IntroductionHigher cognitive stimulation (CS) is associated with improved cognition. Sources of CS among Hispanics/Latinos are understudied.MethodsIn the Hispanic Community Health Study/Study of Latinos 2008 to 2011 (n = 9438), we used finite mixture models to generate latent CS profiles, and multivariate linear regressions to examine associations with cognition in Hispanic/Latino adults (45–74 years). CS included education, occupation, social network, and acculturation. Cognitive measures included the Six-Item Screener, Brief-Spanish English Verbal Learning Test Sum and Recall, Controlled Oral Word Association Test, Digit Symbol Substitution, and Global Cognition.ResultsTwo CS profiles emerged, and were labeled “typical” and “enhanced.” The enhanced CS profile (22%) had more family connections, bicultural engagements, skilled/professional occupations, education, and higher cognitive scores.DiscussionAn enhanced CS profile emerged from contextual and culturally relevant factors, and was associated with higher cognitive scores across all measures. This provides initial evidence on how factors coalesce to shape cognitive protection in Hispanics/Latinos.
Objectives Examine whether racial/ethnic differences in mortality rates have changed in recent years among adults in late midlife, and if so, how. Methods We analyze Health and Retirement Study data on non-Hispanic Whites (Whites), non-Hispanic Blacks (Blacks), and English- and Spanish-speaking Hispanics (Hispanic-English and Hispanic-Spanish), ages 50-64 from two periods: 1998-2004 (P1, n=8920) and 2004-2010 (P2, n=7224). Using survey-generalized linear regression techniques we model death-by-end-of-period as a function of race/ethnicity, and sequentially adjust for a series of period-specific baseline risk factors including demographics, health status, health insurance, health behaviors, and social networks. Regression decomposition techniques are used to assess the contribution of these factors to observed racial/ethnic differences in mortality rates. Results The odds ratio for death (ORD) was not statistically different for Blacks (vs. Whites) in P1 but was 33% higher in P2 (OR=1.33; 95% CI=1.05-1.69). The adjusted ORD among Hispanic-English (vs. Whites) was not statistically different in both periods. The adjusted ORD among Hispanic-Spanish (vs. Whites) was lower (ORD=0.36; 95% CI= 0.22-0.59) in P1 but indistinguishable in P2. In P1, 50.1% of the disparity in mortality rates among Blacks was explained by baseline health status, 53.1% was explained by financial factors. In P2, 55.8% of the disparity in mortality rates was explained by health status, 40.0% by financial factors and 16.2% by health insurance status. Discussion Mortality rates among Blacks and Hispanic-Spanish have risen since the mid-1990s. Hispanic-Spanish, may be losing their advantageous lower risk of mortality, long known as the “Hispanic Paradox.”
Introduction: Recent research has revealed that during late midlife, Hispanics experience a lower mortality relative to non-Hispanic Whites (Whites), whereas non-Hispanic Blacks (Blacks) experience a higher mortality relative to Whites. Much less is known about whether there are also racial/ethnic disparities in patterns of how overall health changes during this period, and if so, whether personal lifestyle or economic characteristics that can explain it. We examine these important issues. Methods: Longitudinal and nationally representative data on adults ages 50-64 from the Health and Retirement Study are used for our analysis. Latent class discrete time and growth curve modeling are implemented to identify different types of “trajectories” in self-rated health and mortality across racial/ethnic groups and three distinct time periods, 1998-2004, 2004-2010, and 2010-2016. Additionally, multinomial logit models are estimated to determine whether Hispanics or Blacks experience different trajectory profiles than Whites do, and how different characteristics at baseline affect one’s own trajectory. Results: We identify five types of trajectories: “Poor-Health with Rapid Mortality,” “Sustained Poor-Health,” “Moderate-Health Back and Forth,” “Good-Health with Rapid Mortality,” and “Sustained Good-Health.” These specific types persist even after controlling for multiple health determinants. Discussion: We find significant and persistent differences across racial/ethnic groups in how health changes during late midlife. After controlling for a wide range of health determinants, Blacks and Hispanics are less likely than Whites to experience “Sustained Good-Health” and more likely to experience “Sustained Poor-Health” across all three time periods. Blacks are also consistently more likely to experience “Poor-Health with Rapid Mortality.”
Objective Derive latent profiles of accelerometry-measured moderate-vigorous physical activity (MVPA) for Hispanic/Latino adults, examine associations between these latent MVPA profiles and neurocognition, and describe profiles via self-reported MVPA. Methods Complex survey design methods were applied to cross-sectional data from 7,672 adults ages 45-74 years in the Hispanic Community Health Study/Study of Latinos (HCHS/SOL; 2008-2011). MVPA was measured via hip-worn accelerometers. Latent profile analysis was applied to derive latent MVPA profiles (minutes/day of week). Neurocognition was assessed with the Brief-Spanish English Verbal Learning Test (B-SEVLT) Sum, B-SEVLT Recall, Controlled Oral Word Association Test (Word Fluency), and Digit Symbol Substitution Test. All tests were z-scored, and a global neurocognition score was generated by averaging across scores. Survey linear regression models were used to examine associations between latent MVPA profiles and neurocognitive measures. Self-reported MVPA domains were estimated (occupational, transportation, and recreational) for each latent profile. Results Four derived latent MVPA profiles from the overall adult target population (18-74 years) were putatively labelled: No MVPA, low, moderate, and high. Only the high MVPA profile (compared to moderate) was associated with lower global neurocognition. Sensitivity analyses using latent MVPA profiles from only participants aged 45-74 years showed similar profiles, but no associations between latent MVPA profiles and neurocognition. The occupational MVPA domain led in all latent MVPA profiles. Discussion We found no consistent evidence to link accelerometry-measured MVPA profiles to neurocognitive function. Research to better characterize the role of high occupational MVPA in relation to neurocognition among Hispanic/Latino adults are needed.
Reducing racial/ethnic disparities in health and functioning among older adults are salient key goals in the U.S. health policy. This study examined whether and how the functioning have progressed between White and minority populations in late midlife in recent years. We analyzed the Health and Retirement Study (HRS) among adults ages 45-64 years across two time periods (2004-2010 and 2010-2016). Using generalized linear regression, we modeled changes in activities of daily living (ADL) and changes in instrumental activities of daily living (IADL) as a function of race/ethnicity and sequentially adjusted for period specific risk factors including sociodemographic factors, health insurance, health behaviors and social networks. Oaxaca-Blinder Regression Decomposition (OBRD) techniques are used to assess the contributions of these factors to the observed trends in ADL/IADL. We find changes in ADL is significantly higher for Blacks (Odds Ratios of 1.23, CI 1.01-1.48) and US-born Hispanics (Odd Ratios of 1.54, CI 1.12-2.12) after adjusting for all the risk factors in the second period. About two-thirds of the disparity in functional status of adults is explained in our OBRD model and more than 70% of these explained differences among minorities is related to socio-demographic factors. This probably occurred due to the differences in income and net wealth which began to widen during the time of 2008 financial crisis. Although recently there is a decline in disability trends for older adults in U.S., our findings point to an increase in racial/ethnic disparities in functional status for adults in late midlife.
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