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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.

Objectives: This study examines whether the effects of receiving and providing social support on cognition differ by education. Methods: Data from 602 African American adults (48-95 years) enrolled in the Baltimore Study of Black Aging-Patterns of Cognitive Aging were analyzed using multiple linear regression. Results: We found no main effects of receiving or providing social support on global cognition. Main effects for receiving or providing social support on memory were detected. Further, a significant moderation effect was observed for memory, such that received social support was more strongly associated with higher working memory among less-educated individuals than those with high levels of education, adjusting for age, sex, marital status, chronic conditions, and depressive symptoms. Discussion: Study findings demonstrate that social support and education have joint effects on memory outcomes, highlighting the importance of considering psychosocial protective factors that might alleviate, reduce, or even eliminate cognitive health disparities in African Americans.

Background: This study examined whether the effects of received and provided social support on blood pressure (BP) would differ by education., Methods: Data from 602 African American adults (48-95 years) enrolled in the Baltimore Study of Black Aging-Patterns of Cognitive Aging were analyzed using multiple linear regression., Results: We found no main effects of received and provided social support on BP. However, a significant moderation effect was observed for systolic BP, such that greater received social support was positively associated with higher systolic BP among individuals with low levels of education, adjusting for age, sex, chronic health conditions, and depressive symptoms., Conclusions: The findings demonstrate that social support and education have joint effects on BP, which highlights the importance of considering psychosocial determinants of adverse cardiovascular health outcomes that disproportionately affect African Americans., (Published by Oxford University Press on behalf of The Gerontological Society of America 2021.)

Objectives: The theory of selective survival suggests that possibly around 70-75 years of age, Blacks may display substantive changes in their pattern of cognitive decline. This study examined the age-graded pattern of cognitive decline within older Blacks by describing a trend that characterizes differences in the change of cognitive decline from ages 51.5 to 95.5, and hypothesized that this age-graded pattern is nonlinear., Method: Utilizing 2 waves of longitudinal data from the Baltimore Study of Black Aging, this study used multilevel modeling to test whether the interaction between age and the 3-year study period (time between waves) had a positive effect on changes in inductive reasoning, declarative memory, working memory, and perceptual speed., Results: A significant positive interaction between age and wave was found for inductive reasoning, demonstrating an age-grade pattern of change/decline in cognitive pattern for Blacks aged 51.5-95.4. Simple slope probing via the Johnson-Neyman Technique suggested that Black adults ~64 years and younger experienced significant decline in inductive reasoning across study time, whereas for those older than 63.71, the decline was nonsignificant. No significant age-wave interactions were found for declarative memory, working memory, or perceptual speed., Discussion: Findings suggest a selective survival effect for inductive reasoning ability among Blacks. With decline evident so early, common cognitive intervention programs targeting adults 65+ may come too late for Blacks, signifying the importance and urgency for early health interventions and public policy designed to promote cognitive reserve., (© The Author(s) 2021. Published by Oxford University Press on behalf of The Gerontological Society of America. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.)

Objective: The objective of study is to examine the relationships between health status and changes in cognition over time among middle to older aged Blacks. Method: Data come from the Baltimore Study of Black Aging-Patterns of Cognitive Aging. At baseline, 602 Black participants, ranging from ages 48 to 95 years, were enrolled. At follow-up, approximately 3 years later, 450 participants were re-interviewed. Results: After accounting for baseline cognition, age, sex, and education, a greater number of health conditions was associated with slower perceptual speed ( b = -5.099, p = .022). Average peak expiratory flow was also associated with improvements in working memory ( b = 0.029, p = .019) and perceptual speed ( b = 0.026, p = .026), controlling for model covariates. Discussion: Study findings demonstrate that greater disease burden is associated with declines in specific fluid cognitive abilities in middle to later life among Blacks. This finding highlights the importance of reducing health disparities that disproportionately affect Blacks.

Social support (SS) is typically associated with lower emotional distress (e.g., stress and depression) in individuals. However, SS is a multifaceted construct that can vary by quality, quantity (amount), and type (i.e., it can be emotional or instrumental in nature)., Objective: The current study examined the relationships between characteristics of SS, stress, and depression in aging African Americans., Participants: Analyses focused on data from 705 participants aged 22-92 years from the Carolina African American Twin Study of Aging., Measurements: Measures included the quality and quantity of emotional and instrumental support received, as well as stress and depression., Design: A series of univariate and increasingly complex multivariate regression models were conducted in MPlus (using the cluster option to control for family structure) to examine the relationships between SS and emotional distress variables., Results: Overall, better quality of emotional SS predicted fewer depression symptoms and less perceived stress, after controlling for age, gender, socioeconomic status variables, and the other subtypes of SS. However, more instances of emotional SS were associated with higher levels of perceived stress, depression symptoms, and more stressful life events within the past year. Likewise, more instrumental SS predicted more perceived stress, while holding the other variables constant., Conclusion: African Americans who experience more emotional distress report more SS, but the quality of emotional support appears to play an important role in the association between reduced levels of stress and depression. These findings suggest that interventions should include approaches to reduce emotional distress as well as enhance the quality SS., (Copyright © 2020 American Association for Geriatric Psychiatry. Published by Elsevier Inc. All rights reserved.)

