scholarly journals Differential Association of Geographical Region of Birth With Dementia Risk Across Black Women and Men

2020 ◽  
Vol 4 (Supplement_1) ◽  
pp. 748-748
Author(s):  
Justina Avila-Rieger ◽  
Audrey Murchland ◽  
Nika Seblova ◽  
Maria Glymour ◽  
Adam Brickman ◽  
...  

Abstract Risk of dementia is both racially and spatially patterned. Less is known about sex/gender differences in pathways linking birth place to late-life cognitive outcomes in older non-Latino Blacks. The 1464 Black men and women included in these analyses were Northern Manhattan residents. Cox regressions revealed that Stroke-Belt South (SB) and Non-Stroke-Belt South (NSB) birth was associated with a higher dementia risk, adjusted for birth year, childhood SES, and risk of death. Compared to Northern-born (NB) men, SB men had the highest risk, followed by NSB women and SB women, while NSB men and NB women had a similar risk to NB men. The higher risk for SB men and NSB women remained after adjusting for education, adult income, and CVD burden. Future work should identify why birth in the SB is uniquely detrimental for cognitive health among Black men, while birth in NSB has the strongest impact on Black women.

Author(s):  
Joshua D. Bundy ◽  
Hongyan Ning ◽  
Victor W. Zhong ◽  
Amanda E. Paluch ◽  
Donald M. Lloyd-Jones ◽  
...  

Background: Long-term risks of cardiovascular disease (CVD) according to levels of cardiovascular health (CVH) have not been characterized in a diverse, representative population. Methods and Results: We pooled individual-level data from 30 447 participants (mean [SD] age, 55.0 [13.9] years; 60.6% women; 31.8% black) from 7 US cohort studies. We defined CVH based on levels of 7 American Heart Association health metrics, scored as ideal (2 points), intermediate (1 point), or poor (0 points). The total CVH score was used to quantify overall CVH as high (12–14 points), moderate (9–11 points), or low (0–8 points). We used a modified Kaplan-Meier analysis, accounting for the competing risk of death, to estimate the lifetime risk of CVD (composite of incident myocardial infarction, stroke, heart failure, or CVD death) separately in white and black men and women free of CVD at index ages of <40, 40 to 59, and ≥60 years. High CVH was more prevalent among women compared with men, white compared with black participants, and in younger compared with older participants. During 538 477 person-years of follow-up, we observed 6546 CVD events. In women aged 40 to 59 years, those with high CVH had lower lifetime risk (95% CI) of CVD (white women, 12.6% [2.6%–22.6%]; black women, 0.0%) compared with moderate (white women, 16.6% [13.0%–20.2%]; black women, 12.7% [6.8%–18.5%]) and low (white women, 33.8% [30.6%–37.1%]; black women, 34.7% [30.4%–39.0%]) CVH strata. Patterns were similar for men and individuals <40 and ≥60 years of age. Conclusions: Higher baseline CVH at all ages in adulthood is associated with substantially lower lifetime risk for CVD compared with moderate and low CVH, in white and black men and women in the United States. Public health and healthcare efforts aimed at maintaining and restoring higher CVH throughout the life course could provide substantial benefits for the population burden of CVD.


2019 ◽  
Vol 3 (Supplement_1) ◽  
pp. S543-S543
Author(s):  
DeAnnah R Byrd ◽  
Roland J Thorpe ◽  
Keith E Whitfield

Abstract Previous literature suggest that women experience more dementia than men. However, it is unclear what accounts for these differences and whether sex differences exist among Blacks over time. We hypothesize that Black women will have worse cognitive outcomes than men and smoking may potentially explain these differences. Longitudinal data from the Baltimore Study of Black Aging-Patterns of Cognitive Aging was used to assess cognitive change over 33 months in five domains. The sample consisted of 602 community-dwelling Blacks, aged 48-92 years at baseline and 450 at follow-up. Findings indicated that Black women reported better vocabulary, working and verbal memory than Black men, controlling for age, education, smoking, and health status. These findings suggest that Black women may have some cognitive advantages in mid to later life compared to Black men. Future research should continue exploring longitudinal sex differences in cognitive domains among Blacks and the underlying drivers of these differences.


Circulation ◽  
2020 ◽  
Vol 142 (Suppl_3) ◽  
Author(s):  
Gursukhman Sidhu ◽  
Charisse J Ward ◽  
Keith Ferdinand

