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Bogoian HR, Barber SJ, Carter SE, Mingo C, Rosano C, Dotson VM. Association of white matter hyperintensities and clinical vascular burden with depressive symptoms in Black older adults. Int J Geriatr Psychiatry 2024; 39:e6052. [PMID: 38165121 PMCID: PMC10947565 DOI: 10.1002/gps.6052] [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: 05/17/2023] [Accepted: 12/18/2023] [Indexed: 01/03/2024]
Abstract
OBJECTIVES Black older adults have a higher vascular burden compared to non-Hispanic White (NHW) older adults, which may put them at risk for a form of depression known as vascular depression (VaDep). The literature examining VaDep in Black older adults is sparse. The current study addressed this important gap by examining whether vascular burden was associated with depressive symptoms in Black older adults. METHODS Participants included 113 Black older adults from the Healthy Brain Project, a substudy of the Health, Aging, and Body Composition Study. In multiple regression analyses, clinical vascular burden (sum of vascular conditions) and white matter hyperintensity (WMH) volume predicted depressive symptoms as measured by the Center for Epidemiologic Studies Depression Scale, controlling for demographic variables. Follow-up analyses compared the associations in the Black subsample and in 179 NHW older adults. RESULTS Higher total WMH volume, but not clinically-defined vascular burden, predicted higher concurrent depressive symptoms and higher average depressive symptoms over 4 years. Similar associations were found between uncinate fasciculus (UF) WMHs and concurrent depressive symptoms and between superior longitudinal fasciculus WMHs and average depressive symptoms. The association between depressive symptoms and UF WMH was stronger in Black compared to NHW individuals. CONCLUSION This research is consistent with the VaDep hypothesis and extends it to Black older adults, a group that has historically been underrepresented in the literature. Results highlight WMH in the UF as particularly relevant to depressive symptoms in Black older adults and suggest this group may be particularly vulnerable to the negative effects of WMH.
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Affiliation(s)
- Hannah R. Bogoian
- Department of Psychology, Georgia State University, Atlanta, Georgia, USA
| | - Sarah J. Barber
- Department of Psychology, Georgia State University, Atlanta, Georgia, USA
- Gerontology Institute, Georgia State University, Atlanta, Georgia, USA
| | - Sierra E. Carter
- Department of Psychology, Georgia State University, Atlanta, Georgia, USA
| | - Chivon Mingo
- Gerontology Institute, Georgia State University, Atlanta, Georgia, USA
| | - Caterina Rosano
- Department of Epidemiology, School of Public Health, University of Pittsburgh, Pittsburgh, Pennsylvania, USA
| | - Vonetta M. Dotson
- Department of Psychology, Georgia State University, Atlanta, Georgia, USA
- Gerontology Institute, Georgia State University, Atlanta, Georgia, USA
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Abstract
Hip osteoarthritis (OA) is common but understudied compared with knee OA, and insights into the impact of this condition on the general population are needed. This review article summarizes findings from the 30-year, longitudinal, population-based Johnston County Osteoarthritis Project cohort to address the prevalence, incidence, and progression of hip OA and differences by sex and race; similarities and differences related to other joints; and impact on morbidity and mortality.
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Affiliation(s)
- Amanda Nelson
- Division of Rheumatology, Allergy, and Immunology, Department of Medicine, Thurston Arthritis Research Center, Gillings School of Global Public Health, The University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
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Cheung KL, Crews DC, Cushman M, Yuan Y, Wilkinson K, Long DL, Judd SE, Shlipak MG, Ix JH, Bullen AL, Warnock DG, Gutiérrez OM. Risk Factors for Incident CKD in Black and White Americans: The REGARDS Study. Am J Kidney Dis 2023; 82:11-21.e1. [PMID: 36621640 PMCID: PMC10293023 DOI: 10.1053/j.ajkd.2022.11.015] [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: 03/22/2022] [Accepted: 11/22/2022] [Indexed: 01/07/2023]
Abstract
RATIONALE & OBJECTIVE Little information exists on the incidence of and risk factors for chronic kidney disease (CKD) in contemporary US cohorts and whether risk factors differ by race, sex, or region in the United States. STUDY DESIGN Observational cohort study. SETTING & PARTICIPANTS 4,198 Black and 7,799 White participants aged at least 45 years, recruited from 2003 through 2007 across the continental United States, with baseline estimated glomerular filtration rate (eGFR)>60mL/min/1.73m2 and eGFR assessed again approximately 9 years later. EXPOSURES Age, sex, race (Black or White), region ("stroke belt" or other), education, income, systolic blood pressure, body mass index, diabetes, coronary heart disease, hyperlipidemia, smoking, and albuminuria. OUTCOMES (1) eGFR change and (2) incident CKD defined as eGFR<60mL/min/1.73m2 and≥40% decrease from baseline or kidney failure. ANALYTICAL APPROACH Linear regression and modified Poisson regression were used to determine the association of risk factors with eGFR change and incident CKD overall and stratified by race, sex, and region. RESULTS Mean age of participants was 63±8 (SD) years, 54% were female, and 35% were Black. After 9.4±1.0 years of follow-up, CKD developed in 9%. In an age-, sex-, and race-adjusted model, Black race (β =-0.13; P<0.001) was associated with higher risk of eGFR change, but this was attenuated in the fully adjusted model (β=0.02; P=0.5). Stroke belt residence was independently associated with eGFR change (β =-0.10; P<0.001) and incident CKD (relative risk, 1.14 [95% CI, 1.01-1.30]). Albuminuria was more strongly associated with eGFR change (β of-0.26 vs-0.17; P=0.01 for interaction) in Black compared with White participants. Results were similar for incident CKD. LIMITATIONS Persons of Hispanic ethnicity were excluded; unknown duration and/or severity of risk factors. CONCLUSIONS Established CKD risk factors accounted for higher risk of incident CKD in Black versus White individuals. Albuminuria was a stronger risk factor for eGFR decrease and incident CKD in Black compared with White individuals. Living in the US stroke belt is a novel risk factor for CKD.
