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1.
J Women Aging ; : 1-17, 2024 Jun 05.
Artigo em Inglês | MEDLINE | ID: mdl-38837898

RESUMO

Most research on sex workers globally has focused on cis women sex workers vulnerabilities including violence, risk for HIV/AIDS, and stigma. Despite the plethora of studies on the topic, older sex workers are significantly underrepresented in research. We used a phenomenological approach to highlight street and home-based sex workers' experiences. Using a purposive sampling strategy, 39 cis women sex workers were recruited from Karnataka, India and data were collected using in-depth interviews and focus group discussions. Findings revealed a range of changes in sex workers' lives as they aged, financial instability, lack of alternate livelihood options, and limited access to governmental benefits and social security. Participant narratives challenged the notion of anticipated traditional familial support especially from their grown children. Findings were replete with instances of sex workers' personal agency to confront personal and professional challenges. Peer networks formed the biggest forms of support as were sex workers' connections with local community-based groups. There is an urgent need for helping professionals to recognize the ongoing marginalization faced by older sex workers. It is critical to address concerns broadly along with inequities in terms of access and power as experienced by older sex workers. Finally, examining the differential impact of ageism, structural barriers including neglect by the State, violence, and stigma that follow sex workers is vital.

3.
Artigo em Inglês | MEDLINE | ID: mdl-38791769

RESUMO

Historically marginalized populations are susceptible to social isolation resulting from their unique social dynamics; thus, they incur a higher risk of developing chronic diseases across the course of life. Research has suggested that the cumulative effect of aging trajectories per se, across the lifespan, determines later-in-life disease risks. Emerging evidence has shown the biopsychosocial effects of social stress and social support on one's wellbeing in terms of inflammation. Built upon previous multidisciplinary findings, here, we provide an overarching model that explains how the social dynamics of marginalized populations shape their rate of biological aging through the inflammatory process. Under the framework of social stress and social support theories, this model aims to facilitate our understanding of the biopsychosocial impacts of social dynamics on the wellbeing of historically marginalized individuals, with a special emphasis on biological aging. We leverage this model to advance our mechanistic understanding of the health disparity observed in historically marginalized populations and inform future remediation strategies.


Assuntos
Envelhecimento , Marginalização Social , Humanos , Envelhecimento/psicologia , Marginalização Social/psicologia , Modelos Biopsicossociais , Disparidades nos Níveis de Saúde , Apoio Social , Estresse Psicológico/psicologia , Isolamento Social/psicologia , Dinâmica de Grupo
4.
Artigo em Inglês | MEDLINE | ID: mdl-38785331

RESUMO

OBJECTIVES: To better understand variations in multimorbidity severity over time, we estimate disability-free and disabling multimorbid life expectancy (MMLE), comparing Costa Rica, Mexico, and the United States. We also assess MMLE inequalities by sex and education. METHODS: Data come from the Costa Rican Study on Longevity and Healthy Aging (2005-2009), the Mexican Health and Aging Study (2012-2018), and the Health and Retirement Study (2004-2018). We apply an incidence-based multistate Markov approach to estimate disability-free and disabling MMLE and stratify models by sex and education to study within-country heterogeneity. Multimorbidity is defined as a count of two or more chronic diseases. Disability is defined using limitations in activities of daily living. RESULTS: Costa Ricans have the lowest MMLE, followed by Mexicans, then individuals from the US. Individuals from the US spend about twice as long with disability-free multimorbidity compared with individuals from Costa Rica or Mexico. Females generally have longer MMLE than males, with particularly stark differences in disabling MMLE. In the US, higher education was associated with longer disability-free MMLE and shorter disabling MMLE. We identified evidence for cumulative disadvantage in Mexico and the US, where sex differences in MMLE were larger among the lower educated. DISCUSSION: Substantial sex and educational inequalities in MMLE exist within and between these countries. Estimating disability-free and disabling MMLE reveals another layer of health inequality not captured when examining disability and multimorbidity separately. MMLE is a flexible population health measure that can be used to better understand the aging process across contexts.

