scholarly journals The Role of Stressful Childhood Experiences in Shaping Later-Life Memory Loss Among Black and White U.S. Adults

2020 ◽  
Vol 4 (Supplement_1) ◽  
pp. 296-296
Author(s):  
Caroline Hartnett
Keyword(s):  
Cognitive Decline ◽  
Memory Loss ◽  
Later Life ◽  
Behavioral Risk ◽  
Black Adults ◽  
Childhood Experiences ◽  
White Children ◽  
Black And White ◽  
Stressful Experiences ◽  
White Adults

Abstract Cognitive decline common in the U.S. and greatly impacts quality of life, both for those who experience it and for those who care for them. Black Americans experience higher burdens of cognitive decline but the mechanisms underlying this disparity have not been fully elucidated. Stress experienced in early life is a promising explanatory factor, since stress and cognition are linked, childhood stressors been shown to have a range of negative implications later in life, and Black children experience more childhood stressors than White children, on average. In this paper, we use data from the Behavioral Risk Factor Surveillance System (BRFSS) to examine whether stressful experiences in childhood help explain Black-White disparities in memory loss. These data were available for 5 state-years between 2011 and 2017 (n=11,708). Preliminary results indicate that, while stressful childhood experiences are strongly associated with memory loss, stressful experiences do not mediate the association between race and memory loss. However, race does appear to moderate the association between stressful childhood experiences and memory loss. Specifically, stressful experiences are associated with a higher likelihood of memory loss for Black adults compared to White adults.In addition, there seem to be some noteworthy patterns across different types of experiences (i.e. parental drinking may predict later memory loss more strongly for Black adults than White adults, but parental hitting may predict memory loss more strongly for White adults than Black adults).

Differences in Polymorphonuclear Cell Counts Between Healthy White and Black Infants: Response to Meningitis

PEDIATRICS ◽  
1983 ◽  
Vol 72 (3) ◽  
pp. 405-407
Author(s):  
P. David Sadowitz ◽  
Frank A. Oski
Keyword(s):  
Black Children ◽  
Polymorphonuclear Cell ◽  
Black Adults ◽  
White Children ◽  
Cell Counts ◽  
Serious Infection ◽  
The Absolute ◽  
Absolute Lymphocyte Counts ◽  
White Adults

Both black adults and black children have significantly lower total WBC counts and absolute polymorphonuclear WBC counts than do white adults and white children. In an effort to determine whether similar differences existed in infancy, 50 healthy black infants and 50 white infants were examined. The black infants, 9 to 12 months of age, were found to have significantly lower total WBC counts, absolute neutrophil counts, and absolute lymphocyte counts. In ten of the 50 black infants, the absolute neutrophil counts were less than 1,000/µL; none of the white infants had absolute neutrophil counts of less than 1,000/µL. Even in the presence of a serious infection, meningitis, significantly fewer black infants had absolute neutrophil counts greater than 10,000/µL than did their white counterparts.

scholarly journals Why are black adults over-represented among individuals who have experienced lifetime homelessness? Oaxaca-Blinder decomposition analysis of homelessness among US male adults

2020 ◽  
pp. jech-2020-214305
Author(s):  
Taeho Greg Rhee ◽  
Robert A Rosenheck
Keyword(s):  
Traumatic Events ◽  
Decomposition Analysis ◽  
White Men ◽  
Epidemiological Survey ◽  
Structural Factors ◽  
Black Adults ◽  
Black And White ◽  
Homeless Men ◽  
Younger Age ◽  
White Adults