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Affiliation(s)
- Katharine L Cheung
- Divisions of Nephrology, Larner College of Medicine at The University of Vermont, Burlington, Vermont.
| | - Deidra C Crews
- Division of Nephrology, Johns Hopkins University, Baltimore, Maryland
| | - Mary Cushman
- Hematology/Oncology, Department of Medicine, Larner College of Medicine at The University of Vermont, Burlington, Vermont
| | - Ya Yuan
- School of Public Health, University of Alabama at Birmingham, Birmingham, Alabama
| | - Katherine Wilkinson
- Larner College of Medicine at The University of Vermont, Burlington, Vermont
| | - D Leann Long
- School of Public Health, University of Alabama at Birmingham, Birmingham, Alabama
| | - Suzanne E Judd
- School of Public Health, University of Alabama at Birmingham, Birmingham, Alabama
| | - Michael G Shlipak
- Division of Nephrology, University of California, San Francisco, San Francisco, California
| | - Joachim H Ix
- Division of Nephrology, University of California, San Diego, La Jolla, California
| | - Alexander L Bullen
- Division of Nephrology, University of California, San Diego, La Jolla, California
| | - David G Warnock
- Division of Nephrology, University of Alabama at Birmingham, Birmingham, Alabama
| | - Orlando M Gutiérrez
- Division of Nephrology, University of Alabama at Birmingham, Birmingham, Alabama
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Desai P, Krueger KR, Mendes de Leon C, Wilson RS, Evans DA, Rajan KB. Race and Apolipoprotein E-e4 Allele Status Differences in the Association Between Loneliness and Cognitive Decline. Psychosom Med 2023; 85:231-237. [PMID: 36626598 PMCID: PMC10073257 DOI: 10.1097/psy.0000000000001168] [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] [Indexed: 01/11/2023]
Abstract
OBJECTIVE This study aimed to examine race and apolipoprotein E-e4 allele (APOE-e4) status differences in the longitudinal associations between loneliness and cognitive decline. METHODS The study sample is composed of participants ( N = 7696, 64% Black participants and 36% White participants) from the Chicago Health and Aging Project, a population-based cohort study. Mixed-effects regression models were conducted to examine the longitudinal associations between loneliness on global cognitive function and individual tests of cognitive function. Models were also stratified by race and APOE-e4. RESULTS A greater percentage of Black participants (17%) reported loneliness at baseline visit compared with White participants (12%). Black and White participants who were lonely individuals had a similar rate of decline in global cognitive function at 0.075 (95% confidence interval [CI] = -0.082 to -0.068) standard deviation unit (SDU) per year for Black participants and at 0.075 (95% CI = -0.086 to -0.063) SDU per year for White participants. Lonely participants with APOE-e4 had a higher rate of global cognitive decline at -0.102 (95% CI = -0.115 to -0.088) SDU per year than for lonely participants without APOE-e4 at -0.052 (95% CI = -0.059 to -0.045) SDU per year. CONCLUSIONS The burden of loneliness and its relation to cognitive decline is higher among participants with APOE-e4 compared with those without APOE-e4. Loneliness is associated with cognitive decline in both Black and White participants.
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Affiliation(s)
- Pankaja Desai
- Rush Institute for Healthy Aging, Rush University Medical Center, Chicago, IL
| | - Kristin R. Krueger
- Rush Institute for Healthy Aging, Rush University Medical Center, Chicago, IL
| | | | - Robert S. Wilson
- Rush Alzheimer’s Disease Center, Rush University Medical Center, Chicago, IL
| | - Denis A. Evans
- Rush Institute for Healthy Aging, Rush University Medical Center, Chicago, IL
| | - Kumar B. Rajan
- Rush Institute for Healthy Aging, Rush University Medical Center, Chicago, IL
- Department of Neurology, University of California at Davis, Davis, CA
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Kobo O, Abramov D, Davies S, Ahmed SB, Sun LY, Mieres JH, Parwani P, Siudak Z, Van Spall HG, Mamas MA. CKD-Associated Cardiovascular Mortality in the United States: Temporal Trends From 1999 to 2020. Kidney Med 2022; 5:100597. [PMID: 36814454 PMCID: PMC9939730 DOI: 10.1016/j.xkme.2022.100597] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [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: 12/29/2022] Open
Abstract
Rationale & Objective Chronic kidney disease (CKD) is associated with an increased risk of cardiovascular (CV) mortality, but there are limited data on temporal trends disaggregated by sex, race, and urban/rural status in this population. Study Design Retrospective observational study. Setting & Participants The Centers for Disease Control and Prevention Wide-Ranging, Online Data for Epidemiologic Research database. Exposure & Predictors Patients with CKD and end-stage kidney disease (ESKD) stratified according to key demographic groups. Outcomes Etiologies of CKD- and ESKD-associated mortality between 1999 and 2000. Analytical Approach Presentation of age-adjusted mortality rates (per 100,000 people) characterized by CV categories, ethnicity, sex (male or female), age categories, state, and urban/rural status. Results Between 1999 and 2020, we identified 1,938,505 death certificates with CKD (and ESKD) as an associated cause of mortality. Of all CKD-associated mortality, the most common etiology was CV, with 31.2% of cases. Between 1999 and 2020, CKD-related age-adjusted mortality increased by 50.2%, which was attributed to an 86.6% increase in non-CV mortality but a 7.1% decrease in CV mortality. Black patients had a higher rate of CV mortality throughout the study period, although Black patients experienced a 38.6% reduction in mortality whereas White patients saw a 2.7% increase. Hispanic patients experienced a greater reduction in CV mortality over the study period (40% reduction) compared to non-Hispanic patients (3.6% reduction). CV mortality was higher in urban areas in 1999 but in rural areas in 2020. Limitations Reliance on accurate characterization of causes of mortality in a large dataset. Conclusions Among patients with CKD-related mortality in the United States between 1999 and 2020, there was an increase in all-cause mortality though a small decrease in CV-related mortality. Overall, temporal decreases in CV mortality were more prominent in Hispanic versus non-Hispanic patients and Black patients versus White patients.
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Affiliation(s)
- Ofer Kobo
- Department of Cardiology, Hillel Yaffe Medical Center, Hadera, Israel,Keele Cardiovascular Research Group, Centre for Prognosis Research, Keele University, Stoke-on-Trent, United Kingdom
| | - Dmitry Abramov
- Division of Cardiology, Department of Medicine, Loma Linda University Health, Loma Linda, California
| | - Simon Davies
- Department of Renal Medicine, School of Medicine, Keele University, David Weatherall Building, Keele, United Kingdom
| | - Sofia B. Ahmed
- Department of Medicine, University of Calgary, Alberta, Canada,Libin Cardiovascular Institute of Alberta, Calgary, Canada,Alberta Kidney Disease Network, Calgary, Canada
| | - Louise Y. Sun
- Division of Cardiac Anesthesiology, University of Ottawa Heart Institute, Ottawa, Ontario, Canada,School of Epidemiology and Public Health, University of Ottawa, Ottawa, Ontario, Canada
| | - Jennifer H. Mieres
- Donald and Barbara Zucker School of Medicine at Hofstra/Northwell, Northwell Health, Hempstead, New York
| | - Purvi Parwani
- Division of Cardiology, Department of Medicine, Loma Linda University Health, Loma Linda, California
| | - Zbigniew Siudak
- Collegium Medicum, Jan Kochanowski University, Kielce, Poland
| | - Harriette G.C. Van Spall
- Department of Medicine and Department of Health Research Methods, Evidence, and Impact, McMaster University, Hamilton, Ontario, Canada,Population Health Research Institute, Hamilton, Ontario, Canada,Research Institute of St. Joseph’s, Hamilton, Ontario, Canada
| | - Mamas A. Mamas
- Keele Cardiovascular Research Group, Centre for Prognosis Research, Keele University, Stoke-on-Trent, United Kingdom,Address for Correspondence: Mamas A. Mamas, Professor of Cardiology, Keele Cardiovascular Research Group, Centre for Prognosis Research, Keele University, UK.
