Dataset Information

Life course trauma and muscle weakness in older adults by gender and race/ethnicity: Results from the U.S. health and Retirement Study.

ABSTRACT: Muscle weakness, as measured by handgrip strength, is a primary determinant of physical functioning and disability. There is a high burden of muscle weakness in the United States with close to 50 percent of older Americans meeting criteria for clinical muscle weakness. While previous racial/ethnic disparities have been documented among older adults, the extent to which lifecourse trauma shapes muscle strength trajectories is unknown. Using U.S. Health and Retirement Study (N = 20,472, Mean Age = 63.8 years) data on grip strength (2006-2014, up to 3 assessments) and retrospectively reported traumatic events, we fit gender-stratified growth curve models to investigate whether traumatic events experienced across the lifecourse or at distinct sensitive periods (childhood, early/emerging adulthood or mid-life) predicted later-life trajectories of grip strength. There was no association between cumulative trauma and trajectories of grip strength and the main effects for the life stage models were largely null. However, among White women, our results suggest that traumatic events experienced during childhood (? = -0.012; 95% CI = -0.024, 0.0004) compared to middle adulthood are associated with faster declines in grip strength in later life. Traumatic events reported during childhood was related to a slower decline in grip strength over time among Hispanic women compared to that for White women (? = 0.086, 95% CI = 0.044, 0.128). Among Black men, the association between traumatic events during early/emerging adulthood and age-related declines in grip strength was stronger for Black men than for White men (interaction ? = -0.070; 95% CI = -0.138, 0.001). Traumatic events experienced during distinct life stages may influence later life declines in grip strength and exacerbate racial inequalities in later life. This study addresses an important gap by investigating the life course social determinants of later life muscle strength, which is a key driver of physical functioning and mobility.

SUBMITTER: Duchowny KA

PROVIDER: S-EPMC7260581 | biostudies-literature | 2020 Aug

REPOSITORIES: biostudies-literature

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Life course trauma and muscle weakness in older adults by gender and race/ethnicity: Results from the U.S. health and Retirement Study.

Duchowny Kate A KA Hicken Margaret T MT Cawthon Peggy M PM Glymour M Maria MM Clarke Philippa P

SSM - population health 20200507

Muscle weakness, as measured by handgrip strength, is a primary determinant of physical functioning and disability. There is a high burden of muscle weakness in the United States with close to 50 percent of older Americans meeting criteria for clinical muscle weakness. While previous racial/ethnic disparities have been documented among older adults, the extent to which lifecourse trauma shapes muscle strength trajectories is unknown. Using U.S. Health and Retirement Study (N = 20,472, Mean Age = ...[more]

PMID: 32490135

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Project description:ImportanceLittle is known about the distribution of life-saving trauma resources by racial/ethnic composition in US cities, and if racial/ethnic minority populations disproportionately live in US urban trauma deserts.ObjectiveTo examine racial/ethnic differences in geographic access to trauma care in the 3 largest US cities, considering the role of residential segregation and neighborhood poverty.Design, setting, and participantsA cross-sectional, multiple-methods study evaluated census tract data from the 2015 American Community Survey in Chicago, Illinois; Los Angeles (LA), California; and New York City (NYC), New York (N = 3932). These data were paired to geographic coordinates of all adult level I and II trauma centers within an 8.0-km buffer of each city. Between February and September 2018, small-area analyses were conducted to assess trauma desert status as a function of neighborhood racial/ethnic composition, and geospatial analyses were conducted to examine statistically significant trauma desert hot spots.Main outcomes and measuresIn small-area analyses, a trauma desert was defined as travel distance greater than 8.0 km to the nearest adult level I or level II trauma center. In geospatial analyses, relative trauma deserts were identified using travel distance as a continuous measure. Census tracts were classified into (1) racial/ethnic composition categories, based on patterns of residential segregation, including white majority, black majority, Hispanic/Latino majority, and other or integrated; and (2) poverty categories, including nonpoor and poor.ResultsChicago, LA, and NYC contained 798, 1006, and 2128 census tracts, respectively. A large proportion comprised a black majority population in Chicago (35.1%) and NYC (21.4%), compared with LA (2.7%). In primary analyses, black majority census tracts were more likely than white majority census tracts to be located in a trauma desert in Chicago (odds ratio [OR], 8.48; 95% CI, 5.71-12.59) and LA (OR, 5.11; 95% CI, 1.50-17.39). In NYC, racial/ethnic disparities were not significant in unadjusted models, but were significant in models adjusting for poverty and race-poverty interaction effects (adjusted OR, 1.87; 95% CI, 1.27-2.74). In comparison, Hispanic/Latino majority census tracts were less likely to be located in a trauma desert in NYC (OR, 0.03; 95% CI, 0.01-0.11) and LA (OR, 0.30; 95% CI, 0.22-0.40), but slightly more likely in Chicago (OR, 2.38; 95% CI, 1.56-3.64).Conclusions and relevanceIn this study, black majority census tracts were the only racial/ethnic group that appeared to be associated with disparities in geographic access to trauma centers.

Project description:Background and objectivesDrawing on the counterbalancing framework, this study examined the counteracting roles of coronavirus disease (COVID)-related stressors (i.e., infection threat, family activity disruption, economic impact) and psychological resilience in explaining racial-ethnic disparities in depressive symptoms during the COVID-19 pandemic.Research design and methodsA competitive mediation model was fitted using nationally representative data from the Health and Retirement Study COVID-19 Project, which were collected in June 2020 (N = 1,717). A competitive mediation model was specified within which the associations between race-ethnicity categories and depressive symptoms were mediated by infection threat, family activity disruption, economic impact, and psychological resilience. A list of pre-COVID covariates and pre-COVID depressive symptoms were adjusted for in this model.ResultsInfection threat, family activity disruption, economic impact, and psychological resilience were all higher among non-Hispanic Blacks and Hispanics than among non-Hispanic Whites. Economic impact had a positive whereas psychological resilience had a negative direct effect on depressive symptoms net of pre-COVID covariates and pre-COVID depressive symptoms. Mediation analyses revealed that, compared to non-Hispanic Whites, non-Hispanic Blacks and Hispanics had higher depressive symptoms due to their higher family activity disruption and higher economic impact, but their higher levels of psychological resilience also reduced depressive symptoms. The counteracting indirect effects offset each other, resulting in a null total effect of race-ethnicity on depressive symptoms.Discussion and implicationsThese findings suggest that interventions addressing the mental health impact of COVID should consider race/ethnicity-specific vulnerabilities and resilience. Future studies need to consider the complex and potentially counterbalancing mechanisms linking race-ethnicity and mental health.

Dataset Information

Life course trauma and muscle weakness in older adults by gender and race/ethnicity: Results from the U.S. health and Retirement Study.

Publications

Life course trauma and muscle weakness in older adults by gender and race/ethnicity: Results from the U.S. health and Retirement Study.

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