Immigration-Related Trauma Associated With Metabolic Risk and Cognition in Hispanic and Latino Immigrant Populations

Recent immigrant and undocumented Hispanic/Latino adults in the United States (U.S.) are an underserved segment of the aging population. In this cross-sectional pilot study, we examined associations between self-reported stressors metabolic syndrome, emotional reactivity, and cognitive functioning in a heterogenous sample (N=80) of Hispanic/Latino adults (43.8% Central America; 43.8% South America; 7.5% Caribbean; mean years in the U.S.=18.1, SD=12.8). Participants (Meducation=10.2 years, SD=5.34; Mage=48.6 years, SD=12.3) underwent blood draw, anthropometrics and NIH-toolbox cognitive and behavioral measures. Linear regressions indicated that, elevated glucose was inversely associated with working memory (r=-.30), whereas higher HDL and controlled glucose were associated with better episodic memory (r=.27) and executive functioning (r=.32). Results further revealed associations between immigration-related trauma and elevated posttraumatic stress symptomatology. Implications for mental health and early detection of modifiable risk factors to promote healthy aging in vulnerable Hispanic/Latino immigrant populations are discussed.

Engaging Isolated Hispanic and Latino Older Adult Caregivers in Remote Behavioral Interventions

Recruiting Hispanic/Latino older adults for behavioral clinical trials is challenging, particularly those who are isolated. This presentation describes the recruitment process and feasibility/acceptability outcomes for the adaptation of two interventions (Connect for Caregivers and Engage Coaching) aimed at improving the social relationships and supports of older adult Hispanic/Latino caregivers of a family member with dementia. We compare online and community-based recruitment methods for English and Spanish-speaking Hispanic/Latino caregivers across the United States and present recruitment challenges during COVID-19. Of eligible participants, 82% were identified via online (e.g., research registry) and 18% via community-based (including snowball sampling) methods. Of participants recruited via online methods, 22% were Spanish-speaking, versus 100% of those recruited by community-based methods. Overall, 91% of all eligible/interested participants enrolled in at least one of the interventions. We discuss further the feasibility/acceptability of study procedures and the interventions, as the study was conducted remotely (via phone/Zoom) due to COVID-19.

Facilitators, Challenges, and Messaging Strategies for Hispanic/Latino Populations Participating in Alzheimer’s Disease and Related Dementias Clinical Research: A Literature Review

Alzheimer’s disease and Alzheimer’s disease-related dementias (AD/ADRD) disproportionally affect Hispanic and Latino populations, yet Hispanics/Latinos are substantially underrepresented in AD/ADRD clinical research. Diverse inclusion in trials is an ethical and scientific imperative, as underrepresentation reduces the ability to generalize study findings and treatments across populations most affected by a disease. This paper presents findings from a narrative literature review (N = 210) of the current landscape of Hispanic/Latino participation in clinical research, including the challenges, facilitators, and communication channels to conduct culturally appropriate outreach efforts to increase awareness and participation of Hispanics/Latinos in AD/ADRD clinical research studies. Many challenges identified were systemic in nature: lack of culturally relevant resources; staffing that do not represent participants’ cultures/language; eligibility criteria that disproportionately excludes Hispanics/Latinos; and too few studies available in Hispanic/Latino communities. The paper also details facilitators and messaging strategies to improve engagement and interest among Hispanics/Latinos in AD/ADRD research, starting with approaches that recognize and address the heterogeneity of the Hispanic/Latino ethnicity, and then, tailor outreach activities and programs to address their diverse needs and circumstances. The needs identified in this article represent longstanding failures to improve engagement and interest among Hispanics/Latinos in AD/ADRD research; we discuss how the field can move forward learning from the experiences of the COVID-19 pandemic.

Who Identifies as “Latinx”? The Generational Politics of Ethnoracial Labels

Over the past 5 years, the “Latinx” label has become increasingly popular within academia, politics, and social media. Yet, little is known about who has adopted the term at this relatively early stage and how it might be interpreted. Drawing on a unique data set of US-born Californians, as well as Latina/o/x Studies insight, this paper provides the first academic survey results on “Latinx” identification. We find that close to 25 percent of respondents identify with the term regularly, and that its early adoption varies across groups. Specifically, political ideology, especially progressive politics, is strongly correlated with use of the label. We also find that both immigrant generation and birth cohort matter considerably, with second generation immigrants and people born in Generation Z (since 1995) most likely to identify with the term. Finally, our findings show that “Latinx” is largely understood as complementary to, not mutually exclusive of, other panethnic labels like “Hispanic” and “Latino.” Taken together, our results suggest that generational politics matter for understanding early label diffusion and that Latinos adopt a variety of panethnic labels that they likely use in different contexts. We discuss these findings in terms of our broader understanding of Latinidad, racialization, and the symbolic power of ethnoracial labels.

Racial Disparities in Intravenous Bisphosphonate Use Among Older Patients With Multiple Myeloma Enrolled in Medicare

PURPOSE: Intravenous (IV) bisphosphonates reduce the risk of skeletal-related events in patients with multiple myeloma (MM). However, data describing racial differences in IV bisphosphonate utilization outside of clinical trial settings are limited. We evaluated population-level IV bisphosphonate initiation and discontinuation among patients of age ≥ 65 years with MM. METHODS: We conducted a retrospective cohort study of patients of age ≥ 65 years diagnosed with first primary MM between 2001 and 2011. Patients were identified using the SEER-Medicare linked database and followed through December 2013. Cumulative incidences of IV bisphosphonate initiation and time to discontinuation among users were compared between racial and ethnic groups. In Fine and Gray competing risk models, we estimated subdistribution hazard ratios (SHRs) and 95% CIs for initiation and discontinuation. RESULTS: We included 14,231 eligible patients with MM (median age, 76 years; 52% male). Over a median follow-up of 23.1 months, 54% of patients received at least one IV bisphosphonate dose. Our final analytical sample included 10,456 non-Hispanic (NH) Whites, 2,267 NH Blacks, 548 Asian and Pacific islanders, and 815 Hispanic and Latino patients. A higher proportion of White patients (56.1%) newly received IV bisphosphonates after MM diagnosis compared with NH Blacks (45.4%). Compared with White patients, NH Black patients were less likely to initiate IV bisphosphonates (SHR, 0.74; 95% CI, 0.70 to 0.79) and slightly more likely to discontinue treatment (SHR, 1.10; 95% CI, 1.01 to 1.19). CONCLUSION: Approximately half of the patients with MM of age ≥ 65 years did not receive IV bisphosphonates, with significant delay among racial minority groups. These findings highlight the need for improvement of IV bisphosphonate uptake in patients with MM of age ≥ 65 years.