In the inpatient setting, prevalence, predictors, and outcomes [mortality risk (MR), length of st... more In the inpatient setting, prevalence, predictors, and outcomes [mortality risk (MR), length of stay (LOS), and total charges (TC)] of Alzheimer's disease (AD) are largely unknown. We used data on older adults (60+ y) from the Nationwide Inpatient Sample (NIS) 2002-2012. AD prevalence was ∼3.12% in 2012 (total weighted discharges with AD ± standard error: 474, 410 ± 6,276). Co-morbidities prevailing more in AD inpatient admissions included depression (OR = 1.67, 95% CI: 1.63-1.71, p < 0.001), fluid/electrolyte disorders (OR = 1.25, 95% CI: 1.22-1.27, p < 0.001), weight loss (OR = 1.26, 95% CI: 1.22-1.30, p < 0.001), and psychosis (OR = 2.59, 95% CI: 2.47-2.71, p < 0.001), with mean total co-morbidities increasing over time. AD was linked to higher MR and longer LOS, but lower TC. TC rose in AD, while MR and LOS dropped markedly over time. In AD, co-morbidities predicting simultaneously higher MR, TC, and LOS (2012) included congestive heart failure, chronic pulmonary disease, coagulopathy, fluid/electrolyte disorders, metastatic cancer, paralysis, pulmonary circulatory disorders, and weight loss. In sum, co-morbidities and TC increased over time in AD, while MR and LOS dropped. Few co-morbidities predicted occurrence of AD or adverse outcomes in AD.
The current investigation examined intraindividual variability and predictors of this variability... more The current investigation examined intraindividual variability and predictors of this variability on neuropsychological measures. A total of 50 (39 women and 11 men) independently living, community-dwelling African Americans ranging in age from 50 to 80 years (M = ...
Poorer health profiles among African American men throughout the life course evince greater rates... more Poorer health profiles among African American men throughout the life course evince greater rates of cardiovascular disease (CVD) and significantly earlier mortality compared with other groups. Despite growing emphasis on identifying how psychosocial factors influence disparate disease risk, little of this research has focused intently on African American men. Using hierarchical linear regression, we explored the additive influence of stress, depression, and perceived control on pulse pressure, an established marker of CVD risk, in a sample (N = 153) of African American men (mean age = 66.73 ± 9.29) from the Baltimore Study of Black Aging (BSBA). After accounting for age and health status indicators, perceived control emerged as a significant predictor of pulse pressure. These findings suggest that greater belief in one's own efficacy is a protective factor for cardiovascular health among African American men. Future research should examine whether enhancing perceived control can have an appreciable impact on the immense CVD burden in this and other at-risk populations.
In the inpatient setting, prevalence, predictors, and outcomes [mortality risk (MR), length of st... more In the inpatient setting, prevalence, predictors, and outcomes [mortality risk (MR), length of stay (LOS), and total charges (TC)] of Alzheimer's disease (AD) are largely unknown. We used data on older adults (60+ y) from the Nationwide Inpatient Sample (NIS) 2002-2012. AD prevalence was ∼3.12% in 2012 (total weighted discharges with AD ± standard error: 474, 410 ± 6,276). Co-morbidities prevailing more in AD inpatient admissions included depression (OR = 1.67, 95% CI: 1.63-1.71, p < 0.001), fluid/electrolyte disorders (OR = 1.25, 95% CI: 1.22-1.27, p < 0.001), weight loss (OR = 1.26, 95% CI: 1.22-1.30, p < 0.001), and psychosis (OR = 2.59, 95% CI: 2.47-2.71, p < 0.001), with mean total co-morbidities increasing over time. AD was linked to higher MR and longer LOS, but lower TC. TC rose in AD, while MR and LOS dropped markedly over time. In AD, co-morbidities predicting simultaneously higher MR, TC, and LOS (2012) included congestive heart failure, chronic pulmonary disease, coagulopathy, fluid/electrolyte disorders, metastatic cancer, paralysis, pulmonary circulatory disorders, and weight loss. In sum, co-morbidities and TC increased over time in AD, while MR and LOS dropped. Few co-morbidities predicted occurrence of AD or adverse outcomes in AD.
The journals of gerontology. Series B, Psychological sciences and social sciences, Jan 31, 2014
The present study examined the relationship between desegregated schooling and cognitive change i... more The present study examined the relationship between desegregated schooling and cognitive change in a sample of 420 community-dwelling African American elders (mean age = 68.6; SD = 9.1). Participants were recruited for the Baltimore Study of Black Aging-Patterns of Cognitive Aging. Cognitive measures from six domains of function were administered at baseline and follow-up 33 months later. Repeated measures multivariate analysis of covariance was conducted; the between subjects factors were schooling type and age cohort, and the within subjects factor was time. Analyses controlled for age, years of education, and sex, and follow-up univariate analyses were used to determine which individual cognitive scores drove the multivariate effects. There were significant multivariate within-group, between-group, and interaction effects (p < .05). Univariate analyses indicated that the desegregated schooling group scored significantly better on Language and Perceptual Speed (p < .01), and...
