Independent associations of phosphorylated tau181 and neurofilament light with cognitive outcomes in the Health and Aging Brain Study-Health Disparities (HABS-HD).

Purpose: Many patients presenting for lung cancer screening are current smokers; screening may be a teachable moment for cessation. The objective of the current analysis is to compare cessation readiness among lung screening patients by rural/urban residence and race/ethnicity to identify populations who may benefit from tailored support. Methods: We enrolled 1,095 current smokers presenting for low dose CT lung cancer screening at 24 NCI Community Oncology Research Program (NCORP) imaging clinics as part of the OaSiS trial (WF 20817CD). Prior to screening, we collected data regarding perceived risk and worry about lung cancer, perceived impact of cessation on lung cancer risk, cessation readiness, and quitting self-efficacy (both 1-10 Likert type scales). We classified participants as rural vs urban using the zip-code-based definitions of the Federal Office of Rural Health Policy. We summarized group differences using chi-square analyses. Results: Participants were 50.2% female; average age 64 years (range 55-79); 81.9% non-Hispanic White (NHW), 13.3% non-Hispanic Black (NHB), 2.6% Hispanic, 2.2% American Indian; 20.2% rural residence). The median cigarettes smoked per day was 20 and the median pack years smoked was 44. NHW participants were less likely than other groups to report being “extremely” worried about lung cancer [15.5% vs NHB (31.4%), Hispanic (35.7%), and American Indian (25%), p<.0001]. When queried about their perceived risk of developing lung cancer, NHB (21.8%), Hispanic (14.3%), and American Indian (12.5%) participants were also more likely to report that they didn’t know, compared to NHW participants (9.7%, p <.0001). NHB participants were more likely to believe that quitting smoking would “very much” reduce their risk of lung cancer (52.1%), compared to NHW (36.3%), Hispanic (35.7%), and American Indian (37.5%) participants (p<.001). NHWs reported lower cessation readiness compared to NHB, Hispanic, and American Indian participants (p<.001). NHB and Hispanic participants also reported high quitting self-efficacy compared to NHW and American Indian participants (p<.0001). With regard to rural/urban differences, compared to urban residents, rural residents reported lower or unknown perceived impact of cessation on lung cancer risk (9.5 vs 6.8% no impact & 13.2 vs 6.9% unknown, p<.01). There were no other differences in cessation readiness factors by rural-urban residence. Conclusions: To advance health equity, it is important to understand cessation readiness, among patients presenting to community-based imaging clinics for lung cancer screening. Evidence-based cessation treatment for racial/ethnic minorities within these settings may be enhanced by tailoring for higher cessation readiness. Rural and racial/ethnic minority patients may benefit from enhanced education regarding lung cancer risk and the impact of cessation. This work was supported by the National Cancer Institute (R01CA207158 & UG1CA189824). Citation Format: Kathryn E. Weaver, Erin L. Sutfin, Emily Dressler, Christina Bellinger, David P. Miller, Caroline Chiles, W. J. Petty, Glenn Lesser, Kristie L. Foley. Rural/urban and race differences in factors related to cessation readiness among cigarette smokers presenting for lung cancer screening in community settings [abstract]. In: Proceedings of the AACR Virtual Conference: Thirteenth AACR Conference on the Science of Cancer Health Disparities in Racial/Ethnic Minorities and the Medically Underserved; 2020 Oct 2-4. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2020;29(12 Suppl):Abstract nr PO-009.

