Behavioral epidemiology of healthy aging

健康老龄化的行为流行病学

• 批准号: 8931482
• 负责人: Alan B Zonderman
• 金额: $ 160.74万
• 依托单位: NATIONAL INSTITUTE ON AGING
• 依托单位国家: 美国
• 资助国家: 美国
• 起止时间: 至
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/8931482
• 关键词: Address; Adult; African American; Age; Age of Onset; Alcohol or Other Drugs use; Antihypertensive Agents; Baltimore; Behavior; Behavioral; Biological; Biological Markers; Blood Pressure; Body fat; C-reactive protein; Cardiovascular Diseases; Censuses; Cerebrovascular Disorders; Characteristics; Clinical; Clinical Trials; Cognitive; Communities; Comorbidity; Coronary Arteriosclerosis; Data; Dementia; Detection; Diabetes Mellitus; Diet; Discrimination; Disease; Dual-Energy X-Ray Absorptiometry; Education; Educational Background; Enrollment; Environment; Environmental Risk Factor; Epidemiology; Equation; Equilibrium; Etiology; Female; Food; Genetic; Genetic Markers; Goals; Health; Health Status; Hour; Hypertension; Income; Individual; Individual Differences; Inflammation; Inflammatory; Intake; Intervention; Latex Particles; Least-Squares Analysis; Life; Linear Models; Logistic Regressions; Longevity; Longitudinal Studies; Low income; Magnesium; Measures; Mental Depression; Mental Health; Methods; Micronutrients; Minerals; Modeling; Monoclonal Antibodies; Morbidity - disease rate; Neighborhoods; Occupations; Odds Ratio; Outcome; Oxidative Stress; Paper; Participant; Pathway interactions; Patient Self-Report; Patients; Performance; Personality; Play; Population Heterogeneity; Poverty; Prevention; Production; Property; Race; Recommended Dietary Allowance; Regulation; Reporting; Research; Research Personnel; Retirement; Risk; Risk Factors; Role; Sampling; Sex Discrimination; Sex Education; Sleep; Smoke; Smoking; Social Environment; Socioeconomic Status; Stress; Surveys; Testing; Time; Vitamin A; Vitamins; Woman; aged; base; cardiovascular disorder risk; cigarette smoking; contextual factors; depressive symptoms; experience; health disparity; healthy aging; improved; indexing; interest; low socioeconomic status; male; men; mortality; physical conditioning; psychologic; racial and ethnic; racial discrimination; sex; social; socioeconomics; tool; trait; vigilance

