Elderly Americans Research Articles

The Mediating Role of Pain Catastrophizing on the Association Between Depression and Pain Severity and Interference Among Elderly Asian Immigrants with Chronic Pain.

PurposeThe association between depression and chronic pain is well established. However, few studies have examined the pathways from depression to chronic pain. The present cross-cultural study aimed to test the mediating effects of pain catastrophizing on associations between depression and chronic pain (eg, pain severity, pain intensity) among Korean American elderly.Patients and MethodsA total of 132 elderly Korean Americans with chronic pain were recruited from elderly daycare centers and Korean ethnic churches in the community. For mediation analyses, structural equation modeling with full information maximum likelihood estimation method was used. The bias-corrected bootstrap confidence interval (CI) method for inferential tests of the indirect effects was also conducted in mediation analysis.ResultsThe results indicated that the proportion of comorbid depression and chronic pain was 45.7%. Elderly Korean Americans with depression scored higher in pain severity, pain interference, and pain catastrophizing than those without depression. Pain catastrophizing was found to have a significant mediating effect on the relationship between depression and pain severity (indirect effect = 0.147, Bootstrap 95% CI = [0.079, 0.226]), controlling for demographic covariates, comorbidities and pain area. Pain catastrophizing also mediated the relationship between depression and pain interference (indirect effect =0.164, Bootstrap 95% CI = [0.097, 0.244]), controlling for the covariates.ConclusionThese findings add to the literature by providing evidence that pain catastrophizing plays a role in high levels of pain severity and pain interference comorbid chronic pain and depression in Asian elderly immigrants. Appropriate culturally tailored programs to redirect pain catastrophizing cognitive process should be developed and provided for elderly Asian Americans to reduce chronic pain disparity.

Abstract PS13-37: Effectiveness of eribulin in poor prognosis subgroups of metastatic breast cancer (mBC) patients (elderly, African Americans, and patients with liver metastases) in the United States

Abstract Background: Eribulin mesylate was approved in the United States (US) in 2010 as third-line or later treatment (after an anthracycline and a taxane) of mBC. Multiple patient demographic and clinical characteristics have been reported to impact clinical outcomes in mBC patients. The objective of these analyses was to assess real-world clinical outcomes of eribulin therapy in three subgroups that generally have poorer prognoses: elderly (≥65 years), African American, and those with liver metastases in clinical practice in the US. Methods: A retrospective chart review study was conducted across community oncology practices in the US. Adult female patients with mBC who initiated treatment with eribulin as per US prescribing information between 2011 and 2017 were included. Data were extracted by prescribing physicians from individual patient’s electronic health records and captured via an electronic case report form. All patient data were de-identified prior to analyses. Clinical outcomes including objective response rate (ORR), progression-free survival (PFS), and overall survival (OS) were assessed in patients who were elderly, African American, or who had liver metastases. Results: Current analyses were based on data from 278 patients including 175 (63%) patients with liver metastases, 98 (35%) elderly patients, and 73 (26%) African American patients. Mean age at initiation of eribulin in each group was: liver metastases, 59; elderly, 71; and African American, 58. Proportion of patients with ECOG-PS ≥2 at initiation of eribulin was: liver metastases, 46%; elderly, 52%; and African American, 47%. The majority of patients received eribulin in 3rd line: liver metastases, 80%; elderly, 87%; and African American, 85%. ORR to eribulin was 34% in patients with liver metastases, 35% in elderly, and 48% in African Americans. Median PFS from initiation of eribulin was 5.2 months in patients with liver metastases, 5.8 months in elderly, and 7.6 months in African Americans. Landmark OS from initiation of eribulin at 6, 12 and 24 months were 71%, 36% and 18%, respectively, in patients with liver metastases, 72%, 35% and 23% in elderly, and 78%, 46%, and 28% in African Americans. Conclusion: Effectiveness of eribulin in clinical practice in patients with liver metastases, elderly, and African Americans was confirmed within this real-world study in the US. Citation Format: Sarah S. Mougalian, Jonathan K. Kish, Jingchuan Zhang, Djibril Liassou, Bruce A. Feinberg. Effectiveness of eribulin in poor prognosis subgroups of metastatic breast cancer (mBC) patients (elderly, African Americans, and patients with liver metastases) in the United States [abstract]. In: Proceedings of the 2020 San Antonio Breast Cancer Virtual Symposium; 2020 Dec 8-11; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2021;81(4 Suppl):Abstract nr PS13-37.