5.
Front Bioeng Biotechnol ; 12: 1356417, 2024.
Artigo em Inglês | MEDLINE | ID: mdl-38770274

RESUMO

The aging process is commonly accompanied by a general or specific loss of muscle mass, force and/or function that inevitably impact on a person's quality of life. To date, various clinical tests and assessments are routinely performed to evaluate the biomechanical status of an individual, to support and inform the clinical management and decision-making process (e.g., to design a tailored rehabilitation program). However, these assessments (e.g., gait analysis or strength measures on a dynamometer) are typically conducted independently from one another or at different time points, providing clinicians with valuable yet fragmented information. We hereby describe a comprehensive protocol that combines both in vivo measurements (maximal voluntary isometric contraction test, superimposed neuromuscular electrical stimulation, electromyography, gait analysis, magnetic resonance imaging, and clinical measures) and in silico methods (musculoskeletal modeling and simulations) to enable the full characterization of an individual from the biomechanical standpoint. The protocol, which requires approximately 4 h and 30 min to be completed in all its parts, was tested on twenty healthy young participants and five elderlies, as a proof of concept. The implemented data processing and elaboration procedures allowing for the extraction of several biomechanical parameters (including muscle volumes and cross-sectional areas, muscle activation and co-contraction levels) are thoroughly described to enable replication. The main parameters extracted are reported as mean and standard deviation across the two populations, to highlight the potential of the proposed approach and show some preliminary findings (which were in agreement with previous literature).

6.
Artigo em Inglês | MEDLINE | ID: mdl-38761039

RESUMO

OBJECTIVES: In aging societies, more people become vulnerable to experiencing cognitive decline. Simultaneously, the role of grandparenthood is central for older adults and their families. Our study investigates inequalities in the level and trajectories of cognitive functioning among older adults, focusing on possible intersectional effects of social determinants and grandparenthood as a life course transition that may contribute to delaying cognitive decline. METHODS: Using longitudinal data from the Survey of Health, Ageing and Retirement in Europe, we analyzed a sample of 19,953 individuals aged 50-85 without grandchildren at baseline. We applied Multilevel Analysis of Individual Heterogeneity and Discriminatory Accuracy to investigate variation in cognitive functioning across 48 intersectional strata, defined by sex/gender, migration, education, and occupation. We allowed the impact of becoming a grandparent on cognitive functioning trajectories to vary across strata by including random slopes. RESULTS: Intersectional strata accounted for 17.43% of the overall variance in cognitive functioning, with most of the stratum-level variation explained by additive effects of the stratum-defining characteristics. Transition to grandparenthood was associated with higher cognitive functioning, showing a stronger effect for women. Stratum-level variation in the grandparenthood effect was modest, especially after accounting for interactions between grandparenthood and the stratum-defining variables. DISCUSSION: This study highlights the importance of social determinants for understanding heterogeneities in older adults' level of cognitive functioning and its association with the transition to grandparenthood. Cumulative disadvantages negatively affect cognitive functioning, hence adopting an intersectional lens is useful to decompose inequalities and derive tailored interventions to promote equal healthy aging.

7.
Front Aging Neurosci ; 16: 1368052, 2024.
Artigo em Inglês | MEDLINE | ID: mdl-38813530

RESUMO

Age-related motor impairments often cause caregiver dependency or even hospitalization. However, comprehensive investigations of the different motor abilities and the changes thereof across the adult lifespan remain sparse. We, therefore, extensively assessed essential basic and complex motor functions in 444 healthy adults covering a wide age range (range 21 to 88 years). Basic motor functions, here defined as simple isolated single or repetitive movements in one direction, were assessed by means of maximum grip strength (GS) and maximum finger-tapping frequency (FTF). Complex motor functions, comprising composite sequential movements involving both proximal and distal joints/muscle groups, were evaluated with the Action Research Arm Test (ARAT), the Jebsen-Taylor Hand Function Test (JTT), and the Purdue Pegboard Test. Men achieved higher scores than women concerning GS and FTF, whereas women stacked more pins per time than men during the Purdue Pegboard Test. There was no significant sex effect regarding JTT. We observed a significant but task-specific reduction of basic and complex motor performance scores across the adult lifespan. Linear regression analyses significantly predicted the participants' ages based on motor performance scores (R2 = 0.502). Of note, the ratio between the left- and right-hand performance remained stable across ages for all tests. Principal Component Analysis (PCA) revealed three motor components across all tests that represented dexterity, force, and speed. These components were consistently present in young (21-40 years), middle-aged (41-60 years), and older (61-88 years) adults, as well as in women and men. Based on the three motor components, K-means clustering analysis differentiated high- and low-performing participants across the adult life span. The rich motor data set of 444 healthy participants revealed age- and sex-dependent changes in essential basic and complex motor functions. Notably, the comprehensive assessment allowed for generating robust motor components across the adult lifespan. Our data may serve as a reference for future studies of healthy subjects and patients with motor deficits. Moreover, these findings emphasize the importance of comprehensively assessing different motor functions, including dexterity, force, and speed, to characterize human motor abilities and their age-related decline.

