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Lange-Maia BS, Kim AY, Willingham JL, Marinello S, Crane MM, Dugan SA, Lynch EB. "You Just Have to Keep It Movin':" Perceptions of Physical Function Limitations in an African American Health Ministry. J Racial Ethn Health Disparities 2024; 11:1434-1443. [PMID: 37133727 DOI: 10.1007/s40615-023-01620-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/13/2023] [Revised: 04/25/2023] [Accepted: 04/25/2023] [Indexed: 05/04/2023]
Abstract
Physical function (PF) limitations are common in aging. However, there is a dearth of interventions focused on addressing PF limitations in community-based settings, particularly in minoritized communities. To guide intervention development, we conducted focus groups to understand perceptions of PF limitations, gauge intervention interest, and identify potential intervention strategies as part of a large health partnership of African American churches in Chicago, IL. Participants were age 40+ years with self-reported PF limitations. Focus groups (N=6 focus groups; N=40 participants) were audio recorded, transcribed, and analyzed using thematic analysis methods.Six themes were identified: (1) causes of PF limitations, (2) impact of PF limitations, (3) terminology and communication, (4) adaptations and treatments, (5) faith and resilience, and (6) prior program experiences. Participants described how PF limitations affected their ability to live a full life and play an active role in their family, church, and community. Faith and prayer aided in coping with limitations and pain. Participants expressed that it is important to keep moving, both from an emotional (not giving up) and physical (to prevent further exacerbation of limitations) standpoint. Some participants shared adaptation and modification strategies, but there were overall frustrations with communicating regarding PF limitations and obtaining medical care for them. Participants expressed that they would like to have programs in their church focused on improving PF (including physical activity), particularly as their communities often lacked resources conducive to being active. Community-based programs focusing on reducing PF limitations are needed, and the church is a potentially receptive setting.
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Affiliation(s)
- Brittney S Lange-Maia
- Department of Family and Preventive Medicine, Rush University Medical Center, Chicago, IL, USA.
- Rush Alzheimer's Disease Center, Rush University Medical Center, Chicago, IL, USA.
| | - Amy Y Kim
- Rush Medical College, Rush University Medical Center, Chicago, IL, USA
| | - Joselyn L Willingham
- Department of Family and Preventive Medicine, Rush University Medical Center, Chicago, IL, USA
| | - Samantha Marinello
- Division of Health Policy and Administration, School of Public Health, University of Illinois Chicago, Chicago, IL, USA
| | - Melissa M Crane
- Department of Family and Preventive Medicine, Rush University Medical Center, Chicago, IL, USA
| | - Sheila A Dugan
- Department of Physical Medicine and Rehabilitation, Rush University Medical Center, Chicago, IL, USA
| | - Elizabeth B Lynch
- Department of Family and Preventive Medicine, Rush University Medical Center, Chicago, IL, USA
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Appelhans BM, Lange-Maia BS, Yeh C, Jackson EA, Schiff MD, Barinas-Mitchell E, Derby CA, Karvonen-Gutierrez CA, Janssen I. Neighborhood physical environments and change in cardiometabolic risk factors over 14 years in the study of Women's health across the nation. Health Place 2024; 87:103257. [PMID: 38696876 DOI: 10.1016/j.healthplace.2024.103257] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/19/2023] [Revised: 04/23/2024] [Accepted: 04/24/2024] [Indexed: 05/04/2024]
Abstract
BACKGROUND Neighborhood physical environments may influence cardiometabolic health, but prior studies have been inconsistent, and few included long follow-up periods. METHODS Changes in cardiometabolic risk factors were measured for up to 14 years in 2830 midlife women in the Study of Women's Health Across the Nation, a multi-ethnic/racial cohort of women from seven U.S. sites. Data on neighborhood food retail environments (modified Retail Food Environment Index) and walkability (National Walkability Index) were obtained for each woman's residence at each follow-up. Data on neighborhood access to green space, parks, and supermarkets were available for subsets (32-42%) of women. Models tested whether rates of change in cardiometabolic outcomes differed based on neighborhood characteristics, independent of sociodemographic and health-related covariates. RESULTS Living in more (vs. less) walkable neighborhoods was associated with favorable changes in blood pressure outcomes (SBP: -0.27 mmHg/year, p = 0.002; DBP: -0.22 mmHg/year, p < 0.0001; hypertension status: ratio of ORs = 0.79, p < 0.0001), and small declines in waist circumference (-0.09 cm/year, p = 0.03). Small-magnitude associations were also observed between low park access and greater increases in blood pressure outcomes (SBP: 0.37 mmHg/year, p = 0.003; DBP: 0.15 mmHg/year, p = 0.04; hypertension status: ratio of ORs = 1.16, p = .04), though associations involving DBP and hypertension were only present after adjustment for sociodemographic variables. Other associations were statistically unreliable or contrary to hypotheses. CONCLUSION Neighborhood walkability may have a meaningful influence on trajectories of blood pressure outcomes in women from midlife to early older adulthood, suggesting the need to better understand how individuals interact with their neighborhood environments in pursuit of cardiometabolic health.
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Affiliation(s)
- Bradley M Appelhans
- Department of Family and Preventive Medicine, Rush University Medical Center, Chicago, IL, USA; Department of Psychiatry and Behavioral Sciences, Rush University Medical Center, Chicago, IL, USA.
| | - Brittney S Lange-Maia
- Department of Family and Preventive Medicine, Rush University Medical Center, Chicago, IL, USA; Rush Alzheimer's Disease Center, Rush University Medical Center, Chicago, IL, USA
| | - Chen Yeh
- Department of Family and Preventive Medicine, Rush University Medical Center, Chicago, IL, USA
| | - Elizabeth A Jackson
- Department of Medicine, The University of Alabama at Birmingham, Birmingham, AL, USA
| | - Mary D Schiff
- UPMC Children's Hospital of Pittsburgh, Pittsburgh, PA, USA
| | - Emma Barinas-Mitchell
- Department of Epidemiology, School of Public Health, University of Pittsburgh, Pittsburgh, PA, USA
| | - Carol A Derby
- Saul R. Korey Department of Neurology, and Department of Epidemiology & Population Health, Albert Einstein College of Medicine, Bronx, NY, USA
| | | | - Imke Janssen
- Department of Family and Preventive Medicine, Rush University Medical Center, Chicago, IL, USA
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Lange-Maia BS, Wagner M, Rogers CA, Mehta RI, Bennett DA, Tangney C, Schoeny ME, Halloway S, Arvanitakis Z. Profiles of Lifestyle Health Behaviors and Postmortem Dementia-Related Neuropathology. J Gerontol A Biol Sci Med Sci 2024; 79:glae100. [PMID: 38597160 PMCID: PMC11059256 DOI: 10.1093/gerona/glae100] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2023] [Indexed: 04/11/2024] Open
Abstract
High engagement in lifestyle health behaviors appears to be protective against cognitive decline in aging. We investigated the association between patterns of modifiable lifestyle health behaviors and common brain neuropathologies of dementia as a possible mechanism. We examined 555 decedents from the Rush Memory and Aging Project, free of dementia at their initial concurrent report of lifestyle health behaviors of interest (physical, social, and cognitive activities, and healthy diet), and who underwent a postmortem neuropathology evaluation. First, we used latent profile analysis to group participants based on baseline behavior patterns. Second, we assessed the associations of profile membership with each neurodegenerative (global Alzheimer's disease [AD] pathology, amyloid-beta load, density of neurofibrillary tangles, and presence of cortical Lewy bodies and TAR DNA-binding protein 43 cytoplasmic inclusions) and neurovascular pathologies (presence of chronic gross or microscopic infarcts, arteriolosclerosis, atherosclerosis, and cerebral amyloid angiopathy), using separate linear or logistic regression models, adjusted for age at death, sex (core model), vascular disease risk factors, and vascular conditions (fully adjusted model). Participants had either consistently lower (N = 224) or consistently higher (N = 331) engagement across 4 lifestyle health behaviors. We generally found no differences in neuropathologies between higher and lower engagement groups in core or fully adjusted models; for example, higher engagement in lifestyle health behaviors was not associated with global AD pathology after core or full adjustment (both p > .8). In conclusion, we found no evidence of associations between patterns of lifestyle health behaviors and neuropathology. Other mechanisms may underlie protective effects of health behaviors against dementia.
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Affiliation(s)
- Brittney S Lange-Maia
- Rush Alzheimer’s Disease Center, Rush University Medical Center, Chicago, Illinois, USA
| | - Maude Wagner
- Rush Alzheimer’s Disease Center, Rush University Medical Center, Chicago, Illinois, USA
| | - Christina A Rogers
- Rush Medical College, Rush University Medical Center, Chicago, Illinois, USA
| | - Rupal I Mehta
- Rush Alzheimer’s Disease Center, Rush University Medical Center, Chicago, Illinois, USA
| | - David A Bennett
- Rush Alzheimer’s Disease Center, Rush University Medical Center, Chicago, Illinois, USA
| | - Christy Tangney
- Department of Clinical Nutrition, Rush College of Health Sciences, Chicago, Illinois, USA
| | - Michael E Schoeny
- Department of Community, Systems, and Mental Health Nursing, Rush University College of Nursing, Chicago, Illinois, USA
| | - Shannon Halloway
- Department of Biobehavioral Nursing Science, College of Nursing, University of Illinois Chicago, Chicago, Illinois, USA
| | - Zoe Arvanitakis
- Rush Alzheimer’s Disease Center, Rush University Medical Center, Chicago, Illinois, USA
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Lange-Maia BS, James BD, Capuano AW, Grodstein F, Chen Y, Barnes LL. Everyday Discrimination Is Associated With Higher Odds of Hospitalizations Among Older African Americans. J Gerontol A Biol Sci Med Sci 2024; 79:glae089. [PMID: 38549555 PMCID: PMC11046980 DOI: 10.1093/gerona/glae089] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/28/2023] [Indexed: 04/04/2024] Open
Abstract
BACKGROUND Everyday discrimination-experiences of being treated unfairly based on background characteristics like race-is linked to poor physical and mental health throughout the lifespan. Whether more experiences of discrimination are associated with higher odds of being hospitalized in older African Americans has not been explored. METHODS Community-dwelling participants from 3 longitudinal cohort studies (N = 446, age 65+ years) with discrimination scores and ≥12 months of linked Medicare claims were included. Hospitalizations were identified using Medicare fee-for-service claims, available for an average of 6.2 (SD: 3.7) years of follow-up after baseline. RESULTS In mixed-effects ordinal logistic regression models (outcomes of 0, 1, or 2+ hospitalizations per year) adjusted for age, sex, education, and income, higher discrimination was associated with higher odds of total annual hospitalizations (odds ratio [OR] per point higher = 1.09, 95% confidence intervals [95% CI]: 1.02-1.17). Results were similar when accounting for depressive symptoms. CONCLUSIONS Higher exposure to everyday discrimination is associated with higher odds of hospitalization among older African Americans. Mechanisms underlying associations should be explored further to understand how hospitalizations may be reduced in older African Americans.
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Affiliation(s)
- Brittney S Lange-Maia
- Department of Family and Preventive Medicine, Rush Medical College, Chicago, Illinois, USA
- Rush Alzheimer’s Disease Center, Rush University Medical Center, Chicago, Illinois, USA
| | - Bryan D James
- Rush Alzheimer’s Disease Center, Rush University Medical Center, Chicago, Illinois, USA
- Department of Internal Medicine, Rush Medical College, Chicago, Illinois, USA
| | - Ana W Capuano
- Rush Alzheimer’s Disease Center, Rush University Medical Center, Chicago, Illinois, USA
- Department of Neurological Sciences, Rush Medical College, Chicago, Illinois, USA
| | - Francine Grodstein
- Rush Alzheimer’s Disease Center, Rush University Medical Center, Chicago, Illinois, USA
- Department of Internal Medicine, Rush Medical College, Chicago, Illinois, USA
| | - Yi Chen
- Rush Alzheimer’s Disease Center, Rush University Medical Center, Chicago, Illinois, USA
| | - Lisa L Barnes
- Rush Alzheimer’s Disease Center, Rush University Medical Center, Chicago, Illinois, USA
- Department of Neurological Sciences, Rush Medical College, Chicago, Illinois, USA
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Bishop-Royse J, Saiyed NS, Schober DJ, Laflamme E, Lange-Maia BS, Ferrera M, Benjamins MR. Cause-Specific Mortality and Racial Differentials in Life Expectancy, Chicago 2018-2019. J Racial Ethn Health Disparities 2024; 11:846-852. [PMID: 36973497 PMCID: PMC10042425 DOI: 10.1007/s40615-023-01566-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/24/2022] [Revised: 03/02/2023] [Accepted: 03/08/2023] [Indexed: 03/29/2023]
Abstract
BACKGROUND In Chicago in 2018, the average life expectancy (ALE) for NH Blacks was 71.5 years, 9.1 fewer years than for NH Whites (80.6 years). Inasmuch as some causes of death are increasingly recognized products of structural racism, in urban areas, such causes may have potential for reducing racial inequities through public health intervention. Our purpose is to allocate racial inequities in ALE in Chicago to differentials in cause-specific mortality. METHODS Using multiple decrement processes and decomposition analysis, we examine cause-specific mortality in Chicago to determine the causes of death that contribute to the gap in life expectancy between NH Blacks and NH Whites. RESULTS Among females, the racial difference in ALE was 8.21 years; for males, it was 10.53 years. We find that cancer and heart disease mortality account for 3.03 years or 36% of the racial gap in average life expectancy among females. Differences in homicide and heart disease mortality rates comprised over 45% of the disparity among males. CONCLUSIONS Strategies for improving inequities in life expectancy should account for differences between males and females in cause-specific mortality rates. In urban areas with high levels of segregation, reducing inequities in ALE may be possible by dramatically reducing mortality rates from some causes. CONTRIBUTION This paper illustrates the state of inequities in ALE between NH Blacks and NH Whites in Chicago for the period just prior to the onset of the COVID-19 pandemic, using a well-established method of decomposing mortality differentials for sub-populations.