Introduction: Despite a recent gradually slowing and perhaps recent increase in the burden of atherosclerotic cardiovascular disease (ASCVD) related hospitalization in the United States population with diabetes, it is unclear whether the prior downward trend was uniform or there was an unbalanced division amongst sex and race. Methods: Adults aged ≥40 years old with comorbid diabetes as a secondary diagnosis were identified using the U.S. 2005-2015 National (Nationwide) Inpatient Sample (NIS) data. The prevalence of other modifiable cardiovascular risk factors (hypertension, dyslipidemia, smoking/substance abuse, obesity, and renal failure), procedures like major amputations in the secondary diagnosis field and their association with ASCVD (acute coronary syndrome (ACS), coronary artery disease (CAD), stroke, or peripheral arterial disease (PAD)) as the first-listed diagnosis were determined. Complex samples multivariate regression was used to determine the odds ratio (O.D.) with 95% confidence limits (C.L.s). Sex and race risk-adjusted ASCVD related in-hospital mortality rates were estimated. Results: The rate of total ASCVD hospitalizations adjusted to the U.S. census population increased by 5.7% for black men compared to 4% for black women cumulatively compared to a stable downtrend in white men and white women. There was a higher odd of an ASCVD hospitalizations if there was comorbid hypertension (Odds Ratio (OR 1.29; 95% Confidence Interval (CI) 95% 1.28 - 1.31), dyslipidemia (OR 2.03; 95% CI 2.01 - 2.05), renal failure (OR 1.84; 95% CI 1.82 - 1.86), and smoking/substance use disorder (OR 1.31; 95% CI 1.29 - 1.33). When compared to white men, black men (OR 1.43; 95% CI 1.3 - 1.57) and black women (OR 1.15; 95% CI 1.04 - 1.27) had a higher likelihood of undergoing a major limb amputation during an ASCVD hospitalization. Conclusions: Blacks with diabetes continue to have a higher hospitalizations burden with a concomitant disparity in procedures and outcomes.


Circulation ◽  
2020 ◽  
Vol 142 (Suppl_3) ◽  
Author(s):  
Ning Ding ◽  
Yejin Mok ◽  
Yingying Sang ◽  
Maya Salameh ◽  
Weihong Tang ◽  
...  

Introduction: Nontraumatic lower-extremity amputation is a serious clinical outcome. Major risk factors include peripheral artery disease and diabetic neuropathy. Although incidence rates of amputation have been reported, no lifetime risk estimates are available. Hypothesis: The lifetime risk of amputation is higher in men, blacks, and those of low socioeconomic status (SES). Methods: In 15,744 ARIC participants aged 45-64 at baseline (1987-89), we estimated the lifetime risk of amputation through age 80 by race-sex and race-SES using Fine and Gray’s proportional subhazards model accounting for the competing risk of death. This method is optimal for time-fixed exposures and thus our primary exposures are sex and race. SES included education, annual family income, and the Area Deprivation Index linked to census tract geocoding. Non-traumatic amputation was identified from hospitalization ICD codes (e.g., 84.1, Z89.4) and related operation codes. Results: There were 253 non-traumatic amputations during a median follow up of 29 years. Lifetime risk of amputation at age 80 was highest in black men (4.6%), followed by black women (2.8%), white men (1.1%) and white women (0.7%) ( Figure ). Blacks of low SES showed the highest lifetime risk (4.5%). Blacks with high SES had a higher lifetime risk of amputation than whites with low SES. The pattern was consistent when we investigated each of education (≤ vs. > high school), income (< vs. ≥$25,000) and Area Deprivation Index (< vs. ≥ race-specific median), separately. Conclusions: In this population-based cohort 5% of black men and 3% of black women experienced a non-traumatic amputation during their lifetime, while only 1% of white men and women had a hospitalization for amputation. The lifetime risk was higher among those with lower SES in both race groups. Future public health and primary care efforts should emphasize risk factor management (e.g., diabetes and smoking) among racial minority groups and those with low SES.


2021 ◽  
Author(s):  
Daisy Massey ◽  
Jeremy Faust ◽  
Karen Dorsey ◽  
Yuan Lu ◽  
Harlan Krumholz

Background: Excess death for Black people compared with White people is a measure of health equity. We sought to determine the excess deaths under the age of 65 (<65) for Black people in the United States (US) over the most recent 20-year period. We also compared the excess deaths for Black people with a cause of death that is traditionally reported. Methods: We used the Multiple Cause of Death 1999-2019 dataset from the Center of Disease Control (CDC) WONDER to report age-adjusted mortality rates among non-Hispanic Black (Black) and non-Hispanic White (White) people and to calculate annual age-adjusted <65 excess deaths for Black people from 1999-2019. We measured the difference in mortality rates between Black and White people and the 20-year and 5-year trends using linear regression. We compared age-adjusted <65 excess deaths for Black people to the primary causes of death among <65 Black people in the US. Results: From 1999 to 2019, the age-adjusted mortality rate for Black men was 1,186 per 100,000 and for White men was 921 per 100,000, for a difference of 265 per 100,000. The age-adjusted mortality rate for Black women was 802 per 100,000 and for White women was 664 per 100,000, for a difference of 138 per 100,000. While the gap for men and women is less than it was in 1999, it has been increasing among men since 2014. These differences have led to many Black people dying before age 65. In 1999, there were 22,945 age-adjusted excess deaths among Black women <65 and in 2019 there were 14,444, deaths that would not have occurred had their risks been the same as those of White women. Among Black men, 38,882 age-adjusted excess <65 deaths occurred in 1999 and 25,850 in 2019. When compared to the top 5 causes of deaths among <65 Black people, death related to disparities would be the highest mortality rate among both <65 Black men and women. Comment: In the US, over the recent 20-year period, disparities in mortality rates resulted in between 61,827 excess deaths in 1999 and 40,294 excess deaths in 2019 among <65 Black people. The race-based disparity in the US was the leading cause of death among <65 Black people. Societal commitment and investment in eliminating disparities should be on par with those focused on other leading causes of death such as heart disease and cancer.