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Perez A, Manning KJ, Powell W, Barry LC. Cognitive Impairment in Older Incarcerated Males: Education and Race Considerations. Am J Geriatr Psychiatry 2021; 29:1062-1073. [PMID: 34193384 PMCID: PMC8448974 DOI: 10.1016/j.jagp.2021.05.014] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [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: 03/16/2021] [Revised: 05/14/2021] [Accepted: 05/21/2021] [Indexed: 11/26/2022]
Abstract
OBJECTIVE Assess cognitive impairment (global cognition and executive functioning) in older incarcerated males overall, and according to education and race. DESIGN Cross-sectional PARTICIPANTS: The sample included 239 racially diverse (37.7% White, 41.4% Black, 20.9% Hispanic/Other) incarcerated males age ≥50 (mean age = 56.4 ± 6.1; range 50-79 years). MEASUREMENTS Global cognitive impairment assessed using the Montreal Cognitive Assessment (MoCA) - standard MoCA scoring (1-point adjustment for ≤12 years education, and score <26 indicating cognitive impairment) versus education- and race-specific cutpoints. Trail Making Test (TMT) assessed executive functioning. The relationship between race and cognitive impairment was evaluated using Chi-Square, One-Way ANOVA, and Tukey's HSD post-hoc analyses. Chi-Square was also used to evaluate the relationship between race and frequency of missed MoCA items. RESULTS Average MoCA score was 24.12 ± 3.38. Overall, 62.8% and 38.5% of participants met criteria for cognitive impairment using standard scoring and education- and race-specific cutpoints, respectively. This difference was largely attributed to the change in proportion of Blacks who met criteria for cognitive impairment after applying education- and race-specific cutpoints (62.6% versus 19.2%). Fewer White inmates were impaired (51.1% versus 36.7%) after applying demographically-adjusted norms; however, the proportion of Hispanics/Others remained largely unchanged (84% versus 80%). A considerable proportion of participants were mildly impaired on TMT-A (18.2% Whites, 7.1% Blacks) and TMT-B (20.5% Whites, 4.1% Blacks). Race differences were observed in missed MoCA items. CONCLUSIONS Cognitive impairment is common in older incarcerated persons, despite applying education- and race-specific norms. Notable race differences highlight need for validated assessments for this diverse population.
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Affiliation(s)
- Alice Perez
- University of Connecticut School of Medicine, Department of Psychiatry
| | - Kevin J. Manning
- University of Connecticut School of Medicine, Department of Psychiatry
| | - Wizdom Powell
- University of Connecticut School of Medicine, Department of Psychiatry,University of Connecticut Health Disparities Institute
| | - Lisa C. Barry
- University of Connecticut School of Medicine, Department of Psychiatry
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Fedewa MV, Nickerson BS, Tinsley GM, Esco MR, Dunbar EG, Boucher AG, DeLeon RM. Examining Race-Related Error in Two-Compartment Models of Body Composition Assessment: A Systematic Review and Meta-Analysis. J Clin Densitom 2021; 24:156-168. [PMID: 31810770 DOI: 10.1016/j.jocd.2019.10.002] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/19/2019] [Revised: 10/15/2019] [Accepted: 10/16/2019] [Indexed: 12/23/2022]
Abstract
BACKGROUND The Brozek and Siri formulas estimate relative adiposity (%Fat) from total body density (Db) using a 2-compartment (2C) model. Racial/ethnic differences in Db have been reported, along with subsequent errors in estimated %Fat. OBJECTIVE The primary aim of this systematic review and meta-analysis was to examine potential race/ethnic differences in the accuracy of the Brozek and Siri 2C formulas using aggregate-level data. METHODS Peer-reviewed studies available in English that provided 2C and 4C estimates of %Fat were located using searches of the PubMed (n = 150), Scopus (n = 170), and Web of Science (n = 138) online electronic databases. Random-effects models were used to determine potential differences between racial groups using a mean ES and 95% confidence intervals. RESULTS The cumulative results from 78 effects indicate that the relative accuracy of the Brozek equation did not vary between racial groups (between group p = 0.053). In contrast, the Siri equation slightly underestimated %Fat for Asian adults (ESWMD = -1.40%, 95%CI -2.33% to -0.46%; p = 0.004) and Black adults (ESWMD = -1.10%, 95%CI -2.11% to -0.08%; p = 0.034), with no significant differences observed in Hispanic adults (ESWMD = 0.64%, 95%CI -1.02% to 2.31%; p = 0.448) and White adults (ESWMD = 0.08%, 95%CI -0.42% to 0.57%; p = 0.766) (between group p = 0.019). CONCLUSION Small, but statistically significant, error was found between racial groups when estimating %Fat using the 2C Siri equation when compared to 4C models. However, the observed error due to race/ethnicity appears to be of little clinical or practical significance when using either equation.
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Affiliation(s)
- Michael V Fedewa
- Department of Kinesiology, The University of Alabama, Tuscaloosa, AL, USA.
