The Intersections of Race, Gender, Age, and Socioeconomic Status: Implications for Reporting Discrimination and Attributions to Discrimination.

This study employed an intersectional approach (operationalized as the combination of more than one social identity) to examine the relationship between aspects of social identity (i.e., race, gender, age, SES), self-reported level of mistreatment, and attributions for discrimination. Self-reported discrimination has been researched extensively and there is substantial evidence of its association with adverse physical and psychological health outcomes. Few studies, however, have examined the relationship of multiple demographic variables (including social identities) to overall levels self-reported mistreatment as well the selection of attributions for discrimination. A diverse community sample (N = 292; 42.12% Black; 47.26% male) reported on experiences of discrimination using the Everyday Discrimination Scale. General linear models were used to test the effect of sociodemographic characteristics (i.e., race, gender, age, SES) on total discrimination score and on attributions for discrimination. To test for intersectional relationships, we tested the effect of two-way interactions of sociodemographic characteristics on total discrimination score and attributions for discrimination. We found preliminary support for intersectional effects, as indicated by a significant race by age interaction on the selection of the race attribution for discrimination; gender by SES on the age attribution; age by gender on the education attribution; and race by SES on the economic situation attribution. Our study extends prior work by highlighting the importance of testing more than one factor as contributing to discrimination, particularly when examining to what sources individuals attribute discrimination

Rural Population Health and Aging: Introduction to the Special Issue

This special issue of the Journal of Rural Social Sciences (JRSS) focuses on rural population health and aging. It showcases the work of scholars from several backgrounds and social science disciplines to advance knowledge in a critical field of investigation. Assembled through an open call for submissions coordinated through the National Institute on Aging (NIA) funded Interdisciplinary Network on Rural Population Health and Aging (INRPHA), the collection of articles helps inform a more nuanced understanding of the factors associated with rural places, which often have different health outcomes and aging patterns than their urban counterparts. The authors achieve this through application of innovative analytical strategies used with a combination of data sources. This introductory essay provides background and an overview of the four articles, followed by discussion of future opportunities to advance an agenda for rural population health and aging research

The role of environmental distractions in the experience of fibrofog in real-world settings

The contents of this article are solely the responsibility of the authors and do not necessarily represent the official views of the National Institutes of Health. Supported by the National Institute of Arthritis and Musculoskeletal and Skin Diseases of the NIH (award K01‐AR‐064275; Principal Investigator, Dr. Kratz). The Michigan Institute for Clinical & Health Research (NIH award UL1‐TR‐002240) provided subject recruitment support through the UMHealthResearch.org website.Peer reviewedPublisher PD

Revisiting the lack of association between affect and physiology: Contrasting between-person and within-person analyses.

ObjectiveDespite experimental manipulations that reliably elicit affective and physiological responses, the relationship between the two frequently appears small or nonexistent. We propose that this is, at least in part, due to a mismatch between the nature of the question being asked and the analytic methods applied. For example, to test if levels of affect reliably covary with physiology over time-a within-person question-one cannot apply analytic approaches that test whether people are similarly reactive across domains-a between-person question. The purpose of this paper is to compare within-person and between-person analyses testing the association between affect and physiology.MethodParticipants (N = 60) recalled an event from their lives that made them angry. Self-reported anger and objective blood pressure levels were recorded at baseline, after the recall, and 5 times during recovery.ResultsBetween-person correlations between anger and blood pressure were nonsignificant across all phases of the study, suggesting that those least/most reactive for anger were not least/most reactive for blood pressure. These null findings held regardless of whether linear or nonlinear assumptions were modeled. In contrast, within-person multilevel modeling indicated a clear relationship, suggesting that when a person was angrier that person's blood pressure was higher compared with when that person was less angry.ConclusionResults suggest the importance of appropriately matching analytic strategy to the nature of the question regarding the relationships between affect and physiology. Implications for past and future research are discussed. (PsycINFO Database Recor

T-MoCA: A valid phone screen for cognitive impairment in diverse community samples

Introduction: There is an urgent need to validate telephone versions of widely used general cognitive measures, such as the Montreal Cognitive Assessment (T-MoCA), for remote assessments. Methods: In the Einstein Aging Study, a diverse community cohort (n = 428; mean age = 78.1; 66% female; 54% non-White), equivalence testing was used to examine concordance between the T-MoCA and the corresponding in-person MoCA assess- ment. Receiver operating characteristic analyses examined the diagnostic ability to dis- criminate between mild cognitive impairment and normal cognition. Conversion meth- ods from T-MoCA to the MoCA are presented. Results: Education, race/ethnicity, gender, age, self-reported cognitive concerns, and telephone administration difficulties were associated with both modes of administra- tion; however, when examining the difference between modalities, these factors were not significant. Sensitivity and specificity for the T-MoCA (using Youden’s index opti- mal cut) were 72% and 59%, respectively. Discussion: The T-MoCA demonstrated sufficient psychometric properties to be use- ful for screening of MCI, especially when clinic visits are not feasible

The Association Between Loneliness and Inflammation: Findings From an Older Adult Sample