While evidence indicates that experienced racial discrimination is associated with increased depressive symptoms for African Americans, there is little research investigating predictors of experienced racial discrimination. This paper examines neighborhood racial composition and sociodemographic factors as antecedents to experienced racial discrimination and resultant levels of depressive symptoms among African American adults. The sample included 505 socioeconomically-diverse African American adults from Baltimore, MD. Study data were obtained via self-report and geocoding of participant addresses based on 2010 census data. Study hypotheses were tested using multiple pathways within a longitudinal structural equation model. Experienced racial discrimination was positively associated with age and sex such that older individuals and males experienced increased levels of racial discrimination. In addition, the percentage of White individuals residing in a neighborhood was positively associated with levels of experienced racial discrimination for African American neighborhood residents. Experienced racial discrimination was positively associated with later depressive symptoms. Neighborhood-level contextual factors such as neighborhood racial composition and individual differences in sociodemographic characteristics appear to play an important role in the experience of racial discrimination and the etiology of depression in African American adults. Compared to men, the decline in smoking over the past few decades has been slower for women and smoking-related morbidity and mortality has increased substantially. Identifying sex-specific risk factors will inform more targeted intervention or prevention efforts. The purpose of this research is to examine the interactive effect of psychological (trait antagonism) and social (perceived sex discrimination) factors on current cigarette smoking and whether these effects differ by sex. Participants in the Healthy Aging in Neighborhoods of Diversity across the Life Span study (HANDLS; N = 454) and participants in the Health and Retirement Study (HRS; N = 8,155) completed measures of antagonism, perceived sex discrimination, and reported whether they smoked currently. Logistic regressions were used to predict smoking from antagonism, discrimination, and their interaction. Antagonism was associated with an increased risk of smoking. For women, there was an interaction between antagonism and discrimination: among women who perceived sex discrimination, every standard deviation increase in antagonism was associated with a 2.5 increased risk of current smoking in HANDLS (odds ratio OR = 2.54, 95% CI = 1.46-4.39) and an almost 1.5 increased risk in HRS (OR = 1.43, 95% CI = 1.18-1.73). This interaction was not significant for men in either sample. In 2 independent samples, perceived sex discrimination amplified the effect of antagonism on cigarette smoking for women, but not men. A hostile disposition and a perceived hostile social environment have a synergistic effect on current cigarette smoking for women. Higher rates of cardiovascular disease (CVD) and its risk factors are well documented among those with objective indicators of lower socioeconomic status (SES), such as income, education, and occupation. However, relatively little is known about the relationship of subjective SES to CVD risk, particularly within different racial groups. Subjective SES and Framingham 10-year CVD risk profile were examined in 1,722 socioeconomically diverse Black and White adults enrolled in the Healthy Aging in Neighborhoods of Diversity across the Life Span (HANDLS) study. The sample had a mean age of 47.7 years, was 57% female, 56% African American, and 39% living in poverty. Subjective SES was associated with greater CVD risk after adjustment for poverty status, substance use, BMI, depression, antihypertensives, and co-morbidities (B = -.059, t1,1711 = -2.44, P = .015). However, when the analysis was race-stratified, subjective SES was associated with CVD risk in Whites (B = -.074, F1,787 = -2.01, P = .045), but not Blacks. These results suggest that subjective SES may aid in predicting CVD risk in Whites, but not Blacks. It is important to note that these analyses were adjusted for poverty status, a potent indicator of objective SES. Thus, these findings further suggest that for Whites, subjective SES may influence CVD risk beyond that associated with objective SES. These findings highlight the potential importance of patients' subjective SES in CVD risk detection. We explored whether there are differences in sleep duration between blacks and whites residing in similar urban neighborhoods and examine whether the relationship between sleep durations and sociodemographic and/or health indices are consistent for blacks and whites. A total of 1,207 participants from the Healthy Aging in Neighborhoods of Disparities across the Life Span study (age: mean = 47, standard deviation = 8.74). Sleep duration was assessed by a self-report of hours of nightly sleep in the past month. Sociodemographic measures included age, sex, education, poverty status, and perceived neighborhood disorder. Health status was assessed using measures of vigilance, depression, perceived stress, coronary artery disease, diabetes, blood pressure, and inflammation. There were no significant racial group differences in sleep duration. Whites, however, were more likely than blacks to report sleep durations of <6/6-7hr compared with >7hr with increasing stress and education levels. Blacks were more likely than whites to report short sleep durations (i.e., 6-7hr vs. >7hr of sleep) with increasing inflammation levels. Although racial disparities in sleep duration are minimized when the environment is equivalent between blacks and whites, the underlying demographic and health explanations for short sleep durations may vary between whites and blacks. C-reactive protein (CRP) is an inflammatory biomarker influenced by many factors, including socioeconomic position, genetics, and diet. The inverse association between diet and CRP is biologically feasible because micronutrients with anti-oxidative properties may enable the body to manage the balance between production and accumulation of reactive species that cause oxidative stress. We examined the quality of the diet (MAR; mean adequacy ratio) consumed by urban, low-income African-American and white adults aged 30 to 64 years in the Healthy Aging in Neighborhoods of Diversity across the Life Span (HANDLS) study and examined the association of diet quality with CRP. MAR equaled the average of the ratio of intakes to Recommended Dietary Allowance for 15 vitamins and minerals. CRP levels were assessed by the nephelometric method utilizing latex particles coated with CRP monoclonal antibodies. Linear ordinary least square regression and generalized linear models were performed to determine the association of MAR (independent variable) with CRP (dependent variable) while adjusting for potential confounders. MAR scores ranged from 74.3 to 82.2. Intakes of magnesium and vitamins A, C, and E were the most inadequate compared with Estimated Average Requirements. CRP levels were significantly associated with MAR, dual-energy X-ray absorptiometry-measured body fat, and hypertension. A 10% increase in MAR was associated with a 4% decrease in CRP. The MAR was independently and significantly inversely associated with CRP, suggesting diet is associated with the regulation of inflammation. Interventions to assist people make better food choices may not only improve diet quality but also their health, thereby possibly reducing risk for cardiovascular disease.

虽然有证据表明，经历过种族歧视与非洲裔美国人的抑郁症状增加有关，但很少有研究调查经历过种族歧视的预测因素。本文考察了社区种族构成和社会人口因素作为经历种族歧视的前因，并由此导致非裔美国成年人抑郁症状的水平。样本包括来自马里兰州巴尔的摩的505名社会经济状况各异的非裔美国成年人。研究数据通过自我报告和基于2010年人口普查数据的参与者地址地理编码获得。研究假设在纵向结构方程模型中使用多种途径进行检验。经历过的种族歧视与年龄和性别呈正相关，因此老年人和男性经历过的种族歧视程度更高。此外，居住在一个社区的白人百分比与非洲裔美国人社区居民经历种族歧视的程度呈正相关。经历过种族歧视与后来的抑郁症状呈正相关。社区层面的背景因素，如社区种族组成和社会人口特征的个体差异，似乎在非裔美国成年人的种族歧视经历和抑郁症病因学中起着重要作用。