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Affiliation(s)
| | | | - Daniel J. Schober
- Master of Public Health Program, Center for Community Health Equity, DePaul University, Chicago, IL USA
| | - Emily Laflamme
- American Medical Association, Center for Health Equity, Center Community Health Equity, Chicago, IL USA
| | - Brittney S. Lange-Maia
- Department of Family and Preventive Medicine, Center for Community Health Equity, Rush Alzheimer’s Disease Center, Rush University, Chicago, IL USA
| | - Maria Ferrera
- Department of Social Work, Center for Community Health Equity, DePaul University, Chicago, IL USA
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Zammit AR, Yu L, Buchman AS, Lange-Maia BS, Bennett DA, Grodstein F. A prospective study of the association of cognitive and motor function with odds of life space constriction in older adults. J Am Geriatr Soc 2024; 72:390-398. [PMID: 37905593 PMCID: PMC10926217 DOI: 10.1111/jgs.18640] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2023] [Revised: 09/22/2023] [Accepted: 10/01/2023] [Indexed: 11/02/2023]
Abstract
BACKGROUND Many studies indicate that smaller life space is related to worse cognitive and motor function. It is plausible that cognitive and motor function also predict life space constriction, thus long-term, prospective studies are needed of cognitive and motor function as predictors of life space. METHODS A total of 1246 participants of the Rush Memory and Aging Project, who reported initial maximal life space and at least one follow-up assessment were included in this prospective study, with up to 19 years follow-up. The outcome of interest was the Modified version of the Life Space Questionnaire; which we categorized into large (beyond community), medium (neighborhood/community), and small (home/yard) life space. Participants also had detailed composite measures of global cognition and motor function as predictors and available at the first life space assessment. Life space transitions over one-year periods were modeled using multistate Markov modeling, including confounders and both predictors simultaneously. RESULTS Better cognitive and motor function were broadly associated with lower odds of life space constriction (Cognitive: Large ➔ medium: OR = 0.91, 95% CI 0.83-1.00; Large ➔ small: OR = 0.85, 95% CI 0.74-0.97; Medium ➔ small: OR = 1.01, 95% CI 0.82-1.22. Motor: large ➔ medium: OR = 0.76, 95% CI 0.69-0.83; large ➔ small: OR = 0.58, 95% CI 0.51-0.67; medium ➔ small: OR = 0.71, 95% CI = 0.57-0.87). CONCLUSIONS Combined with previous literature that life space predicts function, these results support the notion of complex inter-relations of cognitive function, motor function, and life space.
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Affiliation(s)
- Andrea R Zammit
- Rush Alzheimer's Disease Center, Rush University Medical Center, Chicago, Illinois, USA
- Department of Psychiatry and Behavioral Sciences, Rush University Medical Center, Chicago, Illinois, USA
| | - Lei Yu
- Rush Alzheimer's Disease Center, Rush University Medical Center, Chicago, Illinois, USA
- Department of Neurological Sciences, Rush University Medical Center, Chicago, Illinois, USA
| | - Aron S Buchman
- Rush Alzheimer's Disease Center, Rush University Medical Center, Chicago, Illinois, USA
- Department of Neurological Sciences, Rush University Medical Center, Chicago, Illinois, USA
| | - Brittney S Lange-Maia
- Rush Alzheimer's Disease Center, Rush University Medical Center, Chicago, Illinois, USA
- Department of Family and Preventive Medicine, Rush University Medical Center, Chicago, Illinois, USA
| | - David A Bennett
- Rush Alzheimer's Disease Center, Rush University Medical Center, Chicago, Illinois, USA
- Department of Neurological Sciences, Rush University Medical Center, Chicago, Illinois, USA
| | - Francine Grodstein
- Rush Alzheimer's Disease Center, Rush University Medical Center, Chicago, Illinois, USA
- Department of Internal Medicine, Rush University Medical Center, Chicago, Illinois, USA
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Isgor Z, Johnson T, Cmunt K, Lange-Maia BS. Illinois Transplant Fund Experience: Is It a Pathway to Increased Transplant Access for Hispanic Patients With Kidney Failure? Kidney Med 2024; 6:100742. [PMID: 38162539 PMCID: PMC10757032 DOI: 10.1016/j.xkme.2023.100742] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/03/2024] Open
Abstract
Rationale & Objective The Illinois Transplant Fund, established in 2015, provides private health insurance premium support for noncitizen patients with kidney failure in Illinois and thus allows them to qualify for kidney transplants. Our objective was to describe trends in kidney transplant volumes over time to inform the development of a hypothesis regarding the impact of the Illinois Transplant Fund on kidney transplant volumes for adult Hispanic patients with kidney failure in Illinois, especially noncitizen patients. Study Design Retrospective study. Setting & Population We used data on the annual number of kidney transplants and kidney failure prevalence aggregated to the national and state levels from the Organ Procurement and Transplantation Network and United States Renal Data System, respectively. Outcomes The annual number of transplants as a percentage of prevalent kidney failure cases among adults over time from 2010 to 2020 by race/ethnicity for all payer and private insurance-paid transplants and the annual number of transplants by citizenship status (for Hispanic patients only) were examined for the United States (US), Illinois, and 6 selected US states. Analytical Approach Descriptive study. Results From pre- to post-Illinois Transplant Fund, the average annual number of transplants as a percentage of the average annual prevalent kidney failure cases for Hispanic adults increased by 4% in Illinois while the same figure increased by 33% for privately insured transplants. Limitations The observations reported in this paper cannot be interpreted as evidence for the program's impact. Conclusions Observed trends suggest plausibility of developing a hypothesis that Illinois Transplant Fund's introduction may have contributed to improvement in kidney transplantation access for Hispanic patients in Illinois, especially noncitizens, but cannot constitute evidence in support of or against this hypothesis. Future research should test whether the Illinois Transplant Fund improved access to kidney transplants for noncitizens with kidney failure. Plain-Language Summary Health policies regarding kidney transplant access for undocumented residents vary widely by state. The Illinois Transplant Fund (ITF) provides financial support for health insurance premiums, so undocumented patients with kidney failure in Illinois can qualify for a kidney transplant. In this study, we reported kidney transplant trends in Illinois before and after the creation of the ITF along with kidney transplant trends in the US overall and selected states that share similarities to Illinois.
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Affiliation(s)
- Zeynep Isgor
- Department of Health Systems Management, College of Health Sciences, Rush University, Chicago, IL, USA
| | - Tricia Johnson
- Department of Health Systems Management, College of Health Sciences, Rush University, Chicago, IL, USA
| | - Kevin Cmunt
- Gift of Hope Organ and Tissue Donor Network and Illinois Transplant Fund, Itasca, IL, USA
| | - Brittney S. Lange-Maia
- Department of Family & Preventive Medicine and Rush Alzheimer’s Disease Center, Rush University, Chicago, IL, USA
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Lange-Maia BS, El Khoudary SR, Crandall CJ, Zhang Y, Karvonen-Gutierrez CA, Gabriel KP, Appelhans BM, Strotmeyer ES, Ylitalo KR, Karavolos K, Kravitz HM, Dugan SA, Janssen I. Pre- and Early Peri-menopausal Physical Function and Risk of Cardiovascular Events: The Study of Women's Health Across the Nation. J Aging Health 2023; 35:383-391. [PMID: 36250945 PMCID: PMC10106523 DOI: 10.1177/08982643221133580] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/28/2023]
Abstract
OBJECTIVES To determine whether physical function (PF) before menopause is related to cardiovascular disease (CVD) risk. METHODS Participants were N = 2950 pre-/early peri-menopausal women (median age 46, (25th-75th percentile: 43-48 years). Physical function was assessed at baseline using the Physical Function subscale of the SF-36 and scores were trichotomized (no, some, or substantial limitations). Clinical CVD events were ascertained at annual/biennial clinical assessments through the 15th follow-up visit. Risk of CVD was determined with Cox proportional hazards models. Results: Women were followed for a median of 19.1 years, during which 220 women had a CVD event. In fully adjusted models, women with substantial limitations at baseline had higher CVD risk compared to women with no limitations (hazards ratio [HR] = 1.55, 95% confidence interval [CI]: 1.12-2.33). Discussion: Substantial PF limitations in pre- and early peri-menopausal women are associated with higher risk of clinical CVD events, consistent with literature in older adults.
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Affiliation(s)
- Brittney S. Lange-Maia
- Rush Alzheimer’s Disease Center Rush University Medical Center
- Department of Family and Preventive Medicine, Rush University Medical Center
| | | | - Carolyn J. Crandall
- Department of Medicine, David Geffen School of Medicine at University of California Los Angeles
| | - Yanyu Zhang
- Rush Bioinformatics and Biostatics Core, Rush University Medical Center
| | | | | | | | | | | | - Kelly Karavolos
- Department of Family and Preventive Medicine, Rush University Medical Center
| | - Howard M. Kravitz
- Department of Family and Preventive Medicine, Rush University Medical Center
- Department of Psychiatry and Behavioral Sciences, Rush University Medical Center
| | - Sheila A. Dugan
- Department of Physical Medicine and Rehabilitation, Rush University Medical Center
| | - Imke Janssen
- Department of Family and Preventive Medicine, Rush University Medical Center
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Gely YI, Esqueda-Medina M, Johnson TJ, Arias-Pelayo ML, Cortes NA, Isgor Z, Lynch EB, Lange-Maia BS. Experiences With Kidney Transplant Among Undocumented Immigrants in Illinois: A Qualitative Study. Kidney Med 2023; 5:100644. [PMID: 37235043 PMCID: PMC10206204 DOI: 10.1016/j.xkme.2023.100644] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/28/2023] Open
Abstract
Rationale & Objective Noncitizen, undocumented patients with kidney failure have few treatment options in many states, although Illinois allows for patients to receive a transplant regardless of citizenship status. Little information exists about the experiences of noncitizen patients pursuing kidney transplantation. We sought to understand how access to kidney transplantation affects patients, their family, health care providers, and the health care system. Study Design A qualitative study with virtually conducted semistructured interviews. Setting & Participants Participants were transplant and immigration stakeholders (physicians, transplant center and community outreach professionals), and patients who have received assistance through the Illinois Transplant Fund (listed for or received transplant; patients could complete the interview with a family member). Analytical Approach Interview transcripts were coded using open coding and were analyzed using thematic analysis methods with an inductive approach. Results We interviewed 36 participants: 13 stakeholders (5 physicians, 4 community outreach stakeholders, and 4 transplant center professionals), 16 patients, and 7 partners. The following seven themes were identified: (1) devastation from kidney failure diagnosis, (2) resource needs for care, (3) communication barriers to care, (4) importance of culturally competent health care providers, (5) negative impacts of policy gaps, (6) new chance at life after transplant, and (7) recommendations for improving care. Limitations The patients we interviewed were not representative of noncitizen patients with kidney failure overall or in other states. The stakeholders were also not representative of health care providers because they were generally well informed on kidney failure and immigration issues. Conclusions Although patients in Illinois can access kidney transplants regardless of citizenship status, access barriers, and health care policy gaps continue to negatively affect patients, families, health care professionals, and the health care system. Necessary changes for promoting equitable care include comprehensive policies to increase access, diversifying the health care workforce, and improving communication with patients. These solutions would benefit patients with kidney failure regardless of citizenship.
