Healthy Aging In Neighborhoods Of Diversity Across The Life Span Research Articles

Actigraphic Measures of Sleep and White Matter Volume in a Bi‐Racial Cohort

ObjectivesAbout 50% of adults report some form of sleep disturbance with deleterious impact on cerebral white matter (WM). Here, we investigated interactive relations of sleep duration or quality and race on cerebral WM volumes in a largely middle‐aged, bi‐racial cohort.MethodsThe cross‐sectional Healthy Aging in Neighborhoods of Diversity across the Life Span (HANDLS) Scan study yielded 119 stroke and dementia‐free participants (mean age ~51y; 37% African American; ~48% women) with complete actigraphy, magnetic resonance imaging (MRI), and covariate data. A triaxial accelerometer (ActiGraph GT3X+, ActiGraph Corp) worn on the wrists for up to seven consecutive days, provided measures of total sleep time (TST), sleep efficiency (SE), and wake after sleep onset (WASO). Self‐rated sleep quality was assessed via the Pittsburgh Sleep Quality Index (PSQI). Brain MRI, acquired by 3.0 Tesla scanner, yielded quantitative measures of average WM volumes for total brain, total lesion, frontal, occipital, temporal, and parietal lobes. Multivariable linear regression analyzed interactive relations of each sleep variable and race to WM outcomes: model 1‐adjusted for age, sex, and race; model 2‐model 1+ body mass index, smoking, alcohol use, and depressive symptoms. Results are expressed as regression coefficients (β), p‐value.ResultsFollowing adjustments, TST*race interactions were noted for total (17.15, <0.05), frontal (13.17, <0.05), and parietal (7.77, <0.05) WM volumes. Shorter sleep duration was related to lower volumes in African Americans but greater volumes in Whites. PSQI*race interactions for total (59.62, <0.01), frontal (40.07, <0.01) and parietal (17.84, <0.05) WM showed relations of poorer sleep quality to lesser WM volumes in African Americans only.ConclusionShorter sleep duration and lesser self‐reported sleep quality were related to lower total and regional WM volumes among African Americans. The mechanisms underlying these racial differences warrant further investigation and may help explain neuropsychological health disparities.Support or Funding InformationSupported by National Institutes of Health grants ZIA‐AG000195 (MKE), R01‐AG034161 (SRW), and the University of Maryland Claude D. Pepper Older Americans Independence Center (P30 AG028747).

Sociodemographic patterns of pain in an urban community sample: an examination of intersectional effects of sex, race, age, and poverty status.

Pain disparities based on race, sex, age, and socioeconomic status have been well documented. This study aimed to examine interactions among these sociodemographic factors on self-reported bodily pain in an urban community sample to assess whether membership in multiple at-risk groups confers greater risk for pain independent of depressive symptomatology. Participants (N = 1173) were enrolled in the epidemiological Healthy Aging in Neighborhoods of Diversity across the Life Span (HANDLS) study, and reported experiences of pain in various body sites. Logistic regression was used to examine independent and interactive relations of sociodemographic factors on the likelihood of reporting pain in one or more sites. A significant three-way interaction was found for race, sex, and poverty status (odds ratio [OR] = 6.04, 95% confidence interval [CI] [1.26-28.97], P = 0.025). Specifically, among Whites living in poverty, women were more likely to report pain than men (P = 0.043), suggesting a double disadvantage of being both female and living in poverty. Among those above the poverty line, African American (AA) men were less likely to report pain than White men (P = 0.024) and AA women (P = 0.019), potentially due to greater stoicism or coping skills and sources of resilience. Consistent with prior research, significant main effects revealed that older age (OR = 2.16, 95% CI [1.28-3.64], P = 0.004) and higher depressive symptoms (OR = 1.03, 95% CI [1.02-1.04], P < 0.001) were associated independently with increased likelihood of reporting pain. This study demonstrates that in an urban population, intersecting sociodemographic factors create unique social identities that impact pain, and emphasizes the need for identification of relevant mediational pathways.

Association of DASH and Depressive Symptoms with BMI over Adulthood in Racially and Socioeconomically Diverse Adults Examined in the HANDLS Study.

