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1.
Artículo en Inglés | MEDLINE | ID: mdl-39126343

RESUMEN

The coronavirus disease 2019 (COVID-19) pandemic challenged bioethical principles of research and the ability of scientific and healthcare institutions to provide equitable care. How can geroscience adapt to build equity within research protocols to better serve minoritized and marginalized communities? What lessons can geroscience take from the COVID-19 pandemic and its response? Developing geroscience approaches that incorporate such knowledge, including vaccine distribution plans and coalition-building to improve vaccine confidence, may help to reduce health inequities.


Asunto(s)
COVID-19 , SARS-CoV-2 , Humanos , COVID-19/epidemiología , COVID-19/prevención & control , Geriatría/organización & administración , Pandemias , Anciano
2.
Front Psychol ; 15: 1344044, 2024.
Artículo en Inglés | MEDLINE | ID: mdl-38962235

RESUMEN

Introduction: Few studies have examined the association of loneliness and cognitive functioning in the US. We used two common measures of loneliness and examined their association in a large sample of US Black, Latino, and White adults (ages ≥ 50). Methods: We analyzed Wave 3 of the National Social Life, Health, and Aging Project (N = 2,757). We examined loneliness using one item from the CES-D and the Felt Loneliness Measure (NFLM); cognitive functioning was assessed using the Montreal Cognitive Assessment (MoCA) tool, where higher scores indicated better functioning. We used weighted ordinary least squares regressions to examine the effects of loneliness (CES-D loneliness and NFLM in separate models) on MoCA scores. In exploratory analyses, we examined if these relationships varied by race and ethnicity. We adjusted all models for sociodemographic and other salient factors (e.g., chronic disease, depressive symptoms, living alone). Results: Mean age was 63.49 years, 52% were female, and 9% were Black and 6% Latino persons. Approximately 54% endorsed feeling lonely on at least one measure; 31% (CES-D) and 46% (NFLM). The relationship between loneliness measures was positive and significant, X 2 (1, N = 2,757) = 435.493 p < 0.001. However, only 40% of lonely individuals were identified as lonely on both assessments. CES-D loneliness was inversely (߈ = -0.274, p = 0.032) associated with MoCA scores and this association did not vary by race and ethnicity. Greater NFLM loneliness was positively associated (߈ = 0.445, p < 0.001) with higher MoCA scores for Latino participants only. Discussion: Loneliness appears to be an important predictor of cognitive functioning. However, the association of loneliness and cognitive functioning varied when using the CES-D loneliness item or the NFLM. Future work is needed to understand how loneliness and its clinically relevant dimensions (social, emotional, existential, chronicity) relate to global and individual cognitive domains. Research is needed with racially and ethnically diverse midlife and older adults, particularly to understand our counterintuitive finding for Latino participants. Finally, findings also support the need for research on interventions to prevent cognitive decline targeting loneliness.

3.
Ethn Health ; 29(6): 597-619, 2024 Aug.
Artículo en Inglés | MEDLINE | ID: mdl-38932579

RESUMEN

OBJECTIVES: While existing research has shown that Black adults have worse cognitive functioning than their White counterparts, the psychosocial correlates of cognitive functioning for Black older adults are understudied. The objective of this study was to investigate the relationships among perceived neighborhood characteristics, psychosocial resilience resources, and cognitive functioning among midlife and older Black adults. METHODS: Data were from 3,191 Black adults ages 51+ in the 2008-2016 waves of the Health and Retirement Study to examine associations among neighborhood characteristics, psychosocial resilience (sense of purpose, mastery, and social support), and cognitive functioning among Black adults. Multilevel linear regression models assessed direct effects of neighborhood characteristics and psychosocial resources on cognitive functioning. We then tested whether psychosocial resources moderated the association between neighborhood characteristics and cognitive functioning. RESULTS: Mean levels of cognitive functioning, sense of purpose, social support, and mastery were significantly related to neighborhood disorder and discohesion. Regression results showed that levels of neighborhood disorder and high discohesion were significantly associated with cognitive functioning. Sense of purpose was positively associated with cognitive functioning, net of neighborhood characteristics. However, only social support moderated the association between neighborhood discohesion and cognition. CONCLUSIONS: These findings demonstrate the importance of examining psychosocial and contextual risk and resilience resources among midlife and older Black adults. This work may inform the development of cognitive behavioral interventions aimed at increasing sense of purpose to promote and enhance cognitive resiliency among Black adults. Altogether, this work may have implications for policy aimed at advancing cognitive health equity.