2020 ◽  
pp. 67-78
Author(s):  
João Francisco Severo- Santos ◽  
Dimítria Dahmer Santos

The COVID-19 is a disease that presents a wide variety of combinations and intensities of symptoms, characteristic of a Flu Syndrome (FS), which can quickly evolve to a Severe Acute Respiratory Syndrome (SARS). The objectives of this study were to evaluate the hierarchy of symptoms of FS in patients with SARS caused by COVID-19 and to develop a prediction model for potential cases based on sex and race. Binary logistic regression modeling was used in 405,419 records selected from the database of the Ministry of Health of Brazil. It was found that men were more affected by the disease, with a 15.5% higher risk than women. They also died more, with a 13.8% and 15% higher risk for all causes and for COVID-19, respectively. The chances of more than one non-white patient dying from all causes ranged from 18.4% to 38.7% and for Covid-19 it ranged from 16.7% to 64.3% according to race. Fever, muscle pain and loss of smell or taste alternate in the first three positions of the symptom hierarchy, according to sex and race. Cough was only relevant for white men and sore throat for black men. Vomiting was only relevant for black women. The best prediction model developed encompassed seven symptoms adjusted for age, sex and race, but was able to explain only 63% of the cases of COVID-19. Possibly racial diversity, and the socioeconomic inequality associated with it, make the challenge of estimating probabilities of infection by COVID-19, based on symptoms, more complicated in Brazil than in other countries.


2016 ◽  
Vol 5 (1) ◽  
pp. 30-38 ◽  
Author(s):  
Jennifer J. Heisz ◽  
Ana Kovacevic

Age-related changes in the brain can compromise cognitive function. However, in some cases, the brain is able to functionally reorganize to compensate for some of this loss. The present paper reviews the benefits of exercise on executive functions in older adults and discusses a potential mechanism through which exercise may change the way the brain processes information for better cognitive outcomes. Specifically, older adults who are more physically active demonstrate a shift toward local neural processing that is associated with better executive functions. We discuss the use of neural complexity as a sensitive measure of the neural network plasticity that is enhanced through exercise. We conclude by highlighting the future work needed to improve exercise prescriptions that help older adults maintain their cognitive and physical functions for longer into their lifespan.


Author(s):  
Naomi Zack

The subject of critical race theory is implicitly black men, and the main idea is race. The subject of feminism is implicitly white women, and the main idea is gender. When the main idea is race, gender loses its importance and when the main idea is gender, race loses its importance. In both cases, women of color, especially black women, are left out. Needed is a new critical theory to address the oppression of nonwhite, especially black, women. Critical plunder theory would begin with the facts of uncompensated appropriation of the biological products of women of color, such as sexuality and children.


Circulation ◽  
2012 ◽  
Vol 125 (suppl_10) ◽  
Author(s):  
Laura R Loehr ◽  
Xiaoxi Liu ◽  
C. Baggett ◽  
Cameron Guild ◽  
Erin D Michos ◽  
...  

Introduction: Since the 1980’s, length of stay (LOS) for acute MI (AMI) has declined in the US. However, little is known about trends in LOS for non-white racial groups and whether change in LOS is related to insurance type or hospital complications. Methods: We determined 22 year trends in LOS for nonfatal (definite or probable) AMI among black and white residents age 35–74 in 4 US communities (N=396,514 in 2008 population) under surveillance in the ARIC Study. Events were randomly sampled and independently validated using a standardized algorithm. All analyses accounted for sampling scheme. We excluded MI events which started after admission (n=1,677), events within 28 days for the same person (n=3,817), hospital transfers (n=571), and those with LOS=0 or LOS >66 (top 0.5% of distribution, N= 144) leaving 22,258 weighted events for analysis. The average annual change in log LOS was modeled using weighted linear regression with year as a quadratic term. All models adjusted for age and secondary models adjusted for insurance type (Medicare, Medicaid, private, or other), and complications during admission (cardiac arrest, cardiogenic shock, or heart failure). Results: The average age-adjusted LOS from 1987 to 2008 was reduced by 5 days in black men (9.5 to 4.5 days); 4.6 days in white women (9.4 to 4.8 days); 4 days in white men (8.3 to 4.3 days) and 3.6 days in black women (9.0 to 5.4 days). Between 1987 and 2008, the age-adjusted average annual percent change (with 95% CI) in LOS was largest for white men at −4.40 percent per year (−4.91, −3.89) followed by −3.89 percent (−4.52, −3.26) for white women, −3.72 percent (−4.46, −2.89) for black men, and −2.94 percent (−3.92, −1.96) for black women (see Figure). Adjustment for insurance type, and complications did not change the pattern by race and gender. Conclusions: Between 1987 and 2008, LOS for AMI declined significantly and similarly in men and women, blacks and whites. These changes appear independent of differences in insurance type and hospital complications among race-gender groups.


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