scholarly journals Disentangling the Stress Process: Race/Ethnic Differences in the Exposure and Appraisal of Chronic Stressors Among Older Adults

2018 ◽  
Vol 75 (3) ◽  
pp. 650-660 ◽  
Author(s):  
Lauren L Brown ◽  
Uchechi A Mitchell ◽  
Jennifer A Ailshire
Keyword(s):  
Older Adults ◽  
Ethnic Differences ◽  
Minority Groups ◽  
Financial Strain ◽  
Stress Exposure ◽  
Foreign Born ◽  
Physical And Mental Health ◽  
Stress Appraisal ◽  
Chronic Stressors ◽  
Stress Burden

Abstract Objectives Exposure to stressors is differentially distributed by race/ethnicity with minority groups reporting a higher stress burden than their white counterparts. However, to really understand the extent to which some groups bear a disproportionate stress burden, we need to consider race/ethnic differences in stress appraisal, specifically how upsetting stressors may be, in addition to stress exposure. We examine racial/ethnic differences in both the number of reported chronic stressors across five domains (health, financial, residential, relationship, and caregiving) and their appraised stressfulness among a diverse sample of older adults. Method Data come from 6,567 adults ages 52+ from the 2006 Health and Retirement Study. Results Results show older blacks, U.S. and foreign-born Hispanics report more chronic stress exposure than whites and are two to three times as likely to experience financial strain and housing-related stress. Socioeconomic factors fully explain the Hispanic–white difference in stress exposure, but black–white differences remain. Despite experiencing a greater number of stressors, blacks and U.S.-born Hispanics are less likely to be upset by exposure to stressors than whites. U.S.-born Hispanics are less upset by relationship-based stressors specifically, while blacks are less upset across all stress domains in fully-adjusted models. Foreign-born Hispanics are only less upset by caregiving strain. Discussion The distinction between exposure and appraisal-based measures of stress may shed light on important pathways that differentially contribute to race/ethnic physical and mental health disparities.

scholarly journals Effects of Stress Exposure Versus Appraisal on Episodic Memory Trajectories: Evidence for Risk and Resilience among Black Older Adults

2021 ◽  
Author(s):  
Emily P Morris ◽  
Lauren L Brown ◽  
Afsara B Zaheed ◽  
Jordan D Palms ◽  
Ketlyne Sol ◽  
...  
Keyword(s):  
Older Adults ◽  
Episodic Memory ◽  
Racial Disparities ◽  
Chronic Stress ◽  
Indirect Effect ◽  
Memory Task ◽  
Future Research ◽  
Stress Exposure ◽  
Stress Appraisal ◽  
Latent Growth Curves

Abstract Objectives Chronic stressors, experienced disproportionately by Black older adults, are a risk factor for memory impairment. Racially patterned stress exposure may contribute to higher rates of Alzheimer’s disease and related dementias (ADRD) among Black older adults compared with Whites, but less is known about the role of stress appraisal. This study examined whether chronic stress exposure mediates racial disparities in memory and whether stress appraisal moderates these associations. Methods Participants included 16,924 older adults (Mage= 67.39, 21% Black) from the 2010 and 2012 waves of the Health and Retirement Study who completed measures of chronic stress exposure (health, financial, housing, relationships, and caregiving) and appraisal. Latent growth curves modeled longitudinal performance on a word list memory task over six years. Results Black older adults reported greater stress exposure than Whites, and greater stress exposure partially mediated Black-White disparities in initial memory (standardized indirect effect=–.002, p=.009). However, Black older adults appraised stressors as less upsetting than Whites. While stress appraisal did not moderate links between stress exposure and memory, appraising stressors as less upsetting was independently associated with better initial memory. Thus, Black-White disparities in initial memory was partially offset by Blacks participants' appraisal of stressors as less upsetting (standardized indirect effect=.002, p=.016). Discussion Reducing chronic stress exposure may reduce racial disparities in ADRD risk. The counteractive effect of stress appraisal on Black-White disparities in episodic memory highlights resilience factors among Black older adults that should be characterized in future research to move beyond deficit models of ADRD inequality.