Asunto(s)
Negro o Afroamericano , Cognición , Resiliencia Psicológica , Apoyo Social , Humanos , Femenino , Masculino , Persona de Mediana Edad , Negro o Afroamericano/psicología , Negro o Afroamericano/estadística & datos numéricos , Anciano , Características del Vecindario , Características de la Residencia
4.
Clin Gerontol ; : 1-10, 2024 May 02.
Artículo en Inglés | MEDLINE | ID: mdl-38695308

RESUMEN

OBJECTIVES: Asian Americans have the lowest mental health service utilization rate among all racial/ethnic groups. This study investigates how immigration-related factors shape the depression help-seeking behaviors of older Chinese Americans. METHODS: Data were collected from participants who reported experiencing any depressive symptoms in the Population-based Study of Chinese Elderly in Chicago (n = 907). Multinomial logistic regressions were conducted to examine the associations between immigration-related factors and help-seeking behaviors, including not seeking help (23.5%), seeking help from informal source(s) only (40%), seeking help from both informal and formal sources (28.7%), and seeking help from formal source(s) only (8.8%). RESULTS: Older Chinese Americans with lower levels of acculturation (OR = 0.88, 95% CI = 0.79-0.97) and those who lived in Chinatown (OR = 2.34, 95% CI = 1.21-4.52) were more likely to seek help from formal sources only (relative to not seeking any help). CONCLUSIONS: Older Chinese Americans with depressive symptoms predominately relied on informal sources of help, either solely or in combination with formal sources, to address their depressive symptoms. CLINICAL IMPLICATIONS: Leveraging informal support networks and ethnicity-specific resources represents a promising approach for this population.

5.
Artículo en Inglés | MEDLINE | ID: mdl-38581241

RESUMEN

OBJECTIVES: "SuperAgers" are generally defined as people 80+ years old with episodic memory performance comparable to those 20 years younger. Limited knowledge exists to describe characteristics of SuperAgers, with even less known about Hispanic SuperAgers. METHODS: We examined indicators of cognitive, physical, and psychological resilience in relation to the likelihood of being a SuperAger using data from 2 population-based studies of Hispanic older adults (Puerto Rican Elderly: Health Conditions [PREHCO] Study; Health and Retirement Study [HRS]). SuperAgers were defined as (1) ≥80 years old, (2) recall scores ≥ the median for Hispanic respondents aged 55-64, and (3) no cognitive impairment during the observation period. Overall, 640 PREHCO participants and 180 HRS participants were eligible, of whom 45 (7%) and 31 (17%) met SuperAging criteria. RESULTS: Logistic regressions controlling for age and sex demonstrated that higher education (PREHCO: odds ratio [OR] = 1.20, p < .001; HRS: OR = 1.14, p = .044) and fewer instrumental activities of daily living limitations (PREHCO: OR = 0.79, p = .019; HRS: OR = 0.58, p = .077; cognitive resilience), fewer activities of daily living limitations (PREHCO: OR = 0.72, p = .031; HRS: OR = 0.67, p = .068; physical resilience), and fewer depressive symptoms (PREHCO: OR = 0.84, p = .015; HRS: OR = 0.69, p = .007; psychological resilience) were associated with SuperAging, although not all results reached threshold for statistical significance, presumably due to low statistical power. Additionally, known indicators of physical health (e.g., chronic conditions and self-rated health) did not relate to SuperAging. DISCUSSION: Increasing access to education and recognizing/treating depressive symptoms represent potential pathways to preserve episodic memory among older Hispanic adults.


