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The coronavirus (COVID-19) has spread quickly across the nation with a disproportionate impact on Black Americans. Many college-aged students receive their COVID-19-related information through social media and television even though research suggests that social media sources are more likely to be incorrect. Some students report trusting these sources over government sources such as the CDC and WHO. The purpose of this study was to understand Historically Black College and University (HBCU) students' COVID-19 knowledge, sources of information, and planned precautions. There were 21 in-depth interviews conducted with students attending a large southern HBCU during Spring 2020. Themes regarding knowledge included the following: it is a flu-like condition, it has international roots, there is inaccurate and changing information, and it is a pandemic. Themes regarding sources included: the news, US government and related officials, social media, interactions with family, and other social interactions. Themes regarding severity included the following: statistics, a distrust for hospital reporting, a belief that COVID-19 deaths were conflated with baseline health, peer influence, and familial influence. Themes regarding precautions included the following: proper mask use, hand washing/ sanitizing, avoiding large crowds/small crowds only, physical distancing, COVID-19 testing/symptom monitoring, and COVID-19 vaccination.

The longitudinal associations between subjective and objective memory functioning in later life remain unclear. This may be due, in part, to sociodemographic differences across studies, given the hypothesis that these associations differ across racial groups. Using data from the Advanced Cognitive Training for Independent and Vital Elderly (ACTIVE; N = 2,694; 26% African American), multiple-group, parallel-process latent growth curve models were used to explore relationships between subjective and objective memory over 10 years and assess racial differences in these associations. Across African Americans and whites, we found bidirectional associations between subjective and objective memory such that greater self-reported forgetting at baseline predicted faster subsequent verbal episodic memory declines, and higher baseline objective memory scores predicted less increase in self-reported forgetting over time. However, rates of change in self-reported frequency of forgetting were correlated with rates of change in verbal episodic memory in whites, but not in African Americans. Subjective memory complaints may be a harbinger of future memory declines across African Americans and whites but may not track with objective memory in the same way across these racial groups. (PsycInfo Database Record (c) 2021 APA, all rights reserved).

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COVID-19 spread across the nation with Black Americans experiencing twice of the prevalence of deaths than White Americans. Black American college students are facing a unique set of biopsychosocial costs including less retention and poorer mental health. Therefore, the purpose of this study was to examine how Historically Black College or University (HBCU) students contextualize COVID-19. Interviews were conducted with 19 participants and lasted 40-60 minutes. They discussed topics including: their COVID-19 knowledge, precautionary measures, and barriers and promoters of school success were covered. Data were coded through semi-open coding and discussed among the research team. Responses were summarized by eight themes: emotional responses, colorblind rhetoric, lack of healthcare, essential work, distrust for the medical field, barriers to precautions like supply shortages and environmental factors, and poor baseline health. These findings may be used to develop interventions that moderate the impact of COVID-19 and future pandemics on mental health.

Research has shown that socioeconomic factors influence physical mobility; however, less is known about the influence of neighborhood disadvantage on mobility among African American older adults. Data from the Baltimore Study of Black Aging (N=602) were used to examine associations between neighborhood disadvantage, as measured by the Area Deprivation Index (ADI), and self-reported mobility limitations. Two-step logistic regression showed that participants residing in more disadvantaged neighborhoods, based on national ADI, had higher odds of mobility limitations, but those in less disadvantaged neighborhoods, based on state ADI, had higher odds of mobility limitations (national: OR = 1.02 (95% CI: 1.00–1.03); state: OR = 0.78 (95% CI: 0.65–0.92)). Stratified models showed the association was significant only within women (national: OR = 1.02 (95% CI: 1.00–1.04); state: OR = 0.77 (0.63-0.95)). These findings suggest that neighborhood disadvantage is an essential consideration when examining mobility limitations among African Americans.

ObjectivesThis 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.MethodsThe sample was from Wave 1 data of Baltimore Study of Black Aging: Patterns of Cognitive Aging (N = 450; Mage = 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.ResultsParticipants 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.DiscussionThe 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.

