TY - JOUR T1 - Correlates of Elevated C-Reactive Protein among Black Older Adults: Evidence from the Health and Retirement Study. JF - The Journals of Gerontology, Series B Y1 - 2022 A1 - Heather R. Farmer A1 - Thomas Tobin, Courtney S A1 - Roland J. Thorpe Jr. KW - Black Americans KW - Black men KW - Black women KW - C-reactive protein AB -

OBJECTIVES: Substantial evidence documents gender and racial disparities in C-reactive protein (CRP), a measure of systemic inflammation, among older adults. Yet, the comparative approaches of these studies may obscure distinct risk and protective factors associated with elevated CRP among older Black Americans. To pinpoint opportunities for intervention, this study utilizes a "within-group approach" to identify the sociodemographic, psychosocial, behavioral, and health-related correlates of elevated CRP among older Black women and men.

METHOD: The sample consisted of 2,420 Black respondents aged 51+ in the Health and Retirement Study (2006-2016). Gender-stratified, random effects logistic regression models were used to examine correlates of elevated CRP (>3.0 mg/L).

RESULTS: More than 50% of Black women had elevated CRP, and younger age, Medicaid, lower mastery, religiosity, overweight/obesity, physical inactivity, and ADLs contributed to elevated CRP among this group. In contrast, elevated CRP was reported among only 37.25% of Black men, for whom financial distress was associated with lower odds of elevated CRP; religiosity, less neighborhood cohesion, current smoking, overweight/obesity, ADLs, and more chronic conditions were associated with greater odds of elevated CRP among this group.

DISCUSSION: Sociodemographic factors had a limited association with elevated CRP among older Black Americans. Rather, a range of psychosocial, behavioral, and health-related factors were more influential determinants of elevated CRP among older Black Americans. Most notably, findings demonstrate distinct correlates of CRP among Black women and men, underscoring the critical need to further evaluate the risk and protective mechanisms undergirding disparities among this aging population.

VL - 77 IS - 11 ER - TY - JOUR T1 - Examining the Association of Pain and Financial Hardship Among Older Men by Race in the United States. JF - American Journal of Men's Health Y1 - 2021 A1 - Song, Chiho A1 - Gillian L Marshall A1 - Reed, Alyssa A1 - Tamara A. Baker A1 - Roland J. Thorpe Jr. KW - Financial hardship KW - Men KW - pain KW - race AB -

Pain associated with financial hardship among older men varies by race. The purpose of this study was to examine the association of financial hardship with the presence of pain in men 50 years and older by race. Using the Health and Retirement Study (HRS) 2010 wave, bivariate and multivariate logistic regression models were used to assess the association between four financial hardship indicators and total financial hardship as a composite score, and the presence of pain by race. Among White men, the association between the presence of pain and hardship controlling for demographic factors was statistically significant across four indicators and one composite score: ongoing financial hardship (OR = 1.29, 95% CI [1.02, 1.64]), food insecurity (OR = 2.55, 95% CI [1.51, 4.31]), taking less medication due to cost (OR = 2.12, 95% CI [1.40, 3.22]), difficulty paying bills (OR = 1.36, 95% CI [1.07, 1.73]), and total financial hardship (OR = 1.27, 95% CI [1.12, 1.44]). Among African American men, the association between the presence of pain and taking less medication due to cost (OR = 2.99, 95% CI [1.31, 6.85]) was significant. With increasing comorbidities among older adults, particularly African Americans, it is imperative to fully understand the mechanisms of this underexplored area in both the pain and financial hardship literature.