Background and objective Cancer centers and healthcare systems play a pivotal role in identifying and responding appropriately to the population's cancer burden and health needs in their catchment area to reduce health inequities. Community health needs assessment (CHNA) is an integral instrument in identifying individuals' fundamental health needs in a given community. This study utilizes data from a pilot CHNA collected by a Cancer Center at community engagement events to examine cancer screening status, cancer screening education, having a primary care doctor, and barriers to healthcare among older participants. We hypothesize that screening and healthcare needs will differ by racial/ethnic groups. Methods The initial CHNA comprises data from eligible participants aged 18 years and older who attended 13 cultural and health events in Chicago from August to December 2019. The study analysis focused on Hispanic, Non-Hispanic Black (NHB), and Non-Hispanic White (NHW) participants aged 50 years and older. We examined colorectal cancer (CRC) screening and education interest questions as emblematic for both sexes in this age group based on the U.S. Preventive Services Task Force recommendations in 2019. Participants responded to (1) having received colon/rectal cancer screening with stool test (FOBT/FIT) or colonoscopy within the past ten years and (2) interests in learning more about the screening tests. We conducted descriptive bivariate analyses to examine CRC screening status and interests, having primary care, and barriers to care by race/ethnicity and used the Chi-square test of association to compare differences for the descriptive analyses. Results The study consisted of 308 men and women aged 50 years and older. Of these, 25% were Hispanic, 59% were NHB, and 16% were NHW. Compared to NHW participants, a smaller proportion of Hispanics (59.2% vs 78.4%; p=0.02) reported receiving CRC screening while no differences were observed for NHB participants (73.5% vs 78.4%; p=0.47). Compared to NHW participants, more Hispanics (31.6% vs 11.8%; p=0.01) and NHB (27.6% vs 11.8%; p=0.02) participants expressed interest in receiving education on CRC screening. Likewise, more Hispanic participants reported not having a primary care doctor (86.8% vs 94.1%; p=0.02), while no differences were observed for NHB vs NHW participants (92.3% vs 94.1%; p=0.08). Furthermore, compared to NHWs, more Hispanics and NHB participants reported barriers to screening such as transportation (NHW=0% vs Hispanics=7.9% vs NHB=16%), knowledge of screening services (NHW=1.96% vs Hispanics=7.9% vs NHB=20.4%), and lack of provider trust (NHW=3.9% vs Hispanics=11.8% vs NHB=14.3%). Conclusion The study findings show differences in CRC screening status and education interests, having primary care, and barriers to care by race/ethnicity. Minority groups reported higher screening education interests and barriers to care. This study demonstrates a means of identifying the population's healthcare needs and interests within a catchment area using a community engagement model. Citation Format: Ifeanyi B. Chukwudozie, Chibuzor Abasilim, Jessica M. Madrigal, Vida A. Henderson, Erica Martinez, Alana A. Aziz-Bradley, Jeanette Santana Gonzalez, Nasima Mannan, Ahlam Al-Kodmany, Karriem S Watson. Healthcare and colorectal cancer screening needs among older adults in a cancer center catchment area [abstract]. In: Proceedings of the AACR Virtual Conference: 14th AACR Conference on the Science of Cancer Health Disparities in Racial/Ethnic Minorities and the Medically Underserved; 2021 Oct 6-8. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2022;31(1 Suppl):Abstract nr PO-036.

Therapeutic inertia may contribute to racial and ethnic differences in blood pressure (BP) control. To determine the association between race and ethnicity and therapeutic inertia in the Systolic Blood Pressure Intervention Trial (SPRINT). This cross-sectional study was a secondary analysis of data from SPRINT, a randomized clinical trial comparing intensive (<120 mm Hg) vs standard (<140 mm Hg) systolic BP treatment goals. Participants were enrolled between November 8, 2010, and March 15, 2013, with a median follow-up 3.26 years. Participants included adults aged 50 years or older at high risk for cardiovascular disease but without diabetes, previous stroke, or heart failure. The present analysis was restricted to participant visits with measured BP above the target goal. Analyses for the present study were performed in from October 2020 through March 2021. Self-reported race and ethnicity, mutually exclusively categorized into groups of Hispanic, non-Hispanic Black, or non-Hispanic White participants. Therapeutic inertia, defined as no antihypertensive medication intensification at each study visit where the BP was above target goal. The association between self-reported race and ethnicity and therapeutic inertia was estimated using generalized estimating equations and stratified by treatment group. Antihypertensive medication use was assessed with pill bottle inventories at each visit. Blood pressure was measured using an automated device. A total of 8556 participants, including 4141 in the standard group (22 844 participant-visits; median age, 67.0 years [IQR, 61.0-76.0 years]; 1467 women [35.4%]) and 4415 in the intensive group (35 453 participant-visits; median age, 67.0 years [IQR, 61.0-76.0 years]; 1584 women [35.9%]) with at least 1 eligible study visit were included in the present analysis. Among non-Hispanic White, non-Hispanic Black, and Hispanic participants, the overall prevalence of therapeutic inertia in the standard vs intensive groups was 59.8% (95% CI, 58.9%-60.7%) vs 56.0% (95% CI, 55.2%-56.7%), 56.8% (95% CI, 54.4%-59.2%) vs 54.5% (95% CI, 52.4%-56.6%), and 59.7% (95% CI, 56.5%-63.0%) vs 51.0% (95% CI, 47.4%-54.5%), respectively. The adjusted odds ratios in the standard and intensive groups for therapeutic inertia associated with non-Hispanic Black vs non-Hispanic White participants were 0.85 (95% CI, 0.79-0.92) and 0.94 (95% CI, 0.88-1.01), respectively. The adjusted odds ratios for therapeutic inertia comparing Hispanic vs non-Hispanic White participants were 1.00 (95% CI, 0.90-1.13) and 0.89 (95% CI, 0.79-1.00) in the standard and intensive groups, respectively. Among SPRINT participants above BP target goal, this cross-sectional study found that therapeutic inertia prevalence was similar or lower for non-Hispanic Black and Hispanic participants compared with non-Hispanic White participants. These findings suggest that a standardized approach to BP management, as used in SPRINT, may help ensure equitable care and could reduce the contribution of therapeutic inertia to disparities in hypertension. ClinicalTrials.gov identifier: NCT01206062.

