Working with older drinkers

Findings presented in this report demonstrate that older drinkers have different stressors, precipitating factors and risk factors for relapse than younger drinkers. They also face a number of unique barriers to treatment and are more likely to remain ‘hidden’ from services. Despite these challenges, age-specific practices required to meet the needs of older people and draw them into treatment are poorly understood. The purpose of this project was to develop guidelines on what strategies and treatment approaches are likely to work best with older drinkers based on synthesis of relevant literature, insight from alcohol practitioners who specialise in working with older people and the perspectives of older people receiving alcohol treatment. A set of concise guidance documents will be prepared for health and social care workers and alcohol service providers in due course

Cognitive Function Across Self-Identified Ethno-Racial Groups: The Role of Discrimination, Allostatic Load, and Health Behaviors

Background. Cognitive functioning has been shown to vary by race, education, socioeconomic status, and other demographic factors. Although allostatic load is associated with cognitive functioning this association has not been explored in conjunction with the association between race and cognition and race and allostatic load. Among the literature regarding allostatic load there is a demonstrated gap in research regarding health behaviors and their association with allostatic load beyond controlling for their effect. This research aims to fill these literature gaps and to advance understanding regarding the apparent racial differences in cognitive functioning. Method. Analyses included data from the Multiethnic Study of Atherosclerosis (MESA) parent study and the Stress sub-study from MESA. The first analysis included latent class analysis using biological indicators and latent class regression using health behavior data from the participants in the Stress sub-study. The second analysis was a path analysis including participants who had full allostatic load and cognitive functioning data from the MESA parent study. The third analysis utilized multivariable linear regression with interaction terms and included participants from the parent study who had full discrimination and allostatic load data. Results. Four classes were identified in the sample. The metabolic plus blood pressure class was found to be significantly associated with amount of physical activity and alcohol use. Cognitive function differed by race, amount of discrimination, and allostatic load score. Allostatic load score was associated with race and certain health behaviors. Allostatic load at exam 1 was positively associated with chronic discrimination, however change in allostatic load from exam 1 to exam 5 was negatively associated with chronic discrimination. No form of coping moderated the association between allostatic load and chronic discrimination nor did social support. Internal and external coping styles were found to be associated with baseline allostatic load and change in allostatic load independent of amount of chronic discrimination. Discussion. Differences in cognitive test scores by race beyond amount of discrimination, allostatic load, health behaviors, socioeconomic disadvantage, age, and gender underline the need for further research regarding cognitive functioning among minorities. In light of the rapidly changing ethnic and racial make-up of the aging population these needs take on particular importance. The associations between discrimination and allostatic load highlight the importance of better understanding of how discrimination affects physical health and what factors may mitigate that association. Public health implications are discussed

Dislodgement force and shell morphology vary according to wave exposure in a tropical gastropod (Cittarium pica)

Wave exposure has strong influences on population density, morphology and behaviour of intertidal species in temperate zones, but little is known about how intertidal organisms in tropical regions respond to gradients in wave exposure. We tested whether dislodgement force and shell shape of a tropical gastropod, Cittarium pica, differs among shores that vary in wave exposure. After adjusting for body size, we found that C. pica from exposed shores required greater dislodgement force to remove them from the shore, had slightly larger opercula (the closure to the shell aperture), and were slightly squatter in shape (reduced in shell height relative to shell width) than C. pica from sheltered shores. These morphological adjustments are consistent with those observed in temperate gastropods, which are argued to represent adaptive responses to the risk of mortality associated with dislodgement

Navigating Black Aging: The Biological Consequences of Stress and Depression

OBJECTIVES: Black persons in the US are more likely to suffer from social inequality. Chronic stress caused by social inequality and racial discrimination results in weathering of the body that causes physiological dysregulation and biological age being higher than chronological age (accelerated aging). Depression has been linked to both racial discrimination and accelerated aging and accelerated aging has been demonstrated to be higher in Black than White persons, on average. However, we know little about accelerated aging across the life course in Black Americans. METHODS: We used mixed effects growth models to measure biological age acceleration, measured with cardiometabolic markers, over a 20-year period in Black participants of the Coronary Artery Risk Development in Young Adults Study (CARDIA) who were aged 27 - 42 years at analytic baseline. We included an interaction between depressive symptoms and time to determine whether risk of depression was associated with a faster rate of biological aging. RESULTS: We found that the rate of biological aging increased over a 20-year span and that those at risk for depression had a faster rate of biological aging than those not at risk. We also found that various social factors were associated with biological age acceleration over time. DISCUSSION: Given the known association between perceived racial discrimination and depressive symptoms, we provide a novel instance of the long-term effects of social inequality. Specifically, biological age acceleration, a marker of physiological dysregulation, is associated with time among Black persons and more strongly associated among those with depressive symptoms

An investigation into the impact of dementia knowledge and attitudes on individuals’ confidence in practice: a survey of non-healthcare staff inside the prison estate in England and Wales

Whilst the majority of age groups are seeing a decline in numbers in prison custody, the older male population continues to rise year on year. This unexpected trend has led researchers to investigate the needs of this particular cohort in more detail and start to question if the prison estate is able to care for the specific needs of the ageing population. This primary research specifically, looks to investigate what relationship, if any knowledge and attitudes to dementia have on how the confidence in practice levels of non-healthcare prison staff

Intersectional effects of racial and gender discrimination on cardiovascular health vary among black and white women and men in the CARDIA study

Testing hypotheses from the emerging Identity Pathology (IP) framework, we assessed race-gender differences in the effects of reporting experiences of racial and gender discrimination simultaneously compared with racial or gender discrimination alone, or no discrimination, on future cardiovascular health (CVH). Data were from a sample of 3758 black or white adults in CARDIA, a community-based cohort recruited in Birmingham, AL; Chicago, IL; Minneapolis, MN, and Oakland, CA in 1985-6 (year 0). Racial and gender discrimination were assessed using the Experiences of Discrimination scale. CVH was evaluated using a 12-point composite outcome modified from the Life\u27s Simple 7, with higher scores indicating better health. Multivariable linear regressions were used to evaluate the associations between different perceptions of discrimination and CVH scores two decades later by race and gender simultaneously. Reporting racial and gender discrimination in \u3e /=2 settings were 48% of black women, 42% of black men, 10% of white women, and 5% of white men. Year 30 CVH scores (mean, SD) were 7.9(1.4), 8.1(1.6), 8.8(1.6), and 8.7(1.3), respectively. Compared with those of their race-gender groups reporting no discrimination, white women reporting only gender-based discrimination saw an adjusted score difference of +0.3 (95% CI: 0.0,0.6), whereas white men reporting only racial discrimination had on average a 0.4 (95% CI: 0.1,0.8) higher score, and scores among white men reporting both racial and gender discrimination were on average 0.6 (95% CI: 1.1,-0.1) lower than those of their group reporting no discrimination. Consistent with predictions of the IP model, the associations of reported racial and gender discrimination with future CVH were different for different racially-defined gender groups. More research is needed to understand why reported racial and gender discrimination might better predict deterioration in CVH for whites than blacks, and what additional factors associated with gender and race contribute variability to CVH among these groups