VL - 15 IS - 5 ER - TY - JOUR T1 - The Association Between Depressive Symptoms and Accumulation of Stress Among Black Men in the Health and Retirement Study. JF - Innovation in Aging Y1 - 2020 A1 - Roland J. Thorpe Jr. A1 - Ryon J. Cobb A1 - King, Keyonna A1 - Bruce, Marino A A1 - Archibald, Paul A1 - Jones, Harlan P A1 - Norris, Keith C A1 - Keith E Whitfield A1 - Hudson, Darrell KW - Allostatic load KW - Black men KW - Depressive symptoms KW - health KW - Inequities KW - Men KW - Stress AB -

Background and Objectives: Among the multiple factors posited to drive the health inequities that black men experience, the fundamental role of stress in the production of poor health is a key component. Allostatic load (AL) is considered to be a byproduct of stressors related to cumulative disadvantage. Exposure to chronic stress is associated with poorer mental health including depressive symptoms. Few studies have investigated how AL contributes to depressive symptoms among black men. The purpose of the cross-sectional study was to examine the association between AL and depressive symptoms among middle- to old age black men.

Research Design and Methods: This project used the 2010 and 2012 wave of the Health and Retirement Study enhanced face-to-face interview that included a biomarker assessment and psychosocial questionnaire. Depressive symptoms, assessed by the endorsement of 3 or more symptoms on the Center for Epidemiological Studies-Depression 8-item scale, was the outcome variable. The main independent variable, AL, score was calculated by summing the number values that were in the high range for that particular biomarker value scores ranging from 0 to 7. black men whose AL score was 3 or greater were considered to be in the high AL group. Modified Poisson regression was used to estimate prevalence ratios (PRs) and corresponding 95% confidence intervals (CIs).

Results: There was a larger proportion of black men in the high AL group who reported depressive symptoms (30.0% vs. 20.0%) compared with black men in the low AL group. After adjusting for age, education, income, drinking, and smoking status, the prevalence of reporting 3 or more depressive symptoms was statistically significant among black men in the high AL group (PR = 1.61 [95% CI: 1.20-2.17]) than black men in the low AL group.

Discussion and Implications: Exposure to chronic stress is related to reporting 3 or more depressive symptoms among black men after controlling for potential confounders. Improving the social and economic conditions for which black men work, play, and pray is key to reducing stress, thereby potentially leading to the reporting of fewer depressive symptoms.

VL - 4 IS - 5 ER - TY - JOUR T1 - Everyday Discrimination and Kidney Function Among Older Adults: Evidence From the Health and Retirement Study JF - The Journals of Gerontology: Series A Y1 - 2020 A1 - Ryon J. Cobb A1 - Roland J. Thorpe Jr. A1 - Norris, Keith C KW - Discrimination KW - kidney AB - With advancing age, there is an increase in the time of and number of experiences with psychosocial stressors that may lead to the initiation and/or progression of chronic kidney disease (CKD). Our study tests whether one type of experience, everyday discrimination, predicts kidney function among middle and older adults.The data were from 10 973 respondents (ages 52–100) in the 2006/2008 Health and Retirement Study, an ongoing biennial nationally representative survey of older adults in the United States. Estimated glomerular filtration rate (eGFR) derives from the Chronic Kidney Disease Epidemiology Collaboration equation. Our indicator of everyday discrimination is drawn from self-reports from respondents. Ordinary Least Squared regression (OLS) models with robust standard errors are applied to test hypotheses regarding the link between everyday discrimination and kidney function.Everyday discrimination was associated with poorer kidney function among respondents in our study. Respondents with higher everyday discrimination scores had lower eGFR after adjusting for demographic characteristics (B = −1.35, p \< .05), and while attenuated, remained significant (B = −0.79, p \< .05) after further adjustments for clinical, health behavior, and socioeconomic covariates.Our study suggests everyday discrimination is independently associated with lower eGFR. These findings highlight the importance of psychosocial factors in predicting insufficiency in kidney function among middle-aged and older adults. VL - 75 UR - https://doi.org/10.1093/gerona/glz294 ER - TY - JOUR T1 - Interactive Effects of Chronic Health Conditions And Financial Hardship On Episodic Memory Among Older Blacks: Findings From The Health And Retirement Study JF - Research in Human Development Y1 - 2020 A1 - Byrd, DeAnnah R. A1 - Gonzales, Ernest A1 - Beatty Moody, Danielle L. A1 - Gillian L Marshall A1 - Laura B Zahodne A1 - Roland J. Thorpe Jr. A1 - Keith E Whitfield KW - Chronic disease KW - Cognition KW - Financial hardship AB - Previous research links chronic health conditions and financial hardship to cognitive outcomes among older Blacks. However, few studies have explored the moderating effect of financial hardship on chronic disease burden and specific cognitive domains. This study examined whether financial hardship (as measured by difficulty paying monthly bills) modifies the impact of self-reported chronic health conditions (e.g., diabetes, stroke) on episodic memory among 871 older Blacks (50+ years) in the 2006 Health and Retirement Study . Financial hardship modified the association between chronic disease burden and episodic memory performance such that individuals who reported very little difficulty paying their monthly bills had significantly lower memory scores at high levels of disease burden compared to those reporting high financial difficulty after controlling for age, gender and education (F 2, 49 = 5.03, p = .010). This cross-sectional study suggests that both financial and physical wellbeing may have joint effects on cognitive health in older Blacks. VL - 17 SN - 1542-7609 IS - 1 ER - TY - JOUR T1 - Self-Reported Instances of Major Discrimination, Race/Ethnicity, and Inflammation Among Older Adults: Evidence from the Health and Retirement Study. JF - Journals of Gerontology, Series A: Biological Sciences & Medical Sciences Y1 - 2020 A1 - Ryon J. Cobb A1 - Lauren J Parker A1 - Roland J. Thorpe Jr. KW - Discrimination KW - Racial/ethnic differences KW - Self-reports AB -

