Motor and Pulmonary Function and Mobility Disability Among Black and White Older Adults With and Without HIV

Abstract Black-White disparities in gait speed have been observed in studies of adults reporting HIV, consistent with work among older adults without HIV. However, it is unknown if racial differences exist among adults with HIV for other mobility-related factors. We aimed to determine if racial differences exist in mobility disability among older adults with and without HIV and assess if pulmonary and motor function contribute to mobility disability. We examined older adults age 50+ with HIV (N=177; 72% Black) and without HIV (N=191; 68% Black). Motor function summarized 10 motor performances including gait speed; pulmonary function summarized 3 measures assessed using hand-held spirometry. Mobility disability was based on self-report. In regression models adjusted for age, sex, medical conditions, and smoking, neither race nor HIV status were associated with mobility-related factors. However, in models stratified by HIV status, Blacks with HIV had worse motor (β=-4.3, p=0.04) and pulmonary function (β=-50.5, <0.001) and higher odds of mobility disability (odds ratio [OR]=2.9, 95% confidence interval [CI]=1.01-8.2) compared to Whites with HIV. Racial differences were not apparent among uninfected participants in motor function, pulmonary function, or mobility disability. In subsequent models, racial differences in mobility disability were attenuated and no longer significant in HIV when adjusting for motor function (OR=0.88 per/% higher motor composite, 95% CI=0.84-0.93). Racial differences in mobility disability in HIV were unaffected when controlling for pulmonary function. Results suggest that Blacks with HIV have greater mobility disability compared to Whites with HIV, and these differences are due to differences in motor function.

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Racial Differences in the Effect of HIV Status on Motor and Pulmonary Function and Mobility Disability in Older Adults

Journal of Racial and Ethnic Health Disparities ◽

10.1007/s40615-021-01126-0 ◽

2021 ◽

Author(s):

Brittney S. Lange-Maia ◽

Aron S. Buchman ◽

Sue E. Leurgans ◽

Melissa Lamar ◽

Elizabeth B. Lynch ◽

...

Keyword(s):

Older Adults ◽

Pulmonary Function ◽

Racial Differences ◽

Hiv Status ◽

Mobility Disability

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Association between Pneumonia, Fracture, Stroke, Heart Attack and Other Hospitalizations with Changes in Mobility Disability and Gait Speed in Older Adults

Journal of Clinical Medicine ◽

10.3390/jcm10173802 ◽

2021 ◽

Vol 10 (17) ◽

pp. 3802

Author(s):

Joshua D. Brown ◽

Reiko Sato ◽

John E. Morley

Keyword(s):

Older Adults ◽

Gait Speed ◽

Repeated Measures ◽

Heart Attack ◽

Physical Activity Intervention ◽

Self Report ◽

Walk Test ◽

Short Term ◽

Mobility Disability

Pathophysiological changes after acute hospitalizations may influence physical functioning in older adults, which can lead to disability and loss of independence. This study evaluated the association between pneumonia, fracture, heart attack, stroke, and other hospitalizations with major mobility disability (MMD) and gait speed. This was a secondary analysis of the Lifestyle Interventions and Independence for Elders (LIFE) Study, which was conducted across eight sites during 2010–2013 with longitudinal follow-up for 1635 individuals over an average of 2.6 years. Participants included adults ≥70 years old with pre-existing mobility limitations randomized to a physical activity intervention or a health education control arm. Hospitalizations were recorded via self-report and adjudicated by medical reviewers. MMD was measured by the inability to complete a 400 m walk test, or other proxies, as a binary outcome. Gait speed was recorded during the walk test in meters per second (m/s) and measured on a linear scale. Mixed-effects repeated measures regression adjusted for baseline demographics, comorbid conditions, and frailty. Among the 1635 participants, there were 1458 hospitalizations, which included 80 (5.5% of all hospitalizations) cases of pneumonia, 92 (6.3%) hospitalized fractures, 87 (6.0%) heart attacks, and 61 (4.2%) strokes. In the short-term measurement period immediately following hospitalization (1 day to 6 months), stroke (OR = 3.98 (3.41–4.54)) had the strongest association with MMD followed by fracture (OR = 3.03 (2.54–3.52)), pneumonia (OR = 2.76 (2.23–3.30)), and heart attack (OR = 2.03 (1.52–2.53)). Associations with long-term (6–12 months after) MMD were decreased or not significant for all causes. Pneumonia, fracture, stroke, and other hospitalizations were associated with short-term relative gait speed changes between −4.8% up to −19.5%, and only fracture was associated with long-term changes. Hospitalizations for pneumonia, heart attack, stroke, and fractures were associated with short-term decreases in mobility in older adults. Older adults may be at risk for decreased mobility and disability following acute hospitalizations, with the magnitude determined by the cause of the precipitating event.

