Stress, Cognition, and Minority Health

Abstract This symposium examines the many factors influencing cognition and health among ethnically and racially diverse groups. Kindratt et al. use representative, national data to examine cognitive limitations and diabetes among foreign born Non-Hispanic Whites, Blacks, Hispanics, Asians and Arab Americans. Results indicate that prevalence of cognitive limitations was highest among non-Hispanic Whites and Arab-Americans, lowest among Blacks and Asians. Diminich et al. investigate the association of stressors and metabolic risk factors with cognitive/emotional functioning in a population of Hispanic/Latina(o) immigrants. They find a link between components of metabolic syndrome that are associated with domain specific deficits in cognition. These impairments are linked to posttraumatic stress, immigration related trauma and emotional health and wellbeing. Arevalo et al. examine cross-sectional and prospective associations of sleep duration and insomnia symptoms with measures of cognitive functioning among older Latinos from Puerto Rican ancestry with a longitudinal sample of older adults from the Boston Puerto Rican Health Study. Findings indicate that hours of sleep and insomnia symptoms are significantly associated with a number of global and specific cognitive factors. Finally, Munoz and colleagues, using a regional racially and ethnically diverse sample of people living in a large northeastern city, identified four stress profiles. These profiles (which focus on different types of stress) were differentially associated with working memory performance. In sum, these four papers document the experiences of stress and their association with cognitive functioning in diverse minority groups each of whom are disproportionately at risk for ADRD/RD. Gerald, from NIA, will serve as discussant.

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Sleep and Cognition: Results From a Longitudinal Cohort of Older Puerto Rican Adults

Innovation in Aging ◽

10.1093/geroni/igab046.290 ◽

2021 ◽

Vol 5 (Supplement_1) ◽

pp. 76-77

Author(s):

Sandra Arévalo

Keyword(s):

Puerto Rican ◽

Sleep Duration ◽

Sex Education ◽

Health Study ◽

Cross Sectional ◽

Longitudinal Cohort ◽

Global Condition ◽

Global Cognition ◽

Sleep And Cognition ◽

Insomnia Symptoms

Abstract We examined cross-sectional and prospective associations of sleep duration and insomnia symptoms with measures of cognitive function among older adults aged 45-75 y from the Boston Puerto Rican Health Study, a longitudinal cohort of 1500 participants of Puerto Rican ancestry. We found, statistically significant cross-sectional associations of sleep duration (hours) and an executive function domain before (F=6.20; Prob>F=0.0001) and after (F=2.33; Prob>F=0.05) controlling for covariates (age, sex, education, smoking, drinking, mental and health conditions and medication use); between sleep duration and global cognition before (F=5.38; Prob>F=0.0003) and a trend after controlling for covariates (F=2.20; Prob>F=0.0669). In longitudinal associations, sleep duration (time2) was significantly associated with global condition at time3 (F=2.42; Prob>F=0.0475) after controlling for time2 global cognition. In conclusion, we found hours of sleep and insomnia symptoms significantly associated with various cognitive factors. A public health focus on sleep hygiene may improve cognitive health outcomes in older Puerto Rican adults.

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A-27 APOE & BDNF Polymorphisms Interact to Affect Memory Performance at Baseline in Adolescent Athletes

Archives of Clinical Neuropsychology ◽

10.1093/arclin/acaa036.27 ◽

2020 ◽

Vol 35 (5) ◽

pp. 623-623

Author(s):

V C Merritt ◽

E Guty ◽

K Riegler ◽

M Brewer ◽

S Fink ◽

...

Keyword(s):