Objectives: The current study explored whether social support (SS) from family and peers, influences the relationship between depressed mood (DM) and substance use (SU). We hypothesized that SS would have a protective effect on DM, and moderate the association between DM and SU., Participants and Methods: Analyses focused on 703 individuals from the Carolina African American Twin Study on Aging (mean age = 49.78 years, STD = 14.52; 51% female). Participants reported on past year frequency of cigarettes and alcohol consumption, depressed mood, and stressful life events. Social support (SS) was assessed on two domains (i.e., emotional and instrumental), as well as for perceived quality and quantity of each type. Hypotheses were tested using ordinal logistic regression in Mplus while controlling for socioeconomic status, age, and gender., Results: Quality of emotional support was negatively associated with drinking. Smoking, but not drinking was associated with depressed mood. While individuals with high levels of depressed mood received more support, receiving better quality emotional support was associated with fewer mood and stress symptoms. Individuals who reported receiving better quality emotional support typically smoked fewer cigarettes., Conclusion: Quantity of emotional support was associated with higher levels of negative emotionality, whereas the opposite was found for quality of emotional support. Emotional support may indirectly influence smoking via depressed mood. Effecting the perceived quality of support appears to be the mechanism by which emotional support helps to reduce smoking in adult African Americans., Competing Interests: Declarations of Competing Interest The authors have no conflicts to declare., (Copyright © 2020 Elsevier B.V. All rights reserved.)

Background: African American life expectancy at age 65 is about 2 years less than that of Caucasians, but by age 85, African Americans may have a longevity advantage. One possible explanation for this cross-over effect is that African Americans who make it to the oldest ages have done so by handling stressful contextual and health disadvantages. The purpose of this study was to examine possible within group cohort differences that lead to exceptional longevity among older African Americans., Methods: Data came from three cohorts of older African Americans: the Carolina African American Twin Study of Aging (CAATSA), the Baltimore Study of Black Aging-Patterns of Cognitive Aging (BSBA-PCA), and the Study of Longevity and Stress in African American Families (SOLSAA). Of the 533 participants, we compared two age cohorts (60-79 and 80+) with an average age of 73.2 (SD = 8.33) and 26.3% are men. Variables included measures of stress, depression, coping, cognition, and health indicators., Results: The variance for depression and average peak expiratory flow (APEF) was significantly larger for the older cohort but after controlling for demographic factors, the measure of depressive symptoms was not. The Alpha Span test showed a significant difference with the older cohort having larger variances after controlling for demographic factors., Conclusions: The findings suggest that there are changes in the characteristics of who makes it to later life, but counter to our hypothesis, there was greater variability in the oldest group relative to the younger., (© The Author(s) 2019. Published by Oxford University Press on behalf of The Gerontological Society of America. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.)

Objective: The purpose of the current study is to examine the association between subjective memory complaints and sleep (quantity and quality) in African American older adults., Method: Participants from the Baltimore Study of Black Aging (BSBA; n = 351; mean age = 71.99) completed a self-report sleep scale, subjective memory complaint scale, global cognitive status measure, and demographic questionnaire., Results: Worse overall sleep quality was significantly associated with subjective reports of difficulty recalling the placement of objects, recalling specific facts from reading materials, and worse memory currently compared to the past. Specific sleep parameters (e.g., longer sleep latency and shorter sleep duration) were associated with negative appraisals of participants' ability to do specific tasks involving memory (e.g., difficulty recalling placement of objects). Participants classified as poor sleepers (Pittsburgh Sleep Quality Index [PSQI] total score > 5) were more likely to report worse memory now compared to the past than participants classified as good sleepers (PSQI total score ≤ 5)., Conclusions: Evaluation of sleep may be warranted when older adults, particularly African Americans, communicate concerns regarding their memory. Insufficient sleep may be a useful marker of acute daytime dysfunction and, perhaps, cognitive decline. Given memory problems are the hallmark of dementia, our findings support further evaluation of whether poor sleep can aid in the diagnosis of cognitive impairment.

Although men have greater societal and economic privileges, men have higher all-cause mortality rates than women, even after controlling for education. Further, racial/ethnic mortality disparities exist among men with varying levels of education. Few studies have explored the independent effects of education and all-cause mortality between non-Hispanic Black and non-Hispanic White men with the same level of education. Our purpose was to identify trends in racial differences in all-cause mortality between non-Hispanic White and non-Hispanic Black men with the same level of education. Data for the study came from the National Health Interview Surveys 2000-2011 linked to the 2000-2009 Mortality Files. The Student's t and chi-square tests were used to assess the mean and proportional differences between non-Hispanic White and non-Hispanic Black men (≥18 years of age) across a range of demographic and health-related factors. Cox proportional hazard models were specified to examine the association between level of education and all-cause mortality adjusting for the demographic and health characteristics. Except for men who did not complete high school, statistically significant differences in all-cause mortality are present between non-Hispanic Black and non-Hispanic White men with the same level of education. The findings reveal the importance of understanding the level of education on differences in all-cause mortality between non-Hispanic Whites and non-Hispanic Blacks.

African American women with osteoarthritis (OA) are at high risk of experiencing pain. They report more pain than non-Hispanic White women and men of other racial/ethnic groups. This pain can limit independence and diminish their quality of life. Despite the detrimental effects that pain can have on older African American women with OA, there is a dearth of literature examining factors beyond the OA pathology that are associated with pain outcomes within this population. The purpose of this study was to examine the relationships between racial discrimination and depressive symptoms with pain intensity in African American women with OA. The sample comprised of 120 African American women, aged 50-80 years, with OA, from Texas and New Mexico. The women completed survey booklets to answer study questionnaires. We used multiple linear regression to test associations between racial discrimination, depressive symptoms, and pain intensity. We tested whether depressive symptoms mediated the relationship between racial discrimination and pain intensity by using bootstrapping. Results indicated that racial discrimination was significantly associated with pain intensity and that this relationship was mediated by depressive symptoms, even after controlling for body mass index, years of education, and length of time with OA. Both depressive symptoms and racial discrimination may be modifiable. If these modifiable factors are addressed in this population, there may be decreased pain in middle-aged and older African American women., (Copyright © 2017 American Society for Pain Management Nursing. Published by Elsevier Inc. All rights reserved.)

