Effectiveness of non-pharmaceutical interventions on cognitive function among non-demented African American and Latino older adults in the USA: a scoping review

Abstract Objective African Americans and Latinos/Hispanics have a higher prevalence of dementia compared to non-Latino Whites. This scoping review aims to synthesize non-pharmaceutical interventions to delay or slow age-related cognitive decline among cognitively healthy African American and Latino older adults.Design A literature search was performed in PubMed, CINAHL, PsycINFO and Web of Science between January 2000 – May 2019. Relevant cited references and grey literature were also reviewed. Four independent reviewers evaluated 1,181 abstracts, and full-article screening was subsequently performed for 145 articles. The scoping review consisted of eight studies, which were evaluated according to peer-reviewed original manuscript, non-pharmaceutical intervention, cognitive function as an outcome, separate reporting of results for African American and Latino individuals, minimum age of 40, and conducted in the United States. A total of 8 studies were considered eligible and were analyzed in the present scoping review.Results Eight studies were identified. Four studies focused on African Americans and four focused on Latino individuals. Through the analysis, results indicated cognitive training-focused interventions were effective in improving memory, executive function, reasoning, visuospatial, psychological function, and speed among African Americans. Exercise interventions were effective in improving cognition among Latino individuals.Conclusion This scoping review identified effective non-pharmaceutical interventions among African American and Latino individuals. Effective interventions focused on cognitive training alone for African Americans and exercise combined with group educational sessions for Latino individuals. Future research should explore developing culturally appropriate non-pharmaceutical interventions to reduce disparities and to enhance cognition among older African American and Latino individuals.

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Education and skills training for care partners of hospitalised older adults: A scoping review

Health Education Journal ◽

10.1177/00178969211034192 ◽

2021 ◽

pp. 001789692110341

Author(s):

Madeline Carbery ◽

Samantha Schwartz ◽

Nicole Werner ◽

Beth Fields

Keyword(s):

Older Adults ◽

Hospital Admission ◽

Health Outcomes ◽

Older Adult ◽

Scoping Review ◽

Hospital Care ◽

Skills Training ◽

Individual Care ◽

Care Partners ◽

The Usa

Background: The care partners of hospitalised older adults often feel dissatisfied with the education and skills training provided to them, resulting in unpreparedness and poor health outcomes. Objective: This review aimed to characterise and identify gaps in the education and skills training used with the care partners of older adults in the hospital. Methods: We conducted a scoping review on the education and skills training practices used with the care partners of hospitalised older adults in the USA via sources identified in the PubMed, PsychINFO and CINAHL databases. Results: Twelve studies were included in this review. Results illustrate that nurses utilise multiple modes of delivery and frequently provide education and skills training tailored to the needs of care partners at the latter end of hospital care. The provision of education and skills training varies greatly, however, including who provides education, in what way information is conveyed, and how care partner outcomes are measured. Conclusion: This is the first scoping review to describe and synthesise the education and skills training practices used with care partners of hospitalised older adults. Findings highlight the need for education and skills training to be interprofessional, tailored to individual care partners’ needs and begin at, or even before, the hospital admission of older adult patients.

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Polypharmacy Is Associated with Lower Memory Function in African American Older Adults

Brain Sciences ◽

10.3390/brainsci10010049 ◽

2020 ◽

Vol 10 (1) ◽

pp. 49 ◽

Cited By ~ 1

Author(s):

Shervin Assari ◽

Cheryl Wisseh ◽

Mohammed Saqib ◽

Mohsen Bazargan

Keyword(s):