Hemophilia-related distress (HRD) has been shown to be higher among those with lower educational attainment, but potential racial/ethnic differences have not been previously described. Thus, we examined HRD according to race/ethnicity. This cross-sectional study was a planned secondary analysis of the hemophilia-related distress questionnaire (HRDq) validation study data. Adults aged ≥ 18years with Hemophilia A or B were recruited from one of two hemophilia treatment centers between July 2017-December 2019. HRDq scores can range from 0-120, and higher scores indicate higher distress. Self-reported race/ethnicity was grouped as Hispanic, non-Hispanic White (NHW) and non-Hispanic Black (NHB). Unadjusted and multivariable linear regression models were used to examine mediators of race/ethnicity and HRDq scores. Among 149 participants enrolled, 143 completed the HRDq and were included in analyses. Approximately 17.5% of participants were NHB, 9.1% were Hispanic and 72.0% were NHW. HRDq scores ranged from 2 to 83, with a mean of 35.1 [standard deviation (SD) = 16.5]. Average HRDq scores were significantly higher among NHB participants (mean = 42.6,SD = 20.6; p-value = .038) and similar in Hispanic participants (mean = 33.8,SD = 16.7, p-value = .89) compared to NHW (mean = 33.2,SD = 14.9) participants. In multivariable models, differences between NHB vs NHW participants persisted when adjusting for inhibitor status, severity, and target joint. However, after household income was adjusted for, differences in HRDq scores were no longer statistically significant (β = 6.0 SD = 3.7; p-value = .10). NHB participants reported higher HRD than NHW participants. Household income mediated higher distress scores in NHB compared to NHW participants, highlighting the urgent need to understand social determinants of health and financial hardship in persons with hemophilia.

We assessed the combined effect of superoxide and iNOS inhibition on microvascular function in non-Hispanic Black and non-Hispanic White participants (n = 15 per group). Participants were instrumented with four microdialysis fibers: (1) lactated Ringer's (control), (2) 10 μM tempol (superoxide inhibition), (3) 0.1 mM 1400 W (iNOS inhibition), (4) tempol + 1400 W. Cutaneous vasodilation was induced via local heating and NO-dependent vasodilation was quantified. At control sites, NO-dependent vasodilation was lower in non-Hispanic Black (45 ± 9% NO) relative to non-Hispanic White (79 ± 9% NO; p < 0.01; effect size, d = 3.78) participants. Tempol (62 ± 16% NO), 1400 W (78 ± 12% NO) and tempol +1400 W (80 ± 13% NO) increased NO-dependent vasodilation in non-Hispanic Black participants relative to control sites (all p < 0.01; d = 1.22, 3.05, 3.03, respectively). The effect of 1400 W (p = 0.04, d = 1.11) and tempol +1400 W (p = 0.03, d = 1.22) was greater than tempol in non-Hispanic Black participants. There was no difference between non-Hispanic Black and non-Hispanic White participants at 1400 W or tempol + 1400 W sites. These data suggest iNOS has a greater effect on NO-dependent vasodilation than superoxide in non-Hispanic Black participants.