scholarly journals Loneliness, Stress, and Depressive Symptoms Among Older Immigrants: A Moderating Role of Familial Relationships

2021 ◽  
Vol 5 (Supplement_1) ◽  
pp. 122-122
Author(s):  
Heejung Jang
Keyword(s):  
Depressive Symptoms ◽  
Family Relationships ◽  
Health Problems ◽  
Mediating Effect ◽  
Financial Strain ◽  
Stress Exposure ◽  
Stress Appraisal ◽  
Familial Relationships ◽  
Older Immigrants ◽  
Stress Appraisals

Abstract Objectives Immigration is a stressful life event, and immigrants commonly experience loneliness, a risk factor for depression. However, little is known about how and whether older immigrants’ perceived stress exposure/appraisals mediate the association between loneliness and depressive symptoms. Further, this study explores whether familial relationships moderate the indirect or direct effects of the mediation models. Method: This study uses the 2012 Health and Retirement Study from a sample of 719 immigrants age 57 and older. A series of moderated mediation analyses were conducted across the total number of stress exposure and eight stress appraisal domains. Results The findings indicate that the total number of stress exposure and five domains of stress appraisals (health problems in self, physical/emotional problems in spouse/child, financial strain, housing problems, and close relationships in others) mediate the association between loneliness and depressive symptoms. In addition, the perceived negative strain from family moderated the mediating effect of health problems and housing problems in the relationship between loneliness and depressive symptoms. Discussion This study suggests that negative relationships with family may increase upsetting in stress appraisals on health and housing problems, which turn in increased depressive symptoms for lonely older immigrants. Practitioners need to assess older immigrants’ stressors and family relationships to understand their loneliness and depressive symptoms.

scholarly journals Stress Is a Latent Construct: Exploring the Differential Experience of Stress Among Black Older Adults

2021 ◽  
Vol 5 (Supplement_1) ◽  
pp. 190-190
Author(s):  
Catherine Garcia ◽  
Alexis Reeves ◽  
John Pamplin ◽  
Uchechi Mitchell ◽  
Lauren Brown
Keyword(s):  
Older Adults ◽  
Chronic Stress ◽  
Latent Class ◽  
High Stress ◽  
Coping Mechanisms ◽  
Stress Exposure ◽  
Health Consequences ◽  
Stress Burden ◽  
And Coping ◽  
The Impact

Abstract While evidence highlights the detrimental health consequences of stress exposure for Black Americans, the impact of stress exposure on health varies by the stressor, individual appraisal and coping mechanisms examined. In this study, we aim to explore the differential effects of chronic stress exposure by means of latent class analysis on mental and physical health. Data come from 800 Black older adults ages 52+ from the 2006 Health and Retirement Study. A set of items that include stress exposure, appraisal and coping were used to assess chronic stress burden on anxiety, depressive symptoms and chronic conditions to identify stress and health clusters. Analysis revealed four subgroups, each demonstrated a typological response pattern with the most pronounced health consequences for high stress exposure, appraisal and few or no coping mechanisms. Results show an alternative approach to examining the stress-health link by using a combined person- and variable-centered approach.

scholarly journals Measuring More Than Exposure: Does Stress Appraisal Matter for Black–White Differences in Anxiety and Depressive Symptoms Among Older Adults?

2020 ◽  
Vol 4 (5) ◽  
Author(s):  
Lauren L Brown ◽  
Leah R Abrams ◽  
Uchechi A Mitchell ◽  
Jennifer A Ailshire
Keyword(s):  
Mental Health ◽  
Health Disparities ◽  
Depressive Symptoms ◽  
Race Differences ◽  
Anxiety Symptoms ◽  
Stressful Events ◽  
Stress Exposure ◽  
Mental Health Disparities ◽  
Stress Appraisal ◽  
Chronic Stressors