8.
Eur Radiol ; 2024 May 15.
Artigo em Inglês | MEDLINE | ID: mdl-38748243

RESUMO

OBJECTIVE: To comprehensively assess the impact of aging, cigarette smoking, and chronic obstructive pulmonary disease (COPD) on pulmonary physiology using 129Xe MR. METHODS: A total of 90 subjects were categorized into four groups, including healthy young (HY, n = 20), age-matched control (AMC, n = 20), asymptomatic smokers (AS, n = 28), and COPD patients (n = 22). 129Xe MR was utilized to obtain pulmonary physiological parameters, including ventilation defect percent (VDP), alveolar sleeve depth (h), apparent diffusion coefficient (ADC), total septal wall thickness (d), and ratio of xenon signal from red blood cells and interstitial tissue/plasma (RBC/TP). RESULTS: Significant differences were found in the measured VDP (p = 0.035), h (p = 0.003), and RBC/TP (p = 0.003) between the HY and AMC groups. Compared with the AMC group, higher VDP (p = 0.020) and d (p = 0.048) were found in the AS group; higher VDP (p < 0.001), d (p < 0.001) and ADC (p < 0.001), and lower h (p < 0.001) and RBC/TP (p < 0.001) were found in the COPD group. Moreover, significant differences were also found in the measured VDP (p < 0.001), h (p < 0.001), ADC (p < 0.001), d (p = 0.008), and RBC/TP (p = 0.032) between the AS and COPD groups. CONCLUSION: Our findings indicate that pulmonary structure and functional changes caused by aging, cigarette smoking, and COPD are various, and show a progressive deterioration with the accumulation of these risk factors, including cigarette smoking and COPD. CLINICAL RELEVANCE STATEMENT: Pathophysiological changes can be difficult to comprehensively understand due to limitations in common techniques and multifactorial etiologies. 129Xe MRI can demonstrate structural and functional changes caused by several common factors and can be used to better understand patients' underlying pathology. KEY POINTS: Standard techniques for assessing pathophysiological lung function changes, spirometry, and chest CT come with limitations. 129Xe MR demonstrated progressive deterioration with accumulation of the investigated risk factors, without these limitations. 129Xe MR can assess lung changes related to these risk factors to stage and evaluate the etiology of the disease.

9.
Gerontologist ; 64(7)2024 Jul 01.
Artigo em Inglês | MEDLINE | ID: mdl-38767047

RESUMO

BACKGROUND AND OBJECTIVES: This research critically examined the concept of age-friendliness from the perspectives of older Black lesbian women living in New York City (NYC). The primary aim was to extend existing age-friendly frameworks to more inclusively meet the needs of older lesbian, gay, bisexual, transgender, and queer adults of color, promoting greater equity and justice. RESEARCH DESIGN AND METHODS: Applying principles from critical participatory action research, we collected and analyzed data from 5 focus groups consisting of 5 older Black lesbian women. Participants shared their daily experiences living in NYC and proposed ideas to enhance the age-friendliness of the city to better accommodate their unique needs and experiences. RESULTS: Participants called for greater attention to the interaction between identities and structures in relation to age-friendly communities. Historic and contemporary experiences of violence and discrimination, as well as the ever-shifting political context were identified as a key factor shaping their aging experiences. The need for affirming spaces with positive representation of their layered identities was emphasized in the context of age-friendly interventions. DISCUSSION AND IMPLICATIONS: While dominant age-friendly frameworks are universally accepted for improving the health and wellbeing of older adults, the specific challenges of aging with multiple intersecting marginalized identities necessitate a critical perspective. Gerontology needs to take seriously how privilege and oppression operate within society, shaping health and aging trajectories of vulnerable and underserved populations.


