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  • 1
    Online Resource
    Online Resource
    RACE, GENDER, AND LATE-LIFE PRODUCTIVE ACTIVITIES AND DEMENTIA IN THE HEALTH ABC STUDY
    Oxford University Press (OUP) ; 2022
    In:  Innovation in Aging Vol. 6, No. Supplement_1 ( 2022-12-20), p. 218-219
    Details
    In: Innovation in Aging, Oxford University Press (OUP), Vol. 6, No. Supplement_1 ( 2022-12-20), p. 218-219
    Abstract: We hypothesized productive activities, e.g., working and volunteering, would reduce dementia risk and mitigate racial disparities using longitudinal Health, Aging, and Body Composition data (n=3,069). We ran gender-stratified logistic regression models for dementia with socio-demographic and APOE adjustments. Among older men, no significant relationships existed between dementia with work, volunteering, or race in any models. Among older women, in unadjusted models, working vs. not (Yr1) was significantly related to 30% lower odds of dementia (OR=0.70, p≤0.05), and volunteering vs. not (Yr1) was significantly related to 24% lower odds of dementia (OR=0.76, p≤0.05). But, these activities were not significant in other models. Black vs. White women had 35% (OR=1.35, p≤0.05) and 32% (OR=1.32, p=0.052) higher odds of dementia in working and volunteering models with socio-demographic adjustments, respectively, but race was not significant after APOE adjustment. Productive activities are possible contextual interventions to reduce racial disparities in incident dementia among older women.
    Type of Medium: Online Resource
    ISSN: 2399-5300
    URL: Article
    DOI: 10.1093/geroni/igac059.871
    Language: English
    Publisher: Oxford University Press (OUP)
    Publication Date: 2022
    detail.hit.zdb_id: 2905697-4
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  • 2
    Online Resource
    Online Resource
    Longitudinal Daily Living Limitations and Cognitive Status: Results from the 1998-2016 Health and Retirement Study
    Oxford University Press (OUP) ; 2020
    In:  Innovation in Aging Vol. 4, No. Supplement_1 ( 2020-12-16), p. 897-897
    Details
    In: Innovation in Aging, Oxford University Press (OUP), Vol. 4, No. Supplement_1 ( 2020-12-16), p. 897-897
    Abstract: Data increasingly points to midlife health and modifiable risk factors as critical targets for improving older-age health outcomes and mitigating potential cognitive impairment and disease. We used biennial Health and Retirement Study data (1998-2016) collected on adults ages 50-64 years who did not meet criteria for dementia at baseline and who remained living by 2016 (unweighted-n=4,803). Cognitive status was defined using Langa-Weir criteria: Normal, Cognitively Impaired Not Dementia (CIND), and Dementia. We examined how 18-year patterns in activities of daily living (ADLs) and instrumental activities of daily living (IADLs) predicted cognitive status in 2016. We used latent class analysis to extract longitudinal phenotypes of activities limitations, followed by survey multinomial logistic regressions to examine their associations with cognitive status and test for race/ethnic modifications. We identified three groups of functional impairment: (1) gradually increasing (15.7%), (2) stable elevated (5.6%), and (3) minimal dysfunction (78.7%). After covariates adjustment, both the gradual and stable elevated impairment groups (vs. minimal) had substantially higher relative risk ratios (RRR) for dementia (RRR=5.71[3.89;8.39] and RRR=7.87[4.23,14.64] ) and CIND (RRR=2.21 [1.69,2.88] and RRR=1.92[1.16;3.17] ). We detected modifications by race/ethnicity such that Hispanics with stable elevated impairment had a higher probability of dementia compared to their White counterparts. The results varied for Blacks and did not significantly differ from Whites. Data-driven methods may improve our understanding of heterogeneous functional impairment patterns among late middle-aged adults and allow for tailored ADRD prevention strategies. Focused risk-based interventions can yield important public health savings and reductions in structural, social, and individual health burdens.