Cognitive Functioning ◽

Visual Memory ◽

Memory Performance ◽

Cognitive Testing ◽

Clinical Samples ◽

Motor Speed ◽

Adolescent Athletes ◽

Cross Sectional ◽

Healthy Adolescent ◽

The Impact

Abstract Objective Although several single-nucleotide polymorphisms have been associated with cognitive functioning in a variety of healthy and clinical samples, the influence of gene x gene interactions on cognition is poorly understood. The purpose of this study was to examine interactive relationships between apolipoprotein E (APOE) and brain-derived neurotrophic factor (BDNF) polymorphisms on cognitive functioning in a sample of healthy adolescent athletes. Method Participants of this cross-sectional study included 82 athletes (53.7% male, age, M = 12.85, SD = 1.13) who completed the Immediate Post-Concussion and Cognitive Testing (ImPACT) computerized battery at baseline as part of a school-based sports-concussion management program. Athletes also provided a buccal sample for determination of their APOE and BDNF genotypes. Two-way analyses of variance (ANOVAs) were used to evaluate the effect of APOE (ε4+ vs. ε4-) and BDNF (Met+ vs. Met-) genotypes on the ImPACT cognitive composites. Results ANOVAs showed non-significant main effects for both APOE and BDNF genotypes across the four cognitive composites. However, there was a significant APOE x BDNF genotype interaction for the verbal (p = .01; ηp2 = .08) and visual (p = .013; ηp2 = .08) memory composites, such that ε4+/Met+ carriers demonstrated poorer performance relative to the other allele combinations (ε4+/Met-, ε4−/Met+, ε4−/Met-). No significant interactions were observed for the visual motor speed (p = .20; ηp2 = .02) or reaction time (p = .87; ηp2 < .001) composites. Conclusions Our findings suggest a meaningful relationship between APOE and BDNF genotypes on verbal and visual memory performance in healthy adolescent athletes. These findings will need to be replicated using much larger samples, and future studies will need to explore these associations following sports-related concussion.

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Mediterranean Diet Adherence Modulates Anthropometric Measures by TCF7L2 Genotypes among Puerto Rican Adults

Journal of Nutrition ◽

10.1093/jn/nxz210 ◽

2019 ◽

Vol 150 (1) ◽

pp. 167-175 ◽

Cited By ~ 2

Author(s):

Mercedes Sotos-Prieto ◽

Caren E Smith ◽

Chao-Qiang Lai ◽

Katherine L Tucker ◽

José M Ordovas ◽

...

Keyword(s):

Waist Circumference ◽

Puerto Rican ◽

Mediterranean Diet ◽

Population Based ◽

Dietary Factors ◽

Health Study ◽

Anthropometric Measures ◽

Cross Sectional ◽

Sectional Analysis ◽

Tcf7l2 Rs7903146

ABSTRACT Background Transcription factor 7–like 2 (TCF7L2) genetic variants that predispose individuals to type 2 diabetes (T2D) show inconsistent associations with anthropometric traits. Interaction between TCF7L2 genotypes and dietary factors may help explain these observations. Objective We aimed to examine the potential modulation of TCF7L2-rs7903146 and rs12255372 on anthropometric markers by a Mediterranean diet (MedDiet). Methods Cross-sectional analysis was conducted in 1120 participants (aged 45–75 y) of the Boston Puerto Rican Health Study. Anthropometric variables were measured, and polymorphisms were genotyped using standardized protocols. Diet was assessed using a validated FFQ. The MedDiet was defined based on adherence to 9 food and nutrient components using sex-specific population-based median cut-offs; high adherence was defined as meeting ≥4 components. Haplotypes were tested for association with obesity traits, independently and via interaction with the MedDiet. Results TCF7L2-rs7903146 showed significant interaction with the MedDiet influencing BMI, weight, and waist circumference. The T risk-allele carriers (CT + TT) with a high MedDiet score had lower weight (77.3 ± 1.0 compared with CC 80.9 ± 1.0 kg; P = 0.013) and waist circumference (99.2 ± 0.9 compared with CC 102.2 ± 0.9 cm; P = 0.021), when compared with CC participants. A low MedDiet score resulted in no significant differences between genotypes. For TCF7L2-rs12255372, we found significant interactions with the MedDiet for weight (P-interaction = 0.034) and BMI (P-interaction = 0.036). The T allele carriers with a higher MedDiet score showed a trend of lower but no significant differences when compared with CC participants for BMI (P = 0.19), weight (P = 0.09), and waist circumference (P = 0.11). We found significant interactions between the 2 risk-carrying haplotypes and the MedDiet compared with the common haplotype (GC), with lower BMI (β ± SE, TT: −1.53 ± 0.68; P-interaction = 0.024), weight (TT: −4.16 ± 1.77; P-interaction = 0.019), and waist circumference (GT: −5.07 ± 2.50; P-interaction = 0.042) at a high MedDiet score. Conclusion Puerto Ricans with the TCF7L2-rs7903146 and rs12255372 T2D risk genotypes, although still high, had better anthropometric profiles when adhering to a MedDiet, suggesting that this diet may offset unfavorable genetic predisposition.

