Elderly African Americans Research Articles

Intervening to reduce sedentary behavior among African American elders: the "Stand Up and Move More" intervention.

Reducing sedentary behavior is a promising intervention target for improving health for older adults; however, few interventions include African American communities. The purpose of this research was to extend the reach of an effective sedentary behavior intervention to African American elders. Two pilot studies assessed the feasibility (retention, adherence, and safety) and acceptability (participant and leader perspectives) of a 4-wk "Stand Up and Move More" (SUMM) intervention. Sedentary behavior (self-reported and monitor-derived), function (short physical performance battery), and quality of life (SF-36) were measured at baseline (wk0), postintervention (wk4), and follow up (wk12; study 1) to examine preliminary effectiveness of the intervention. Participants (N=26) attended SUMM or an attention-matched stress management intervention (study 2). The magnitude of treatment effects were determined using Hedge's g effect size calculations [small (g=0.20 to 0.49), moderate (g=0.50 to 0.79), large (g>0.80)]. Retention and adherence rates ranged from 50%-100% and 80%-100%, respectively. There were no adverse events. Participants expressed high satisfaction, and the leader of the SUMM intervention indicated that the intervention content was beneficial. Hedges' g revealed negligible to small changes in sedentary behavior (g<0.50) following SUMM. There were moderate to large improvements in function (g=0.51-0.82) and quality of life (g=0.54-1.07) from wk0 to wk4 in study 1; and moderate to large improvements in function (g=0.51-0.88) from wk0 to wk4 in study 2. There was a moderate improvement in quality of life (SF-36 emotional role limitations g=0.54) in the SUMM group only. Given its feasibility, safety, and acceptability, SUMM may be a promising intervention to improve functioning and well-being among African American elders.

Alzheimer’s disease susceptibility in African American elders: a classification and regression tree (CART) analysis approach

Alzheimer's disease (AD) is increasingly prevalent, especially among African American older adults. Despite its widespread nature, accurate and timely diagnosis of AD remains challenging. Addressing the research gap in sociodemographic and cardiovascular risk factor research associated with AD in African American older adults, this study aimed to identify and analyze distinct subgroups within this population that are particularly vulnerable to AD, thereby contributing to the development of targeted interventions and healthcare strategies. This study employs a rigorous methodology utilizing classification and regression tree (CART) analysis to examine data from the 2017 Uniform Data Set (UDS). This approach enables a nuanced analysis of AD susceptibility among African American older adults. The CART analysis revealed significant associations between the studied sociodemographic and cardiovascular risk factors and AD susceptibility among African American older adults. The results indicate the presence of specific subgroups with increased vulnerability to AD, shaped by varying levels of education [relative importance (RI): 100%], antidepressant usage (RI: 83.1%), BMI (RI: 71.2%), use of antipsychotic agents (RI: 35.5%), and age of smoking cessation (RI: 21.5%). These findings underscore the importance of culturally specific research and interventions for addressing AD among African Americans. This study's findings, revealing significant associations between sociodemographic and cardiovascular risk factors and AD susceptibility among African American older adults, underscore the necessity of developing healthcare policies and interventions specifically tailored to address these risks.

A - 41 The Association between Education, Literacy, and Performance on the Loewenstein-Acevedo Scale for Semantic Interference and Learning (LASSI-L) in African American (AA) Older Adults.

The LASSI-L, a cognitive challenge test, has been found to be highly discriminative between AA elders with amnestic mild cognitive impairment (aMCI) versus cognitively unimpaired (CU) counterparts. Given potentially lower levels of formal education and literacy in some AA groups, it is important to determine whether such factors might adversely influence performance. 41 AA adults (53.7% males), with a mean age of 63.9 (SD = 5.1years, range = 54-83) were deemed to be CU after a clinical interview resulted in a CDR = 0, and scores from a neuropsychological battery were deemed normal by experienced neuropsychologists. The LASSI-L was not used in diagnosis. Level of educational attainment was 13.3 (SD = 2.3years: range = 9-20). Level of reading literacy, as assessed by the WRAT-4, yielded an average grade equivalent (GE) of 9.6 (SD = 3.5 range = 2.0-12.9); substantially lower than reported educational attainment. Association between formal education and literacy was 0.52 which accounted for 27% of the shared variance. There were no statistically significant correlations between formal education or WRAT-4 scores in any LASSI-L variables, including initial learning (Cued Recall 2 List A), proactive semantic interference (PSI) (Cued List B1-List B2), failure to recover from PSI, or semantic intrusion errors. Performance on the LASSI-L among AA-CU did not suggest biases associated with formal education or word literacy, making it a promising tool for research. Many neuropsychological measures do not have acceptable diagnostic accuracy when used among individuals that are racially diverse, have lower-education levels, and lower socioeconomic status. This is important in consideration for potential use of LASSI-L in clinical settings.

