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. 2021 Feb 2;18(3):1358.
doi: 10.3390/ijerph18031358.

The Relationship of Race, Psychosocial Stress and Resiliency Indicators to Neurocognitive Impairment among Older Americans Enrolled in the Health and Retirement Survey: A Cross-Sectional Study

Allan K Nkwata  1 , Ming Zhang  1 , Xiao Song  1 , Bruno Giordani  2 , Amara E Ezeamama  3
Affiliations

The Relationship of Race, Psychosocial Stress and Resiliency Indicators to Neurocognitive Impairment among Older Americans Enrolled in the Health and Retirement Survey: A Cross-Sectional Study

Allan K Nkwata et al. Int J Environ Res Public Health. .

Abstract

Background: Race/ethnicity, toxic stress (TS), resilience-promoting factors (RPFs), and their interactions were investigated in relationship to neurocognitive impairment (NI) in a nationally representative sample of adult Americans ≥50 years enrolled in the Health and Retirement Study (HRS) between 2012 and 2014.

Methods: NI was defined as physician diagnosis of Alzheimer's disease/dementia or HRS total cognition score ≤ 10. Race/ethnicity (i.e., African American, White, or Other), TS (i.e., everyday discrimination and chronic stressors), and mastery (as indicator of RPF) were self-reported. Multivariable logistic regression models estimated race-, TS-, RPF-associated odds ratios (ORs), and 95% confidence intervals (CI) for NI adjusting for socio-demographic confounders.

Results: 6317 respondents interviewed between the years 2012 and 2014, age range 55-104 years old, 83% White, 13% Black and 4% Other race were included in the study. Chronic stress (OR = 1.88, 95% CI: 1.42-2.48), discrimination (OR = 3.31, 95% CI: 2.12-5.19) and low mastery (OR = 1.85, 95% CI: 1.38-2.48) were each associated with higher NI risk while low mastery was associated with higher NI risk in discrimination and race/ethnicity dependent manner. Specifically, low mastery-associated risk for NI was evident among adults that denied experiencing discrimination (OR = 2.01, 95% CI: 1.51-2.68), but absent among those that experienced discrimination (OR = 0.72, 95% CI: 0.32-1.62). Further, AA race was associated with NI risk but only among adults with high mastery (OR = 2.00, 95% CI: 1.20-3.35).

Conclusions: Discrimination, chronic stress, and low mastery were associated with worse cognition. Persisting cognitive disadvantage for AA vs. White/Other race only among high mastery adults suggests that adverse social experiences may counteract mastery-associated cognitive benefits among AA population. TS reduction through policies that promote equal treatment by race/ethnicity in social life, health, justice, and economic systems may promote successful cognitive aging.

Keywords: everyday discrimination; minority race; neurocognitive impairment; older Americans; resilience promoting factors; toxic stress.

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Conflict of interest statement

The authors declare no conflict of interest.

Figures

Figure 1
Figure 1
Race and discrimination-related differences in risk of Neurocognitive impairment within strata of mastery.
Figure 2
Figure 2
Heterogeneity in age and chronic stress-related associations for risk of neurocognitive impairment.
Figure 3
Figure 3
Low mastery associated risk of Neurocognitive impairment varies within strata of race, and social experience of discrimination.
See this image and copyright information in PMC

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References

    1. U.S. Census Bureau PD . Annual Estimates of the Resident Population by Sex, Race and Hispanic Origin for the United States, States and Counties: 1 April 2010 to 1 July 2014. U.S. Census Bureau, Population Division; Washington, DC, USA: 2015.
    1. The Henry J. Kaiser Family Foundation Key Facts Race, Ethnicity & Medical Care, 2007. [(accessed on 19 May 2020)]; Available online: www.kff.org.
    1. Jones C.P. Levels of racism: A theoretic framework and a gardener’s tale. Am. J. Public Health. 2000;90:1212–1215. - PMC - PubMed
    1. Gee G., Walsemann K. Does health predict the reporting of racial discrimination or do reports of discrimination predict health? Findings from the National Longitudinal Study of Youth. Soc. Sci. Med. 2009;68:1676–1684. doi: 10.1016/j.socscimed.2009.02.002. - DOI - PubMed
    1. Williams D.R., Yan Y., Jackson J.S., Anderson N.B. Racial Differences in Physical and Mental Health: Socio-economic Status, Stress and Discrimination. J. Health Psychol. 1997;2:335–351. doi: 10.1177/135910539700200305. - DOI - PubMed

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