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Affiliation(s)
- Yumiko I. Gely
- Rush Medical College, Rush University Medical Center, Chicago, IL
| | - Maritza Esqueda-Medina
- Department of Family and Preventive Medicine, Rush University Medical Center, Chicago, IL
| | - Tricia J. Johnson
- Department of Health Systems Management, Rush University Medical Center, Chicago, IL
| | | | - Nancy A. Cortes
- Rush Medical College, Rush University Medical Center, Chicago, IL
| | - Zeynep Isgor
- Department of Health Systems Management, Rush University Medical Center, Chicago, IL
| | - Elizabeth B. Lynch
- Department of Family and Preventive Medicine, Rush University Medical Center, Chicago, IL
| | - Brittney S. Lange-Maia
- Department of Family and Preventive Medicine, Rush University Medical Center, Chicago, IL
- Rush Alzheimer’s Disease Center, Rush University Medical Center, Chicago, IL
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10
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Lamar M, Kershaw KN, Leurgans SE, Mukherjee RR, Lange-Maia BS, Marquez DX, Barnes LL. Neighborhood-level social vulnerability and individual-level cognitive and motor functioning over time in older non-Latino Black and Latino adults. Front Hum Neurosci 2023; 17:1125906. [PMID: 37250695 PMCID: PMC10213534 DOI: 10.3389/fnhum.2023.1125906] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2022] [Accepted: 04/25/2023] [Indexed: 05/31/2023] Open
Abstract
Introduction Despite known health disparities in cognitive aging, a comprehensive rationale for the increased burden in older minoritized populations including non-Latino Black and Latino adults has yet to be elucidated. While most work has focused on person-specific risk, studies are increasingly assessing neighborhood-level risk. We evaluated multiple aspects of the environmental milieu that may be critical when considering vulnerability to adverse health outcomes. Methods We investigated associations between a Census-tract derived Social Vulnerability Index (SVI) and level of and change in cognitive and motor functioning in 780 older adults (590 non-Latino Black adults, ∼73 years old at baseline; 190 Latinos, ∼70 years old baseline). Total SVI scores (higher = greater neighborhood-level vulnerability) were combined with annual evaluations of cognitive and motor functioning (follow-up ranged from 2 to 18 years). Demographically-adjusted mixed linear regression models tested for associations between SVI and cognitive and motor outcomes in analyses stratified by ethno-racial group. Results For non-Latino Black participants, higher SVI scores were associated with lower levels of global cognitive and motor functioning-specifically, episodic memory, motor dexterity and gait-as well as longitudinal change in visuospatial abilities and hand strength. For Latinos, higher SVI scores were associated with lower levels of global motor functioning only-specifically, motor dexterity; there were no significant associations between SVI and change in motor functioning. Discussion Neighborhood-level social vulnerability is associated with cognitive and motor functioning in non-Latino Black and Latino older adults, although associations appear to contribute to level more so than longitudinal change.
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Affiliation(s)
- Melissa Lamar
- Rush Alzheimer’s Disease Center, Rush University Medical Center, Chicago, IL, United States
- Department of Psychiatry and Behavioral Sciences, Rush University Medical Center, Chicago, IL, United States
| | - Kiarri N. Kershaw
- Department of Preventive Medicine, Northwestern University Feinberg School of Medicine, Chicago, IL, United States
| | - Sue E. Leurgans
- Rush Alzheimer’s Disease Center, Rush University Medical Center, Chicago, IL, United States
- Department of Neurological Sciences, Rush University Medical Center, Chicago, IL, United States
| | - R. Reshmi Mukherjee
- Rush Alzheimer’s Disease Center, Rush University Medical Center, Chicago, IL, United States
- Claremont McKenna College, Claremont, CA, United States
| | - Brittney S. Lange-Maia
- Rush Alzheimer’s Disease Center, Rush University Medical Center, Chicago, IL, United States
- Department of Family and Preventive Medicine, Rush University Medical Center, Chicago, IL, United States
| | - David X. Marquez
- Rush Alzheimer’s Disease Center, Rush University Medical Center, Chicago, IL, United States
- Department of Kinesiology and Nutrition, University of Illinois Chicago, Chicago, IL, United States
| | - Lisa L. Barnes
- Rush Alzheimer’s Disease Center, Rush University Medical Center, Chicago, IL, United States
- Department of Psychiatry and Behavioral Sciences, Rush University Medical Center, Chicago, IL, United States
- Department of Neurological Sciences, Rush University Medical Center, Chicago, IL, United States
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11
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Sanders WM, Harlow SD, Ylitalo KR, Lange-Maia BS, Leis AM, McConnell DS, Karvonen-Gutierrez CA. The Association of Inflammatory Factors With Peripheral Neuropathy: The Study of Women's Health Across the Nation. J Clin Endocrinol Metab 2023; 108:962-970. [PMID: 36260527 PMCID: PMC10211489 DOI: 10.1210/clinem/dgac612] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/03/2022] [Revised: 09/27/2022] [Indexed: 11/19/2022]
Abstract
PURPOSE Previous work has focused on the role of diabetes in peripheral neuropathy (PN), but PN often occurs before, and independently from, diabetes. This study measures the association of cardiometabolic and inflammatory factor with PN, independent of diabetes. METHODS Study of Women's Health Across the Nation participants (n = 1910), ages 60 to 73 (mean 65.6) were assessed for PN by symptom questionnaire and monofilament testing at the 15th follow-up visit (V15). Anthropometric measures and biomarkers were measured at study baseline approximately 20 years prior, and C-reactive protein (CRP) and fibrinogen were measured longitudinally. Log-binomial regression was used to model the association between metabolic syndrome (MetS), obesity (≥35 body mass index), CRP, and fibrinogen with PN, adjusting for sociodemographic and health behavior measures. RESULTS Baseline MetS [prevalence ratio (PR) 1.79, 95% CI (1.45, 2.20)], obesity [PR 2.08 (1.65, 2.61)], median CRP [PR 1.32 per log(mg/dL), (1.20, 1.45)], and mean fibrinogen (PR 1.28 per 100 mg/dL, (1.09, 1.50)] were associated with PN symptoms at V15. After excluding participants with baseline diabetes or obesity, MetS [PR 1.59 (1.17, 2.14)] and CRP [PR 1.19 per log(mg/dL), (1.06, 1.35)] remained statistically significantly associated with PN. There was a negative interaction between MetS and obesity, and the association between these conditions and PN was mediated by CRP. CONCLUSIONS Cardiometabolic factors and inflammation are significantly associated with PN, independent of diabetes and obesity. CRP mediates the relationship of both obesity and MetS with PN, suggesting an etiological role of inflammation in PN in this sample.
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Affiliation(s)
- Wade M Sanders
- Department of Epidemiology, School of Public Health, University of Michigan, Ann Arbor, MI
| | - Siobán D Harlow
- Department of Epidemiology, School of Public Health, University of Michigan, Ann Arbor, MI
| | - Kelly R Ylitalo
- Department of Public Health, Robbins College of Health and Human Sciences, Baylor University, Waco, TX
| | - Brittney S Lange-Maia
- Rush Alzheimer's Disease Center and Department of Preventative Medicine, Rush University Medical Center, Chicago, IL
| | - Aleda M Leis
- Department of Epidemiology, School of Public Health, University of Michigan, Ann Arbor, MI
| | - Daniel S McConnell
- Department of Epidemiology, School of Public Health, University of Michigan, Ann Arbor, MI
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12
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Appelhans BM, Gabriel KP, Lange-Maia BS, Karavolos K, Ylitalo KR, Karvonen-Gutierrez CA, Kravitz HM, Janssen I. Longitudinal associations of mid-life employment status with impaired physical function in the Study of Women's Health Across the Nation. Ann Epidemiol 2022; 74:15-20. [PMID: 35714876 PMCID: PMC10214385 DOI: 10.1016/j.annepidem.2022.06.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/18/2022] [Revised: 06/03/2022] [Accepted: 06/06/2022] [Indexed: 11/19/2022]
Abstract
PURPOSE This study examined whether employment status during mid-life and older adulthood is associated with physical function impairment. METHODS Participants were 2700 women in the multiracial/multiethnic Study of Women's Health Across the Nation. Time-varying, lagged, and cumulative exposure analyses modeled associations between self-reported employment status and the likelihood of severe physical function impairment across 19 years of follow-up. RESULTS Independent of demographic variables, women who were not working (OR = 1.58, 95% CI = 1.22, 2.04) or employed part-time (OR = 1.29, 95% CI = 1.04, 1.61) were more likely to report severe physical function impairments than women employed full-time. This same pattern was seen in lagged analyses predicting risk of physical function impairment from employment status at the prior assessment (not working vs. full-time: OR = 1.53, 95% CI = 1.08, 2.18; part-time vs. full-time: OR = 1.53, 95% CI = 1.17, 2.00). The likelihood of severe physical function impairment increased by 20% for every additional 10% of follow-up spent not working (OR = 1.02, 95% CI: 1.01, 1.03). Associations were robust to adjustment for health-related variables, body mass index, and physical activity. CONCLUSIONS Women with lower levels of employment from mid-life to older adulthood were more likely to experience severe impairment in physical function. However, the underlying mechanisms, and the timescales over which associations unfold, require further study.
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Affiliation(s)
- Bradley M Appelhans
- Department of Preventive Medicine, Rush University Medical Center, Chicago, IL, USA; Department of Psychiatry and Behavioral Sciences, Rush University Medical Center, Chicago, IL, USA.
| | - Kelley Pettee Gabriel
- Department of Epidemiology, School of Public Health, The University of Alabama at Birmingham, Birmingham, AL, USA
| | - Brittney S Lange-Maia
- Department of Preventive Medicine, Rush University Medical Center, Chicago, IL, USA; Rush Alzheimer's Disease Center, Rush University Medical Center, Chicago, IL, USA
| | - Kelly Karavolos
- Department of Preventive Medicine, Rush University Medical Center, Chicago, IL, USA
| | - Kelly R Ylitalo
- Department of Public Health, Baylor University, Waco, TX, USA
| | | | - Howard M Kravitz
- Department of Preventive Medicine, Rush University Medical Center, Chicago, IL, USA; Department of Psychiatry and Behavioral Sciences, Rush University Medical Center, Chicago, IL, USA
| | - Imke Janssen
- Department of Preventive Medicine, Rush University Medical Center, Chicago, IL, USA
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13
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Lange-Maia BS, Buchman AS, Leurgans SE, Lamar M, Lynch EB, Erlandson KM, Barnes LL. Racial Differences in the Effect of HIV Status on Motor and Pulmonary Function and Mobility Disability in Older Adults. J Racial Ethn Health Disparities 2022; 9:1888-1896. [PMID: 34403124 PMCID: PMC8850535 DOI: 10.1007/s40615-021-01126-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2021] [Revised: 07/29/2021] [Accepted: 08/02/2021] [Indexed: 11/24/2022]
Abstract
BACKGROUND Older Black adults face a disproportionate burden of HIV prevalence, but less is known about racial disparities in age-related outcomes in HIV. We assessed the effect of HIV status and race on motor and pulmonary function, as well as how they contribute to mobility disability. SETTING Community-based study; Chicago, IL METHODS: Participants were 363 community-dwelling adults age ≥ 50 years, 48% living with HIV, and 68% Black. Participants with HIV were recruited from a specialty HIV clinic, and participants without HIV (comparable on key demographic, lifestyle, and behavioral characteristics) were recruited from the community. Measures included motor function summarized by 10 motor performance measures, pulmonary function summarized by 3 measures assessed using handheld spirometry, and self-reported mobility disability. RESULTS In fully adjusted linear models, HIV was associated with better motor (β = 9.35, p < 0.001) and pulmonary function (β = 16.34, p < 0.001). For pulmonary function, the effect of HIV status was moderated by race (interaction between Black race and HIV status: β = - 11.66, p = 0.02), indicating that better pulmonary function among participants with HIV was less evident among Black participants. In fully adjusted models, odds of mobility disability did not differ by race, HIV status, or pulmonary function; better motor function was associated with lower odds of mobility disability (OR = 0.91 per 1-point higher, 95% CI 0.88-0.93). CONCLUSION Better motor and pulmonary function exhibited by participants with HIV could reflect access to medical care. Racial differences in lung function among participants with HIV indicate potential disparities in prevention or treatment of pulmonary disease or underlying risk factors.
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Affiliation(s)
- Brittney S Lange-Maia
- Rush Alzheimer's Disease Center, Rush University Medical Center, Chicago, IL, USA.