| | - Brett S Nickerson
- College of Nursing and Health Sciences, Texas A&M International University, Laredo, TX, USA
| | - Grant M Tinsley
- Department of Kinesiology & Sport Management, Texas Tech University, Lubbock, TX, USA
| | - Michael R Esco
- Department of Kinesiology, The University of Alabama, Tuscaloosa, AL, USA
| | - Elisabeth G Dunbar
- Department of Kinesiology, The University of Alabama, Tuscaloosa, AL, USA
| | - Abigail G Boucher
- Department of Kinesiology, The University of Alabama, Tuscaloosa, AL, USA
| | - Ricardo M DeLeon
- Department of Kinesiology, The University of Alabama, Tuscaloosa, AL, USA
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8
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Briggs FBS, Hill E, Abboud H. The prevalence of hypertension in multiple sclerosis based on 37 million electronic health records from the United States. Eur J Neurol 2020; 28:558-566. [PMID: 32981133 DOI: 10.1111/ene.14557] [Citation(s) in RCA: 17] [Impact Index Per Article: 4.3] [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: 04/17/2020] [Accepted: 09/17/2020] [Indexed: 12/12/2022]
Abstract
BACKGROUND AND PURPOSE Hypertension (HTN) is a common comorbidity in multiple sclerosis (MS), and it significantly contributes to adverse outcomes. Unfortunately, the distribution of HTN in persons with MS has not been well characterized, and prior estimates have primarily relied on modest sample sizes. The objective of this study was to robustly describe the distribution of HTN in the MS population in comparison to the non-MS population with considerations for age, sex, and race. To date, this is the largest investigation of its kind. METHODS We conducted a cross-sectional study of 37 million unique electronic health records available in the IBM Explorys Enterprise Performance Management: Explore database (Explorys) spanning the United States. This resource has previously been validated for use in MS. We evaluated the prevalence of HTN in MS (N = 122 660) and non-MS (N = 37 075 350) cohorts, stratifying by age, sex, and race. RESULTS The prevalence of HTN was significantly greater among those with MS than among those without MS across age, sex, and race subpopulations, even after adjusting for age and sex. HTN was 25% more common in MS. In both MS and non-MS cohorts, the prevalence of HTN progressively increased with age and was higher in Black Americans and in males. DISCUSSION This study demonstrated that HTN is significantly more common in the MS population compared to the non-MS population, irrespective of sex and race. Because HTN is the leading global risk factor for disability and death, these results emphasize the need for aggressive screening for, and management of, HTN in the MS population.
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Affiliation(s)
- F B S Briggs
- Neuroimmunological Disorders Gene-Environment Epidemiology Laboratory, Department of Population and Quantitative Health Sciences, School of Medicine, Case Western Reserve University, Cleveland, Ohio, USA
| | - E Hill
- Neuroimmunological Disorders Gene-Environment Epidemiology Laboratory, Department of Population and Quantitative Health Sciences, School of Medicine, Case Western Reserve University, Cleveland, Ohio, USA.,School of Medicine, Case Western Reserve University, Cleveland, Ohio, USA
| | - H Abboud
- School of Medicine, Case Western Reserve University, Cleveland, Ohio, USA.,Multiple Sclerosis and Neuroimmunology Program, University Hospitals of Cleveland, Cleveland, Ohio, USA
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9
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Pool AC, Coffman DL, Sarwer DB, LaRose JG, Hart CN. Associations between weight misperception, contextual factors, and weight loss behaviours in young adult men with overweight/obesity. Obes Sci Pract 2020; 6:39-46. [PMID: 32128241 PMCID: PMC7042023 DOI: 10.1002/osp4.382] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2018] [Revised: 10/14/2019] [Accepted: 10/16/2019] [Indexed: 11/17/2022] Open
Abstract
OBJECTIVE Young men are less likely to engage in weight loss behaviours than their female counterparts. This may be because of an increased likelihood for young men, particularly young black men, with overweight/obesity to misperceive their weight status. This study examined racial differences in weight status perception accuracy and associations between this perception and weight loss behaviours among young men. Associations between weight loss behaviours and contextual factors were also explored. METHODS Data from 1417 young adult (YA) men with overweight/obesity from the 2007 to 2014 National Health and Nutrition Examination Survey (NHANES) were analysed. Associations between weight status perception accuracy, contextual factors, and weight loss attempts and behaviours were examined with logistic regression. RESULTS YA men with overweight/obesity were more likely to report weight loss attempts and behaviours if they perceived themselves as being overweight (OR = 3.10; 95% CI, 2.18-4.41; P < .01; OR = 3.20, 95% CI, 2.16-4.72, P < .01, respectively). Greater education and income were associated with a greater likelihood of reporting weight loss attempts and healthy weight loss behaviours. Greater reported depressive symptoms were associated with reported weight loss attempts but not healthy weight loss behaviours. There were no differences by race for reported weight loss attempts or behaviours. CONCLUSION Among YA men with overweight/obesity, perceiving oneself as overweight was associated with reporting weight loss attempts and healthy weight loss behaviours. Future research should consider how weight status perception accuracy affects weight loss attempts among YA men and what additional factors may account for racial differences.
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Affiliation(s)
- Andrew C. Pool
- Center for Parent and Teen CommunicationCraig‐Dalsimer Division of Adolescent Medicine, Children's Hospital of PhiladelphiaPhiladelphiaPennsylvania
| | - Donna L. Coffman
- Department of Epidemiology and BiostatisticsTemple UniversityPhiladelphiaPennsylvania
| | - David B. Sarwer
- Center for Obesity Research and EducationTemple UniversityPhiladelphiaPennsylvania
- Department of Social and Behavioral SciencesTemple UniversityPhiladelphiaPennsylvania
| | - Jessica G. LaRose
- Department of Health Behavior and PolicyVirginia Commonwealth University School of MedicineRichmondVirginia
| | - Chantelle N. Hart
- Center for Obesity Research and EducationTemple UniversityPhiladelphiaPennsylvania
- Department of Social and Behavioral SciencesTemple UniversityPhiladelphiaPennsylvania
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10
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Robinson AT, Cook MD, Lane-Cordova AD. Making cell culture more physiological: a call for a more comprehensive assessment of racial disparities in endothelial cell culture studies. Am J Physiol Cell Physiol 2019; 318:C238-C241. [PMID: 31747315 DOI: 10.1152/ajpcell.00467.2019] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
Abstract
In the United States, cardiovascular diseases (CVDs) are the leading cause of death and disproportionately affect ethnic and racial minority populations. Black individuals are more likely to develop advanced CVD and microvascular complications resulting in end-organ damage. Endothelial cell dysfunction leads to microvascular and macrovascular dysfunction and is predictive of the development of CVD. Black versus white racial disparities in in vivo and in vitro studies of endothelial cell function are well documented. However, race-related disparities in maternal environment and lifestyle may be a major unconsidered factor in racial differences in endothelial cell culture studies. Further, rates of hypertensive disorders of pregnancy are higher in black versus white women. These pregnancy complications may result in placental dysfunction, including excess production of inflammatory and antiangiogenic molecules that impair endothelial function. Therefore, studies that include other ethnic and racial minorities are needed, in addition to a more thorough characterization of endothelial cell donors and targeted cell culture studies (e.g., genotyping) to generate information that can be translated into effective preventive or treatment strategies for ethnic/racial disparities in CVD.