BACKGROUND: This study examines the relationship between self-reported instances of major discrimination and inflammation among older adults, and explores whether this relationship varies in accordance with race/ethnicity. We hypothesized that self-reported instances of major discrimination would be associated with higher levels of high-risk inflammation, and that this relationship would be stronger for racial/ethnic minorities than Whites.

METHODS: Data from the 2006/2008 Health and Retirement Study (HRS), an ongoing biennial nationally representative sample of older adults in the United States, was used to collect measures of self-reported instances of major discrimination and high-risk C-reactive protein (CRP), which was assayed from blood samples. Modified Poisson regression with robust standard errors was applied to estimate the prevalence ratios of self-reported instances of major discrimination, as it relates to high-risk CRP (CRP≥ 22 kg/m2), and test whether this relationship varies by race/ethnicity.

RESULTS: Respondents who experienced any instances of major discrimination had a higher likelihood of high-risk CRP (prevalence ratio [PR]: 1.14, 95% confidence interval [CI] = 1.07-1.22) than those who did not report experiencing any instances of major discrimination. This association was independent of differences in newly diagnosed health conditions and socioeconomic status. The relationship between any self-reported instance of major discrimination and high-risk CRP was weaker for Blacks than Whites (PR: 0.81, 95% CI = 0.69-0.95).

CONCLUSIONS: Our study confirms that self-reported instances of major lifetime discrimination is a psychosocial factor that is adversely associated with high-risk CRP among older adults; this association is especially pronounced among older Whites. Future studies among this population are required to examine whether the relationship between self-reported instances of major discrimination and high-risk CRP changes over time.