A - 32 Impact of Demographic Factors in African American (AA) Older Adults in Relation to Confrontational Naming Deficits on an Object Naming Task.

Dysnomia, or complaints of word-finding difficulties for names, places, and objects is common in patients with Alzheimer's Disease (ad). This common characteristic makes confrontational naming a fundamental component of neuropsychological assessment in aging populations. The Multilingual Naming Test (MINT) detects naming impairments at various stages of cognitive decline. However, our understanding of how performance varies based on education, is sparse. Authors evaluated the sensitivity of the MINT in predicting naming impairments in AA in relation to education levels. 842 cognitively unimpaired (CU) and 413 mild cognitive impairment (MCI) AA elders were administered the MINT as part of the National Alzheimer's Coordinating Center neuropsychological battery. The MINT consists of 32 items of ascending difficulty that participants must name spontaneously. Semantic and phonemic cues are given in the absence of immediate responses. A 5-number MEANS analysis was used to measure differences among CU and MCI stratifying by education level. Overall naming scores were consistently lower in cohorts with lower education across diagnosis. Unsurprisingly CU participants outperformed MCI counterparts. More sensitive tools are needed to detect cognitive functioning changes in individuals with lower education levels. The MINT offers a novel approach in detecting confrontational naming deficits in those at risk of developing ad, but norms accounting for scholastic attainment are necessary to accurately diagnose minority populations with varying education levels. Further research is required to validate the MINT in participants with diverse backgrounds, low literacy levels and other factors that could affect quality of formative education.

Interface of resilience with other related concepts in physiological and psychosocial/spiritual domains.

Interface of resilience with other related concepts in physiological and psychosocial/spiritual domains.

African American Males Have More Distress During Cancer Treatment Than White Males.

African American (AA) males have a higher incidence and mortality rate for some cancers than other races and sexes, which could be associated with distress during treatment, medical mistrust, and health disparities. We hypothesize distress in AA males during treatment is higher than in other races and sexes. We assessed effect modification of moderate to severe (≥ 4) distress scores during cancer treatment by race and sex, age, and socioeconomic status (SES). National Comprehensive Cancer Network's distress thermometer (scale 0-10) and characteristics for 770 cancer patients were collected from a Philadelphia hospital. Variables included age, sex, race, smoking status, marital status, SES, comorbidities, mental health, period before and during COVID-19, cancer diagnosis, and stage. Descriptive statistics, chi-square tests, and t-tests were used to compare AA and White patients. Effect modification of ≥ 4 distress by race and sex, age, and SES were analyzed by logistic regression. A p value of ≤ .05 was significant, and 95% confidence intervals (CIs) were reported. On average, AA patients had a non-significant, higher distress score (4.53, SD = 3.0) than White patients (4.22, SD = 2.9) (p = .196). The adjusted odds ratio of ≥4 distress was 2.8 (95% CI [1.4, 5.7]) for AA males compared with White males. There was no significant difference between White and AA females, race and age, or race and SES. There was an effect modification of ≥4 distress by race and sex. AA males in cancer treatment had higher odds of ≥4 distress compared with White males.

Prenatal exposure to persistent and non-persistent chemical mixtures and associations with adverse birth outcomes in the Atlanta African American Maternal-Child Cohort.