Using Native Woody Plants for Phytomanagement of Urban Technosols Contaminated by Wood Pole Preservatives

AbstractTechnosols are a major component of urban areas with little to no value, but many benefits can be gained by the use of native plants for their ecological reclamation. The aim of this study is to examine the capacity of North American native woody species to establish in and remediate a wood preservative‐contaminated technosol. Nine species are planted in mesocosms containing highly contaminated or non‐contaminated synthetic technosols. Remediation potential and plant physiology parameters (survival, photosynthesis and root growth) are monitored during one growing season. Results show an inverse relation between species performance ranking in the non‐contaminated technosol compared to ranking in contaminated soil. Overall, Salix bebbiana and Sambucus canadensis show good potential for phytomanagement of heterogenous contaminated technosols, offering the best compromise between performance in non‐contaminated and contaminated soils. Most species are able to phytoextract copper (Cu), with Rhus typhina, Alnus crispa, and S. bebbiana showing the highest Cu concentrations in stems. The use of multiple native species for technosol reclamation can be beneficial due to the heterogeneous nature of soil contaminants.

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.

Pilot testing of a dementia literacy intervention for Korean American elders with dementia and their caregivers

To test the feasibility and acceptability of a dementia literacy intervention for Korean American (KA) elders with dementia and their caregivers: K-PLAN (Preparing successful aging through dementia Literacy education And Navigation). Twenty cognitively impaired Korean elders (Clinical Dementia Rating 1+) and their caregivers participated in a pilot trial to receive the K-PLAN intervention, which consisted of 1-h dementia literacy education followed by monthly phone counseling sessions and navigation assistance for 3 months by a trained bilingual community health worker. Outcomes of interest were linkage to medical services for dementia evaluation (KA elders) and dementia literacy, social support, self-efficacy in dementia care, depression, and quality of life (caregivers). Using a one-group pre-and post-test design, all ten dyads were followed up at 12 weeks. The K-PLAN intervention was highly feasible and acceptable. We were able to retain all twenty participants over the study period (100% retention rate). In addition, 100% of the caregivers would recommend the program with an overall satisfaction rating of 9.7 on a 1-10-point scale. Three of the elders (30%) were linked to medical services for dementia by medical record review. The effect sizes for caregiver outcomes ranged from 0.4 to 0.7 in absolute value. Dementia literacy intervention has the potential to promote linkage to medical services for dementia evaluation and early diagnosis among linguistically isolated KA elders while improving caregiver psychological outcomes. Studies with larger sample sizes, comparison groups, and cost-effective analyses are needed to inform the application of K-PLAN in diverse community settings. Early diagnosis of dementia can help preserve functional status. Promoting dementia literacy and linkage to health services through community-based programs such as K-PLAN may enable underserved racial/ethnic minority communities to make timely follow-up for dementia evaluation and care planning.

Social Connectivity During the COVID-19 Pandemic: Disparities among Medicare Beneficiaries.

PurposeSocial connections are essential for health and well-being at all ages and may be especially important for promoting health in later life. Maintaining social connections, however, became increasingly difficult during the COVID-19 pandemic when stay-at-home orders were enacted, and social distancing became necessary. This study examines the social connectivity among Medicare beneficiaries during the COVID-19 pandemic highlighting the importance technological availability, income, and race.MethodsData from the 2020 Medicare Beneficiaries Survey COVID supplement was used to evaluate social connectedness during the spring and fall of 2020. Binomial logistic regression evaluated the relationship between feelings of social connectedness and race/ethnicity, urban status of residence, income, availability of household technologies, internet access, and chronic conditions.ResultsLower social connectivity is significantly correlated with race and income. Blacks had a nearly 30% higher likelihood of feeling socially disconnected than other racial groups. Individuals with chronic conditions, particularly cancer, were significantly more likely to feel socially disconnected. Internet access and the availability of technological devices decreased the odds of feeling socially disconnected by 20% and 15% respectively.ConclusionThe COVID-19 pandemic decreased the social connectedness of many vulnerable groups specifically Blacks, those living with chronic conditions, and individuals with limited access to technology. While it is outside the scope of the current study, additional research is needed to determine how to address the social and psychological impacts of the COVID-19 pandemic among elderly Americans.