- Department of Preventive Medicine, Rush University Medical Center, Chicago, IL, USA.
| | - Aron S Buchman
- Rush Alzheimer's Disease Center, Rush University Medical Center, Chicago, IL, USA
- Department of Neurological Sciences Rush, University Medical Center, Chicago, IL, USA
| | - Sue E Leurgans
- Rush Alzheimer's Disease Center, Rush University Medical Center, Chicago, IL, USA
- Department of Neurological Sciences Rush, University Medical Center, Chicago, IL, USA
| | - Melissa Lamar
- Rush Alzheimer's Disease Center, Rush University Medical Center, Chicago, IL, USA
- Department of Psychiatry & Behavioral Sciences, Rush University Medical Center, Chicago, IL, USA
| | - Elizabeth B Lynch
- Department of Preventive Medicine, Rush University Medical Center, Chicago, IL, USA
| | - Kristine M Erlandson
- Department of Medicine and Epidemiology, University of Colorado Anschutz Medical Center, Aurora, CO, USA
| | - Lisa L Barnes
- Rush Alzheimer's Disease Center, Rush University Medical Center, Chicago, IL, USA
- Department of Neurological Sciences Rush, University Medical Center, Chicago, IL, USA
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14
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Solomon DH, Colvin A, Lange-Maia BS, Derby C, Dugan S, Jackson EA, Ruppert K, Karvonen-Gutierrez C, Santacroce L, Strotmeyer ES, Avis NE. Factors Associated With 10-Year Declines in Physical Health and Function Among Women During Midlife. JAMA Netw Open 2022; 5:e2142773. [PMID: 35006247 PMCID: PMC8749479 DOI: 10.1001/jamanetworkopen.2021.42773] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/28/2023] Open
Abstract
IMPORTANCE Women in midlife often develop chronic conditions and experience declines in physical health and function. Identifying factors associated with declines in physical health and function among these women may allow for targeted interventions. OBJECTIVE To examine the factors associated with clinically important 10-year declines in the physical component summary score (PCS) of the Short Form 36 (SF-36), a widely used patient-reported outcome measure, in women in midlife. DESIGN, SETTING, AND PARTICIPANTS This longitudinal cohort study collected data from geographically dispersed sites in the US. Participants were part of the Study of Women's Health Across the Nation (SWAN), a racially and ethnically diverse cohort of women enrolled at or immediately before the menopause transition. Women have been followed for up to 21 years, between 1996 and 2016, with annual visits. Data were analyzed from October 2020 to March 2021. EXPOSURES Demographic indicators, health status measures, and laboratory and imaging assessments. MAIN OUTCOMES AND MEASURES The main outcome was a clinically important decline (≥8 points) on the PCS, based on the 10-year difference in scores between ages 55 and 65 years. RESULTS From the SWAN cohort of 3302 women, 1091 women (median [IQR] age, 54.8 [54.3-55.4] years; 264 [24.2%] Black women; 126 [11.6%] Chinese women; 135 [12.4%] Japanese women; 566 [51.9%] White women) were eligible for analyses based on duration of follow-up and availability of SF-36 data. At age 55, women had a median (IQR) body mass index (BMI; calculated as weight in kilograms divided by height in meters squared) of 27.0 (23.2-32.6), a median (IQR) baseline PCS of 53.1 (46.8-56.7), 108 women (9.9%) were current smokers, and 938 women (86.3%) had at least 1 comorbidity. Between ages 55 and 65 years, the median (IQR) change in PCS was -1.02 (-6.11 to 2.53) points with 206 women (18.9%) experiencing declines of 8 points or more. In multivariable models, factors associated with clinically important decline included higher baseline PCS (odds ratio [OR], 1.08; 95% CI, 1.06-1.11), greater BMI (OR, 1.06; 95% CI, 1.03-1.09), less educational attainment (OR, 1.87; 95% CI, 1.32-2.65), current smoking (OR, 1.93; 95% CI, 1.14-3.26), osteoarthritis (OR, 1.46; 95% CI, 1.01-2.09), clinically significant depressive symptoms (OR, 2.03; 95% CI, 1.34-3.09), and cardiovascular disease (OR, 2.06; 95% CI, 1.26-3.36). CONCLUSIONS AND RELEVANCE In this cohort study, clinically important declines in women's physical health and function were relatively common between ages 55 and 65 years. Several variables associated with these declines were identified as potentially useful components in a clinical score identifying women at increased risk of physical health and functional declines.
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Affiliation(s)
- Daniel H. Solomon
- Division of Rheumatology, Brigham and Women’s Hospital, Harvard Medical School, Boston, Massachusetts
| | - Alicia Colvin
- Department of Epidemiology, University of Pittsburgh, Pittsburgh, Pennsylvania
| | - Brittney S. Lange-Maia
- Rush Alzheimer’s Disease Center and Department of Preventive Medicine, Rush University Medical Center, Chicago, Illinois
| | - Carol Derby
- Neurology, and Epidemiology and Population Health, Albert Einstein College of Medicine, Bronx, New York
| | - Sheila Dugan
- Department of Physical Medicine and Rehabilitation, Rush University Medical Center, Chicago, Illinois
- Department of Preventive Medicine, Rush University Medical Center, Chicago, Illinois
| | | | - Kristine Ruppert
- Department of Epidemiology, University of Pittsburgh, Pittsburgh, Pennsylvania
| | | | - Leah Santacroce
- Division of Rheumatology, Brigham and Women’s Hospital, Harvard Medical School, Boston, Massachusetts
| | - Elsa S. Strotmeyer
- Department of Epidemiology, University of Pittsburgh, Pittsburgh, Pennsylvania
| | - Nancy E. Avis
- Department of Social Sciences & Health Policy, Wake Forest School of Medicine, Winston-Salem, North Carolina
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15
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Lange-Maia BS, Johnson TJ, Gely YI, Ansell DA, Cmunt JK, Lynch EB. End Stage Kidney Disease in Non-citizen Patients: Epidemiology, Treatment, and an Update to Policy in Illinois. J Immigr Minor Health 2021; 24:1557-1563. [PMID: 34773520 DOI: 10.1007/s10903-021-01303-7] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/22/2021] [Indexed: 11/30/2022]
Abstract
End-stage kidney disease (ESKD) is common in the U.S. There is no cure, and survival requires either dialysis or kidney transplant. Medicare provides coverage for most ESKD patients in the U.S., though non-citizens are excluded from most current policies providing standard ESKD care, especially regarding kidney transplants. Despite being eligible to be organ donors, non-citizens often have few avenues to be organ recipients-a major equity problem. Overall, transplants are cost-saving compared to dialysis, and non-citizens have comparable outcomes to the general population. We reviewed the literature regarding the vastly different policies across the U.S., with a focus on current Illinois policy, including updates regarding Illinois legislation which passed in 2014 providing non-citizens to receive coverage for transplants. Unfortunately, despite legislation providing avenues for transplants, funds were not allocated, and the bill has not had the impact that was expected when initially passed. We outline opportunities for improving current policies.
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Affiliation(s)
- Brittney S Lange-Maia
- Department of Preventive Medicine, Rush University Medical Center, Chicago, IL, USA. .,Center for Community Health Equity, Rush University Medical Center, Chicago, IL, USA. .,Rush University Medical Center, 1750 W. Harrison St. Suite 1000, Chicago, IL, 60612, USA.
| | - Tricia J Johnson
- Center for Community Health Equity, Rush University Medical Center, Chicago, IL, USA.,Department of Health Systems Management, Rush University, Chicago, IL, USA
| | - Yumiko I Gely
- Rush Medical College, Rush University Medical Center, Chicago, IL, USA
| | - David A Ansell
- Center for Community Health Equity, Rush University Medical Center, Chicago, IL, USA.,Department of Internal Medicine, Rush University Medical Center, Chicago, IL, USA
| | - J Kevin Cmunt
- Gift of Hope Organ and Tissue Donor Network and Illinois Transplant Fund, Itasca, IL, USA
| | - Elizabeth B Lynch
- Department of Preventive Medicine, Rush University Medical Center, Chicago, IL, USA.,Center for Community Health Equity, Rush University Medical Center, Chicago, IL, USA
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16
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Lange-Maia BS, Chiume T, Dugan SA, Hudnall J, Karavolos K, Lynch EB. Keeping It Movin’ Through Covid-19: Results From A Church-based Physical Activity And Physical Function Program Set In Early 2020. Med Sci Sports Exerc 2021. [DOI: 10.1249/01.mss.0000764912.57196.eb] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
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17
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Moffit RE, Qiao YS, Moored KD, Santanasto AJ, Lange-Maia BS, Cawthon PM, Goodpaster BH, Strotmeyer ES, Newman AB, Glynn NW. Estimating cardiorespiratory fitness in older adults using a usual-paced 400-m long-distance corridor walk. J Am Geriatr Soc 2021; 69:3328-3330. [PMID: 34269423 DOI: 10.1111/jgs.17360] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2021] [Revised: 06/21/2021] [Accepted: 06/27/2021] [Indexed: 11/29/2022]
Affiliation(s)
- Reagan E Moffit
- Department of Epidemiology, Graduate School of Public Health, University of Pittsburgh, Pittsburgh, Pennsylvania, USA
| | - Yujia Susanna Qiao
- Department of Epidemiology, Graduate School of Public Health, University of Pittsburgh, Pittsburgh, Pennsylvania, USA
| | - Kyle D Moored
- Department of Epidemiology, Graduate School of Public Health, University of Pittsburgh, Pittsburgh, Pennsylvania, USA
| | - Adam J Santanasto
- Department of Epidemiology, Graduate School of Public Health, University of Pittsburgh, Pittsburgh, Pennsylvania, USA
| | - Brittney S Lange-Maia
- Rush Alzheimer's Disease Center, Rush University Medical Center, Chicago, Illinois, USA
| | - Peggy M Cawthon
- Translational Research Institute, AdventHealth Research Institute, Orlando, Florida, USA
| | - Bret H Goodpaster
- Research Institute, California Pacific Medical Center, San Francisco, California, USA
| | - Elsa S Strotmeyer
- Department of Epidemiology, Graduate School of Public Health, University of Pittsburgh, Pittsburgh, Pennsylvania, USA
| | - Anne B Newman
- Department of Epidemiology, Graduate School of Public Health, University of Pittsburgh, Pittsburgh, Pennsylvania, USA
| | - Nancy W Glynn
- Department of Epidemiology, Graduate School of Public Health, University of Pittsburgh, Pittsburgh, Pennsylvania, USA
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18
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Napoleone JM, Boudreau RM, Lange-Maia BS, El Khoudary SR, Ylitalo KR, Kriska AM, Karvonen-Gutierrez CA, Strotmeyer ES. Metabolic Syndrome Trajectories and Objective Physical Performance in Mid-to-Early Late Life: The Study of Women's Health Across the Nation (SWAN). J Gerontol A Biol Sci Med Sci 2021; 77:e39-e47. [PMID: 34216218 PMCID: PMC8824556 DOI: 10.1093/gerona/glab188] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2020] [Indexed: 01/28/2023] Open
Abstract
BACKGROUND Little is known about how adverse, midlife metabolic profiles affect future physical functioning. We hypothesized that a higher number of midlife metabolic syndrome (MetS) components are associated with poorer physical performance in early old age for multiethnic women. METHODS MetS status from 1996 to 2011 (8 visits) and objective physical performance in 2015/2016 (Short Physical Performance Battery [SPPB; 0-12], 40-foot walk [meter/second], 4-meter gait speed [meter/second], chair stands [seconds], stair climb [seconds]) were assessed in the Study of Women's Health Across the Nation (SWAN; n = 1722; age 65.4 ± 2.7 years; 26.9% African American, 10.1% Chinese, 9.8% Japanese, 5.5% Hispanic). Poisson latent class growth modeling identified MetS component trajectory groups: none (23.9%), 1 = low-MetS (28.7%), 2 = mid-MetS (30.9%), and ≥3 = high-MetS (16.5%). Adjusted linear regression related MetS groups to physical performance outcomes. RESULTS High-MetS versus none had higher body mass index, pain, financial strain, and lower physical activity and self-reported health (p < .0001). Compared with White, African American and Hispanic women were more likely to be in the high-MetS groups and had worse physical functioning along with Chinese women (SPPB, chair stand, stair climb, and gait speed-not Hispanic). After adjustments, high-MetS versus none demonstrated significantly worse 40-ft walk (β: -0.08; 95% CI: -0.13, -0.03), gait speed (β: -0.09; 95% CI: -0.15, -0.02), SPPB (β: -0.79; 95% CI: -1.15, -0.44), and chair stands (β: 0.69; 95% CI: 0.09, 1.28), but no difference in stair climb. CONCLUSIONS Midlife MetS groups were related to poor physical performance in early old age multiethnic women. Midlife management of metabolic function may improve physical performance later in life.
