scholarly journals FEASIBILITY OF A LOW-DOSE FRAILTY PREVENTION INTERVENTION AMONG OLDER AFRICAN AMERICANS

2019 ◽  
Vol 3 (Supplement_1) ◽  
pp. S293-S293
Author(s):  
Heather A Fritz ◽  
Wassim Tarraf ◽  
Pragnesh Patel
Keyword(s):  
African Americans ◽  
Low Dose ◽  
Healthy Lifestyle ◽  
Primary Care Clinic ◽  
Later Life ◽  
Community Dwelling ◽  
Feasibility Trial ◽  
Care Clinic ◽  
Prevention Intervention ◽  
Older African Americans

Abstract Older African Americans (OAA) are at high risk for becoming frail in later life. Interventions can reverse or delay frailty, yet OAA have largely been excluded from frailty intervention research. Many interventions are also time and resource intensive, making them inaccessible to socially disadvantaged OAA. We present results of a feasibility trial of a low dose frailty prevention intervention among 60 community-dwelling, pre-frail OAA aged 55+ recruited from a primary care clinic between June 1st and October 31st 2018. Using a 2-arm RCT, participants were assigned to the intervention, which was delivered by an occupational therapist (OT) and comprised of four sessions over four months (an OT evaluation, and sessions on healthy dietary practices, increasing physical activity, and maintaining a healthy lifestyle), or enhanced usual care (publicly available information about healthy lifestyle, home safety, and local elder services). Feasibility criteria were set a priori at 75% for participant retention (including attrition due to death/hospitalization), 80% for session engagement, 2 participants/week for mean participant accrual, and 90% for program satisfaction. Participants were 65% female with an average age of 76.58 years, 51.67% of which lived alone and 51.67% lived off of less than 15K per year. Feasibility metrics were met. The study recruited 2.5 participants per week and retained 75% of participants who attended 95% of scheduled sessions. Mean satisfaction scores were 93%. The intervention was feasible to deliver. Qualitative findings from exit interviews suggested changes to the program dose, structure, and content that could improve it for future use.

Feasibility of a Habit Formation Intervention to Delay Frailty Progression Among Older African Americans: A Pilot Study

2019 ◽  
Vol 60 (7) ◽  
pp. 1353-1363
Author(s):  
Heather Fritz ◽  
Yi-Ling Hu ◽  
Wassim Tarraf ◽  
Pragnesh Patel
Keyword(s):  
Primary Care ◽  
African Americans ◽  
Habit Formation ◽  
A Priori ◽  
Primary Care Clinic ◽  
Later Life ◽  
Community Dwelling ◽  
Dietary Habit ◽  
Care Clinic ◽  
Older African Americans

Abstract Background and Objectives Older African Americans are at high risk for becoming frail in later life. Interventions can reverse or delay frailty, yet African Americans have largely been excluded from such research. Many interventions are also time- and resource-intensive, and thus inaccessible to socially disadvantaged older African Americans. We evaluated the feasibility of a low-dose frailty prevention intervention integrated with primary care among 60 community-dwelling, prefrail older African Americans aged 55+ recruited from a primary care clinic. Research Design and Methods We conducted a 2-arm randomized control trial. Participants were assigned to a 4-session intervention (1 session per month), delivered by an occupational therapist, or enhanced usual care. Feasibility criteria were set a priori at 75% for participant retention (including attrition due to death/hospitalization), 80% for session engagement, 2 participants/week for mean participant accrual, and 90% for program satisfaction. Results Participants were 65% female with an average age of 76.6 years, 51.7% lived alone and 39.1% reported <$10,000 in yearly income. Feasibility metrics were met. The study recruited, a mean of, 2.5 participants per week and retained 75% of participants who attended 95% of scheduled sessions. The mean satisfaction score was 29.75 (range = 0–32; SD .25). Changes in physical activity and dietary habit formation as well as changes in secondary outcomes were largely in the expected direction. Discussion and Implications The intervention was feasible to deliver. Qualitative findings from exit interviews suggested changes to the program dose, structure, and content that could improve it for future use.

scholarly journals Cross-Cultural Comparisons of Subjective Cognitive Complaints in a Diverse Primary Care Population