This study examined racial and ethnic differences in percent total weight loss (%TWL) and glycemic improvement following sleeve gastrectomy (SG) and explored the role of socioeconomic and psychosocial factors in postsurgical outcomes. This longitudinal study included patients who underwent SG between 2017 and 2020, with follow-up visits over 24 months. Non-Hispanic Black (NHB) participants had lower %TWL at 3, 12, and 24 months compared with Hispanic (H) and non-Hispanic White (NHW) participants. Fat mass index was initially lower in NHB, with smaller reductions over time and significant group differences persisting at 24 months. NHB participants had higher baseline fat-free mass index values; by 24 months, fat-free mass index values were lower in H participants. Hemoglobin A1c decreased across all groups but remained consistently higher in NHB and H compared with NHW at 24 months. NHB participants reported higher perceived discrimination, sleep disturbance, and perceived stress than H and NHW participants at all time points. Employment status predicted %TWL at 12 months. There was a significant interaction between race and ethnicity and employment status observed at 12 and 24 months, suggesting that employment-related disparities could impact surgical outcomes. NHB participants experienced less favorable outcomes following SG, emphasizing the need for tailored interventions addressing socioeconomic and psychosocial disparities.

Background We examined arterial stiffness in individuals with type 1 diabetes, and explored whether differences between Hispanic, non-Hispanic Black (NHB), and non-Hispanic White (NHW) individuals were attributable to modifiable clinical and social factors. Methods and Results Participants (n=1162; 22% Hispanic, 18% NHB, and 60% NHW) completed 2 to 3 research visits from ≈10 months to ≈11 years post type1diabetesdiagnosis (mean ages of ≈9 to ≈20 years, respectively) providing data on socioeconomic factors, type1diabetescharacteristics, cardiovascular risk factors, health behaviors, quality of clinical care, and perception of clinical care. Arterial stiffness (carotid-femoral pulse wave velocity [PWV], m/s) was measured at ≈20 years of age. We analyzed differences in PWV by race and ethnicity, then explored the individual and combined impact of the clinical and social factors on these differences. PWV did not differ between Hispanic (adjusted mean 6.18 [SE 0.12]) and NHW (6.04 [0.11]) participants after adjustment for cardiovascular risks (P=0.06) and socioeconomic factors (P=0.12), or between Hispanic and NHB participants (6.36 [0.12]) after adjustment for all factors (P=0.08). PWV was higher in NHB versus NHW participants in all models (all P<0.001). Adjustment for modifiable factors reduced the difference in PWV by 15% for Hispanic versus NHW participants; by 25% for Hispanic versus NHB; and by 21% for NHB versus NHW. Conclusions Cardiovascular and socioeconomic factors explain one-quarter of the racial and ethnic differences in PWV of young people with type1diabetes, but NHB individualsstill experienced greater PWV. Exploration of pervasive inequities potentially driving these persistent differences is needed.

IntroductionOlder adults, including racial and ethnic minorities, are underrepresented in research. As the US population ages, the number of older racial and ethnic minority individuals will increase. Including these individuals in research is an important step towards reducing health disparities.MethodsWe used data from HealthStreet, a University of Florida community engagement program which uses community health workers to assess the health of the community, to assess willingness to participate in different types of health research by race/ethnicity. Descriptive statistics and logistic regression models were used to assess willingness to participate among adults aged 50 and older, by race/ethnicity (n = 4694).ResultsOur sample was 42.0% non-Hispanic White, 52.8% non-Hispanic Black, and 5.2% Hispanic. Non-Hispanic White participants reported more past research participation than non-Hispanic Black and Hispanic participants (28.7% vs. 19.0% and 19.2%, respectively). Compared with non-Hispanic White participants, non-Hispanic Black participants were less willing to participate in most types of studies, while Hispanic participants were less willing to participate in studies that might be seen as invasive (required blood sample, genetic sample, or participants to take medicine, or use of medical equipment).ConclusionsOur study provides investigators with a general profile of research preferences by race/ethnicity; compared with non-Hispanic White individuals, non-Hispanic Black individuals are less willing to participate in most studies, while Hispanic individuals are less willing to participate in studies that may be seen as invasive or demanding. It is imperative to include diverse older adults in health research. By tailoring research based on preferences we can improve recruitment in underrepresented populations.