Adherence to the Dietary Approaches to Stop Hypertension (DASH) diet is linked to slower weight gain over time. Elevated depressive symptoms may lead to poor quality diets, potentially increasing Body Mass Index (BMI). This study explored these pathways using longitudinal data extracted from 1201–1458 Healthy Aging in Neighborhoods of Diversity across the Life Span (HANDLS) study participants. DASH mean score was computed using four 24 h recalls [visits(v)1 + v2/2: 2004–2013] and depressive symptoms using the Center for Epidemiologic Studies Depression (CES-D) scale (v1 + v2/2: 2004–2013). BMI was measured at v2: 2009–2013 and v3: 2013–2017. Multiple linear mixed regression and mediation modeling were conducted, linking CES-D(mean) and DASH(mean) to BMI [v2 and annualized change ΔBMI (v3-v2)] and exploring mediation of the CES-D(mean)–BMI(v3) and DASH(mean)–BMI(v3) associations through DASH(mean) and CES-D(mean), respectively. Models were further stratified by sex, race and poverty status. Inverse cross-sectional and longitudinal relationships of DASH(mean) with BMI(v2) and ΔBMI were detected, mainly in women and <125% of poverty participants. CES-D(mean) was not associated with BMI(v3); no mediation was detected through DASH(mean) in all socio-demographic strata. Moreover, the inverse DASH(mean)–BMI(v3) total effect was not mediated through CES-D(mean). Future studies should explore other pathways aside from depressive symptoms by which DASH can have a preventive effect on weight status over time.

NEIGHBORHOOD ENVIRONMENTS AND OBESITY: EXPLORING PATHWAYS TO RISK OF CARDIOVASCULAR DISEASE

Modifying neighborhood environments to target well-established risk factors for cardiovascular disease may reduce health disparities by complementing clinical services. Prior research, however, includes limited measures of neighborhoods and does not adequately account for individual-level processes known to mediate health outcomes. We combine baseline data from the Healthy Aging in Neighborhoods of Diversity Across the Life Span (HANDLS) dataset with neighborhood-level data to yield a diverse sample of Black and white middle-aged and older residents of Baltimore City (N=2707). We use structural equation modeling to examine associations between neighborhood environments and obesity (BMI>=30), focusing on individual-level mediators. Initial direct associations between neighborhoods and obesity (e.g., presence of businesses, β=-0.062) are mediated by healthcare access and health behaviors. Additional indirect pathways exist through health behaviors (e.g., neighborhood disorder, access to parks). These findings highlight the importance of considering indirect pathways to cardiovascular health promotion among aging adults in different neighborhood contexts.

Longitudinal Associations between Monetary Value of the Diet, DASH Diet Score and the Allostatic Load among Middle-Aged Urban Adults.

Lower cost can lead to poorer-quality diets, potentially worsening metabolic profiles. We explored these pathways among urban adults. Longitudinal data were extracted from 1224–1479 participants in the Healthy Aging in Neighborhoods of Diversity across the Life Span (HANDLS) study. DASH(mean) (Dietary Approaches to Stop Hypertension) score was computed using four 24 h recalls (v1/v2: 2004–2013) linked with a national food price database to estimate monetary value of the diet [MVD(mean)]. Allostatic load (AL) was measured at visits 2 (v2) and 3 (v3) in 2009–2018. Mixed-effects regression and structural equation modeling (SEM) were conducted, linking MVD(mean)/DASH(mean) to AL [v2 and annual change(v3–v2)] and exploring mediating pathways between MVD(mean) and AL(v3) through DASH(mean), stratifying by sex, race and poverty status. MVD(mean) tertiles were linearly associated with contemporaneous DASH(mean), after energy adjustment. In mixed-effects regression models, DASH(mean) was consistently linked to lower AL(v2). DASH(mean) and MVD(mean) were positively associated with higher serum albumin(v2). In SEM, MVD(mean) was linked to AL(v3) through DASH(mean), mainly among Whites and specifically for the cholesterol and Waist-Hip-Ratio AL components. In summary, energy and other covariate-adjusted increase in MVD may have a sizeable impact on DASH which can reduce follow-up AL among urban White middle-aged adults. More studies are needed to replicate findings in comparable samples of urban adults.