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Diverse Sources of Social Support and Cognitive Functioning by Race, Ethnicity, and Nativity

Innovation in Aging ◽

10.1093/geroni/igaa057.935 ◽

2020 ◽

Vol 4 (Supplement_1) ◽

pp. 292-292

Author(s):

G Robin Gauthier ◽

Marc Garcia ◽

Catherine García

Keyword(s):

Social Support ◽

Cognitive Functioning ◽

Family Support ◽

Family Relationships ◽

Cognitive Status ◽

Foreign Born ◽

Cross Sectional ◽

Frequency Of Contact ◽

Race Ethnicity ◽

The Relationship

Abstract This study examines the relationship between social support profiles and cognitive functioning by race, ethnicity and nativity in older adults using cross-sectional data drawn from the Health and Retirement Study (2010 and 2012). We employed a hierarchical clustering routine to generate nine support profiles that differentiated three sources of support: children, wider family relationships and friendships. Cognitive functioning was measured as the score on the Telephone Interview for Cognitive Status (TICS-m), a 27 point scale of cognitive function. Our approach explicitly acknowledges the ambivalence and multidimensionality of close relationships and the resources embedded within them. Descriptive analyses revealed significant differences in access to support across demographic groups. White respondents are over-represented in profiles that are characterized by support from friends, and under-represented in family support profiles. The reverse is found among Foreign-born Hispanic respondents who are over-represented in the profiles characterized by high family support and under-represented in those with high friend support. Native-born Hispanic respondents and Black respondents have less clear support patterns, although both are more likely to receive support from family and children compared to friends. Findings from the poisson regression suggest that the relationship between familial support and cognitive decline is stronger among Hispanic respondents, particularly those who are foreign born. These findings are supported even with the inclusion of other relationship quality indicators including negative support and frequency of contact.

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A prospective longitudinal study shows putamen volume is associated with moderate amphetamine use and resultant cognitive impairments

10.1101/2020.10.29.361378 ◽

2020 ◽

Author(s):

Keith M Kendrick ◽

Joerg Daumann ◽

Daniel Wagner ◽

Philip Koester ◽

Marc Tittgemeyer ◽

...

Keyword(s):

Longitudinal Study ◽

Cognitive Functioning ◽

Verbal Memory ◽

Memory Performance ◽

Public Health Issue ◽

Initial Examination ◽

Cross Sectional ◽

Prospective Longitudinal Study ◽

Prospective Longitudinal

AbstractBackgroundAmphetamine-type stimulants (ATS) have become a critical public health issue. Animal models have indicated a clear neurotoxic potential of ATSs. In humans, chronic use has been associated with cognitive deficits and structural brain abnormalities. However, cross-sectional retrospective designs in chronic users cannot truly determine the causal direction of the effects.MethodsIn a prospective-longitudinal study design cognitive functioning and brain structure were assessed at baseline and at 12-months follow-up in occasional ATS users (cumulative lifetime use <10 units at baseline).ResultsExamination of change-scores between the initial examination and follow-up revealed declined verbal memory performance and putamen volume in users with high relative to low interim ATS exposure. In the entire sample interim ATS use, memory decline and putamen volume reductions were strongly associated.ConclusionsThe present findings support the hypothesis that ATS use is associated with deficient dorsal striatal morphology which might reflect alterations in dopaminergic pathways. More importantly, these findings strongly suggest that even occasional, low-dose ATS use disrupts striatal integrity and cognitive functioning.

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Gut Microbiota Metabolites and Cardiometabolic Risk Among Older Puerto Ricans: Findings from the Boston Puerto Rican Health Study

Current Developments in Nutrition ◽

10.1093/cdn/nzaa061_006 ◽

2020 ◽

Vol 4 (Supplement_2) ◽

pp. 1378-1378

Author(s):

Shilpa Bhupathiraju ◽

Megu Baden ◽

Danielle Haslam ◽

Liming Liang ◽

Clary Clish ◽

...