Objectives: The purpose of this study was to determine whether stability and change in cognitive status are associated with sociodemographic characteristics and health function., Design: Secondary analysis of data., Setting: Baltimore Study of Black Aging-Patterns of Cognitive Aging., Participants: Community-dwelling black adults (N = 407; mean age 68.6 ± 9.1)., Measurements: Baseline (n = 602) and 33-month follow-up (n = 450) assessments of cognition, health, and psychosocial function., Results: For the present analyses, participants were grouped as being cognitively normal (n = 249), having stable mild cognitive impairment (MCI) (n = 32), or being MCI converters (n = 72; normal at baseline, MCI at follow-up) or reverters (n = 54; MCI at baseline, normal at follow-up). Multivariate analysis of variance showed that the groups differed significantly in education and lung function (P < .010). Post hoc analyses indicated that converters had fewer years of education than the other groups, whereas those who were cognitively normal had better lung function than converters and reverters (P < .050)., Conclusion: These results suggest that education and lung health are associated with patterns of cognitive status change and stability. Future research should account for sociodemographic and health factors when examining stability of cognitive status classifications., (© 2017, Copyright the Authors Journal compilation © 2017, The American Geriatrics Society.)

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., (Copyright © 2016 National Medical Association. Published by Elsevier Inc. All rights reserved.)

Study Objectives: There is a growing body of research examining the relationship between sleep and functional outcomes. However, little is known about sleep and physical functioning in older African Americans., Methods: Data for this project included 450 community-dwelling older African Americans (71.4 ± 9.2 years of age) who participated in the Baltimore Study of Black Aging. Overall sleep pattern and quality was measured by the Pittsburgh Sleep Quality Index (PSQI). Physical functioning was measured by the number of activities of daily living that each participant reported difficulty (ADL; e.g. eating, dressing, and bathing). Negative binomial regression models were conducted to estimate the association between sleep quality and physical functioning., Results: Seventy-two percent of the participants reported poor sleep quality. African Americans who reported poor sleep quality had a greater likelihood of an increase in the number of difficulties in ADLs that they reported even after accounting for demographic characteristics and health conditions. The relationship between sleep quality and physical functioning did not vary by gender., Conclusions: Sleep may be an important factor to consider when seeking to improve physical functioning among community-dwelling older African Americans., (© 2016 American Academy of Sleep Medicine)

The objectives of the study were to examine whether measures of total obesity (body mass index [BMI]) and central obesity (waist circumference [WC] and waist-to-hip ratio [WHR]) are associated with cognitive function in African Americans, and whether sex moderates these associations. A sample of 194 African Americans, with a mean age of 58.97 years, completed a battery of cognitive tests and a self-reported health questionnaire. Height, weight, waist and hip circumference, and blood pressure were assessed. Linear regression analyses were run. Results suggested lower performance on measures of verbal fluency and complex attention/cognitive flexibility was accounted for by higher levels of central adiposity. Among men, higher WHR was more strongly related to complex attention/cognitive flexibility performance, but for women, WC was a salient predictor. Higher BMI was associated with poorer verbal memory performance among men, but poorer nonverbal memory performance among women. Findings suggest a need for healthy lifestyle interventions for African Americans to maintain healthy weight and cognitive function., (© The Author 2015. Published by Oxford University Press. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.)

Background: Race differences in chronic conditions and disability are well established; however, little is known about the association between specific chronic conditions and disability in African Americans. This is important because African Americans have higher rates and earlier onset of both chronic conditions and disability than white Americans., Methods: We examined the relationship between chronic conditions and disability in 602 African Americans aged 50 years and older in the Baltimore Study of Black Aging. Disability was measured using self-report of difficulty in activities of daily living (ADL). Medical conditions included diagnosed self-reports of asthma, depressive symptoms, arthritis, cancer, diabetes, cardiovascular disease (CVD), stroke, and hypertension., Results: After adjusting for age, high school graduation, income, and marital status, African Americans who reported arthritis (women: odds ratio (OR)=4.87; 95% confidence interval(CI): 2.92-8.12; men: OR=2.93; 95% CI: 1.36-6.30) had higher odds of disability compared to those who did not report having arthritis. Women who reported major depressive symptoms (OR=2.59; 95% CI: 1.43-4.69) or diabetes (OR=1.83; 95% CI: 1.14-2.95) had higher odds of disability than women who did not report having these conditions. Men who reported having CVD (OR=2.77; 95% CI: 1.03-7.41) had higher odds of disability than men who did not report having CVD., Conclusions: These findings demonstrate the importance of chronic conditions in understanding disability in African Americans and how it varies by gender. Also, these findings underscore the importance of developing health promoting strategies focused on chronic disease prevention and management to delay or postpone disability in African Americans., Publication Indices: Pubmed, Pubmed Central, Web of Science database., (Copyright © 2016. Published by Elsevier Inc.)

Objective: Poorer health profiles among African American men throughout the life course evince greater rates of cardiovascular disease (CVD) and significantly earlier mortality compared with other groups. Despite growing emphasis on identifying how psychosocial factors influence disparate disease risk, little of this research has focused intently on African American men., Methodology: Using hierarchical linear regression, we explored the additive influence of stress, depression, and perceived control on pulse pressure, an established marker of CVD risk, in a sample (N = 153) of African American men (mean age = 66.73 ± 9.29) from the Baltimore Study of Black Aging (BSBA)., Results: After accounting for age and health status indicators, perceived control emerged as a significant predictor of pulse pressure., Discussion: These findings suggest that greater belief in one's own efficacy is a protective factor for cardiovascular health among African American men. Future research should examine whether enhancing perceived control can have an appreciable impact on the immense CVD burden in this and other at-risk populations.

