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

Background: Musculoskeletal pain alters physiological function, which may be evidenced as early as middle age. Previous research has concluded that middle-aged adults are a high-risk group for musculoskeletal pain and report functional limitations similar to older adults. However, few studies have examined the relationships between musculoskeletal pain and physical function, using objective performance measures in a sample of racially and socioeconomically diverse adults. Thus, this study examined musculoskeletal pain in relation to physical function in middle-aged (30-64 years) White and Black adults and investigated whether the relationship varied by sociodemographic characteristics.Methods: This cross-sectional examination incorporated data from the Healthy Aging in Neighborhoods of Diversity across the Life-Span Study. Participants (n = 875) completed measures of musculoskeletal pain and objective measures of physical performance (ie, lower and upper body strength, balance, and gait abnormalities). Physical performance measures were standardized to derive a global measure of physical function as the dependent variable.Results: Approximately, 59% of participants identified at least 1 pain sites (n = 518). Multivariable regression analyses identified significant relationships between greater musculoskeletal pain and poorer physical function (β = -0.07, p = .031), in mid midlife (β = -0.04, p = .041; age 40-54) and late midlife (β = -0.05, p = .027; age 55-64).Conclusions: This study observed that musculoskeletal pain was associated with poorer physical function within a diverse group of middle-aged adults. Future research should longitudinally explore whether chronic musculoskeletal pain identified at younger ages is associated with greater risk for functional limitation and dependence in later life. [ABSTRACT FROM AUTHOR]

We assessed trends, predictors and outcomes of resource utilization in hospital inpatient discharges with a principal diagnosis of Alzheimer's disease (AD) with at least one procedure. Using Nationwide Inpatient Sample data (NIS, 2002-2012), discharges primarily diagnosed with AD, aged ≥60 y and with ≥1 procedure, were selected (Weighted N = 92,300). Hospital resource utilization were assessed using ICD-9-CM codes, while hospitalization outcomes included total charges (TC, 2012$), length of stay (LOS, days), and mortality risk (MR, %). Brain and respiratory/gastrointestinal procedure utilization both dropped annually by 3-7%, while cardiovascular procedures/evaluations, blood evaluations, blood transfusion, and resuscitation ("CVD/Blood") as well as neurophysiological and psychological evaluation and treatment ("Neuro") procedures increased by 5-8%. Total charges, length of stay, and mortality risk were all markedly higher with use of respiratory/gastrointestinal procedures as opposed to being reduced with use of "Brain" procedures. Procedure count was positively associated with all three hospitalization outcomes. In sum, patterns of hospital resources that were used among AD inpatients changed over-time, and were associated with hospitalization outcomes such as total charges, length of stay, and mortality risk. [ABSTRACT FROM AUTHOR]

Objectives To examine the relationship between erythrocyte mean corpuscular volume ( MCV) and cognitive performance over time. Design Longitudinal. Setting Sample from the Baltimore Longitudinal Study of Aging ( BLSA). Participants Eight hundred twenty-seven participants from the BLSA (mean age 67, range 50-96). Measurements Mean corpuscular volume and several other blood indices were measured, including hemoglobin, iron, ferritin, vitamin B12, folate, white blood cell count, albumin, and erythrocyte sedimentation rate. Cognitive performance was examined using neuropsychological measures of visual memory, verbal memory, language, attention, executive function, and global mental status. Results High MCV levels were significantly associated with lower global mental status even after adjusting for potential confounders. High MCV levels were also significantly associated with high rates of decline on tasks of global mental status, long delay memory, and attention, even after adjusting for potential confounders. Conclusion The findings confirm a previous observation that larger erythrocytes in older adults are associated with poorer cognitive function. Anemia and inflammation do not appear to explain the relationship between MCV and cognition. Further research is needed to clarify the mechanisms behind this association. [ABSTRACT FROM AUTHOR]

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

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

In the inpatient setting, prevalence, predictors, and outcomes [mortality risk (MR), length of stay (LOS), and total charges (TC)] of Alzheimer's disease (AD) are largely unknown. We used data on older adults (60+ y) from the Nationwide Inpatient Sample (NIS) 2002-2012. AD prevalence was ∼3.12% in 2012 (total weighted discharges with AD ± standard error: 474, 410 ± 6,276). Co-morbidities prevailing more in AD inpatient admissions included depression (OR = 1.67, 95% CI: 1.63-1.71, p <  0.001), fluid/electrolyte disorders (OR = 1.25, 95% CI: 1.22-1.27, p <  0.001), weight loss (OR = 1.26, 95% CI: 1.22-1.30, p <  0.001), and psychosis (OR = 2.59, 95% CI: 2.47-2.71, p <  0.001), with mean total co-morbidities increasing over time. AD was linked to higher MR and longer LOS, but lower TC. TC rose in AD, while MR and LOS dropped markedly over time. In AD, co-morbidities predicting simultaneously higher MR, TC, and LOS (2012) included congestive heart failure, chronic pulmonary disease, coagulopathy, fluid/electrolyte disorders, metastatic cancer, paralysis, pulmonary circulatory disorders, and weight loss. In sum, co-morbidities and TC increased over time in AD, while MR and LOS dropped. Few co-morbidities predicted occurrence of AD or adverse outcomes in AD. [ABSTRACT FROM AUTHOR]

Objective: Our aim was to examine sex- and age-specific relationships of sleep behaviors with all-cause mortality rates.Methods: A retrospective cohort study was conducted among 5288 adults (≥50 years) from the 2005-2008 National Health and Nutrition Examination Surveys who were followed-up for 54.9 ± 1.2 months. Sleep duration was categorized as < 7 h, 7-8 h and >8 h. Two sleep quality indices were generated through factor analyses. 'Help-seeking behavior for sleep problems' and 'diagnosis with sleep disorders' were defined as yes/no questions. Sociodemographic covariates-adjusted Cox regression models were applied to estimate hazard ratios (HRs) and 95% confidence intervals (CIs).Results: A positive relationship was observed between long sleep and all-cause mortality rate in the overall sample (HR = 1.90, 95% CI: 1.38, 2.60), among males (HR = 1.48, 95% CI: 1.05, 2.09), females (HR = 2.32, 95% CI: 1.48, 3.61) and elderly (≥65 years) people (HR = 1.80, 95% CI: 1.30, 2.50). 'Sleepiness/sleep disturbance' (Factor I) and all-cause mortality rate were positively associated among males (HR = 1.22, 95% CI: 1.03, 1.45), whereas 'poor sleep-related daytime dysfunction' (Factor II) and all-cause mortality (HR = 0.75, 95% CI: 0.62, 0.91) were negatively associated among elderly people.Conclusions: Sex- and age-specific relationships were observed between all-cause mortality rate and specific sleep behaviors among older adults. [ABSTRACT FROM AUTHOR]