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Affiliation(s)
- Jenna M Napoleone
- Department of Epidemiology, Graduate School of Public Health, University of Pittsburgh, Pennsylvania, USA
- Address correspondence to: Jenna M. Napoleone, PhD, MPH, Department of Epidemiology, Graduate School of Public Health, University of Pittsburgh, 130 DeSoto Street, Pittsburgh, PA 15261, USA. E-mail:
| | - Robert M Boudreau
- Department of Epidemiology, Graduate School of Public Health, University of Pittsburgh, Pennsylvania, USA
| | - Brittney S Lange-Maia
- Department of Preventive Medicine, Rush University Medical Center, Chicago, Illinois, USA
| | - Samar R El Khoudary
- Department of Epidemiology, Graduate School of Public Health, University of Pittsburgh, Pennsylvania, USA
| | - Kelly R Ylitalo
- Department of Public Health, Robbins College of Health and Human Sciences, Baylor University, Waco, Texas, USA
| | - Andrea M Kriska
- Department of Epidemiology, Graduate School of Public Health, University of Pittsburgh, Pennsylvania, USA
| | | | - Elsa S Strotmeyer
- Department of Epidemiology, Graduate School of Public Health, University of Pittsburgh, Pennsylvania, USA
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19
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Lange-Maia BS, Karvonen-Gutierrez CA, Kazlauskaite R, Strotmeyer ES, Karavolos K, Appelhans BM, Janssen I, Avery EF, Dugan SA, Kravitz HM. Impact of Chronic Medical Condition Development on Longitudinal Physical Function from Mid- to Early Late-Life: The Study of Women's Health Across the Nation. J Gerontol A Biol Sci Med Sci 2021; 75:1411-1417. [PMID: 31732730 DOI: 10.1093/gerona/glz243] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/19/2019] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND Chronic medical conditions (CMCs) often emerge and accumulate during the transition from mid- to late-life, and the resulting multimorbidity can greatly impact physical function. We assessed the association of CMC presence and incidence on trajectories of physical function from mid- to early late-life in the Study of Women's Health Across the Nation. METHODS Physical function was assessed at eight clinic visits (average 14 years follow-up) using the physical function subscale of the Short Form-36. CMCs included osteoarthritis, diabetes, stroke, hypertension, heart disease, cancer, osteoporosis, and depressive symptomatology, and were considered cumulatively. Repeated-measures Poisson models estimated longitudinal change (expressed as percent difference) in physical function by chronic CMCs. Change-points assessed physical function change coincident with the development of a new condition. RESULTS Women (N = 2,283) followed from age 50.0 ± 2.7 to 64.0 ± 3.7 years; 7.3% had zero CMCs through follow-up, 22.5% (N = 513) had no baseline CMCs but developed ≥1, 22.7% women had ≥1 baseline CMC but never developed another, and 47.6% had ≥1 baseline CMC and developed ≥1 more. Each additional baseline CMC was associated with 4.0% worse baseline physical function and annual decline of 0.20%/year. Women with more baseline CMCs had greater decline in physical function with a new CMC (-1.90% per condition); and annual decline when developing a new condition accelerated by -0.33%/year per condition. CONCLUSIONS Self-reported physical function changes are evident from mid- to early late-life with the development of CMCs. Preventing or delaying CMCs may delay declines in physical function, and these potential pathways to disability warrant further research.
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Affiliation(s)
- Brittney S Lange-Maia
- Department of Preventive Medicine, Chicago, Illinois.,Center for Community Health Equity, Rush University Medical Center, Chicago, Illinois
| | | | - Rasa Kazlauskaite
- Department of Internal Medicine, Rush University Medical Center, Chicago, Illinois
| | - Elsa S Strotmeyer
- Department of Epidemiology, Graduate School of Public Health, University of Pittsburgh, Pittsburgh
| | | | | | - Imke Janssen
- Department of Preventive Medicine, Chicago, Illinois
| | - Elizabeth F Avery
- Department of Preventive Medicine, Chicago, Illinois.,Center for Community Health Equity, Rush University Medical Center, Chicago, Illinois
| | - Sheila A Dugan
- Department of Physical Medicine and Rehabilitation, Chicago, Illinois
| | - Howard M Kravitz
- Department of Preventive Medicine, Chicago, Illinois.,Department of Psychiatry, Rush University Medical Center, Chicago, Illinois
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20
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Ylitalo KR, Strotmeyer ES, Pettee Gabriel K, Lange-Maia BS, Avis NE, Karvonen-Gutierrez CA. Peripheral Nerve Impairment and Recurrent Falls Among Women: Results From the Study of Women's Health Across the Nation. J Gerontol A Biol Sci Med Sci 2020; 75:2020-2027. [PMID: 31549141 DOI: 10.1093/gerona/glz211] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/04/2019] [Indexed: 11/14/2022] Open
Abstract
BACKGROUND Falls and related injuries are important public health concerns yet underappreciated in early aging. This study examined the association of peripheral nerve impairment (PNI) with fall outcomes in early old aged women (60-72 years). METHODS Women (n = 1,725; mean age 65.1 ± 2.7 years) from the longitudinal cohort Study of Women's Health Across the Nation completed a PNI questionnaire on presence, frequency, and severity of symptoms, and 10- and 1.4-g monofilament testing in 2016-2017. PNI was defined as four or more self-reported symptoms or monofilament insensitivity. Recurrent falls (two or more) and recurrent fall injuries (two or more falls with one or more injuries) in the previous 12 months were assessed via questionnaire. Poisson regression was used to generate risk ratios (RRs) and corresponding 95% confidence intervals (CIs) for the fall outcomes, adjusting for covariates. RESULTS Approximately 12.3% of participants reported two ore more falls, 7.6% reported recurrent falls with injury, and 15.8% reported four or more PNI symptoms. Women with recurrent falls were more likely to report four or more PNI symptoms compared to women without recurrent falls (32.1% vs 13.5%; p < .001). One quarter (25.6%) of participants had four or more PNI symptoms or monofilament insensitivity; after adjusting for covariates, women with either symptoms or insensitivity were more likely to report recurrent falls compared to women with neither (RR = 1.64; 95% CI: 1.24, 2.17). CONCLUSIONS These findings suggest that PNI may identify those at high risk for falls, particularly among women during early late life. Neuropathy screening instruments such as symptom questionnaires or monofilament testing are easy to implement and may have utility for fall risk assessment.
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Affiliation(s)
- Kelly R Ylitalo
- Department of Public Health, Robbins College of Health and Human Sciences, Baylor University, Waco, Texas
| | - Elsa S Strotmeyer
- Department of Epidemiology, Graduate School of Public Health, University of Pittsburgh, Pennsylvania
| | - Kelley Pettee Gabriel
- Department of Epidemiology, Human Genetics, and Environmental Sciences, UTHealth School of Public Health - Austin Campus, Texas.,Department of Women's Health, Dell Medical School, Chicago, Illinois.,Department of Kinesiology and Health Education, The University of Texas at Austin, Chicago, Illinois
| | - Brittney S Lange-Maia
- Department of Preventive Medicine, Center for Community Health Equity, Rush University Medical Center, Chicago, Illinois
| | - Nancy E Avis
- Department of Social Sciences & Health Policy, Wake Forest School of Medicine, Winston-Salem, North Carolina
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Appelhans BM, Lange-Maia BS, Pettee Gabriel K, Karvonen-Gutierrez C, Karavolos K, Dugan SA, Greendale GA, Avery EF, Sternfeld B, Janssen I, Kravitz HM. Body mass index versus bioelectrical impedance analysis for classifying physical function impairment in a racially diverse cohort of midlife women: the Study of Women's Health Across the Nation (SWAN). Aging Clin Exp Res 2020; 32:1739-1747. [PMID: 31584147 DOI: 10.1007/s40520-019-01355-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/18/2019] [Accepted: 09/13/2019] [Indexed: 11/29/2022]
Abstract
BACKGROUND Body composition strongly influences physical function in older adults. Bioelectrical impedance analysis (BIA) differentiates fat mass from skeletal muscle mass, and may be more useful than body mass index (BMI) for classifying women on their likelihood of physical function impairment. AIMS This study tested whether BIA-derived estimates of percentage body fat (%BF) and height-normalized skeletal muscle mass (skeletal muscle mass index; SMI) enhance classification of physical function impairment relative to BMI. METHOD Black, White, Chinese, and Japanese midlife women (N = 1482) in the Study of Women's Health Across the Nation (SWAN) completed performance-based measures of physical function. BMI (kg/m2) was calculated. %BF and SMI were derived through BIA. Receiver-operating characteristic (ROC) curve analysis, conducted in the overall sample and stratified by racial group, evaluated optimal cutpoints of BMI, %BF, and SMI for classifying women on moderate-severe physical function impairment. RESULTS In the overall sample, a BMI cutpoint of ≥ 30.1 kg/m2 correctly classified 71.1% of women on physical function impairment, and optimal cutpoints for %BF (≥ 43.4%) and SMI (≥ 8.1 kg/m2) correctly classified 69% and 62% of women, respectively. SMI did not meaningfully enhanced classification relative to BMI (change in area under the ROC curve = 0.002; net reclassification improvement = 0.021; integrated discrimination improvement = - 0.003). Optimal cutpoints for BMI, %BF, and SMI varied substantially across race. Among Black women, a %BF cutpoint of 43.9% performed somewhat better than BMI (change in area under the ROC curve = 0.017; sensitivity = 0.69, specificity = 0.64). CONCLUSION Some race-specific BMI and %BF cutpoints have moderate utility for identifying impaired physical function among midlife women.
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Affiliation(s)
- Bradley M Appelhans
- Department of Preventive Medicine, Rush University Medical Center, 1700 W. Van Buren St., Suite 470, Chicago, IL, 60612, USA.
- Department of Psychiatry and Behavioral Sciences, Rush University Medical Center, 2150 W. Harrison St., Room 278, Chicago, IL, 60612, USA.
| | - Brittney S Lange-Maia
- Department of Preventive Medicine, Rush University Medical Center, 1700 W. Van Buren St., Suite 470, Chicago, IL, 60612, USA
| | - Kelley Pettee Gabriel
- Department of Epidemiology, Human Genetics & Environmental Sciences, School of Public Health - Austin Campus, The University of Texas Health Science Center, Austin, USA
- Department of Women's Health, Dell Medical School, The University of Texas at Austin, Austin, USA
- Department of Kinesiology and Health Education, The University of Texas at Austin, Austin, USA
| | | | - Kelly Karavolos
- Department of Preventive Medicine, Rush University Medical Center, 1700 W. Van Buren St., Suite 470, Chicago, IL, 60612, USA
| | - Sheila A Dugan
- Department of Physical Medicine and Rehabilitation, Rush University Medical Center, Chicago, USA
| | - Gail A Greendale
- Department of Medicine, David Geffen School of Medicine at the University of California, Los Angeles, Los Angeles, USA
| | - Elizabeth F Avery
- Department of Preventive Medicine, Rush University Medical Center, 1700 W. Van Buren St., Suite 470, Chicago, IL, 60612, USA
| | - Barbara Sternfeld
- Division of Research, Kaiser Permanente Northern California, Oakland, USA
| | - Imke Janssen
- Department of Preventive Medicine, Rush University Medical Center, 1700 W. Van Buren St., Suite 470, Chicago, IL, 60612, USA
| | - Howard M Kravitz
- Department of Preventive Medicine, Rush University Medical Center, 1700 W. Van Buren St., Suite 470, Chicago, IL, 60612, USA
- Department of Psychiatry and Behavioral Sciences, Rush University Medical Center, 2150 W. Harrison St., Room 278, Chicago, IL, 60612, USA
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22
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Mathew AR, Yang E, Avery EF, Crane MM, Lange-Maia BS, Lynch EB. Trauma exposure, PTSD symptoms, and tobacco use: Does church attendance buffer negative effects? J Community Psychol 2020; 48:2364-2374. [PMID: 32789875 PMCID: PMC7654728 DOI: 10.1002/jcop.22420] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/17/2020] [Revised: 06/03/2020] [Accepted: 07/13/2020] [Indexed: 06/11/2023]
Abstract
Traumatic stress and posttraumatic stress disorder (PTSD) are overrepresented in urban African American communities, and associated with health risk behaviors such as tobacco use. Support and resources provided by churches may reduce trauma-related health risks. In the current study, we assessed weekly church attendance as a moderator of relations between (a) traumatic event exposure and probable PTSD, and (b) probable PTSD and tobacco use. Data were drawn from a health surveillance study conducted in seven churches located in Chicago's West Side. Participants (N = 1015) were adults from churches as well as the surrounding community. Trauma exposure was reported by 62% of participants, with 25% of those who experienced trauma reporting probable PTSD. Overall, more than one-third of participants (37.2%) reported current tobacco use. As compared with non-weekly church attendance, weekly church attendance was associated with a lower likelihood of PTSD (odds ratio [OR] = 0.41; 95% confidence interval [CI] = 0.26-0.62; p < .0001) and lower tobacco use overall (OR = 0.22; 95% CI = 0.16-0.30; p < .0001), but did not moderate the effect of trauma exposure on risk of PTSD, or the effect of PTSD on tobacco use. Findings support church attendance as a potential buffer of trauma-related stress.