Asunto(s)
Hispánicos o Latinos , Resiliencia Psicológica , Humanos , Masculino , Femenino , Hispánicos o Latinos/estadística & datos numéricos , Hispánicos o Latinos/psicología , Anciano de 80 o más Años , Persona de Mediana Edad , Anciano , Memoria Episódica , Envejecimiento/psicología , Envejecimiento/etnología , Actividades Cotidianas/psicología , Escolaridad , Estado de Salud , Estados Unidos/epidemiología
6.
Artículo en Inglés | MEDLINE | ID: mdl-38549555

RESUMEN

BACKGROUND: Everyday discrimination-experiences of being treated unfairly based on background characteristics like race-is linked to poor physical and mental health throughout the lifespan. Whether more experiences of discrimination are associated with higher odds of being hospitalized in older African Americans has not been explored. METHODS: Community-dwelling participants from 3 longitudinal cohort studies (N = 446, age 65+ years) with discrimination scores and ≥12 months of linked Medicare claims were included. Hospitalizations were identified using Medicare fee-for-service claims, available for an average of 6.2 (SD: 3.7) years of follow-up after baseline. RESULTS: In mixed-effects ordinal logistic regression models (outcomes of 0, 1, or 2+ hospitalizations per year) adjusted for age, sex, education, and income, higher discrimination was associated with higher odds of total annual hospitalizations (odds ratio [OR] per point higher = 1.09, 95% confidence intervals [95% CI]: 1.02-1.17). Results were similar when accounting for depressive symptoms. CONCLUSIONS: Higher exposure to everyday discrimination is associated with higher odds of hospitalization among older African Americans. Mechanisms underlying associations should be explored further to understand how hospitalizations may be reduced in older African Americans.


Asunto(s)
Negro o Afroamericano , Hospitalización , Humanos , Masculino , Hospitalización/estadística & datos numéricos , Femenino , Anciano , Negro o Afroamericano/estadística & datos numéricos , Estados Unidos/epidemiología , Estudios Longitudinales , Medicare/estadística & datos numéricos , Anciano de 80 o más Años , Racismo/estadística & datos numéricos , Racismo/psicología
7.
Aging Ment Health ; 28(2): 319-329, 2024.
Artículo en Inglés | MEDLINE | ID: mdl-37650239

RESUMEN

OBJECTIVES: Focusing on the nexus of race/ethnicity and nativity, this study examined profiles of adversity and their mental health implications in five groups of middle-aged and older adults: native-born whites, native-born blacks, native-born Hispanics, foreign-born whites, and foreign-born Hispanics. METHODS: Data were from the 2018 psychosocial assessment of the HRS (N = 5,223). Latent class analysis (LCA) was employed to identify patterns of eleven adversity indicators and to compare the latent structures and class prevalence across the race/ethnicity and nativity groups. Regressions were used to examine the associations between adversity profiles and depression and life satisfaction, respectively. RESULTS: Four adversity profiles emerged: low adversity (59.84%), low human capital (15.27%), socially marginalized (15.26%), and neighborhood adversity (9.63%). Regardless of nativity status, white older adults were most likely to have the low adversity profile (74 ∼ 75%). In contrast, all the racial/ethnic minority groups were more likely to have the other three adversity profiles. The adversity experienced by racial/ethnic minorities was further cofounded by their immigration status. Overall, having low adversity was associated with the best mental health outcomes and socially marginalized had the poorest outcomes. Even with the low adversity profile, native-born blacks had significantly more depressive symptoms than native-born whites. CONCLUSION: Findings revealed heterogeneity in adversity profiles and their mental health implications in disadvantaged aging populations. Tailored programs are needed to address unique needs of different minority populations.


Asunto(s)
Etnicidad , Salud Mental , Grupos Minoritarios , Grupos Raciales , Anciano , Humanos , Persona de Mediana Edad , Etnicidad/psicología , Grupos Minoritarios/psicología , Grupos Raciales/psicología , Estados Unidos , Depresión/epidemiología , Satisfacción Personal
8.
Artículo en Inglés | MEDLINE | ID: mdl-37498769