Grandparenting and the Receipt of Filial Piety From Adult Children in Chinese American Families

The current study explores the association between grandparent caregiving by Chinese American elders and their perceived receipt of filial support from their adult children, called filial piety (xiao). Many studies find a correlation between grandparent caregiving and filial behaviors from their adult children, which is notably higher among minority families, especially among Asians than among white families, stimulated by the norm of reciprocity, familism, and extended kinship. Drawing from the theory of intergenerational relationships, social exchange theory, and the role theory, this study questions whether a more active engagement in grandparenting renders higher levels of filial piety returns from adult children. It uses the PINE data, a survey on the wellbeing of Chinese American elders in Chicago. The results show that more hours of grandparent caregiving relate to higher returns of filial piety perceived by older parents. Correspondingly, though with a marginal significance, more pressures to take care of a grandchild from adult children reduce the elders’ perception of filial piety receipt. No interaction effect is found between the grandparenting hours and the pressure from adult children. Additionally, Chinese American elders possessing higher levels of education, mastery, and longer stays in the US perceive lower levels of filial piety receipt from adult children. Discussion will focus on how grandparent caregiving can be mutually beneficial and strengthen intergenerational relationships among Chinese American families.

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.

Traditional Cultural Practices Provide More Frequent Feelings of Happiness and Calm for Native American Elders

Though American Indian, Alaska Native, and Native Hawaiian (AI/AN/NH) elders are an understudied population, available data demonstrates higher rates of depressive symptoms among these elders. In addition, AI/AN/NH elders are a medically underserved population, with geographic isolation a common barrier to accessing emotional/mental health services. However, cultural practices are important sources of resilience for AI/AN/NH elders. Survey data from “Identifying our Needs: A Survey of Elders” Cycle VI (2014-2017), conducted by the National Resource Center on Native American Aging, were analyzed using ordinal logistic regression; N=18,134 adults age 55+ from 164 tribal survey sites. Respondents indicated how often (from none to all of the time) they participate in cultural practices (e.g., traditional food, music, customs). Frequency of participation varied; 27% of elders reported participating in traditional cultural practices a good bit of the time or more, 28% some of the time, 18% a little of the time, and 27% did not ever participate. We explored the relationship between frequency of cultural practices and frequency of feelings of happiness, calm/peacefulness, nervousness, and being downhearted/blue. A significant positive association was found between higher frequency of cultural participation and feelings of happiness and calm/peacefulness; no association was found with nervousness or depressive symptoms. While the frequency of participation by elders in cultural practices is directly related to better self-reported levels of happiness and peacefulness, nearly half (45%) never/almost never participated in these types of practices, which underscores the need to support availability of and elders’ participation in cultural practices.

Accumulation of Anthocyanins and Other Phytochemicals in American Elderberry Cultivars during Fruit Ripening and its Impact on Color Expression.

American elderberry (Sambucus canadensis) is a plant native to North America with anthocyanin-rich fruits. Our objective was to investigate the effects of cultivar and ripeness on the phytochemical characteristics of its fruits and the corresponding color performance. Cultivars ‘Adams’, ‘Johns’, ‘Nova’, ‘Wyldewood’, and ‘York’ were examined for their °Brix, pH, anthocyanin (pH-differential method), and phenolic content (Folin-Ciocalteau method). Extract composition were analyzed by uHPLC-PDA-MS/MS. Color and spectra were determined using a plate reader. All characteristics evaluated were significantly affected by ripeness and cultivar, except for °Brix and total phenolic content, which did not vary significantly among cultivars. Most anthocyanins (63–72%) were acylated with p-coumaric acid, with cyanidin-3-(trans)-coumaroylsambubioside-5-glucoside the most predominant. The proportion of acylated anthocyanins was the only characteristic evaluated that decreased during ripening (from 80 to 70%). Extract from fully-ripened fruits exhibited red (lvis-max ~520 nm) and blue hues (lvis-max ~600 nm) at acidic and alkaline pH, respectively. Extracts from half-ripe fruit rendered yellowish tones and overall dull color. C-18 semi-purified extracts displayed higher color saturation (smaller L* and larger C*ab) than crude extracts. The vibrant and broad color expression of fully-ripened fruit extract, especially after C-18 purification, suggests this North American native plant as a promising natural colorant source.

