%0 Journal Article %J American journal of preventive medicine %D Forthcoming %T Neighborhood Features and Cognitive Function: Moderating Roles of Individual Socioeconomic Status. %A Yang, Tse-Chuan %A Kim, Seulki %A Choi, Seung-Won Emily %A Halloway, Shannon %A Mitchell, Uchechi A %A Shaw, Benjamin A %K cognitive function %K low-education %K low-income %K Older Adults %K socioeconomic status %X

INTRODUCTION: There is an interest in exploring the associations between neighborhood characteristics and individual cognitive function; however, little is known about whether these relationships can be modified by individual socioeconomic status, such as educational attainment and income.

METHODS: Drawing from the 2010-2018 Health and Retirement Study, this study analyzed 10,621 older respondents (aged 65+) with a total of 33,931 person-waves. These respondents did not have dementia in 2010 and stayed in the same neighborhood throughout the study period. Cognitive function was measured with a 27-point indicator biennially, and neighborhood characteristics (i.e., walkability, concentrated disadvantage, and social isolation) were assessed in 2010. All analyses were performed in 2023.

RESULTS: Cognitive function is positively associated with neighborhood walkability and negatively related to concentrated disadvantage, suggesting that exposures to these neighborhood characteristics have long-lasting impacts on cognitive function. Furthermore, individual socioeconomic status modifies the relationship between neighborhood characteristics and cognitive function. Compared with those graduating from college, respondents without a bachelor's degree consistently have lower cognitive function but the educational gap in cognitive function narrows with increases in walkability (b= -0.152, SE=0.092), and widens when neighborhood concentrated disadvantage (b=0.212, SE=0.070) or social isolation (b=0.315, SE=0.125) rises. The income gap in cognitive function shrinks with increases in walkability (b= -0.063, SE=0.027).

CONCLUSIONS: The moderating role of socioeconomic status indicates that low-socioeconomic status older adults who also live in disadvantaged neighborhoods face a higher risk of poor cognitive function. Low-education and low-income aging adults may have the most to gain from investments to improve neighborhood characteristics.

%B American journal of preventive medicine %G eng %R 10.1016/j.amepre.2023.10.012 %0 Journal Article %J Alzheimers & dementia: the journal of the Alzheimer's Association %D Forthcoming %T Spouses of individuals living with mild cognitive impairment or dementia in the United States: A descriptive, population-based study. %A Torres, Jacqueline M %A Flores Romero, Karla Renata %A Kotwal, Ashwin A %A Chen, Ruijia %A Hill-Jarrett, Tanisha %A Mitchell, Uchechi A %A Glymour, Medellena Maria %K Dementia %K Epidemiology %K Family %K health equity %K mild cognitive impairment %K Spouses %X

BACKGROUND: Little is known about the population of individuals who live with a spouse with cognitive impairment (CI) or dementia.

METHODS: Using the US Health and Retirement Study, 2000 to 2018, we estimated the population of adults ≥ 50 years old co-residing with a spouse with probable CI/dementia. We described their socio-demographic and health characteristics and quantified socio-demographic inequities.

RESULTS: Among community-dwelling adults ≥ 50 years old, 6% of women and 4% of men co-resided with a spouse with probable CI/dementia. Among those who were married/partnered, the prevalence of spousal dementia was greater for Black and Hispanic adults compared to their White counterparts, and for those with lower versus higher educational attainment. Among spouses, activities of daily living disability, depression, and past 2-year hospitalization was common.

DISCUSSION: Millions of older adults, disproportionately Black and Hispanic people and people with lower levels of educational attainment, live with a spouse with CI while also facing their own major health challenges.

%B Alzheimers & dementia: the journal of the Alzheimer's Association %G eng %R 10.1002/alz.13555 %0 Journal Article %J Journal of Applied Gerontology, Series B, Psychological Sciences and social sciences %D 2023 %T The Effects of Midlife Acute and Chronic Stressors on Black-White Differences in Cognitive Decline. %A Mitchell, Uchechi A %A Shaw, Benjamin A %A Torres, Jacqueline M %A Brown, Lauren L %K Black or African American %K Cognition %K Cognitive Dysfunction %K Humans %K Middle Aged %K Stress, Psychological %K White %X

OBJECTIVES: Midlife stressors may be particularly consequential for cognitive performance and disparities in cognitive decline. This study examined Black-White differences in trajectories of cognition among middle-aged adults and the effects of acute and chronic stressors on these trajectories.

METHODS: Data come from 4,011 cognitively healthy individuals aged 51-64 (620 Black and 3,391 White) who participated in the 2006-2018 waves of the Health and Retirement Study. Stressors included a count of recent life events and measures of financial strain and everyday discrimination. Global cognition was assessed using a modified version of the Telephone Interview for Cognitive Status. Linear mixed models with random slopes and intercepts assessed change in cognition over time. Race-by-time, race-by-stressor, time-by-stressor, and race-by-stressor-by-time interactions were assessed as were quadratic terms for time and each stressor.

RESULTS: After adjusting for sociodemographic, health behaviors, and health-related factors, Black respondents had lower initial cognitive performance scores (b = -1.75, p < .001) but experienced earlier but slower decline in cognitive performance over time (Black × Time2 interaction: b = 0.02, p < .01). Financial strain, discrimination, and recent life events each had distinct associations with cognitive performance but did not influence racial differences in levels of or change in cognition over time.