Peripheral inflammation is elevated in older Black adults, an elevation which prior work has suggested may be due to chronic stress associated with systemic racism and related adverse cardiovascular health conditions. Inflammation is also involved in the pathogenic processes of dementia; however, limited (and mixed) results exist concerning inflammation and cognitive decline in Black adults. We characterized patterns of inflammation and their role in cognitive decline in 280 older Black adults (age = 72.99 ± 6.00 years; 69.6% female) from the Minority Aging Research Study (MARS) who were without dementia at baseline and followed between 2 and 15 years (mean = 9 years). Participants completed a blood draw at baseline and annual cognitive evaluations. Serum was assayed for 9 peripheral inflammatory markers; 19 neuropsychological test scores were used to create indices of global cognition and five cognitive domains. Principal component analysis with varimax rotation characterized patterns of inflammation with factor loadings 0.6 per component contributing to two composite scores representing acute/upstream and chronic/downstream inflammation. These composites were used as separate predictors in linear mixed regression models to determine associations with level and change in cognition adjusting for relevant covariates. Higher baseline upstream/acute inflammation associated with lower baseline semantic memory (p = .040) and perceptual speed (p = .046); it was not related to cognitive decline. By contrast, higher baseline downstream/chronic inflammation associated with faster declines in global cognition (p = .010), episodic (p = .027) and working memory (p = .006); it was not related to baseline cognition. For older Black adults, chronic, but not acute, inflammation may be a risk factor for changes in cognition.

Limited research has examined the extent neighborhood disadvantage relates to subclinical CVD such as carotid atherosclerosis, arterial stiffness, and endothelial dysfunction which are key, understudied CVD risk markers. Our objective was to examine associations between neighborhood disadvantage and subclinical CVD and whether associations vary by age, sex, race, and education. The analysis included 165 Black and White older adults (mean age=64.5y). Neighborhood disadvantage was characterized using the Area Deprivation Index (ADI). Multivariable regression analysis, adjusted for age, sex, race, education, and depression, showed that national and state ADI were significant, inverse predictors of carotid atherosclerosis (near wall IMT; p=.02) and state ADI was a significant, inverse predictor of flow-mediated dilation (p=.04). A significant interaction between state and national ADI and education predicting carotid IMT emerged, but the simple slopes were non-significant (p=.02, .03). Future research should consider the role of neighborhood as a predictor of early cardiovascular risk.

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. The Baltimore Study of Black Aging (n = 424) was utilized to examine the association between ADI and prospective physical health. Multiple regression analyses, covarying for age, sex, education, and income, showed that living in a neighborhood with greater disadvantage was significantly associated with decreasing average heart rate from wave 1 to wave 2 (approximately 33 months apart) (p < .05). This result was specifically significant for women living in neighborhoods with greater disadvantage. Additionally, findings indicated that living in a neighborhood with greater disadvantage was significantly associated with increased difficulty with activities of daily living (p < .01). More research is needed to examine the implications of neighborhood context on older Black adults’ health prospectively.

Previous research has suggested an important and understudied association between neighborhood disadvantage and cognitive functioning among older African Americans. Data from the Baltimore Study of Black Aging (N=602) was utilized to examine the associations between Area Deprivation Index (ADI) and cognition. Multiple stepwise regression models, controlling for age, sex, education, and income, showed participants who scored better on measures of immediate memory, vocabulary, reasoning, and everyday cognition had lower ADI (less disadvantaged neighborhoods; p < .05). Interestingly, individuals living with higher ADI had better attention/working memory scores and better self-reported memory (p < .05). ADI was significantly associated with improvements or declines in performance, depending on the cognitive ability (e.g., learning and memory, working memory, global mental status, and visuospatial skill, p < .05). These findings suggest the importance of accounting for neighborhood context in African Americans’ cognitive aging research.