Cross-Sectional Associations of Neighborhood Perception, Physical Activity, and Sedentary Time in Community-Dwelling, Socioeconomically Diverse Adults.

Background: Little is known about the role of perceived neighborhood environment as a determinant of physical activity (PA) and sedentary time (ST) in understanding obesity-related health behaviors. We focus on a biracial, socioeconomically diverse population using objectively measured ST, which is under-represented in the literature.Methods: We examined the association between self-reported neighborhood perception (Likert-scale questions), PA using the Baecke questionnaire, and both non-sedentary time and ST using accelerometry from wave 4 of the Healthy Aging in Neighborhoods of Diversity across the Life Span (HANDLS) study (n = 2,167). After applying exclusion criteria, the sample size was n = 1,359 for analyses of self-reported PA and n = 404 for analyses of accelerometry data. Factor analysis identified key neighborhood characteristics to develop a total neighborhood perception score (NPS). Higher NPS indicated less favorable neighborhood perception. Linear regression was used to determine the relationship between NPS, PA, non-sedentary time, and ST.Results: Complete data were available for n = 1,359 [age 56.6(9.0) years, 59.5% female, 62.2% African American] for whom we identified four neighborhood perception factors: (1) concern about crime, (2) physical environment, (3) location of violent crime, and (4) social environment. Worsening perception of the overall neighborhood [β = −0.13 (SE = 0.03); p = 0.001], the physical environment [−0.11 (0.05); p = 0.03], and the social environment [−0.46 (0.07); p < 0.0001] were associated with decreased PA. Worsening perception of the overall neighborhood [1.14 (0.49); p = 0.02] and neighborhood social environment [3.59 (1.18); p = 0.003] were associated with increased ST over the day. There were no interactions for race, sex, poverty status, or economic index.Conclusion: Poor overall neighborhood perception, perceived social environment, and perceived neighborhood physical environment are associated with PA and ST in a multi-racial, socioeconomically diverse cohort of urban adults.Clinical Trial Registration: The HANDLS study is registered at ClinicalTrials.gov as NCT01323322.

The Interplay of Diet Quality and Alzheimer’s Disease Genetic Risk Score in Relation to Cognitive Performance Among Urban African Americans

We examined the interactive associations of poor diet quality and Alzheimer’s Disease (AD) genetic risk with cognitive performance among 304 African American adults (mean age~57 years) from the Healthy Aging in Neighborhoods of Diversity across the Life Span (HANDLS) study. In this cross-sectional study, selected participants had complete predictors and covariate data with 13 cognitive test scores as outcomes. Healthy Eating Index-2010 (HEI-2010), Dietary Approaches to Stop Hypertension (DASH), and mean adequacy ratio (MAR) were measured. A genetic risk score for AD in HANDLS (hAlzScore) was computed from 12 selected single nucleotide polymorphisms (SNPs). Our key hypotheses were tested using linear regression models. The hAlzScore was directly associated with poor performance in verbal memory (−0.4 ± 0.2, 0.01) and immediate visual memory (0.4 ± 0.2, 0.03) measured in seconds, in women only. The hAlzScore interacted synergistically with poorer diet quality to determine lower cognitive performance on a test of verbal fluency. Among numerous SNP × diet quality interactions for models of cognitive performance as outcomes, only one passed correction for multiple testing, namely verbal fluency. Our results suggest that improved diet quality can potentially modify performance on cognitive tests of verbal fluency among individuals with higher AD genetic risk.

A Longitudinal Assessment of Diet Quality and Risks Associated with Malnutrition in Socioeconomic and Racially Diverse Adults.