African Americans (AAs) experience higher rates of preterm birth and fetal growth restriction relative to other pregnant populations. Differential in utero exposure to environmental chemicals may partially explain these health disparities, as AAs are disproportionately exposed to environmental hazards. We examined the individual and mixture effects of non-persistent chemicals and persistent organic pollutants (POPs) on gestational age at birth and birthweight for gestational age z-scores within a prospective cohort of pregnant AAs. First-trimester serum and urine samples obtained from participants within the Atlanta African American Maternal-Child cohort were analyzed for 43 environmental chemicals, including per-and polyfluoroalkyl substances (PFAS), polybrominated diphenyl ethers (PBDEs), organochlorine pesticides, pyrethroid insecticides, phthalates, bisphenol A, nicotine, and the primary metabolite of delta-9-tetrahydrocannabinol. Linear regression was used to estimate individual associations between chemicals and gestational age and birthweight z-scores (N ranging from 107 to 523). Mixture associations were estimated using quantile g-computation, principal component (PC) analyses, and hierarchical Bayesian kernel machine regression among complete cases (N = 86). Using quantile g-computation, increasing all chemical exposures by one quantile was modestly associated with a reduction in gestational age (mean change per quartile increase = -0.47, 95% CI = -1.56, 0.61) and birthweight z-scores (mean change per quartile increase = -0.49, 95% CI = -1.14, 0.15). All PCs were associated with a reduction in birthweight z-scores; associations were greatest in magnitude for the two PCs reflecting exposure to combined tobacco, insecticides, PBDEs, and phthalates. In single pollutant models, we observed inconsistent and largely non-significant associations. We conducted multiple targeted exposure assessment methods to quantify levels of environmental chemicals and leveraged mixture methods to quantify their joint effects on gestational age and birthweight z-scores. Our findings suggest that prenatal exposure to multiple classes of persistent and non-persistent chemicals is associated with reduced gestational age and birthweight z-scores in AAs. African Americans (AAs) experience higher rates of preterm birth and fetal growth restriction relative to other pregnant populations. Differential in utero exposure to environmental chemicals may partially explain these health disparities, as AAs are disproportionately exposed to environmental hazards. In the present study, we analyzed serum and urine samples for levels of 43 environmental chemicals. We used quantile g-computation, principal component analysis, and BKMR to assess associations between chemical exposure mixtures and adverse birth outcomes. Our findings suggest that prenatal exposure to multiple classes of chemicals is associated with reduced birthweight z-scores, a proxy for fetal growth, in AAs.

A Race-Specific, DNA Methylation Analysis of Aging in Normal Rectum: Implications for the Biology of Aging and Its Relationship to Rectal Cancer.

Approximately 90% of colorectal cancer (CRC) develop over the age of 50, highlighting the important role of aging in CRC risk. African Americans (AAs) shoulder a greater CRC burden than European Americans (EA) and are more likely to develop CRC at a younger age. The effects of aging in AA and EA normal rectal tissue have yet to be defined. Here, we performed epigenome-wide DNA methylation analysis in the first, large-scale biracial cohort of normal rectum (n = 140 samples). We identified increased epigenetic age acceleration in EA than AA rectum (p = 3.91 × 10-4) using linear regression. We also identified differentially methylated regions (DMRs) associated with chronological aging in AA and EA, separately using DMRcate. Next, a consensus set of regions associated with cancer was identified through DMR analysis of two rectal cancer cohorts. The vast majority of AA DMRs were present in our analysis of aging in rectum of EA subjects, though rates of epigenetic drift were significantly greater in AA (p = 1.94 × 10-45). However, 3.66-fold more DMRs were associated with aging in rectum of EA subjects, many of which were also associated with rectal cancer. Our findings reveal a novel relationship between race, age, DNA methylation and rectal cancer risk that warrants further investigation.