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Affiliation(s)
- Amanda R. Mathew
- Department of Preventive Medicine, Rush University Medical Center
| | - Eric Yang
- Center for Community Health Equity, Rush University Medical Center
| | | | - Melissa M. Crane
- Department of Preventive Medicine, Rush University Medical Center
| | - Brittney S. Lange-Maia
- Department of Preventive Medicine, Rush University Medical Center
- Center for Community Health Equity, Rush University Medical Center
| | - Elizabeth B. Lynch
- Department of Preventive Medicine, Rush University Medical Center
- Center for Community Health Equity, Rush University Medical Center
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Lange-Maia BS, Karavolos K, Avery EF, Strotmeyer ES, Karvonen-Gutierrez CA, Appelhans BM, Janssen I, Dugan SA, Kravitz HM. Contribution of common chronic conditions to midlife physical function decline: The Study of Women's Health Across the Nation. Womens Midlife Health 2020; 6:6. [PMID: 32742664 PMCID: PMC7385881 DOI: 10.1186/s40695-020-00053-0] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/10/2019] [Accepted: 07/13/2020] [Indexed: 12/25/2022] Open
Abstract
Background Chronic conditions are associated with worse physical function and commonly develop during midlife. We tested whether the presence of 8 chronic conditions, or the development of these conditions, is associated with declines in physical function among midlife women as they transition into early late life. Methods Participants (N = 2283) were from the Study of Women’s Health Across the Nation. Physical function was assessed at 8 visits starting at the study’s fourth clinic visit in 2000/2001 through follow-up visit 15 (2015/2017) using the Short Form-36 Physical Function subscale. Chronic conditions included diabetes, hypertension, osteoarthritis, osteoporosis, stroke, heart disease, cancer, and depressive symptoms. Repeated-measures Poisson regression modeled associations between 1) prevalent chronic conditions at analytic baseline (visit 4) and longitudinal physical function, and 2) change in physical function associated with developing a new condition. Models were adjusted with the total number of other chronic conditions at visit 4. Results In separate fully-adjusted longitudinal models, prevalent heart disease and osteoporosis were associated with 18% (IRR = 0.815, 95% confidence interval [CI]: 0.755–0.876) and 12% (IRR = 0.876, 95% CI: 0.825–0.927) worse initial physical function, respectively. Prevalent osteoarthritis was associated with approximately 6% (IRR = 0.936, 95% CI: 0.913–0.958) worse initial physical function, and a slight additional worsening over time (IRR = 0.995, 95% CI: 0.994–0.996). A 12% (IRR = 0.878, 95% CI: 0.813–0.950) decrease in physical function concurrent with stroke development was evident, as was accelerated decline in physical function concurrent with heart disease development (IRR = 0.991, 95% CI: 0.988–0.995). Conclusions Initial prevalent conditions related to the musculoskeletal system were associated with worse initial physical function, with some evidence of accelerated decline in physical function with osteoarthritis. Stroke and heart disease are less common than osteoarthritis in this age group, but the severe effects of these conditions on physical function shows the need for a greater focus on cardiovascular health during midlife. Women who develop chronic conditions during midlife may be at particular risk for poor physical function as they age, warranting disability prevention efforts focused on this population.
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Affiliation(s)
- Brittney S Lange-Maia
- Department of Preventive Medicine, Rush University Medical Center, Chicago, IL USA.,Center for Community Health Equity, Rush University Medical Center, Chicago, IL USA
| | - Kelly Karavolos
- Department of Preventive Medicine, Rush University Medical Center, Chicago, IL USA
| | - Elizabeth F Avery
- Department of Preventive Medicine, Rush University Medical Center, Chicago, IL USA.,Center for Community Health Equity, Rush University Medical Center, Chicago, IL USA
| | - Elsa S Strotmeyer
- Department of Epidemiology, Graduate School of Public Health, University of Pittsburgh, Pittsburgh, PA USA
| | | | - Bradley M Appelhans
- Department of Preventive Medicine, Rush University Medical Center, Chicago, IL USA
| | - Imke Janssen
- Department of Preventive Medicine, Rush University Medical Center, Chicago, IL USA
| | - Sheila A Dugan
- Department of Physical Medicine & Rehabilitation, Rush University Medical Center, Chicago, IL USA
| | - Howard M Kravitz
- Department of Preventive Medicine, Rush University Medical Center, Chicago, IL USA.,Department of Psychiatry and Behavioral Sciences, Rush University Medical Center, Chicago, IL USA
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Lange-Maia BS, Dugan SA, Lindich DR, Marinello S, Banks C, Lynch EB. Perceptions Regarding Physical Function Limitations Among Midlife And Older Adults In A Health Ministry Program. Med Sci Sports Exerc 2020. [DOI: 10.1249/01.mss.0000683212.55541.f9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
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25
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Moorthi RN, Doshi S, Fried LF, Moe SM, Sarnak MJ, Satterfield S, Schwartz AV, Shlipak M, Lange-Maia BS, Harris TB, Newman AB, Strotmeyer ES. Chronic kidney disease and peripheral nerve function in the Health, Aging and Body Composition Study. Nephrol Dial Transplant 2020; 34:625-632. [PMID: 29757410 DOI: 10.1093/ndt/gfy102] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/01/2018] [Indexed: 11/14/2022] Open
Abstract
BACKGROUND Chronic kidney disease (CKD) is associated with poor mobility. Peripheral nerve function alterations play a significant role in low mobility. We tested the hypothesis that early CKD is associated with altered sensory, motor and autonomic nerve function. METHODS Participants in the Health, Aging and Body Composition cohort who had kidney function measures in Year 3 (1999-2000) and nerve function measurements at Year 4 (2000-01) were analyzed (n = 2290). Sensory (vibration threshold, monofilament insensitivity to light and standard touch), motor [compound motor action potentials (CMAPs), nerve conduction velocities (NCVs)] and autonomic (heart rate response and recovery after a 400-m walk test) nerve function as well as participant characteristics were compared across cystatin C- and creatinine-based estimated glomerular filtration rate categorized as ≤60 (CKD) or >60 mL/min/1.73 m2 (non-CKD). The association between CKD and nerve function was examined with logistic regression adjusted for covariates. RESULTS Participants with CKD (n = 476) were older (77 ± 3 versus 75 ± 3 years; P < 0.05) and had a higher prevalence of diabetes (20.6% versus 13.1%; P < 0.001). CKD was associated with higher odds for vibration detection threshold {odds ratio [OR] 1.7 [95% confidence interval (CI) 1.1-2.7]} and light touch insensitivity [OR 1.4 (95% CI 1.1-1.7)]. CMAPs and NCVs were not significantly different between CKD and non-CKD patients. In adjusted analyses, participants with CKD had higher odds of an abnormal heart rate response [OR 1.6 (95% CI 1.1-2.2)] and poor heart rate recovery [OR 1.5 (95% CI 1.1-2.0)]. CONCLUSIONS CKD is associated with changes in sensory and autonomic nerve function, even after adjustment for demographics and comorbidities, including diabetes. Longitudinal studies in CKD are needed to determine the contribution of nerve impairments to clinically important outcomes.
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Affiliation(s)
- Ranjani N Moorthi
- Department of Medicine, Division of Nephrology, Indiana University School of Medicine, Indianapolis, IN, USA
| | - Simit Doshi
- Department of Medicine, Division of Nephrology, Indiana University School of Medicine, Indianapolis, IN, USA
| | - Linda F Fried
- Renal Section, VA Pittsburgh Healthcare System, Pittsburgh, Pennsylvania, USA.,Department of Medicine, University of Pittsburgh, Pittsburgh, Pennsylvania, USA.,Department of Epidemiology, University of Pittsburgh Graduate School of Public Health, Pittsburgh, PA
| | - Sharon M Moe
- Department of Medicine, Division of Nephrology, Indiana University School of Medicine, Indianapolis, IN, USA.,Roudebush VA Medical Center, Indianapolis, IN, USA
| | - Mark J Sarnak
- Department of Medicine, Division of Nephrology, Tufts Medical Center, Boston, MA, USA
| | - Suzanne Satterfield
- Department of Preventive Medicine, University of Tennessee Health Science Center, Memphis, TN, USA
| | - Ann V Schwartz
- Department of Epidemiology and Biostatistics, University of California San Francisco, San Francisco, CA, USA
| | - Michael Shlipak
- Division of Nephrology, Department of Medicine, San Francisco VA Medical Center, San Francisco, CA; Kidney Health Research Collaborative, San Francisco VA Medical Center and University of California, San Francisco, CA, USA
| | - Brittney S Lange-Maia
- Department of Preventive Medicine and Center for Community Health Equity, Rush University Medical Center, Chicago, IL, USA
| | - Tamara B Harris
- Intramural Research Program, Laboratory of Epidemiology, and Population Sciences, National Institute on Aging, National Institutes of Health, Laboratory of Epidemiology, Demography, and Biometry, Bethesda, MD, USA
| | - Anne B Newman
- Department of Epidemiology, University of Pittsburgh, Pittsburgh, PA, USA
| | - Elsa S Strotmeyer
- Department of Epidemiology, University of Pittsburgh, Pittsburgh, PA, USA
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Glynn NW, Gmelin T, Santanasto AJ, Lovato LC, Lange-Maia BS, Nicklas BJ, Fielding RA, Manini TM, Myers VH, de Rekeneire N, Spring BJ, Pahor M, King AC, Rejeski WJ, Newman AB. Impact of Baseline Fatigue on a Physical Activity Intervention to Prevent Mobility Disability. J Am Geriatr Soc 2019; 68:619-624. [PMID: 31867713 DOI: 10.1111/jgs.16274] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/24/2019] [Revised: 10/02/2019] [Accepted: 11/04/2019] [Indexed: 11/28/2022]
Abstract
OBJECTIVES Our aim was to examine the impacts of baseline fatigue on the effectiveness of a physical activity (PA) intervention to prevent major mobility disability (MMD) and persistent major mobility disability (PMMD) in participants from the Lifestyle Interventions and Independence for Elders (LIFE) study. DESIGN Prospective cohort of individuals aged 65 years or older undergoing structured PA intervention or health education (HE) for a mean of 2.6 years. SETTING LIFE was a multicenter eight-site randomized trial that compared the efficacy of a structured PA intervention with an HE program in reducing the incidence of MMD. PARTICIPANTS Study participants (N = 1591) at baseline were 78.9 ± 5.2 years of age, with low PA and at risk for mobility impairment. MEASUREMENTS Self-reported fatigue was assessed using the modified trait version of the Exercise-Induced Feelings Inventory, a six-question scale rating energy levels in the past week. Responses ranged from 0 (none of the time) to 5 (all of the time). Total score was calculated by averaging across questions; baseline fatigue was based on the median split: 2 or higher = more fatigue (N = 856) and lower than 2 = less fatigue (N = 735). Participants performed a usual-paced 400-m walk every 6 months. We defined incident MMD as the inability to walk 400-m at follow-up visits; PMMD was defined as two consecutive walk failures. Cox proportional hazard models quantified the risk of MMD and PMMD in PA vs HE stratified by baseline fatigue adjusted for covariates. RESULTS Among those with higher baseline fatigue, PA participants had a 29% and 40% lower risk of MMD and PMMD, respectively, over the trial compared with HE (hazard ratio [HR] for MMD = .71; 95% confidence interval [CI] = .57-.90; P = .004) and PMMD (HR = .60; 95% CI = .44-.82; P = .001). For those with lower baseline fatigue, no group differences in MMD (P = .36) or PMMD (P = .82) were found. Results of baseline fatigue by intervention interaction was MMD (P = .18) and PMMD (P = .05). CONCLUSION A long-term moderate intensity PA intervention was particularly effective at preserving mobility in older adults with higher levels of baseline fatigue. J Am Geriatr Soc 68:619-624, 2020.
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Affiliation(s)
- Nancy W Glynn
- Center for Aging and Population Health, Department of Epidemiology, Graduate School of Public Health, University of Pittsburgh, Pittsburgh, Pennsylvania
| | - Theresa Gmelin
- Center for Aging and Population Health, Department of Epidemiology, Graduate School of Public Health, University of Pittsburgh, Pittsburgh, Pennsylvania
| | - Adam J Santanasto
- Center for Aging and Population Health, Department of Epidemiology, Graduate School of Public Health, University of Pittsburgh, Pittsburgh, Pennsylvania
| | - Laura C Lovato
- Department of Biostatistical Sciences, Wake Forest University School of Medicine, Winston-Salem, North Carolina
| | - Brittney S Lange-Maia
- Department of Preventive Medicine and Center for Community Health Equity, Rush University Medical Center, Chicago, Illinois
| | - Barbara J Nicklas
- Department of Internal Medicine, Section on Gerontology and Geriatric Medicine, Sticht Center on Aging, Wake Forest School of Medicine, Winston-Salem, North Carolina
| | - Roger A Fielding
- Jean Mayer USDA Human Nutrition Research Center on Aging, Tufts University, Boston, Massachusetts
| | - Todd M Manini
- Institute on Aging, Department of Aging and Geriatric Research, University of Florida, Gainesville, Florida
| | | | | | - Bonnie J Spring
- Department of Preventive Medicine, Northwestern University, Chicago, Illinois
| | - Marco Pahor
- Institute on Aging, Department of Aging and Geriatric Research, University of Florida, Gainesville, Florida
| | - Abby C King
- Department of Health Research & Policy, and the Stanford Prevention Research Center, Department of Medicine, Stanford University School of Medicine, Stanford, California
| | - W Jack Rejeski
- Department of Health and Exercise Science, Wake Forest University, Winston-Salem, North Carolina
| | - Anne B Newman
- Center for Aging and Population Health, Department of Epidemiology, Graduate School of Public Health, University of Pittsburgh, Pittsburgh, Pennsylvania
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Strotmeyer E, Lange-Maia BS, Cauley JA, Dugan SA, Khoudary SRE, Gabriel KP, Glynn NW, Karvonen-Gutierrez CA. STAIR CLIMB TIME AND FUNCTIONAL POWER ASSOCIATIONS IN EARLY OLD AGE: SWAN. Innov Aging 2019. [PMCID: PMC6846212 DOI: 10.1093/geroni/igz038.1988] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Abstract
Stair climbing assesses neuromuscular components of movement, including muscle power (force*velocity) which may decline earlier in aging vs. strength. We hypothesized age and age-related factor (N=1370; 65.5±2.7 years) associations to stair climb total time (sec), ascend lap time degradation (lap 1 minus 3), power (W/kg body weight) and power degradation (lap 1 minus 3). Adjusting for demographic, lifestyle and age-related comorbidity factors using multivariate linear regression, older age independently related to slower total time and lower power. Non-white ethnicity had slower total time (Black, Hispanic), higher ascend time degradation (Hispanic), and lower power (Hispanic, Chinese, Japanese) vs. Whites. Higher 36-Item Short Form Health Survey (SF-36) and Modified Baecke physical activity scores indicated better performance: lower total time, higher power (SF-36 only), and less degradation in ascend time and power. Stair climb time and power in early old age may capture initial functional loss targets for interventions to prevent late-life disability.