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Talk or Walk? Gait Speed over Self-Report in Association with Cognitive Speed in Healthy Older Adults

GeroPsych ◽

10.1024/1662-9647/a000202 ◽

2019 ◽

Vol 32 (1) ◽

pp. 41-52

Author(s):

Matthew C. Costello ◽

Shane J. Sizemore ◽

Kimberly E. O’Brien ◽

Lydia K. Manning

Keyword(s):

Older Adults ◽

Older Adult ◽

Gait Speed ◽

Well Being ◽

Self Report ◽

Subjective Report ◽

Healthy Older Adults ◽

Relative Value ◽

Cognitive Speed ◽

Age Range

Abstract. This study explores the relative value of both subjectively reported cognitive speed and gait speed in association with objectively derived cognitive speed. It also explores how these factors are affected by psychological and physical well-being. A group of 90 cognitively healthy older adults ( M = 73.38, SD = 8.06 years, range = 60–89 years) were tested in a three-task cognitive battery to determine objective cognitive speed as well as measures of gait speed, well-being, and subjective cognitive speed. Analyses indicated that gait speed was associated with objective cognitive speed to a greater degree than was subjective report, the latter being more closely related to well-being than to objective cognitive speed. These results were largely invariant across the 30-year age range of our older adult sample.

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Muscular Function: An alternative way to identify cognitive impairment, Secondary Analysis From SABE-Colombia

10.21203/rs.3.rs-131443/v1 ◽

2020 ◽

Author(s):

Elkin Garcia-Cifuentes ◽

Felipe Botero-Rodríguez ◽

Felipe Ramirez Velandia ◽

Angela Iragorri ◽

Isabel Marquez ◽

...

Keyword(s):

Older Adults ◽

Cognitive Impairment ◽

Cognitive Performance ◽

Motor Function ◽

Gait Speed ◽

Handgrip Strength ◽

Secondary Analysis ◽

Screening Tools ◽

Cognitively Impaired ◽

Recall Memory

Abstract Background Traditionally, the identification of cognitive impairment is based on neuropsychological tests and supported with not widely available biomarkers. This study aimed to establish the association between motor function (Gait Speed and Handgrip Strength) and the performance in a global cognitive performance and various cognitive domains. Our secondary objective was to determine a cut-off point for Gait Speed and Handgrip Strength to classify older adults as cognitively impaired. Methods This is a secondary analysis from the SABE Colombia study (Health, Well-Being, and Aging) conducted in 2015. We performed linear regression models, to establish association with motor function, clinical, and sociodemographic variables, and predict the scores of the Mini-mental State Examination and its domains (i.e. orientation, recall, counting, and language). The evaluation of the motor function variables as an instrument to separate cognitively impaired older adults was evaluated by developing a receiving operating characteristic curve (ROC). Results Gait speed was associated with orientation (r2 = 0.16), language (r2 = 0.15), recall memory (r2 = 0.14) and counting (r2 = 0.08). Similarly, handgrip strength was associated with orientation (r2 = 0.175), language (r2 = 0.164), recall memory (r2 = 0.137), and counting (r2 = 0.08). Slow gait had a cut-off point of 0,59 m/s, with an area under the curve (AUC) of 0.629 (0.613–0.646), whereas a weak handgrip strength had an AUC of 0.653 (0.645–0.661), with a cut-off point of 17.50 Kg for separating those older adults with cognitive impairment. Conclusions Gait Speed or Handgrip Strength are similarly associated with cognitive performance, exhibiting the larger associations with orientation and language domains. Gait Speed and Handgrip Strength can be easily performed by any clinician and seems to be useful screening tools to detect cognitive impairment.