Uncovering Ethnic Genomic Disparities Associated with Inferior Outcome in African Americans Diagnosed with Acute Myelogenous Leukemia

Background: African Americans (AA) have higher cancer-associated mortality than other ethnicities. AA with AML exhibit inferior overall survival (OS) to non-AA subgroups (OS=162 d vs 709 d, respectively, p=0.0001, HR=7.8) Fig 1A. In other cancers, higher genomic instability (GI) and differential oncogenic addiction contribute to AA worse outcomes; however, in AML, genetic causes of inferior outcomes are uncharacterized. In this study, we seek to investigate differential AML mut and other factors that contribute to inferior AA OS. Methods: After IRB approval, 92/250 (36.8%) available AML patients (pt) had next generation sequencing (NGS) data and were included. Mut frequencies were annotated by ethnicity [White (W) vs AA vs Hispanic (H) vs Asians (A)] and prioritized by European Leukemia Network (ELN) 2017 classification. Numeric chromosomic alterations (NCA) were extracted from metaphase karyotyping at diagnosis. Deleteriousness of mutations to protein function was calculated with sorting intolerant from tolerant (SIFT) prediction method. Chi-square and t-test evaluated differences in categorical and continuous variables respectively. Logistic binary regression was used to detect predictors for racial induced survival. SAS software was used. Results: Whites (W), AA, Hispanics (H) and Asians (A) represented 57/91 (62%), 14/91 (15%), 20/91 and (22%), 5/91 (5.4%) of the cohort, respectively. Median age was 63 (W) , 57.5 (AA) , 53 (H), 62 (A), p=NS. 60/92 (65%) were male. Median number of mut were 2.04 (W), 1.8 (AA), 2.2 (H) and 1.8 (A), p=NS. Distribution for adverse ELN-2017 defects were equivalent among AA vs non-AA except RUNX1, p=0.05. Lack of favorable mut was observed among AA. Only AA demonstrated CUX1, previously associated with DNA repair defects, and FBXW7 mut. A non-significant trend for higher NCA in AA (2.7 [W], 6.4 [AA], 3 [H] and 0.8 [A], p=0.09) was observed. Age correlated with NCA and number of mut in AML genome, p=0.02 and p=0.004. Interestingly, correlation effect was mostly driven only by AA, p=0.02 and p=0.003, respectively. SIFT score was 0.01 (W), 0.09 (AA), 0.02 (H), and 0.01 (A). These SIFT results suggest that AA mut are functionally tolerated. After adjusting for multiple factors, only canonical ELN-2017 mut, p=0.02 (OR 0.37, CI 0.16-0.8), and AA race, p=0.005 (OR 0.25, CI 0.1-0.67) increased risk of death (c-statistics=0.66) Fig.1B. Conclusions: In AA, frequency of Adverse ELN-2017 mut is similar to other races, but favorable mutations were lacking. NCA and number of AML genome mut strongly correlate with aging in AA, but not other ethnic groups. Surprisingly, SIFT score failed to demonstrate functional deleteriousness for AA mut, which suggests alternative genomic defects as a culprit for poor outcome. Acknowledging the small number of mut in our cohort, our study advances our understanding of racial disparity in AML survival. Figure 1View largeDownload PPTFigure 1View largeDownload PPT Close modal

The Role of Transportation in the Enrollment of Elderly African Americans into Exercise and Memory Study: GEMS Study

BackgroundUnderstanding the factors driving recruitment and enrollment of African Americans (AA)s in clinical translational research will assure that underrepresented populations benefit from scientific progress and new developments in the diagnosis and treatment of Alzheimer’s disease and related disorders. While transportation is pivotal to volunteers’ ability to participate in research, its contribution to enrollment in exercise studies on AD is yet to be elucidated. Thus, this research focuses on identifying factors that influence the recruitment and enrollment of African Americans in biomedical studies and determining whether the availability of transportation motivates participation in time-demanding exercise studies on AD.MethodsWe analyzed recruitment data collected from 567 volunteers ages 55 and older screened through various recruitment sources and considered for enrollment in our exercise and memory study. To determine whether transportation influenced the enrollment of African Americans (AA)s in biomedical studies, multiple logistic regression analysis was performed to identify significant factors that drive enrollment. Furthermore, the association of race and demographic factors on the availability of transportation was assessed.ResultsDemographic factors, age at screening, education, gender, and cognitive scores were not significantly different among those enrolled compared to control (not-enrolled). In the relationship of enrollment to transportation, enrolled participants were more likely to have access to transportation (79.12%) than not-enrolled participants who had less access to transportation (71.6%); however, the association was not statistically significant. However, race differentially influenced the likelihood of enrollment, with elderly AAs being significantly less likely to have transportation (p = 0.020) than the Whites but more likely than “others” to have transportation.ConclusionOur findings suggest that access to transportation may be a key factor motivating enrollment in an exercise and memory study in a predominantly AA sample. Notably, AAs in our sample were less likely to have transportation than Whites. Other demographic factors and cognitive scores did not significantly influence enrollment in our sample. A larger sample and more detailed assessment of transportation are needed to further discern the role of transportation in clinical trials.