BackgroundNon-Hispanic black adults experience homelessness at higher rates than non-Hispanic white adults in many studies. We aim to identify factors that could account for this disparity.MethodsWe used national survey data on non-Hispanic black and white men with complete data from the National Epidemiological Survey on Alcohol and Related Conditions Wave III. Using the Oaxaca-Blinder decomposition analysis, we examined race-based disparities in correlates of risk for lifetime homelessness.ResultsIn our analysis, 905 of 11 708 (7.7%) respondents, representing 6 million adults nationwide, reported lifetime homelessness. Black adults were 1.41 times more likely to have been homeless than white adults (95% CI 1.14 to 1.73; p=0.002). Overall, 81.6% of race-based inequality in lifetime homelessness were explained by three main variables with black adults having: lower incomes, greater incarceration histories since age of 18 and a greater risk of traumatic events (p<0.01 for each). They also had more antisocial personality disorder, younger age and parental drug use (p<0.05 for each).ConclusionAlthough previous studies suggested that black homeless men have higher rates of drug abuse than white homeless men, our findings highlight the fact that black–white disparities in lifetime homeless risk are associated with socio-structural factors (eg, income and incarceration) and individual adverse events (eg, traumatic events), and not associated with psychiatric or substance use disorders.

scholarly journals Racial differences in statin adherence following hospital discharge for ischemic stroke

Neurology ◽  
2017 ◽  
Vol 88 (19) ◽  
pp. 1839-1848 ◽  
Author(s):  
Karen C. Albright ◽  
Hong Zhao ◽  
Justin Blackburn ◽  
Nita A. Limdi ◽  
T. Mark Beasley ◽  
...  
Keyword(s):  
Ischemic Stroke ◽  
Hospital Discharge ◽  
Racial Differences ◽  
Low Income ◽  
Carotid Artery Disease ◽  
Adjusted Relative Risk ◽  
Black Adults ◽  
Black And White ◽  
History Of ◽  
White Adults

Objective:To compare nonadherence to statins in older black and white adults following an ischemic stroke.Methods:We studied black and white adults ≥66 years of age with Medicare fee-for-service insurance coverage hospitalized for ischemic stroke from 2007 to 2012 who filled a statin prescription within 30 days following discharge. Nonadherence was defined as a proportion of days covered <80% in the 365 days following hospital discharge. In addition, we evaluated factors associated with nonadherence for white and black participants separately.Results:Overall 2,763 beneficiaries met the inclusion criteria (13.5% black). Black adults were more likely than white adults to be nonadherent (49.7% vs 41.5%) even after adjustment for demographics, receipt of a low-income subsidy, and baseline comorbidities (adjusted relative risk [RR] 1.14, 95% confidence interval [CI] 1.01–1.29). Among white adults, receipt of a low-income subsidy (adjusted RR 1.13, 95% CI 1.02–1.26), history of coronary heart disease (adjusted RR 1.15, 95% CI 1.01–1.30), and discharge directly home following stroke hospitalization (adjusted RR 1.26, 95% CI 1.10–1.44) were associated with a higher risk of nonadherence. Among black adults, a 1-unit increase in the Charlson comorbidity index (adjusted RR 1.04, 95% CI 1.01–1.09), history of carotid artery disease (adjusted RR 2.38, 95% CI 1.08–5.25), and hospitalization during the 365 days prior to the index stroke (adjusted RR 1.34, 95% CI 1.01–1.78) were associated with nonadherence.Conclusions:Compared with white adults, black adults were more likely to be nonadherent to statins following hospitalization for ischemic stroke.

scholarly journals Neural control of cardiovascular function in black adults: implications for racial differences in autonomic regulation

2020 ◽  
Vol 318 (2) ◽  
pp. R234-R244 ◽  
Author(s):  
Rachel C. Drew ◽  
Nisha Charkoudian ◽  
Jeanie Park
Keyword(s):  
Blood Pressure ◽  
Chronic Kidney Disease ◽  
Kidney Disease ◽  
Racial Differences ◽  
Neural Control ◽  
Cardiovascular Function ◽  
Black Adults ◽  
Black And White ◽  
Increased Risk ◽  
White Adults

