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1.
Ann Behav Med ; 2024 Sep 04.
Artigo em Inglês | MEDLINE | ID: mdl-39231442

RESUMO

BACKGROUND: Physical activity is associated with both the hedonic (e.g., affect) and eudaimonic (e.g., purpose in life) aspects of well-being. While there is evidence linking momentary physical activity and affect in daily life, the examination of momentary purpose remains largely unexplored. PURPOSE: This study investigates the bidirectional associations between physical activity, positive and negative affect, and momentary purpose using Ecological Momentary Assessment (EMA) and accelerometer data. METHODS: Middle-aged participants (40-70 years old, n = 291) wore accelerometers and completed three daily EMA surveys on momentary experiences for 8 consecutive days. Physical activity (active time and counts) from 20- to 60-min periods before and after EMA surveys were used in the analyses. Multilevel models were adjusted for temporal and contextual factors, age, sex, education, work status, and race/ethnicity. RESULTS: When participants were more physically active than usual, they reported feeling more purpose-driven and positive affect. Similarly, when participants reported feeling more purpose-driven or experiencing positive affect, they engaged in more physical activity in the subsequent time period. These associations were similar for physical activity from 20- to 60-min periods before and after the EMA survey. Physical activity and negative affect were not related in either direction. CONCLUSIONS: In middle-aged adults' daily lives, physical activity has bidirectional relations with purpose and positive affect. This study highlights the dynamic associations between physical activity and the positive aspects of both hedonic and eudaimonic well-being. Future interventions or public health programs should integrate physical activity and mental well-being to maximize mutual benefits.


This study examined how physical activity relates to feelings of purpose and positive and negative affect in daily life among middle-aged adults (aged 40­70). Participants wore activity trackers and completed surveys on their smartphones about their feelings three times a day for 8 days. The study found that when participants were more physically active than usual, they experienced higher levels of purpose and more positive emotions. Conversely, feeling more purposeful or positive also led to more physical activity later on. The results suggest that physical activity and positive well-being are interconnected and reinforce each other in daily life.

2.
Ethn Health ; 29(7): 774-792, 2024 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-39003724

RESUMO

Despite the association of neighborhood quality with poorer adult health, limited research has explored the association between neighborhood disadvantage, e.g. Area Deprivation Index (ADI), and older Black adults' health, prospectively. This observational study examined the association between ADI and changes in longitudinal physical health within older Black adults. The analytic sample (n = 317) included data from waves 1 & 2 of the Baltimore Study of Black Aging: Patterns of Cognitive Aging (BSBA-PCA). Study variables included the Area Deprivation Index (ADI), objective (e.g. average heart rate) and subjective (e.g. activities of daily living) measures of physical health. Multiple linear regression models were conducted controlling for sociodemographic and social support characteristics. Participants living in more disadvantaged neighborhoods, based on national and state ADIs, were more likely to have a decreasing heart rate even after adjusting for covariates. Likewise, participants reporting increasing levels of ADL difficulty were living in a neighborhood with greater disadvantage based on national and state ADI rankings. Significant social support received and ADI (national and state) interactions were observed for average heart rate. The findings suggest that research on the effect of neighborhood quality and social support can enhance our understanding of its impact on older Black adults' health prospectively.


Assuntos
Negro ou Afro-Americano , Apoio Social , Humanos , Baltimore/epidemiologia , Masculino , Feminino , Negro ou Afro-Americano/psicologia , Negro ou Afro-Americano/estatística & dados numéricos , Idoso , Pessoa de Meia-Idade , Nível de Saúde , Atividades Cotidianas , Estudos Longitudinais , Características da Vizinhança , Características de Residência/estatística & dados numéricos , Frequência Cardíaca/fisiologia , Envelhecimento/psicologia , Envelhecimento/etnologia , Estudos Prospectivos , Fatores Socioeconômicos , Idoso de 80 Anos ou mais
3.
Aging Ment Health ; : 1-9, 2024 May 13.
Artigo em Inglês | MEDLINE | ID: mdl-38738650