Community reentry: Racial/ethnic differences in unmet needs among adults with co-occurring opioid use and mental health disorder

Primary prevention of atherosclerotic cardiovascular disease (ASCVD) relies on risk stratification. Genome-wide polygenic risk scores (PRSs) are proposed to improve ASCVD risk estimation. To determine whether genome-wide PRSs for coronary artery disease (CAD) and acute ischemic stroke improve ASCVD risk estimation with traditional clinical risk factors in an ancestrally diverse midlife population. This was a prognostic analysis of incident events in a retrospectively defined longitudinal cohort conducted from January 1, 2011, to December 31, 2018. Included in the study were adults free of ASCVD and statin naive at baseline from the Million Veteran Program (MVP), a mega biobank with genetic, survey, and electronic health record data from a large US health care system. Data were analyzed from March 15, 2021, to January 5, 2023. PRSs for CAD and ischemic stroke derived from cohorts of largely European descent and risk factors, including age, sex, systolic blood pressure, total cholesterol, high-density lipoprotein (HDL) cholesterol, smoking, and diabetes status. Incident nonfatal myocardial infarction (MI), ischemic stroke, ASCVD death, and composite ASCVD events. A total of 79 151 participants (mean [SD] age, 57.8 [13.7] years; 68 503 male [86.5%]) were included in the study. The cohort included participants from the following harmonized genetic ancestry and race and ethnicity categories: 18 505 non-Hispanic Black (23.4%), 6785 Hispanic (8.6%), and 53 861 non-Hispanic White (68.0%) with a median (5th-95th percentile) follow-up of 4.3 (0.7-6.9) years. From 2011 to 2018, 3186 MIs (4.0%), 1933 ischemic strokes (2.4%), 867 ASCVD deaths (1.1%), and 5485 composite ASCVD events (6.9%) were observed. CAD PRS was associated with incident MI in non-Hispanic Black (hazard ratio [HR], 1.10; 95% CI, 1.02-1.19), Hispanic (HR, 1.26; 95% CI, 1.09-1.46), and non-Hispanic White (HR, 1.23; 95% CI, 1.18-1.29) participants. Stroke PRS was associated with incident stroke in non-Hispanic White participants (HR, 1.15; 95% CI, 1.08-1.21). A combined CAD plus stroke PRS was associated with ASCVD deaths among non-Hispanic Black (HR, 1.19; 95% CI, 1.03-1.17) and non-Hispanic (HR, 1.11; 95% CI, 1.03-1.21) participants. The combined PRS was also associated with composite ASCVD across all ancestry groups but greater among non-Hispanic White (HR, 1.20; 95% CI, 1.16-1.24) than non-Hispanic Black (HR, 1.11; 95% CI, 1.05-1.17) and Hispanic (HR, 1.12; 95% CI, 1.00-1.25) participants. Net reclassification improvement from adding PRS to a traditional risk model was modest for the intermediate risk group for composite CVD among men (5-year risk >3.75%, 0.38%; 95% CI, 0.07%-0.68%), among women, (6.79%; 95% CI, 3.01%-10.58%), for age older than 55 years (0.25%; 95% CI, 0.03%-0.47%), and for ages 40 to 55 years (1.61%; 95% CI, -0.07% to 3.30%). Study results suggest that PRSs derived predominantly in European samples were statistically significantly associated with ASCVD in the multiancestry midlife and older-age MVP cohort. Overall, modest improvement in discrimination metrics were observed with addition of PRSs to traditional risk factors with greater magnitude in women and younger age groups.