Loneliness has been linked to poor mental and physical health outcomes. Past research suggests that inflammation is a potential pathway linking loneliness and health, but little is known about how loneliness assessed in daily life links with inflammation, or about linkages between loneliness and inflammation among older adults specifically. As part of a larger investigation, we examined the cross-sectional associations between loneliness and a panel of both basal and LPS-stimulated inflammatory markers. Participants were 222 socioeconomically and racially diverse older adults (aged 70&ndash;90 years; 38% Black; 13% Hispanic) systematically recruited from the Bronx, NY. Loneliness was measured in two ways, with a retrospective trait measure (the UCLA Three Item Loneliness Scale) and an aggregated momentary measure assessed via ecological momentary assessment (EMA) across 14 days. Inflammatory markers included both basal levels of C-reactive protein (CRP) and cytokines (IL-1&beta;, IL-4, IL-6, IL-8, IL-10, TNF-&alpha;) and LPS-stimulated levels of the same cytokines. Multiple regression analyses controlled for age, body-mass index, race, and depressive symptoms. Moderation by gender and race were also explored. Both higher trait loneliness and aggregated momentary measures of loneliness were associated with higher levels of CRP (&beta; = 0.16, p = 0.02; &beta; = 0.15, p = 0.03, respectively). There were no significant associations between loneliness and basal or stimulated cytokines and neither gender nor race were significant moderators. Results extend prior research linking loneliness with systemic inflammation in several ways, including by examining this connection among a sample of older adults and using a measure of aggregated momentary loneliness. &nbsp;</p

Is healthy neuroticism associated with longevity? A coordinated integrative data analysis

Early investigations of the neuroticism by conscientiousness interaction with regards to health have been promising, but to date, there have been no systematic investigations of this interaction that account for the various personality measurement instruments, varying populations, or aspects of health. The current study - the second of three - uses a coordinated analysis approach to test the impact of the neuroticism by conscientiousness interaction on the prevalence and incidence of chronic conditions. Using 15 pre-existing longitudinal studies (N > 49,375), we found that conscientiousness did not moderate the relationship between neuroticism and having hypertension (OR = 1.00,95%CI[0.98,1.02]), diabetes (OR = 1.02[0.99,1.04]), or heart disease (OR = 0.99[0.97,1.01]). Similarly, we found that conscientiousness did not moderate the prospective relationship between neuroticism and onset of hypertension (OR = 0.98,[0.95,1.01]), diabetes (OR = 0.99[0.94,1.05]), or heart disease (OR = 0.98[0.94,1.03]). Heterogeneity of effect sizes was largely nonsignificant, with one exception, indicating that the effects are consistent between datasets. Overall, we conclude that there is no evidence that healthy neuroticism, operationalized as the conscientiousness by neuroticism interaction, buffers against chronic conditions

Is healthy neuroticism associated with health behaviors? A coordinated integrative data analysis

Current literature suggests that neuroticism is positively associated with maladaptive life choices, likelihood of disease, and mortality. However, recent research has identified circumstances under which neuroticism is associated with positive outcomes. The current project examined whether “healthy neuroticism”, defined as the interaction of neuroticism and conscientiousness, was associated with the following health behaviors: smoking, alcohol consumption, and physical activity. Using a pre-registered multi-study coordinated integrative data analysis (IDA) approach, we investigated whether “healthy neuroticism” predicted the odds of engaging in each of the aforementioned activities. Each study estimated identical models, using the same covariates and data transformations, enabling optimal comparability of results. These results were then meta-analyzed in order to estimate an average (N-weighted) effect and to ascertain the extent of heterogeneity in the effects. Overall, these results suggest that neuroticism alone was not related to health behaviors, while individuals higher in conscientiousness were less likely to be smokers or drinkers, and more likely to engage in physical activity. In terms of the healthy neuroticism interaction of neuroticism and conscientiousness, significant interactions for smoking and physical activity suggest that the association between neuroticism and health behaviors was smaller among those high in conscientiousness. These findings lend credence to the idea that healthy neuroticism may be linked to certain health behaviors and that these effects are generalizable across several heterogeneous samples

Clinical Phenotypes and Comorbidity in European Sleep Apnoea Patients

Background Clinical presentation phenotypes of obstructive sleep apnoea (OSA) and their association with comorbidity as well as impact on adherence to continuous positive airway pressure (CPAP) treatment have not been established. Methods A prospective follow-up cohort of adult patients with OSA (apnoea-hypopnoea index (AHI) of 655/h) from 17 European countries and Israel (n = 6,555) was divided into four clinical presentation phenotypes based on daytime symptoms labelled as excessive daytime sleepiness ("EDS") and nocturnal sleep problems other than OSA (labelled as "insomnia"): 1) EDS (daytime+/nighttime-), 2) EDS/insomnia (daytime+/nighttime+), 3) non-EDS/noninsomnia (daytime-/nighttime-), 4) and insomnia (daytime-/nighttime+) phenotype. Results The EDS phenotype comprised 20.7%, the non-EDS/non-insomnia type 25.8%, the EDS/ insomnia type 23.7%, and the insomnia phenotype 29.8% of the entire cohort. Thus, clinical presentation phenotypes with insomnia symptoms were dominant with 53.5%, but only 5.6% had physician diagnosed insomnia. Cardiovascular comorbidity was less prevalent in the EDS and most common in the insomnia phenotype (48.9% vs. 56.8%, p<0.001) despite more severe OSA in the EDS group (AHI 35.0\ub125.5/h vs. 27.9\ub122.5/h, p<0.001, respectively). Psychiatric comorbidity was associated with insomnia like OSA phenotypes independent of age, gender and body mass index (HR 1.5 (1.188-1.905), p<0.001). The EDS phenotype tended to associate with higher CPAP usage (22.7 min/d, p = 0.069) when controlled for age, gender, BMI and sleep apnoea severity. Conclusions Phenotypes with insomnia symptoms comprised more than half of OSA patients and were more frequently linked with comorbidity than those with EDS, despite less severe OSA. CPAP usage was slightly higher in phenotypes with EDS