Assuntos
Grupos Focais , Minorias Sexuais e de Gênero , Justiça Social , Humanos , Feminino , Minorias Sexuais e de Gênero/psicologia , Idoso , Cidade de Nova Iorque , Negro ou Afro-Americano , Pessoa de Meia-Idade , Envelhecimento/psicologia , Masculino , Características de Residência , Idoso de 80 Anos ou mais
10.
Med Anthropol ; 43(4): 310-323, 2024 05 18.
Artigo em Inglês | MEDLINE | ID: mdl-38753499

RESUMO

In Denmark, people are expected to take responsibility for their health, not least as their bodies age and they experience signs of physical or mental decline. Drawing on fieldwork among older Danes, I illustrate that an excessive focus on health gives rise to social and structural controversies and disparities, linking ideas of healthy behavior at the individual level with the societal framing of disease and aging. I argue that this emphasis contributes to the unwarranted diagnosis of bodily variations that naturally occur in the aging process, a phenomenon referred to as overdiagnosis, adding to a broader medicalization of old age.


Assuntos
Envelhecimento , Antropologia Médica , Uso Excessivo dos Serviços de Saúde , Medicalização , Humanos , Dinamarca/etnologia , Idoso , Envelhecimento/etnologia , Feminino , Masculino , Idoso de 80 Anos ou mais
11.
J Environ Manage ; 360: 121196, 2024 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-38763117

RESUMO

At present, biochar has a large application potential in soil amelioration, pollution remediation, carbon sequestration and emission reduction, and research on the effect of biochar on soil ecology and environment has made positive progress. However, under natural and anthropogenic perturbations, biochar may undergo a series of environmental behaviors such as migratory transformation, mineralization and decomposition, and synergistic transport, thus posing certain potential risks. This paper outlines the multi-interfacial migration pathway of biochar in "air-soil-plant-animal-water", and analyzes the migration process and mechanism at different interfaces during the preparation, transportation and application of biochar. The two stages of the biochar mineralization process (mineralization of easily degradable aliphatic carbon components in the early stage and mineralization of relatively stable aromatic carbon components in the later stage) were described, the self-influencing factors and external environmental factors of biochar mineralization were analyzed, and the mineral stabilization mechanism and positive/negative excitation effects of biochar into the soil were elucidated. The proximity between field natural and artificially simulated aging of biochar were analyzed, and the change of its properties showed a trend of biological aging > chemical aging > physical aging > natural aging, and in order to improve the simulation and prediction, the artificially simulated aging party needs to be changed from a qualitative method to a quantitative method. The technical advantages, application scope and potential drawbacks of different biochar modification methods were compared, and biological modification can create new materials with enhanced environmental application. The stability performance of modified biochar was compared, indicating that raw materials, pyrolysis temperature and modification method were the key factors affecting the stability of biochar. The potential risks to the soil environment from different pollutants carried by biochar were summarized, the levels of pollutants released from biochar in the soil environment were highlighted, and a comprehensive selection of ecological risk assessment methods was suggested in terms of evaluation requirements, data acquisition and operation difficulty. Dynamic tracing of migration decomposition behavior, long-term assessment of pollution remediation effects, and directional design of modified composite biochar materials were proposed as scientific issues worthy of focused attention. The results can provide a certain reference basis for the theoretical research and technological development of biochar.


Assuntos
Carvão Vegetal , Ecossistema , Solo , Carvão Vegetal/química , Solo/química , Medição de Risco , Poluentes do Solo , Ecologia
12.
Mult Scler Relat Disord ; 87: 105671, 2024 May 06.
Artigo em Inglês | MEDLINE | ID: mdl-38728961

RESUMO

BACKGROUND/OBJECTIVE: Falls research in older adults with MS (OAMS) is scarce, and no studies have reported on the association between life-space mobility and falls in this group. Herein, we hypothesized that higher baseline life-space scores would be associated with reduced odds of reporting falls during follow-up, and explored whether the association differed by MS subtype (progressive vs. relapsing-remitting). METHODS: OAMS (n = 91, mean age = 64.7 ± 4.3ys, %female = 66.9,%progressive MS = 30.7) completed the University of Alabama at Birmingham Life-Space-Assessment (UAB-LSA) scale and reported falls during a structured monthly telephone interview during follow-up (mean = 16.39 ± 11.44 months). General Estimated Equations (GEE) models were utilized to determine whether UAB-LSA scores predicted falls during follow-up. RESULTS: GEE models revealed that higher UAB-LSA scores were associated with a significant reduction in the odds of falling during follow-up (OR = 0.69, p = 0.012, 95 %CI = 0.51 to 0.92). Stratified analyses revealed that this association was significant in progressive (OR = 0.57, p = 0.004, 95 %CI = 0.39 to 0.84), but not relapsing-remitting (OR = 0.93, p = 0.779, 95 %CI = 0.57 to 1.53) MS. CONCLUSION: Higher life-space mobility was associated with lower odds of falling among OAMS with progressive subtype. The UAB-LSA may complement existing mobility measures for predicting fall risk.

