THE ASSOCIATION OF LONELINESS AND CHRONIC CLINICALLY SIGNIFICANT PAIN AMONG AFRICAN AMERICAN AND WHITE OLDER ADULTS

Abstract Loneliness and pain are significant public health problems in later life, yet limited research has examined how these factors interact among racially diverse older adults. Guided by the Biopsychosocial Model of Pain, we used data from Waves 2 and 3 of the National Social Life, Health, and Aging Project to investigate the relationship between loneliness and chronic pain among 1,102 African-American and White adults aged 50 and over. Using logistic regression analyses, our final models considered demographics, physical and mental health, functioning, medication, health behaviors and social factors. Approximately 32% of African Americans and 28% of Whites reported chronic loneliness. Compared to Whites African-Americans were 2.5 times more likely to experience chronic pain. Among White participants, loneliness was not associated with chronic pain; however, the interaction of being African-American and lonely was associated with decreased odds of chronic pain in main and gendered analyses. African American women were 4 times more likely than White women to report chronic pain. Our results address the objectives of the National Pain Strategy (2016) to elucidate the experiences of chronic pain among diverse elders in the US. Future work should seek a deeper understanding of loneliness and chronic pain among African Americans elders and how cultural dynamics may help explain our counter intuitive findings (e.g., “Superwoman Schema”).

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THE EFFECTS OF CHRONIC PAIN AND LONELINESS ON FUNCTIONING AMONG LATINO AND WHITE OLDER ADULTS

Innovation in Aging ◽

10.1093/geroni/igz038.2169 ◽

2019 ◽

Vol 3 (Supplement_1) ◽

pp. S585-S585

Author(s):

David Camacho ◽

Maria P Aranda ◽

Denise Burnette ◽

Ellen Lukens

Keyword(s):

Older Adults ◽

Chronic Pain ◽

Social Life ◽

Later Life ◽

Interactive Effects ◽

Physical And Mental Health ◽

Racially Diverse ◽

Two Factors ◽

Diverse Groups ◽

White Adults

Abstract The detrimental effects of loneliness and chronic pain on functioning in later life are well documented, yet there is little evidence of whether these patterns hold across racially diverse older adults. Guided by the Biopsychosocial Model of Assessment, Prevention, and Treatment of Chronic Pain, we used data from Waves 2 and 3 of the National Social Life, Health, and Aging Project (NSHAP) to examine the additive and interactive effects of loneliness and chronic pain on Elemental and Instrumental Activities of Daily Living (ADLs & IADLs) among a sample of 1046 Latino and White adults aged 50 and over. Using linear regression analyses, our final models (Adjusted R-squares: .316 & .304) included demographic characteristics, physical and mental health, medication, health behaviors and social factors. In this sample, approximately 33% experienced chronic pain, 50% reported at least transitory loneliness and 22% experienced both. Neither loneliness nor chronic pain was independently associated with functioning impairment. However, these two factors in combination were associated with lower scores on ADLs and I-ADLs. In addition, Latinos who reported chronic pain were more likely to report lower scores on ADLs only. Results highlight variations in the detrimental effects of loneliness and chronic pain for white and Latino elders. Findings suggest the need for interventions that address chronic pain and loneliness simultaneously. Future studies should examine how culturally-grounded experiences of loneliness and chronic pain may contribute to worsening of functioning among diverse groups of Latino elders.

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

Innovation in Aging ◽

10.1093/geroni/igaa057.2839 ◽

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.

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A Dream Deferred: African American Women’s Diminished Socioeconomic Returns of Postponing Childbearing from Teenage to Adulthood

Reproductive Medicine ◽

10.3390/reprodmed1020005 ◽

2020 ◽

Vol 1 (2) ◽

pp. 62-76 ◽

Cited By ~ 3

Author(s):

Shervin Assari ◽

Shanika Boyce ◽

Mohsen Bazargan ◽

Cleopatra H. Caldwell

Keyword(s):