Older Adults ◽

African American ◽

Cognitive Function ◽

Los Angeles ◽

Living Arrangement ◽

Memory Function ◽

Continuous Variable ◽

Financial Strain ◽

Outcome Variable ◽

Future Research

Although previous research has linked polypharmacy to lower cognitive function in the general population, we know little about this association among economically challenged African American (AA) older adults. This study explored the link between polypharmacy and memory function among AA older adults. This community-based study recruited 399 AA older adults who were 65+ years old and living in economically disadvantaged areas of South Los Angeles. Polypharmacy (taking 5+ medications) was the independent variable, memory function was the outcome variable (continuous variable), and gender, age, living arrangement, socioeconomic status (educational attainment and financial strain), health behaviors (current smoking and any binge drinking), and multimorbidity (number of chronic diseases) were the covariates. Linear regression was used for data analyses. Polypharmacy was associated with lower scores on memory function, above and beyond covariates. Among AA older adults, polypharmacy may be linked to worse cognitive function. Future research should test the mechanisms by which polypharmacy is associated with lower levels of cognitive decline. There is a need for screening for memory problems in AA older adults who are exposed to polypharmacy.

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Emergency Department Utilization, Hospital Admissions, and Office-Based Physician Visits Among Under-Resourced African American and Latino Older Adults

Journal of Racial and Ethnic Health Disparities ◽

10.1007/s40615-021-01211-4 ◽

2022 ◽

Author(s):

Sharon Cobb ◽

Mohsen Bazargan ◽

Shervin Assari ◽

Lisa Barkley ◽

Shahrzad Bazargan-Hejazi

Keyword(s):

Older Adults ◽

Emergency Department ◽

African American ◽

Hospital Admissions ◽

Predisposing Factors ◽

Emergency Department Utilization ◽

Enabling Factors ◽

Physician Visits ◽

African American Older Adults ◽

Latino Older Adults

Abstract Objectives This study uses a theoretical model to explore (a) emergency department (ED) utilization, (b) hospital admissions, and (c) office-based physician visits among sample of under-resourced African American and Latino older adults. Methods Nine hundred five African American and Latino older adults from an under-resourced urban community of South Los Angeles participated in this study. Data was collected using face-to-face interviews. Poisson and logistic regression analysis were used to estimate the parameters specified in the Andersen behavioral model. Predictors included predisposing factors, defined as demographic and other personal characteristics that influence the likelihood of obtaining care, and enabling factors defined as personal, family, and community resources that support or encourage efforts to access health services. Results African American older adults have a greater frequency of hospital admissions, ED, and physician visits than their Latino counterparts. About 25%, 45%, and 59% of the variance of the hospital admissions, ED utilization, and physician visits could be explained by predisposing and enabling characteristics. Lower health-related quality of life was associated with a higher number of hospital admissions, ED, and physician visits. Financial strain and difficulty accessing medical care were associated with a higher number of hospital admissions. Being covered by Medicare and particularly Medi-Cal were positively associated with higher hospital admissions, ED, and physician visits. Discussion Compared to African American older adults, Latino older adults show higher utilization of (a) emergency department (ED) utilization, (b) hospital admissions, and (c) office-based physician visits. A wide range of predisposing and enabling factors such as insurance and financial difficulties correlate with some but not other types of health care use. Multi-disciplinary, culturally sensitive, clinic- and community-based interventions are needed to address enabling and predisposing factors that influence ED utilization and hospital admission among African American and Latino older adults in under-resourced communities.

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Investigating walnut consumption and cognitive trajectories in a representative sample of older US adults

Public Health Nutrition ◽

10.1017/s1368980020001287 ◽

2020 ◽

pp. 1-12

Author(s):

Nicholas J Bishop ◽

Krystle E Zuniga

Keyword(s):