RESUMEN

OBJECTIVES: Immigrants to Canada tend to have a lower incidence of diagnosed depression than nonimmigrants. One theory suggests that this "healthy immigrant effect (HIE)" is due to positive selection. Another school of thought argues that the medical underuse of immigrants may be the underlying reason. This unclear "immigrant paradox" is further confounded by the intersecting race-migration nexus. METHODS: This population-based study analyzed data of participants (n = 28,951, age ≥45) from the Canadian Community Health Survey (2015-2018). Multivariable logistic regression was employed to examine associations between race-migration nexus and mental health outcomes, including depressive symptoms (Patient Health Questionnaire [PHQ-9] score ≥10). RESULTS: Compared to Canadian-born (CB) Whites, immigrants, regardless of race, were less likely to receive a mood/anxiety disorder diagnosis (M/A-Dx) by health providers in their lifetime. Racialized immigrants were mentally disadvantaged with increased odds of undiagnosed depression (Adjusted odds ratio [AOR] = 1.76, 99% Confidence interval [CI]:1.30-2.37), whereas White immigrants were mentally healthier with decreased odds of PHQ depression (AOR=0.75, 99%CI: 0.58, 0.96) and poor self-rated mental health (AOR=0.56, 99% CI=0.33, 0.95). Among the subpopulation without a previous M/A-Dx (N = 25,203), racialized immigrants had increased odds of PHQ depression (AOR = 1.45, 99% CI: 1.15-1.82) and unrecognized depression (AOR = 1.47, 99% CI: 1.08-2.00) than CB Whites. Other risk factors for undiagnosed depression include the lack of regular care providers, emergency room as the usual source of care, and being home renters. DISCUSSION: Despite Canadian universal health coverage, the burden of undiagnosed depression disproportionately affects racialized (but not White) immigrants in mid to late life. Contingent on race-migration nexus, the HIE in mental health may be mainly driven by the healthier profile of White immigrants and partly attributable to the under-detection (by health professionals) and under-recognition of mental health conditions among racialized immigrants. A paradigm shift is needed to estimate late-life depression for medically underserved populations.


Asunto(s)
Depresión , Emigrantes e Inmigrantes , Humanos , Depresión/diagnóstico , Depresión/epidemiología , Canadá/epidemiología , Estado de Salud , Salud Mental
9.
Gerontologist ; 64(2)2024 Feb 01.
Artículo en Inglés | MEDLINE | ID: mdl-37394998

RESUMEN

BACKGROUND AND OBJECTIVES: Although East Asian American family caregivers are known to underutilize formal support services, there is a lack of evidence regarding the associations of formal service utilization with caregivers' well-being. This study examined the prevalence of different types of home-and community-based formal service utilization among Korean and Chinese American family caregivers of persons with dementia and how utilization of such services was associated with their well-being. We also explored their overall experience in accessing and utilizing formal dementia support services and programs. RESEARCH DESIGN AND METHODS: We employed a convergent mixed-methods study design. In a convenience sampling method, we recruited 62 family caregivers. Logistic regression and thematic analysis were utilized to analyze data. RESULTS: The results showed in-home services were mostly utilized among family caregivers of these ethnic groups. Out of 9 different support services, those who utilized nutrition programs and case management were more likely to report higher overall well-being. Four themes were developed: (1) awareness of formal support services but uncertainty on how to access them, (2) language barriers imposing additional challenges in accessing formal support services, (3) traveling to access culturally appropriate services, and (4) desire for culturally tailored medical and long-term care services. DISCUSSION AND IMPLICATIONS: Findings from this study suggest the importance of case management services to overcome barriers to accessing and utilizing a wide range of formal support services and provision of culturally appropriate food in formal support services to increase East Asian American family caregivers' utilization of long-term care services.


Asunto(s)
Cuidadores , Demencia , Humanos , Asiático , Pueblo Asiatico , Etnicidad , Estados Unidos
10.
Gerontologist ; 64(4)2024 Apr 01.
Artículo en Inglés | MEDLINE | ID: mdl-37434547

RESUMEN

BACKGROUND AND OBJECTIVES: Although disparities in disability and the unequal distribution of care resources are widely discussed in the literature, there has been less research on disparities in experiencing unmet care needs among older adults. This study aims to investigate how unmet care needs are unevenly distributed across social groups with various intersecting identities, such as race/ethnicity, nativity, and gender, although considering their care needs and care networks, drawing on the conceptual framework of the pathway to unmet needs. RESEARCH DESIGN AND METHODS: The data for this study came from the National Health and Aging Trends Study (2011-2018), and the study sample consisted of 7,061 Medicare beneficiaries who needed assistance with daily activities. Questions about unmet care needs were in the form of consequences related to difficulty or lack of help with daily activities. Mixed-effects negative binomial regression models were used to predict rates of unmet needs. RESULTS: Older adults of color, especially women, experienced higher rates of unmet care needs compared with their White and male counterparts. Although Black-White and gender differences in unmet needs were mostly explained by unequal exposures to care needs and differential care networks, Hispanic women and foreign-born Hispanic men were still at a disadvantage even after adjusting for these covariates. DISCUSSION AND IMPLICATIONS: These results emphasize the importance of adopting an intersectional approach to enhance the quality of long-term services and support for older adults facing social disadvantages.


