Neighborhood Social Cohesion and Walking Limitations in Ethnically Diverse Older Latinos in the United States

Race and ethnic differences in physical activity, osteopenia, and osteoporosis: results from NHANES 2009-2010, 2013-2014, 2017-2018

This study aimed to determine current physical activity trends association with bone density in a racial and ethnically diverse sample of older adults. We found that those engaged in no and some physical activity had lower femoral BMD when compared to those that met the physical activity recommendation.

PURPOSE

Most older adults do not engage in the recommended levels of physical activity to improve health, and there are racial and ethnic differences in physical activity participation. This study aims to evaluate whether meeting the physical activity recommendation is related to osteopenia and osteoporosis in a racially and ethnically diverse sample of older adults.

METHODS

Femoral neck bone mineral density (BMD) data from the National Health and Nutrition Examination Survey (NHANES 2009-2010, 2013-2014, 2017-2018) was obtained from 5252adults 60-80 years old. Self-reported physical activity was categorized into met recommendation, some physical activity, and no physical activity. We used linear regression models to examine the association between physical activity and BMD for each race and ethnic group adjusting for sociodemographics and other selected variables.

RESULTS

Non-Latino Blacks (NLB) and Latinos reported the lowest prevalence of meeting the physical activity recommendation, compared with Non-Latino Whites (NLW) (40.0%, 44.0%, and 51.4%, respectively; p < 0.0001). Further, NLB and Latinos had a lower prevalence of osteoporosis when compared to NLW (5.4%, 7.3%, and 9.1% respectively; p < 0.0001). There was a 0.03 g/cm2 difference in BMD between those who met the physical activity recommendation when compared to the no physical activity group; however, this decreased after adjusting for selected covariates.

CONCLUSION

Considering the prevalence and burden of osteopenia and osteoporosis, and projected increases in the racial and ethnic diversity of the older population, more research is needed to further understand the association between meeting the physical activity recommendation and bone health among racial and ethnic diverse older adults.

A Scoping Review of Personal, Financial, and Environmental Determinants of Mobility Among Older Adults

OBJECTIVE

To synthesize available evidence of factors comprising the personal, financial, and environmental mobility determinants and their association with older adults' self-reported and performance-based mobility outcomes.

DATA SOURCES

PubMed, EMBASE, PsychINFO, Web of Science, AgeLine, Sociological Abstract, Allied and Complementary Medicine Database, and Cumulative Index to Nursing and Allied Health Literature databases search for articles published from January 2000 to December 2021.

STUDY SECTION

Using predefined inclusion and exclusion criteria, multiple reviewers independently screened 27,293 retrieved citations from databases, of which 422 articles underwent full-text screening, and 300 articles were extracted.

DATA EXTRACTION

The 300 articles' information, including study design, sample characteristics including sample size, mean age and sex, factors within each determinant, and their associations with mobility outcomes, were extracted.

DATA SYNTHESIS

Because of the heterogeneity of the reported associations, we followed Barnett et al's study protocol and reported associations between factors and mobility outcomes by analyses rather than by article to account for multiple associations generated in 1 article. Qualitative data were synthesized using content analysis. A total of 300 articles were included with 269 quantitative, 22 qualitative, and 9 mixed-method articles representing personal (n=80), and financial (n=1), environmental (n=98), more than 1 factor (n=121). The 278 quantitative and mixed-method articles reported 1270 analyses; 596 (46.9%) were positively and 220 (17.3%) were negatively associated with mobility outcomes among older adults. Personal (65.2%), financial (64.6%), and environmental factors (62.9%) were associated with mobility outcomes, mainly in the expected direction with few exceptions in environmental factors.

CONCLUSIONS

Gaps exist in understanding the effect of some environmental factors (eg, number and type of street connections) and the role of gender on older adults' walking outcomes. We have provided a comprehensive list of factors with each determinant, allowing the creation of core outcome set for a specific context, population, or other forms of mobility, for example, driving.

