Sara J. McLaughlin

Public opinion about alzheimer disease among blacks, hispanics, and whites : Results from a national survey

Recent research has documented notable differences in knowledge, awareness, and cultural beliefs about Alzheimer disease (AD) among groups defined by race and ethnicity. The present study was conducted to assess racial differences in knowledge and attitudes about AD among a national sample of adults. Data from 1176 adults aged 35 years and over (48.6% White, 25.7% Black, and 25.8% Hispanic) obtained via telephone interview were used in this study. Although some notable group differences defined by race/ethnicity were observed, more similarities in patterns of response were discovered than expected. Black and Hispanic respondents were significantly more likely to believe that AD is a normal part of aging, but were more optimistic about future advances in research than White participants. Compared with White and Black respondents, Hispanics were more likely to report feeling well-prepared for handling a diagnosis of AD in a family member. Overall, the results suggest that misconceptions about AD remain among large segments of the population, that AD remains a source of significant concern, and that continued efforts are needed to educate the public about this disease.

Racial differences in knowledge and beliefs about Alzheimer disease.

Alzheimer disease (AD) is a growing public health problem that disproportionately affects racial and ethnic minorities, including African Americans. Given that the perceptions of illness can influence response to treatment options and coping with disease burden, we examined differences between African Americans and whites with regard to their attitudes, beliefs, and knowledge about AD. A total of 301 participants (mean age=57 y; 80% female; 47% African American) were surveyed by telephone, with overrepresentation of caregivers and first-degree relatives of people with AD (62% of sample). After controlling for potentially confounding covariates, the 2 groups differed in terms of the following: (1) their knowledge about the disease (eg, recognizing that AD is not a part of normal aging); (2) concern about AD (eg, worry about developing the disease); (3) beliefs about putative causes of AD (eg, stress); and 4) beliefs about the effectiveness of various options for reducing risk of and treating AD (eg, physical activity). Findings suggest that AD outreach and education efforts may do well to take into account divergent illness perceptions across racial and ethnic groups. Further research is needed to confirm these findings in more representative samples and to identify factors that explain these racial differences.

Black and White Adult Family Members' Attitudes Toward a Dementia Diagnosis

OBJECTIVES: To examine potential benefits of and barriers to diagnosis from the perspective of black and white adults directly affected by Alzheimers disease (AD).

Public beliefs and knowledge about risk and protective factors for Alzheimer's disease

The purpose of this study was to assess public beliefs and knowledge about risk and protective factors for Alzheimers disease (AD).

Are Pets a Source of Support or Added Burden for Married Couples Facing Dementia

In studies that have explored pet ownership in families affected by dementia, reported benefits have ranged from improvements in patient behavior to reduction in caregiver blood pressure. In this exploratory study, the impact of dementia on relationships among pets, caregivers, and care recipients was examined using content analysis of open-ended questions included in a telephone survey. Female spouse caregivers who owned pets were asked how their (and their husbands) relationship with their pets changed since they started caring for their husband. Most caregivers reported that they felt closer and more attached to their pets than previously. However, some caregivers reported that their pets created an additional burden and that they and their spouse had less time to care for the pets since the onset of illness. Findings highlight the need for further research to explore the unique benefits and burdens of owning a pet for families affected by dementia.

The association of diabetes complications with physical activity in a representative sample of older adults in the United States.

Objective Most adults with diabetes do not engage in the level of physical activity recommended for optimal disease management. Diabetes complications are not generally considered a clinical contraindication to exercise. No prior national studies have examined the associations of these complications with physical activity. Methods Data are from the 2003 Diabetes Supplement to the nationally representative US Health and Retirement Study (n = 1811; age >50 years). Multiple logistic regression was used to examine the association between diabetes complications and the odds of meeting physical activity guidelines. Results Forty-three percent of the sample met physical activity guidelines. Adjusting for sociodemographic variables, retinopathy (odds ratios (OR) OR = 0.54, 95% confidence intervals (CI) = 0.36–0.81), nephropathy (OR = 0.70, 95% CI = 0.50–0.99), neuropathy (OR = 0.75, 95% CI = 0.59–0.95), and heart disease (OR = 0.69, 95% CI = 0.51–0.94) were all independently associated with reduced odds of meeting guidelines. A borderline significant association was observed for stroke. Discussion Adults with diabetes with complications of the eyes, kidneys, or nerves and those with heart disease are less likely to meet physical activity guidelines compared to those without these complications. These individuals may require additional support from health professionals to achieve recommended amounts of physical activity. More studies are needed to clarify the barriers and benefits to engaging in physical activity in the presence of diabetes complications.