Coupling Hearing Health With Community-Based Group Therapy for Cognitive Health in Low-Income African American Elders

Purpose: To address disparities in the domains of hearing health and cognitive health experienced by African American elders in early stages of cognitive-communicative decline, a cognitive stimulation therapy (CST) group was established. The group intervention was coupled with comprehensive audiology services. This clinical focus article describes the features of the program, its implementation, and outcomes from its first cohort of participants. Method: CST is an evidence-based group intervention for elderly individuals living with mild-to-moderate dementia. The program was designed to (a) adapt and then apply CST to a target group of low-income African American elders and (b) integrate audiology services and education about hearing health and hearing loss in the context of CST therapy. In partnership with two community health centers in North St. Louis, a CST group was established for 12 elderly African American clients with cognitive-communicative impairments as measured by standardized assessments. During weekly group sessions, culturally informed activities and discussions were conducted with input from staff and participants to stimulate social interaction and cognition. Health topics relevant to age-related sensory and cognitive decline were introduced, with emphasis on management of common chronic diseases such as diabetes that are known to be associated with increased risk of hearing loss. Free hearing health services were provided, including screenings and, as needed, full audiological evaluations, cerumen management, otolaryngology referrals, hearing aids, and aural rehabilitation. Results: Participants' self-administered ratings and self-generated comments indicated meaningful increases in actionable knowledge about both hearing and cognitive health that led to enhanced utilization of available health services. They also suggested that audiology services were paramount to their enthusiastic adherence to the combined CST–audiology program. Conclusion: Interlinking of interventions for hearing and cognition reduced common barriers to care for this target group of low-income African American elders with cognitive-communicative impairments.

Aerobic Exercise Training-Induced Changes on DNA Methylation in Mild Cognitively Impaired Elderly African Americans: Gene, Exercise, and Memory Study - GEMS-I.

BackgroundDNA methylation at CpG sites is a vital epigenetic modification of the human genome affecting gene expression, and potentially, health outcomes. However, evidence is just budding on the effects of aerobic exercise-induced adaptation on DNA methylation in older mild cognitively impaired (MCI) elderly African American (AAs). Therefore, we examined the effects of a 6-month aerobic exercise-intervention on genome-wide DNA methylation in elderly AA MCI volunteers.DesignElderly AA volunteers confirmed MCI assigned into a 6-month program of aerobic exercise (eleven participants) underwent a 40-min supervised-training 3-times/week and controls (eight participants) performed stretch training. Participants had maximal oxygen consumption (VO2max) test and Genome-wide methylation levels at CpG sites using the Infinium HumanMethylation450 BeadChip assay at baseline and after a 6-month exercise program. We computed false discovery rates (FDR) using Sidak to account for multiplicity of tests and performed quantitative real-time polymerase chain-reaction (qRT-PCR) to confirm the effects of DNA methylations on expression levels of the top 5 genes among the aerobic participants. CpG sites identified from aerobic-exercise participants were similarly analyzed by the stretch group to quantify the effects of exercise-induced methylation changes among the group of stretch participants.ResultsEleven MCI participants (aerobic: 73% females; mean age 72.3 ± 6.6 years) and eight MCI participants (stretch: 75% female; mean age 70.6 ± 6.7 years) completed the training. Aerobic exercise-training was associated with increases in VO2max and with global hypo- and hypermethylation changes. The most notable finding was CpG hypomethylation within the body of the VPS52 gene (P = 5.4 × 10–26), a Golgi-associated protein, involved in intracellular protein trafficking including amyloid precursor protein. qRT-PCR confirmed a nearly twofold increased expression of VPS52. Other top findings with FDR q-value < 10–5, include hypomethylations of SCARB1 (8.8 × 10–25), ARTN (6.1 × 10–25), NR1H2 (2.1 × 10–18) and PPP2R5D (9.8 × 10–18).ConclusionWe conclude that genome-wide DNA methylation patterns is associated with exercise training-induced methylation changes. Identification of methylation changes around genes previously shown to interact with amyloid biology, intracellular protein trafficking, and lipoprotein regulations provide further support to the likely protective effect of exercise in MCI. Future studies in larger samples are needed to confirm our findings.