RESUMO

OBJECTIVES: Perceived discrimination is associated with racial cognitive health disparities. Links between discrimination and cognitive performance, like working memory, in everyday settings (i.e. ambulatory performance) require investigation. Depressive symptoms may be a mechanism through which discrimination relates to ambulatory working memory. METHOD: Discrimination, retrospective and momentary depressive symptoms/mood, and aggregated and momentary working memory performance among older Black and White adults were examined within the Einstein Aging Study. RESULTS: Racially stratified analyses revealed that discrimination did not relate to Black or White adults' ambulatory working memory. Among Black adults, however, more frequent discrimination was associated with greater retrospectively reported depressive symptoms, which related to more working memory errors across two weeks (indirect effect p < 0.05). This path was not significant among White adults. Links between discrimination and momentary working memory were not explained by momentary reports of depressed mood for Black or White adults. CONCLUSION: Depressive symptoms may play an important role in the link between discrimination and ambulatory working memory among Black adults across extended measurements, but not at the momentary level. Future research should address ambulatory cognition and momentary reports of discrimination and depression to better understand how to minimize cognitive health disparities associated with discrimination.

4.
Policy Polit Nurs Pract ; 25(3): 152-161, 2024 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-39150355

RESUMO

Research to assess and inform health policy is an essential component of the policymaking process to advance equity in public health practice. This study investigated health disparities during the COVID-19 pandemic (2020-2022) in older adult institutional settings in Philadelphia, PA, to inform policy initiatives, interventions, and infrastructure development. We first explored the changing patterns of nursing staffing levels (total direct care staff and registered nurses [RNs]) measured by hours per resident per day (HPRD) before and after COVID-19. Our findings revealed that HPRD levels consistently fell below the Centers for Medicare and Medicaid Services recommended standards from 2018 to 2022, with notable declines observed starting from 2021. Results from multilevel modeling showed significant declines in HPRD for total direct care nursing staff in nursing homes located in zip codes with a high proportion of Black residents (≥40%). In contrast, HPRD for RNs significantly declined in nursing homes located in zip codes with a lower proportion of Black residents (<40%). Moreover, higher reported direct care HPRD and RN HPRD were associated with any reported COVID-19 cases only within zip codes with a low proportion of Black residents. These findings indicate the need for additional policies to address these observed patterns in staffing levels. Our study provides a foundation for future policy reviews utilizing a conceptual framework that is health equity-centric for local and state health departments program and units intended for institutional care settings for older adults.


Assuntos
COVID-19 , Casas de Saúde , Admissão e Escalonamento de Pessoal , Humanos , COVID-19/epidemiologia , Casas de Saúde/estatística & dados numéricos , Philadelphia/epidemiologia , Admissão e Escalonamento de Pessoal/estatística & dados numéricos , Idoso , Estados Unidos/epidemiologia , Feminino , Masculino , Pandemias , Recursos Humanos de Enfermagem/provisão & distribuição , Recursos Humanos de Enfermagem/estatística & dados numéricos , SARS-CoV-2 , Disparidades em Assistência à Saúde/estatística & dados numéricos , Idoso de 80 Anos ou mais
5.
Int J Behav Nutr Phys Act ; 20(1): 137, 2023 Nov 22.
Artigo em Inglês | MEDLINE | ID: mdl-37993862

RESUMO

BACKGROUND: The beneficial effect of acute physical exercise on cognitive performance has been studied in laboratory settings and in long-term longitudinal studies. Less is known about these associations in everyday environment and on a momentary timeframe. This study investigated momentary and daily associations between physical activity and cognitive functioning in the context of everyday life. METHODS: Middle-aged adults (n = 291, aged 40-70) were asked to wear accelerometers and complete ecological momentary assessments for eight consecutive days. Processing speed and visual memory were assessed three times per day and self-rated evaluations of daily cognition (memory, thinking, and sharpness of mind) were collected each night. The number of minutes spent above the active threshold (active time) and the maximum vector magnitude counts (the highest intensity obtained) before each cognitive test and at a daily level were used as predictors of momentary cognitive performance and nightly subjective cognition. Analyses were done with multilevel linear models. The models were adjusted for temporal and contextual factors, age, sex, education, and race/ethnicity. RESULTS: When participants had a more active time or higher intensity than their average level within the 20 or 60 minutes prior to the cognitive test, they performed better on the processing speed task. On days when participants had more active time than their average day, they rated their memory in the evening better. Physical activity was not associated with visual memory or self-rated thinking and sharpness of mind. CONCLUSIONS: This study provides novel evidence that outside of laboratory settings, even small increases in physical activity boost daily processing speed abilities and self-rated memory. The finding of temporary beneficial effects is consistent with long-term longitudinal research on the cognitive benefits of physical activity.