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Affiliation(s)
- Elsa Strotmeyer
- University of Pittsburgh, Pittsburgh, Pennsylvania, United States
| | | | - Jane A Cauley
- University of Pittsburgh, Pittsburgh, Pennsylvania, United States
| | - Sheila A Dugan
- Rush University Medical Center, Chicago, Illinois, United States
| | | | | | - Nancy W Glynn
- University of Pittsburgh, Pittsburgh, Pennsylvania, United States
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Lange-Maia BS, Karvonen-Gutierrez CA, Strotmeyer ES, Avery EF, Appelhans BM, Fitzpatrick SL, Janssen I, Dugan SA, Kravitz HM. Factors Influencing Longitudinal Stair Climb Performance from Midlife to Early Late Life: The Study of Women's Health Across the Nation Chicago and Michigan Sites. J Nutr Health Aging 2019; 23:821-828. [PMID: 31641731 PMCID: PMC6818752 DOI: 10.1007/s12603-019-1254-2] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Abstract
OBJECTIVES To quantify the longitudinal change in stair climb performance (a measure indicative of both physical function and muscle power), determine whether physical activity is related to slower decline in performance, and to identify factors that modify the longitudinal change in performance among women from midlife to late life. DESIGN Longitudinal cohort study with up to 15 study visits. SETTING Two sites of the Study of Women's Health Across the Nation. PARTICIPANTS Black (n=411) and white (N=419) women followed from median age 47.0 (44.6-49.6) to 62.0 (55.8-65.3) years. INTERVENTIONS N/A. MEASUREMENTS Performance on a stair climb test (ascend/descend 4 steps, 3 cycles) was timed. Physical activity (PA) was assessed using the Kaiser Physical Activity Survey (KPAS; possible range 0-15 points). Sociodemographic and health factors were assessed via self-report. BMI was calculated with measured height and weight. Mixed-effects regression modeled longitudinal change in stair climb performance. RESULTS Average baseline stair climb time was 18.12 seconds (95% CI: 17.83-18.41), with 0.98% (95% CI: 0.84%-1.11%) annual slowing. In fully adjusted models, higher levels of PA were associated with faster stair climb times (2.09% faster per point higher, 95% CI: -2.87%- -1.30%), and black women had 5.22% (95% CI: 2.43%-8.01%) slower performance compared to white women. Smoking, financial strain, diabetes, osteoarthritis, fair/poor health, and stroke were associated with 3.36% (95% CI: 0.07%-6.65%), 7.56% (95% CI: 4.75%-10.37%), 8.40% (95% CI: 2.89%-13.92%), 8.46% (95% CI: 5.12%-11.79%), 9.16% (95% CI: 4.72%-13.60%), and 16.94% (95% CI: 5.37%-28.51%) slower performance, respectively. In separate models, higher BMI (per 1-unit), osteoarthritis, fair/poor health, and diabetes, were each associated with 0.06% (95% CI:0.04%-0.08%), 0.48% (95% CI:0.12%-0.84%), 0.81% (95% CI:0.35%-1.28%), and 0.84% (95% CI:0.22%-1.46%), additional slowing per year over time. CONCLUSION Significant declines in function were evident as women transitioned from midlife to early late life. Declines were amplified by indicators of poor health, emphasizing the importance of health in midlife for promoting healthy aging.
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Affiliation(s)
- B S Lange-Maia
- Brittney Lange-Maia, PhD, MPH, 1700 W. Van Buren St., Suite 470, Chicago, IL 60612, Phone: 312-942-9697; Fax: 312-942-8119;
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Abstract
Evidence supports that the physical disablement process starts earlier than previously thought, in midlife when women still have many years to live. Physical activity participation and interventions have been successful in preventing disability in older adults and may be promising for maintaining function at younger ages. Changing the conversation to more relevant topics in midlife, like positive changes in body composition, sleep, and improved mood, may move the dial on participation, as midlife women do not meet guidelines for physical activity. Exploring the role of reproductive aging beyond chronologic aging may provide gender-specific insights on both disablement and participation.
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Affiliation(s)
- Sheila A Dugan
- Department of Physical Medicine and Rehabilitation, Rush University Medical Center, 1725 W. Harrison Street, Suite 885, Chicago, IL 60612, USA; Department of Preventive Medicine, Rush University Medical Center, 1700 W. Van Buren, Suite 470, Chicago, IL 60612, USA.
| | - Kelley Pettee Gabriel
- Department of Epidemiology, Human Genetics, and Environmental Sciences, University of Texas Health Science Center at Houston, School of Public Health, Austin Campus, Michael and Susan Dell Center for Healthy Living, 1616 Guadalupe Street, Suite 6.300, Austin, TX 78701, USA; Department of Women's Health, The University of Texas at Austin, Dell Medical School, Medical Park Tower, 1301 W. 38th Street, Suite 705, Austin, TX 78705, USA
| | - Brittney S Lange-Maia
- Department of Preventive Medicine, Rush University Medical Center, 1700 W. Van Buren, Suite 470, Chicago, IL 60612, USA; Rush University Medical Center, Center for Community Health Equity, 600 S. Paulina Street, Suite 480, AAC, Chicago, IL 60612, USA
| | - Carrie Karvonen-Gutierrez
- Department of Epidemiology, University of Michigan, School of Public Health, 1415 Washington Heights, Room 6618, Ann Arbor, MI 48109-2029, USA
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30
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Lange-Maia BS, De Maio F, Avery EF, Lynch EB, Laflamme EM, Ansell DA, Shah RC. Association of community-level inequities and premature mortality: Chicago, 2011-2015. J Epidemiol Community Health 2018; 72:1099-1103. [PMID: 30171083 DOI: 10.1136/jech-2018-210916] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/18/2018] [Revised: 07/31/2018] [Accepted: 08/05/2018] [Indexed: 11/04/2022]
Abstract
BACKGROUND Substantial disparities in life expectancy exist between Chicago's 77 defined community areas, ranging from approximately 69 to 85 years. Prior work in New York City and Boston has shown that community-level racial and economic segregation as measured by the Index of Concentration at the Extremes (ICE) is strongly related to premature mortality. This novel metric allows for the joint assessment of area-based income and racial polarisation. This study aimed to assess the relationships between racial and economic segregation and economic hardship with premature mortality in Chicago. METHODS Annual age-adjusted premature mortality rates (deaths <65 years) from 2011 to 2015 were calculated for Chicago's 77 community areas. ICE measures for household income (<US$25 000 vs ≥US$100 000), race (black vs non-Hispanic white), combined ICE measure incorporating income and race, and hardship index were calculated from 2015 American Community Survey 5-year estimates. RESULTS Average annual premature mortality rates ranged from 94 (95% CI 61 to 133) deaths per 100 000 population age <65 to 699 (95% CI 394 to 1089). Compared with the highest ICE quintiles, communities in the lowest quintiles had significantly higher rates of premature mortality (ICEIncomerate ratio (RR)=3.06, 95% CI 2.51 to 3.73; ICERaceRR=3.07, 95% CI 2.62 to 3.58; ICEIncome+RaceRR=3.27, 95% CI 2.84 to 3.77). Similarly, compared with communities in the lowest hardship index quintile, communities in the highest quintile had significantly higher premature mortality rates (RR=2.79, 95% CI 2.18 to 3.57). CONCLUSIONS The strong relationships observed between ICE measures and premature mortality-particularly the combined ICE metric encompassing race and income-support the use of ICE in public health monitoring.
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Affiliation(s)
- Brittney S Lange-Maia
- Center for Community Health Equity, Rush University Medical Center, Chicago, Illinois, USA.,Department of Preventive Medicine, Rush University Medical Center, Chicago, Illinois, USA
| | - Fernando De Maio
- Center for Community Health Equity, DePaul University, Chicago, Illinois, USA.,Department of Sociology, DePaul University, Chicago, Illinois, USA
| | - Elizabeth F Avery
- Center for Community Health Equity, Rush University Medical Center, Chicago, Illinois, USA.,Department of Preventive Medicine, Rush University Medical Center, Chicago, Illinois, USA
| | - Elizabeth B Lynch
- Center for Community Health Equity, Rush University Medical Center, Chicago, Illinois, USA.,Department of Preventive Medicine, Rush University Medical Center, Chicago, Illinois, USA
| | - Emily M Laflamme
- Office of Epidemiology, Chicago Department of Public Health, City of Chicago, Chicago, Illinois, USA
| | - David A Ansell
- Center for Community Health Equity, Rush University Medical Center, Chicago, Illinois, USA.,Department of Medicine, Rush University Medical Center, Chicago, Illinois, USA
| | - Raj C Shah
- Center for Community Health Equity, Rush University Medical Center, Chicago, Illinois, USA.,Rush Alzheimer's Disease Center, Rush University Medical Center, Chicago, Illinois, USA.,Department of Family Medicine, Rush University Medical Center, Chicago, Illinois, USA
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Lange-Maia BS, Janssen I, Karvonen-Gutierrez C, Fitzpatrick SL, Strotmeyer ES, Appelhans BM, Avery EF, Dugan SA, Kravitz HM. Trajectories of Stair Climbing Performance for Black and White Midlife Women. Med Sci Sports Exerc 2018. [DOI: 10.1249/01.mss.0000535326.27707.bf] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
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Lange-Maia BS, Newman AB, Jakicic JM, Cauley JA, Boudreau RM, Schwartz AV, Simonsick EM, Satterfield S, Vinik AI, Zivkovic S, Harris TB, Strotmeyer ES. Relationship between sensorimotor peripheral nerve function and indicators of cardiovascular autonomic function in older adults from the Health, Aging and Body Composition Study. Exp Gerontol 2017; 96:38-45. [PMID: 28442382 DOI: 10.1016/j.exger.2017.04.007] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2016] [Revised: 04/06/2017] [Accepted: 04/18/2017] [Indexed: 01/17/2023]
Abstract
BACKGROUND Age-related peripheral nervous system (PNS) impairments are highly prevalent in older adults. Although sensorimotor and cardiovascular autonomic function have been shown to be related in persons with diabetes, the nature of the relationship in general community-dwelling older adult populations is unknown. METHODS Health, Aging and Body Composition participants (n=2399, age=76.5±2.9years, 52% women, 38% black) underwent peripheral nerve testing at the 2000/01 clinic visit. Nerve conduction amplitude and velocity were measured at the peroneal motor nerve. Sensory nerve function was assessed with vibration detection threshold and monofilament (1.4-g/10-g) testing at the big toe. Symptoms of lower-extremity peripheral neuropathy were collected by self-report. Cardiovascular autonomic function indicators included postural hypotension, resting heart rate (HR), as well as HR response to and recovery from submaximal exercise testing (400m walk). Multivariable modeling adjusted for demographic/lifestyle factors, medication use and comorbid conditions. RESULTS In fully adjusted models, poor motor nerve conduction velocity (<40m/s) was associated with greater odds of postural hypotension, (OR=1.6, 95% CI: 1.0-2.5), while poor motor amplitude (<1mV) was associated with 2.3beats/min (p=0.003) higher resting HR. No associations were observed between sensory nerve function or symptoms of peripheral neuropathy and indicators of cardiovascular autonomic function. CONCLUSIONS Motor nerve function and indicators of cardiovascular autonomic function remained significantly related even after considering many potentially shared risk factors. Future studies should investigate common underlying processes for developing multiple PNS impairments in older adults.