Protective Role of Social Networks for the Well-Being of Persons with Disabilities: Results from a State-Wide Cross-Sectional Survey in Kerala, India

The current study presents the findings from a cross-sectional survey on social factors associated with the well-being of persons with disabilities (PWDs) in Kerala, India. We conducted a community-based survey across three geographical zones, North, Central, and South of Kerala state, between April and September 2021. We randomly selected two districts from each zone using a stratified sample method, followed by one local self-government from each of these six districts. Community health professionals identified individuals with disabilities, and researchers collected information on their social networks, service accessibility, well-being, and mental health. Overall, 244 (54.2%) participants had a physical disability, while 107 (23.78%) had an intellectual disability. The mean well-being score was 12.9 (S.D = 4.9, range = 5-20). Overall, 216 (48%) had poor social networks, 247 (55%) had issues regarding service accessibility, and 147 (33%) had depressive symptoms. Among the PWDs with issues with service access, 55% had limited social networks. A regression analysis revealed that social networks (b = 2.30, p = 0.000) and service accessibility (b = -2.09, p = 0.000) were associated with well-being. Social networks are more important than financial assistance because they facilitate better access to psycho-socioeconomic resources, a prerequisite for well-being.

Food Insecurity and Type 2 Diabetes Among Latinos: Examining Neighborhood Cohesion as a Protective Factor

Qualitative work has found that Latino food pantry recipients share food and reciprocally provide social support to their food-insecure neighbors. These findings suggest that neighborhood cohesion (NC) may serve as an important community-level resource that Latinos utilize as a coping mechanism when food-insecure. High levels of NC may be a proxy for instrumental support outside the household and act as a buffer against the adverse health effects of food insecurity including type 2 diabetes (T2D), which is highly sensitive to food insecurity. The purpose of this study was to quantitatively test this theory by examining whether NC moderated the association between T2D and food security (FS) status among Latino adults nationwide. We used data from the 2013-2018 National Health Interview Survey (n = 23,478). We found that FS status was associated with T2D prevalence, with Latino adults having a higher odds of T2D if they had low FS or very low FS compared to their FS counterparts. We also found Latinos adults who reported high NC had a lower odds of T2D compared to those who reported low NC. However, we did not find there was significant interaction between FS status and NC on T2D. NC may instead be a precursor to FS status, rather than a buffer of food insecurity on T2D. Low NC may lead to less instrumental support and tangible benefits that determine FS. Additionally, perceived NC might not align with objective NC and T2D may be too distal of a health outcome to test the protective effect of NC.

Cognitive, psychological and social factors associated with older adults' mobility: a scoping review of self-report and performance-based measures

Although many factors have been associated with mobility among older adults, there is paucity of research that explores the complexity of factors that influence mobility. This review aims to synthesise the available evidence for factors comprising the cognitive, psychological, and social mobility determinants and their associations with mobility self-reported and performance-based outcomes in older adults (60 years). We followed Arksey and O'Malley's five stages of a scoping review and searched PubMed, EMBASE, PsychINFO, Web of Science, AgeLine, Allied and Complementary Medicine Database, Cumulative Index to Nursing and Allied Health Literature and Sociological Abstract databases. Reviewers in pairs independently conducted title, abstract, full-text screening and data extraction. We reported associations by analyses rather than articles because articles reported multiple associations for factors and several mobility outcomes. Associations were categorised as significantly positive, negative, or not significant. We included 183 peer-reviewed articles published in 27 countries, most of which were cross-sectional studies and conducted among community-dwelling older adults. The 183 articles reported 630 analyses, of which 381 (60.5%) were significantly associated with mobility outcomes in the expected direction. For example, older adults with higher cognitive functioning such as better executive functioning had better mobility outcomes (e.g., faster gait speed), and those with poor psychological outcomes, such as depressive symptoms, or social outcomes such as reduced social network, had poorer mobility outcomes (e.g., slower gait speed) compared to their counterparts. Studies exploring the association between cognitive factors, personality (a psychological factor) and self-reported mobility outcomes (e.g., walking for transportation or driving), and social factors and performance-based mobility outcomes in older adults are limited. Understanding the additive relationships between cognitive, psychological, and social factors highlights the complexity of older adults' mobility across different forms of mobility, including independence, use of assistive devices, transportation, and driving.

Mixed methods evaluation on village neighborhood social cohesiveness and quality of life

Purpose

The “Village” model has become an emerging, community-based, social initiative to help older adults age in place. This study aims to examine neighborhood social cohesion (NSC), or social connectedness and quality of life, from the perspective of village members.

Design/methodology/approach

A mixed-method evaluation was used to examine two Florida villages, a master-planned village (FV1) and a diverse neighborhood village (FV2). Both are full members of the National Village to Village Network.

