Adrienne T. Aiken-Morgan

Exercise and sleep in community‐dwelling older adults: evidence for a reciprocal relationship

Exercise behaviour and sleep are both important health indicators that demonstrate significant decreases with age, and remain modifiable well into later life. The current investigation examined both the chronic and acute relationships between exercise behaviour and self‐reported sleep in older adults through a secondary analysis of a clinical trial of a lifestyle intervention. Seventy‐nine community‐dwelling, initially sedentary, older adults (mean age = 63.58 years, SD = 8.66 years) completed daily home‐based assessments of exercise behaviour and sleep using daily diary methodology. Assessments were collected weekly and continued for 18 consecutive weeks. Multilevel models revealed a small positive chronic (between‐person mean‐level) association between exercise and wake time after sleep onset, and a small positive acute (within‐person, day‐to‐day) association between exercise and general sleep quality rating. The within‐person exercise and general sleep quality rating relationship was found to be reciprocal (i.e. sleep quality also predicted subsequent exercise behaviour). As such, it appears exercise and sleep are dynamically related in older adults. Efforts to intervene on either sleep or exercise in late‐life would be wise to take the other into account. Light exposure, temperature regulation and mood may be potential mechanisms of action through which exercise can impact sleep in older adults.

Intervention markers of physical activity maintenance in older adults.

OBJECTIVES To identify intervention components that may promote longterm changes of physical activity among older adults in a behavioral theory-based physical activity trial. METHODS Participants (N = 24; aged 65 ± 8.79 years) shared perceptions of intervention components at the end of the intervention and physical activity was assessed at 18 months. Mixed-methods analyses using a pragmatic content analysis of interview data were conducted. RESULTS Active study participants (25%) cited more specific goals/actions to achieve goals and more social support from family/friends, and had significantly higher self-determined motivation mean scores at 18 months than insufficiently active study participants (75%). CONCLUSIONS Specific goal-setting behaviors and social support from family/friends may be key elements of physical activity maintenance in older adults.

Content and Perceived Utility of Mental Imagery by Older Adults in a Peer-Delivered Physical Activity Intervention.

Imagery interventions intended to increase exercise behavior are rare. The Active Adult Mentoring Program (AAMP) was a randomized controlled trial with imagery content. The purposes of this study were to examine the content and perceived utility of mental imagery with 24 AAMP participants (Mage = 65.00, SD = 8.79 years). Digital recordings of AAMP sessions and post-intervention interviews were content-analyzed. Emergent themes included images of the physical activity context and negative impressions about imagery. Post-intervention interviews revealed that 13 participants reported positive experiences using mental imagery while 9 would not engage in further use. Important implications are discussed.

Education Desegregation and Cognitive Change in African American Older Adults

OBJECTIVES 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). METHOD 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. RESULTS 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 the youngest age cohort (50- to 59-year-olds) performed better on measures of Perceptual Speed. There were no significant univariate interactions between schooling group or age cohort and cognitive change over time. DISCUSSION Overall, these findings suggest a slight advantage of desegregated schooling for cognitive performance, but no advantage of desegregated schooling on the rate of cognitive change over time in this sample.

Sleep complaints in older blacks: do demographic and health indices explain poor sleep quality and duration?

OBJECTIVE To examine the relationship between measures of sleep quality and the presence of commonly encountered comorbid and sociodemographic conditions in elderly Black subjects. METHOD 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. RESULTS 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 increasing levels of stress, there was no significant relationship between sleep quality and stress for participants 81 years and older. CONCLUSIONS Several potential mechanisms may explain poor sleep in urban, community dwelling Blacks. Perceived stressors, including current financial hardship or hardship experienced for an extended time period throughout the lifespan, may influence sleep later in life.

Cognition and Health in African American Men

Objective: 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. Method: 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. Results: After adjustment, significant relationships were found between average peak expiratory flow rate (APEFR) and cognitive performance measures. Discussion: 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 this population will be critical as life expectancies increase.

Stability and Change in Cognitive Status Classification of Black Older Adults

The purpose of this study was to determine whether stability and change in cognitive status are associated with sociodemographic characteristics and health function.

Pain inconsistency and sleep in mid to late-life: the role of depression

Abstract Objectives: Inconsistency in pain may lead to depression, which may then influence sleep. Thus, the purpose of this study was to examine whether depression mediates the relationship between day-to-day inconsistency in pain and sleep in middle aged to older adults. Methods: Baseline measures from the Active Adult Mentoring Project were used for secondary data analysis. Participants included 82 adults in mid- to late-life. Pain was assessed for seven consecutive days on an 11-point Likert-scale, with pain inconsistency defined as the seven-day individual standard deviation. A self-report daily diary was used to assess sleep efficiency (SE), total wake time (TWT), total sleep time (TST), and sleep quality (SQ), and depression was assessed using the BDI-II. Results: Mediation analyses revealed that depression partially mediated the relationship between pain inconsistency and SE, TWT, and SQ but not TST. Conclusions: Results indicate that depression may be an important factor through which pain inconsistency influences sleep. Although further research is warranted, these preliminary findings suggest that intervening on both pain inconsistency and depression may be one way to improve sleep in older adults.

Perceived Control Predicts Pulse Pressure in African American Men: The Baltimore Study of Black Aging.

OBJECTIVE 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. METHODOLOGY 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). RESULTS After accounting for age and health status indicators, perceived control emerged as a significant predictor of pulse pressure. DISCUSSION These findings suggest that greater belief in ones 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.