Keyword(s):

High Risk ◽

Gut Microbiota ◽

Puerto Rican ◽

Cardiometabolic Risk ◽

Puerto Ricans ◽

Conditional Logistic Regression ◽

Health Study ◽

Future Research ◽

High Risk Population ◽

Cross Sectional

Abstract Objectives Puerto Ricans are the second-largest Hispanic sub-group and have high rates of type 2 diabetes (T2D). Yet, there is limited understanding of the molecular pathways that contribute to cardiometabolic risk in this high-risk group. We hypothesized that circulating gut microbiota metabolites, which have been linked to T2D risk in non-Hispanic whites, are associated with a higher T2D likelihood and cardiometabolic risk markers among older Puerto Ricans. Methods We developed a case-control study within the Boston Puerto Rican Health Study (BPRHS) with 275 prevalent T2D cases and 275 age and sex matched controls (mean age = 58.1 y, 71% female). We used LC/MS to measure baseline plasma gut microbiota metabolites (L-carnitine, betaine, choline, trimethylamine oxide [TMAO], and betaine: choline). We used conditional logistic regression to model the likelihood of prevalent T2D for each standard deviation (SD) increase in metabolites. Among controls free of T2D, we examined cross-sectional and prospective (2-year) linear associations (β [SD]) between metabolites and glycemia and dyslipidemia measures. Results After multivariable adjustment, significant differences in T2D likelihood [OR (95% CI)] were observed for each SD increase in L-carnitine [0.78 (0.62–0.99)], choline [1.33 (1.05–1.68)], betaine: choline [0.69 (0.54–0.88)], and TMAO [1.32 (1.04–1.67)]. We replicated findings for L-carnitine and betaine: choline in the WHI metabolomics study. Among BPRHS controls, cross-sectionally, higher betaine was associated with lower HOMA-IR (−9.97 [3.02]), insulin (−9.78 [2.83]), triglycerides (−11.4 [2.54]), and higher HDL-C (2.05 [0.65]). Prospectively, higher betaine and betaine: choline were associated with lower HOMA-IR (betaine −11.5 [3.63], betaine: choline −9.57 [3.68]), insulin (betaine −9.21 [3.27], betaine: choline −8.01 [3.31]), and glucose (betaine −2.17 [0.74], betaine: choline −1.58 [0.76]) concentrations, while higher choline was prospectively associated with higher triglycerides (5.17 [2.09]). No associations were seen between L-carnitine, TMAO, and cardiometabolic markers among controls. Conclusions Plasma betaine, choline, and betaine: choline may be markers of cardiometabolic risk in this high-risk population. Future research should examine dietary and lifestyle correlates of betaine and choline. Funding Sources NIH.

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Disparities in Cognition Among U.S. and Foreign-Born Minority Populations With and Without Diabetes

Innovation in Aging ◽

10.1093/geroni/igab046.289 ◽

2021 ◽

Vol 5 (Supplement_1) ◽

pp. 76-76

Author(s):

Tiffany Kindratt ◽

Florence Dallo ◽

Laura Zahodne ◽

Kristine Ajrouch

Keyword(s):

Medical Expenditure Panel Survey ◽

Medical Expenditure ◽

Arab Americans ◽

Minority Populations ◽

Panel Survey ◽

Foreign Born ◽

Cognitive Limitations ◽

Interview Survey ◽

Immigrant Health Paradox ◽

Health Paradox

Abstract Adults with cognitive limitations and diabetes may be less able to adhere to treatment recommendations. Our aims were to: 1) estimate and compare the prevalence of cognitive limitations and diabetes among foreign-born non-Hispanic whites, blacks, Hispanics, Asians, and Arab Americans to US-born non-Hispanic whites; and 2) examine associations after controlling for covariates. We linked 2002-2016 National Health Interview Survey and 2003-2017 Medical Expenditure Panel Survey data (ages >=45 years, n=122,898). The prevalence of cognitive limitations was highest among foreign-born non-Hispanic whites (9.71%) and Arab Americans (9.40%) and lowest among foreign-born blacks (5.19%). Foreign-born non-Hispanic whites had higher odds (OR=1.36; 95% CI=1.05-1.49) of cognitive limitations than their US-born counterparts. Foreign-born Hispanics with diabetes had greater odds of cognitive limitations (OR=1.91; 95% CI=1.63, 2.24) compared to US-born non-Hispanic whites. Additional findings will be discussed focused on stressors that may contribute to cognition disparities using the immigrant health paradox framework.