Black adults are at increased risk for developing hypertension and cardiovascular and chronic kidney disease and have greater associated morbidity/mortality than white adults who are otherwise demographically similar. Despite the key role of the autonomic nervous system in the regulation of cardiovascular function, the mechanistic contributions of sympathetic nerves to racial differences in cardiovascular dysfunction and disease remain poorly understood. In this review, we present an update and synthesis of current understanding regarding the roles of autonomic neural mechanisms in normal and pathophysiological cardiovascular control in black and white adults. At rest, many hemodynamic and autonomic variables, including blood pressure, cardiac output, and sympathetic nerve activity, are similar in healthy black and white adults. However, resting sympathetic vascular transduction and carotid baroreflex responses are altered in ways that tend to promote increased vasoconstriction and higher blood pressure, even in healthy, normotensive black adults. Acute sympathoexcitatory maneuvers, including exercise and cold pressor test, often result in augmented sympathetic and hemodynamic responses in healthy black adults. Clinically, although mechanistic evidence is scarce in this area, existing data support the idea that excessive sympathetic activation and/or transduction into peripheral vasoconstriction contribute importantly to the pathophysiology of hypertension and chronic kidney disease in black compared with white adults. Important areas for future work include more detailed study of sympathetic and hemodynamic reactivity to exercise and other stressors in male and female black adults and, particularly, sympathetic control of renal function, an important area of clinical concern in black patients.

scholarly journals Superiority of Out-of-Office Blood Pressure for Predicting Hypertensive Heart Disease in Non-Hispanic Black Adults

Hypertension ◽  
2019 ◽  
Vol 74 (5) ◽  
pp. 1192-1199 ◽  
Author(s):  
Florian Rader ◽  
Stanley S. Franklin ◽  
James Mirocha ◽  
Wanpen Vongpatanasin ◽  
Robert W. Haley ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Heart Disease ◽  
Left Ventricular Hypertrophy ◽  
Ventricular Hypertrophy ◽  
Hypertensive Heart Disease ◽  
Left Ventricular ◽  
Office Blood Pressure ◽  
Black Adults ◽  
Black And White ◽  
White Adults

Black Americans suffer disproportionately from hypertension and hypertensive heart disease. Out-of-office blood pressure (BP) is more predictive for cardiovascular complications than clinic BP; however, the relative abilities of clinic and out-of-office BP to predict left ventricular hypertrophy in black and white adults have not been established. Thus, we aimed to compare associations of out-of-office and clinic BP measurement with left ventricular hypertrophy by cardiac magnetic resonance imaging among non-Hispanic black and white adults. In this cross-sectional study, 1262 black and 927 white participants of the Dallas Heart Study ages 30 to 64 years underwent assessment of standardized clinic and out-of-office (research staff-obtained) BP and left ventricular mass index. In multivariable-adjusted analyses of treated and untreated participants, out-of-office BP was a stronger determinant of left ventricular hypertrophy than clinic BP (odds ratio per 10 mm Hg, 1.48; 95% CI, 1.34–1.64 for out-of-office systolic BP and 1.15 [1.04–1.28] for clinic systolic BP; 1.71 [1.43–2.05] for out-of-office diastolic BP, and 1.03 [0.86–1.24] for clinic diastolic BP). Non-Hispanic black race/ethnicity, treatment status, and lower left ventricular ejection fraction were also independent determinants of hypertrophy. Among treated Blacks, the differential association between out-of-office and clinic BP with hypertrophy was more pronounced than in treated white or untreated participants. In conclusion, protocol-driven supervised out-of-office BP monitoring provides important information that cannot be gleaned from clinic BP assessment alone. Our results underscore the importance of hypertension management programs outside the medical office to prevent hypertensive heart disease, especially in high-risk black adults. Clinical Trial Registration— URL: https://www.clinicaltrials.gov . Unique identifier: NCT00344903.

scholarly journals O7D.5 Subjective cognitive decline among us workers aged ≥45 years by occupation, BRFSS, 2015–2016

2019 ◽  
Vol 76 (Suppl 1) ◽  
pp. A68.1-A68
Author(s):  
Harpriya Kaur ◽  
James Grosch
Keyword(s):  
Cognitive Decline ◽  
Older Workers ◽  
Administrative Support ◽  
Memory Loss ◽  
Public Health Issue ◽  
Subjective Cognitive Decline ◽  
Behavioral Risk ◽  
Subjective Memory ◽  
Behavioral Risk Factor Surveillance ◽  
Risk Factor Surveillance