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&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% > high school graduates, 14% < 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.

Using the Framingham Cardiovascular Disease Risk Score to predict cognitive performance in cognitively normal non‐hispanic whites and Mexican American elders

AbstractBackgroundPrevalence of cardiovascular disease risk factors (CVRFs) is higher among Mexican Americans (MAs) that non‐Hispanic Whites (NHWs), placing this population at a higher risk of cognitive decline. The purpose of this study was to examine the relationship between the Framingham Cardiovascular Disease 10‐years risk score (FCVDRS) and cognitive performance among MAs and NHWs. This study extends the limited literature about FCVDRS and cognition among MAs.MethodWe studied 518 cognitively normal participants (92 NHWs and 426 MAs) from an epidemiological study of aging. Gender, age, hypertension treatment status, systolic blood pressure (SBP) level, smoking status, diabetes mellitus diagnosis (DM), HDL, and total cholesterol levels were used to calculate the FCVDRS for each individual. A linear regression was conducted to examine the association of FCVDRS with MMSE, logical memory I and II, Trails B, FAS, and digit span scores. A one‐way ANOVA was used to analyze the relationship of FCVDRS categories (low < 10, moderate 10 – 20, high > 20), and test scores, along with Tukey post hoc tests to elucidate the magnitude of differences between the groups. Education was entered as a covariate in the model.ResultMAs had a higher prevalence of DM, higher SBP, and lower HDL values. Linear regression model was significant only for executive function in MAs , F(1,352) = 7.86, p = 0.005. One ‐way ANOVA showed a significant difference for Trails B, F(2,351) = 5.21, p = 0.006, and MMSE, F(2,414) = 3.00, p = 0.005 among MAs. In both cases, post hoc test indicated that MMSE and Trails B mean scores were lower in the high risk group when compared to the low risk group. No significant trends were seen in the Non‐Hispanic White subset.ConclusionOur data has shown that FCVDRS can be used to predict performance on measures of global cognition and executive function in MAs. Although more work has to be done to further understand the predictive power of FCVDRS, there is promise in using this model to develop early intervention programs targeted to MAs.

FOXO3 longevity genotype mitigates the increased mortality risk in men with a cardiometabolic disease.

FOXO3 is a prominent longevity gene. To date, no-one has examined whether longevity-associated FOXO3 genetic variants protect against mortality in all individuals, or only in those with aging-related diseases. We therefore tested longevity-associated FOXO3 single nucleotide polymorphisms in a haplotype block for association with mortality in 3,584 elderly American men of Japanese ancestry, 2,512 with and 1,072 without a cardiometabolic disease (CMD). At baseline (1991–1993), 1,010 CMD subjects had diabetes, 1,919 had hypertension, and 738 had coronary heart disease (CHD). Follow-up until Dec 31, 2019 found that in CMD-affected individuals, longevity-associated alleles of FOXO3 were associated with significantly longer lifespan: haplotype hazard ratio 0.81 (95% CI 0.72-0.91; diabetes 0.77, hypertension 0.82, CHD 0.83). Overall, men with a CMD had higher mortality than men without a CMD (P=6x10-7). However, those men with a CMD who had the FOXO3 longevity genotype had similar survival as men without a CMD. In men without a CMD there was no association of longevity-associated alleles of FOXO3 with lifespan. Our study provides novel insights into the basis for the long-established role of FOXO3 as a longevity gene. We suggest that the FOXO3 longevity genotype increases lifespan only in at-risk individuals by protection against cardiometabolic stress.

A cross-sectional study of blood selenium concentration and cognitive function in elderly Americans: National Health and Nutrition Examination Survey 2011–2014

Background Cognitive decline can develop into mild cognitive impairment, a high-risk factor in the progression of Alzheimer’s disease. The antioxidant micronutrient selenium may have some effect on preventing cognitive decline, but the association between whole blood selenium concentration and cognitive function remains controversial. Aim To investigate the association between whole blood selenium concentration and cognitive function score in elderly Americans. Subjects and methods Data was obtained from the national health and nutrition survey between 2011 and 2014. A general linear model was used to adjust for possible risk factors to analyse the association between blood selenium concentration and cognitive function. Results 2068 participants were included in our study, and the average blood selenium concentration was high at 195.08 μg/L. The risk of lower cognitive scores was higher in people with lower blood selenium concentration (p < 0.05). The lower cognition may also be associated with one or more of the following characteristics: older, male, had a low poverty-income ratio, low education level, and consumed less alcohol. Related conditions such as stroke, diabetes and high blood pressure may also affect cognitive scores. Conclusions Higher blood selenium is associated with higher cognitive scores in elderly Americans.