2021 ◽  
pp. 1-11
Author(s):  
Danelly Rodríguez ◽  
Emmeline Ayers ◽  
Erica F. Weiss ◽  
Joe Verghese
Keyword(s):  
Primary Care ◽  
Depressive Symptoms ◽  
Cognitive Function ◽  
African Americans ◽  
Primary Care Clinic ◽  
Depression Scale ◽  
Cognitive Complaints ◽  
Care Clinic ◽  
Primary Care Population ◽  
Subjective Cognitive Complaints

Background: Very few studies have explored the utility of subjective cognitive complaints (SCCs) in primary care settings. Objective: We aim to investigate associations between SCCs (item-level), objective cognitive function (across domains and global), and mood in a diverse primary care population, including subjects with mild cognitive impairment. Methods: We studied 199 (75.9%females; 57.8%Hispanics; 42.2%African Americans) older adults (mean age 72.5 years) with memory concerns at a primary care clinic. A five-item SCC questionnaire, and objective cognitive assessments, including the Montreal Cognitive Assessment (MoCA) and the Geriatric Depression Scale, were administered. Results: Logistic regression analyses showed associations between SCC score and depressive symptoms. A memory-specific (“memory worsening”) SCC predicted scores on the MoCA (p = 0.005) in Hispanics. Conclusion: SCCs are strongly linked to depressive symptoms in African Americans and Hispanics in a primary care setting; a specific type of SCC is related to global cognitive function in Hispanics.

scholarly journals Older African Americans’ Perspectives on Exposure to Structural Discrimination Across Contexts and the Life Course

2020 ◽  
Vol 4 (Supplement_1) ◽  
pp. 689-689
Author(s):  
Sarah LaFave ◽  
Sarah Szanton ◽  
Roland Thorpe
Keyword(s):  
African Americans ◽  
Life Course ◽  
Healthcare Services ◽  
Community Dwelling ◽  
Structured Interviews ◽  
Older African Americans ◽  
Environmental Toxin ◽  
Development Of Instrument ◽  
The Life Course ◽  
Interpersonal Level

Abstract This presentation reports on findings from the first phase of a mixed methods study aimed at developing an instrument to assess older African Americans’ exposure to structural racial discrimination. We conducted semi-structured interviews with older African Americans about their perspectives on and exposure to structural discrimination. Participants (n=20) were community-dwelling African Americans aged fifty and older in Baltimore, MD. Participants described exposure to structural discrimination that had accumulated across the life course and across the contexts of education, employment, healthcare services, criminal justice system, neighborhood factors, media and marketing of unhealthy products, environmental toxin exposures, and income, credit and wealth. In the next phase of the study, we will incorporate these findings into the development of instrument items. Developing and testing a tool to assess exposure to discrimination beyond the interpersonal level is an important step in identifying solutions to mitigate the contribute of discrimination to racial health disparities.

scholarly journals Temporal aspects of wellbeing in later life: gardening among older African Americans in Detroit

2019 ◽  
Vol 40 (12) ◽  
pp. 2614-2634
Author(s):  
Jessica C. Robbins ◽  
Kimberly A. Seibel
Keyword(s):  
Older Adults ◽  
African Americans ◽  
Social Relations ◽  
Multiple Scales ◽  
Later Life ◽  
Structural Inequality ◽  
City Life ◽  
Social And Emotional ◽  
Older African Americans ◽  
Nuanced Understanding

AbstractGardening has well-established physical, social and emotional benefits for older adults in varied circumstances. In Detroit, Michigan (United States of America), as in many cities, policy makers, funders, researchers, community organisations and residents regard gardening as a means of transforming bodies, persons, communities, cities and broader polities. We draw on ethnographic research conducted during one gardening season with 27 older African Americans in Detroit to foreground the social dimensions of wellbeing in later life and thus develop a more robust and nuanced understanding of gardening's benefits for older adults. Based on anthropological understandings of personhood and kinship, this article expands concepts of wellbeing to include social relations across multiple scales (individual, interpersonal, community, state) and temporalities (of the activity itself, experiences of ageing, city life). Even when performed alone, gardening fosters connections with the past, as gardeners are reminded of deceased loved ones through practices and the plants themselves, and with the future, through engagement with youth and community. Elucidating intimate connections and everyday activities of older African American long-term city residents counters anti-black discourses of ‘revitalisation’. An expansive concept of wellbeing has implications for understanding the generative potential of meaningful social relations in later life and the vitality contributed by older adults living in contexts of structural inequality.

