The impact of social stress and strain on cognitive function in older people

2020 ◽  
Vol 30 (Supplement_5) ◽  
Author(s):  
J Lindert ◽  
K C Paul ◽  
M Lachman ◽  
B Ritz ◽  
T Seeman

Abstract Background Social stress and strain, especially discrimination and inequality might have an impact on memory and cognitive function. This is a major concern for older individuals, their families, communities and societies. We sought to assess changes in episodic memory (EM) and executive functioning (EF) among men and women in the 'Midlife in the United States' (MIDUS) cohort study, to delineate variations in EM and EF by gender, and to determine the impact of social stress/strain at three levels (family, work, society) on longitudinal changes in EM and EF in men and women. Methods We used data from the MIDUS study - a national probability sample of non-institutionalized, English speaking respondents aged 25-74 living in the 48 contiguous states of the United States. The initial wave in our study (1995) included 4963 non-institutionalized adults aged 32 to 84 (M = 55, SD = 12.4). The dependent variables are EM and EF, which were assessed with the Brief Test for Cognition. The independent variables were social stress and discrimination variables at the family/partner level, the work level and the society level, assessed with validated discrimination measures. To assess cognition changes we estimated adjusted linear regression models. Results Women report more perceived inequality for their family and more family strain than men across all age groups. After controlling for other explanatory variables, the main effect on cognition for all age groups was found for perceived inequality of one's family opportunities. Conclusions Reducing social stress and providing opportunities might be an important measure to support episodic memory and executive functioning in aging populations.

Author(s):  
Jutta Lindert ◽  
Kimberley C. Paul ◽  
E. Lachman Margie ◽  
Beate Ritz ◽  
Teresa Seeman

AbstractLimited research is available on the relationship between social stress and risk of declining cognition. We sought to examine whether social stress has adverse effects on risk of declining episodic memory and executive functioning in aging individuals. We used data from the MIDUS study, a national probability sample of non-institutionalized, English speaking respondents aged 25–74 living in the 48 contiguous states of the United States. The initial wave (1995) included 4963 non-institutionalized adults aged 32–84 (M = 55, SD = 12.4). We used an analytic sample from MIDUS-II (1996/1997) and MIDUS-III (2013) (n = 1821). The dependent variables are episodic memory and executive functioning, which were assessed with the Brief Test for Cognition (BTACT). The independent variables were social stress variables (subjective social status, family and marital stress, work stress and discrimination). To evaluate episodic memory and executive functioning changes over a time period of 10 years, we estimated adjusted linear regression models. Women report significantly lower subjective social status and more discrimination stress than men across all age groups. Controlling for education and income, age, and baseline episodic memory and executive functioning, lower subjective social status had additional adverse effects on declines in episodic memory in men and women. Marital risk had adverse effects on episodic memory in men but not in women. Daily discrimination had adverse effects on executive functioning on all individuals. Public health strategies should focus on reducing social stress in a socio-ecological perspective. Especially, subjective social status and discrimination stress might be a target for prevention efforts.


Circulation ◽  
2020 ◽  
Vol 141 (Suppl_1) ◽  
Author(s):  
Yoshihiro Tanaka ◽  
Nilay Shah ◽  
Rod Passman ◽  
Philip Greenland ◽  
Sadiya Khan

Background: Atrial fibrillation (AF) is the most common sustained arrhythmia in adults and the prevalence is increasing due to the aging of the population and the growing burden of vascular risk factors. Although deaths due to cardiovascular disease (CVD) death have dramatically decreased in recent years, trends in AF-related CVD death has not been previously investigated. Purpose: We sought to quantify trends in AF-related CVD death rates in the United States. Methods: AF-related CVD death was ascertained using the CDC WONDER online database. AF-related CVD deaths were identified by listing CVD (I00-I78) as underlying cause of death and AF (I48) as contributing cause of death among persons aged 35 to 84 years. We calculated age-adjusted mortality rates (AAMR) per 100,000 population, and examined trends over time estimating average annual percent change (AAPC) using Joinpoint Regression Program (National Cancer Institute). Subgroup analyses were performed to compare AAMRs by sex-race (black and white men and women) and across two age groups (younger: 35-64 years, older 65-84 years). Results: A total of 522,104 AF-related CVD deaths were identified between 1999 and 2017. AAMR increased from 16.0 to 22.2 per 100,000 from 1999 to 2017 with an acceleration following an inflection point in 2009. AAPC before 2009 was significantly lower than that after 2009 [0.4% (95% CI, 0.0 - 0.7) vs 3.5% (95% CI, 3.1 - 3.9), p < 0.001). The increase of AAMR was observed across black and white men and women overall and in both age groups (FIGURE), with a more pronounced increase in black men and white men. Black men had the highest AAMR among the younger decedents, whereas white men had the highest AAMR among the older decedents. Conclusion: This study revealed that death rate for AF-related CVD has increased over the last two decades and that there are greater black-white disparities in younger decedents (<65 years). Targeting equitable risk factor reduction that predisposes to AF and CVD mortality is needed to reduce observed health inequities.