    Type of Medium: Online Resource
    ISSN: 2399-5300
    URL: Article
    DOI: 10.1093/geroni/igaa057.3306
    Language: English
    Publisher: Oxford University Press (OUP)
    Publication Date: 2020
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  • 3
    Online Resource
    Online Resource
    The Intersection of Race and Ethnicity, Nativity, and Sex on Cognitive Trajectories of Older Adults in the United States
    Oxford University Press (OUP) ; 2021
    In:  Innovation in Aging Vol. 5, No. Supplement_1 ( 2021-12-17), p. 240-240
    Details
    In: Innovation in Aging, Oxford University Press (OUP), Vol. 5, No. Supplement_1 ( 2021-12-17), p. 240-240
    Abstract: We used longitudinal data from the Health and Retirement Study (1998-2016) to estimate sex-specific age-graded changes in global cognition and memory among White, Black, and U.S.- and foreign-born Latino adults 51 years and older. Among males, racial/ethnic and nativity differences in cognitive function were mainly evident at younger ages, particularly for Blacks compared to Whites. We found no evidence to support male racial/ethnic or nativity differentials in trajectories of cognitive aging. For women, older Blacks and U.S.-Born Latinas, and to a lesser degree foreign-born Latinas, had lower cognitive function at younger ages. However, White women showed more pronounced cognitive aging in comparison to U.S.- and foreign-born Latinas. Results applied to both global and memory outcomes. Our findings support calls for nuanced considerations of racial/ethnic and nativity effects on cognitive aging and ADRDs. Continued monitoring of differential cognitive aging trends is warranted as the vascular and neurologic sequelae of COVID-19 manifests.
    Type of Medium: Online Resource
    ISSN: 2399-5300
    URL: Article
    DOI: 10.1093/geroni/igab046.925
    Language: English
    Publisher: Oxford University Press (OUP)
    Publication Date: 2021
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  • 4
    Online Resource
    Online Resource
    The WALLET Study: Examining Early Memory Loss and Personal Finance
    Oxford University Press (OUP) ; 2022
    In:  Innovation in Aging Vol. 6, No. 5 ( 2022-07-01)
    Details
    In: Innovation in Aging, Oxford University Press (OUP), Vol. 6, No. 5 ( 2022-07-01)
    Abstract: This feasibility study tests a new approach for assessing personal finance in older persons with early memory loss. The project examines 2 primary outcomes that gauge the financial viability and well-being of older adults: wealth loss and financial exploitation. The overall objective is to determine the association of financial literacy and management, financial decision-making, and cognition with wealth loss and financial exploitation. Research Design and Methods This cross-sectional study recruited 46 participants who were 60 years of age or older. Participants were classified as having mild cognitive impairment, perceived cognitive impairment, or no cognitive impairment. The study coordinator arranged with each participant to obtain copies of their main checking account statements for 12 consecutive months within the previous 2 years and, if appropriate, credit card statements. All statements were de-identified and assigned a random ID number. Participants then completed 2 telephone interviews. Results The average participant age was 72 years (standard deviation [SD] = 7.7); 84% were female, 39% White, and 35% currently married. Average education was 16.2 years (SD = 2.4); mean yearly household income was almost $42,000 (SD = 25,752); and monthly social security payments averaged $1,446 (SD = 1,244). Our results indicate that the methods used to analyze checkin g account statements, followed by telephone interviews to verify identified trends, were useful in developing a financial behavior index to measure wealth loss. Discussion and Implications We demonstrate an alternative method for assessing personal finance using person-centered principles, which we believe are critical in the presence of diminished or impaired cognition. Our findings offer an innovative method for assessing the risk for wealth loss and financial exploitation.
    Type of Medium: Online Resource
    ISSN: 2399-5300
    URL: Article
    DOI: 10.1093/geroni/igac038
    Language: English
    Publisher: Oxford University Press (OUP)
    Publication Date: 2022
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  • 5
    Online Resource
    Online Resource
    FEASIBILITY OF A LOW-DOSE FRAILTY PREVENTION INTERVENTION AMONG OLDER AFRICAN AMERICANS
    Oxford University Press (OUP) ; 2019
    In:  Innovation in Aging Vol. 3, No. Supplement_1 ( 2019-11-08), p. S293-S293
    Details
    In: Innovation in Aging, Oxford University Press (OUP), Vol. 3, No. Supplement_1 ( 2019-11-08), p. S293-S293
    Abstract: Older African Americans (OAA) are at high risk for becoming frail in later life. Interventions can reverse or delay frailty, yet OAA have largely been excluded from frailty intervention research. Many interventions are also time and resource intensive, making them inaccessible to socially disadvantaged OAA. We present results of a feasibility trial of a low dose frailty prevention intervention among 60 community-dwelling, pre-frail OAA aged 55+ recruited from a primary care clinic between June 1st and October 31st 2018. Using a 2-arm RCT, participants were assigned to the intervention, which was delivered by an occupational therapist (OT) and comprised of four sessions over four months (an OT evaluation, and sessions on healthy dietary practices, increasing physical activity, and maintaining a healthy lifestyle), or enhanced usual care (publicly available information about healthy lifestyle, home safety, and local elder services). Feasibility criteria were set a priori at 75% for participant retention (including attrition due to death/hospitalization), 80% for session engagement, 2 participants/week for mean participant accrual, and 90% for program satisfaction. Participants were 65% female with an average age of 76.58 years, 51.67% of which lived alone and 51.67% lived off of less than 15K per year. Feasibility metrics were met. The study recruited 2.5 participants per week and retained 75% of participants who attended 95% of scheduled sessions. Mean satisfaction scores were 93%. The intervention was feasible to deliver. Qualitative findings from exit interviews suggested changes to the program dose, structure, and content that could improve it for future use.