Objectives: Given prevalence differences of mild cognitive impairment (MCI) among Black and white older adults, this study aimed to examine whether overall vascular risk factor (VRF) burden and individual VRF associations with amnestic (aMCI) and nonamnestic (naMCI) MCI status varied by Black/white race. Methods: Participants included 2755 older adults without dementia from the ACTIVE study. Comprehensive neuropsychological criteria were used to classify cognitively normal, aMCI, and naMCI. VRFs were primarily defined using subjective report and medication data. Multinomial logistic regression was run predicting MCI subtype. Results: Greater overall VRF burden, high cholesterol, and obesity evinced greater odds of naMCI in Black participants than whites. Across participants, diabetes and hypertension were associated with increased odds of aMCI and naMCI, respectively. Discussion: Results may reflect known systemic inequities on dimensions of social determinants of health for Black older adults. Continued efforts toward examining underlying mechanisms contributing to these findings are critical.

STUDY OBJECTIVES: The objective of this study was to examine independent and interactive associations between self-reported sleep (sleep efficiency and total sleep time [TST]) and pain with cognition in sedentary middle-aged and older adults. METHODS: Seventy-five sedentary adults at least 50 years of age (M(age) = 63.24, standard deviation = 8.87) completed 14 daily diaries measuring sleep and pain. Weekly average sleep efficiency, TST, and pain were computed. Participants also completed computerized cognitive tasks: Letter Series (reasoning), N-back (working memory), Symbol Digit Modalities Test (processing speed, attention), and Number Copy (processing speed). Multiple regression analyses were conducted to determine independent and interactive (with pain) associations of sleep efficiency and TST with cognition, controlling for age, education, and sex. RESULTS: Sleep efficiency and pain interacted in their associations with Letter Series performance and N-back difference scores (2-back minus 1-back). Specifically, higher sleep efficiency was associated with better reasoning and working memory in those with highest pain but not average or lowest pain. TST and pain also interacted in their associations with Letter Series performance. Specifically, longer TST associated with worse reasoning in those with lowest (not average or highest) pain. CONCLUSIONS: Preliminary results show that in sedentary middle-aged and older adults, pain and sleep interact in their associations with executive function tasks. Higher sleep efficiency may be associated with better reasoning and working memory in those with highest pain. Lower TST may be associated with better reasoning in those with lowest pain. Studies evaluating temporal associations between sleep, pain, and cognition are needed. CITATION: . Preliminary investigation of interactive associations of sleep and pain with cognition in sedentary middle-aged and older adults. J Clin Sleep Med. 2021;17(2):233–242.

BACKGROUND/OBJECTIVES: The purpose of this study was to: (1) examine relationships between body mass index (BMI) stability and cognitive decline in older African Americans; and (2) investigate differences in the relationships between women and men. DESIGN: The present study is a secondary data analysis of the Minority Aging Research Study, which is a longitudinal, cohort study of risk factors for cognitive decline and Alzheimerʼs disease among older African Americans living in the Chicago, IL, area. The study entails annual clinical evaluations, including measures of 19 neuropsychological tests that represent five cognitive domains, including episodic, semantic, and working memory, perceptual speed, and visuospatial ability. PARTICIPANTS: Participants (n = 671; mean age = 73.5 years; standard deviation = 6.2 years) were included in the present analysis if they were dementia free at baseline and completed at least two clinical evaluations, on average 1 year apart, that included valid cognitive and BMI assessments. RESULTS: Mixed-effects models showed higher baseline BMI was related to slower global cognitive decline, whereas changes in BMI (instability) were related to faster global cognitive decline. These effects were the same for four of five cognitive domains and remained after controlling for various health characteristics. However, women and men did not differ in any of the relationships. CONCLUSION: Higher BMI is related to slower cognitive decline in older African Americans, but greater BMI instability is related to faster decline. Stability of BMI should be considered in the cognitive aging of African Americans. J Am Geriatr Soc 68:2662–2667, 2020.