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Abstract MP37: Association of Acculturation With Six-year Change in Systolic Blood Pressure Across Diverse Hispanic/Latino Background Groups, the Hispanic Community Health Study/Study of Latinos, 2008-2017

Circulation ◽

10.1161/circ.141.suppl_1.mp37 ◽

2020 ◽

Vol 141 (Suppl_1) ◽

Author(s):

Tali Elfassy ◽

Neil Schneiderman ◽

Tatjana Rundek ◽

Leopoldo Raij ◽

Asmi Panigrahi ◽

...

Keyword(s):

Blood Pressure ◽

Systolic Blood Pressure ◽

Community Health ◽

Puerto Rican ◽

Central American ◽

Health Study ◽

Foreign Born ◽

Potential Health ◽

Hispanic Community

Introduction: Among US Hispanics/Latinos, greater acculturation to US society is associated with higher blood pressure. However, the extent to which this relationship varies across diverse Hispanic/Latino groups is unclear. Objectives: To determine whether acculturation is differentially associated with six-year change in systolic blood pressure (SBP) across Hispanic/Latino groups. Methods: The Hispanic Community Health Study/Study of Latinos is a prospective population-based study of diverse Hispanics/Latinos aged 18-74 years from four US communities. Acculturation at baseline (2008-2011) was defined by the Short Acculturation Scale for Hispanics (SASH) social and language scales (low, medium, or high acculturation) and nativity/duration of US residence (foreign-born with < 10 or ≥ 10 years of US residence, or US born-not including Puerto Rico). The average of three seated SBP measurements was used; difference in SBP from baseline to follow-up (2014-2017) was calculated in 7,836 adults free from hypertension at baseline (SBP < 140 mmHg; diastolic blood pressure < 90 mmHg; and not taking hypertension medication). Using linear regression models accounting for the complex survey design and adjusted for baseline age, sex, education, income, body mass index, years of follow-up, and hypertension medication at follow-up, we estimated the association of each measure of acculturation with change in SBP. Significant interactions between Hispanic/Latino group and measures of acculturation led to stratified models (SASH interaction p=0.01 for social; p=0.28 for language; and nativity/duration of US residence US interaction, p=0.05). Results: Mean baseline age was 36.7 years (SE: 0.23) and 51.7% were women (SE: 0.77). After an average follow-up of 6.2 years (SE: 0.02), mean change in SBP was 2.01 mmHg (SE: 0.20). Among individuals of Central American background, high vs. low SASH language was associated with +3.21 mmHg SBP increase (95% CI: 0.19, 6.24) and being US born vs. foreign-born < 10 years in US was associated with +5.31 mmHg SBP increase (95% CI: 2.10, 8.53). Among individuals of Puerto Rican background, those with ≥ 10 vs. < 10 years in the US 50 states had a 5.67 mmHg lower increase in SBP (95% CI: -9.85, -1.50). Associations between measures of acculturation and changes in SBP were not significant in other groups (i.e. Cubans, Dominicans, and South Americans), but did suggest a greater SBP increase with greater acculturation among Mexican background individuals (e.g. high vs. low SASH social β=1.67, 95% CI: -0.19, 3.52, p=0.08). Conclusions: Greater acculturation was associated with a greater SBP increase among those of Central American background but a lower SBP increase among individuals of Puerto Rican background. These findings show that consideration of Hispanic/Latino group is warranted when assessing potential health effects of acculturation.

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Abstract 15859: Fibroblast Growth Factor 23 and Myocardial Infarction in the Boston Puerto Rican Health Study

Circulation ◽

10.1161/circ.142.suppl_3.15859 ◽

2020 ◽

Vol 142 (Suppl_3) ◽

Author(s):

Chinedu C Ochin ◽

Joseph Salami ◽

Emir Veledar ◽

Mahdi O Garelnabi ◽

Katherine L Tucker

Keyword(s):