Little is known about the effects of diet quality through adulthood and its association with malnutrition later in life. The first research objective was to evaluate diet quality assessed by Mean Adequacy Ratio (MAR) of United States African American and White adults (n = 2066), examined at baseline and two follow-up waves in the Healthy Aging in Neighborhoods of Diversity across the Life Span (HANDLS) study. The sample was split into cohorts by age at study baseline: Younger, <50, and older, ≥50 years. The second objective was to assess the association of MAR and risk for malnutrition in adults who were ≥60 years at wave 4 (n = 746). The Mini Nutritional Assessment was used to determine risk for malnutrition. At each of the three study waves, 17 micronutrients from two 24 h dietary recalls were used to calculate MAR. Over 13 years MAR changed minimally in the younger cohort as they aged from early to middle adulthood. In contrast, a statistically significant decline in MAR was observed for the older cohort between baseline (2004–2009) and wave 4 (2013–2017), with a greater degree of worsening at low energy levels. The risk for malnutrition was significantly associated with consuming a diet low in energy, lower protein as a percent of energy at baseline, as well as being food insecure, a current smoker, and having income <125% poverty. The risk for malnutrition was not associated with a change in protein intake in years prior to age 60, change in MAR scores across waves, MAR at wave 4, age, sex, race, or having hypertension or diabetes. These longitudinal study findings revealed that diet quality was not predictive of risk for malnutrition.

Disparities in Diffuse Cortical White Matter Integrity Between Socioeconomic Groups.

There is a growing literature demonstrating a link between lower socioeconomic status (SES) and poorer neuroanatomical health, such as smaller total and regional gray and white matter volumes, as well as greater white matter lesion volumes. Little is known, however, about the relation between SES and white matter integrity. Here we examined the relation between SES and white matter integrity of the brain’s primary cortical regions, and evaluated potential moderating influences of age and self-identified race. Participants were 192 neurologically intact, community-dwelling African American and White adults (mean age = 52 years; 44% male, 60% White, low SES = 52%) from the Healthy Aging in Neighborhoods of Diversity across the Life Span (HANDLS) SCAN study. Participants underwent 3.0-T cranial magnetic resonance imaging. Diffusion tensor imaging was used to estimate regional fractional anisotropy (FA) to quantify the brain’s white matter integrity and trace to capture diffusivity. Multiple regression analyses examined independent and interactive associations of SES, age, and race with FA of the frontal, temporal, parietal, and occipital lobes bilaterally. Sensitivity analyses assessed the influence of several biopsychosocial risk factors on these associations. Exploratory analyses examined these relations with trace and using additional SES indicators. Results indicated there were no significant interactions of SES, age, and race for any region. Individuals with low SES had lower FA in all regions, and higher trace in the right and left frontal, right and left temporal, and left occipital lobes. Findings remained largely unchanged after inclusion of sensitivity variables. Older age was associated with lower FA and greater trace for all regions, except for the right temporal lobe with FA. No main effects were found for race in FA, and Whites had higher trace values in the parietal lobes. Novel findings of this study indicate that relative to the high SES group, low SES was associated with poorer white matter integrity and greater diffusivity. These results may, in part, reflect exposures to various biopsychosocial risk factors experienced by those of lower SES across the lifespan, and may help explain the preponderance of cognitive and functional disparities between socioeconomic groups.

Aspects of Dietary Diversity Differ in Their Association with Atherosclerotic Cardiovascular Risk in a Racially Diverse US Adult Population.

The study objectives were to measure dietary diversity (DD) of an urban US population and to determine if associations of 10 year atherosclerotic cardiovascular (ASCVD) risk with DD were independent of dietary quality. Participants were drawn from the Healthy Aging in Neighborhoods of Diversity across the Life Span (HANDLS) study, wave 4 (n = 2066, 1259 African Americans (AA), 807 Whites (W). Three DD measures were derived from 2 days of 24 h recall data collected with the USDA automated-multiple-pass-method. Count was based on consumption of at least half an equivalent of food from 21 subgroups. Evenness was calculated using Berry Index (BI) and BI-adjusted by food health values. Dissimilarity was calculated by Mahalanobis Distance. Diet quality was assessed by Mean Nutrient Adequacy (MAR) and DASH scores. Associations of DD and quality with ASCVD risk, calculated using 2013 American College of Cardiology and American Heart Association guidelines, were assessed with multivariable regression. Covariates included income, education, food security, and energy/kg weight. Count and MAR were positively associated whereas dissimilarity was negatively associated with ASCVD risk. There was no evidence that evenness contributed to cardiovascular health. The findings suggest more diversity in food attributes and diets rich in micronutrients rather than increased count support cardiovascular health.