OBJECTIVES: Inconsistency in pain may lead to depression, which may then influence sleep. Thus, the purpose of this study was to examine whether depression mediates the relationship between day-to-day inconsistency in pain and sleep in middle aged to older adults. METHODS: Baseline measures from the Active Adult Mentoring Project were used for secondary data analysis. Participants included 82 adults in mid- to late-life. Pain was assessed for seven consecutive days on an 11-point Likert-scale, with pain inconsistency defined as the seven-day individual standard deviation. A self-report daily diary was used to assess sleep efficiency (SE), total wake time (TWT), total sleep time (TST), and sleep quality (SQ), and depression was assessed using the BDI-II. RESULTS: Mediation analyses revealed that depression partially mediated the relationship between pain inconsistency and SE, TWT, and SQ but not TST. CONCLUSIONS: Results indicate that depression may be an important factor through which pain inconsistency influences sleep. Although further research is warranted, these preliminary findings suggest that intervening on both pain inconsistency and depression may be one way to improve sleep in older adults.

Previous research suggests depressive symptoms and loneliness are increasingly prevalent among older adults living in lower-income neighborhoods. The purpose of this study was to examine the extent to which neighborhood socioeconomic status (SES) was associated with depressive symptoms and loneliness among a sample of older adults from the Healthy Heart and Mind Study (N = 165; mean age = 68.48 (SD = 6.26); 66.7% women; 40.6% African American). It was hypothesized that older adults living in neighborhoods with greater socioeconomic disadvantage would report more depressive symptoms and loneliness than those residing in neighborhoods with less socioeconomic disadvantage. Depression was assessed with the Beck Depression Inventory-II (BDI-II), and loneliness was assessed using the Revised University of California, Los Angeles (UCLA) Loneliness scale. Neighborhood SES was measured with the Area Deprivation Index (ADI), which allows rankings of neighborhoods by SES disadvantage both statewide and nationally. After controlling for demographic variables (age, sex, and race), linear regression analyses showed that greater neighborhood SES disadvantage was associated with higher depression scores (β = -.094; p = .041) and higher loneliness scores (β = -.258; p = .003). These findings highlight the importance of neighborhood context on mental health in older adults, as underserved populations are more likely to experience declines in mental health under strenuous circumstances. Future research should investigate the impact of neighborhood SES on mental health in aging adults.

Previous research suggests a decline in body mass index (BMI) among older adults is associated with negative health outcomes, including mild cognitive impairment (MCI) and incident dementia (Gao et al., 2011). However, few studies have examined BMI longitudinal trajectories and how they change after MCI diagnosis among older African Americans. To characterize trajectories of change in BMI among older African American participants with no cognitive impairment at baseline we used data from the Minority Aging Research Study, MARS (N=408, 76.5% women, mean age = 73.5, mean education = 15.0). We constructed piecewise linear mixed-effects models that included a random intercept and two random slopes. The first slope began at baseline. The second slope began at MCI diagnosis allowing for acceleration in the rate of decline after the diagnosis. The results showed BMI declined over time (B=-0.19, SE=0.04, p

Research shows regular physical activity (PA) is associated with better health and longevity; however, few studies consider contextual factors related to PA among African American (AA) older adults living in socioeconomically disadvantaged neighborhoods. The Physical and Cognitive Health Pilot Study (n=50) was used to examine associations between PA and level of neighborhood socioeconomic disadvantage among sedentary, AA older adults from four public housing communities in Durham, NC and Annapolis, MD (mean age=64.5; SD=10.42; 72% women). Participants were administered the Community Healthy Activities Model Program for Seniors (CHAMPS), a self-report questionnaire measuring weekly frequency and duration of PAs. Neighborhood socioeconomic disadvantage was defined by the Neighborhood Atlas Area Deprivation Index (ADI), which ranks neighborhoods according to Census block group/neighborhoods within each state and nationally. For the present sample, two of the Durham housing facilities were located in communities in the most disadvantaged block groups. Meanwhile, one Durham location and the Annapolis community were located in the least disadvantaged block groups. Bivariate correlations showed greater neighborhood socioeconomic disadvantage was associated with less participation in various PAs (p

