. Raji
- Division of Geriatrics and Palliative Medicine, Department of Internal Medicine, University of Texas Medical Branch, Galveston, TX, United States
- Sealy Center on Aging, University of Texas Medical Branch, Galveston, TX, United States
- Department of Preventive Medicine and Population Health, University of Texas Medical Branch, Galveston, TX, United States
| | - Yong-Fang Kuo
- Division of Geriatrics and Palliative Medicine, Department of Internal Medicine, University of Texas Medical Branch, Galveston, TX, United States
- Sealy Center on Aging, University of Texas Medical Branch, Galveston, TX, United States
- Center for Interdisciplinary Research in Women's Health, University of Texas Medical Branch, Galveston, TX, United States
- Department of Preventive Medicine and Population Health, University of Texas Medical Branch, Galveston, TX, United States
- Office of Biostatistics, University of Texas Medical Branch, Galveston, TX, United States
| | - David S. Lopez
- Department of Preventive Medicine and Population Health, University of Texas Medical Branch, Galveston, TX, United States
| | - Kyriakos S. Markides
- Sealy Center on Aging, University of Texas Medical Branch, Galveston, TX, United States
- Department of Preventive Medicine and Population Health, University of Texas Medical Branch, Galveston, TX, United States
| | - Soham Al Snih
- Division of Geriatrics and Palliative Medicine, Department of Internal Medicine, University of Texas Medical Branch, Galveston, TX, United States
- Sealy Center on Aging, University of Texas Medical Branch, Galveston, TX, United States
- Department of Nutrition, Metabolism, and Rehabilitation Sciences, University of Texas Medical Branch, Galveston, TX, United States
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Noren Hooten N, Pacheco NL, Smith JT, Evans MK. The accelerated aging phenotype: The role of race and social determinants of health on aging. Ageing Res Rev 2022; 73:101536. [PMID: 34883202 PMCID: PMC10862389 DOI: 10.1016/j.arr.2021.101536] [Citation(s) in RCA: 62] [Impact Index Per Article: 31.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2021] [Revised: 11/12/2021] [Accepted: 12/03/2021] [Indexed: 02/06/2023]
Abstract
The pursuit to discover the fundamental biology and mechanisms of aging within the context of the physical and social environment is critical to designing interventions to prevent and treat its complex phenotypes. Aging research is critically linked to understanding health disparities because these inequities shape minority aging, which may proceed on a different trajectory than the overall population. Health disparities are characteristically seen in commonly occurring age-associated diseases such as cardiovascular and cerebrovascular disease as well as diabetes mellitus and cancer. The early appearance and increased severity of age-associated disease among African American and low socioeconomic status (SES) individuals suggests that the factors contributing to the emergence of health disparities may also induce a phenotype of 'premature aging' or 'accelerated aging' or 'weathering'. In marginalized and low SES populations with high rates of early onset age-associated disease the interaction of biologic, psychosocial, socioeconomic and environmental factors may result in a phenotype of accelerated aging biologically similar to premature aging syndromes with increased susceptibility to oxidative stress, premature accumulation of oxidative DNA damage, defects in DNA repair and higher levels of biomarkers of oxidative stress and inflammation. Health disparities, therefore, may be the end product of this complex interaction in populations at high risk. This review will examine the factors that drive both health disparities and the accelerated aging phenotype that ultimately contributes to premature mortality.
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Affiliation(s)
- Nicole Noren Hooten
- Laboratory of Epidemiology and Population Science, National Institute on Aging, National Institutes of Health, 251 Bayview Boulevard, Baltimore, MD 21224, USA
| | - Natasha L Pacheco
- Laboratory of Epidemiology and Population Science, National Institute on Aging, National Institutes of Health, 251 Bayview Boulevard, Baltimore, MD 21224, USA
| | - Jessica T Smith
- Laboratory of Epidemiology and Population Science, National Institute on Aging, National Institutes of Health, 251 Bayview Boulevard, Baltimore, MD 21224, USA
| | - Michele K Evans
- Laboratory of Epidemiology and Population Science, National Institute on Aging, National Institutes of Health, 251 Bayview Boulevard, Baltimore, MD 21224, USA.