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THE INFLUENCE OF PERSONALITY ON MEMORY SELF-REPORT AMONG BLACK AND WHITE OLDER ADULTS

Innovation in Aging ◽

10.1093/geroni/igz038.805 ◽

2019 ◽

Vol 3 (Supplement_1) ◽

pp. S220-S220

Author(s):

Nikki Hill ◽

Jacqueline Mogle ◽

Sakshi Bhargava ◽

Tyler Bell ◽

Rachel Wion

Keyword(s):

Older Adults ◽

Personality Traits ◽

Community Dwelling ◽

Self Report ◽

Racial Groups ◽

Memory Decline ◽

Black And White ◽

Memory Problems ◽

Aging Study ◽

One Year

Abstract Personality traits, particularly neuroticism, have been associated with self-reported memory problems, but little is known regarding differences across racial groups. Community-dwelling older adults (n=425; M(SD) = 76.7(4.7) years; 62.6% female; 72.0% White) without cognitive impairment completed up to 11 annual comprehensive medical and neuropsychological examinations as part of the Einstein Aging Study. Multilevel modeling tested: 1) the association of neuroticism, conscientiousness, extraversion, openness, and agreeableness with three types of self-reported memory problems (frequency, one-year decline, and ten-year decline), and 2) whether these associations differed by race, specifically Black and White. Neuroticism predicted self-reported frequency of memory problems and perceived one-year decline when considered alone; however, this did not remain significant after including all personality traits. Conscientiousness influenced perceived ten-year memory decline in Black older adults but not White. Our findings suggest that the influence of personality on self-reported memory problems may not be consistent across racial groups.

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The influence of personality on memory self-report among black and white older adults

PLoS ONE ◽

10.1371/journal.pone.0219712 ◽

2019 ◽

Vol 14 (7) ◽

pp. e0219712 ◽

Cited By ~ 2

Author(s):

Nikki L. Hill ◽

Jacqueline Mogle ◽

Sakshi Bhargava ◽

Tyler Reed Bell ◽

Rachel K. Wion

Keyword(s):

Older Adults ◽

Self Report ◽

Black And White

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Residential Segregation and Hypertension Prevalence in Black and White Older Adults

Journal of Applied Gerontology ◽

10.1177/0733464816638788 ◽

2016 ◽

Vol 37 (2) ◽

pp. 177-202 ◽

Cited By ~ 6

Author(s):

Therri Usher ◽

Darrell J. Gaskin ◽

Kelly Bower ◽

Charles Rohde ◽

Roland J. Thorpe

Keyword(s):

Older Adults ◽

Logistic Models ◽

Poverty Level ◽

Related Factors ◽

Poor Whites ◽

Neighborhood Poverty ◽

Black And White ◽

White Neighborhoods ◽

Health Related ◽

Blacks And Whites

Purpose: The purpose of this article was to assess segregation’s role on race differences in hypertension among non-Hispanic Blacks and Whites aged 50 and over. Method: Hypertension was defined as systolic blood pressure (BP) ≥ 140 mmHg, diastolic BP ≥ 90 mmHg, or self-reported antihypertensive medication use. Segregation measures combined race, neighborhood racial composition, and individual and neighborhood poverty level. Logistic models produced odds ratios and 95% confidence intervals (CIs) for each segregation category, adjusting for health-related factors. Results: Blacks in Black (OR = 2.54, CI = [1.61, 4.00]), White (OR = 2.56, CI = [1.24, 5.31]), and integrated neighborhoods (OR = 3.23, CI = [1.72, 6.03]) had greater odds of hypertension compared with Whites in White neighborhoods. Poor Whites in poor neighborhoods (OR = 1.74, CI = [1.09, 2.76]), nonpoor Blacks in nonpoor (OR = 3.03, CI = [1.79, 5.12]) and poor neighborhoods (OR = 4.08, CI = [2.16, 7.70]), and poor Blacks in nonpoor (OR = 4.35, CI = [2.17, 8.73]) and poor neighborhoods (OR = 2.75, CI = [1.74, 4.36]) had greater odds compared with nonpoor Whites in nonpoor neighborhoods. Conclusion: Interventions targeting hypertension among older adults should consider neighborhood compositions.

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Resistance training improves mobility disability in community-dwelling older adults: a meta-analysis

Innovation in Aging ◽

10.1093/geroni/igab046.3253 ◽

2021 ◽

Vol 5 (Supplement_1) ◽

pp. 904-904

Author(s):

Christina Prevett ◽

Kevin Moncion ◽

Stuart Phillips ◽

Julie Richardson ◽

Ada Tang

Keyword(s):