Objective: Previous research suggests that chronic stress is associated with worse cognitive aging, but minimal research has examined potential mechanisms and moderators of these associations. Chronic stress is known to increase inflammation (e.g., C-reactive protein [CRP]), which has in turn been associated with worse cognition among older adults. The present study examined whether (1) CRP mediates associations between chronic stress and episodic memory and verbal fluency; and (2) these relationships differ by race/ethnicity. Methods: Participants included 18,968 adults (64% non-Hispanic White; 19% non-Hispanic Black; 14% Hispanic; 3% non-Hispanic other race/ethnicity; Mage=71.8; SDage=6.0) from the Health and Retirement Study. Chronic stress was operationalized as the occurrence and impact of eight ongoing stressors. Cross-sectional, stratified mediation models were conducted for three cognitive outcomes: immediate recall, delayed recall, and verbal fluency. Covariates included sociodemographics and vascular disease burden. Results: Chronic stress was associated worse immediate recall (beta=-.028). Higher CRP was not associated with any cognitive domains. Non-Hispanic Black participants reported more chronic stress than non-Hispanic White and Hispanic participants. Chronic stress was less strongly associated with higher CRP in non-Hispanic Black (beta=-.035) participants than non-Hispanic White (beta=.046) or Hispanic (beta=.059) participants. Discussion: Chronic stress may negatively influence episodic memory, but findings do not suggest that CRP mediates links between chronic stress and cognition. CRP may not track as closely with chronic stress among non-Hispanic Black older adults who may experience additional risk factors for inflammation and/or adapt to increased chronic stress.

Black women in the United States have higher breast cancer (BC) mortality rates than White women. The combined role of multiple factors, including body mass index (BMI), age, and tumor subtype, remains unclear. To assess the association of race and ethnicity with survival among clinical trial participants with early-stage BC (eBC) according to tumor subtype, age, and BMI. This cohort study analyzed survival data, as of November 12, 2021, from participants enrolled between 1997 and 2010 in 4 randomized adjuvant chemotherapy trials: Cancer and Leukemia Group B (CALGB) 9741, 49907, and 40101 as well as North Central Cancer Treatment Group (NCCTG) N9831, legacy groups of the Alliance of Clinical Trials in Oncology. Median follow-up was 9.8 years. Non-Hispanic Black and Hispanic participants were compared with non-Hispanic White participants within subgroups of subtype (hormone receptor positive [HR+]/ERBB2 [formerly HER2] negative [ERBB2-], ERBB2+, and HR-/ERBB2-), age (<50, 50 to <65, and ≥65 years), and BMI (<18.5, 18.5 to <25.0, 25.0 to <30.0, and ≥30.0). Recurrence-free survival (RFS) and overall survival (OS). Of 9479 participants, 436 (4.4%) were Hispanic, 871 (8.8%) non-Hispanic Black, and 7889 (79.5%) non-Hispanic White. The median (range) age was 52 (19.0-89.7) years. Among participants with HR+/ERBB2- tumors, non-Hispanic Black individuals had worse RFS (hazard ratio [HR], 1.49; 95% CI, 1.04-2.12; 5-year RFS, 88.5% vs 93.2%) than non-Hispanic White individuals, although the global test for association of race and ethnicity with RFS was not significant within any tumor subtype. There were no OS differences by race and ethnicity in any subtype. Race and ethnicity were associated with OS in young participants (age <50 years; global P = .008); young non-Hispanic Black participants (HR, 1.34; 95% CI, 1.04-1.71; 5-year OS, 86.6% vs 92.0%) and Hispanic participants (HR, 1.62; 95% CI, 1.16-2.29; 5-year OS, 86.2% vs 92.0%) had worse OS than young non-Hispanic White participants. Race and ethnicity were associated with RFS in participants with BMIs of 25 to less than 30, with non-Hispanic Black participants having worse RFS (HR, 1.81; 95% CI, 1.23-2.68; 5-year RFS, 83.2% vs 87.3%) than non-Hispanic White participants. In this cohort study, racial and ethnic survival disparities were identified in patients with eBC receiving standardized initial care, and potentially at-risk subgroups, for whom focused interventions may improve outcomes, were found.