African American ◽

African Americans ◽

Marital Status ◽

African American Women ◽

Social Mobility ◽

White Women ◽

The United States ◽

Continuous Measure ◽

American Women ◽

Upward Social Mobility

Background: Brookings Institution has identified postponing childbirth from teenage to adulthood as a major strategy that is needed for upward social mobility of women. However, according to the Minorities’ Diminished Returns (MDRs), the associations between aspirations, investments, behaviors, and socioeconomic position (SEP) may be diminished for marginalized groups such as African Americans. Objective: To extend the existing knowledge on the MDRs, the current study had two aims: First to compare White and African American women for the association between postponing childbearing to adulthood and SEP in a national sample of American women. Second, to test correlates of postponing childbearing to adulthood and SEP at birth with long term outcomes 15 years later when the child was 15 years old. Methods: For this longitudinal study, data came from the Fragile Families and Child Well-being Study (FFCWS), a national longitudinal prospective study in the United States (US) that followed an ethnically diverse sample of women from childbirth for 15 years from 1998 to 2016. For the first aim, this study included 2679 women composed of 723 Whites and 1956 African Americans. For the second aim, among 1842 individuals who had available data 15 years later, we measured various economic, behavioral, and mental health outcomes when the child was 15 years old. For aim 1 we ran linear regression. Postponing childbearing to adulthood was the independent variable. The dependent variable, SEP (poverty) was treated as a continuous measure with higher score indicating more poverty. Confounders included marital status and delivery characteristics. For the aim 2, we ran Pearson correlation test (exploratory analysis) to test if baseline SEP correlates with future outcomes. Results: Postponing childbearing from adolescence to adulthood was associated with higher SEP in adulthood, net of all confounders including marital status and education. We found a significant interaction between postponing childbearing from adolescence to adulthood and race on SEP, suggesting that the economic reward of postponing childbearing may be weaker for African American women than for White women. Conclusions: Although postponing the age at childbirth is a recommended strategy for women who wish to maximize their chance of upward social mobility, this strategy may be associated with smaller economic returns for African American women than White women. The results can also be interpreted as MDRs in investments in terms of a postponing childbearing. In a fair society, the same investment should be similarly rewarded across diverse racial groups. In the reality, however, the US society differently rewards White and African American women who postpone childbearing. Research should explore the roles of social stratification, blocked opportunities, and concentrated poverty in explaining the unequal return of such an investment for African American and White women.

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Ethnic Differences in Magnesium Intake in U.S. Older Adults: Findings from NHANES 2005–2016

Nutrients ◽

10.3390/nu10121901 ◽

2018 ◽

Vol 10 (12) ◽

pp. 1901 ◽

Cited By ~ 2

Author(s):

Sarah Jackson ◽

Lee Smith ◽

Igor Grabovac ◽

Sandra Haider ◽

Jacopo Demurtas ◽

...

Keyword(s):

Older Adults ◽

African American ◽

African Americans ◽

Ethnic Groups ◽

Later Life ◽

Targeted Interventions ◽

Magnesium Intake ◽

Health And Nutrition ◽

Dietary Magnesium ◽

Using Data

Magnesium plays a crucial role in hundreds of bodily processes relevant to aging, but consumption of dietary magnesium intake has been shown to be inadequate in a large proportion of older adults. Identifying groups at risk of low magnesium intake is important for informing targeted advice. Using data from the National Health and Nutrition Examination Survey (NHANES) 2005–2016, we examined the association between ethnicity (Caucasian/African American/Hispanic/other) and magnesium intake in a large representative sample of U.S. older adults (≥65 y, n = 5682, mean (SD) 72.9 (0.10) y). Analyses adjusted for total energy intake and a range of relevant covariates. Overall, 83.3% of participants were not meeting the recommended level of dietary magnesium intake, ranging from 78.1% of other ethnic groups to 90.6% of African Americans. In the fully adjusted model, magnesium intake was lower among African American older adults (−13.0 mg/d, 95% CI: −18.8 to −7.2), and higher among Hispanics (14.0 mg/d, 95% CI: 7.5 to 20.5) and those from other ethnic groups (17.2, 95% CI: 3.8 to 30.5) compared with Caucasian older adults. These results highlight the need for targeted interventions to increase magnesium intake in U.S. older adults, with a focus on African Americans, in order to reduce the burden of morbidity and ethnic inequalities in health in later life.

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“Puttin’ on”: Expectations Versus Family Responses, the Lived Experience of Older African Americans With Chronic Pain

Journal of Family Nursing ◽

10.1177/1074840719884560 ◽

2019 ◽

Vol 25 (4) ◽

pp. 533-556 ◽

Cited By ~ 4

Author(s):

Staja Q. Booker ◽

Lakeshia Cousin ◽

Harleah G. Buck

Keyword(s):

Chronic Pain ◽

African American ◽

African Americans ◽

Lived Experience ◽

African American Culture ◽

Descriptive Phenomenology ◽

Management Interventions ◽

Older African Americans ◽

Family Based ◽

Biopsychosocial Model Of Pain

The lack of family research documenting the changes that occur and the capacity of families to support individuals with chronic pain effectively is a major limitation in the application of the biopsychosocial model of pain. This study investigated the lived experience of older African Americans ( N = 18) with chronic pain and explored their expectations and perceptions of familial support. A descriptive phenomenology framework revealed an existential theme: “puttin’ on,” a phenomenon that potentiates the power of pain to disrupt roles and relationships and discourages the family from meeting the expected needs of older African Americans. We uncovered new information into the actual support mechanisms that are missing or, when present, are not as positive and strong as would be expected in the African American culture, at least in the context of chronic pain management. Interventions should target family-based education, chronic pain destigmatization, and intergenerational empathy in the African American community.