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Affiliation(s)
- Austin T Robinson
- School of Kinesiology, Neurovascular Physiology Laboratory, Auburn University, Auburn, Alabama
| | - Marc D Cook
- Department of Kinesiology, North Carolina Agriculture and Technology State University, Greensboro, North Carolina
| | - Abbi D Lane-Cordova
- Department of Exercise Science, Arnold School of Public Health, University of South Carolina at Columbia, Columbia, South Carolina
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11
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Bleakley A, Ellithorpe ME, Prince L, Hennessy M, Khurana A, Jamieson PE, Weitz I. Do you see what I see? A character analysis of health risk behaviors in television shows popular with Black adolescents in the US. J Child Media 2018; 12:478-495. [PMID: 30643541 PMCID: PMC6329382 DOI: 10.1080/17482798.2018.1487310] [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] [Subscribe] [Scholar Register] [Indexed: 06/09/2023]
Abstract
Adolescents spend many hours per day watching television, and there are racial differences in time spent watching television and in show preferences. Prior research suggests there are also differential associations in how exposure to media content affects adolescent behavior. This study examines the demographic representation of main characters and health risk behaviors (i.e., sex, alcohol use, violence, bullying, and their combinations) portrayed in television content popular with Black and non-Black adolescents. A content analysis of television show characters (n=377) from the 2014-15 season was conducted on shows popular with 14-17 year old adolescent audiences in the United States. Group popularity was determined by Nielsen ratings segmented by Black and non-Black (primarily White) adolescents. Results suggest that character representation varies by whether shows were popular with Blacks or others, and that risk portrayals are common in all popular content with few group differences. Implications for adolescent behavior are discussed.
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Affiliation(s)
- Amy Bleakley
- Corresponding author: Annenberg School for Communication, University of Pennsylvania, 3901 Walnut Street, Philadelphia, PA 19104; , 215.573.1961
| | - Morgan E Ellithorpe
- Department of Advertising & Public Relations, College of Communication Arts & Sciences, Michigan State University, 369 Communication Arts & Sciences, East Lansing, MI 48823, USA; , 517.355.0256
| | - Lisa Prince
- Philadelphia Department of Public Health, 1101 market Street, 9 Floor, Philadelphia, PA 19107; ; 215.573.1961
| | - Michael Hennessy
- Annenberg School for Communication, University of Pennsylvania, 3901 Walnut Street, Philadelphia, PA 19104; ; 215.898.7041
| | - Atika Khurana
- Department of Counseling Psychology and Human Services, University of Oregon, 369 HEDCO Education Building, Eugene, OR 97403; , 541.346.5540
| | - Patrick E Jamieson
- Annenberg Public Policy Center, University of Pennsylvania, 202 S. 36th Street, Philadelphia, PA 19104; , 215.746.5374
| | - Ilana Weitz
- Annenberg Public Policy Center, University of Pennsylvania, 202 S. 36th Street, Philadelphia, PA 19104; , 215.746.0303
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White UA, Fitch MD, Beyl RA, Hellerstein MK, Ravussin E. Racial differences in in vivo adipose lipid kinetics in humans. J Lipid Res 2018; 59:1738-1744. [PMID: 29910190 DOI: 10.1194/jlr.p082628] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [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: 12/18/2017] [Revised: 05/16/2018] [Indexed: 11/20/2022] Open
Abstract
The storage of lipids in the form of triglycerides (TGs) and the de novo synthesis (lipogenesis) of fatty acids from nonlipid precursors [de novo lipogenesis (DNL)] are important functions of adipose tissue (AT) that influence whole-body metabolism. Yet, few studies have reported in vivo estimates of adipose lipid kinetics in humans. Fifty-two women with obesity (27 African-American and 25 Caucasian; 29.7 ± 5.5 years; BMI 32.2 ± 2.8 kg/m2; 44.3 ± 4.0% body fat) were enrolled in the study. In vivo synthesis (or replacement) of TGs (fTG) as well as the synthesis of the fatty acid, palmitate [a measure of adipose DNL (fDNL)], were assessed using an 8 week incorporation of deuterium into lipids (glycerol and palmitate moieties of TGs) in subcutaneous abdominal (scABD) and subcutaneous femoral (scFEM) AT. We report, for the first time, significant race differences in both TG synthesis and absolute DNL, with Caucasians having higher fTG and fDNL as compared with African-Americans. The DNL contribution to newly synthesized TG (corrected fDNL) was not different between races. Interestingly, our findings also show that the scFEM adipose depot had higher TG replacement rates relative to the scABD. Finally, the replacement rate of TG (fTG) was negatively correlated with changes in body weight over the 8 week labeling period. Our results provide the first evidence that in vivo TG replacement (synthesis and breakdown) rates differ by ethnicity. In addition, TG turnover varies by depot location in humans, implying an increased capacity for TG storage and higher lipolytic activity in the scFEM AT.
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Affiliation(s)
- Ursula A White
- Pennington Biomedical Research Center, Louisiana State University System, Baton Rouge, LA
| | - Mark D Fitch
- University of California at Berkeley, Berkeley, CA
| | - Robbie A Beyl
- Pennington Biomedical Research Center, Louisiana State University System, Baton Rouge, LA
| | | | - Eric Ravussin
- Pennington Biomedical Research Center, Louisiana State University System, Baton Rouge, LA.
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Xie C, Shao N, He L, Li X, Li C, Li J, Su D. Exploration of Racial Differences in Reproductive Factors for Breast Cancer among Women aged 55-74. J Cancer 2018; 9:469-478. [PMID: 29483951 PMCID: PMC5820913 DOI: 10.7150/jca.22869] [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] [Received: 09/18/2017] [Accepted: 11/03/2017] [Indexed: 12/02/2022] Open
Abstract
Background Reproductive factors have been well-documented risk factors for breast cancer. Few studies have examined whether the associations between reproductive factors and breast cancer differed across races/ethnicities. Methods We analyzed a sub-sample (70, 734) of the Prostate, Lung, Colorectal, and Ovarian (PLCO) dataset. Participants with valid baseline questionnaire and without breast cancer at enrollment were included into analysis. We stratified the participants into subgroups based on their races/ethnicities then estimated the effects of the reproductive factors on breast cancer within each group using Cox-proportion regression models. Results Oral contraceptive use (HR=1.09, 95% confidence interval or CI=1.01, 1.18), advanced age at natural menopause (HR=1.25, 95% CI=1.06, 1.49) were associated with increased risk of breast cancer in non-Hispanic Caucasians group only. Long term use of menopausal hormone therapy (more than five years) was associated with increased risk of breast cancer in both of the non-Hispanic Caucasian (HR=1.44, 95% CI=1.31, 1.59) group and the non-Hispanic Asian/Pacific Islander (HR=1.98, 95% CI=1.23, 3.20) group, but not in other race/ethnic groups. Hispanics who tried to become pregnant for a year or more had increased risk of breast cancer (HR=2.60, 95% CI=1.05, 6.46) than their counterparts without difficulty in getting pregnancy. In addition, surgery induced menopause was found to be a protective factor for breast cancer in non-Hispanic Caucasian (HR=0.88, 95% CI=0.79, 0.98) group only. Conclusions We concluded that different races/ethnicities had different breast cancer related reproductive risk factors. Non-Hispanic Caucasians had the most breast cancer related reproductive risk factors, while the minorities had none or few breast cancer related reproductive risk factors and among these few factors only 1 was also risk factor for non-Hispanic Caucasians.