Older Adults ◽

Cognitive Function ◽

Representative Sample ◽

Secondary Analysis ◽

Health Behaviours ◽

Cognitive Change ◽

Cognitive Status ◽

Sensitivity Analyses ◽

Age Related ◽

The Usa

Abstract Objective: Existing research suggests walnut intake may be associated with better cognitive function in older adults, yet few studies utilise longitudinal data from observational studies of ageing populations. Our objective was to estimate the association between whole walnut intake and cognitive change in a representative sample of older Americans. Design: Secondary analysis of the Health and Retirement Study and Health Care and Nutrition Study. Walnut consumption was defined as a categorical measure (none, low intake (0·01–0·08 1 oz. servings per day) and moderate intake (>0·08 1 oz. servings per day)) and cognitive function was measured using the Telephone Interview for Cognitive Status. Latent growth modelling estimated the association between walnut consumption and trajectories of cognitive status over a 4-year observational period. Sensitivity analyses assessing non-random dropout and Monte Carlo power analyses were conducted to contextualise results. Setting: The USA. Participants: A sample of 3632 US adults aged 65 years and older. Results: Those reporting any walnut consumption had greater cognitive scores at baseline than those not consuming walnuts (low walnut consumption, b = 1·53, se = 0·21, P < 0·001; moderate walnut consumption, b = 2·22, se = 0·27, P < 0·001), but walnut consumption was not associated with cognitive change. Walnut consumption was positively associated with socioeconomic status and health behaviours as well as intake of nutrients identified to have neuroprotective benefits. Conclusions: We identified an association between walnut consumption and cognitive function in older adults, although we did not find that walnut consumption was protective against age-related cognitive decline.

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Racial and ethnic differences in cognitive function among older adults in the USA

International Journal of Geriatric Psychiatry ◽

10.1002/gps.4410 ◽

2016 ◽

Vol 31 (9) ◽

pp. 1004-1012 ◽

Cited By ~ 42

Author(s):

Carlos Díaz-Venegas ◽

Brian Downer ◽

Kenneth M. Langa ◽

Rebeca Wong

Keyword(s):

Older Adults ◽

Cognitive Function ◽

Ethnic Differences ◽

Racial And Ethnic Differences ◽

The Usa

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Physical Activity and Cognitive Function in African American Older Adults Living With HIV

Journal of Gerontological Nursing ◽

10.3928/00989134-20211109-06 ◽

2021 ◽

Vol 47 (12) ◽

pp. 27-34

Author(s):

Nadia Winston ◽

Barbara Swanson ◽

Louis F. Fogg ◽

Ana W. Capuano ◽

JoEllen Wilbur ◽

...

Keyword(s):

Physical Activity ◽

Older Adults ◽

African American ◽

Cognitive Function ◽

Living With Hiv ◽

African American Older Adults

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Accounting for differences in cognitive health between older adults in New Zealand and the USA

International Psychogeriatrics ◽

10.1017/s1041610214002579 ◽

2014 ◽

Vol 27 (4) ◽

pp. 591-600 ◽

Cited By ~ 4

Author(s):

Christine Stephens ◽

John Spicer ◽

Claire Budge ◽

Brendan Stevenson ◽

Fiona Alpass

Keyword(s):

Risk Factors ◽

Older Adults ◽

New Zealand ◽

Cognitive Function ◽

Hierarchical Regression ◽

Cognitive Health ◽

National Differences ◽

The Us ◽

The Usa ◽

Age And Sex

ABSTRACTBackground:National differences in cognitive health of older adults provide an opportunity to shed light on etiological factors. We compared the cognitive health of older adults in New Zealand and the USA, and examined differences in known risk factors.Methods:Two nationally representative samples were derived from the 2010 waves of the New Zealand Longitudinal Study of Ageing (n = 953) and the US Health and Retirement Study (HRS) (n = 3,746). Data from comparable measures of cognitive function, gender, age, income, education, prevalence of cancer, diabetes, heart disease, hypertension and stroke, exercise, alcohol consumption, smoker status, depression, and self-reported health were subjected to hierarchical regression analysis to examine how national differences in cognitive function might be explained by differences in these risk factors.Results:The New Zealand sample scored 4.4 points higher on average than the US sample on the 43 point cognitive scale. Regression analyses of the combined samples showed that poorer cognitive health is more likely in those who are male, older, less educated, have suffered a stroke, consume alcohol less frequently, are more depressed, and report worse overall health. Controlling for age and sex reduced the mean difference to 2.6 and controlling for risk factors further reduced it to 2.3.Conclusions:Older New Zealand adults displayed better cognitive function than those in a US sample. This advantage can be partially explained by age and sex differences and, to some extent, by differences in known risk factors. However, the national advantage remained even when all measured risk factors are statistically controlled.