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The Health and Well-Being of African-American Older Adults With a History of Incarceration

Innovation in Aging ◽

10.1093/geroni/igaa057.1633 ◽

2020 ◽

Vol 4 (Supplement_1) ◽

pp. 506-506

Author(s):

Rodlescia Sneed

Keyword(s):

Older Adults ◽

African American ◽

African Americans ◽

Well Being ◽

Formerly Incarcerated ◽

Older Prisoners ◽

Health Related ◽

History Of ◽

Health And Well Being ◽

African American Older Adults

Abstract African-Americans are overrepresented in the criminal justice system. Longer prison stays and release programs for older prisoners may result in an increased number of community-dwelling older adults with a history of incarceration. In recent years, there has been a substantial increase in research on health-related outcomes for currently incarcerated older adults; however, there has been little inquiry into outcomes for formerly incarcerated African-American older adults following community re-entry. In this study, we used secondary data from the Health and Retirement Study to describe employment, economic, and health-related outcomes in this population. Twelve percent of the 2238 African-Americans in our sample had been previously incarcerated. Those who had been previously incarcerated had higher rates of lung disease, arthritis, back problems, mobility problems, and mental health issues than their counterparts. They also had higher rates of hospitalization and lower use of dental health services. Further, while they did not experience lower employment rates than those with no criminal history, those who had been incarcerated had more physically demanding jobs and reported greater economic strain. Given the disproportionate incarceration rates among African-Americans, the aging of the prison population, and the increase in community re-entry for older prisoners, research that explores factors that impact the health and well-being of formerly incarcerated individuals has broad impact. Future work should focus on addressing the needs of this vulnerable population of African-American older adults.

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Contributors to and Consequences of Poor Sleep in Older Adults: Biopsychosocial Perspectives

Innovation in Aging ◽

10.1093/geroni/igaa057.1923 ◽

2020 ◽

Vol 4 (Supplement_1) ◽

pp. 578-578

Author(s):

Adam Spira ◽

Katie Stone

Keyword(s):

Older Adults ◽

Sleep Problems ◽

Later Life ◽

Poor Sleep ◽

Physical And Mental Health ◽

Older Parents ◽

Use Patterns ◽

Health Related ◽

Objectively Measured ◽

Ecological Momentary

Abstract Sleep is a significant contributor to health and wellbeing across the lifespan, especially in later life. Poor sleep is common among older adults and can be both a risk factor for and consequence of numerous physical and mental health-related outcomes. In this symposium, we will present novel results from four studies that will advance understanding of the biological, psychological, and social factors that may contribute to or result from poor sleep in older adults. Specifically, Study 1 will present findings tying objectively measured sleep to performance on cognitive tasks administered using ecological momentary assessment (EMA) in the day-to-day lives of older adults with or without mild cognitive impairment (MCI). Study 2 will examine associations of personality dimensions and facets with insomnia symptoms in well-functioning older adults. Study 3 will examine psychological pathways linking parent-child relationships to subjective and objective sleep characteristics among older parents. Finally, study 4 will examine use patterns of cannabis for the treatment of sleep problems in older adults, and the ways in which this might differ from patients using cannabis for other reasons (e.g., pain). Together, this symposium will highlight novel links of an array of factors with sleep health in the aging population and their implications for prevention. Sleep, Circadian Rhythms and Aging Interest Group Sponsored Symposium.

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The Sense of Smell and Aging: What We Have Learned From Population Studies

Innovation in Aging ◽

10.1093/geroni/igaa057.2947 ◽

2020 ◽

Vol 4 (Supplement_1) ◽

pp. 810-811

Author(s):

Jayant Pinto

Keyword(s):

Mental Health ◽

Older Adults ◽

Social Life ◽

Large Scale ◽

Population Studies ◽

Vital Role ◽

Sensory Function ◽

Physical And Mental Health ◽

Sense Of Smell ◽

Health Aging

Abstract Decline of the sense of smell with age causes a marked impact on older adults, markedly reducing quality of life. Olfactory dysfunction impairs nutrition, decreases the ability to experience pleasure, and results in depression, among other burdens. Large-scale population studies have identified impaired olfaction as a key heath indicator that predicts the development of decreased physical and mental health, reduced physical activity, weight loss, mild cognitive impairment and dementia, and mortality itself. These data have been generated via analyses of data from several aging cohorts, including the National Social Life, Health, and Aging Project (NSHAP); the Beaver Dam cohort; the Atherosclerosis Risk in Communities project; the Rush Memory and Aging Project; the Health, Aging, and Body Composition project; the Washington Heights/Inwood Columbia Aging Project; among others. In this presentation, we will review the close connection between olfaction, health, aging, including discussion of insights from these studies. We will also discuss emerging data from NSHAP on the effects of sensory function on cognition, mental health, and social interaction, which demonstrate that sensory function plays a vital role in the lives of older adults. Part of a symposium sponsored by Sensory Health Interest Group.