Objectives: The present study examined the relationship between desegregated schooling and cognitive change in a sample of 420 community-dwelling African American elders (mean age = 68.6; SD = 9.1)., Method: Participants were recruited for the Baltimore Study of Black Aging - Patterns of Cognitive Aging. Cognitive measures from six domains of function were administered at baseline and follow-up 33 months later. Repeated measures multivariate analysis of covariance was conducted; the between subjects factors were schooling type and age cohort, and the within subjects factor was time. Analyses controlled for age, years of education, and sex, and follow-up univariate analyses were used to determine which individual cognitive scores drove the multivariate effects., Results: There were significant multivariate within-group, between-group, and interaction effects (p < .05). Univariate analyses indicated that the desegregated schooling group scored significantly better on Language and Perceptual Speed (p < .01), and the youngest age cohort (50- to 59-year-olds) performed better on measures of Perceptual Speed. There were no significant univariate interactions between schooling group or age cohort and cognitive change over time., Discussion: Overall, these findings suggest a slight advantage of desegregated schooling for cognitive performance, but no advantage of desegregated schooling on the rate of cognitive change over time in this sample., (© The Author 2014. Published by Oxford University Press on behalf of The Gerontological Society of America. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.)

Objective: Despite high rates of poor health outcomes, little attention has been focused on associations between prominent health factors and cognitive function in African American men, exclusively. The objective was to examine relationships between cardiovascular and pulmonary health, and cognitive function in African American men., Method: Data from 257 men were pooled from two studies of African American aging. The mean age of participants was 58.15 and mean educational attainment was 11.78 years. Participants provided self-reported health and demographic information, completed cognitive measures, and had their blood pressure and peak expiratory flow assessed., Results: After adjustment, significant relationships were found between average peak expiratory flow rate (APEFR) and cognitive performance measures., Discussion: Results suggest that lung function is important to consider when examining cognitive function in African American men. Understanding the role of health in cognition and implications for quality of life in this population will be critical as life expectancies increase., (© The Author(s) 2014.)

Purpose: Few studies have examined the behavioral and clinical indicators of sleep difficulty among older African Americans diagnosed with arthritis. This study aimed to examine the association of sleep, pain, and comorbid indicators among this population., Method: Using a cross-sectional design, 193 older African Americans (70.4 ± 9.11 years of age) completed a series of questions assessing health, pain, and sleep., Results: Findings showed that young old participants (β = -.28, p < .001) reported more difficulty sleeping and being awakened due to pain (β = -.17, p < .05) than the old old adults., Conclusion: There is significant within-group variability, with young old adults being most affected by sleep difficulties., Implications for Practice: While the relationship between pain and sleep may be intuitive for majority populations, the dynamics of this association may be useful in promoting sleep awareness and providing resources for caregivers and health care professionals to better meet the needs of this population., (© The Author(s) 2014.)

Background: Perceived discrimination is a major source of health-related stress. The purpose of this study was to model the heterogeneity of everyday-discrimination experiences among African American and Caribbean Blacks and to identify differences in the prevalence of mood and substance use outcomes, including generalized anxiety disorder, major depressive disorder, alcohol-use disorder, and illicit drug-use disorder among the identified subgroups., Method: The study uses data from the National Survey of American Life obtained from a sample of African American and Caribbean Black respondents (N=4,462) between 18 and 65 years., Results: We used latent profile analysis and multinomial regression analyses to identify and validate latent subgroups and test hypotheses, yielding 4 classes of perceived everyday discrimination: Low Discrimination, Disrespect and Condescension, General Discrimination, and Chronic Discrimination. Findings show significant differences exist between the Low Discrimination and General Discrimination classes for major depressive disorder, alcohol-use disorder, and illicit drug-use disorder. Moreover, we find significant differences exist between the Low Discrimination and Chronic Discrimination classes for the four disorders examined. Compared with the Chronic Discrimination class, members of the other classes were significantly less likely to meet criteria for generalized anxiety disorder, major depressive disorder, alcohol-use disorder, and illicit drug-use disorder., Conclusions: Findings suggest elevated levels of discrimination increase risk for mood and substance-use disorders. Importantly, results suggest the prevalence of mood and substance-use disorders is a function of the type and frequency of discrimination that individuals experience., (Copyright © 2014 Elsevier Ltd. All rights reserved.)

Objective: Persistent and consistently observed racial disparities in physical functioning likely stem from racial differences in social resources and environmental conditions., Method: We examined the association between race and reported difficulty performing instrumental activities of daily living (IADL) in 347 African American (45.5%) and Whites aged 50 or above in the Exploring Health Disparities in Integrated Communities-Southwest Baltimore, Maryland Study (EHDIC-SWB)., Results: Contrary to previous studies, African Americans had lower rates of disability (women: 25.6% vs. 44.6%, p = .006; men: 15.7% vs. 32.9%; p = .017) than Whites. After adjusting for sociodemographics, health behaviors, and comorbidities, African American women (odds ratio [OR] = 0.32, 95% confidence interval [CI] = [0.14, 0.70]) and African American men (OR = 0.34, 95% CI = [0.13, 0.90]) retained their functional advantage compared with White women and men, respectively., Conclusion: These findings within an integrated, low-income urban sample support efforts to ameliorate health disparities by focusing on the social context in which people live., (© The Author(s) 2014.)

Objective: The goal of our study was to examine how Big Five personality factors predict variability in self-rated health in a sample of older African Americans from the Baltimore Study of Black Aging., Methods: Personality was measured by the NEO Personality Inventory-Revised, and self-rated health was assessed by the Health Problems Checklist., Participants: The study sample had 202 women and 87 men. Ages ranged from 49 to 90 years (M = 67.2 years, SD = 8.55), and average years of formal education was 10.8 (SD = 3.3)., Results: Multiple linear regressions showed that neuroticism and extraversion were significant regression predictors of self-rated health, after controlling for demographic factors., Conclusions: These findings suggest individual personality traits may influence health ratings, behaviors, and decision-making among older African Americans.