Despite high rates of poor health outcomes, little attention has been focused on associations bet... more Despite high rates of poor health outcomes, little attention has been focused on associations between prominent health factors and cognitive function in African American men, exclusively. The objective was to examine relationships between cardiovascular and pulmonary health, and cognitive function in African American men. Data from 257 men were pooled from two studies of African American aging. The mean age of participants was 58.15 and mean educational attainment was 11.78 years. Participants provided self-reported health and demographic information, completed cognitive measures, and had their blood pressure and peak expiratory flow assessed. After adjustment, significant relationships were found between average peak expiratory flow rate (APEFR) and cognitive performance measures. Results suggest that lung function is important to consider when examining cognitive function in African American men. Understanding the role of health in cognition and implications for quality of life in...
The rates of high blood pressure among African Americans, as a group, are the highest in the worl... more The rates of high blood pressure among African Americans, as a group, are the highest in the world. The implications for higher average blood pressure include complications for many major chronic conditions, such as cardiovascular disease and diabetes. Less well studied is the effect of blood pressure on the cognitive functioning of African Americans. The purpose of this study was to examine the effect of blood pressure on memory measures in a sample of adult African Americans. Analyses were conducted on a sample of 361 African American adults (mean age 61.50 years, standard deviation 9.39 years). We found significant correlations between systolic blood pressure and most cognitive measures but only for one of the measures and diastolic blood pressure. Regressions revealed significant effects for systolic blood pressure on Digit Symbol, Telephone Interview of Cognitive Status, and Immediate Recall on the Wechsler Logical Memory test. These findings suggest that blood pressure is a so...
Journal of clinical sleep medicine : JCSM : official publication of the American Academy of Sleep Medicine, Jan 15, 2014
To examine the relationship between measures of sleep quality and the presence of commonly encoun... more To examine the relationship between measures of sleep quality and the presence of commonly encountered comorbid and sociodemographic conditions in elderly Black subjects. Analyses included participants from the Baltimore Study of Black Aging (BSBA; n = 450; mean age 71.43 years; SD 9.21). Pittsburgh Sleep Quality Index (PSQI) measured overall sleep pattern and quality. Self-reported and objective measures of physical and mental health data and demographic information were collected for all participants. Sociodemographic and comorbid health factors were significantly associated with sleep quality. Results from regression analyses revealed that older age, current financial strain, interpersonal problems, and stress were unique predictors of worse sleep quality. Sleep duration was significantly correlated with age, depressive affect, interpersonal problems, and stress; only age was a unique significant predictor. While participants 62 years or younger had worse sleep quality with incre...
Older adults commonly report disturbed sleep, and recent studies in humans and animals suggest li... more Older adults commonly report disturbed sleep, and recent studies in humans and animals suggest links between sleep and Alzheimer disease biomarkers. Studies are needed that evaluate whether sleep variables are associated with neuroimaging evidence of β-amyloid (Aβ) deposition. OBJECTIVE To determine the association between self-reported sleep variables and Aβ deposition in community-dwelling older adults. Cross-sectional study of 70 adults (mean age, 76 [range, 53-91] years) from the neuroimaging substudy of the Baltimore Longitudinal Study of Aging, a normative aging study. EXPOSURE Self-reported sleep variables. MAIN OUTCOMES AND MEASURES β-Amyloid burden, measured by carbon 11-labeled Pittsburgh compound B positron emission tomography distribution volume ratios (DVRs). After adjustment for potential confounders, reports of shorter sleep duration were associated with greater Aβ burden, measured by mean cortical DVR (B = 0.08 [95% CI, 0.03-0.14]; P = .005) and precuneus DVR (B = 0.11 [0.03-0.18]; P = .007). Reports of lower sleep quality were associated with greater Aβ burden measured by precuneus DVR (B = 0.08 [0.01-0.15]; P = .03). Among community-dwelling older adults, reports of shorter sleep duration and poorer sleep quality are associated with greater Aβ burden. Additional studies with objective sleep measures are needed to determine whether sleep disturbance causes or accelerates Alzheimer disease.