2021 ◽  
Author(s):  
Taylor Chin ◽  
Dennis M. Feehan ◽  
Caroline O. Buckee ◽  
Ayesha S. Mahmud

SARS-CoV-2 is spread primarily through person-to-person contacts. Quantifying population contact rates is important for understanding the impact of physical distancing policies and for modeling COVID-19, but contact patterns have changed substantially over time due to shifting policies and behaviors. There are surprisingly few empirical estimates of age-structured contact rates in the United States both before and throughout the COVID-19 pandemic that capture these changes. Here, we use data from six waves of the Berkeley Interpersonal Contact Survey (BICS), which collected detailed contact data between March 22, 2020 and February 15, 2021 across six metropolitan designated market areas (DMA) in the United States. Contact rates were low across all six DMAs at the start of the pandemic. We find steady increases in the mean and median number of contacts across these localities over time, as well as a greater proportion of respondents reporting a high number of contacts. We also find that young adults between ages 18 and 34 reported more contacts on average compared to other age groups. The 65 and older age group consistently reported low levels of contact throughout the study period. To understand the impact of these changing contact patterns, we simulate COVID-19 dynamics in each DMA using an age-structured mechanistic model. We compare results from models that use BICS contact rate estimates versus commonly used alternative contact rate sources. We find that simulations parameterized with BICS estimates give insight into time-varying changes in relative incidence by age group that are not captured in the absence of these frequently updated estimates. We also find that simulation results based on BICS estimates closely match observed data on the age distribution of cases, and changes in these distributions over time. Together these findings highlight the role of different age groups in driving and sustaining SARS-CoV-2 transmission in the U.S. We also show the utility of repeated contact surveys in revealing heterogeneities in the epidemiology of COVID-19 across localities in the United States.


Author(s):  
Christina M Ackerman ◽  
Jennifer L Nguyen ◽  
Swapna Ambati ◽  
Maya Reimbaeva ◽  
Birol Emir ◽  
...  

Abstract Background Pregnant women with coronavirus disease 19 (COVID-19) may be at greater risk of poor maternal and pregnancy outcomes. This retrospective analysis reports clinical and pregnancy outcomes among hospitalized pregnant women with COVID-19 in the United States. Methods The Premier Healthcare Database – Special Release was used to examine the impact of COVID-19 among pregnant women aged 15–44 years who were hospitalized and who delivered compared with pregnant women without COVID-19. Outcomes evaluated were COVID-19 clinical progression, including the use of supplemental oxygen therapy, intensive care unit admission, critical illness, receipt of invasive mechanical ventilation/extracorporeal membrane oxygenation, and maternal death, and pregnancy outcomes, including preterm delivery and stillbirth. Results Overall, 473,902 hospitalized pregnant women were included, of whom 8584 (1.8%) had a COVID-19 diagnosis (mean [SD] age 28.4 [6.1] years; 40% Hispanic). The risk of poor clinical and pregnancy outcomes was greater among pregnant women with COVID-19 compared with pregnant women without a COVID-19 diagnosis in 2020; the risk of poor clinical and pregnancy outcomes increased with increasing age. Hispanic and Black non-Hispanic women were consistently observed to have the highest relative risk of experiencing poor clinical or pregnancy outcomes across all age groups. Conclusions Overall, COVID-19 had a significant negative impact on maternal health and pregnancy outcomes. These data help inform clinical practice and counselling to pregnant women regarding the risks of COVID-19. Clinical studies evaluating the safety and efficacy of vaccines against severe acute respiratory syndrome coronavirus 2 in pregnant women are urgently needed.


2020 ◽  
Vol 19 (3) ◽  
pp. 2497
Author(s):  
V. G. Vilkov ◽  
S. A. Shalnova ◽  
Yu. A. Balanova ◽  
S. E. Evstifeeva ◽  
A. E. Imaeva ◽  
...  