13.
Artigo em Inglês | MEDLINE | ID: mdl-38727240

RESUMO

The current study evaluated the reliability and validity of a novel, performance-based banking task in 60 younger (18-34 years) and 60 older (50-85 years) adults. All participants completed the Telephone-based Daily Instrumental Activities of Living (T-DIAL) using interactive voice response technology to complete a series of mock actions with a financial institution via telephone. The T-DIAL showed strong inter-rater reliability and internal consistency. T-DIAL accuracy was significantly and independently related to better self-reported instrumental activities of daily living and executive functions at a large effect size. Findings from this study provided preliminary supportive evidence for the reliability and validity of the T-DIAL, which had robust associations with manifest everyday functioning and higher-order cognitive ability. Future work is needed on the psychometrics (e.g. test-retest reliability, normative standards), and construct validity (e.g. diagnostic accuracy) of the T-DIAL in neurocognitive disorders and under-served communities for whom remote evaluations might be particularly relevant.

14.
JACC Adv ; 3(4)2024 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-38694996

RESUMO

Calcific aortic stenosis can be considered a model for geriatric cardiovascular conditions due to a confluence of factors. The remarkable technological development of transcatheter aortic valve replacement was studied initially on older adult populations with prohibitive or high-risk for surgical valve replacement. Through these trials, the cardiovascular community has recognized that stratification of these chronologically older adults can be improved incrementally by invoking the concept of frailty and other geriatric risks. Given the complexity of the aging process, stratification by chronological age should only be the initial step but is no longer sufficient to optimally quantify cardiovascular and noncardiovascular risk. In this review, we employ a geriatric cardiology lens to focus on the diagnosis and the comprehensive management of aortic stenosis in older adults to enhance shared decision-making with patients and their families and optimize patient-centered outcomes. Finally, we highlight knowledge gaps that are critical for future areas of study.

15.
BMC Public Health ; 24(1): 1274, 2024 May 09.
Artigo em Inglês | MEDLINE | ID: mdl-38724956

RESUMO

BACKGROUND: Demographic and epidemiological dynamics characterized by lower fertility rates and longer life expectancy, as well as higher prevalence of non-communicable diseases such as diabetes, represent important challenges for policy makers around the World. We investigate the risk factors that influence the diagnosis of diabetes in the Mexican population aged 50 years and over, including childhood poverty. RESULTS: This work employs a probabilistic regression model with information from the Mexican Health and Aging Study (MHAS) of 2012 and 2018. Our results are consistent with the existing literature and should raise strong concerns. The findings suggest that risk factors that favor the diagnosis of diabetes in adulthood are: age, family antecedents of diabetes, obesity, and socioeconomic conditions during both adulthood and childhood. CONCLUSIONS: Poverty conditions before the age 10, with inter-temporal poverty implications, are associated with a higher probability of being diagnosed with diabetes when older and pose extraordinary policy challenges.


Assuntos
Diabetes Mellitus , Fatores Socioeconômicos , Humanos , México/epidemiologia , Pessoa de Meia-Idade , Diabetes Mellitus/epidemiologia , Feminino , Masculino , Idoso , Fatores de Risco , Criança , Pobreza/estatística & dados numéricos , Idoso de 80 Anos ou mais
16.
Proc Natl Acad Sci U S A ; 121(20): e2315921121, 2024 May 14.
Artigo em Inglês | MEDLINE | ID: mdl-38709928