Systemic inflammation is associated with depressive symptoms differentially by sex and race: a longitudinal study of urban adults

Systemic inflammation may influence trajectories of depressive symptoms over time, perhaps differentially by sex and race. Inflammatory markers and the Center for Epidemiologic Studies-Depression scale [total score: CES-Dtotal and four distinctive domains: somatic complaints, depressed affect, positive affect and interpersonal problems] were examined among African-American (AA) and White urban adults participating in the Healthy Aging in Neighborhoods of Diversity across the Life Span (HANDLS) study [2004–2013, Agebase:30–64 y, mean ± SD follow-up time: 4.64 ± 0.93 y, N = 150 (with cytokine data) to N = 1,767 (with other inflammatory markers)]. Findings suggest that serum concentrations of high-sensitivity C-reactive protein (hsCRP), z-inflammation composite score [ICS, combining elevated hsCRP and ESR with low serum albumin and iron], and serum interleukin (IL) 1β were positively associated with ΔCES-Dtotal (Δ: annual rate of increase) among Whites only. IL-12 was directly related to ΔCES-Dtotal among men and AA. The race-specific associations of hsCRP, ICS, IL-1β and the sex-specific association of IL-12 with ΔCES-Dtotal were replicated for the “depressed affect” domain. Similarly, among men, lower serum albumin and higher ICS were linked with higher baseline “somatic complaints”. IL-10 among AA and IL-12 among men were inversely related to Δ“positive affect”, while “interpersonal problems” were cross-sectionally associated with IL-6 among AA and IL-10 among Whites. Finally, baseline ICS was positively associated with incident “elevated depressive symptoms” (EDS: CES-Dtotal ≥ 16) among AA (HR = 1.28, 95% CI: 1.04–1.56, P = 0.017). Overall, systemic inflammation was directly linked to increased depressive symptoms over time and at baseline, differentially across sex and race groups. More longitudinal research is needed to replicate our findings.

Cytokines are associated with longitudinal changes in cognitive performance among urban adults

BackgroundChronic systemic inflammation has been positively associated with structural and functional brain changes representing early markers of Alzheimer’s Disease (AD) and cognitive decline. The current study examined associations between systemic inflammation and cognitive performance among African-Americans and Whites urban adults. MethodsParticipants were selected from the Healthy Aging in Neighborhoods of Diversity across the Life Span (HANDLS) study (2004–2013, baseline age: 30–64 y, mean ± SD follow-up time of 4.64 ± 0.93 y, N = 189–222, k = 1.5–1.7 observations/participant). Cytokines known to be positively linked to AD incidence among others were tested against cross-sectional and longitudinal cognitive function, stratifying by age group (≤50 y vs. >50 y), sex and race. A series of mixed-effects regression models were conducted, adjusting for key confounders. ResultsAmong key findings, IL1β was positively associated with a faster rate of decline on a test of executive functioning, among older adults (age >50 y, γ11 = +2.49 ± 0.89, p = 0.005), while in the total population, IL-6 was linked to a faster decline on a test of verbal memory (γ11 = −0.011 ± 0.004, p = 0.009). Among younger participants, IL-18 was linked to a poorer performance on a test of attention at baseline (age ≤50 y, γ01 = −0.007 ± 0.0025, p = 0.004) though a slower rate of decline with higher IL-18 was detected for a test of psychomotor speed in older adults (age >50 y, γ11 = +0.0010 ± 0.0004, p = 0.008). Finally, among Whites, unlike among African-Americans, IL-6 was associated with a better baseline performance on two tests of verbal and working memory. ConclusionsCytokines were shown to be associated with age-related cognitive decline among middle-aged and older urban adults in an age group and race-specific manner. Further longitudinal studies are needed to replicate our findings and mediation through relevant biological and psychosocial factors need to be studied as well.