DISCUSSION: Middle-aged Black adults have lower initial cognition levels and experience earlier but less accelerated cognitive decline compared to White middle-aged adults. Midlife acute and chronic stressors influence baseline cognition but do so in different ways. Future research should examine the influence of other stressors on racial differences in cognitive decline at other points in the life course.

%B Journal of Applied Gerontology, Series B, Psychological Sciences and social sciences %V 78 %P 2147-2155 %G eng %N 12 %R 10.1093/geronb/gbad143 %0 Journal Article %J Journal of Applied Gerontology, Series B, Psychological Sciences and social sciences %D 2023 %T The Effects of Midlife Acute and Chronic Stressors on Black-White Differences in Cognitive Decline. %A Mitchell, Uchechi A %A Shaw, Benjamin A %A Torres, Jacqueline M %A Brown, Lauren L %A Barnes, Lisa L %K Black or African American %K Cognition %K Cognitive Dysfunction %K Humans %K Middle Aged %K Stress, Psychological %K White %X

OBJECTIVES: Midlife stressors may be particularly consequential for cognitive performance and disparities in cognitive decline. This study examined Black-White differences in trajectories of cognition among middle-aged adults and the effects of acute and chronic stressors on these trajectories.

METHODS: Data come from 4,011 cognitively healthy individuals aged 51-64 (620 Black and 3,391 White) who participated in the 2006-2018 waves of the Health and Retirement Study. Stressors included a count of recent life events and measures of financial strain and everyday discrimination. Global cognition was assessed using a modified version of the Telephone Interview for Cognitive Status. Linear mixed models with random slopes and intercepts assessed change in cognition over time. Race-by-time, race-by-stressor, time-by-stressor, and race-by-stressor-by-time interactions were assessed as were quadratic terms for time and each stressor.

RESULTS: After adjusting for sociodemographic, health behaviors, and health-related factors, Black respondents had lower initial cognitive performance scores (b = -1.75, p < .001) but experienced earlier but slower decline in cognitive performance over time (Black × Time2 interaction: b = 0.02, p < .01). Financial strain, discrimination, and recent life events each had distinct associations with cognitive performance but did not influence racial differences in levels of or change in cognition over time.

DISCUSSION: Middle-aged Black adults have lower initial cognition levels and experience earlier but less accelerated cognitive decline compared to White middle-aged adults. Midlife acute and chronic stressors influence baseline cognition but do so in different ways. Future research should examine the influence of other stressors on racial differences in cognitive decline at other points in the life course.

%B Journal of Applied Gerontology, Series B, Psychological Sciences and social sciences %V 78 %P 2147-2155 %G eng %N 12 %R 10.1093/geronb/gbad143 %0 Journal Article %J Journal of Aging and Health %D 2022 %T Hope, Purpose, and Religiosity: The Impact of Psychosocial Resources on Trajectories of Depressive Symptoms Among Middle-Aged and Older Blacks. %A Mitchell, Uchechi A %A Nguyen, Ann W %A Brown, Lauren L %K African Americans %K Age differences %K Mental Health %K Protective factors %K Resilience %K stress process %X

We assessed the effects of hope, purpose in life, and religiosity on trajectories of depressive symptoms among middle-aged and older Blacks, with a focus on age differences in these associations. Data come from 1906 respondents from the 2006-2016 Health and Retirement Study. Linear mixed models were estimated and included interactions between age and time and between age and each psychosocial resource. Depressive symptoms decreased for Blacks ages 51-64, did not change for those 65-74, and increased among Blacks age 75+. Hope and purpose in life were inversely associated with symptom levels but were not associated with change over time in symptomology. Associations were stronger among the youngest age group and weakest among the oldest. Religiosity was unrelated to depressive symptoms. Psychosocial resources protect against depressive symptoms in age-dependent ways among middle-aged and older Blacks. Differences in these effects may be related to aging, cohort, and selection effects.

%B Journal of Aging and Health %V 34 %P 363-377 %G eng %N 3 %R 10.1177/08982643221085820 %0 Journal Article %J Journal of Aging and Health %D 2022 %T Stress is a Latent Construct: Exploring the Differential Experience of Stress and Discrimination on Depressive Symptoms Among Black Older Adults. %A Brown, Lauren L %A García, Catherine %A Reeves, Alexis N %A Pamplin, John R %A Mitchell, Uchechi A %K Chronic stress %K Mental Health %K Racism %K stress appraisal %X

While evidence highlights the detrimental mental health consequences of chronic stress exposure, the impact of this stress exposure on older Black Americans' mental health varies by exposure to other types of stressors like discrimination as well as subjective evaluations of stress like chronic stress appraisal. Using data from the 2010/2012 Health and Retirement Study, we use latent profile analysis (LPA) to describe 2,415 Black older adults experience with chronic stress exposure, appraisal, and discrimination and examine which stress contexts are associated with depressive symptomology. Analyses revealed five stress clusters-demonstrating the diversity in the stress experience for older Black adults. Black older adults with stress profiles that include lower stress appraisal report fewer depressive symptoms regardless of number of stress exposures. LPA is as an alternative approach to examining the stress-mental health link that can define stress profiles by both exposure and appraisal-based measures.

%B Journal of Aging and Health %V 34 %P 334-346 %G eng %N 3 %R 10.1177/08982643221086333