Assuntos
Cognição , Exercício Físico , Adulto , Pessoa de Meia-Idade , Humanos , Exercício Físico/psicologia , Velocidade de Processamento
6.
Alzheimers Dement ; 19(10): 4475-4487, 2023 10.
Artigo em Inglês | MEDLINE | ID: mdl-37547953

RESUMO

INTRODUCTION: Among older adults, total and hospitalized infection may be associated with incidence of all-cause and Alzheimer's disease (AD) dementias, with variation by cardiovascular health (CVH). METHODS: We used Cox proportional hazards (PH) models to examine the relationships between International Classification of Diseases-10th revision (ICD-10)-specific viral and bacterial infectious agents and incident all-cause and AD dementia among 355,046 UK Biobank participants ≥50 years at baseline. Life's Essential 8 (LE8) index reflected CVH. RESULTS: In both sexes, total infection burden (yes vs. no) was associated with all-cause dementia, with significant interactions by LE8 tertiles, whereby this relationship was significant only in the lowest LE8 tertile. Hospital-treated infection burden (yes vs no) was significantly related to all-cause and AD dementia, with no significant interaction with LE8 tertile. Age group patterns were detected. DISCUSSION: AD and all-cause dementia were related to hospital-treated infections, while CVH modified the relationship of total infection burden with all-cause dementia. Highlights Secondary analysis on >355,000 UK Biobank participants ≥50 years at baseline. Alzheimer's disease and all-cause dementia are both related to hospital-treated infection. Cardiovascular health modifies association of infection burden with all-cause dementia.


Assuntos
Doença de Alzheimer , Doenças Cardiovasculares , Feminino , Masculino , Humanos , Idoso , Doença de Alzheimer/epidemiologia , Bancos de Espécimes Biológicos , Reino Unido/epidemiologia , Fatores de Risco , Doenças Cardiovasculares/epidemiologia
7.
Int J Behav Med ; 27(4): 481-485, 2020 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-31755033

RESUMO

BACKGROUND: There is growing evidence that five-factor model personality traits are associated with self-reported sleep. We test whether these associations extend to objective sleep measures in older adulthood and whether measures of objective sleep mediate the relation between personality and subjective sleep. METHODS: A random subsample of participants in the National Social Life and Aging Project (NSHAP) wore an accelerometer for up to three nights and had information on FFM personality traits (N = 620). Participants also reported on their feelings of being rested. RESULTS: Higher neuroticism and lower extraversion and conscientiousness were associated with more frequent wake after sleep onset, greater fragmentation, and feeling less rested. Concurrent body mass index, disease burden, perceived stress, and depressive symptoms accounted for these associations. Personality was unrelated to total time spent asleep but conscientiousness was associated with earlier and more consistent bedtimes. None of the objective sleep metrics mediated the relation between personality and subjective sleep. CONCLUSIONS: The present research indicates that the associations typically found for personality and subjective sleep extend to objective sleep fragmentation. These objective measures, however, do not account for the relation between personality and feeling rested.


Assuntos
Inventário de Personalidade , Personalidade/fisiologia , Sono/fisiologia , Idoso , Envelhecimento , Índice de Massa Corporal , Extroversão Psicológica , Feminino , Humanos , Masculino , Neuroticismo , Autorrelato
8.
Int Psychogeriatr ; 30(3): 311-322, 2018 03.
Artigo em Inglês | MEDLINE | ID: mdl-28689501

RESUMO

ABSTRACTBackground:To expand on prior literature by examining how various education parameters (performance-based reading literacy, years of education, and self-rated quality of education) relate to a cognitive screening measure's total and subscale scores of specific cognitive abilities. METHODS: Black adults (age range: 55-86) were administered self-rated items years of education and quality of education, and a measure of performance-based reading literacy. The Mini-Mental State Examination (MMSE) was used to screen for overall cognitive functioning as well as performance on specific cognitive abilities. RESULTS: Sixty-nine percent of the sample had reading grade levels that were less than their reported years of education. Lower years of education and worse reading literacy are associated with poorer MMSE performance, particularly on the attention and calculation subscales. CONCLUSIONS: Years of education, a commonly used measure for education, may not be reflective of Black adults' educational experiences/qualities. Thus, it is important to account for the unique educational experiences of adults that could influence their MMSE performance. Incorporating quality and quantity of education will provide a more comprehensive understanding of the individual's performance on cognitive measures, specifically as it relates to sociocultural differences.