Objective: Little is known about the relationship between family longevity, stress, and CVD in African Americans., Methodology: Data consisted of 3274 participants aged ≥ 50 years with information on parental living status, the three indicators of stress, and cardiovascular health from the Jackson Heart Study (JHS)., Results: Those with both parents dead had significantly fewer life events than those with mother alive but father dead and those with both parents alive. Controlling for age, sex, and education, there were significant main effects for the number of life events, as well as the three parental living status variables in comparison to the both dead category. There is evidence for mediation with life events and weekly stress events, but not with global stress., Discussion: The results show that there is a pattern on longevity in African American families that intersects with their stress experiences. Further examination of how generational patterns of stress are passed down is warranted.

Differentiating somatic from emotional influences on the experience of chronic pain has been of interest to clinicians and researchers for many years. Although prior research has not well specified these pathways at the anatomical level, some evidence, both theoretical and empirical, suggest that emotional reactions influence the experience of disease and non-disease-related pains. Other studies suggest that treatments directed at negative emotional responses reduce suffering associated with pain. The current study was conducted to explore the influence of emotional reactions to pain as a predictor of psychological distress in a sample of adult Blacks with Sickle Cell Disease (SCD). Using cross-sectional survey data, we evaluated whether negative emotional reactions to the experience of pain were predictive of psychological distress after controlling for the somatic dimension of pain and age in n = 67 Black patients with Sickle Cell Disease (SCD). Results showed that greater negative emotion associated with pain predicted Somatization (p < .01), Anxiety (p < .05), Phobic Anxiety (p < .05), and Psychoticism (p < .05). Increased negative emotion associated with pain was also predictive of the General Symptoms Index (p < .05) and the Positive Symptoms Total from the SCL-90-R (p < .01). We believe the current study demonstrates that negative emotional reactions to the experience of pain in adults with SCD are predictive of psychological distress above and beyond the influences of age and the direct nociceptive experience. We also believe these data to be valuable in conceptualizing the allocation of treatment resources toward a proactive approach with early identification of patients who are responding poorly for the purpose of potentially reducing later psychopathology. A deeper understanding of the ways that subpopulations cope with chronic disease-related pain may produce models that can be ultimately generalized to the consumers of the majority of healthcare resources.

This study examined factors that influence sleep quality in older African American women (N = 181) reporting chronic pain. Participants completed a series of questions assessing demographic and behavioral characteristics, health status, pain intensity, and sleep disturbance. Findings indicated that younger participants and those experiencing poorer physical functioning reported more difficulty sleeping due to pain. Similarly, participants who reported being awakened from sleep due to pain were younger and experienced greater pain intensity. Understanding the relationship between sleep and pain in this group of women may be useful in promoting effective disease management and sleep awareness among patients, caregivers, and healthcare professionals.

Objective: The current study examined a 5-year cognitive change in untrained African American and White participants from the Advanced Cognitive Training in Independent and Vital Elderly (ACTIVE) study., Method: Five-year trajectories of memory, reasoning, visual processing speed/useful field of view, digit-symbol substitution, and vocabulary were investigated. Education, health, gender, age, and retest/practice effects were controlled for, and a missing data pattern mixture approach was used to adjust for dropout effects., Results: After considering age, education, health, and gender, being African American uniquely explained 2% to 7% of the variance in cognitive performance. There were virtually no significant race differences in the rates of change., Discussion: Race-related results in the current study are consistent with previous research suggesting that social advantage factors such as education have a stronger influence on the level of performance than the rate of change. The small remaining effects of being African American on performance levels likely reflect uncontrolled variation in factors like literacy and financial advantage.

Objective: To determine whether the association between SES and disability vary by age in African Americans., Methods: Logistic regression models were conducted to estimate the association between SES and disability by age group in 395 African Americans participating in the Carolina African American Twin Study of Aging. Disability was defined as difficulty in performing at least one of seven basic activities of daily living. Education and family income were used as measures of SES. Age was categorized as individuals aged < 49 years and aged > or = 50 years., Results: After adjusting for demographic and health-related characteristics among older adults, a higher odds of disability was associated with no post-secondary education (OR = 3.09, 95% CI: 1.24-7.71), and with low-income (OR = 2.74, 95% CI: 1.17-6.43) compared to more educated or affluent people, respectively. No association between SES and disability was observed in young adults. When considering the combined effect of no post-secondary education and low-income on disability, older adults with no post-secondary education had a greater odds of being disabled (OR = 2.63, 95% CI: 1.03-6.73) relative to those with a post-secondary education controlling for covariates., Conclusions: The findings demonstrate the advantage of disentangling the confounding of race and SES as an initial step to understanding the relationship among age, SES and disability in African Americans.

Because of the excess burden of preventable chronic diseases and premature death among African American men, identifying health behaviors to enhance longevity is needed. We used data from the Third National Health and Nutrition Examination Survey 1988-1994 (NHANES III) and the NHANES III Linked Mortality Public-use File to determine the association between health behaviors and all-cause mortality and if these behaviors varied by age in 2029 African American men. Health behaviors included smoking, drinking, physical inactivity, obesity, and a healthy eating index score. Age was categorized as 25-44 years (n = 1,045), 45-64 years (n = 544), and 65 years and older (n = 440). Cox regression analyses were used to estimate the relationship between health behaviors and mortality within each age-group. All models were adjusted for marital status, education, poverty-to-income ratio, insurance status, and number of health conditions. Being a current smoker was associated with an increased risk of mortality in the 25- to 44-year age-group, whereas being physically inactive was associated with an increased risk of mortality in the 45- to 64-year age-group. For the 65 years and older age-group, being overweight or obese was associated with decreased mortality risk. Efforts to improve longevity should focus on developing age-tailored health promoting strategies and interventions aimed at smoking cessation and increasing physical activity in young and middle-aged African American men.