African Americans and Whites Are Equally Appropriate to be Considered for Total Joint Arthroplasty

2009 ◽  
Vol 36 (9) ◽  
pp. 1971-1976 ◽  
Author(s):  
DENNIS C. ANG ◽  
NIGHAT TAHIR ◽  
HUFZA HANIF ◽  
YAN TONG ◽  
SAID A. IBRAHIM
Keyword(s):  
African Americans ◽  
Racial Differences ◽  
Total Joint Arthroplasty ◽  
Primary Care Clinic ◽  
Ethnic Disparities ◽  
Hip Osteoarthritis ◽  
Joint Arthroplasty ◽  
Care Clinic ◽  
Symptomatic Knee ◽  
The Mean

Objective.Ethnic disparities in the use of total joint arthroplasty (TJA) may be attributed to differences in the clinical appropriateness to undergo TJA. We sought to determine if racial differences in clinical appropriateness for surgery existed among a sample of primary care clinic patients with moderately to severely symptomatic knee or hip osteoarthritis (OA).Methods.We used the cross-sectional data of 684 patients who are potential candidates for TJA. Using a validated TJA appropriateness algorithm, an appropriateness factor was derived using the following variables: age (50–70 or > 70 yrs), Charlson comorbidity (≤ 1 or > 1), Western Ontario and McMaster Universities OA Index (WOMAC) pain and physical function, and adequacy of previous medical management. We used logistic regression to estimate the association of race with the dichotomous outcome of clinical appropriateness for TJA consideration.Results.Sample consisted of 425 (62%) whites and 260 (38%) African Americans; 532 (78%) had knee OA and 153 (22%) had hip OA. The mean age was 64 ± 9 years and the mean body mass index was 33.6 ± 8 kg/m2. The mean overall WOMAC score was 56 ± 14 (range 30–96), suggesting moderately severe OA. There were no significant racial group differences (p = 0.3) in the proportions of those deemed clinically appropriate for TJA. After controlling for potential confounders, race was not a predictor of clinical appropriateness for TJA (odds ratio 1.2, 95% confidence interval 0.8–1.8, p = 0.3).Conclusion.African Americans and whites were equally appropriate to be considered for TJA.

scholarly journals New Evidence on the Biobehavioral Mechanisms of Chronic Pain in Aging African Americans

2020 ◽  
Vol 4 (Supplement_1) ◽  
pp. 784-784
Author(s):  
Staja Booker
Keyword(s):  
Older Adults ◽  
Chronic Pain ◽  
African Americans ◽  
Racial Differences ◽  
Pain Catastrophizing ◽  
Later Life ◽  
Genetic Alterations ◽  
Cross Sectional ◽  
Older African Americans ◽  
New Evidence

Abstract African American older adults are living longer with chronic pain, which presents a huge personal and societal burden. A growing group of scholars are now devoted to accurately and precisely characterizing and phenotyping the experience of pain in aging using within-group and advanced methodological designs to elucidate the biopsychosocial-behavioral responses to pain. In this symposium, five dynamic presenters present new evidence on mechanisms of pain in older African-Americans. Dr. Roach’s investigation reveals the effect of genetic alterations of sickle cell disease (SCD) on stress-related pain in younger and older adults; this scientific inquiry is especially important because there is little research on SCD in aging. Next, Dr. Terry, extends these findings by exploring the association between psychosocial factors such as experiences of discrimination, pain catastrophizing, and perceived stress on neural (brain) responses via magnetic resonance imaging. From a clinical perspective, Dr. Booker reports on the first-ever model of intra-racial differences in movement-evoked pain in older African-Americans with knee osteoarthritis and healthy controls. Our final two presenters use a translational approach to identify how older African-Americans cope with chronic pain. Dr. Robinson-Lane’s study highlights the unique experience and predictors of coping, adaptation, and self-management of chronic pain in Black dementia caregivers. Finally, Dr. Cobb’s research from a large cross-sectional study correlates social, behavioral, and health factors with opioid and psychotropic use in economically disadvantaged older African-Americans. This symposium offers novel ways of understanding social determinants of pain and assisting African-Americans and their caregivers to manage complex chronic pain in later life.

scholarly journals Self-Reported Sleep in Older African Americans and White Americans