Assuntos
Idoso/estatística & dados numéricos , Negro ou Afro-Americano/estatística & dados numéricos , Cognição/fisiologia , Escolaridade , Avaliação Geriátrica/métodos , Entrevista Psiquiátrica Padronizada/normas , Leitura , Negro ou Afro-Americano/psicologia , Idoso de 80 Anos ou mais , Feminino , Florida , Humanos , Masculino , Programas de Rastreamento , Pessoa de Meia-Idade , Valor Preditivo dos Testes
9.
J Natl Med Assoc ; 108(4): 195-200, 2016.
Artigo em Inglês | MEDLINE | ID: mdl-27979004

RESUMO

INTRODUCTION: Compared with other racial/ethnic groups, African Americans have higher rates of chronic conditions and suffer a disproportionate burden of disability. We aimed to examine the effects of social support on physical functioning among older African Americans. METHODS: We analyzed a sample of 448 urban, community-dwelling, older African Americans (aged 48-98 years) from the Baltimore Study of Black Aging. Baseline physical functioning was collected between 2006 and 2008 (wave 1), and change in physical functioning was collected between 2009 and 2011 (wave 2), physical functioning was assessed by self-reported limitations in 7 activities of daily living-eating, dressing, grooming, walking, bathing, using the toilet, and transferring in and out of bed-using a binary variable to indicate whether the individual had difficulty performing each specific activity. Social support was measured by how frequently participants provided/received goods and services, financial assistance, transportation, companionship, advice, or encouragement (never [0], rarely [1], sometimes [2], frequently [3]). Negative binomial regression models were used to test the effects of social support given, received, and a ratio (support received/support given) on physical functioning for those who improved and those who declined in physical functioning. RESULTS: Participants reported physical functioning at wave 1 (1.24, standard deviation [SD] = 1.98) and at wave 2 (0.34, SD = 0.83). Average social support given was 7.49 (SD = 3.26), and average social support received was 7.81 (SD = 3.17). Those who improved in physical function gave less social support and had lower social support ratios; social support received had no effect. Those who remained stable or declined in physical function gave more social support; neither social support received nor social ratio had an effect. CONCLUSION: Social support given and social support received as well as the ratio should be considered when seeking to understand how physical functioning changes over time among older African Americans.


Assuntos
Atividades Cotidianas , Envelhecimento , Negro ou Afro-Americano/psicologia , Apoio Social , Negro ou Afro-Americano/estatística & dados numéricos , Idoso , Idoso de 80 Anos ou mais , Envelhecimento/fisiologia , Envelhecimento/psicologia , Baltimore , Pessoas com Deficiência , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Estados Unidos
10.
J Nutr ; 144(6): 890-901, 2014 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-24744319

RESUMO

Among modifiable lifestyle factors, diet may affect cognitive health. Cross-sectional and longitudinal associations may exist between dietary exposures [e.g., caffeine (mg/d), alcohol (g/d), and nutrient adequacy] and cognitive performance and change over time. This was a prospective cohort study, the Baltimore Longitudinal Study of Aging (n = 628-1305 persons depending on the cognitive outcome; ∼2 visits/person). Outcomes included 10 cognitive scores, spanning various domains of cognition. Caffeine and alcohol intakes and a nutrient adequacy score (NAS) were estimated from 7-d food diaries. Among key findings, caffeine intake was associated with better baseline global cognition among participants with a baseline age (Agebase) of ≥70 y. A higher NAS was associated with better baseline global cognition performance (overall, women, Agebase <70 y), better baseline verbal memory (immediate and delayed recall, Agebase ≥70 y), and slower rate of decline or faster improvement in the attention domain (women). For an Agebase of <70 y, alcohol consumption was associated with slower improvement on letter fluency and global cognition over time. Conversely, for an Agebase of ≥70 y and among women, alcohol intake was related to better baseline attention and working memory. In sum, patterns of diet and cognition associations indicate stratum-specific associations by sex and baseline age. The general observed trend was that of putative beneficial effects of caffeine intake and nutrient adequacy on domains of global cognition, verbal memory, and attention, and mixed effects of alcohol on domains of letter fluency, attention, and working memory. Further longitudinal studies conducted on larger samples of adults are needed to determine whether dietary factors individually or in combination are modifiers of cognitive trajectories among adults.