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Affiliation(s)
- Brittney S Lange-Maia
- Department of Epidemiology, Graduate School of Public Health, University of Pittsburgh, 130 N. Bellefield Ave., 5th Floor, Pittsburgh, PA 15213, United States
| | - Anne B Newman
- Department of Epidemiology, Graduate School of Public Health, University of Pittsburgh, 130 N. Desoto Street., A528 Crabtree Hall, Pittsburgh, PA 15261, United States
| | - John M Jakicic
- Department of Health and Physical Activity, School of Education, University of Pittsburgh, Oak Hill Commons, 32 Oak Hill Court, Pittsburgh, PA 15261, United States
| | - Jane A Cauley
- Department of Epidemiology, Graduate School of Public Health, University of Pittsburgh, 130 N. Desoto Street, A510 Crabtree Hall, Pittsburgh, PA 15261, United States
| | - Robert M Boudreau
- Department of Epidemiology, Graduate School of Public Health, University of Pittsburgh, 130 N. Bellefield Ave., 5th Floor, Pittsburgh, PA 15213, United States
| | - Ann V Schwartz
- Department of Epidemiology and Biostatistics, University of California San Francisco, 550 16th Street, San Francisco, CA 94158, United States
| | - Eleanor M Simonsick
- Translational Gerontology Branch, National Institute on Aging, National Institutes of Health, 251 Bayview Boulevard, Suite 100, Baltimore, MD 21224, United States
| | - Suzanne Satterfield
- Department of Preventive Medicine, University of Tennessee Health Science Center, 649 Doctor's Office Building, 66 N. Pauline St., Memphis, TN 38163, United States
| | - Aaron I Vinik
- Department of Neurobiology, Eastern Virginia Medical School, 855 W. Brambleton Avenue, Norfolk, VA 23510, United States
| | - Sasa Zivkovic
- Department of Neurology, University of Pittsburgh, 3471 Fifth Ave. Suite 810, Pittsburgh, PA 15213, United States
| | - Tamara B Harris
- Intramural Research Program, Laboratory of Epidemiology, and Population Sciences, National Institute on Aging, National Institutes of Health, Laboratory of Epidemiology, Demography, and Biometry, Gateway Building, 3C309, 7201 Wisconsin Avenue, Bethesda, MD 20892, United States
| | - Elsa S Strotmeyer
- Department of Epidemiology, Graduate School of Public Health, University of Pittsburgh, 130 N. Bellefield Ave., 5th Floor, Pittsburgh, PA 15213, United States.
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Lange-Maia BS, Karavolos K, Avery EF, Nackers L, Powell LH, Lynch EB, Dugan SA. Association between International Physical Activity Questionnaire and Triaxial Accelerometry in Detecting Intervention-Related Physical Activity Changes. Med Sci Sports Exerc 2016. [DOI: 10.1249/01.mss.0000487329.86636.4a] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
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Lange-Maia BS, Newman AB, Cauley JA, Boudreau RM, Jakicic JM, Caserotti P, Glynn NW, Harris TB, Kritchevsky SB, Schwartz AV, Satterfield S, Simonsick EM, Vinik AI, Zivkovic S, Strotmeyer ES. Sensorimotor Peripheral Nerve Function and the Longitudinal Relationship With Endurance Walking in the Health, Aging and Body Composition Study. Arch Phys Med Rehabil 2016; 97:45-52. [PMID: 26343170 PMCID: PMC4696894 DOI: 10.1016/j.apmr.2015.08.423] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/20/2015] [Revised: 07/28/2015] [Accepted: 08/16/2015] [Indexed: 12/25/2022]
Abstract
OBJECTIVES To determine whether lower extremity sensorimotor peripheral nerve deficits are associated with reduced walking endurance in older adults. DESIGN Prospective cohort study with 6 years of follow-up. SETTING Two university research clinics. PARTICIPANTS Community-dwelling older adults enrolled in the Health, Aging and Body Composition Study from the 2000-2001 annual clinical examination (N=2393; mean age ± SD, 76.5±2.9y; 48.2% men; 38.2% black) and a subset with longitudinal data (n=1178). INTERVENTIONS Not applicable. MAIN OUTCOME MEASURES Participants underwent peripheral nerve function examination in 2000-2001, including peroneal motor nerve conduction amplitude and velocity, vibration perception threshold, and monofilament testing. Symptoms of lower extremity peripheral neuropathy included numbness or tingling and sudden stabbing, burning, pain, or aches in the feet or legs. The Long Distance Corridor Walk (LDCW) (400 m) was administered in 2000-2001 and every 2 years afterward for 6 years to assess endurance walking performance over time. RESULTS In separate, fully adjusted linear mixed models, poor vibration threshold (>130 μm), 10-g and 1.4-g monofilament insensitivity were each associated with a slower 400-m walk completion time (16.0 s, 14.4s, and 6.9 s slower, respectively; P<.05 for each). Poor motor amplitude (<1 mV), poor vibration perception threshold, and 10-g monofilament insensitivity were related to greater slowing per year (4.7, 4.2, and 3.8 additional seconds per year, respectively; P<.05), although poor motor amplitude was not associated with initial completion time. CONCLUSIONS Poorer sensorimotor peripheral nerve function is related to slower endurance walking and greater slowing longitudinally. Interventions to reduce the burden of sensorimotor peripheral nerve function impairments should be considered to help older adults maintain walking endurance-a critical component for remaining independent in the community.
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Affiliation(s)
- Brittney S Lange-Maia
- Department of Epidemiology, Graduate School of Public Health, University of Pittsburgh, Pittsburgh, PA
| | - Anne B Newman
- Department of Epidemiology, Graduate School of Public Health, University of Pittsburgh, Pittsburgh, PA
| | - Jane A Cauley
- Department of Epidemiology, Graduate School of Public Health, University of Pittsburgh, Pittsburgh, PA
| | - Robert M Boudreau
- Department of Epidemiology, Graduate School of Public Health, University of Pittsburgh, Pittsburgh, PA
| | - John M Jakicic
- Department of Health and Physical Activity, School of Education, University of Pittsburgh, Pittsburgh, PA
| | - Paolo Caserotti
- Department of Sports Science and Clinical Biomechanics, University of Southern Denmark, Odense, Denmark
| | - Nancy W Glynn
- Department of Epidemiology, Graduate School of Public Health, University of Pittsburgh, Pittsburgh, PA
| | - Tamara B Harris
- Intramural Research Program, Laboratory of Epidemiology and Population Sciences, National Institute on Aging, National Institutes of Health, Bethesda, MD
| | - Stephen B Kritchevsky
- Division of Gerontology and Geriatric Medicine, Department of Internal Medicine, Wake Forest School of Medicine, Winston-Salem, NC
| | - Ann V Schwartz
- Department of Epidemiology and Biostatistics, University of California San Francisco, San Francisco, CA
| | - Suzanne Satterfield
- Department of Preventive Medicine, University of Tennessee Health Science Center, Memphis, TN
| | - Eleanor M Simonsick
- Translational Gerontology Branch, National Institute on Aging, National Institutes of Health, Baltimore, MD
| | - Aaron I Vinik
- Department of Neurobiology, Eastern Virginia Medical School, Norfolk, VA
| | - Sasa Zivkovic
- Department of Neurology, University of Pittsburgh Medical Center, Pittsburgh, PA
| | - Elsa S Strotmeyer
- Department of Epidemiology, Graduate School of Public Health, University of Pittsburgh, Pittsburgh, PA.
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Lange-Maia BS, Strotmeyer ES, Harris TB, Glynn NW, Simonsick EM, Brach JS, Cauley JA, Richey PA, Schwartz AV, Newman AB. Physical Activity and Change in Long Distance Corridor Walk Performance in the Health, Aging, and Body Composition Study. J Am Geriatr Soc 2015; 63:1348-54. [PMID: 26096803 DOI: 10.1111/jgs.13487] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
OBJECTIVES To examine the prospective relationship between self-reported physical activity and aerobic fitness in the Health, Aging, and Body Composition Study (Health ABC) using the Long Distance Corridor Walk (LDCW). DESIGN Cohort study with 7 years of follow-up. SETTING Two U.S. clinical sites. PARTICIPANTS Community-dwelling older adults enrolled in Health ABC (N = 3,075, aged 70-79, 52% female, 42% black) with no self-reported difficulty walking one-quarter of a mile or climbing 10 steps. MEASUREMENTS Participants were classified based on a physical activity questionnaire as being inactive (≤1,000 kcal/wk exercise activity, ≤2,719 kcal/wk total physical activity), lifestyle active (≤1,000 kcal/wk exercise activity, >2,719 kcal/wk total physical activity), or exercisers (≥1,000 kcal/wk exercise activity). The LDCW, an endurance walking test (400 m), was administered at Years 1 (baseline), 2, 4, 6, and 8 to assess aerobic fitness. RESULTS At baseline, LDCW completion times (adjusted for age and sex) were 351.8 seconds (95% confidence interval (CI) = 346.9-356.8 seconds) for the inactive group, 335.9 seconds (95% CI = 332.7-339.1 seconds) for the lifestyle active group, and 307.7 seconds (95% CI = 303.2-312.3 seconds) for the exerciser group (P < .001). From baseline to Year 8, the inactive group slowed 36.1 seconds (95% CI = 28.4-43.8 seconds), the lifestyle active group slowed 38.1 seconds (95% CI = 33.6-42.4 seconds), and the exerciser group slowed 40.8 seconds (95% CI = 35.2-46.5 seconds), and did not differ significantly between groups. In linear mixed-effects models, the rate of change in LDCW time did not differ between the groups, although exercisers consistently had the fastest completion times (P < .001 for all pairwise comparisons). CONCLUSION Decline in LDCW time occurred regardless of baseline activity, although exercisers maintained higher aerobic fitness, which may delay reaching a critically low threshold of aerobic fitness at which independence is impaired.
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Affiliation(s)
- Brittney S Lange-Maia
- Center for Aging and Population Health, Department of Epidemiology, Graduate School of Public Health, University of Pittsburgh, Pittsburgh, Pennsylvania
| | - Elsa S Strotmeyer
- Center for Aging and Population Health, Department of Epidemiology, Graduate School of Public Health, University of Pittsburgh, Pittsburgh, Pennsylvania
| | - Tamara B Harris
- Intramural Research Program, Laboratory of Epidemiology and Population Sciences, National Institute on Aging, Bethesda, Maryland
| | - Nancy W Glynn
- Center for Aging and Population Health, Department of Epidemiology, Graduate School of Public Health, University of Pittsburgh, Pittsburgh, Pennsylvania
| | - Eleanor M Simonsick
- Intramural Research Program, National Institute on Aging, Baltimore, Maryland
| | - Jennifer S Brach
- Department of Physical Therapy, School of Health and Rehabilitation Science, University of Pittsburgh, Pittsburgh, Pennsylvania
| | - Jane A Cauley
- Center for Aging and Population Health, Department of Epidemiology, Graduate School of Public Health, University of Pittsburgh, Pittsburgh, Pennsylvania
| | - Phyllis A Richey
- Department of Preventive Medicine, University of Tennessee Health Science Center, Memphis, Tennessee
| | - Ann V Schwartz
- Department of Epidemiology and Biostatistics, University of California at San Francisco, San Francisco, California
| | - Anne B Newman
- Center for Aging and Population Health, Department of Epidemiology, Graduate School of Public Health, University of Pittsburgh, Pittsburgh, Pennsylvania
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Lange-Maia BS, Newman AB, Strotmeyer ES, Harris TB, Caserotti P, Glynn NW. Performance on fast- and usual-paced 400-m walk tests in older adults: are they comparable? Aging Clin Exp Res 2015; 27:309-14. [PMID: 25373610 DOI: 10.1007/s40520-014-0287-y] [Citation(s) in RCA: 30] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/02/2014] [Accepted: 10/28/2014] [Indexed: 11/29/2022]
Abstract
BACKGROUND AND AIMS Fast- and usual-paced 400-m walking tests are often used to assess physical fitness or function, respectively, though it is not known how performance converges on these tests. This study aims to determine whether performance on the fast- and usual-paced 400-m walks varies based upon age and physical function. METHODS Participants (26 men, 38 women aged 70-92) completed a fast- and usual-paced 400-m walk. The Short Physical Performance Battery was used to assess function (score range 0-12). Body mass index and health history were also assessed. RESULTS Finish times for the fast- and usual-paced 400-m walks were 333.3 and 380.3 s, respectively (P < 0.0001), and highly correlated (r = 0.88, P < 0.001). Higher functioning participants (SPPB > 10) had greater differences between tests compared to lower functioning participants (SPPB ≤ 10) (52.9 vs. 26.2 s, P = 0.005), as did younger participants (age < 80) compared to those age 80 and older (56.8 vs. 32.8 s, P = 0.003). DISCUSSION Older and lower functioning participants had greater convergence on the fast- and usual-paced 400-m walks. Potentially some of these lower functioning and older adults may have already performed at their maximal capacity during the usual-paced walk, while the younger and higher functioning participants were able to walk substantially faster when asked. CONCLUSIONS Choice of walking test should consider the age and functional capacity of the population as well as whether function or fitness is of interest.
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Affiliation(s)
- Brittney S Lange-Maia
- Graduate School of Public Health, Department of Epidemiology, Center for Aging and Population Health, University of Pittsburgh, 130 N. Bellefield Avenue, Room 548, Pittsburgh, PA, 15261, USA,
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Lange-Maia BS, Cauley JA, Newman AB, Boudreau R, Jakicic J, Glynn NW, Zivkovic S, Dam T, Caserotti P, Cawthon P, Strotmeyer E. Worse Sensorimotor Peripheral Nerve Function is Associated with Lower Objective Physical Activity in Older Men. Med Sci Sports Exerc 2015. [DOI: 10.1249/01.mss.0000466158.68779.a5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
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