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Affiliation(s)
- Chuanbo Xie
- State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Sun Yat-sen University Cancer Center, Guangzhou, China
| | - Nan Shao
- Breast Disease Center, The First Affiliated Hospital of Sun Yat-Sen University, Guangzhou, Guangdong, China
| | - Longjun He
- State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Sun Yat-sen University Cancer Center, Guangzhou, China
| | - Xiuhong Li
- Department of Maternal and Child Health, School of Public Health, Sun Yat-sen University, Guangzhou, Guangdong, China
| | - Cong Li
- State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Sun Yat-sen University Cancer Center, Guangzhou, China
| | - Jibin Li
- State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Sun Yat-sen University Cancer Center, Guangzhou, China
| | - Dongfang Su
- State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Sun Yat-sen University Cancer Center, Guangzhou, China
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Everhart JS, Chaudhari AMW, Flanigan DC. Creation of a simple distal femur morphology classification system. J Orthop Res 2016; 34:924-31. [PMID: 26573967 DOI: 10.1002/jor.23102] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [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: 06/11/2015] [Accepted: 11/09/2015] [Indexed: 02/04/2023]
Abstract
The purpose of this study is to propose a binary classification system based on simple measurements that summarizes individual, race, and sex-specific differences in distal femur shape. Surface models of 165 distal femurs (79 female, 86 male; 85 African-American, 80 Caucasian, 28.8 ± 7.6 years) were created with a 3-dimensional laser scanner. Surface area, width, length, curvature, and angulation were measured. Knees were classified as either type A or B within five distinct categories: (i) aspect ratio, (ii) trochlear-intercondylar width ratio, (iii) trochlear tilt, (iv) medial-lateral trochlear width ratio, and (v) trochlear sulcus shape. Correlations between these measures and surface area were calculated, and receiver-operator curves were used to select cutoff values between type A and B knees to improve differentiation of femur shapes by sex or race. The cutoff values between type A and B knees for the five categories are as follows: Category I: 0.90, Category II: 0.51, Category III: 1.02, Category IV: 0.67, and Category V: 128.7°. Other than category IV (medial-lateral trochlear width ratio) (p = 0.004, R = 0.22), no categories were correlated with surface area (p > 0.25). Category I (aspect ratio, cutoff = 0.90) best differentiated femurs by sex (p < 0.001, AUC = 0.80), and Category V (sulcus shape) best differentiated femurs by race (p < 0.001, AUC = 0.73). This system uses simple measurements to summarize important individual, race, and sex-specific differences in distal femur shape. It can be used in a clinical setting to provide insight into the relationship between sex or race differences in knee shape and mechanically influenced knee disorders. © 2015 Orthopaedic Research Society. Published by Wiley Periodicals, Inc. J Orthop Res 34:924-931, 2016.
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Affiliation(s)
- Joshua S Everhart
- Department of Orthopaedics, The Ohio State University Wexner Medical Center, Columbus, Ohio
| | - Ajit M W Chaudhari
- Department of Physical Medicine and Rehabilitation, The Ohio State University Wexner Medical Center, Columbus, Ohio
| | - David C Flanigan
- Department of Orthopaedics, The Ohio State University Wexner Medical Center, Columbus, Ohio
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15
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André Christie-Mizell C, Blount SA, Laster Pirtle WN, Dagadu HE, Leslie ETA, Vielehr PS. Psychiatric Medication, African Americans and the Paradox of Mistrust. J Natl Med Assoc 2015; 107:51-9. [PMID: 27269491 DOI: 10.1016/s0027-9684(15)30025-0] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [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: 10/22/2022]
Abstract
OBJECTIVES To examine race differences in how generalized mistrust, mistrust in physicians, and mistrust in psychiatric medication shape the willingness to utilize psychiatric medication. METHODS Data was used from two waves (1998 and 2006) of the U.S. General Social Survey a representative sample of non-institutionalized Americans. We analyzed data for 343 African American and 1,920 white adults, ages 18-89. The data included measures of the respondents' willingness to utilize psychiatric medication as well as measures of generalized mistrust, mistrust in physicians, and mistrust in psychiatric medication. We employed ordinary least squares regression to test whether these three forms of mistrust reduce the black-white gap in psychiatric drug usage and whether race moderates the association between any type of mistrust and the willingness to endorse psychiatric medication utilization. RESULTS Mistrust in physicians and psychiatric medication is related to less willingness to utilize psychiatric medicines for both African Americans and whites; however, paradoxically, these forms of mistrust decrease psychiatric drug usage more steeply for whites. CONCLUSIONS The pattern of findings in this study suggests that trust or low levels of mistrust, rather than high levels of mistrust, actually maintains the black-white difference in the use of psychiatric medication.
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16
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Spaeth AM, Dinges DF, Goel N. Resting metabolic rate varies by race and by sleep duration. Obesity (Silver Spring) 2015; 23:2349-56. [PMID: 26538305 PMCID: PMC4701627 DOI: 10.1002/oby.21198] [Citation(s) in RCA: 56] [Impact Index Per Article: 6.2] [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: 04/17/2015] [Revised: 06/15/2015] [Accepted: 06/16/2015] [Indexed: 11/08/2022]
Abstract
OBJECTIVE Short sleep duration is a significant risk factor for weight gain, particularly in African Americans and men. Increased caloric intake underlies this relationship, but it remains unclear whether decreased energy expenditure is a contributory factor. The current study assessed the impact of sleep restriction and recovery sleep on energy expenditure in African American and Caucasian men and women. METHODS Healthy adults participated in a controlled laboratory study. After two baseline sleep nights, subjects were randomized to an experimental (n = 36; 4 h sleep/night for five nights followed by one night with 12 h recovery sleep) or control condition (n = 11; 10 h sleep/night). Resting metabolic rate and respiratory quotient were measured using indirect calorimetry in the morning after overnight fasting. RESULTS Resting metabolic rate-the largest component of energy expenditure-decreased after sleep restriction (-2.6%, P = 0.032) and returned to baseline levels after recovery sleep. No changes in resting metabolic rate were observed in control subjects. Relative to Caucasians (n = 14), African Americans (n = 22) exhibited comparable daily caloric intake but a lower resting metabolic rate (P = 0.043) and higher respiratory quotient (P = 0.013) regardless of sleep duration. CONCLUSIONS Sleep restriction decreased morning resting metabolic rate in healthy adults, suggesting that sleep loss leads to metabolic changes aimed at conserving energy.