Twin studies have seldom addressed ethnicity as one of the possible factors that create unique combinations of genetic and environmental influences. The major objective of the Carolina African American Twin Study of Aging is to identify the proportion of the genetic and environmental sources of individual variation in measures of health and behavioral factors in a sample of adult African Americans. Drawn from birth records from the State of North Carolina, this in-person study used public records to identify a cohort of twins between 22 and 92 years of age (X = 49.82 yrs, SD = 14.62), 39.7% of which were men. Members of non-intact twin pairs and siblings were also recruited to explore alternative models to the classic twin design. To date, the project has contributed to knowledge about blood pressure, forced expiratory volume, chronic illness, body mass index, and waist-hip ratio memory, personality, social, and demographic factors, mortality, and mental health.

Social support and functional ability are related to a number of outcomes in later life among African Americans, including cognitive performance. This study examined how providing and receiving social support was related to fluid and crystallized cognitive abilities among aging African American adults after accounting for functional limitations, age, education, sex, income, and self-reported health. Data from 602 African American adults (M = 69.08, SD = 9.74; 25% male) were analyzed using latent variable modeling. Fluid ability was a second-order factor indicated by measures that assessed verbal memory, working memory, perceptual speed, and inductive reasoning. Crystallized ability was a first-order factor indicated by three measures that assessed vocabulary (Shipley Verbal Meaning Test and parts A and B of the ETS Vocabulary Test). Results indicated that the receipt of social support was negatively related to both fluid and crystallized abilities, while the provision of support was positively related to fluid and crystallized ability. Follow-up tests found that the receipt of support was more strongly related to fluid ability than crystallized ability. There was no significant difference regarding the relationship of provision of support with fluid ability compared to crystallized ability. Results discuss the importance of considering the social context of older adults when examining cognitive ability.

This study examines day-to-day variability in psychometrically defined mild cognitive impairment (MCI) status and potential predictors of changes in MCI status in an independent-living sample of urban dwelling older adults in Baltimore, Maryland. The participant sample consisted of 50 older adults, ranging in age from 50 to 80 years. Participants completed health and cognitive measures (i.e., executive function, language, memory, and global cognition) over 8 occasions within a 2-3-week period. After each testing occasion, a post hoc classification of MCI status was determined using psychometrically defined criteria based on cognitive performance. Participants who classified as MCI after one assessment often did not meet MCI criteria at subsequent occasions. Daily fluctuations in sleep duration were associated with an increased risk for MCI classification. These results demonstrate that changes in sleep may explain changes in MCI status, particularly for African Americans., (2013 APA, all rights reserved)

Purpose: To determine the genetic and environmental influences exerted on arthritis by measuring the distribution of self-reported arthritis diagnoses among monozygotic (MZ) and dizygotic (DZ) African American twins., Methods: A cross-sectional study was conducted on 97 MZ and 113 DZ twin pairs recruited into the Carolina African American Twin Study of Aging (CAATSA). The sample had a mean age of 47 +/- 13.9 years. A twin design was used to determine correlations in arthritis diagnosis for MZ and DZ twins and to estimate the contribution of genes and environment to the variation in an arthritis diagnosis., Results: The concordance rate for being diagnosed with arthritis was 42% for MZ twins, and 20% for DZ twins, resulting in a 2.1:1 ratio of MZ to DZ concordance. These results indicate a significant proportion of individual variability was due to genetic factors (43%) on an arthritis diagnosis as well as 57% of variance due to nonshared environmental influences., Conclusion: This research suggests that while there are genetic influences on arthritis diagnosis, environmental factors, such as infections, dietary factors, urbanization, and pollutants, also play a role in accounting for variability in the diagnosis and treatment of arthritis among diverse populations.

Unlabelled: BACKGROUND/STUDY CONTEXT: The current study examined the relationship between intellectual control and cognition and related the results to everyday problem solving in a mixed ethnicity sample of 35% African American and 65% Caucasian elders., Methods: Participants completed the Personality in Intellectual Aging Contexts Inventory (PIC; Lachman et al., 1982 , Journal of Research in Personality, 16, 485-501), Everyday Cognition Battery (ECB; Allaire & Marsiske, 1999 , Psychology & Aging, 14, 627-644; 2002 , Psychology & Aging, 17, 101-115), and a battery of basic cognitive ability tests assessing memory, inductive reasoning, and verbal meaning., Results: Results indicated that African Americans had significantly lower intellectual control beliefs relative to Caucasian older adults. Regression models suggested that relationship between control beliefs and cognition was moderated by education and race. Decomposing the interactions with simple slope analysis revealed that across cognitive abilities, better cognitive performance was related to higher control beliefs in African Americans with at least 13 years of education. A similar relationship was also found in Caucasian elders with lower education., Conclusion: African American elders' reaching a higher level of education may provide a basis for which individual differences in intellectual control beliefs are activated and thereby more strongly associated with cognitive performance.

Unlabelled: BACKGROUND/STUDY CONTEXT: Everyday cognition represents the ability to solve problems within domains that are representative of issues faced by adults on a daily basis. The current study examined individual differences in everyday cognitive ability among aging Black/African American adults., Methods: Demographic data on age, gender, education, physical functioning, chronic illnesses, self-reported health, and depression were collected from 248 African American adults (mean age = 67.8 years, standard deviation = 8.47 years). A multiple indicators, multiple causes (MIMIC) modeling approach was used to examine the associations of individual characteristics with latent everyday cognitive ability and composite score indicators., Results: Age, depressive symptoms, and number of chronic illnesses were negatively related to latent everyday cognition. The individual characteristics of age, depressive symptoms, self-rated health, and education were directly associated with composite indicators of latent everyday cognition. This suggests that within this sample of older Black/African American adults that certain composite scores (i.e., telephone use, food preparation, and finances) may be particularly sensitive to these individual characteristics., Conclusion: These results identify specific sources of variability in everyday cognitive ability among aging Blacks/African Americans. These individual differences should be accounted for when studying everyday cognition among Blacks/African Americans and when comparing the everyday cognitive ability of Blacks/African Americans with other groups.