Defining and Estimating Healthy Aging in Spain: A Cross-sectional Study

Purpose of the Study Using an operational continuum of healthy aging developed by U.S. researchers, we sought to estimate the prevalence of healthy aging among older Spaniards, inform the development of a definition of healthy aging in Spain, and foster cross-national research on healthy aging. Design and Methods The ELES pilot study is a nationwide, cross-sectional survey of community-dwelling Spaniards 50 years and older. The prevalence of healthy aging was calculated for the 65 and over population using varying definitions. To evaluate their validity, we examined the association of healthy aging with the 8 foot up & go test, quality of life scores and self-perceived health using multiple linear and logistic regression. Results The estimated prevalence of healthy aging varied across the operational continuum, from 4.5% to 49.2%. Prevalence figures were greater for men and those aged 65 to 79 years and were higher than in the United States. Predicted mean physical performance scores were similar for 3 of the 4 definitions, suggesting that stringent definitions of healthy aging offer little advantage over a more moderate one. Implications Similar to U.S. researchers, we recommend a definition of healthy aging that incorporates measures of functional health and limiting disease as opposed to definitions requiring the absence of all disease in studies designed to assess the effect of policy initiatives on healthy aging.

Healthy Aging in the Context of Educational Disadvantage: The Role of “Ordinary Magic”:

Objective: The objective of this study is to examine the correlates of healthy aging in the context of educational disadvantage and the extent to which identified correlates are shared with the wider, more educationally advantaged population. Method: Data are from the 2012 Health and Retirement Study. The analytic sample included 17,484 self-respondents ≥50 years of age. Educational disadvantage was defined as having less than a high school diploma. Using logistic regression, healthy aging was regressed on demographic, early-life, and health-related factors by educational status. Results: Among educationally disadvantaged adults, demographic characteristics (e.g., age), health practices (e.g., physical activity), and the presence of health conditions were independently correlated with healthy aging. With few exceptions, correlates of healthy aging were similar among educationally advantaged and disadvantaged adults. Discussion: Ordinary factors are associated with healthy aging among adults without a high school diploma, suggesting that healthy aging is possible for larger numbers of adults aging in the context of educational disadvantage.

Gender Differences in Trajectories of Physical Activity Among Older Americans With Diabetes.

Objective: The primary objective of this study was to examine gender differences in engagement in physical activity over time among older U.S. adults with diabetes. Method: Using data from the Health and Retirement Study, we investigated physical activity between 2004 and 2010 among 1,857 adults aged 65 years and above with diabetes. Results: Less than half of adults were physically active at baseline. The probability of physical activity declined over the 6-year period, with no significant gender variation in the effect of time. Because the odds of physical activity were lower for women at baseline and the effect of time did not vary by gender, the trajectory of physical activity was less favorable for women than men. Discussion: The women in this cohort of older Americans started and remained less active than their male counterparts. Investigations covering a larger portion of the life course and those examining the impact of life events and transitions on physical activity among adults with diabetes are needed.

Cumulative exposure to air pollution and subsequent mortality among older adults in China

Background Research on the health effects of exposure to air pollution is growing. However, relatively little attention has been paid to the effects of long-term and cumulative exposure to air pollutants. Individual-level studies on the health consequences of air pollution in China are especially scarce. The purpose of this study is to examine the effect of cumulative exposure to sulfur dioxide (SO2), an air pollutant of particular concern in China, on all-cause mortality in older Chinese adults. Methods Using a nationally representative sample of older adults in China (N = 11 199), we tracked mortality over an 11-year period (2000-11). Air pollution data were linked to respondents using provincial identifiers. To examine the effect of cumulative SO2 exposure on mortality, we employed multilevel multinomial logistic regression models that account for within subject clustering of observations over time and clustering at the province level. Results We found that every 10-μg/m3 increase in cumulative exposure to SO2 increased the odds of death by nearly 1% (OR = 1.008; 95% CI: 1.002-1.014), controlling for province- and individual-level social and economic characteristics. Conclusions Our analysis shows that air pollution is a risk factor for morality in older Chinese adults. Findings suggest that stronger SO2 regulations may enhance longevity.