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Affiliation(s)
- Andrea M Spaeth
- Center for Sleep and Circadian Neurobiology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA
| | - David F Dinges
- Division of Sleep and Chronobiology, Department of Psychiatry, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA
| | - Namni Goel
- Division of Sleep and Chronobiology, Department of Psychiatry, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA
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Staiano AE, Harrington DM, Johannsen NM, Newton RL, Sarzynski MA, Swift DL, Katzmarzyk PT. Uncovering physiological mechanisms for health disparities in type 2 diabetes. Ethn Dis 2015; 25:31-37. [PMID: 25812249 PMCID: PMC4378536] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [MESH Headings] [Grants] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/04/2023] Open
Abstract
Type 2 diabetes (T2D) prevalence in the United States is significantly higher in African Americans vs Whites. Yet, the physiological mechanisms contributing to this health disparity have been poorly described. To design effective strategies to reduce this disparity, there is a need to determine whether racial differences in diabetes prevalence are attributable to modifiable or non-modifiable factors. This review synthesizes and critically evaluates the potential physiological and genetic mechanisms that may contribute to the higher susceptibility of African Americans to T2D. These mechanisms include: 1) obesity and fat distribution; 2) metabolic flexibility; 3) muscle physiology; 4) energy expenditure and fitness; and 5) genetics. We focus on the clinical significance of findings and limitations of the recent literature.
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Barry LC, Thorpe RJ, Penninx BW, Yaffe K, Wakefield D, Ayonayon HN, Satterfield S, Newman AB, Simonsick EM. Race-related differences in depression onset and recovery in older persons over time: the health, aging, and body composition study. Am J Geriatr Psychiatry 2014; 22:682-91. [PMID: 24125816 PMCID: PMC3984378 DOI: 10.1016/j.jagp.2013.09.001] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.4] [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: 06/04/2013] [Revised: 09/03/2013] [Accepted: 09/03/2013] [Indexed: 11/30/2022]
Abstract
OBJECTIVES To evaluate race-related differences in depression onset and recovery in older persons, overall and by sex, and examine race-related differences in mortality according to depression. DESIGN Prospective cohort study. SETTING General community in pre-designated zip code areas in Memphis, Tennessee, and Pittsburgh, Pennsylvania. PARTICIPANTS 3,075 persons aged 70-79 years at baseline in the Health, Aging, and Body Composition study. MEASUREMENTS Depression was assessed at eight time points over 10 years using the 10-item Center for Epidemiologic Studies-Depression scale; patients were categorized as nondepressed (score less than 8) or depressed (score of 8 or higher). We created variables for transitions across each 18-month time interval, namely, from nondepressed or depressed to nondepressed, depressed, or death, and determined the association between race and the average likelihood of these transitions over time. RESULTS A higher percentage of blacks than whites were depressed at nearly all time points. Adjusting for demographics, common chronic conditions, and body mass index, blacks had a higher likelihood of experiencing depression onset than whites (odds ratio [OR]: 1.22; 95% confidence interval [CI]: 1.03-1.43); among men, blacks were more likely to experience depression onset than whites (OR: 1.44; 95% CI: 1.24-2.89). Blacks also had a higher likelihood of transitioning from nondepressed to death (OR: 1.79; 95% CI: 1.30-2.46). Overall and in sex-stratified analyses, race was not associated with recovery from depression or with the transition from depression to death. CONCLUSION Our findings highlight race differences in depression in older persons and encourage further research on the course of depression in older black patients.
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Affiliation(s)
- Lisa C. Barry
- Center on Aging, University of Connecticut, Farmington, Connecticut 06030-5215, US
| | - Roland J. Thorpe
- Department of Health Policy and Management, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, US
| | - Brenda W.J.H. Penninx
- Department of Psychiatry, VU University Medical Center in Amsterdam, The Netherlands
| | - Kristine Yaffe
- Department of Psychiatry, University of California, San Francisco, California, US
| | - Dorothy Wakefield
- Center on Aging, University of Connecticut, Farmington, Connecticut, US
| | - Hilsa N. Ayonayon
- Department of Epidemiology and Biostatistics, University of California, San Francisco, California, US
| | - Suzanne Satterfield
- Department of Preventive Medicine, University of Tennessee Health Science Center, Memphis, Tennessee, US
| | - Anne B. Newman
- Department of Epidemiology, University of Pittsburgh, Pittsburgh, Pennsylvania, US
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Abstract
Aging is associated with an increase in need for assistance. Preparation for future care (PFC) is related to improved coping ability as well as better mental and physical health outcomes among older adults. We examined the association of optimism with components of PFC among older adults. We also explored race differences in the relationship between optimism and PFC. In Study 1, multiple regression showed that optimism was positively related to concrete planning. In Study 2, optimism was related to gathering information. An exploratory analysis combining the samples yielded a race interaction: For Whites higher optimism, but for Blacks lower optimism was associated with more planning. High optimism may be a barrier to future planning in certain social and cultural contexts.
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Affiliation(s)
- Silvia Sörensen
- Department of Psychiatry, University of Rochester School of Medicine and Dentistry, Rochester, NY, USA
| | - Jameson K Hirsch
- Department of Psychiatry, University of Rochester School of Medicine and Dentistry, Rochester, NY, USA ; Department of Psychology, East Tennessee State University, Johnson City, TN, USA
| | - Jeffrey M Lyness
- Department of Psychiatry, University of Rochester School of Medicine and Dentistry, Rochester, NY, USA
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Katzmarzyk PT, Greenway FL, Heymsfield SB, Bouchard C. Clinical utility and reproducibility of visceral adipose tissue measurements derived from dual-energy X-ray absorptiometry in White and African American adults. Obesity (Silver Spring) 2013; 21:2221-4. [PMID: 23794256 PMCID: PMC3819404 DOI: 10.1002/oby.20519] [Citation(s) in RCA: 38] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/31/2013] [Revised: 04/22/2013] [Accepted: 05/06/2013] [Indexed: 12/28/2022]
Abstract
OBJECTIVE The purpose of this study was to determine reproducibility and clinical thresholds for DXA-derived visceral adipose tissue (VAT). DESIGN AND METHODS The sample included 2317 white and African American adults 18-74 years of age. VAT areas (cm(2) ) were measured using a Hologic DXA scanner equipped with APEX 4.0 software. Reproducibility was assessed using repeated measurements on 101 participants scanned 14 days apart. Receiver Operating Characteristic (ROC) curves were used to assess clinical utility and select thresholds that identified elevated cardiometabolic risk, defined as the presence of ≥2 risk factors. RESULTS Reproducibility of DXA-VAT was 8.1%. The areas under the ROC curves ranged from 0.754 in African American men to 0.807 in white women. The thresholds were higher in white men (154 cm(2) ) and women (143 cm(2) ) compared to African American men (101 cm(2) ) and women (114 cm(2) ). CONCLUSION The results demonstrated that DXA VAT is a useful clinical marker of cardiometabolic risk; however, further research is required to determine associations with health outcomes using longitudinal studies.