Assuntos
Consumo de Bebidas Alcoólicas/efeitos adversos , Cafeína/administração & dosagem , Cognição/efeitos dos fármacos , Comportamento Alimentar , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Atenção/efeitos dos fármacos , Estudos Transversais , Dieta , Registros de Dieta , Feminino , Qualidade dos Alimentos , Humanos , Estilo de Vida , Modelos Lineares , Estudos Longitudinais , Masculino , Memória/efeitos dos fármacos , Rememoração Mental/efeitos dos fármacos , Pessoa de Meia-Idade , Dinâmica não Linear , Avaliação Nutricional , Estudos Prospectivos , Adulto Jovem
11.
BMC Public Health ; 14: 643, 2014 Jun 24.
Artigo em Inglês | MEDLINE | ID: mdl-24962204

RESUMO

BACKGROUND: Cognitive impairment, including dementia, is a major health concern with the increasing aging population. Preventive measures to delay cognitive decline are of utmost importance. Alzheimer's disease (AD) is the most frequent cause of dementia, increasing in prevalence from <1% below the age of 60 years to >40% above 85 years of age. METHODS: We systematically reviewed selected modifiable factors such as education, smoking, alcohol, physical activity, caffeine, antioxidants, homocysteine (Hcy), n-3 fatty acids that were studied in relation to various cognitive health outcomes, including incident AD. We searched MEDLINE for published literature (January 1990 through October 2012), including cross-sectional and cohort studies (sample sizes > 300). Analyses compared study finding consistency across factors, study designs and study-level characteristics. Selecting studies of incident AD, our meta-analysis estimated pooled risk ratios (RR), population attributable risk percent (PAR%) and assessed publication bias. RESULTS: In total, 247 studies were retrieved for systematic review. Consistency analysis for each risk factor suggested positive findings ranging from ~38.9% for caffeine to ~89% for physical activity. Education also had a significantly higher propensity for "a positive finding" compared to caffeine, smoking and antioxidant-related studies. Meta-analysis of 31 studies with incident AD yielded pooled RR for low education (RR = 1.99; 95% CI: 1.30-3.04), high Hcy (RR = 1.93; 95% CI: 1.50-2.49), and current/ever smoking status (RR = 1.37; 95% CI: 1.23-1.52) while indicating protective effects of higher physical activity and n-3 fatty acids. Estimated PAR% were particularly high for physical activity (PAR% = 31.9; 95% CI: 22.7-41.2) and smoking (PAR% = 31.09%; 95% CI: 17.9-44.3). Overall, no significant publication bias was found. CONCLUSIONS: Higher Hcy levels, lower educational attainment, and decreased physical activity were particularly strong predictors of incident AD. Further studies are needed to support other potential modifiable protective factors, such as caffeine.


Assuntos
Doença de Alzheimer/prevenção & controle , Transtornos Cognitivos/prevenção & controle , Cognição , Dieta , Escolaridade , Exercício Físico , Homocisteína/metabolismo , Consumo de Bebidas Alcoólicas , Doença de Alzheimer/sangue , Doença de Alzheimer/etiologia , Antioxidantes/uso terapêutico , Cafeína/farmacologia , Transtornos Cognitivos/sangue , Transtornos Cognitivos/etiologia , Demência/etiologia , Ácidos Graxos Ômega-3/sangue , Ácidos Graxos Ômega-3/uso terapêutico , Feminino , Humanos , Masculino , Fumar
12.
Artigo em Inglês | MEDLINE | ID: mdl-38771450