In the inpatient setting, prevalence, predictors, and outcomes [mortality risk (MR), length of st... more In the inpatient setting, prevalence, predictors, and outcomes [mortality risk (MR), length of stay (LOS), and total charges (TC)] of Alzheimer&amp;amp;#39;s disease (AD) are largely unknown. We used data on older adults (60+ y) from the Nationwide Inpatient Sample (NIS) 2002-2012. AD prevalence was ∼3.12% in 2012 (total weighted discharges with AD ± standard error: 474, 410 ± 6,276). Co-morbidities prevailing more in AD inpatient admissions included depression (OR = 1.67, 95% CI: 1.63-1.71, p &amp;amp;lt; 0.001), fluid/electrolyte disorders (OR = 1.25, 95% CI: 1.22-1.27, p &amp;amp;lt; 0.001), weight loss (OR = 1.26, 95% CI: 1.22-1.30, p &amp;amp;lt; 0.001), and psychosis (OR = 2.59, 95% CI: 2.47-2.71, p &amp;amp;lt; 0.001), with mean total co-morbidities increasing over time. AD was linked to higher MR and longer LOS, but lower TC. TC rose in AD, while MR and LOS dropped markedly over time. In AD, co-morbidities predicting simultaneously higher MR, TC, and LOS (2012) included congestive heart failure, chronic pulmonary disease, coagulopathy, fluid/electrolyte disorders, metastatic cancer, paralysis, pulmonary circulatory disorders, and weight loss. In sum, co-morbidities and TC increased over time in AD, while MR and LOS dropped. Few co-morbidities predicted occurrence of AD or adverse outcomes in AD.
The current investigation examined intraindividual variability and predictors of this variability... more The current investigation examined intraindividual variability and predictors of this variability on neuropsychological measures. A total of 50 (39 women and 11 men) independently living, community-dwelling African Americans ranging in age from 50 to 80 years (M = ...
Poorer health profiles among African American men throughout the life course evince greater rates... more Poorer health profiles among African American men throughout the life course evince greater rates of cardiovascular disease (CVD) and significantly earlier mortality compared with other groups. Despite growing emphasis on identifying how psychosocial factors influence disparate disease risk, little of this research has focused intently on African American men. Using hierarchical linear regression, we explored the additive influence of stress, depression, and perceived control on pulse pressure, an established marker of CVD risk, in a sample (N = 153) of African American men (mean age = 66.73 ± 9.29) from the Baltimore Study of Black Aging (BSBA). After accounting for age and health status indicators, perceived control emerged as a significant predictor of pulse pressure. These findings suggest that greater belief in one&#39;s own efficacy is a protective factor for cardiovascular health among African American men. Future research should examine whether enhancing perceived control can have an appreciable impact on the immense CVD burden in this and other at-risk populations.
In the inpatient setting, prevalence, predictors, and outcomes [mortality risk (MR), length of st... more In the inpatient setting, prevalence, predictors, and outcomes [mortality risk (MR), length of stay (LOS), and total charges (TC)] of Alzheimer&amp;amp;amp;amp;amp;amp;#39;s disease (AD) are largely unknown. We used data on older adults (60+ y) from the Nationwide Inpatient Sample (NIS) 2002-2012. AD prevalence was ∼3.12% in 2012 (total weighted discharges with AD ± standard error: 474, 410 ± 6,276). Co-morbidities prevailing more in AD inpatient admissions included depression (OR = 1.67, 95% CI: 1.63-1.71, p &amp;amp;amp;amp;amp;amp;lt; 0.001), fluid/electrolyte disorders (OR = 1.25, 95% CI: 1.22-1.27, p &amp;amp;amp;amp;amp;amp;lt; 0.001), weight loss (OR = 1.26, 95% CI: 1.22-1.30, p &amp;amp;amp;amp;amp;amp;lt; 0.001), and psychosis (OR = 2.59, 95% CI: 2.47-2.71, p &amp;amp;amp;amp;amp;amp;lt; 0.001), with mean total co-morbidities increasing over time. AD was linked to higher MR and longer LOS, but lower TC. TC rose in AD, while MR and LOS dropped markedly over time. In AD, co-morbidities predicting simultaneously higher MR, TC, and LOS (2012) included congestive heart failure, chronic pulmonary disease, coagulopathy, fluid/electrolyte disorders, metastatic cancer, paralysis, pulmonary circulatory disorders, and weight loss. In sum, co-morbidities and TC increased over time in AD, while MR and LOS dropped. Few co-morbidities predicted occurrence of AD or adverse outcomes in AD.