Abstract Background and Objectives Prior research and theory suggest that exposure to objectively stressful events contributes to mental health disparities. Yet, blacks report higher cumulative stress exposure than whites but lower levels of common psychiatric disorders. In order to understand why blacks bear disproportionate stress exposure but similar or better mental health relative to whites, we need to consider race differences in not only stress exposure, but also stress appraisal—how upsetting stress exposures are perceived to be. Research Design and Methods We examine whether race differences in the number of reported chronic stressors across 5 domains (health, financial, residential, relationship, and caregiving) and their appraised stressfulness explain black–white differences in anxiety and depressive symptoms. Data come from 6019 adults aged older than 52 from the 2006 Health and Retirement Study. Results Older blacks in this sample experience greater exposure to chronic stressors but appraise stressors as less upsetting relative to whites. In fully adjusted models, stress exposure is related to higher levels of anxiety and depressive symptoms, and perceiving stress as upsetting is associated with higher symptomology for whites and blacks. We also find that blacks report greater anxiety symptoms but fewer depressive symptoms with more stress exposure relative to whites. Stress appraisal partially explains race differences in the association between stress exposure and anxiety symptoms and fully explains race differences in the association between exposure and depressive symptoms. Discussion and Implications The relationship between race, chronic stress exposure, and mental health is mediated by stress appraisal. Stress appraisal provides insight on important pathways contributing to black–white mental health disparities in older adulthood.

scholarly journals Death by a Thousand Cuts: Stress Exposure and Black–White Disparities in Physiological Functioning in Late Life

2019 ◽  
Vol 75 (9) ◽  
pp. 1937-1950 ◽  
Author(s):  
Courtney Boen
Keyword(s):  
Multiple Stressors ◽  
Critical Role ◽  
Ordinary Least Squares ◽  
Race Differences ◽  
Financial Strain ◽  
Stress Exposure ◽  
Major Life ◽  
Cumulative Stress ◽  
Metabolic Dysregulation ◽  
Stress Burden

Abstract Objectives This paper investigates Black–White differences in stress—including diverse measures of chronic, acute, discrimination-related, and cumulative stress exposure—and examines whether race differences in these stress measures mediate Black–White disparities in C-reactive protein (CRP) and metabolic dysregulation in later life. Methods Using data from the Health and Retirement Study (HRS) (2004–2012), this study uses stepwise ordinary least squares (OLS) regression models to examine the prospective associations between multiple stressors—including traumatic and stressful life events, financial strain, chronic stress, everyday and major life discrimination, and measures of cumulative stress burden—and CRP and metabolic dysregulation. Mediation analyses assessed the contribution of stress exposure to Black–White disparities in the outcomes. Results Blacks experienced more stress than Whites across domains of stress, and stress exposure was strongly associated with CRP and metabolic dysregulation. Race differences in financial strain, everyday and major life discrimination, and cumulative stress burden mediated Black–White gaps in the outcomes, with measures of cumulative stress burden mediating the greatest proportion of the racial disparities. Discussion The “thousand cuts” that Blacks experience from their cumulative stress exposure across domains of social life throughout the life course accelerate their physiological deterioration relative to Whites and play a critical role in racial health disparities at older ages.

scholarly journals Financial Strain, Self-Rated Health, and the Mediating Role of Health Behaviors During the Great Recession

2020 ◽  
Vol 4 (Supplement_1) ◽  
pp. 395-395
Author(s):  
Lindsay Wilkinson
Keyword(s):  
Older Adults ◽  
Health Behaviors ◽  
Economic Recession ◽  
Financial Strain ◽  
Economic Downturn ◽  
Physical And Mental Health ◽  
Self Rated Health ◽  
Prescription Drug Use ◽  
Lagged Dependent Variable

Abstract Previous research has revealed the physical and mental health consequences of the economic recession that began in 2007 and ended in 2009. Despite accumulating evidence of the harmful health effects of the economic downturn on older adults, relatively little research has examined the mechanisms involved in this relationship. Moreover, most research on the financial crisis has relied on objective indicators of the recession, despite evidence demonstrating the predictive utility of subjective measures such as financial strain. Drawing on a subsample of respondents age 50 or older from the Health and Retirement Study (N = 2040), this research (1) examines whether initial financial strain and that due to the recession independently contribute to worsening self-rated health over the period of the recession and (2) investigates the role of health behaviors as mechanisms in this relationship. Using longitudinal lagged dependent variable models that adjust for pre-recession self-rated health, the results reveal that both initial and increased financial strain due to the recession were associated with worsening self-rated health between 2006 and 2009. In addition, increased financial strain during the recession was found to be associated with skipped or postponed health care visits and change in prescription drug use, such as pill splitting and reduced or skipped doses, which, in turn, were associated with decreased health ratings. The results from this study suggest two important pathways in the recession-health relationship and have implications for policies aimed at supporting older adults during future financial crises.