Lessons Learned From Focus Groups and Community Education Provision in the African American Community

The present symposium will synthesize themes derived from eight different projects designed to better understand dementia in Minnesota (MN) within the African American community (where individuals are disproportionately susceptible to dementia and the tolls of dementia care). These projects included focus groups, community outreach, community education, networking with aging service providers, and community forums. Projects were funded by and conducted in partnership with the MN Department of Human Services, the Alzheimer’s Association, the MN Board on Aging, and the MN Leadership Council on Aging’s Diverse Elders Coalition. Themes included the unique ways that African American elders share their viewpoints and the importance of faith-based outreach. Another major theme, which connects to the other symposium talks, was the importance of three S’s: Stigma, Shame, and Silence as cultural considerations in the African American, West African, and Latino/a/x/e communities as they apply to access to information and training to better understand AD/ADRD.

How SWEET It Is: Fellowship and Continuity in a Church-Based Fall Prevention Program with African American Elders in the Northeastern United States

Deaths from unintentional injuries are the seventh leading cause of death among older adults and falls account for the largest percentage of these deaths, with individuals aged ≥85 particularly vulnerable. Physical activity can reduce frailty and prevent falls; however, many elders are not physically active and women, ethnic minorities, and those with low education levels are the least active. Moreover, experiences of racial discrimination can lead to increased stress and unhealthy adaptive behaviors, and the cumulative effects of age and race related stressors have been shown to negatively impact the physical and mental health of elderly African Americans. Thus, participation in public health research has been deemed essential to identify effective interventions that will improve health outcomes and reduce health disparities among African American elders. We discuss a the creation and implementation of a fall-prevention exercise program created for older African Americans based in a Black Church in Philadelphia that has been a successful university/community partnership for the last 8 years. A qualitative evaluation of participant experience was carried out using focus groups to examine why there has been such a high degree of compliance. Key themes related to the program’s sustainability are physical and psychosocial benefits of attendance, fellowship among exercise participants and a therapeutic alliance with the instructor. It is our hope that this discussion and evaluation can inform other faith and community-based health promotion programs for minority elders, while also contributing to on-going efforts to reduce health disparities among at risk populations.

Abstract LB083: Characterizing colon and prostate cancers with comorbid chronic kidney disease in NHANES