Multiple Influences on Cognitive Function Among Urban-Dwelling African Americans.

This study examined multiple influences on cognitive function among African Americans, including education, literacy, poverty status, substance use, depressive symptoms, and cardiovascular disease (CVD) risk factors. Baseline data were analyzed from the Healthy Aging in Neighborhoods of Diversity across the Life Span (HANDLS) study. Participants were 987 African Americans (mean age 48.5years, SD = 9.17) who completed cognitive measures assessing verbal learning and memory, nonverbal memory, working memory, verbal fluency, perceptuo-motor speed, attention, and cognitive flexibility. Using preplanned hierarchical regression, cognitive performance was regressed on the following: (1) age, sex, education, poverty status; (2) literacy; (3) cigarette smoking, illicit substance use; (4) depressive symptoms; and (5) number of CVD risk factors. Results indicated that literacy eliminated the influence of education and poverty status in select instances, but added predictive utility in others. In fully adjusted models, results showed that literacy was the most important influence on cognitive performance across all cognitive domains (p < .001); however, education and poverty status were related to attention and cognitive flexibility. Depressive symptoms and substance use were significant predictors of multiple cognitive outcomes, and CVD risk factors were not associated with cognitive performance. Overall, findings underscore the need to develop cognitive supports for individuals with low literacy, educational attainment, and income, and the importance of treating depressive symptoms and thoroughly examining the role of substance use in this population.

CKD Awareness in the General Population: Performance of CKD-Specific Questions

Rationale & ObjectiveData from patients in one delivery system have suggested that the prevalence of chronic kidney disease (CKD) awareness differs by how the question is asked. We examined the sensitivity and specificity of different CKD awareness questions among diverse community-dwelling adults who were not necessarily engaged in primary care to determine the generalizability of prior results.Study DesignCross-sectional study.Setting & ParticipantsParticipants in the Healthy Aging in Neighborhoods of Diversity Across the Life Span (HANDLS) Study.PredictorCKD awareness, ascertained using 5 different questions.OutcomeSensitivity and specificity of each awareness question, using laboratory results as the gold standard.Analytic ApproachLogistic regression was used to compare sensitivities of different awareness questions.ResultsAmong 2,046 participants, mean (SD) age was 56.5 (9.1) years, 41.5% were men, and 61.3% were African American. More than 40% were poor, 35% reported not having health insurance, and 16.9% had low health literacy. More than 20% (n = 424) had CKD. Sensitivities of single CKD awareness questions ranged from 2.2% for “kidney damage” to 5.2% for “kidney problem.” Sensitivity of the compound question asking about “weak kidneys, failing kidneys, or kidney disease” was 19.5%. Sensitivity of this compound CKD awareness question was higher among study participants with more advanced CKD and low health literacy, and those who lived below the poverty level.LimitationsSingle measures of estimated glomerular filtration rate and albuminuria; study participants may have been more engaged in their health care than the average US adult, potentially limiting the generalizability of results.ConclusionsCKD awareness is low among community-dwelling adults with kidney disease, though data using a sensitive compound question ascertaining awareness suggest that we have met the Healthy People 2020 goal related to CKD awareness of 13.4%. Understanding the phrases about kidney disease that are most understandable to patients with and at risk for CKD is important to further increase CKD awareness.

Lifetime discrimination burden, racial discrimination, and subclinical cerebrovascular disease among African Americans.