Findings

The quantitative and qualitative data provided complementary and deeper understanding. Quantitative findings showed that FV1 members scored higher at NSC, and qualitative findings further confirmed that village program social activities were critical to building connections, especially for those who have lost loved ones and were single.

Research limitations/implications

Findings should be interpreted considering the predominantly white racial makeup and affluence of village participants.

Practical implications

Findings point to the importance of NSC as older adults age and suggest that programs should prioritize activities that strengthen social connectiveness.

Originality/value

This is one of the first mixed-methods evaluations examining NSC and quality of life among village participants.

Diabetes prevalence among diverse Hispanic populations: considering nativity, ethnic discrimination, acculturation, and BMI

PURPOSE

To compare prevalence of self-reported diabetes between U.S. state-born, Puerto Rico-born, Mexico-born, Cuba-born, and South/Central America-born Hispanic groups, and examine whether risk for diabetes differs by country of origin and experiences with discrimination when accounting for BMI.

METHODS

Data from 6223 Hispanic respondents from the nationally representative NESARC-III study was used. Sociodemographic characteristics were compared across nativity groups, and adjusted odds of self-reported diabetes diagnosis (past year) tested. Differences by perceived discrimination (using endorsement of individual items assessing specific experiences) and by nativity were examined when accounting for sociodemographic characteristics, acculturation, and BMI.

RESULTS

Prevalence of self-reported diabetes diagnosis was significantly higher among the Puerto Rico-born Hispanics, and remained significantly elevated when adjusting for perceived discrimination, acculturation, and health risk behaviors. When adjusting further for BMI, there were no significant differences in the odds of diabetes by nativity. Prevalence of lifetime perceived discrimination was significantly lower among Cuba-born Hispanics. Mean BMI was significantly lower in South/Central America-born Hispanic individuals relative to U.S. state-, Mexico-, and Puerto Rico-born Hispanic groups. Higher BMI was associated with significantly greater risk of diabetes diagnosis across groups.

CONCLUSION

Marked heterogeneity exists in prevalence and in factors associated with diabetes risk and weight status across Hispanic groups in the U.S. Experiences with discrimination may play an important role in accounting for these differences. This should be considered when planning future research to inform the most optimal patient-centered prevention efforts.

LEVEL OF EVIDENCE

Level III, Evidence obtained from well-designed cohort analytic study.

Neighborhood Social Cohesion and Mobility Limitations Among Community-dwelling Older Americans: The Mediating Roles of Depressive Symptoms and Mastery

Neighborhood environment plays an important role in late-life health; yet, the social aspect of neighborhood environment and its impact on mobility limitations have rarely been examined. This nonexperimental, cross-sectional study examines the relationship between neighborhood social cohesion and mobility limitations and the potential mediators (i.e., depressive symptoms, mastery) of this relationship. A total of 8,317 Americans aged 65 years and older were selected from the Health and Retirement Study. Using ordinary least squares regressions, this study shows that neighborhood social cohesion was negatively associated with mobility limitations (B  =  -0.04, p < .01). A Sobel test of mediation indicated that this relationship was significantly mediated by depressive symptoms (z  =  -9.10, p < .001) and mastery (z  =  -8.86, p < .001). Findings suggest that neighborhood cohesion can reduce mobility limitations through mitigating depressive symptoms and increasing mastery. Future research should disentangle the temporal ordering of the mediators.

Remain Independence and Neighborhood Social Cohesiveness Among Older Adults Participating in Three Community-Based Programs Promoting Aging-in-Community in the USA

Objectives: Aging-in-community has been a preferred way to aging. This study examines and compares remain independence (RI) and neighborhood social cohesiveness (NSC) among three programs promoting aging-in-community (AIC). Methods: Older adults from three AIC programs were surveyed: a village program, a county neighborhood lunch program, and a university-based lifelong learning program. Previously validated RI (3-item) and NSC (4-items) measures were used. Results: Mean age was 72.4 (SD = 8.68) years (n = 289). Both the RI and NSC scales showed satisfactory reliabilities, with Cronbach's alphas of .81 and .88, respectively. Analyses showed significant inter-group differences on both RI and NSC. After controlling for demographics, regressions showed inter-group differences remained for RI, while disappeared for NSC. Education level had an inverse relationship with RI, whereas married status had a positive relationship with NSC scores. Discussion: Findings call attentions to RI among higher education and NSC among single older adults for community-based services and programs promoting aging-in-community.