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Allencherril RP, Markides KS, Al Snih S. Liver Disease Among Mexican Americans Aged 67 Years and Older. J Prim Care Community Health 2022; 13:21501319221116231. [PMID: 35929017 PMCID: PMC9358553 DOI: 10.1177/21501319221116231] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
Abstract
Background: The Center for Disease Control and Prevention (CDC) reports that liver disease is a significant cause of morbidity and mortality in the US, afflicting 4.5 million people in 2018, or approximately 1.7% of the American adult population. Objective: To determine the prevalence and risk factors associated with liver disease among older Mexican Americans over 18 years of follow-up. Methods: Non-institutionalized Mexican Americans aged ≥67 years (N = 1938) from the Hispanic Established Population for the Epidemiologic Study of the Elderly (1995/96-2012/13) were studied. Measures included socio-demographic variables, self-reported liver disease, language of interview, medical conditions, hand-grip strength, physical and cognitive function, depressive symptoms, and body mass index. Generalized estimating equation models were used to estimate the odds ratio and 95% confidence interval (CI) of liver disease over time. Results: The mean age at baseline was 74.9 ± 6.0 years and 58.4% were female. The prevalence of liver disease ranged from 2.4% to 8.4%. Over time, the odds ratio of reporting liver disease was 1.17 (CI = 1.12-1.22). Older age, Spanish interview, arthritis, diabetes, heart failure, cancer, and high scores on the Mini-Mental-State-Examination were factors associated with greater odds of reporting liver disease over time. Married participants reported lower odds of liver disease over time. Conclusions: The prevalence of liver disease in this population was high, ranging from 2.4% to 8.4%. Diabetes, heart failure, arthritis, and cancer were risk factors for liver disease. Screening for liver function among patients with these morbidities may help prevent liver disease in this population with high rates of diabetes and obesity.
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Affiliation(s)
| | | | - Soham Al Snih
- The University of Texas Medical Branch, Galveston, TX, USA
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12
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Erving CL, Frazier C. The Association between Multiple Chronic Conditions and Depressive Symptoms: Intersectional Distinctions by Race, Nativity, and Gender. JOURNAL OF HEALTH AND SOCIAL BEHAVIOR 2021; 62:599-617. [PMID: 34590498 PMCID: PMC9280855 DOI: 10.1177/00221465211040174] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/14/2023]
Abstract
Using random coefficient growth curve analysis, this study utilizes 12 waves of data from the Health and Retirement Study (1994-2016; person-waves = 145,177) to examine the association between multiple chronic conditions (MCC) and depressive symptoms among older adults. Applying cumulative disadvantage and intersectionality theories, we also test whether the association between MCC and depressive symptoms differs by race, nativity, and gender. Findings reveal that MCC prevalence is highest among U.S.-born black women, whereas depressive symptoms are highest among foreign-born Hispanic women. Compared to men, MCC has a stronger effect on women's depressive symptoms. Furthermore, the MCC-depressive symptoms association is strongest for foreign-born Hispanic women. Despite an increase in MCC in the transition from midlife to late life, all race-nativity-gender groups experience a decline in depressive symptoms as they age. The decline in depressive symptoms is steepest for U.S.-born black and foreign-born Hispanic women. Study implications are discussed.