RESUMO

INTRODUCTION: While research has shown a positive association between a higher sense of purpose in life and functional health, there is a gap in understanding its benefits for racially minoritized and low SES individuals. This study aimed to investigate the correlation between purpose in life and physical functional health in a diverse sample, hypothesizing that purpose in life would be negatively associated with functional difficulties, with potentially stronger associations in White and high SES groups. METHODS: Data from the Healthy Aging in Neighborhoods of Diversity across the Life Span (HANDLS) study were utilized (166 participants, mean age 59.44 [SD = 8.28], 59.6% females, 65.06% Black participants, 40.36% below poverty). Purpose in life was measured by Ryff's Psychological Well-being Purpose in Life subscale. Functional health was measured by functional difficulties in mobility and daily living. Race (Black and White) and poverty status (above and below) were used as moderators to probe the purpose-functional health association using zero-inflated Poisson regression while adjusting for age, education, depressive symptomology, and previous functional difficulties in four hierarchical models. RESULTS: Results showed that purpose in life was negatively associated with functional difficulty, indicating fewer difficulties in mobility and daily activities among those with a high sense of purpose. While the association did not remain significant after including previous functional difficulty as a covariate in Model 4, suggesting that race may not be a consistent moderator, poverty status remained a consistent moderator. The association was stronger for individuals above the poverty level. DISCUSSION: These findings underscore the complex interplay between purpose in life, race, poverty status, and functional health, emphasizing the importance of considering socioeconomic factors in interventions aimed at eliminating functional health disparities among diverse adult populations.

13.
J Res Pers ; 1092024 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-38312326

RESUMO

This study examines the association between personality and cognitive errors in the Healthy Aging in Neighborhoods of Diversity across the Life Span study, a sample diverse across race (Black, White) and SES (above, below 125% of the federal poverty line). Participants (N=1,062) completed a comprehensive personality questionnaire and were administered a brief mental status screener of cognitive errors. Higher neuroticism was associated with more cognitive errors, whereas higher openness and conscientiousness were associated with fewer errors. These associations were independent of age, sex, race, poverty status, and education and were generally not moderated by these factors. These findings support the associations between personality and cognition across race and SES.

14.
Innov Aging ; 8(3): igae018, 2024.
Artigo em Inglês | MEDLINE | ID: mdl-38511204

RESUMO

Background and Objectives: Purpose in life is associated with healthier cognitive outcomes in older adulthood. This research examines within-person dynamics between momentary purpose and cognitive function to provide proof of concept that increases in purpose are associated with better cognitive performance. Research Design and Methods: Participants (N = 303; 54% female; Mage = 51.71, SD = 7.32) completed smartphone-based momentary assessments of purpose and short cognitive tasks 3 times a day for 8 days. Results: In moments when participants felt more purpose driven than their average, they had faster processing speed (b = -1.240, SE = 0.194; p < .001), independent of person, temporal, and contextual factors and practice effects. Momentary purpose was unrelated to visual working memory performance (b = -0.001, SE = 0.001; p = .475). In contrast to purpose, momentary hedonic affect (e.g., happiness) was unrelated to momentary cognition. Discussion and Implications: Feeling more momentary purpose may support faster processing speed in daily life. Such evidence provides stage 0 support for a purpose-based intervention for healthier cognition, which may be particularly useful in middle adulthood and the transition to older adulthood before the onset of cognitive impairment.

15.
Artigo em Inglês | MEDLINE | ID: mdl-38656243

RESUMO

It is not well understood how neighborhood disadvantage is associated with specific domains of cognitive function and underlying brain health within older adults. Thus, the objective was to examine associations between neighborhood disadvantage, brain health, and cognitive performance, and examine whether associations were more pronounced among women. The study included 136 older adults who underwent cognitive testing and MRI. Neighborhood disadvantage was characterized using the Area Deprivation Index (ADI). Descriptive statistics, bivariate correlations, and multiple regressions were run. Multiple regressions, adjusted for age, sex, education, and depression, showed that higher ADI state rankings (greater disadvantage) were associated with poorer working memory performance (p < .01) and lower hippocampal volumes (p < .01), but not total, frontal, and white matter lesion volumes, nor visual and verbal memory performance. There were no significant sex interactions. Findings suggest that greater neighborhood disadvantage may play a role in working memory and underlying brain structure.