Explore interactive relations of lifetime discrimination burden and racial discrimination-chronic stressors among African Americans (AAs)-and age with MRI-assessed white matter lesion volume (WMLV), a prognostic indicator of poor clinical brain health outcomes. AAs (N = 71; 60.6% female, mean age = 50) participating in the Healthy Aging in Neighborhoods of Diversity across the Life Span (HANDLS) SCAN study underwent quantitative magnetic resonance imaging coded for WMLV. Participants self-reported lifetime discrimination burden and racial discrimination approximately 5 years earlier. Multivariable regression models assessed interactions of linear and quadratic effects of discrimination and age with WMLV adjusted for sex and socioeconomic status. Findings revealed significant interactive relations of age and (a) quadratic, lifetime discrimination burden, B = .05, p = .014, ηpartial2 = .092, and (b) quadratic, racial discrimination, B = .03, p = .001, ηpartial2 = .155, with WMLV. Among older AA, increases in lifetime discrimination burden and racial discrimination were associated with increases in WMLV (ps < .03); in younger AA, decreasing levels of racial discrimination were related to increases in WMLV (p = .006). Among older AA, as lifetime discrimination burden and racial discrimination increased, so did WMLV. However, in younger AA, decreases in racial discrimination were associated with increased WMLV. Elucidation of complex mechanistic underpinnings, including potentially differential impacts of the acknowledgment versus suppression or underreporting of discriminatory experiences, among AA of different age cohorts, is critical to understanding the present pattern of findings. (PsycINFO Database Record (c) 2018 APA, all rights reserved).

Dietary Flavonoid Intakes Are Associated with Race but Not Income in an Urban Population.

Flavonoids are polyphenolic phytochemicals with health-promoting properties, yet knowledge about their intake in at-risk populations is limited. This study sought to estimate intakes of total flavonoids and six flavonoid classes in the Healthy Aging in Neighborhoods of Diversity across the Life Span (HANDLS) study; determine if differences in intakes exist by race (African American (AA) and White (W)) and income (< or >125% Federal poverty guidelines); and compare intakes to those of a nationally representative population with similar demographic and socioeconomic characteristics. Data transformation normalized the flavonoid intake distributions prior to conducting statistical tests. With the exception of the flavanone class, flavonoid intakes of AAs were significantly lower than those of W (p < 0.01), regardless of other potential mediating factors including sex, age, and income. Total flavonoid intakes in HANDLS did not differ from intakes in the nationally representative study, but anthocyanidin and flavone intakes were lower, and race specific differences were found for several flavonoid classes. These findings imply that benefits attributable to flavonoid consumption may not be experienced equally by AAs and Whites, nor in vulnerable populations such as that represented by HANDLS relative to the U.S. population, and may play a role in observed health disparities.

Dorsolateral prefrontal cortex volume as a mediator between socioeconomic status and executive function.

Lower socioeconomic status (SES) is related to poorer cognitive performance, but the neural underpinnings of this relation are not fully understood. This study examined whether SES-linked decrements in executive function were mediated by smaller dorsolateral prefrontal cortex (DLPFC) volumes. Given the literature demonstrating that SES-brain relations differ by race, we examined whether race moderated these mediations. Participants were 190 socioeconomically diverse, self-identified African American (AA) and White adults from the Healthy Aging in Neighborhoods of Diversity across the Life Span (HANDLS) SCAN study. Regional brain volumes were derived using T1-weighted MP-RAGE images. Adjusting for age and sex, moderated mediation analyses examined if the DLPFC mediated SES-executive function relations differently across racial groups. Executive function was measured using Trail Making Test part B (Trails B), Digit Span Backwards (DSB), and verbal fluency. Moderated mediation demonstrated that DLPFC volume significantly mediated the association between SES and Trails B in Whites (lower confidence interval [CI] = 0.01; upper CI = 0.07), but not in AAs (lower CI = -0.05; upper CI = 0.01). No mediations were found for DSB or verbal fluency, although SES was related to all tests. The DLPFC may be important in the association of SES and mental flexibility for White, but not AA adults. It is possible that the well-replicated advantages of high SES among Whites do not readily translate, on average, to AAs. These findings highlight the importance of brain volume for cognitive functioning, while adding to the literature on sociodemographic health disparities. (PsycINFO Database Record (c) 2018 APA, all rights reserved).

Longitudinal change in the diet's monetary value is associated with its change in quality and micronutrient adequacy among urban adults.

