A Preliminary Analysis of Stress Burden and Cognitive Function and Clinically Adjudicated Cognitive Outcomes in Black American Adults.

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  • Additional Information
    • Source:
      Publisher: published on behalf of the Gerontological Society of America by Oxford University Press Country of Publication: United States NLM ID: 9502837 Publication Model: Print Cited Medium: Internet ISSN: 1758-535X (Electronic) Linking ISSN: 10795006 NLM ISO Abbreviation: J Gerontol A Biol Sci Med Sci Subsets: MEDLINE
    • Publication Information:
      Publication: Washington, DC : published on behalf of the Gerontological Society of America by Oxford University Press
      Original Publication: Washington, DC : Gerontological Society of America, c1995-
    • Subject Terms:
      Black or African American*/psychology ; Black or African American*/statistics & numerical data ; Stress, Psychological*/ethnology ; Cognition*/physiology; Humans ; Female ; Male ; Middle Aged ; Aged ; Cognitive Dysfunction/ethnology ; Cognitive Dysfunction/epidemiology ; Psychological Distress ; Executive Function ; Pennsylvania/epidemiology
    • Abstract:
      Background: The combination of exposure to multiple stressors and psychological distress may contribute to the disproportionate burden of dementia risk among Black Americans. This study estimates the effect of an index of stress and psychological distress (ie, "stress burden") on cognitive function and clinically adjudicated cognitive outcomes among older Black American adults, and examines sleep as a mediator.
      Methods: The sample included 204 Black adults (79% female; mean age = 64 years) from Pittsburgh, PA, USA. Stress burden comprised 3 self-reported stress and distress measures assessed in 2016: discrimination, psychological distress, and posttraumatic stress. Potential mediators included actigraphy-assessed sleep duration and efficiency from 2018. Cognitive battery and clinical adjudication in 2019 assessed cognitive function and clinically adjudicated outcomes. Causal mediation analysis estimated the direct effect between stress burden and cognitive outcomes, and indirect effects through sleep, after adjusting for sociodemographics and hypertension.
      Results: Higher stress burden had a significant direct effect on lower executive functioning and visuospatial performance. However, there were no significant indirect effects (ie, mediation) by sleep disturbances on any domain of cognitive function assessed. Also, there were no significant direct or indirect effects on clinically adjudicated outcomes.
      Conclusions: Multiple stressors often co-occur and may contribute to racial disparities in cognitive health. Findings suggest that higher stress burden had negative effects on functioning in executive and visuospatial domains in this community-based sample of older Black American adults. However, there was no evidence of mediation by sleep. Findings highlight the importance of continued work to identify modifiable pathways between stress burden and cognitive health disparities.
      (© The Author(s) 2024. Published by Oxford University Press on behalf of The Gerontological Society of America. All rights reserved. For commercial re-use, please contact [email protected] for reprints and translation rights for reprints. All other permissions can be obtained through our RightsLink service via the Permissions link on the article page on our site—for further information please contact [email protected].)
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    • Grant Information:
      R01 HL131531 United States HL NHLBI NIH HHS; NIH; R01 AG072652 United States AG NIA NIH HHS; HSPC #2014-0605 RAND Human Subjects Protection Committee; AG072652 United States AG NIA NIH HHS; R01 CA149105 United States CA NCI NIH HHS; CR19030308-004 University of Pittsburgh Institutional Review Board; R01CA149105 United States CA NCI NIH HHS
    • Contributed Indexing:
      Keywords: Alzheimer’s disease; Discrimination; Health disparities; Sleep; Stress
    • Publication Date:
      Date Created: 20240718 Date Completed: 20240817 Latest Revision: 20240820
    • Publication Date:
      20240820
    • Accession Number:
      PMC11329620
    • Accession Number:
      10.1093/gerona/glae177
    • Accession Number:
      39021075