Obesity is a biological risk factor or comorbidity that has not received much attention from scientists studying hypertension among African American men. The purpose of this study was to examine the relationship between weight status and high blood pressure among African American men with few economic resources. The authors used surveillance data collected from low-income adults attending community- and faith-based primary care clinics in West Tennessee to estimate pooled and group-specific regression models of high blood pressure. The results from group-specific logistic regression models indicate that the factors associated with hypertension varied considerably by weight status. This study provides a glimpse into the complex relationship between weight status and high blood pressure status among African American men. Additional research is needed to identify mechanisms through which excess weight affects the development and progression of high blood pressure.

The current analysis examined (a) if measures of psychological well-being predict subjective memory, and (b) if subjective memory is consistent with actual memory. Five hundred seventy-nine older African Americans from the Baltimore Study of Black Aging completed measures assessing subjective memory, depressive symptomatology, perceived stress, locus of control, and verbal and working memory. Higher levels of perceived stress and greater externalized locus of control predicted poorer subjective memory, but subjective memory did not predict objective verbal or working memory. Results suggest that subjective memory is influenced by aspects of psychological well-being but is unrelated to objective memory in older African Americans.

Purpose: African Americans are disproportionately affected by hypertension. The goal here was to better understand the relationship between well-being and environmental factors and their influence on hypertension. It was hypothesized that there would be a positive association among perceived stress, depression, and hypertension mediated by social support., Methods: Data from 2 sample populations were included: the Carolina African American Study of Aging (N = 395) and the Baltimore Study of Black Aging (N = 602) provided information on demographics, perceived stress, social support, depression, and hypertension. Regression analysis was used to examine the hypothesis., Results: Significant relationships were found between perceived stress/depression and hypertension. The relationship between depression and hypertension was partially mediated by social support (given), while the relationship between depression and hypertension was not., Conclusions: Our findings suggest that the impact of stress and hypertension is mediated by individual coping strategies. Given the excess stress and hypertension experienced by African Americans, coping may be a particularly salient factor in longevity. Future research should provide insight about specific aspects of coping and other personal characteristics that facilitate and limit the effect of coping on hypertension.

This study examined the within-person relationship between sleep and cognitive functioning. Fifty community-dwelling African Americans (age range = 50-80 years) were asked to report their sleep duration and quality the previous evening and to complete cognitive measures over 8 occasions within a 2-3 week period. A within-person daily change in sleep duration was significantly associated with worse global cognitive performance. The greater an individual deviated away from his or her average sleep duration on a particular day, the more likely his or her performance would decline. These results demonstrate that the sleep-cognition relationship can be observed at a within-person level of analysis., ((c) 2010 APA, all rights reserved).)

This study examined the fluid-crystallized distinction of cognitive abilities in African Americans. We analyzed the factorial invariance of a battery of cognitive ability measures in a sample of 197 community-dwelling African American elders. Specifically, factorial invariance was tested in groups of African American elders differing in age (50-61 years, 62-79 years) and education (low, high). Using a partial invariance approach, if non-invariance was found between two groups, we explored the specific model parameters that contributed to the overall lack of invariance. The results indicated that the factor structure was confirmed in the sample as a whole. Evidence of strict invariance was found between age groups. However, a lack of invariance of specific factor loadings, intercepts, and uniqueness terms was found between education groups. The importance of highlighting idiosyncrasies in cognitive performance among African Americans is shown using a within group variation approach.

Objectives: To examine the frequency of Mild Cognitive Impairment (MCI) in African American older adults. The study also plans to explore the specific cognitive domains of impairment as well as whether there are differences in demographics, health, and cognitive performance between MCI and normal participants., Design: Cross-sectional., Setting: Independent-living sample of urban dwelling elders in Baltimore, Maryland., Participants: The sample consisted of 554 subjects ranging in age from 50 to 95 (Mean = 68.79 +/- 9.60)., Measurements: Socio-demographics and health were assessed. Several cognitive measures were administered to assess inductive reasoning, declarative memory, perceptual speed, working memory, executive functioning, language and global cognitive functioning., Results: Approximately 22% of participants were considered MCI (i.e. 18% non-amnestic vs. 4% amnestic). A majority of the non-amnestic MCI participants had impairment in one cognitive domain, particularly language and executive function. Individuals classified as non-amnestic MCI were significantly older and had more years of education than normal individuals. The MCI groups were not significantly different than cognitively normal individuals on health factors. Individuals classified as MCI performed significantly worse on global cognitive measures as well as across specific cognitive domains than cognitively normal individuals., Conclusion: This study demonstrates that impairment in a non-memory domain may be an early indicator of cognitive impairment, particularly among African Americans., ((c) 2010 John Wiley & Sons, Ltd.)

Objective: To examine the interrelated effects of cardiovascular health, education, and cognitive functioning in African Americans., Method: The present study utilized data from the Baltimore Study of Black Aging to examine whether (a) cardiovascular health and educational attainment predicted cognitive functioning, after controlling for age, and (b) there was an interaction between cardiovascular health and education in predicting cognitive functioning., Results: Using hierarchical regression analyses, results showed education was significant for all cognitive measures; however, cardiovascular health was significant for only three., Discussion: These findings suggest that although self-reported cardiovascular health contributes to variability in late life cognition in African Americans, education is a more universal predictor that should be further examined.

Few studies have examined traits or behaviors that may predispose some African Americans to poor cardiovascular health outcomes. While several models of personality exist, the 5-factor model (FFM) is arguably the best representation of personality and provides a useful framework for the study of personality and health. Among personality characteristics associated with health risks among African Americans, a high-effort coping style called John Henryism is among the most thoroughly examined. It is not clear if personality coping and health are connected in a meaningful way. The present study utilized data from the Baltimore Study of Black Aging (BSBA) to examine whether personality was linked to John Henryism, how personality might be linked to cardiovascular health, and how John Henryism might mediate the relationship between personality and cardiovascular health. The sample consisted of 234 older African Americans (mean age, 67 years), 28% of which were men. Regressions were used to examine the questions. The results indicated that those who are more neurotic report more cardiovascular health problems, and that openness and conscientiousness were significant predictors of active coping. The mediation analysis results suggest that coping style did not mediate the relationship between personality and reports of cardiovascular health problems. These findings highlight the importance of personality in accounting for cardiovascular health in African Americans.