BackgroundSubjective cognitive decline (SCD) is one of the earliest noticeable symptom of dementia, including Alzheimer’s disease. Some studies have shown that half of older adults with subjective memory complaints go on to develop more severe cognitive decline within 7–18 years. The objective of this study was to examine the prevalence of SCD among US workers and to identify occupations with a high prevalence of SCD, even after adjustment for common risk factors.MethodsData from the 2015–2016 Behavioral Risk Factor Surveillance System were used to examine the prevalence of SCD among US workers aged ≥45 years who were currently employed or were employed at some point in the past 12 months. SCD is defined as frequent confusion or memory loss within the previous 12 months. Only states (n=28) that collected data on both industry/occupation and cognitive decline were included in this study.ResultsThe overall prevalence of SCD among US workers aged ≥45 years was 6.2%, and was higher for workers 65 years and older. The prevalence was significantly higher among Veterans (8.3%) compared to non-veterans (5.9%). 29.2% of those with SCD reported that they need assistance with day-to day activities and 35.1% had discussed confusion/memory loss with a healthcare professional. The prevalence of SCD was significantly lower among workers in management, business and financial operations, Healthcare practitioners and technical, and office and administrative support occupations. While workers in building and ground cleaning and maintenance, and personal care and service occupations had elevated prevalence of SCD.ConclusionCognitive decline is an important public health issue affecting older workers and their ability to work. SCD prevalence is much higher among occupations that are less mentally challenging which indicates that interventions to improve or maintain cognitive functioning may help older workers to remain productive and in the workforce.

scholarly journals Susceptibility to Scams in Older Black and White Adults

2021 ◽  
Vol 12 ◽  
Author(s):  
S. Duke Han ◽  
Lisa L. Barnes ◽  
Sue Leurgans ◽  
Lei Yu ◽  
Christopher C. Stewart ◽  
...  
Keyword(s):  
Racial Differences ◽  
Research Study ◽  
Race Differences ◽  
Black Adults ◽  
Aging Research ◽  
Association Analyses ◽  
Affective Factors ◽  
Black And White ◽  
Global Cognition ◽  
White Adults

Previous reports on racial differences in scam susceptibility have yielded mixed findings, and few studies have examined reasons for any observed race differences. Older Black and White participants without dementia (N = 592) from the Minority Aging Research Study and the Rush Memory and Aging Project who completed a susceptibility to scam questionnaire and other measures were matched according to age, education, sex, and global cognition using Mahalanobis distance. In adjusted models, older Black adults were less susceptible to scams than older White adults (Beta = −0.2496, SE = 0.0649, p = 0.0001). Contextual factors did not mediate and affective factors did not moderate this association. Analyses of specific items revealed Black adults had greater knowledge of scam targeting of older adults and were less likely to pick up the phone for unidentified callers. Older Black adults are less susceptible to scams than demographically-matched older White adults, although the reasons remain unknown.

scholarly journals Associations between estimated and measured carotid-femoral pulse wave velocity in older Black and White adults: the atherosclerosis risk in communities (ARIC) study

2022 ◽  
Author(s):  
Kevin Heffernan ◽  
Lee Stoner ◽  
Michelle L. Meyer ◽  
Adam Keifer ◽  
Lauren Bates ◽  
...  
Keyword(s):  
Risk Factors ◽  
Pulse Wave Velocity ◽  
Wave Velocity ◽  
Pulse Wave ◽  
Cvd Risk ◽  
Black Adults ◽  
Atherosclerosis Risk In Communities ◽  
Black And White ◽  
Aric Study ◽  
White Adults