INTRODUCTIONAlzheimer's disease (AD) biomarkers of Amyloid(A), Tau(T), and Neurodegeneration(N) have been increasingly studied to fill the gap in our understanding of racial and ethnic differences. This study aimed to examine the relationship between plasma AT(N) biomarkers and (1) AT(N) neuroimaging biomarkers, (2) demographics, (3) medical comorbidities, and (4) cognitive diagnosis.METHODSData were analyzed from n = 764 non‐Hispanic Black (NHB), n = 1230 Hispanic, and n = 1232 non‐Hispanic White (NHW) participants. Plasma AT(N) biomarkers were derived using single molecule array (SIMOA) technology on an HD‐X imager and included amyloid beta (Aβ)42/40, total tau, ptau181, and neurofilament light chain (NfL). Clinical reads of positron emission tomography (PET) amyloid and tau positivity were used to examine the link between AT(N) plasma and neuroimaging biomarkers. Generalized linear models were conducted to examine the relationship between plasma AT(N) biomarkers and select demographic, diagnostic, and medical comorbidities (hypertension, diabetes, dyslipidemia, chronic kidney disease).RESULTSDifferences in the AT(N) biomarkers were found across racial/ethnic groups. Plasma Aβ42/40 was found to be associated with PET amyloid positivity only among NHW participants, while plasma NfL was found to correlate with Meta‐ROI among NHB and Hispanic participants. Ptau181 was associated with PET amyloid positivity among NHB and NHW participants and well as PET tau positivity among the latter group and Hispanic participants. Diabetes was related to increased plasma AT(N) biomarkers among NHB and Hispanic participants. CKD was associated with increased AT(N) biomarkers for all race/ethnic groups with the exception of Aβ42/40. While Aβ42/40, total tau, ptau181, and NfL were found to be related to a dementia diagnosis among NHW participants, only ptau181 and NfL were found to be related to this same diagnostic category among NHB and Hispanic participants.DISCUSSIONOur findings indicate differential relationships between comorbidities (demographic, medical, diagnostic) across NHB, Hispanic, and NHW participants. This work expands our knowledge regarding the associations of plasma biomarkers to AD pathology in diverse populations.HighlightsDifferences in AT(N) plasma biomarkers were found in a diverse community cohort.While plasma Aβ42/40 was associated with PET amyloid positivity among non‐Hispanic white participants, this did not apply to non‐Hispanic Black or Hispanic participants.Medical comorbidity of diabetes and chronic kidney disease was related to increased plasma AT(N) biomarkers among the ethnically diverse segment of the cohort.Plasma AT(N) biomarkers were more so related to a diagnosis of dementia for non‐Hispanic white as compared to Hispanic or non‐Hispanic Black participants.Across racial/ethnic groups, the plasma biomarkers of neurodegeneration (NfL) and ptau181 were related to a diagnosis of dementia.

Ethnic differences in pain response have been well documented, with non-Hispanic Black (NHB) participants reporting enhanced clinical pain and greater laboratory-evoked pain sensitivity to a variety of quantitative sensory testing (QST) methods compared to non-Hispanic Whites (NHW). One potential mechanism that may contribute to these disparities is differential functioning of endogenous pain-regulatory systems. To evaluate endogenous opioid (EO) mechanisms in pain responses, we examined group differences in response to tonic capsaicin pain following double-blinded crossover administration of saline and the opioid antagonist, naloxone. Ten percent topical capsaicin cream and a thermode were applied to the dorsum of the non-dominant hand, maintaining a constant temperature of 40°C for 90 min. Naloxone (0.1 mg/kg) or saline placebo was administered at the 25 min mark and post-drug pain intensity ratings were obtained every 5 min thereafter. As an index of EO function, blockade effects were derived for each participant, reflecting the difference between mean post-drug pain intensity ratings under the saline versus naloxone conditions, with higher positive scores reflecting greater EO inhibition of pain. Thirty-nine healthy, young individuals (19 non-Hispanic Black [NHB], 20 non-Hispanic White [NHW]) participated. Group difference in EO function were identified, with NHB participants displaying lower EO function scores (mean=-10.8, SD=10.1) as compared to NHW participants (mean=-0.89, SD=11.5; p=0.038). NHB participants experienced significant paradoxical analgesia with naloxone. Thirty five percent of the NHW participants showed a positive blockade effect indicating EO analgesia (i.e., an increase in pain with naloxone), while only 10% of the NHB participants exhibited evidence of EO analgesia. These findings suggest differential functioning of the endogenous opioid pain regulatory system between NHB and NHW participants. Future research is warranted to examine whether these differences contribute to the disparities observed in clinical pain between groups.

Differences in Infant Diet Quality Index by Race and Ethnicity Predict Differences in Later Diet Quality