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Race-Specific Association of Caesarean-Section Delivery with Body Size at Age 2 Years

Ethnicity & Disease ◽

10.18865/ed.26.1.61 ◽

2016 ◽

Vol 26 (1) ◽

pp. 61 ◽

Cited By ~ 1

Author(s):

Andrea E Cassidy-Bushrow ◽

Ganesa Wegienka ◽

Suzanne Havstad ◽

Albert M. Levin ◽

Susan V. Lynch ◽

...

Keyword(s):

African American ◽

Caesarean Section ◽

African American Women ◽

Birth Cohort ◽

Racial Differences ◽

White Women ◽

Specific Effect ◽

Delivery Mode ◽

Font Size ◽

African American Mothers

Objectives: African American children are at higher risk of obesity than White children and African American women are more likely to undergo caesarean-section (CS) delivery than White women. CS is associated with childhood obesity, however, little is known whether this relationship varies by race.We examined if the association of CS with obesity at age 2 years varied by race. Design: Longitudinal birth cohort.Setting: Birth cohort conducted in a health care system in metropolitan Detroit, Michigan with follow-up at age 2 years.Participants: 639 birth cohort participants; 367 children (57.4%) were born to African American mothers and 230 (36.0%) children were born via CS.Main Outcome Measure: Obesity defined as body mass index ≥95th percentile at age 2 years.Results: Slightly more children of African American (n=37; 10.1%) than non-African American mothers (n=18; 6.6%) were obese (P=.12). There was evidence of effect modification between race and delivery mode with obesity at age 2 years (interaction P=.020). In children of African-American mothers, CS compared to vaginal birth was associated with a significantly higher odds of obesity (aOR=2.35 (95% CI: 1.16, 4.77), P=.017). In contrast, delivery mode was not associated with obesity at age 2 years in children of non-African-American mothers (aOR=.47 (95% CI: .13, 1.71), P=.25). Conclusions: There is evidence for a race-specific effect of CS on obesity at age 2 years; potential underlying mechanisms may be racial differences in the developing gut microbiome or in epigenetic programming. Future research is needed to determine if this racial difference persists into later childhood. Ethn Dis. 2016;26(1):61-68; doi:10.18865/ed.26.1.61

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Cardiovascular and Metabolic Risk in Women in the First Year Postpartum: Allostatic Load as a Function of Race, Ethnicity, and Poverty Status

American Journal of Perinatology ◽

10.1055/s-0038-1675618 ◽

2018 ◽

Vol 36 (10) ◽

pp. 1079-1089 ◽

Cited By ~ 6

Author(s):

Madeleine U. Shalowitz ◽

Christine Dunkel Schetter ◽

Marianne M. Hillemeier ◽

Vernon M. Chinchilli ◽

Emma K. Adam ◽

...

Keyword(s):

African American ◽

Child Health ◽

African American Women ◽

Low Income ◽

Allostatic Load ◽

White Women ◽

Disease Risk ◽

Community Sample ◽

Density Lipoprotein ◽

First Year

Objective Allostatic load (AL) represents multisystem physiological “wear-and-tear” reflecting emerging chronic disease risk. We assessed AL during the first year postpartum in a diverse community sample with known health disparities. Study Design The Eunice Kennedy Shriver National Institute for Child Health and Human Development Community Child Health Network enrolled 2,448 predominantly low-income African-American, Latina, and White women immediately after delivery of liveborn infants at ≥20 weeks' gestation, following them over time with interviews, clinical measures, and biomarkers. AL at 6 and 12 months postpartum was measured by body mass index, waist:hip ratio, blood pressure, pulse, hemoglobin A1c, high-sensitive C-reactive protein, total cholesterol and high-density lipoprotein, and diurnal cortisol slope. Results Adverse AL health-risk profiles were significantly more prevalent among African-American women compared with non-Hispanic Whites, with Latinas intermediate. Breastfeeding was protective, particularly for White women. Complications of pregnancy were associated with higher AL, and disparities persisted or worsened through the first year postpartum. Conclusion Adverse AL profiles occurred in a substantial proportion of postpartum women, and disparities did not improve from birth to 1 year. Breastfeeding was protective for the mother.

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