16.
Aging (Albany NY) ; 16(17): 12138-12167, 2024 Sep 04.
Artigo em Inglês | MEDLINE | ID: mdl-39237306

RESUMO

BACKGROUND: Evidence points to associations between sleep quality, dementia, and mortality. We examined whether poor sleep quality mediated or moderated the association between dementia and mortality risk among older US adults and vice versa, and whether these associations differed by sex and by race. METHODS: The study investigated bi-directional associations between sleep quality, dementia and mortality in older US adults using data from the Health and Retirement Study (N = 6,991, mean age = 78.1y, follow-up: 2006-2020, number of deaths = 4,938). It tested interactions and mediating effects, using Cox proportional hazards models and four-way decomposition models. RESULTS: Poor sleep quality was associated with increased mortality risk, particularly among male and White older adults. However, the association was reversed in the fully adjusted model, with a 7% decrease in risk per tertile. Probable dementia was associated with a two-fold increase in mortality risk, with a stronger association found among White adults. The association was markedly attenuated in the fully adjusted models. Sleep quality-stratified models showed a stronger positive association between dementia and mortality among individuals with better sleep quality. Both mediation and interaction were involved in explaining the total effects under study, though statistically significant total effects were mainly composed of controlled direct effects. CONCLUSIONS: Poor sleep quality is directly related to mortality risk before lifestyle and health-related factors are adjusted. Dementia is linked to mortality risk, especially in individuals with better sleep quality, males, and White older adults. Future research should explore the underlying mechanisms.


Assuntos
Demência , Qualidade do Sono , Humanos , Masculino , Feminino , Idoso , Demência/mortalidade , Demência/epidemiologia , Estados Unidos/epidemiologia , Idoso de 80 Anos ou mais , Fatores de Risco , Modelos de Riscos Proporcionais , Mortalidade
17.
J Psychopathol Clin Sci ; 132(5): 531-541, 2023 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-37104791

RESUMO

Existing disparities regarding Black Americans' psychological health warrant further investigation of socioecological factors that may be associated with negative and positive dimensions of psychological health in this population. Romantic relationship functioning and neighborhood context are two domains relevant to Black Americans' mental health. However, less is known about how they may serve as independent and interactive prospective predictors of Black Americans' psychological health and potentially in distinctive ways for Black men and women. Using data from 333 partnered Black Americans who participated in the Midlife in the United States study, we investigated relationship adjustment and neighborhood quality as independent and interactive predictors of negative and positive affect 10 years later and examined gender differences in these linkages. Higher neighborhood quality predicted lower levels of negative affect and higher levels of positive affect for both men and women a decade later. Additionally, for Black men, the longitudinal association between relationship adjustment and negative affect differed by neighborhood quality such that better relationship adjustment predicted higher subsequent negative affect only for men in lower quality neighborhoods. Findings demonstrate the connections among romantic relationship functioning, ecological resources, and gender in this population and highlight the importance of incorporating socioecological and intersectional perspectives for predicting Black Americans' long-term psychological health. (PsycInfo Database Record (c) 2023 APA, all rights reserved).


Assuntos
Negro ou Afro-Americano , Disparidades nos Níveis de Saúde , Relações Interpessoais , Amor , Saúde Mental , Características da Vizinhança , Feminino , Humanos , Masculino , Negro ou Afro-Americano/psicologia , Saúde Mental/etnologia , Fatores Sexuais , Estados Unidos/epidemiologia
18.
J Gerontol B Psychol Sci Soc Sci ; 78(4): 596-608, 2023 04 01.
Artigo em Inglês | MEDLINE | ID: mdl-36420651

RESUMO

OBJECTIVES: Heterogeneity among Black adults' experiences of discrimination and education quality independently influence cognitive function and sleep, and may also influence the extent to which sleep is related to cognitive function. We investigated the effect of discrimination on the relationship between objective sleep characteristics and cognitive function in older Black adults with varying education quality. METHOD: Cross-sectional analyses include Black participants in the Einstein Aging Study (N = 104, mean age = 77.2 years, 21% males). Sleep measures were calculated from wrist actigraphy (15.4 ± 1.3 days). Mean ambulatory cognitive function (i.e., spatial working memory, processing speed/visual attention, and short-term memory binding) was assessed with validated smartphone-based cognitive tests (6 daily). A modified Williams Everyday Discrimination Scale measured discriminatory experiences. Linear regression, stratified by reading literacy (an indicator of education quality), was conducted to investigate whether discrimination moderated associations between sleep and ambulatory cognitive function for individuals with varying reading literacy levels. Models controlled for age, income, sleep-disordered breathing, and sex assigned at birth. RESULTS: Higher reading literacy was associated with better cognitive performance. For participants with both lower reading literacy and more discriminatory experiences, longer mean sleep time was associated with slower processing speed, and lower sleep quality was associated with worse working memory. Later sleep midpoint and longer nighttime sleep were associated with worse spatial working memory for participants with low reading literacy, independent of their discriminatory experiences. DISCUSSION: Sociocultural factors (i.e., discrimination and education quality) can further explain the association between sleep and cognitive functioning and cognitive impairment risk among older Black adults.