Abstract In the US, the prevalence of chronic kidney disease (CKD) is estimated at 30 million, or approximately 15% of the population. Compared to Caucasians (CA), African Americans (AAs) have a higher prevalence of CKD, and faster decline in kidney function. Relationships between low socio-economic status (SES), area-level social disadvantages, and CKD are well documented. In cancer patients, CKD impedes overall survival, treatment, and surgical outcomes. Given the link between kidney disease preceding cancer, as well as the higher risk of mortality for cancer patients with CKD, the goals of this research were to identify the tumor types most associated with CKD prevalence and to elucidate the modifying effects of age, race, gender, and lifestyle/environmental measures on these relationships. Using the National Health and Nutrition Examination Survey (NHANES), we generated cross-sectional associations between CKD and various cancer types for the years of 2007-2018. After exclusion for age under 18 years, non-AA or non-CA race, or incomplete information for exposure (CKD) or outcome (cancer), a nationally representative, weighted sample of ~25,000 subjects was included in the analysis. CKD was defined as estimated glomerular function (eGFR) &amp;lt;60 ml/min/1.73 m2. Self-reported measures of ever having any type of cancer and type of cancer were used for tumor variables. CKD was present in 15% of all NHANES subjects, and 21% of those with CKD reported having any cancer versus 12% of those without CKD. In a cancer-only analysis, overrepresented tumor types in CKD vs. non-CKD patients were prostate (23% vs. 6%) and colon (7% vs. 4%). Cases of colon cancer were significantly higher for CKD patients of all races, with the largest CKD-related difference for female AAs (28% in CKD vs. 7% in non-CKD). For both races, prostate cancer had higher CKD comorbidity, strongest for male AAs. While eGFR normally decreases with age, AAs had low eGFR in younger cases (50-60years), for both prostate and colon cancers, notably in female AAs with colon cancer. Body mass index (BMI) was higher for those with CKD (29.4) versus non-CKD (28.9). In a gender/race stratified analysis, AA women with colon cancer who were obese (BMI 30+) had 1.66 times the odds of also having CKD relative to all other BMI categories. Men with colon cancer also showed increased odds of CKD in obese versus all other BMI categories (AA 1.98, CA 1.21). There was no effect of BMI on prostate cancer. Overall, CKD is a more frequent in cancer patients than for cancer-free patients even when accounting for age. This relationship is modified by tumor type, race, and gender. Prostate and colon cancers have strong associations with CKD which are independent of age in AAs. Obesity is linked to CKD-comorbid colon cancers for AAs and males. These findings identify high-risk subgroups for colon cancer and suggest dietary/metabolic/environmental etiology and intervention strategies. Citation Format: Michael Behring, Dawna Nelson, Tina Vazin, Ram Alagan, Seela Aladuwaka, Manoj Mishra, Tariq Shafi, Orlando Gutierrez, Upender Manne. Characterizing colon and prostate cancers with comorbid chronic kidney disease in NHANES [abstract]. In: Proceedings of the American Association for Cancer Research Annual Meeting 2021; 2021 Apr 10-15 and May 17-21. Philadelphia (PA): AACR; Cancer Res 2021;81(13_Suppl):Abstract nr LB083.

Left atrial structure and function of the amyloidogenic V122I transthyretin variant inelderly African Americans.

African-American carriers of the transthyretin (TTR) valine-to-isoleucine substitution (V122I) are at increased risk of heart failure, yet many have relatively subtle abnormalities of left ventricular (LV) function. We sought to explore the influence of this mutation on left atrial (LA) structure and function in this population. We assessed 1225 genotyped African-Americans (age range, 67-89 years) participating in the Atherosclerosis Risk in Communities study who underwent echocardiography and were in sinus rhythm at study Visit 5 (2011 to 2013). Six LA parameters [LA maximum/minimum volume index, ejection fraction, and LA reservoir, conduit, and contractile longitudinal strains (LS)] were compared between V122I TTR variant carriers (n=46) and non-carriers (n=1179). LA minimum volume index was significantly greater and LA contractile LS was worse in carriers than non-carriers (19.5 ± 10.6 mL/m2 vs. 16.3 ± 8.4 mL/m2 ; 15.0 ± 5.8% vs. 16.8 ± 5.7%, respectively, both P < 0.05). Carriers had a significantly higher number of LA abnormalities than non-carriers (1.8 ± 2.2 vs. 1.1 ± 1.6, P=0.009). The number of subjects with at least four LA abnormalities was significantly increased among carriers compared with non-carriers (27% vs. 12%; odds ratio 2.43; 95% confidence interval 1.06-5.58 after adjusting for age, sex, body mass index, and LV wall thickness and global LS). Left atrial enlargement and dysfunction were common in V122I TTR carriers with sinus rhythm than non-carriers, suggesting that abnormalities of LA function may represent early markers of subclinical disease in these individuals.

The Rising Tide of Elderly African-American Suicides: A Call for Action

Suicides are among the leading causes of death in elderly Americans. The problem is expected to grow with an aging population in the U.S. Suicides in African-American elderly are not well studied. This article enumerates the risk factors for suicidal behaviors in elderly African-Americans; presents an epidemiological assessment of suicides in elderly African-Americans from 2010 to 2018 with gender-specific differences, and explores public health considerations for helping to reduce the growing numbers of suicides in elderly African-Americans. Currently, there are very limited evidence-based interventions to reduce or prevent suicides in older African-Americans. This article also provides implications and recommendations for prevention practice and research that is needed to help alleviate suicides in older African-Americans.