Objective: We investigated the associations between hypertension status and the genotypes of four single nucleotide polymorphism (SNP) sites in four hypertension-related genes (Angiotensinogen [AGT], Angiotensin I Converting Enzyme [ACE], Angiotensinogen II receptor, subtype 1 [AGTR1], and Alpha 1-Antichymotrypsin [ACT or SERPINA3]), in an African American sample., Methods: DNA from 628 participants of the Carolina African American Twin Study of Aging project, a population-based study of African American adult twins, was genotyped using SNPs shown to be associated with hypertension in other studies., Results: The ACE SNP (ACE4 or A-240T) was associated with hypertension (P = .047 in a generalized estimating equations alternating logistics regression model that included age, body mass index, sex, and education. The analysis indicated a protective effect of the TT genotype (odds ratio [OR] 1.59, 95% confidence interval [CI] 1.03-2.48, P = .04) and of the AT genotype (OR 1.91, 95% CI 1.01-3.62, P = .047) compared with the AA genotype., Discussion: These results extend previous findings of associations of various polymorphisms of ACE to hypertension and support the association of hypertension to the A allele of ACE4. The potential for this polymorphism to alter expression by its position in the gene's promoter region suggests that future studies of altered ACE protein activity are warranted.

The structure and organization of cognitive abilities has been examined across the life span. The current analysis had three specific aims: (1) test the factor structure of a broad cognitive ability battery across three age groups; (2) examine differences in the pattern of factor covariation across age groups; and (3) examine the pattern of factor mean differences across age groups. A sample of 512 older African Americans (mean age = 66.6 years, 25.4% male) from the Baltimore Study of Black Aging was administered a battery of cognitive tests assessing the domains of perceptual speed, verbal memory, inductive reasoning, vocabulary, and working memory. Factor models were estimated separately in middle-age adults (50-59 years, n = 107), young-old adults (60-69 years, n = 198), and old-old adults (70-79 years, n = 207). There was loading invariance across the three age groups that suggests that the selected tests measured cognition similarly across age. There was no evidence of dedifferentiation across increasingly older age groups. Factor mean differences were observed with the middle-age group having significantly higher factor means than the young-old and old-old groups; however, there was only one factor mean difference between the young-old and the old-old groups. The results suggest that a pattern of dedifferentiation of cognitive abilities does not exist within this sample of older African Americans and that the 60-69 year age range may be a critical period for cognitive decline in this population.

Background: There is significant attention to the growing elderly African American population and estimating who and how many within this population will be affected by cognitive impairment., Objective: The etiology of cognitive impairment has not been well studied in African Americans and the contribution of genetic and environmental influences to cognitive impairment is not clear., Methods: We calculated concordance rates and heritability for cognitive impairment in 95 same-sexed pairs of African American twins from the Carolina African American Twin Study on Aging (CAATSA). The sample had an average age of 59.6 years (SD = 8.6 years, range 50-88 years) and 60% were female. The Telephone Interview for Cognitive Status (TICS) was used to assess cognitive impairment with a lower cutoff based on our previous research with African Americans., Results: Thirteen of the monozygotic (MZ) twins (30.2%) and 9 of the dizygotic (DZ) twins (17.3%) were cognitively impaired. The concordance rate was 72% for MZ and 45% for DZ. We found the heritability for cognitive impairment to be 54%., Conclusions: The study findings indicate that cognitive impairment is highly heritable, suggesting that genetics may play a relatively large role in the development of cognitive impairment in African American twins.

This article compared and contrasted the Telephone Interview of Cognitive Status (TICS) to the racially-sensitive Short Portable Mental Status Questionnaire (SPMSQ). The empirical questions addressed was whether the TICS over-represented African American (AA) cognitive impairment (CI) relative to the SPMSQ, if there were age differences in CI prevalence between younger subjects (ages 50-64) and older ones (>64 years) and on accuracy to detect CI in individuals with higher levels of educations (> or =13 years) versus those with lower education levels (<13 years). A secondary data analysis was performed on 396 AA participants from the Carolina African American Twin Study on Aging (CAATSA). The SPMSQ measured CI prevalence at 10.3% and the TICS at 45.0%. Within the younger group, TICS and CI prevalence was 49.3 and 80% among the older group. Within the younger group SPMSQ and CI prevalence was 14.5 and 53.8% among the older group. Within the higher educated group, TICS and CI prevalence was 36.7 and 51.4% among the lower educated. Within the higher educated group, SPMSQ and CI prevalence was 7.7 and 14.5% among the lower educated. Findings are consistent with our hypotheses that the TICS would be a less accurate assessor of CI among AAs.

Depression is typically considered relative to individuals and thought to originate from both biological and environmental factors. However, the environmental constraints and insults that African Americans experience likely influence the concordance by age and gender for depression scores among adult African American twins. Monozygotic (MZ) (n = 102) and Dizygotic (DZ) (n = 110) twins, age 25-88 years in the Carolina African American Twin Study of Aging were examined using an 11-item version of the CES-D measure of depressive symptomatology. Those participants with scores above nine were considered depressed. Overall, the MZ pairs had a higher concordance than the DZ pairs implying genetic influence. Both MZ and DZ males had higher concordances than either female zygosity groups. The difference between the concordance rates for MZ and DZ twin pairs was greater in males than females. By age group, the difference between the concordance rates for younger MZ and DZ twin pairs was much larger than for older pairs. The results suggest that, even though African Americans may be at risk for depression due to contextual/environmental factors, genetic influences remain important.