RESUMO

The comparative studies of aging have established a negative correlation between Gompertz postnatal growth constant and maximum lifespan across mammalian species, but the underlying physiological mechanism remains unclear. This study shows that the Gompertz growth constant can be decomposed into two energetic components, mass-specific metabolic rate and the energetic cost of biosynthesis, and that after controlling the former as a confounder, the negative correlation between growth constant and lifespan still exists due to a 100-fold variation in the latter, revealing that the energetic cost of biosynthesis is a link between growth and longevity in mammals. Previously, the energetic cost of biosynthesis has been thought to be a constant across species and therefore was not considered a contributor to the variation in any life history traits, such as growth and lifespan. This study employs a recently proposed model based on energy conservation to explain the physiological effect of the variation in this energetic cost on the aging process and illustrates its role in linking growth and lifespan. The conventional life history theory suggested a tradeoff between growth and somatic maintenance, but the findings in this study suggest that allocating more energy to biosynthesis may enhance the somatic maintenance and extend lifespan and, hence, reveal a more complex nature of the tradeoff.


Assuntos
Metabolismo Energético , Longevidade , Mamíferos , Animais , Mamíferos/metabolismo , Modelos Biológicos , Envelhecimento/metabolismo
17.
Kidney Int ; 2024 Apr 29.
Artigo em Inglês | MEDLINE | ID: mdl-38692408

RESUMO

Organ shortage is a major challenge in kidney transplantation but the use of older donors, often with co-morbidities, is hampered by inconsistent outcomes. Methods of accurately stratifying marginal donor organs by clinical and histological assessment are lacking. To better understand organ variability, we profiled the transcriptomes of 271 kidneys from deceased donors at retrieval. Following correction for biopsy composition, we assessed molecular pathways that associated with delayed, and sub-optimal one-year graft function. Analysis of cortical biopsies identified an adaptive immune gene-rich module that significantly associated with increasing age and worse outcomes. Cellular deconvolution using human kidney reference single cell transcriptomes confirmed an increase in kidney-specific B and T cell signatures, as well as kidney macrophage, myofibroblast and fibroblast gene sets in this module. Surprisingly, innate immune pathway and neutrophil gene signature enrichment was associated with better outcomes. Thus, our work uncovers cellular molecular features of pathological organ ageing, identifiable at kidney retrieval, with translational potential.

18.
Biosci Trends ; 18(2): 116-126, 2024 Jun 06.
Artigo em Inglês | MEDLINE | ID: mdl-38658363

RESUMO

As the population ages, the prevalence of dysphagia among older adults is a growing concern. Age-related declines in physiological function, coupled with neurological disorders and structural changes in the pharynx associated with aging, can result in weakened tongue propulsion, a prolonged reaction time of the submental muscles, delayed closure of the laryngeal vestibule, and delayed opening of the upper esophageal sphincter (UES), increasing the risk of dysphagia. Dysphagia impacts the physical health of the elderly, leading to serious complications such as dehydration, aspiration pneumonia, malnutrition, and even life-threatening conditions, and it also detrimentally affects their psychological and social well-being. There is a significant correlation between frailty, sarcopenia, and dysphagia in the elderly population. Therefore, older adults should be screened for dysphagia to identify both frailty and sarcopenia. A reasonable diagnostic approach for dysphagia involves screening, clinical assessment, and instrumental diagnosis. In terms of treatment, multidisciplinary collaboration, rehabilitation training, and the utilization of new technologies are essential. Future research will continue to concentrate on these areas to enhance the diagnosis and treatment of dysphagia, with the ultimate aim of enhancing the quality of life of the elderly population.


Assuntos
Transtornos de Deglutição , Humanos , Transtornos de Deglutição/terapia , Transtornos de Deglutição/diagnóstico , Transtornos de Deglutição/epidemiologia , Transtornos de Deglutição/fisiopatologia , Idoso , Sarcopenia/diagnóstico , Sarcopenia/terapia , Sarcopenia/epidemiologia , Sarcopenia/fisiopatologia , Idoso de 80 Anos ou mais , Qualidade de Vida , Fragilidade/diagnóstico , Fragilidade/complicações , Avaliação Geriátrica/métodos
19.
AIDS Patient Care STDS ; 38(5): 195-205, 2024 May.
Artigo em Inglês | MEDLINE | ID: mdl-38662469