Aim. To study the prevalence of hypotension according to several criteria in the Russia and the USA.Material and methods. We used data of Russian population studies performed in 1975-1982 and ESSE-RF study performed in 2012-2014 at the National Medical Research Center for Therapy and Preventive Medicine. A comparison was made with the data of cross-sectional stu - dies of the US population — National Health and Nutrition Examination Survey (NHANES): NHANES II (1976-1980) and Continuous NHANES (2007-2012). We analyzed age, sex, and systolic and diastolic blood pressure. The prevalence of individuals with hypotension was calculated in men and women of five age groups using four different criteria for hypertension.Results. The prevalence of hypotension in studies of different years according to different criteria was as follows: in the Russia — 0,3-9,0% in men and 2-15% in women; in the USA — 5-30% in men and 8-45% in women. In age group >30 years, the prevalence of hypotension in Russia, by most criteria, decreased approximately by 50% in men and did not change in women. In the United States, according to all criteria, the prevalence in men and women has increased 2-3 times.Conclusion. The prevalence of hypotension in the adult population ranges from decimal percentages to 45% and varies many times depending on the selected criterion.


2020 ◽  
Vol 7 (Supplement_1) ◽  
pp. S703-S703
Author(s):  
Elizabeth M La ◽  
Justin Carrico ◽  
Sandra E Talbird ◽  
Ya-Ting Chen ◽  
Mawuli K Nyaku ◽  
...  

Abstract Background Routine immunizations for children aged 10 years and younger in the United States (US) currently cover 14 diseases. Updated estimates of public health impact are needed, given changes in disease epidemiology, evolving recommendations, and the dynamic nature of compliance with the immunization schedule. Methods Pre-vaccine disease incidence was estimated before each routine vaccine was recommended, with average values across multiple years obtained directly from published literature or calculated based on disease surveillance data or annual case estimates from the published literature. Pre-vaccine incidence then was compared to current, post-vaccine incidence, which was generally calculated as average values over the most recent 5 years of available incidence data. Overall incidence estimates and estimates by age group were calculated. Differences in pre- and post-vaccine disease incidence rates were used to calculate the annual number of cases averted, based on 2019 US population estimates. This analysis did not separately estimate the proportion of disease incidence reduction that may be attributed to adult vaccines or booster doses. Results Post-vaccine disease incidence decreased overall and for all age groups across all diseases evaluated (Table 1). Decreases ranged from 17.4% for influenza to 100.0% for polio (Figure 1). Over 90% reduction in incidence was achieved for 10 of the 14 diseases evaluated (including reduction in incidence of rotavirus hospitalizations). Overall post-vaccine disease incidence estimates were highest for influenza, rotavirus, and varicella. Estimated annual cases averted by vaccination in 2019 ranged from 1,269 for tetanus to more than 4.2 million for varicella. Table 1. Pre- and Post-Vaccine Disease Incidence Estimates, Annual Cases, and 2019 Cases Averted, by Disease Figure 1. Percentage Reduction in Disease Incidence Post-Vaccine, by Disease Conclusion Routine childhood immunization in the US continues to result in high, sustained reduction in disease across all vaccines and for all age groups evaluated. Disclosures Elizabeth M. La, PhD, RTI Health Solutions (Employee) Justin Carrico, BS, GlaxoSmithKline (Consultant) Sandra E. Talbird, MSPH, RTI Health Solutions (Employee) Ya-Ting Chen, PhD, Merck & Co., Inc. (Employee, Shareholder) Mawuli K. Nyaku, DrPh, Merck & Co. Inc. (Employee, Shareholder) Cristina Carias, PhD, Merck (Employee, Shareholder) Gary S. Marshall, MD, GlaxoSmithKline (Consultant, Scientific Research Study Investigator)Merck (Consultant, Scientific Research Study Investigator)Pfizer (Consultant, Scientific Research Study Investigator)Sanofi Pasteur (Consultant, Grant/Research Support, Scientific Research Study Investigator, Honorarium for conference lecture)Seqirus (Consultant, Scientific Research Study Investigator) Craig S. Roberts, PharmD, MPA, MBA, Merck & Co., Inc (Employee, Shareholder)


Blood ◽  
2014 ◽  
Vol 124 (21) ◽  
pp. 1292-1292
Author(s):  
Philip S Rosenberg ◽  
Kimberly A Barker ◽  
William F Anderson