The journals of gerontology. Series B, Psychological sciences and social sciences, Jan 31, 2014
The present study examined the relationship between desegregated schooling and cognitive change i... more The present study examined the relationship between desegregated schooling and cognitive change in a sample of 420 community-dwelling African American elders (mean age = 68.6; SD = 9.1). Participants were recruited for the Baltimore Study of Black Aging-Patterns of Cognitive Aging. Cognitive measures from six domains of function were administered at baseline and follow-up 33 months later. Repeated measures multivariate analysis of covariance was conducted; the between subjects factors were schooling type and age cohort, and the within subjects factor was time. Analyses controlled for age, years of education, and sex, and follow-up univariate analyses were used to determine which individual cognitive scores drove the multivariate effects. There were significant multivariate within-group, between-group, and interaction effects (p < .05). Univariate analyses indicated that the desegregated schooling group scored significantly better on Language and Perceptual Speed (p < .01), and...
Despite high rates of poor health outcomes, little attention has been focused on associations bet... more Despite high rates of poor health outcomes, little attention has been focused on associations between prominent health factors and cognitive function in African American men, exclusively. The objective was to examine relationships between cardiovascular and pulmonary health, and cognitive function in African American men. Data from 257 men were pooled from two studies of African American aging. The mean age of participants was 58.15 and mean educational attainment was 11.78 years. Participants provided self-reported health and demographic information, completed cognitive measures, and had their blood pressure and peak expiratory flow assessed. After adjustment, significant relationships were found between average peak expiratory flow rate (APEFR) and cognitive performance measures. Results suggest that lung function is important to consider when examining cognitive function in African American men. Understanding the role of health in cognition and implications for quality of life in...
The rates of high blood pressure among African Americans, as a group, are the highest in the worl... more The rates of high blood pressure among African Americans, as a group, are the highest in the world. The implications for higher average blood pressure include complications for many major chronic conditions, such as cardiovascular disease and diabetes. Less well studied is the effect of blood pressure on the cognitive functioning of African Americans. The purpose of this study was to examine the effect of blood pressure on memory measures in a sample of adult African Americans. Analyses were conducted on a sample of 361 African American adults (mean age 61.50 years, standard deviation 9.39 years). We found significant correlations between systolic blood pressure and most cognitive measures but only for one of the measures and diastolic blood pressure. Regressions revealed significant effects for systolic blood pressure on Digit Symbol, Telephone Interview of Cognitive Status, and Immediate Recall on the Wechsler Logical Memory test. These findings suggest that blood pressure is a so...
Journal of clinical sleep medicine : JCSM : official publication of the American Academy of Sleep Medicine, Jan 15, 2014
To examine the relationship between measures of sleep quality and the presence of commonly encoun... more To examine the relationship between measures of sleep quality and the presence of commonly encountered comorbid and sociodemographic conditions in elderly Black subjects. Analyses included participants from the Baltimore Study of Black Aging (BSBA; n = 450; mean age 71.43 years; SD 9.21). Pittsburgh Sleep Quality Index (PSQI) measured overall sleep pattern and quality. Self-reported and objective measures of physical and mental health data and demographic information were collected for all participants. Sociodemographic and comorbid health factors were significantly associated with sleep quality. Results from regression analyses revealed that older age, current financial strain, interpersonal problems, and stress were unique predictors of worse sleep quality. Sleep duration was significantly correlated with age, depressive affect, interpersonal problems, and stress; only age was a unique significant predictor. While participants 62 years or younger had worse sleep quality with incre...
Older adults commonly report disturbed sleep, and recent studies in humans and animals suggest li... more Older adults commonly report disturbed sleep, and recent studies in humans and animals suggest links between sleep and Alzheimer disease biomarkers. Studies are needed that evaluate whether sleep variables are associated with neuroimaging evidence of β-amyloid (Aβ) deposition. OBJECTIVE To determine the association between self-reported sleep variables and Aβ deposition in community-dwelling older adults. Cross-sectional study of 70 adults (mean age, 76 [range, 53-91] years) from the neuroimaging substudy of the Baltimore Longitudinal Study of Aging, a normative aging study. EXPOSURE Self-reported sleep variables. MAIN OUTCOMES AND MEASURES β-Amyloid burden, measured by carbon 11-labeled Pittsburgh compound B positron emission tomography distribution volume ratios (DVRs). After adjustment for potential confounders, reports of shorter sleep duration were associated with greater Aβ burden, measured by mean cortical DVR (B = 0.08 [95% CI, 0.03-0.14]; P = .005) and precuneus DVR (B = 0.11 [0.03-0.18]; P = .007). Reports of lower sleep quality were associated with greater Aβ burden measured by precuneus DVR (B = 0.08 [0.01-0.15]; P = .03). Among community-dwelling older adults, reports of shorter sleep duration and poorer sleep quality are associated with greater Aβ burden. Additional studies with objective sleep measures are needed to determine whether sleep disturbance causes or accelerates Alzheimer disease.
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