2016 ◽  
Vol 26 (4) ◽  
pp. 521 ◽  
Author(s):  
Arlener D. Turner ◽  
Andrew S. Lim ◽  
Sue E. Leurgans ◽  
David A. Bennett ◽  
Aron S. Buchman ◽  
...  
Keyword(s):  
Sleep Apnea ◽  
African Americans ◽  
Sleep Quality ◽  
Activities Of Daily Living ◽  
Sleep Disorders ◽  
Daily Living ◽  
Community Dwelling ◽  
Mobility Disability ◽  
Older African Americans ◽  
Impaired Sleep

<p class="Pa7"><strong>Objective: </strong>Assess the relationship of self-reported sleep quality and possible sleep disorders with disability in a racially diverse sample of community-dwelling older adults.</p><p class="Pa7"><strong>Methods: </strong>Participants included 943 non-demented older African Americans (n=452) and Whites (n=491) from two cohort studies, the Minority Aging Research Study (MARS) and the Rush Memory and Aging Project (MAP). Participants completed a 32-item questionnaire assessing sleep quality and the possible presence of three sleep disorders (sleep apnea, restless leg syndrome [RLS] and REM behavior disorder [RBD]). Disability was assessed with scales that quantified the ability to perform instru­mental activities of daily living (IADL), basic activities of daily living (ADL), and physical mobility activities.</p><p class="Pa7"><strong>Results: </strong>More than half of the participants reported impaired sleep quality (51%), or the possible presence of at least one sleep disorder (57%; sleep apnea 44%, RLS 25% and RBD 7%). Sleep quality was rated poorer in African Americans, those with advancing age and fewer years of educa­tion (all P&lt;.05). Only sleep apnea risk was associated with age (P&lt;.02). In logistic regression models adjusted for age, sex, years of education, and race, both sleep quality and disorders were associated with disability (sleep quality with mobility disabil­ity (P&lt;.001), sleep apnea risk with mobility disability and IADL disability (all P&lt;.001) and RLS symptoms with mobility disability (P&lt;.01).</p><p class="Pa7"><strong>Conclusions: </strong>Results indicate that self-assessed impaired sleep is common in old age and is associated with disability. <em></em></p><p class="Pa7"><em>Ethn Dis.</em>2016;26(4):521-528; doi:10.18865/ ed.26.4.521</p><strong></strong>

scholarly journals The Effect of Vaccines on Older African Americans Emotional Experiences During the COVID-19 Pandemic

2021 ◽  
Vol 5 (Supplement_1) ◽  
pp. 727-727
Author(s):  
Sophie Hanna ◽  
Dwana Bass ◽  
Sarah Shair ◽  
Loraine DiCerbo ◽  
Bruno Giordani ◽  
...  
Keyword(s):  
African Americans ◽  
Health And Safety ◽  
The United States ◽  
Community Dwelling ◽  
Minority Population ◽  
Emotional Experiences ◽  
State Institute ◽  
Older African Americans ◽  
Black Elders ◽  
Age Range

Abstract The COVID-19 pandemic is an unprecedented health emergency that has forced a change in the daily life of all individuals across the nation for over a year. As vaccinations have begun in Detroit, we examined their effect on older African Americans’ emotional experiences and intent to get vaccinated during the pandemic to help understand how persons make decisions to accept vaccinations. For this study, 194 community-dwelling older African Americans (mean age = 75, age range = 64-94) were recruited from the Wayne State Institute of Gerontology Healthier Black Elders Center and general Detroit area. A telephone survey was administered to assess pandemic experience including demographics, emotional responses (e.g., gratitude, happiness, anger, fear), everyday stressors (e.g., economic problems, reduced privacy), and vaccination attitude (e.g., concern over safety, intent to vaccinate). Of the 194 participants, 149 completed the survey before the first vaccination occurred in the United States on December 15, 2020, and 45 completed the survey after. Participants had not yet been vaccinated, but 67% said they would as soon as available. Participants in the post-vaccination group, as compared to pre-vaccination group, showed increases in stress-related locus of control (p=.03) and reported being more likely to get vaccinated (p=.02). They showed decreased worry about availability of health and safety supplies (p=.01), reduced perceived stress (p=.02), and a decrease in fears of COVID-19 (p=.05) and vaccination safety (p&lt;.001). The current study highlights the effect of vaccinations on the attitudes and emotions experienced by an older minority population living in an urban area.

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