Older Adults ◽

Resistance Training ◽

Physical Function ◽

Gait Speed ◽

Positive Impact ◽

Community Dwelling ◽

Mobility Disability ◽

Exercise Interventions ◽

Walking Capacity ◽

Community Dwelling Older Adults

Abstract Mobility disability is the impairment in function that affects the performance of daily tasks due to declines in physical function. Exercise interventions, particular resistance training, may have a positive impact on mobility disability, but the evidence for the effects of resistance training in older adults with mobility disability has not been previously systematically reviewed. This study was a systematic review of evidence related to resistance training on physical function for adults over 65 years of age with mobility disability. Four databases (PEDro, MedLine, Ovid, Web of Science) were searched from inception to February 2, 2021 for randomized controlled trials. Twenty-four articles from 22 studies (3,656 participants) were included in the review. Mean participant age ranged from 63-87 years and exercise interventions ranged from 10 weeks to 12 months in duration. Greater changes in 6-minute Walk Test (6MWT) distance (n=638, p<0.0001; mean difference (MD) 16.1 metres; 95%CI 12.3-19.9), lower extremity strength (n=785, p<0.0001; standard MD 2.01; 95%CI 1.27-2.75) and usual gait speed (n=2,106, p<0.001; MD 0.05 metres/second, 95%CI 0.03-0.07) were seen with resistance training as compared to control. These results were maintained if resistance training was a sole intervention or a component of a multi-component program. Sensitivity analysis based on risk of bias concerns did not change results. This review demonstrates that resistance training improves walking capacity, strength and walking speed in community-dwelling older adults and may facilitate aging in place. Since improvements in strength and gait speed contribute to independence, our results indicate highly beneficial outcomes for older persons.

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Relationship Between Meaningful Activity Engagement and Well-Being Moderated by Race

Innovation in Aging ◽

10.1093/geroni/igab046.3159 ◽

2021 ◽

Vol 5 (Supplement_1) ◽

pp. 874-874

Author(s):

Dugan O'Connor ◽

Jennifer Smith

Keyword(s):

Older Adults ◽

Positive Affect ◽

Racial Differences ◽

Online Survey ◽

Leisure Activities ◽

Religious Faith ◽

Well Being ◽

Target Population ◽

Black And White ◽

Meaningful Activity

Abstract Engaging in meaningful activities has benefits for health and well-being in older adults; however, racial differences in meaning from activities have been observed. The current study examined how the relationship between engagement in a variety of meaningful activities and well-being differs for Black and White older adults. Participants (130 White and 101 Black older adults), ages 53 to 90 (M=69), completed an online survey that measured the extent to which engaging in various activities provided meaning or fulfillment as well as measures of purpose in life, positive affect, negative affect, and loneliness. Overall, the most meaningful activities included “spending time with family,” “reading,” and “being outdoors/experiencing nature.” The least meaningful activities included “job/career,” “caring for pets/animals,” and “supporting a social or political cause.” Black older adults reported greater meaning from “religious faith,” “spiritual practices/meditation,” “spending time with family,” and “listening to music,” and less meaning from “caring for pets/animals,” compared to White older adults. A series of multiple regression analyses (with age, gender, education, and income as covariates) revealed that greater meaning across activities was associated with lower loneliness, regardless of race. Significant Meaning x Race interactions revealed meaning was positively associated with sense of purpose and positive affect for Black but not White older adults. These findings suggest that finding meaning in leisure activities is a psychological resource that may contribute to Black older adults’ well-being. The racial differences in sources of meaning further support the importance of considering the target population when designing activity programs for older adults.

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Racial Differences in the Pathway to Diagnosis of Alzheimer's Disease and Related Dementias

Innovation in Aging ◽

10.1093/geroni/igab046.1082 ◽

2021 ◽

Vol 5 (Supplement_1) ◽

pp. 280-280

Author(s):

James Burke ◽

Matthew Dupre ◽

Se Hee Min ◽

Ruth Anderson ◽

David Page ◽

...

Keyword(s):

Alzheimer’S Disease ◽

Older Adults ◽

Alzheimer's Disease ◽

Racial Differences ◽

Primary Diagnosis ◽

Health Records ◽

Black And White ◽

Clinical Encounters ◽

To Receive ◽

Hispanic White

Abstract This study examined differences in the pathway to diagnosis of Alzheimer's disease and related dementias (ADRD) between Black and White older adults. Using electronic health records from a large health system, we included 2,085 non-Hispanic Black and 6,269 non-Hispanic White older adults with a final/primary diagnosis of ADRD between 2014 and 2020. Black older adults were more likely to receive the ADRD diagnosis from a primary care provider (35.4% vs. 29.8%), during a hospital admission (19.5% vs. 13.6%), or during an emergency department visit (4.2% vs. 2.0%); but were less likely to be diagnosed by an ADRD specialist (31.6% vs. 45.2%). Black older adults had nearly twice as many clinical encounters in the two years prior to the ADRD diagnosis than their White counterparts (43 vs. 26). Despite having more clinical encounters, Black older adults were more likely to be at a later stage when diagnosed than White older adults.

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