OBJECTIVES: The goal of the study was to examine the influence of sleep efficiency on the relationship between anxiety and executive functions. METHOD: Secondary data analyses of eighty-two community-dwelling middle-aged and older adults were performed (M age = 63.00, SD = 8.64). Anxiety was measured using the trait anxiety subscale of the State-Trait Anxiety Inventory. Sleep efficiency was measured using one-week of sleep diary data. Two executive functions, cognitive flexibility and inductive reasoning, were measured using the Trail-Making Test and Letter Series task, respectively. SPSS PROCESS macro software version 2 was used to assess the moderating role of sleep efficiency in the relationship between anxiety and executive functions. RESULTS: Sleep significantly moderated the relationship between anxiety and inductive reasoning. Among middle-aged and older adults with high anxiety, those with good sleep efficiency displayed significantly better inductive reasoning than those with poor sleep efficiency after controlling for age, gender, and education (ΔR(2) = .05, p = .017). Sleep efficiency did not significantly moderate the relationship between anxiety and cognitive flexibility. CONCLUSION: Sleep efficiency weakened the association between anxiety and inductive reasoning in middle-aged and older adults. Evidence from the study suggests better sleep may limit the negative effects of anxiety on executive functions in mid-to-late life. Further research is needed to elucidate the impact of anxiety and sleep on executive functions in clinical populations with anxiety.

Despite general negative health effects, elevated body mass index (BMI) can be “protective” against poor health outcomes, including cognitive decline and mild cognitive impairment (MCI), in old age. However, few studies have examined the effects of BMI fluctuations (BMI instability) over time. The purpose of this study was to examine how BMI level at baseline and BMI instability is related to incident MCI in Black participants from the Minority Aging Research Study (MARS; N = 522, mean age = 73.5, mean education = 15.0; 76.5% women). Participants without cognitive impairment at baseline underwent annual clinical evaluations, including measurement of BMI and 19 neuropsychological tests for up to 15 years of follow-up to document MCI. 192 of 522 persons developed MCI. In Cox models adjusted for age, sex, and education, 1) higher baseline BMI, across the range of all values (mean=30.5; SD=6.5), was related to a decreased risk of MCI (Hazard Ratio = 0.97; 95% CI = 0.94-1.00); and 2) BMI instability (with a maximal range of 0-15.7; mean=3.2; SD=2.5) was related to an increased risk of MCI (Hazard Ratio = 1.09; 95% CI = 1.03-1.15). The present findings suggest that while late-life higher BMI level may protect against MCI, BMI instability over the years is detrimental to cognition in Black persons without dementia. Future research should investigate underlying mechanisms.

With the burgeoning older adult population, there will be an increased demand for neighborhood and housing developments conducive to the interests and needs of older adults from diverse backgrounds of varying health and functional status. Several initiatives have sought to develop age-friendly neighborhoods, which focused on improving access and affordability of community resources. However, limited effort has focused on physical and social attributes of immediate housing environments, particularly amongst lower-income older adults. The need for affordable and usable housing developments for older adults that provide greater opportunities for social engagement, social services, and convenience to neighborhood resources (e.g., grocery stores, healthcare) will continue to rise. The objectives of the proposed symposium are the following: (1) to explore the physical and social attributes of older and low-income residents’ housing and their surrounding community; and (2) discuss how older and low-income residents’ housing and community resources relates to their health and well-being. This symposium will include presentations from three pilot investigations that highlight relevant subjective and objective contextual metrics related to health and well-being in underserved older populations. Tan and colleagues explored the role of well-being (i.e., purpose in life) in the relationships among sociodemographics, health, housing and community resources. Sardina and colleagues explored perceived leisure barriers and their relationship to sociodemographic, health, and psychosocial characteristics. Aiken-Morgan and colleagues examined associations between neighborhood socioeconomic disadvantage and health status among low-income African American older adults. Wright and colleagues explored associations between neighborhood disadvantage, brain health, and neurocognitive function in cognitively normal older adults.