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Multi-Dimensional Impact of Chronic Low Back Pain among Underserved African American and Latino Older Adults

International Journal of Environmental Research and Public Health ◽

10.3390/ijerph18147246 ◽

2021 ◽

Vol 18 (14) ◽

pp. 7246

Author(s):

Mohsen Bazargan ◽

Margarita Loeza ◽

Tavonia Ekwegh ◽

Edward Adinkrah ◽

Lucy Kibe ◽

...

Keyword(s):

Mental Health ◽

Older Adults ◽

African American ◽

Low Back Pain ◽

Back Pain ◽

Health Outcomes ◽

Chronic Low Back Pain ◽

Low Back ◽

Latino Older Adults

Chronic low back pain is one of the most common, poorly understood, and potentially disabling chronic pain conditions from which older adults suffer. The existing low back pain research has relied almost exclusively on White/Caucasian participant samples. This study examines the correlates of chronic low back pain among a sample of underserved urban African American and Latino older adults. Controlling for age, gender, race/ethnicity, education, living arrangement, and number of major chronic conditions, associations between low back pain and the following outcome variables are examined: (1) healthcare utilization, (2) health-related quality of life (HR-QoL) and self-rated quality of health; and (3) physical and mental health outcomes. Methods: We recruited nine hundred and five (905) African American and Latino older adults from the South Los Angeles community using convenience and snowball sampling. In addition to standard items that measure demographic variables, our survey included validated instruments to document HR-QoL health status, the Short-Form McGill Pain Questionnaire-2, Geriatric Depression Scale, sleep disorder, and healthcare access. Data analysis includes bivariate and 17 independent multivariate models. Results: Almost 55% and 48% of the Latino and African American older adults who participated in our study reported chronic low back pain. Our data revealed that having low back pain was associated with three categories of outcomes including: (1) a higher level of healthcare utilization measured by (i) physician visits, (ii) emergency department visits, (iii) number of Rx used, (iv) a higher level of medication complexity, (v) a lower level of adherence to medication regimens, and (vi) a lower level of satisfaction with medical care; (2) a lower level of HR-QoL and self-assessment of health measured by (i) physical health QoL, (ii) mental health QoL, and (iii) a lower level of self-rated health; and (3) worse physical and mental health outcomes measured by (i) a higher number of depressive symptoms, (ii) a higher level of pain, (iii) falls, (iv) sleep disorders, (v) and being overweight/obese. Discussion: Low back pain remains a public health concern and significantly impacts the quality of life, health care utilization, and health outcomes of underserved minority older adults. Multi-faceted and culturally sensitive interventional studies are needed to ensure the timely diagnosis and treatment of low back pain among underserved minority older adults. Many barriers and challenges that affect underserved African American and Latino older adults with low back pain simply cannot be addressed in over-crowded EDs. Our study contributes to and raises the awareness of healthcare providers and health policymakers on the necessity for prevention, early diagnosis, proper medical management, and rehabilitation policies to minimize the burdens associated with chronic low back pain among underserved older African American and Latino patients in an under-resourced community such as South Los Angeles.

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Toward Identifying Mild Cognitive Impairment in Hispanic and African American Adults

Perspectives of the ASHA Special Interest Groups ◽

10.1044/persp2.sig2.110 ◽

2017 ◽

Vol 2 (2) ◽

pp. 110-116

Author(s):

Valarie B. Fleming ◽

Joyce L. Harris

Keyword(s):

Older Adults ◽

African American ◽

Cognitive Impairment ◽

Mild Cognitive Impairment ◽

Healthcare Access ◽

Communication Disorders ◽

Healthcare Systems ◽

Prevention Education ◽

Education Management ◽

African American Adults

Across the breadth of acquired neurogenic communication disorders, mild cognitive impairment (MCI) may go undetected, underreported, and untreated. In addition to stigma and distrust of healthcare systems, other barriers contribute to decreased identification, healthcare access, and service utilization for Hispanic and African American adults with MCI. Speech-language pathologists (SLPs) have significant roles in prevention, education, management, and support of older adults, the population must susceptible to MCI.

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