Asunto(s)
Etnicidad , Medicare , Humanos , Masculino , Femenino , Anciano , Estados Unidos , Hispánicos o Latinos , Envejecimiento , Modelos Estadísticos
11.
J Gerontol Soc Work ; 67(1): 80-95, 2024 Jan.
Artículo en Inglés | MEDLINE | ID: mdl-37246421

RESUMEN

This study compared the level of loneliness among older immigrants residing in subsidized senior housing with that of non-immigrant residents. The study also sought to examine the differential influence of perceived social cohesion on loneliness among these groups. 231 study participants were recruited from subsidized senior housing in St. Louis and the Chicago area. Multiple regression analyses showed that there was a significant difference in loneliness between immigrants and non-immigrants (b = .3, SE = 0.150, p < .05). Also, perceived social cohesion was negatively associated with loneliness (b=-.102, SE = .022, p < .001). Furthermore, immigration status moderated the relationship (b=-.147, SE = .043, p < .01), showing immigrants may benefit more from higher perceived social cohesion in terms of loneliness. The results suggest that perceived social cohesion may act as an important community-level protective factor against loneliness, particularly for older immigrants residing in subsidized senior housing. Creating socially cohesive environments, particularly for this subgroup, could be a crucial strategy for mitigating loneliness. .


Asunto(s)
Emigrantes e Inmigrantes , Soledad , Humanos , Anciano , Hogares para Ancianos , Cohesión Social , Pobreza
12.
J Gerontol B Psychol Sci Soc Sci ; 78(10): 1747-1755, 2023 10 09.
Artículo en Inglés | MEDLINE | ID: mdl-37466307

RESUMEN

OBJECTIVES: Assisted living (AL), a popular long-term care setting for older Americans, increasingly is a site for end-of-life care. Although most residents prefer AL to be their final home, relatively little is known about end-of-life preferences and advance care planning, especially among African American residents. Our research addresses this knowledge gap. METHODS: Informed by grounded theory, we present an analysis of qualitative data collected over 2 years in a 100-bed AL community catering to African American residents. Data consisted of field notes from participant observation conducted during 310 site visits and 818 observation hours, in-depth interviews with 25 residents, and a review of their AL records. RESULTS: Residents varied in their end-of-life preferences and advance care planning, but united in the belief that God was in control. We identified "Turning it over to God" as an explanatory framework for understanding how this group negotiated end-of-life preferences and advance care planning. Individual-level resident factors (e.g., age, pain, and function) and factors reflecting broader cultural and societal influences, including health literacy and care experiences, were influential. DISCUSSION: Contradictions arose from turning it over to God, including those between care preferences, planning, and anticipated or actual end-of-life outcomes.


Asunto(s)
Planificación Anticipada de Atención , Cuidado Terminal , Anciano , Humanos , Negro o Afroamericano , Muerte , Estados Unidos , Religión , Prioridad del Paciente
13.
J Gerontol A Biol Sci Med Sci ; 78(10): 1816-1825, 2023 10 09.
Artículo en Inglés | MEDLINE | ID: mdl-37306295

RESUMEN

BACKGROUND: Evidence on sleep duration or quality and cognitive function in diverse older adults is limited. We examined prospective associations between subjective sleep measures and cognitive function, with modifying effects of sex and age (<65 vs ≥65 years). METHODS: Data are from the longitudinal Boston Puerto Rican Health Study, Waves 2 (n = 943) and 4 (n = 444), with mean follow-up of 10.5 years (range 7.2-12.8). Subjective measures of sleep duration (short <7, ref. 7, or long ≥8 hours) and insomnia symptoms (sum of difficulty falling asleep, waking up at night, and early morning awakening), were assessed at Wave 2. Linear regression models were used to assess changes in global cognition, executive function, memory, and Mini-Mental State Examination, and tested for modifying roles of sex and age. RESULTS: Significant 3-way interaction (sex × age × cognition) in fully adjusted models showed greater decline in global cognitive function in older men with short (ß [95% confidence interval]: -0.67 [-1.24, -0.10]) or long sleep duration (-0.92 [-1.55, -0.30]), compared to women, younger men, and older men with 7 hours of sleep. Insomnia symptoms were associated with a greater decline in memory (-0.54, [-0.85, -0.22]) among older men, compared to women and younger men. CONCLUSION: Sleep duration showed a U-shaped association with cognitive decline, and insomnia symptoms were associated with memory decline in fully adjusted models. Older men, versus women and younger men, were at relatively greater risk for cognitive decline associated with sleep factors. These findings are important for personalizing sleep interventions to support cognitive health.


