Lesbian, Gay, and Bisexual Adults Have Higher Prevalence of Illicit Opioid Use than Heterosexual Adults: Evidence from the National Survey on Drug Use and Health, 2015-2017

Purpose: We estimated illicit opioid use prevalence among LGB and heterosexual adults. Methods: Cross-sectional National Survey on Drug Use and Health data (2015-2017) were used to estimate illicit opioid use prevalence by sexual identity, age, and gender. Results: An estimated 1.1 million LGB adults used illicit opioids in the preceding 12 months (LGB adults: 9.8%; heterosexual adults: 4.24%). Prevalence of illicit opioid use was significantly higher among LGB women aged /bisexual men (18-25 and 50 +) compared with their heterosexual counterparts. Conclusions: Interventions targeting LGB illicit opioid use should account for possible differential minority stress associated with age and gender

Stroke-Associated Differences in Rates of Activity of Daily Living Loss Emerge Years Before Stroke Onset

To compare typical age-related changes in activities of daily living (ADL) independence in stroke-free adults to long-term ADL trajectories before and after stroke

The Disability Burden Associated With Stroke Emerges Before Stroke Onset and Differentially Affects Blacks: Results From the Health and Retirement Study Cohort

Background. Few longitudinal studies compare changes in instrumental activities of daily living (IADLs) among stroke-free adults to prospectively document IADL changes among adults who experience a stroke. We contrast annual declines in IADL independence for older individuals who remain stroke-free to those for individuals who experienced a stroke. We also assess whether these patterns differ by sex, race, or Southern birthplace. Methods. Health and Retirement Study participants who were stroke-free in 1998 (n = 17,741) were followed through 2010 (average follow-up = 8.9 years) for self- or proxy-reported stroke. We used logistic regressions to compare annual changes in odds of self-reported independence in six IADLs among those who remained stroke-free throughout follow-up (n = 15,888), those who survived a stroke (n = 1,412), and those who had a stroke and did not survive to participate in another interview (n = 442). We present models adjusted for demographic and socioeconomic covariates and also stratified on sex, race, and Southern birthplace. Results. Compared with similar cohort members who remained stroke-free, participants who developed stroke had faster declines in IADL independence and a lower probability of IADL independence prior to the stroke. After a stroke, independence declined at an annual rate similar to those who did not have a stroke. The black-white disparity in IADL independence narrowed poststroke. Conclusion. Racial differences in IADL independence are apparent long before stroke onset. Poststroke differences in IADL independence largely reflect pre stroke disparities

Does Duration of Spousal Caregiving Affect Risk of Depression Onset? Evidence from the Health and Retirement Study

To assess the association of current and long-term spousal caregiving with risk of depression in a nationally (U.S.) representative sample of older adults

Dementia and dependence: Do modifiable risk factors delay disability?

OBJECTIVE: To identify modifying factors that preserve functional independence among individuals at high dementia risk. METHODS: Health and Retirement Study participants aged 65 years or older without baseline activities of daily living (ADL) limitations (n = 4,922) were interviewed biennially for up to 12 years. Dementia probability, estimated from direct and proxy cognitive assessments, was categorized as low (i.e., normal cognitive function), mild, moderate, or high risk (i.e., very impaired) and used to predict incident ADL limitations (censoring after limitation onset). We assessed multiplicative and additive interactions of dementia category with modifiers (previously self-reported physical activity, smoking, alcohol consumption, depression, and income) in predicting incident limitations. RESULTS: Smoking, not drinking, and income predicted incident ADL limitations and had larger absolute effects on ADL onset among individuals with high dementia probability than among cognitively normal individuals. Smoking increased the 2-year risk of ADL limitations onset from 9.9% to 14.9% among the lowest dementia probability category and from 32.6% to 42.7% among the highest dementia probability category. Not drinking increased the 2-year risk of ADL limitations onset by 2.1 percentage points among the lowest dementia probability category and 13.2 percentage points among the highest dementia probability category. Low income increased the 2-year risk of ADL limitations onset by 0.4% among the lowest dementia probability category and 12.9% among the highest dementia probability category. CONCLUSIONS: Smoking, not drinking, and low income predict incident dependence even in the context of cognitive impairment. Regardless of cognitive status, reducing these risk factors may improve functional outcomes and delay institutionalization

Changes in Memory before and after Stroke Differ by Age and Sex, but Not by Race

Post-stroke memory impairment is more common among older adults, women, and blacks. It is unclear whether post-stroke differences reflect differential effects of stroke per se, or differences in pre-stroke functioning. We compare memory trajectories before and after stroke by age, sex and race