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Affiliation(s)
- Peter T Katzmarzyk
- Pennington Biomedical Research Center, Louisiana State University System, Baton Rouge, Louisiana, USA
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Thomas A, Low LK, Tumbarello JA, Miller JM, Fenner DE, DeLancey JOL. Changes in self-assessment of continence status between telephone survey and subsequent clinical visit. Neurourol Urodyn 2010; 29:734-40. [PMID: 19816917 PMCID: PMC3375677 DOI: 10.1002/nau.20827] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [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: 11/06/2022]
Abstract
AIMS To explore variance in reporting continence information obtained by telephone survey with face-to-face clinician interview in a clinical setting. METHODS As part of a cross-sectional, epidemiologic study of incontinence prevalence among Black and White women aged 35-64 years, randomly selected households were contacted from geographic areas of known racial composition. Of 2,814 women who completed a 20-min, 137-item telephone interview, 1,702 were invited for future components of the study. A subset of these women was recruited for a clinical evaluation that was conducted within a mean of 82 days (SD 38 days) following the interviews. Prior to urodynamics testing, a clinician interview was conducted inquiring about continence status. The criterion for incontinence for both the telephone interview and the clinician interview was constant: 12 or more episodes of incontinence per year. Women whose subjective reports of continence information differed between telephone and clinician interviews were designated as "switchers." RESULTS Of the 394 women (222 Black and 172 White) who completed the clinical portion, 24.6% (n = 97) were switchers. Switchers were four times more likely to change from continent to incontinent (80.4%, N = 78) than from incontinent to continent (19.4%, N = 19; P = 0.000) and nearly three times more likely to be Black (69%, N = 67) than White (31%, N = 30; P = 0.001). Telephone qualitative interviews were completed with 72 of the switchers. The primary reason for switching was changes in women's life circumstances such as variation in seasons, activities of daily living, and health status followed by increased awareness of leakage secondary to the phone interview. CONCLUSION One-time subjective telephone interviews assessing incontinence symptoms may underestimate the prevalence of incontinence especially among Black women.
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Affiliation(s)
- A Thomas
- Pelvic Floor Research Group, University of Michigan, Ann Arbor, Michigan, USA
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McFadden D, Bracht MS. Sex and race differences in the relative lengths of metacarpals and metatarsals in human skeletons. Early Hum Dev 2009; 85:117-24. [PMID: 18789613 PMCID: PMC2649659 DOI: 10.1016/j.earlhumdev.2008.07.001] [Citation(s) in RCA: 24] [Impact Index Per Article: 1.6] [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: 01/29/2008] [Revised: 06/20/2008] [Accepted: 07/01/2008] [Indexed: 10/21/2022]
Abstract
BACKGROUND Previous research has revealed that the ratios of the lengths of various pairs of human fingers differ in males and females. METHOD In an attempt to determine whether parallel sex differences also exist in the relative lengths of human metacarpals and metatarsals, the lengths of the metapodials for both hands and both feet were measured in a collection of human skeletons. For each hand and each foot, all of the 10 possible pairwise ratios for length of the five metapodials were calculated. RESULTS For the skeletons of European/Caucasian extraction (Ns=89 males, 50 females), there were substantial sex differences for several of the metacarpal-length ratios, but the pattern was not identical with the pattern previously reported for human fingers. Namely, the largest sex differences were for the three ratios involving metacarpal 5 on the left hand, while the sex difference for the ratio comparing the second and fourth metacarpals (the comparison commonly showing the largest sex difference for fingers) was small and non-significant for both hands in these European-Americans. For the skeletons of African extraction (Ns=65 males, 55 females), no sex differences were found in any of the 20 metacarpal-length ratios. This outcome was unexpected because past research had shown sex differences in finger-length ratios for people of African extraction. For metatarsals, none of the 20 ratios exhibited a substantial sex difference for either group of skeletons. CONCLUSIONS A discrepancy apparently exists between the length ratios based on fingers and those based on metacarpals.
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Affiliation(s)
- Dennis McFadden
- Department of Psychology and Center for Perceptual Systems, University of Texas, Austin, Texas, 78712-0187, USA.
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Demerath EW, Shen W, Lee M, Choh AC, Czerwinski SA, Siervogel RM, Towne B. Approximation of total visceral adipose tissue with a single magnetic resonance image. Am J Clin Nutr 2007; 85:362-8. [PMID: 17284730 PMCID: PMC2883309 DOI: 10.1093/ajcn/85.2.362] [Citation(s) in RCA: 101] [Impact Index Per Article: 5.9] [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: 11/12/2022] Open
Abstract
BACKGROUND A single axial image measured between the 4th and 5th lumbar vertebrae (L4-L5) is most frequently chosen to approximate total abdominal visceral adipose tissue (VAT) volume, but growing evidence suggests that this measurement site is not ideal. OBJECTIVE The objective was to determine the single magnetic resonance (MR) image that best approximates the total VAT volume in a biracial sample of healthy subjects. DESIGN We used contiguous abdominal MR images to measure VAT area and summed them to determine total VAT volume. The sample included 820 healthy men and women (n = 692 whites, 128 blacks) aged 18-88 y. RESULTS A range of MR images had equally high correlations with total VAT in each race and sex group. The image 6 cm above L4-L5 (L4-L5 + 6) was within the best equivalent range for all race and sex groups. The L4-L5 + 6 image crossed the L3 vertebra in 85% of subjects and crossed the L2-L3 intervertebral space or the L2 vertebra for 15% of subjects. Linear regression models indicated that the L4-L5 + 6 image explained 97% of the variance in total abdominal VAT volume, and additional covariates did not increase the R(2) value significantly. The L4-L5 image explained 83% of the variance in VAT volume, and the covariates accounted for an additional 7% of the variance. Rank-order values for VAT can change if total VAT volume is approximated by a single image area. Whereas 25% of subjects changed rank by >or=10% with the L4-L5 image, only 3% changed rank to that degree with the L4-L5 + 6 image. CONCLUSIONS A single MR image located approximately at the L3 vertebra can accurately estimate total VAT volume in blacks and whites of both sexes.
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Affiliation(s)
- Ellen W Demerath
- Lifespan Health Research Center, Department of Community Health, Boonshoft School of Medicine, Wright State University, Dayton, OH, USA.
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