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Ortiz K, Garcia MA, Briceño E, Diminich ED, Arévalo SP, Vega IE, Tarraf W. Glycosylated hemoglobin level, race/ethnicity, and cognition in midlife and early old age. RESEARCH IN HUMAN DEVELOPMENT 2020; 17:20-40. [PMID: 34093090 PMCID: PMC8174791 DOI: 10.1080/15427609.2020.1743810] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
Empirical evidence linking racial/ethnic differences in glycosylated hemoglobin levels (HbA1c) to cognitive function in midlife and early old age is limited. We use biomarker data from the Health and Retirement Study (HRS, 2006-2014), on adults 50-64 years at baseline (57-73 years by 2014), and fit multinomial logistic regression models to assess the association between baseline HbA1c, cognitive function (using Langa-Weir classifications) and mortality across 8-years. Additionally, we test for modification effects by race/ethnicity. In age- and sex-adjusted models high HbA1c level was associated with lower baseline cognition and higher relative risk ratios (RRR; vs. normal cognition) for cognitive impairment no dementia (CIND; RRR= 2.3; 95%CI=[1.38;3.84]; p<0.01), and dementia (RRR= 4.00; 95%CI=[1.76;9.10]; p<0.01). Adjusting for sociodemographic, behavioral risk factors, and other health conditions explained the higher RRR for CIND and attenuated the RRR for dementia by approximately 30%. HbA1c levels were not linked to the slope of cognitive decline, and we found no evidence of modification effects for HbA1c by race/ethnicity. Targeting interventions for glycemic control in the critical midlife period can protect baseline cognition and buffer against downstream development of cognitive impairment. This can yield important public health benefits and reductions in burdens associated with cognitive impairment, particularly among race/ethnic minorities who are at higher risk for metabolic diseases.
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Affiliation(s)
- Kasim Ortiz
- University of New Mexico, Department of Sociology & Criminology, Institute for the Study of “Race” & Social Justice, Center for Participatory Research
| | - Marc A. Garcia
- University of Nebraska, Lincoln, Department of Sociology & Institute of Ethnic Studies
| | - Emily Briceño
- University of Michigan, School of Medicine, Department of Physical Medicine & Rehabilitation
| | - Erica D. Diminich
- Stony Brook University, Renaissance School of Medicine, Program in Public Health, Department of Family, Population and Preventive Medicine
| | - Sandra P. Arévalo
- California State University, Long Beach, Department of Human Development
| | - Irving E. Vega
- Michigan State University, College of Human Medicine, Department of Translational Neuroscience
| | - Wassim Tarraf
- Wayne State University, Institute of Gerontology & Department of Healthcare Sciences
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Garcia MA, Reyes AM, García C, Chiu CT, Macias G. Nativity and Country of Origin Variations in Life Expectancy With Functional Limitations Among Older Hispanics in the United States. Res Aging 2020; 42:199-207. [PMID: 32238009 DOI: 10.1177/0164027520914512] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
This study examined racial/ethnic, nativity, and country of origin differences in life expectancy with and without functional limitations among older adults in the United States. We used data from the National Health Interview Survey (1999-2015) to estimate Sullivan-based life tables of life expectancies with functional limitations and without functional limitations by sex for U.S.-born Mexicans, foreign-born Mexicans, U.S.-born Puerto Ricans, island-born Puerto Ricans, foreign-born Cubans, and U.S.-born Whites. We find that Latinos exhibit heterogeneous life expectancies with functional limitations. Among females, U.S.-born Mexicans, foreign-born Mexicans, and foreign-born Cubans spend significantly fewer years without functional limitations, whereas island-born Puerto Ricans spend more years with functional limitations. For men, U.S.-born Puerto Ricans were the only Latino subgroup disadvantaged in the number of years lived with functional limitations. Conversely, foreign-born Cubans spend significantly fewer years without functional limitations. To address disparities in functional limitations, we must consider variation in health among Latino subgroups.
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Affiliation(s)
- Marc A Garcia
- Department of Sociology and Institute for Ethnic Studies, University of Nebraska-Lincoln, NE, USA
| | - Adriana M Reyes
- Department of Policy Analysis and Management, Cornell University, Ithaca, NY, USA
| | - Catherine García
- Leonard Davis School of Gerontology, University of Southern California, Los Angeles, CA, USA
| | - Chi-Tsun Chiu
- Institute of European and American Studies, Academia Sinica, Taipei
| | - Grecia Macias
- School of Information, University of Michigan-Ann Arbor, MI, USA
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