Abstract BACKGROUND: Multiple myeloma (MM) is the second most common hematological malignancy in the United States (US), representing 1.4% of all new cancers. MM incidence increases rapidly with age, is twice as common among African Americans versus other groups, and is a top ten cause of cancer deaths among African Americans. Although the absolute number of new MM cases per year, or MM burden, is expected to be higher in future years because of predictable changes in the demographic profile of the US, to date no study has made detailed forecasts of future MM incidence or burden by age, race/ethnicity, and sex. In this study we construct such forecasts for the period 2011 through 2034 using cancer incidence data from the National Cancer Institute’s Surveillance Epidemiology and End Results (SEER) Program, a novel age-period-cohort (APC) forecasting model, and official projections of population sizes produced by the US Bureau of the Census. METHODS: We obtained MM case and population data from the SEER 13 Registries Database for 1993 – 2010 for all men and women, and for non-Hispanic whites, Hispanics, Blacks, and Asian and Pacific Islanders (API). To obtain stable APC estimates for each population, we aggregated single-year data into sixteen 3-year age groups (37 – 39 through 82 – 84) and six 3-year periods (1993 – 1995 through 2008 – 2010) spanning 21 partially overlapping 6-year birth cohorts centered on birth-years 1911, 1914, through 1971. Cohort effects in our APC models enabled us to make incidence forecasts allowing for different time trends in different age groups and to extrapolate incidence trends to future birth cohorts. We estimated future numbers of new cases for each sex by race/ethnic group by multiplying APC incidence rate forecasts from SEER 13 (which covers 14% of the US) by US Census population projections for the entire US for each sex and race/ethnic group. RESULTS: APC-based age incidence curves estimated from SEER13 data for incorporation into national projections reflected the contemporary epidemiology of MM: age incidence was higher among men than women in every race/ethnic group especially at ages 64 – 84 years, was highest in Blacks and lowest in API, and was similar in non-Hispanic Whites and Hispanics. In APC analyses, observed MM incidence from 1993 – 2010 was stable among men ages 37 – 63, increasing by around 0.5 percent per year among men ages 64 – 84, and stable among women in all age groups. Projected incidence for 2011 – 2034 was stable or slightly increasing in every age group. Projected MM burdens (numbers of new cases per year) were stable or slightly increasing for men and women ages 37 – 63. In contrast, large increases in the numbers of Americans ages 64 – 84 are expected to result in substantial increases in MM burden in this age group. In 2011-2013 we estimate a total of 11,200 new MM cases in men and 8,500 new cases in women. For 2032-2034 we forecast a total of 18,500 new cases in men and 13,700 new cases in women (65% and 61% increases, respectively). Among older persons ages 64 – 84, corresponding estimates are 7,300 male and 5,400 female cases in 2011 – 2013 approximately doubling to 14,100 male and 10,300 female cases in 2032-2034. Among older black men, who have the highest MM incidence and whose population is expected to increase by 4.3% per year, the projected increase in burden is 152% (from 1,210 to 3,050 cases per year). Among older Hispanic men (stable MM incidence, population increasing by 5.5% per year) the burden is expected to triple (from 460 to 1,370 cases per year). Among all older men, increases in MM burden above population growth reflect a modest increase in MM incidence. Increases in MM burden in other groups are in line with corresponding increases in population. DISCUSSION: MM incidence has been relatively stable in the US during 1993 – 2010. Our forecast is that MM incidence will continue to be quite stable during 2011 – 2032. Nonetheless, because of predictable demographic shifts in the US, the number of new MM cases per year is expected to increase by 65% in men and 61% in women between 2011-2013 and 2032-2034. Almost all of these increases will occur among older Americans ages 64 – 84. In this age group, the number of new cases overall will double, and more than double among Black and Hispanic men and women. IMPACT: Detailed forecasts quantify increasing demands for health services personnel and resources, and highlight the need for more effective MM therapies, especially for patients ages 64 – 84. Disclosures No relevant conflicts of interest to declare.


2021 ◽  
Vol 38 (1) ◽  
pp. 79-94
Author(s):  
Stamatis Agiovlasitis ◽  
Jooyeon Jin ◽  
Joonkoo Yun

The authors examined if body mass index (BMI), weight, and height across age groups differ between adults with Down syndrome (DS) and adults with intellectual disability but without DS. They conducted secondary analyses of cross-sectional data from 45,803 individuals from the United States from 2009 to 2014 of the National Core Indicators Adult Consumer Survey across five age groups: 18–29, 30–39, 40–49, 50–59, and 60+ years. For both men and women with DS, BMI and weight increased between the 18- to 29- and the 30- to 39-year age groups and decreased thereafter. For both men and women with intellectual disability, BMI and weight increased between the 18- to 29- and the 30- to 39-year age groups, stayed about the same until the 50- to 59-year age group, and decreased thereafter. Height demonstrated a small but significant decrease with older age in all groups. These cross-sectional comparisons indicate that BMI and weight may start decreasing at a younger age in adults with DS than in adults with intellectual disability.


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