Asunto(s)
Disfunción Cognitiva , Trastornos del Inicio y del Mantenimiento del Sueño , Masculino , Humanos , Femenino , Anciano , Trastornos del Inicio y del Mantenimiento del Sueño/epidemiología , Cognición , Sueño , Disfunción Cognitiva/epidemiología , Estudios Longitudinales , Hispánicos o Latinos
14.
J Gerontol Soc Work ; 66(7): 874-887, 2023 10.
Artículo en Inglés | MEDLINE | ID: mdl-36919914

RESUMEN

This study examines the relationship between social support sources and unmet needs among U.S. Chinese older adults. Data were from the Population Study of Chinese Elderly in Chicago. Unmet needs were assessed by indexes of activities of daily living (ADL) and instrumental activities of daily living (IADL). Three specific sources of social support (spouse, family members, and friends) were included. Multivariable logistic regression models were conducted. Approximately 17% of the 3,157 respondents reported having unmet ADL/IADL needs. U.S. Chinese older adults with less overall social support were more likely to have unmet ADL needs (odds ratio [OR]=0.91, 95% CI=0.83-0.99) and IADL needs (OR=0.84, 95% CI=0.81-0.88). Family and friend support were associated with a lower likelihood of having unmet ADL needs. Support from spouse, family, and friends was associated with a lower likelihood of having unmet IADL needs. The findings highlight the importance of informal social support in addressing unmet needs .


Asunto(s)
Personas con Discapacidad , Vida Independiente , Apoyo Social , Anciano , Humanos , Actividades Cotidianas , Asiático
15.
Gerontologist ; 63(8): 1376-1384, 2023 09 02.
Artículo en Inglés | MEDLINE | ID: mdl-36905359

RESUMEN

BACKGROUND AND OBJECTIVES: Older Chinese immigrants are at risk for depression due to acculturative stress and language barriers. Residential segregation with respect to language use plays an important role in the mental health of historically marginalized populations. Previous research provided mixed evidence about the segregation effect among older Latino and Asian immigrants. Guided by a model of social processes, we examined the direct and indirect effects of residential segregation on depressive symptoms via multiple mechanisms of acculturation, discrimination, social network, social support, social strain, and social engagement. RESEARCH DESIGN AND METHODS: Four waves of depressive symptoms were assessed in the Population Study of Chinese Elderly (2011-19, N = 1,970), and linked to the 2010-14 American Community Survey estimates of neighborhood context. Residential segregation was measured by the Index of Concentrations at the Extremes which simultaneously assesses Chinese and English language use within a given census tract. Latent growth curve models with adjusted cluster robust standard errors were estimated after controlling for individual-level factors. RESULTS: Residents of segregated Chinese-speaking neighborhoods had fewer baseline depressive symptoms but a slower rate of symptom reduction than those living in neighborhoods segregated with English-only speakers. Racial discrimination, social strain, and social engagement partially mediated the association between segregation and baseline depressive symptoms; social strain and social engagement partially mediated the association with long-term reduction in depressive symptoms. DISCUSSION AND IMPLICATIONS: This study demonstrates the importance of residential segregation and social processes in shaping mental well-being among older Chinese immigrants and suggests potential mechanisms to alleviate mental health risks.


