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Objectives. We e va luated th e e ffe c t o f n e ig h b o rh o o d d isa d van ta g e (ND) on o ld e r a d u lts ' prevalence, awareness, tre a tm e n t, and c o n tro l o f h yp e rte n s io n . Methods. Data w e re from th e U n iv e rs ity o f A la b am a at B irm in g h am S tu d y o f A g in g , an o b s e rv a tio n a l s tu d y o f 1000 c om m u n ity -dw e llin g Black and W h ite A la b am ia n s aged 65 years and o ld e r, in 1999 to 2001. We assessed h yp e rte n s io n prevalence, awareness, tre a tm e n t, and c o n tro l w ith b lo o d pressure measurem e n ts and se lf-re p o rt data. We assessed ND w ith US Census data c o rre s p o n d in g w ith participants' census tracts, created tertiles o f ND, and fit models w ith generalized estimating equations via a lo g it link function w ith a binomial distribution. Adjusted models included variables assessing personal advantage and disadvantage, placebased factors, sociodemographics, comorbidities, and health behaviors. Results. L iv in g in m id -N D (adjusted o dds ra tio [AOR] = 1.6; 95% co n fid e n ce in te rva l [Cl] = 1.2, 2.1) and h ig h -N D te rtile s (AOR = 1.8; 95% Cl = 1.3, 2.3) was associated w ith h ig h e r hype rte n s io n prevalence, and liv in g in high-ND te rtile s w as associated w ith low e r o dds o f co n tro lle d h yp ertens ion (AOR = 0.6; 95% Cl = 0.4, 0.6). In adjusted models, ND was n o t associated w ith h yp ertens ion awareness o r tre a tm e n t. Conclusions. These fin d in g s s h ow th a t n e ig h b o rh o o d e n v iro nm e n ta l fa c to rs matter for hypertension outcomes and suggest the importance of ND for hypertension management in older adults. [ABSTRACT FROM AUTHOR]

Background: Body image (BI) may be important in understanding weight-related attitudes and behaviors in black women. Specifically, body dissatisfaction may mediate the relationship between body mass index (BMI) and weight-related quality of life (QOL) in black women. We examined the relationship between BMI and weight-related QOL in black women and tested for mediation by body dissatisfaction. Methods: The sample included 149 black women recruited from Birmingham, Alabama, for a one-time clinic visit. BIs were self-reported using the Pulvers figure rating scale. Body discrepancy (BD), a surrogate measure of body dissatisfaction, was calculated as perceived current image minus ideal image. QOL was self-reported using the Impact of Weight on Quality of Life-Lite (IWQOL-Lite). Baron and Kenny's test for mediation was conducted where BMI was the predictor, IWQOL-Lite score was the outcome, and BD was the mediator under investigation. Results: Mean age was 40.5 years, and mean BMI was 36.1 kg/m2. The mean IWQOL-Lite score was 81.1±15.8 out of 100. Participants had a BD score of 2.3, indicating a desire to be two figure sizes smaller than their current perceived body size. Tests for mediation revealed that BD partially mediated the relationship between BMI and IWQOL-Lite scores in this sample. Conclusions: BD was in the pathway of the association between BMI and IWQOL-Lite scores. BI dissatisfaction may contribute to explaining more about black women's weight-related QOL beyond actual BMI alone. Additional research is needed to better understand black women's perception of weight and subsequent weight-related behaviors. [ABSTRACT FROM AUTHOR]

Background: The association between years of education and cognitive function in older adults has been studied extensively, but the role of quality of education is unknown. We examined indicators of childhood educational quality as predictors of cognitive performance and decline in later life., Methods: Participants included 433 older adults (52% African American) who reported living in Alabama during childhood and completed in-home assessments of cognitive function at baseline and 4 years later. Reports of residence during school years were matched to county-level data from the 1935 Alabama Department of Education report for school funding (per student), student-teacher ratio, and school year length. A composite measure of global cognitive function was utilized in analyses. Multilevel mixed effects models accounted for clustering of educational data within counties in examining the association between cognitive function and the educational quality indices., Results: Higher student-teacher ratio was associated with worse cognitive function and greater school year length was associated with better cognitive function. These associations remained statistically significant in models adjusted for education level, age, race, gender, income, reading ability, vascular risk factors, and health behaviors. The observed associations were stronger in those with lower levels of education (≤12 years), but none of the education quality measures were related to 4-year change in cognitive function., Conclusions: Educational factors other than years of schooling may influence cognitive performance in later life. Understanding the role of education in cognitive aging has substantial implications for prevention efforts as well as accurate identification of older adults with cognitive impairment.

Background: Reduced glomerular filtration rate and albuminuria are associated with an increased risk for stroke. Their association with stroke symptoms is not known., Methods: The incidence of stroke symptoms was determined in 20 386 participants ≥45 years of age in the REasons for Geographic and Racial Differences in Stroke (REGARDS) study who were free of a history of stroke, transient ischemic attack and stroke symptoms at baseline. Six stroke symptoms were assessed via telephone interviews at baseline and every 6 months. Participants were followed over a median of 2.1 years (maximum follow-up of 6 years). Estimated glomerular filtration rate (eGFR) was calculated using the CKD-EPI equation and the albumin-to-creatinine ratio from spot urine samples., Results: The incidence of any stroke symptom (n = 2548 cases) was 10.8, 12.9, 18.2 and 20.7% among participants with an eGFR ≥90, 60-89, 45-59 and <45 mL/min/1.73m(2), respectively, and 10.8, 14.4, 17.0 and 18.8 for participants with albumin-to-creatinine ratios <10, 10-29, 30-299 and ≥300 mg/g, respectively (each P-trend < 0.001). The multivariable-adjusted hazard ratio (95% confidence interval) for any stroke symptom was 1.02 (0.91-1.14), 1.22 (1.01-1.48) and 1.26 (0.98-1.62) for those with an eGFR of 60-89, 45-59 and <45 mL/min/1.73m(2), respectively, versus ≥90 mL/min/1.73m(2) (P-trend = 0.022) and 1.16 (1.03-1.31), 1.29 (1.12-1.50) and 1.11 (0.82-1.49) for those with albumin-to-creatinine ratios of 10-29, 30-299 and ≥300 versus <10 mg/g, respectively (P-trend = 0.005)., Conclusions: Reduced eGFR and higher albuminuria levels are associated with an increased risk for incident stroke symptoms.