scholarly journals Physical Inactivity in Older Adult Couples: A Dyadic Analysis Using Continuous In-Home Monitoring

2020 ◽  
Vol 4 (Supplement_1) ◽  
pp. 412-412
Author(s):  
Chao-Yi Wu ◽  
Lyndsey Miller ◽  
Rachel Wall ◽  
Zachary Beattie ◽  
Jeffrey Kaye ◽  
...  
Keyword(s):  
Mental Health ◽  
Older Adults ◽  
Older Adult ◽  
Physical Inactivity ◽  
Home Monitoring ◽  
Health Determinants ◽  
Dyadic Analysis ◽  
Physical And Mental Health ◽  
Positive Health ◽  
Aging Research

Abstract Many older adults remain inactive despite the known positive health implications of physical activity (e.g. improved mood, reduced mortality risk). Physical inactivity is a known interdependent phenomenon in couples, but the majority of research identifies determinants of physical inactivity at the individual level. We estimated the average amount of physical inactivity for older adult couples and, using dyadic analysis, identified physical and mental health determinants thereof. Forty-eight heterosexual older adult couples (mean age=70.6, SD=6.63) from the Veterans Integrated Service Network 20 cohort of the Collaborative Aging Research using Technology (CART) initiative were included in this study. Both dyad members wore actigraph devices for a month. The average number per day of inactive periods (defined as no movement or sleep activity for ≥ 30 minutes) was estimated. Multilevel modeling revealed that, within couples, there was no difference between partners in the average number of inactive periods, but on average across couples, males had more inactive periods per day (13.4, SD=4.43) than females (12.3, SD=4.87). For males, older age was the only variable associated with more inactive periods (β=0.13, p=.013). For females, more depressive symptoms in men were associated with fewer inactive periods (β=-0.37, p=.002), and more dependence in completing their own IADLs predicted more inactive periods (β=2.80, p<.001). All models were adjusted for covariates. Viewing couples’ activity as a unit, rather than as separate individuals, provides a novel approach to identifying pathways to reduce inactivity in older adults, especially when focusing on mental health issues and decreased independence within the couple.

scholarly journals Contributors to and Consequences of Poor Sleep in Older Adults: Biopsychosocial Perspectives

2020 ◽  
Vol 4 (Supplement_1) ◽  
pp. 578-578
Author(s):  
Adam Spira ◽  
Katie Stone
Keyword(s):  
Older Adults ◽  
Sleep Problems ◽  
Later Life ◽  
Poor Sleep ◽  
Physical And Mental Health ◽  
Older Parents ◽  
Use Patterns ◽  
Health Related ◽  
Objectively Measured ◽  
Ecological Momentary

Abstract Sleep is a significant contributor to health and wellbeing across the lifespan, especially in later life. Poor sleep is common among older adults and can be both a risk factor for and consequence of numerous physical and mental health-related outcomes. In this symposium, we will present novel results from four studies that will advance understanding of the biological, psychological, and social factors that may contribute to or result from poor sleep in older adults. Specifically, Study 1 will present findings tying objectively measured sleep to performance on cognitive tasks administered using ecological momentary assessment (EMA) in the day-to-day lives of older adults with or without mild cognitive impairment (MCI). Study 2 will examine associations of personality dimensions and facets with insomnia symptoms in well-functioning older adults. Study 3 will examine psychological pathways linking parent-child relationships to subjective and objective sleep characteristics among older parents. Finally, study 4 will examine use patterns of cannabis for the treatment of sleep problems in older adults, and the ways in which this might differ from patients using cannabis for other reasons (e.g., pain). Together, this symposium will highlight novel links of an array of factors with sleep health in the aging population and their implications for prevention. Sleep, Circadian Rhythms and Aging Interest Group Sponsored Symposium.

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