Asunto(s)
Depresión , Emigrantes e Inmigrantes , Humanos , Anciano , Depresión/psicología , Segregación Residencial , Pueblos del Este de Asia , Apoyo Social , Lenguaje , Características de la Residencia
16.
Curr Epidemiol Rep ; 10(1): 44-50, 2023.
Artículo en Inglés | MEDLINE | ID: mdl-36785762

RESUMEN

Purpose of Review: This study aims to understand how intergenerational relationships impact minority aging in the USA. We reviewed studies published in the last 5 years that examine both familial and non-familial intergenerational relationships. Recent Findings: Intergenerational relationships can have positive and negative implications for minority aging. Minority older adults benefit most from these relationships when they increase social interaction and/or offer social support by reducing acculturative stress, providing emotional closeness, or increasing access to tangible resources. At the same time, these relationships can be sources of strain as they lead to burden among already disadvantaged groups. Summary: Future studies should explore the impact of intergenerational relations among more diverse subgroups of older adults and identify mechanisms linking intergenerational relationships to health-related outcomes among minority older adults. Further, longitudinal cohort studies and randomized trials are needed to test mechanisms and evaluate the effectiveness of promising intergenerational interventions.

17.
J Gerontol B Psychol Sci Soc Sci ; 78(9): 1555-1571, 2023 08 28.
Artículo en Inglés | MEDLINE | ID: mdl-36842070

RESUMEN

OBJECTIVES: Contemporary immigration scholarship has typically treated immigrants with diverse racial backgrounds as a monolithic population. Knowledge gaps remain in understanding how racial and nativity inequities in mental health care intersect and unfold in midlife and old age. This study aims to examine the joint impact of race, migration, and old age in shaping mental health treatment. METHODS: Pooled data were obtained from the Canadian Community Health Survey (2015-2018) and restricted to respondents (aged ≥45 years) with mood or anxiety disorders (n = 9,099). Multivariable logistic regression was performed to estimate associations between race-migration nexus and past-year mental health consultations (MHC). Classification and regression tree (CART) analysis was applied to identify intersecting determinants of MHC. RESULTS: Compared to Canadian-born Whites, racialized immigrants had greater mental health needs: poor/fair self-rated mental health (odds ratio [OR] = 2.23, 99% confidence interval [CI]: 1.67-2.99), perceived life stressful (OR = 1.49, 99% CI: 1.14-1.95), psychiatric comorbidity (OR = 1.42, 99% CI: 1.06-1.89), and unmet needs for care (OR = 2.02, 99% CI: 1.36-3.02); in sharp contrast, they were less likely to access mental health services across most indicators: overall past-year MHC (OR = 0.54, 99% CI: 0.41-0.71) and consultations with family doctors (OR = 0.67, 99% CI: 0.50-0.89), psychologists (OR = 0.54, 99% CI: 0.33-0.87), and social workers (OR = 0.37, 99% CI: 0.21-0.65), with the exception of psychiatrist visits (p = .324). The CART algorithm identifies three groups at risk of MHC service underuse: racialized immigrants aged ≥55 years, immigrants without high school diplomas, and linguistic minorities who were home renters. DISCUSSION: To safeguard health care equity for medically underserved communities in Canada, multisectoral efforts need to guarantee culturally responsive mental health care, multilingual services, and affordable housing for racialized immigrant older adults with mental disorders.


Asunto(s)
Emigrantes e Inmigrantes , Trastornos Mentales , Humanos , Anciano , Canadá/epidemiología , Salud Mental , Cobertura Universal del Seguro de Salud , Trastornos Mentales/epidemiología , Trastornos Mentales/terapia
18.
J Gerontol B Psychol Sci Soc Sci ; 78(5): 880-890, 2023 05 11.
Artículo en Inglés | MEDLINE | ID: mdl-36809313

RESUMEN

OBJECTIVES: Ageism is a prevalent, insidious social justice issue that has harmful effects on the health of older adults. Preliminary literature explores the intersectionality of ageism with sexism, ableism, and ageism experienced among LGBTQ+ older adults. Yet, the intersectionality of ageism with racism remains largely absent from the literature. Therefore, this study explores the lived experience of the intersectionality of ageism and racism among older adults. METHODS: This qualitative study applied a phenomenological approach. Twenty participants 60+ years of age (M = 69, standard deviation = 8.84) in the U.S. Mountain West identifying as Black, Latino(a), Asian-American/Pacific Islander, Indigenous, or White engaged in a 1-hr interview between February and July 2021. A 3-cycle coding process applied constant comparison methods. Five coders independently coded interviews, engaging in critical discussion to resolve disagreements. An audit trail, member checking, and peer debriefing enhanced credibility. RESULTS: This study focuses on individual-level experiences exemplified by 3 umbrella themes and 7 subthemes. The subthemes are (a) compounding oppression, (b) intersection of disparities, (c) White privilege, (d) racism and ageism: being tokenized or ignored, (e) ageism and racism: unspoken bias, (f) racism versus ageism: overt or covert? and (g) racism versus ageism: differentiated or ubiquitous? DISCUSSION: The findings indicate how ageism may be racialized through stereotypes related to mental (in)capability. Practitioners can apply the findings to enhance support for older adults by designing interventions aimed at reducing racialized ageist stereotypes and increasing collaboration through education across anti-ageism/anti-racism initiatives. Future research should focus on the impacts of the intersectionality of ageism and racism on specific health outcomes in addition to structural-level interventions.