U1 - http://www.ncbi.nlm.nih.gov/pubmed/30508069?dopt=Abstract ER - TY - JOUR T1 - Racial/Ethnic Differences in Insomnia Trajectories Among U.S. Older Adults JF - The American Journal of Geriatric Psychiatry Y1 - 2016 A1 - Christopher N Kaufmann A1 - Ramin Mojtabai A1 - Hock, Rebecca S. A1 - Roland J. Thorpe Jr. A1 - Sarah L. Canham A1 - Chen, Lian-Yu A1 - Alexandra M. V. Wennberg A1 - Lenis P. Chen-Edinboro A1 - Adam P Spira KW - Health Conditions and Status KW - Other AB - Objectives Insomnia is reported to be more prevalent in minority racial/ethnic groups. Little is known, however, about racial/ethnic differences in changes in insomnia severity over time, particularly among older adults. We examined racial/ethnic differences in trajectories of insomnia severity among middle-aged and older adults. Design Data were drawn from five waves of the Health and Retirement Study (2002 2010), a nationally representative longitudinal biennial survey of adults aged andgt; 50 years. Setting Population-based. Participants 22,252 participants from non-Hispanic white, non-Hispanic black, Hispanic, and other racial/ethnic groups. Measurements Participants reported the severity of four insomnia symptoms; summed scores ranged from 4 (no insomnia) to 12 (severe insomnia). We assessed change in insomnia across the five waves as a function of race/ethnicity. Results Across all participants, insomnia severity scores increased 0.19 points (95 CI: 0.14 0.24; t = 7.52; design df = 56; p andlt; 0.001) over time after adjustment for sex, race/ethnicity, education, and baseline age. After adjusting for the number of accumulated health conditions and body mass index, this trend decreased substantially and even changed direction (B = 0.24; 95 CI: 0.29 to 0.19; t = 9.22; design df = 56; p andlt; 0.001). The increasing trajectory was significantly more pronounced in Hispanics compared with non-Hispanic whites, even after adjustment for number of accumulated health conditions, body mass index, and number of depressive symptoms. Conclusions Although insomnia severity increases with age largely due to the accumulation of health conditions this trend appears more pronounced among Hispanic older adults than in non-Hispanic whites. Further research is needed to determine the reasons for a different insomnia trajectory among Hispanics. VL - 24 UR - http://www.sciencedirect.com/science/article/pii/S1064748116002153 IS - 7 U4 - Disparities/Aging/Insomnia/Chronic health conditions ER - TY - JOUR T1 - Race/ethnic differences in cognitive decline: Results from the health and retirement study JF - Alzheimer's and dementia : the journal of the Alzheimer's Association Y1 - 2008 A1 - Kala M. Mehta A1 - Lisa L. Barnes A1 - Roland J. Thorpe Jr. A1 - Eliseo J Perez-Stable A1 - Kenneth E Covinsky A1 - Kristine Yaffe KW - Health Conditions and Status AB - Background: As the minority population and dementia prevalence are rapidly growing, understanding cognitive decline in racially diverse elders is an increasingly important public health issue. Our goal was to evaluate whether cognitive decline occur at an accelerated rate for persons of non-White race/ethnicity (African American, Latino) compared to White older adults. Methods: Participants were from the US-representative Health and Retirement Study (HRS) 1998-2004. Cognitive assessment consisted of immediate and delayed free recall as well as serial 7s test, orientation, and naming for a total score of 35 points. Our primary outcomes were biennial cognitive change from 1998 to 2004 and cognitive decline defined as 5 point decline from 1998 to 2004. We calculated change in cognition, odds of cognitive decline, and evaluated mediators by race/ethnic group using mixed effects regression and logistic regression models. Results: The 5,552 HRS participants (mean age 72 6 years, 60 Female, 10 African Amercan, 6 Latino) had an average cognitive decline of 2.1 4.3 points over the 6 year study period. Overall, 33 of African Americans declined, 28 of Latinos declined and 26 of Whites declined. After controlling for age, gender, educational level in years, socioeconomic factors (total net worth and current income), self-reported medical comorbidity (self reported medical history of hypertension, heart disease, diabetes and stroke), and baseline cognition, African Americans were more likely to decline compared to Whites (OR 2.2; 95 CI 1.7-2.7). Latino older adults were similar to Whites in odds of cognitive decline (OR Latino 1.3; 95 CI 0.9-1.7). Conclusions: African American adults aged 65 and above were more likely to experience cognitive decline compared to White older adults after accounting for demographics, socioeconomics, comorbidity, and their baseline cognitive function. There was no difference between Latino older adults and Whites in rates of cognitive decline. Future research to identify ways to reduce cognitive decline, particularly for racially-diverse groups, are needed. PB - 4 VL - 4 IS - 4 U4 - Dementia/Cognitive decline/COMORBIDITY ER -