Assuntos
Disfunção Cognitiva , Sono , Masculino , Humanos , Idoso , Feminino , Estudos Transversais , Envelhecimento/psicologia , Cognição
19.
Front Sleep ; 22023.
Artigo em Inglês | MEDLINE | ID: mdl-37427086

RESUMO

Objectives: To evaluate the association between resilience, sleep quality, and health. Methods: This cross-sectional study included 190 patients (Mean age = 51, SD = 15.57) recruited from the Johns Hopkins Center for Sleep and Wellness. Patients completed a modified version of the brief resilience scale (BRS) to assess characteristics of resilience and questions to assess aspects of mental health, physical health, sleep quality, and daytime functioning. Results: Participants' average score on the BRS was 4.67 (SD = 1.32, range = 1.17-7), reflecting a high level of resilience. There was a significant gender difference in resilience levels for men (Mean = 5.04, SD = 1.14) and women (Mean = 4.30, SD = 1.38), such that men reported significantly higher levels of resilience compared to women (t (188) = 4.02, p < 0.001) [lower levels of resilience were significantly associated with higher levels of (current) fatigue and tiredness after adjusting for demographic, physical, and mental covariates. In those reporting between one and three mental health symptoms, high levels of resilience minimized the negative influence that these symptoms had on sleep quality. This minimizing effect was no longer evident in those experiencing >3 mental health symptoms, who also reported significantly higher symptoms of fatigue despite their high resilience scores. Conclusions: This study emphasizes how resilience may affect the relationship between mental health and sleep quality in sleep patients. Resilience may further our understanding of the inter-relationships between sleep and the manifestation of physical health symptoms, a relationship that will likely heighten in relevance during personal and global crisis. An awareness of this interaction could be used as a proactive prevention and treatment strategy. In other words, incorporating methods to evaluate resilience in patients with mental illnesses regularly can be useful for predicting the potential manifestation and severity of sleep disturbance. Therefore, strategies that focus on promoting resilience could improve health and wellness.

20.
J Gerontol B Psychol Sci Soc Sci ; 78(2): 253-263, 2023 02 19.
Artigo em Inglês | MEDLINE | ID: mdl-36161476

RESUMO

OBJECTIVES: This study explored the association between place-based characteristics (e.g., neighborhood socioeconomic deprivation) and physical health within older Black adults, a critical gap in the literature as identified by the National Institute on Minority Health and Health Disparities. METHODS: The sample was from Wave 1 data of Baltimore Study of Black Aging: Patterns of Cognitive Aging (N = 450; Mage = 68.34). Variables included the area deprivation index (ADI), objective (e.g., average blood pressure) and subjective (e.g., self-rated health) measures of physical health. Multiple linear regression models were conducted controlling for key sociodemographic characteristics. RESULTS: Participants reporting better self-rated health and less likely to need help with activities of daily living were significantly more likely to be living in more disadvantaged neighborhoods based on national and state ADI, respectively, even after adjusting for covariates. A significant age and ADI interaction revealed better self-rated health was associated with a more disadvantaged neighborhood particularly for individuals ≤66 years. There was no significant association between ADI and objective physical health measures. DISCUSSION: The findings suggest that national- and state-level place-based characteristics should be considered along with individual-level factors, which can enrich the scientific understanding of how neighborhood characteristics relate to varying health indicators among older Black adults.


Assuntos
Atividades Cotidianas , Características de Residência , Humanos , Envelhecimento , Baltimore , Fatores Socioeconômicos
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