The Association Between Leukocyte Telomere Length and Cognitive Performance Among the American Elderly.

BackgroundAge-related cognitive decline begins in middle age and persists with age. Leukocyte telomere length (LTL) decreases with age and is enhanced by inflammation and oxidative stress. However, whether shorter LTL correlates with cognitive decline remains controversial.AimsWe aimed to investigate the relationship between LTL and cognitive decline in the American elderly.MethodsWe used data from the 1999 to 2002 U.S. National Health and Nutrition Examination Survey (NHANES). We included participants aged 65–80 with available data on LTL and cognitive assessments. The cognitive function assessment used the digit symbol substitution test (DSST). We applied multivariate modeling to estimate the association between LTL and cognitive performance. Additionally, to ensure robust data analysis, we converted LTL into categorical variables through quartile and then calculated the P for trend.ResultsAfter adjusting for age, cardiovascular disease (CAD) score, gender, race, body mass index (BMI), and educational level, LTL showed a positive correlation with DSST score (odds ratio [OR] 3.47 [0.14, 6.79], P = 0.04). Additionally, to further quantify the LTL–DSST interaction, we found a similar trend when LTL was regarded as a categorical variable (quartile) (P for trend = 0.03).ConclusionLTL was associated with cognitive capabilities among the elderly, implying that LTL might be a biomarker of cognitive aging.

Estimation of covariate effects in proportional cross-ratio model of bivariate time-to-event outcomes

Medical studies often collect bivariate survival data including time to the same type of disease in twins or time to two different diseases from the same individuals. Cross-ratio, defined as the ratio of conditional hazard functions for one event given the other, is often used as a measure of dependency between the two survival outcomes. Statistical methods have also been proposed to estimate the effect of covariates on cross-ratio in order to identify common factors influencing both survival outcomes. There are currently three estimation approaches for cross-ratio, namely, a parametric approach using the Clayton copula, a semi-parametric two-stage approach proposed by Shih and Louis, and a nonparametric pseudo-partial likelihood approach proposed by Hu et al. In this paper, we compare the three estimation approaches on estimating covariates’ effect on the cross-ratio in simulation studies. We found that the nonparametric pseudo-partial likelihood estimation approach performed well and that the method was also robust under various model assumptions. Data from a longitudinal cohort of elderly African Americans were used to illustrate the three estimation approaches.

Elderberry and Elderflower (Sambucus spp.): A Cultivation Guide for Florida

The purpose of this new 9-page paper, written by David Jarnagin, Ali Sarkhosh, Juanita Popenoe, Steve Sargent, and Kevin Athearn, and published by the UF/IFAS Horticultural Sciences Department, is to provide information on growing American elderberry in Florida as an alternative crop for commercial growers as well as homeowners. Although elderberry has been historically grown at commercial scale in some world regions, especially throughout Europe, in the New World it has not found meaningful commercial acceptance until recently.https://edis.ifas.ufl.edu/hs1390

Incidence and risk factors for osteoporotic non-vertebral fracture in low-income community-dwelling elderly: a population-based prospective cohort study in Brazil. The São Paulo Ageing and Health (SPAH) study.