RESUMO

Neurocognitive impairment and metabolic syndrome (MetS) are prevalent in persons with HIV (PWH). We examined disparities in HIV-associated neurocognitive function between Hispanic and non-Hispanic White older PWH, and the role of MetS in explaining these disparities. Participants included 116 community-dwelling PWH aged 50-75 years enrolled in a cohort study in southern California [58 Hispanic (53% Spanish speaking) and 58 age-comparable non-Hispanic White; overall group: age: M = 57.9, standard deviation (SD) = 5.7; education (years): M = 13, SD = 3.4; 83% male, 58% AIDS, 94% on antiretroviral therapy]. Global neurocognition was derived from T-scores adjusted for demographics (age, education, sex, ethnicity, language) on a battery of 10 cognitive tests. MetS was ascertained via standard criteria that considered central obesity, and fasting elevated triglycerides, low high-density lipoprotein cholesterol and elevated glucose, or medical treatment for these conditions. Covariates examined included sociodemographic, psychiatric, substance use and HIV disease characteristics. Compared with non-Hispanic Whites, Hispanics showed worse global neurocognitive function (Cohen's d = 0.56, p < 0.05) and had higher rates of MetS (38% vs. 56%, p < 0.05). A stepwise regression model including ethnicity and significant covariates showed Hispanic ethnicity was the sole significant predictor of worse global neurocognition (B = -3.82, SE = 1.27, p < 0.01). A model also including MetS showed that both Hispanic ethnicity (B = -3.39, SE = 1.31, p = 0.01) and MetS (B = -2.73, SE = 1.31, p = 0.04) were independently associated with worse neurocognition. In conclusion, findings indicate that increased MetS is associated with worse neurocognitive function in both Hispanic and non-Hispanic White older PWH, but does not explain neurocognitive disparities. MetS remains an important target for intervention efforts to ameliorate neurocognitive dysfunction among diverse older PWH.


Assuntos
Infecções por HIV , Hispânico ou Latino , Síndrome Metabólica , Testes Neuropsicológicos , População Branca , Humanos , Hispânico ou Latino/estatística & dados numéricos , Hispânico ou Latino/psicologia , Masculino , Feminino , Pessoa de Meia-Idade , Síndrome Metabólica/epidemiologia , Síndrome Metabólica/etnologia , Síndrome Metabólica/psicologia , Infecções por HIV/psicologia , Infecções por HIV/tratamento farmacológico , Infecções por HIV/etnologia , Infecções por HIV/complicações , Infecções por HIV/epidemiologia , Idoso , California/epidemiologia , População Branca/estatística & dados numéricos , População Branca/psicologia , Prevalência , Disparidades nos Níveis de Saúde , Estudos de Coortes , Cognição , Disfunção Cognitiva/epidemiologia
20.
Sci Total Environ ; 929: 172394, 2024 Jun 15.
Artigo em Inglês | MEDLINE | ID: mdl-38636850

RESUMO

Microplastics (MPs) and persistent pollutants (POPs) are new pollutants that are extensively studied worldwide. To fill the gaps that the degradation processes and mechanisms of polycyclic aromatic hydrocarbons (PAHs) on the surface of most MPs are still unclear, the photochemical transformation of benzo(a)anthracene (BaA) on polyvinyl chloride (PVC) MPs and polystyrene (PS) MPs in water were investigated and compared. The photolysis of BaA on the surface of PS in water proceeded easier than that on PVC within the 48 h irradiation period, with the pseudo-first-order rate constant of 0.0489 min-1 and 0.0181 min-1, respectively, which can be ascribed to the smaller particle size and more OH production of PS MPs. Due to the light competition between the chromophore and BaA as well as the light-shielding effect, aged MPs showed an inhibitory effect on the degradation of BaA compared with pristine MPs. For BaA/PVC MPs system, the degradation of BaA in real water was not significantly affected by coexisting ions and humic acid (HA) (p < 0.05), while slight inhibitory effect on the degradation of BaA appeared for PS MPs in different water matrices (UP: 86.97 %, YR: 84.47 %, PR: 81.42 % and HR: 83.21 %). According to the electron paramagnetic resonance (EPR) test, quenching experiment and probe experiment, the relative contribution of direct photolysis (PVC: 82.02 %; PS: 69.54 %) and indirect photolysis (PVC: 17.98 %; PS: 30.46 %) was confirmed. A total of 14 products were identified, and the product types were not affected by plastics aging. The results of the toxicity assessment indicated that although some intermediate products remained toxic to aquatic organisms, the toxicity of most products was lower than that of BaA. This study provides new insights into the environmental fate of PAHs and the role of MPs in the photolysis process of contaminants in surface water.

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