Asunto(s)
Ageísmo , Racismo , Humanos , Anciano , Discriminación Social
19.
J Gerontol B Psychol Sci Soc Sci ; 78(6): 1051-1059, 2023 05 26.
Artículo en Inglés | MEDLINE | ID: mdl-36688593

RESUMEN

OBJECTIVES: Investigate subjective cognitive decline (SCD) among 4 study groups consisting of cisgender and transgender adults who are from minoritized ethnoracial groups (i.e., minoritized ethnoracial transgender, minoritized ethnoracial cisgender) and White cisgender and transgender adults aged 45+ (i.e., White transgender, White cisgender) to determine the odds of SCD by group and to test for group differences. METHODS: Data from the 2015-2020 Behavioral Risk Factor Surveillance System were used in a modified case-control approach to perform an intercategorical intersectional study. Each transgender participant was matched to 2 cisgender men and 2 cisgender women, on state, ethnoracial identity, and age. Multivariable logistic regressions modeled SCD odds by group and post hoc contrasts estimated pairwise odds ratios comparing the SCD odds for each combination of groups. RESULTS: SCD prevalence was highest among minoritized ethnoracial transgender (21.6%), followed by White transgender (15.0%), minoritized ethnoracial cisgender (12.0%), and White cisgender (9.0%). After accounting for age, education, and survey year, the odds of SCD were higher in minoritized ethnoracial transgender when compared to White cisgender (adjusted odds ratio [aOR] = 2.51, 95% confidence interval [CI]: 1.59-3.96) and minoritized ethnoracial cisgender (aOR = 1.89, 95% CI: 1.16-3.09). The odds of SCD were higher in White transgender compared to White cisgender (aOR = 1.66, 95% CI: 1.20-2.30). DISCUSSION: When considering the intersection of transgender and ethnoracial identities, we found that transgender adults from minoritized ethnoracial groups reported higher odds of SCD when compared to cisgender adults from minoritized ethnoracial groups. Additional studies are needed to understand the relationship between racialized and gendered inequities in cognitive impairment and how specific mechanisms of systemic transphobia and racism may contribute to this inequity.


Asunto(s)
Disfunción Cognitiva , Personas Transgénero , Masculino , Humanos , Femenino , Personas Transgénero/psicología , Encuestas y Cuestionarios , Escolaridad , Oportunidad Relativa , Disfunción Cognitiva/epidemiología , Identidad de Género
20.
Curr Epidemiol Rep ; 10(1): 33-43, 2023.
Artículo en Inglés | MEDLINE | ID: mdl-36644596

RESUMEN

Purpose of Review: Growing racial/ethnic diversity among America's older adults necessitates additional research specifically focused on health and well-being among aging minoritized populations. Although Black and Latinx adults in the USA tend to face worse health outcomes as they age, substantial evidence points to unexpected health patterns (e.g., the race paradox in mental health, the Latino health paradox) that challenge our understanding of health and aging among these populations. In this review, we demonstrate the value of intersectionality theory for clarifying these health patterns and highlight the ways that intersectionality has been applied to minority aging research. To advance the field, we also make several recommendations for incorporating intersectional approaches in future scholarship on minority aging. Recent Findings: Scholars have applied intersectional approaches to health and aging to unravel how social statuses and social conditions, such as race, ethnicity, gender, nativity, incarceration history, geographic region, and age, produce distinct shared experiences that shape health trajectories through multiple mechanisms. Summary: We highlight common intersectional approaches used in minority aging research and underscore the value of this perspective for elucidating the complex, and often unexpected, health patterns of aging minoritized populations. We identify several key lessons and propose recommendations to advance scholarship on minority aging.

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