Introduction: Aortic stiffness offers important insight into vascular aging and cardiovascular disease (CVD) risk. The referent measure of aortic stiffness is carotid-femoral pulse wave velocity (cfPWV). cfPWV can be estimated (ePWV) from age and mean arterial pressure. Few studies have directly compared the association of ePWV to measured cfPWV, particularly in non-White adults. Moreover, whether ePWV and cfPWV correlate similarly with CVD risk remains unexplored. Aim: (1) To estimate the strength of the agreement between ePWV and cfPWV in both Black and White older adults; and (2) to compare the associations of ePWV and cfPWV with CVD risk factors and determine whether these associations were consistent across races. Methods and Results: We evaluated 4478 [75.2 (SD 5.0) years] Black and White older adults in the Atherosclerosis Risk in Communities (ARIC) Study. cfPWV was measured using an automated pulse waveform analyzer. ePWV was derived from an equation based on age and mean arterial pressure. Association and agreement between the two measurements were determined using Pearson’s correlation coefficient (r), standard error of estimate (SEE), and Bland-Altman analysis. Associations between traditional risk factors with ePWV and cfPWV were evaluated using linear mixed regression models. We observed weak correlations between ePWV and cfPWV within White adults (r = 0.36) and Black adults (r = 0.31). The mean bias for Bland-Altman analysis was low at -0.17 m/s (95%CI: -0.25 to -0.09). However, the inspection of the Bland-Altman plots indicated systematic bias (P < 0.001), which was consistent across race strata. The SEE, or typical absolute error, was 2.8 m/s suggesting high variability across measures. In models adjusted for sex, prevalent diabetes, the number of prevalent cardiovascular diseases, and medication count, both cfPWV and ePWV were positively associated with heart rate, triglycerides, and fasting glucose, and negatively associated with body mass index (BMI) and smoking status in White adults (P < 0.05). cfPWV and ePWV were not associated with heart rate, triglycerides, and fasting glucose in Black adults, while both measures were negatively associated with BMI in Black adults. Conclusions: Findings suggest a weak association between ePWV and cfPWV in older White and Black adults from ARIC. There were similar weak associations between CVD risk factors with ePWV and cfPWV in White adults with subtle differences in associations in Black adults. One sentence summary: Estimated pulse wave velocity is weakly associated with measured carotid-femoral pulse wave velocity in older Black and White adults in ARIC.

scholarly journals Improving Usefulness of Cognitive Decline Population Measures in Predicting Future Dementia Burden

2021 ◽  
Vol 5 (Supplement_1) ◽  
pp. 183-183
Author(s):  
Benjamin Olivari ◽  
Christopher Taylor ◽  
Lisa McGuire
Keyword(s):  
Cognitive Impairment ◽  
Cognitive Decline ◽  
Memory Loss ◽  
Population Level ◽  
Subjective Cognitive Decline ◽  
Behavioral Risk ◽  
Functional Difficulties ◽  
Increased Risk ◽  
Future Burden ◽  
Core Questions

Abstract Alzheimer’s disease and related dementias begin with mild early symptoms of memory loss, progressing to more severe cognitive and functional impairment. Reports of worsening memory and subjective cognitive decline (SCD) are often the earliest possible signs of dementia onset. The trajectory of certain types of dementia may require early detection of worsening memory in the disease progression for successful interventions. However, the predictive value of subjective measures of cognitive decline is limited; the majority of those who report subjective symptoms do not progress to diagnosed cognitive impairment or dementia. These two realities create a significant challenge in confronting the growing dementia crisis. Population-level data can be beneficial in tracking trends in SCD. Data from the Behavioral Risk Factor Surveillance System (BRFSS) core questions related to chronic diseases and from the SCD optional module from survey years 2015-2019 were aggregated across the participating 50 states, D.C., and Puerto Rico for this analysis. Among 181,097 U.S. respondents aged ≥45 years, 11.3% (95% CI=10.9-11.6) reported SCD; among 20,424 with SCD symptoms, 39.4% (37.6-40.6) reported functional difficulties associated with SCD symptoms and 33.9% (32.4-35.5) needed assistance with day-to-day activities resulting from symptoms. Studies suggest persons experiencing SCD symptoms and associated functional difficulties are at increased risk for dementia compared with those with SCD without functional difficulties. Combining responses about SCD with associated functional difficulties, anxiety, and other measures might help to better inform the future burden of more severe cognitive impairment than SCD status alone.

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