Operationalizing Frailty in the Atherosclerosis Risk in Communities Study Cohort

Background: Factors that may contribute to the development of frailty in late life have not been widely investigated. The Atherosclerosis Risk in Communities (ARIC) Study cohort presents an opportunity to examine relationships of midlife risk factors with frailty in late life. However, we first present findings on the validation of an established frailty phenotype in this predominantly biracial population of older adults. Methods: Among 6,080 participants, we defined frailty based upon the Cardiovascular Health Study (CHS) criteria incorporating measures of weight loss, exhaustion, slow walking speed, low physical activity, and low grip strength. Criterion and predictive validity of the frailty phenotype were estimated from associations between frailty status and participants' physical and mental health status, physiologic markers, and incident clinical outcomes. Results: A total of 393 (6.5%) participants were classified as frail and 50.4% pre-frail, similar to CHS (6.9% frail, 46.6% pre-frail). In age-adjusted analyses, frailty was concurrently associated with depressive symptoms, low self-rated health, low medication adherence, and clinical biomarker levels (ie, cholesterol, hemoglobin A1c, white blood cell count, C-reactive protein, and hemoglobin). During 1-year follow-up, frailty was associated with falls, low physical ability, fatigue, and mortality. Conclusions: These findings support the validity of the CHS frailty phenotype in the ARIC Study cohort. Future studies in ARIC may elucidate early-life exposures that contribute to late-life frailty

Does the Association Between Depressive Symptoms and Cardiovascular Mortality Risk Vary By Race? Evidence from the Health and Retirement Study

Objective—To test whether the association between depressive symptoms and cardiovascular disease (CVD) mortality is stronger among blacks than whites. Design, Setting and Participants: 2,638 black and 15,132 white participants from a prospective, observational study of communitydwelling Health and Retirement Study participants (a nationally representative sample of U.S. adults age 50+). Average follow-up was 9.2 years. Outcome Measure: Cause of death (per ICD codes) and month of death were identified from National Death Index linkages. Methods—The associations between elevated depressive symptoms and mortality from stroke, ischemic heart disease (IHD), or total CVD were assessed using Cox proportional hazards models to estimate adjusted hazard ratios (HRs). We used interaction terms for race by depressive symptoms to assess effect modification (multiplicative scale). Results—For both whites and blacks, depressive symptoms were associated with a significantly elevated hazard of total CVD mortality (whites: HR=1.46; 95% CI: 1.33, 1.61; blacks: HR=1.42, 95% CI: 1.10, 1.83). Adjusting for health and socioeconomic covariates, whites with elevated depressive symptoms had a 13% excess hazard of CVD mortality (HR=1.13, 95% CI: 1.03, 1.25) compared to whites without elevated depressive symptoms. The HR in blacks was similar, although the confidence interval included the null (HR=1.12, 95% CI: 0.86, 1.46). The hazard associated with elevated depressive symptoms did not differ significantly by race (p>0.15 for all comparisons). Patterns were similar in analyses restricted to respondents age 65+. Conclusions—Clinicians should consider the depressive state of either black or white patients as a potential CVD mortality risk factor

TESS Hunt for Young and Maturing Exoplanets (THYME). XI. An Earth-sized Planet Orbiting a Nearby, Solar-like Host in the 400 Myr Ursa Major Moving Group

Young terrestrial worlds are critical test beds to constrain prevailing theories of planetary formation and evolution. We present the discovery of HD 63433 d—a nearby (22 pc), Earth-sized planet transiting a young Sun-like star (TOI-1726, HD 63433). HD 63433 d is the third planet detected in this multiplanet system. The kinematic, rotational, and abundance properties of the host star indicate that it belongs to the young (414 ± 23 Myr) Ursa Major moving group, whose membership we update using new data from the third data release of the Gaia mission and TESS. Our transit analysis of the TESS light curves indicates that HD 63433 d has a radius of 1.1 R⊕ and closely orbits its host star with a period of 4.2 days. To date, HD 63433 d is the smallest confirmed exoplanet with an age less than 500 Myr, and the nearest young Earth-sized planet. Furthermore, the apparent brightness of the stellar host (V ≃ 6.9 mag) makes this transiting multiplanet system favorable to further investigations, including spectroscopic follow-up to probe the atmospheric loss in a young Earth-sized world