No data on incidence of osteoporotic non-vertebral fracture have been reported in low-income countries where the population's aging has been faster. Even in developed countries, currently available prospective data on major fracture rates beyond hip are scarce. The aim of this study is to describe the incidence and risk factors for non-vertebral fracture in a longitudinal prospective Brazilian population-based elderly cohort. Seven hundred seven older adults (449 women, 258 men) were evaluated at baseline and after a mean follow-up of 4.3 ± 0.8years. Clinical questionnaire, bone mineral density (BMD), and laboratory tests were performed at baseline. New non-vertebral fracture (hip, proximal humerus, rib, forearm) was determined during the follow-up. Multivariate Poisson regression models were used to identify independent predictors of fracture. The age-standardized incidence of non-vertebral fracture was 1562.3/100,000 (1085.7-2248.1/100,000) person-years (pyr) in women and 632.8/100,000 (301.7-1327.3/100,000) in men. Concerning to hip fractures, the incidence was 421.2/100,000 (210.7-842.3/100,000) pyr in women and 89.9/100,000 (12.7-638.5/100,000) in men. In a multivariate analysis, age (RR 2.07, 95% CI 1.13-3.82, p = 0.019, each 10-year increase), prior non-vertebral fracture (RR 3.08, 95% CI 1.36-6.95, p = 0.007), and total hip BMD (RR 1.68, 95% CI 1.11-2.56, p = 0.015, each 1 SD decrease) were predictors of new non-vertebral fracture. In men, fitting a model of risk factors for fracture was prevented by the limited number of events in male sample. This is the first population-based study to ascertain the incidence of major non-vertebral fractures in elderly Latin Americans, confirming the high frequency of the disorder. Age, prior fracture, and hip BMD were predictors of the short-term incidence of fracture.

Abstract P113: Genotypic Effect Of Foxo3 On Lifespan Is Confined To Men With A Cardiometabolic Disorder (hypertension Or Coronary Heart Disease Or Diabetes)

FOXO3 is a prominent human longevity gene. To date, no-one has examined whether longevity-associated genetic variants of FOXO3 protect against mortality in all individuals, or whether they protect against mortality only in individuals with aging-related diseases. Here, we examined this issue for the first time. We tested 9 representative longevity associated single nucleotide polymorphisms (SNPs) located within a haplotype block of FOXO3 for association with mortality in 3,584 elderly American men of Japanese ancestry. At baseline (1991-1993), 2,512 had either diabetes (n=1,010), coronary heart disease (CHD; n=738), or hypertension (n=1,919), and 1,072 lacked any of these cardiometabolic disorders (CMDs). The men were followed from baseline until Dec 31, 2019. The longevity-associated (minor) alleles of all 9 SNPs were strongly associated with longer lifespan in individuals who had a CMD (covariate-adjusted hazard ratios [HRs] for each SNP: 0.82-0.95 [ P =0.00008 to 0.020]; covariate adjusted haplotype analysis HR=0.81, P =0.0003). For just diabetes, just hypertension, and just CHD, haplotype HRs were 0.77, 0.82 and 0.83 ( P =0.007, 0.0003 and 0.10), respectively. Reduced mortality was strongest for carriers of the minor ( G ) allele of SNP rs2802292 (covariate adjusted HR=0.82, 95% CI 0.75-0.90; P= 0.00008), as were survival curve differences (covariate adjusted Cox proportional hazard model difference, P =0.0002). As expected, men without a CMD outlived men with a CMD (Kaplan-Meier Log-rank chi-squared=24.8, P =0.0001). There was, however, no genotypic difference in lifespan of men who did not have a CMD (haplotype HR 1.02, P = 0.74). We propose that in individuals with a cardiometabolic disorder, longevity-associated genetic variants of FOXO3 enhance resilience mechanisms in cells and tissues to help protect against cardiometabolic stress caused by CMDs, thereby allowing CMD-affected men to live longer than men without the protective variants.

Collectivism: An American Safety Net

In the face of deepening economic precarity, Americans have been turning to one another for informal support. What is the value of this collectivist safety net? Through a combination of anthropology and economics, this study introduces a way to measure collectivist practices. Applying this methodology to data from the 2014 Survey of Income and Program Participation, we investigate the extent of collectivism across the age distribution, focusing in particular on collectivism’s impact on retirement savings, its relationship to near retirees’ proximity to meeting their savings targets, and its effect on the wellbeing of elderly Americans. Contrary to the myth that the elderly are a financial burden on society, relatively few seniors receive collectivist support--only 8%. But for those who do receive that support, it makes up 31-43% of their total income. Among pre-retirees ages 55-66, collective assets comprise 12-18% of total personal savings. Taking into account the value of Social security assets, 86% of pre-retirees without collective assets meet or exceed their retirement savings target, but that figure jumps to 94% for Americans with collective assets. These results highlight the importance of accounting for collectivist support in the portfolios of aging Americans.