    Type of Medium: Online Resource
    ISSN: 2399-5300
    URL: Article
    DOI: 10.1093/geroni/igz038.1079
    Language: English
    Publisher: Oxford University Press (OUP)
    Publication Date: 2019
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  • 6
    Online Resource
    Online Resource
    Phenotypes of obstructive sleep apnea in the Hispanic Community Health Study/Study of Latinos
    Oxford University Press (OUP) ; 2021
    In:  Sleep Vol. 44, No. 12 ( 2021-12-10)
    Details
    In: Sleep, Oxford University Press (OUP), Vol. 44, No. 12 ( 2021-12-10)
    Abstract: Recent work on US Whites from clinical samples used obstructive sleep apnea (OSA) symptoms to generate phenotypes for individuals with moderate-severe OSA which suggested 3 to 5 symptom classes. However, it is unknown whether similar classes generalize to diverse Hispanics/Latino adults. Therefore, we sought to fill this gap by empirically deriving sleep phenotypes among a large sample of diverse Hispanics/Latinos. Methods We used data from The Hispanic Community Health Study/Study of Latinos (HCHS/SOL; 2008–2011), a prospective cohort study designed using a multisite multistage probability sample of adults 18–74 years old. The subpopulation of interest included participants with moderate-severe OSA symptoms (≥15 respiratory event index (REI) events per hour; n = 1,605). We performed latent class analysis for complex survey data using 15 common OSA symptoms (e.g. Epworth Sleepiness Scale) and 4 comorbidities to identify phenotype classes. Results Average age was 52.4 ± 13.9 years and 34.0% were female. Mean REI was 33.8 ± 22.5 events per hour. Fit statistics and clinical significance suggested that a three-class solution provided the best fit to the data. The three phenotypes were: (1) Minimally Symptomatic (47.7%), (2) Excessive sleepiness (37.1%), and (3) Disturbed Sleep (15.2%). Sensitivity models were consistent with the main proposed solution. Conclusions Derived sleep phenotypes among diverse Hispanic/Latinos were consistent with recent findings from the Sleep Apnea Global Interdisciplinary Consortium, but we found notable differences in class prevalence relative to Whites. Further research is needed to link derived sleep phenotypes to health comorbidities in diverse populations.
    Type of Medium: Online Resource
    ISSN: 0161-8105 , 1550-9109
    URL: Article
    DOI: 10.1093/sleep/zsab181
    Language: English
    Publisher: Oxford University Press (OUP)
    Publication Date: 2021
    detail.hit.zdb_id: 2056761-3
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  • 7
    Online Resource
    Online Resource
    Sleep Duration and Neurocognitive Function in the Hispanic Community Health Study/Study of Latinos
    Oxford University Press (OUP) ; 2016
    In:  Sleep Vol. 39, No. 10 ( 2016-10-01), p. 1843-1851
    Details
    In: Sleep, Oxford University Press (OUP), Vol. 39, No. 10 ( 2016-10-01), p. 1843-1851
    Type of Medium: Online Resource
    ISSN: 0161-8105 , 1550-9109
    URL: Article
    DOI: 10.5665/sleep.6166
    Language: English
    Publisher: Oxford University Press (OUP)
    Publication Date: 2016
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  • 8
    Online Resource
    Online Resource
    Racial and Ethnic Differences in Preventive Services Use After the Affordable Care Act’s Enhancement of Medicare Benefits
    Oxford University Press (OUP) ; 2020
    In:  Innovation in Aging Vol. 4, No. Supplement_1 ( 2020-12-16), p. 98-98
    Details
    In: Innovation in Aging, Oxford University Press (OUP), Vol. 4, No. Supplement_1 ( 2020-12-16), p. 98-98
    Abstract: As a consequence of the Affordable Care Act’s enhancements of Medicare benefits, certain recommended clinical preventive services became available to Medicare beneficiaries without cost-sharing. We study the impact of these mandates on racial/ethnic disparities in the use of preventive services among traditional Medicare beneficiaries. We analyze nationally representative data on non-institutionalized Medicare seniors from the 2006-2016 Medical Expenditure Panel Survey (N=27,124). Our preventive services of interest include yearly receipt of cholesterol check, blood pressure test, flu shot, endoscopy, blood stool test, clinical breast examination, mammography and prostate exam. We estimate propensity score weighted difference-in-difference (DID) models to test for differences in preventive services utilization by race/ethnicity. Among traditional Medicare beneficiaries, we do not observe significant change in the use of most preventive services for Blacks and Hispanics compared to their White counterparts. However, Hispanics have significantly increased their use of blood stool tests relative to whites. Overall, we do not find major evidence to support a differential effect of reforms on race/ethnic minorities’ uptake of preventive services following the mandates. Our results suggest that despite an overall benefit trough services expansion and cost-sharing elimination race/ethnic group differences persist. As such, disparities might continue and would require additional interventions. Reduction in disparities is a stated goal of US policy for many decades and achieving equity might require additional work and more varied and targeted interventions.