BackgroundReducing diet costs may lead to the selection of energy-dense foods, such as refined grains or foods high in added sugars and/or fats, which can lower overall dietary quality. We examined the longitudinal association between the monetary value of the diet (MVD) and the overall dietary quality across sex, race and income groups.Methods and findingsLongitudinal data from 1,466 adult urban participants from Healthy Aging in Neighborhoods of Diversity across the Life Span (HANDLS) study were used. Healthy Eating Index–2010 (HEI–2010) and Mean Adequacy Ratio (MAR) were computed and a national food price database was used to estimate MVD. Multiple linear regression analyses were conducted linking annual rates of change (Δ) in MVD to ΔHEI-2010 and ΔMAR, stratifying by sex, race and income groups. Among key findings, ΔHEI-2010 was comparable across socio-demographic groups, while ΔMAR was higher among women and individuals above poverty. Adjusting for key covariates, ΔMVD was positively associated with both ΔHEI-2010 and ΔMAR, and with a consistently stronger association among individuals above poverty, specifically for the total proteins and empty calories components of HEI-2010 and several nutrient adequacy ratios (NARs: vitamins C, E, B-6 and Zinc). ΔMVD-ΔMAR association was stronger in women, mainly influenced by ΔMVD’s positive associations with B-vitamins, copper, calcium, magnesium and phosphorus NARs. ΔMVD-Δvitamin D NAR’s positive relationship was stronger among Whites, while ΔMVD-Δvitamin B-12 NAR’s association was stronger among African-Americans.ConclusionsIn sum, a potential increase in MVD may have a stronger impact on dietary quality among urban adult women and above-poverty individuals.

Breakfast Habits and Diet Quality in Economically Diverse African American and White Adults

Both skipping breakfast and away-from-home (AFH) food consumption can influence diet quality. This study compared diet quality when breakfasts were eaten at home, eaten AFH, or skipped among adults (aged 32-70 years; 59% female, 62% African American) in the Healthy Aging in Neighborhoods of Diversity across the Life Span (HANDLS) study who completed two 24-hour recalls (n = 2140). Individuals who ate breakfast at home had the highest diet quality (Healthy Eating Index-2010 score). Persons who ate breakfast AFH or skipped breakfast had diet quality scores that were 3.98 and 4.62 points lower. Dietitians could promote more at-home meals as an effective strategy to improve the diet quality for Americans' breakfast.

Abstract P324: Association of Neighborhood Perception and Physical Activity in the Healthy Aging in Neighborhoods of Diversity Across the Lifespan (HANDLS) Study

Introduction: As obesity rates rise, it is increasingly important to understand obesity-related health behaviors, including physical activity (PA). Less is known about the role of perceived neighborhood environment, particularly perceptions of crime and violence, in preventing PA. Hypothesis: Unfavorable neighborhood perception is associated with lower PA levels, and may be moderated by socioeconomic status (SES). Methods: Within the multiracial, socioeconomically diverse HANDLS cohort, we examined the association between self-reported neighborhood perception (Likert-scale questions) and physical activity (Baecke PA questionnaire). Factor analysis identified key neighborhood characteristics to develop a total neighborhood perception score (NPS), which was divided into quintiles for analysis. Higher NPS indicated less favorable neighborhood perception. Linear regression was used to determine the relationship between total NPS, factor scores, and PA. Results: In Wave 4 [n=2167; mean age 56.6(9.1) years, 58.6% female, 61.1% black, 40.5% below poverty line], we identified five neighborhood perception factors: 1) concern about specific crime types 2) physical environment, 3) violent crime, 4) social environment and 5) violence beyond the neighborhood. Across NPS quintiles, those in quintile 5 were more likely to be younger ( p &lt; 0.001), white ( p &lt; 0.001), above the poverty level ( p &lt; 0.001), and more highly educated ( p &lt; 0.001), but less likely to be smokers ( p = 0.05) or engage in leisure time PA ( p &lt; 0.001). Total PA decreased with increasing NPS in Factor 4 across all race/sex groups and with total NPS for white females. Total PA increased with increasing NPS in Factor 3 for white males. The NPS-PA relationship was not moderated by SES. Conclusions: Poor perceived social cohesion is associated with decreasing PA, while - paradoxically - increased perceived violent crime is associated with higher PA for white males. Further work should investigate potential mediators between social cohesion, crime and PA.