Myocardial Infarction ◽

Cardiovascular Disease ◽

Plasma Concentration ◽

Puerto Rican ◽

Cardiovascular Events ◽

Cardiovascular Outcomes ◽

Health Study ◽

Cross Sectional ◽

Increased Risk ◽

Fgf 23

Background: FGF-23 is an endocrine regulator of phosphate metabolism as well as also a potent biomarker that mediates cardiovascular remodeling, with markedly elevated plasma concentration associated with the occurrence of morbid cardiovascular events such as myocardial infarction. This association usually indicates risk of developing further adverse cardiovascular events in individuals that are already susceptible to repeat morbid cardiovascular outcomes. This cross-sectional epidemiological study aims at investigating the risk association between FGF-23 and individuals in the 8 th year cohort of the Boston Puerto Rican Health Study (BPRHS) that have self-reported clinical cardiovascular disease in the form of myocardial infarction. Methods: FGF-23 plasma concentration was measured by ELISA in 496 participants of the fourth wave of the Boston Puerto Rican Health Study (BPRHS). Multivariate logistic regressions were used to analyze the cross-sectional association of plasma FGF-23 quartile distribution with self-reported clinical diagnosis of myocardial infarction (MI). Results: The crude model for the association between FGF-23 and MI showed increased risk across the 2 nd , 3 rd and 4 th quartiles, OR (95% CI); 1.27 (0.48-3.34), 1.13 (0.42-3.04), and 3.13 (1.33-7.33), respectively. The relationship with the highest vs lowest quartile remained significant after adjusting for age, sex and BMI, OR (95% CI); 2.91 (1.15-7.36). With further adjustment for diabetes, smoking, plasma total cholesterol, HDL cholesterol and triglycerides, results were attenuated, and the latter comparison was no longer statistically significant, OR (95% CI); 2.15 (0.79-5.79). The test for trend across the quartiles yielded a p value of 0.03. Conclusion: Within this population of older Puerto Rican adults, FGF-23 was not significantly associated with increased likelihood of self-reported history of myocardial infarction. Longitudinal studies, using clinical parameters that objectively measure the progression of cardiovascular disease are needed to assess the prognostic value of FGF-23 for future cardiovascular outcomes.

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Cognitive dysfunctions in patients with bipolar disorder: A comparative study from Western Rajasthan

Asian Journal of Medical Research ◽

10.47009/ajmr.2020.9.2.py1 ◽

2020 ◽

Vol 9 (2) ◽

pp. 1-6

Author(s):

Ankit Awasthi ◽

Arpit Koolwal ◽

Nikita Dhaka ◽

Ghanshyam Das Koolwal ◽

Sanjay Gehlot

Keyword(s):

Bipolar Disorder ◽

Cognitive Functioning ◽

Rating Scale ◽

Memory Performance ◽

Tertiary Care ◽

Brain Dysfunction ◽

Cross Sectional Study ◽

Young Mania ◽

Chi Square ◽

Cross Sectional

Background: Cognitive dysfunction is an established entity in bipolar disorder. The affected individuals exhibit wide-ranging deficits involving multiple domains of cognitive functioning. These deficits are associated with poor functional outcome and residual disability in patients. A substantial literature exists globally on cognition in bipolar disorder; however, few studies have been carried out on this subject in India and in Rajasthan. The aim of the study is to compare cognitive functions of bipolar disorder patients and healthy control subjects. Subjects and Methods: This cross-sectional study was conducted at the Psychiatry department of a tertiary care institution on 50 bipolar disorder patients and matched healthy controls subjects who fulfilled the inclusion criteria. The diagnosis was made by DSM-V criteria, and symptom severity was determined by the Young Mania Rating Scale (YMRS) and the Hamilton Depression Rating Scale (HAM-D). After seeking socio-demographic details, all participants were administered the Post Graduate Institute Battery of Brain Dysfunction (PGI-BBD) to assess cognitive functioning. Data collected were subjected to suitable statistical analysis (mean, standard deviation, and chi-square test). Results: The majority of the bipolar disorder patients (54%) were under 35 years of age, were males (60%), were from the urban background (70%), and were married (82%). Bipolar disorder patients performed poorly on all domains of cognitive functioning, i.e. memory, performance and verbal intelligence, and perceptuo-motor skills. Conclusion: The present study affirmed the previous findings of wide-spread cognitive impairment in bipolar disorder patients. Prompt diagnosis and treatment are the key steps to reduce the cognitive morbidity associated with this disorder.

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