    Type of Medium: Online Resource
    ISSN: 2399-5300
    URL: Article
    DOI: 10.1093/geroni/igaa057.324
    Language: English
    Publisher: Oxford University Press (OUP)
    Publication Date: 2020
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  • 9
    Online Resource
    Online Resource
    Neurocognitive Function Among Middle-aged and Older Hispanic/Latinos: Results from the Hispanic Community Health Study/Study of Latinos
    Oxford University Press (OUP) ; 2015
    In:  Archives of Clinical Neuropsychology Vol. 30, No. 1 ( 2015-02-01), p. 68-77
    Details
    In: Archives of Clinical Neuropsychology, Oxford University Press (OUP), Vol. 30, No. 1 ( 2015-02-01), p. 68-77
    Type of Medium: Online Resource
    ISSN: 0887-6177 , 1873-5843
    URL: Article
    DOI: 10.1093/arclin/acu066
    Language: English
    Publisher: Oxford University Press (OUP)
    Publication Date: 2015
    detail.hit.zdb_id: 2003528-7
    SSG: 5,2
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  • 10
    Online Resource
    Online Resource
    Cognitive Associates of Current and More Intensive Control of Hypertension: Findings From the Hispanic Community Health Study/Study of Latinos
    Oxford University Press (OUP) ; 2017
    In:  American Journal of Hypertension Vol. 30, No. 6 ( 2017-06-01), p. 624-631
    Details
    In: American Journal of Hypertension, Oxford University Press (OUP), Vol. 30, No. 6 ( 2017-06-01), p. 624-631
    Abstract: Hypertension control in Hispanics/Latinos lag behind general US trends by 10–15%. Intensive systolic blood pressure (SBP) management & lt;120 mm Hg may significantly reduce morbidity/mortality risk in adults with hypertension; less is known about cognition. We investigated cross-sectional associations of cognition with observed hypertension control at currently recommended (SBP & lt; 140 mm Hg) and more intensive (SBP & lt; 120 mm Hg) levels using baseline data from the Hispanic Community Health Study/Study of Latinos. METHODS From this multicenter cohort study, we focused on 1,735 Hispanic/Latino men and women ages 45–74 years with hypertension and verified antihypertensive use. Verbal fluency, information processing speed, learning, and memory were tested in Spanish or English. RESULTS Separate linear regressions revealed that being on 1 vs. & gt;1 antihypertensive medication was not associated with cognition; however, individuals with SBP controlled to currently recommended levels outperformed individuals with uncontrolled SBP on verbal fluency [Beta = 1.44 (0.52), P & lt; 0.01] and information processing speed [Beta = 3.01 (0.89), P & lt; 0.001] in age-adjusted regression analyses; only information processing speed remained significant (P & lt; 0.05) after additional adjustments including acculturation, health insurance, and other cardiovascular disease risk factors. When regrouping individuals based on more intensive SBP control, individuals with levels & lt;120 mm Hg outperformed individuals with higher SBP on verbal fluency regardless of adjustments (P & lt; 0.01). More intensive rather than currently recommended levels of control associated with higher verbal fluency performance regardless of adjustments (P & lt; 0.05). CONCLUSIONS Individual cognitive test scores related to distinct SBP management with more intensive management appearing more robust against confounders. While cognitive associations with hypertension in Hispanics/Latinos may be multifactorial, different levels of SBP control should be considered in future prospective intervention studies.
    Type of Medium: Online Resource
    ISSN: 0895-7061 , 1941-7225
    URL: Article
    DOI: 10.1093/ajh/hpx023
    Language: English
    Publisher: Oxford University Press (OUP)
    Publication Date: 2017
    detail.hit.zdb_id: 1479505-X
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