Elderly African Americans Insights on the COVID-19 Pandemic: An Exploratory Study of Risk Perception and Personal, Social, and Cultural Factors

This exploratory study examined elderly African Americans attitudes on the COVID-19 pandemic by identifying their perceptions of risk based personal, social, and cultural factors. It seeks to understand their insights toward public health pandemic response initiatives and other efforts to mitigate COVID-19 outbreak response measures impacting elderly African Americans, including policies, interventions, and public information/communication. The effectiveness of pandemic response measures and community caregiving support for the elderly African Americans was examined as well. Respondents in this study were a convenient sample of 60 residents predominantly in a Midwestern metropolitan area. Respondents were eligible for study participation if 1) there were 60 years and over and, 2) African American or people of African descent. A mixed research method design comprising focus groups and online survey was used to collect the data for the study. The respondents characterized the impact of the coronavirus as a personal, family, and community loss (e.g., less socially engaged and burdensome). An overwhelming majority (98.3%) expressed no worries about getting health care if they or their family members needed it. A sizable number of respondents expressed the need for all to be tested to help prevent the spread of the virus.

Neighborhood Socioeconomic Disadvantage and Health Status Among African Americans Living in Low-Income Housing

Research has shown the importance of social determinants of health in explaining racial/ethnic disparities in many health outcomes; however, less attention has been given to within-group differences in social determinants of health among low-income African American older adults. The Physical and Cognitive Health Pilot Study (n=50) was utilized to examine associations between level of neighborhood socioeconomic disadvantage and self-reported health in African American older adults living in public housing in Durham, NC and Annapolis, MD. Results from ANOVA showed that Durham participants living in more disadvantaged neighborhoods had statistically significantly worse cardiovascular health, higher depression symptoms, worse sleep quality, and higher alcohol use (p=.05) than Annapolis participants living in a more resource-rich neighborhood. These findings suggest that among low-income African American elders, greater neighborhood/state socioeconomic disadvantage is associated with worse health status. Future research should consider neighborhood context as an essential variable when assessing health status among aging African Americans.

Attitudes towards memory research participation: Focus groups with elderly African Americans viewing a community‐created educational video

AbstractBackgroundAlzheimer’s Disease (AD) disproportionately impacts African Americans (AA) but they are underrepresented in clinical research. A previous study (Sewell et al., AAIC 2019), found that the use of an educational video (Memory Research: Is it right for me?) created by the ADRC in collaboration with our primarily Latino Community Advisory Board was, in conjunction with Q&amp;A sessions, effective at increasing interest in research among Latinos. The aim of the current pilot study was to engage community AA elders in focus groups to explore their feedback as regards clarity, relatability, and effectiveness of the video as a tool to engage them in conversations about research participation.MethodA Moderator’s Guide was created to ask the interviewees to evaluate the video re relatability, clarity and whether it impacted interest in participating in research. General questions were asked regarding knowledge of research and memory health. Two hour‐long focus groups were conducted with 14 participants who watched the video. An ADRC faculty member used the Moderator’s Guide to prompt responses while an observer took notes.ResultsMean age 72; 93% female; 93% AA; 7% Latino; 86% &gt; high school graduates, 14% &lt; 6th grade. Groups were transcribed, and data was coded to extrapolate themes using Grounded Theory techniques. One theme pertaining to attitudes toward research participation was fear (43% of participants) and included concerns that there would be side effects from medications or overly personal questions; the second theme was the video increased curiosity but a need for more information (e.g. requests for more details, and for specifics of how research is conducted) (62%). Participants also stated that the video clarified their understanding and decreased fear of research participation. As regards relatability, one member noted that the video should have included men and African Americans.ConclusionThe video was well‐received in primarily AA focus groups. Themes included both fear of research but also curiosity and a desire to know more. Given these encouraging results, a quantitative research study with a larger sample further exploring these themes and looking at the effectiveness of this recruitment strategy in increasing research participation is warranted.