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Article

The Relationship of Race, Psychosocial Stress and Resiliency Indicators to Neurocognitive Impairment among Older Americans Enrolled in the Health and Retirement Survey: A Cross-Sectional Study

1
Department of Epidemiology and Biostatistics, University of Georgia, Athens, GA 30602, USA
2
Department of Psychiatry, University of Michigan, Ann Arbor, MI 48105, USA
3
Department of Psychiatry, College of Osteopathic Medicine, Michigan State University, East Lansing, MI 48824, USA
*
Authors to whom correspondence should be addressed.
Academic Editor: Lilah Marie Besser
Int. J. Environ. Res. Public Health 2021, 18(3), 1358; https://0-doi-org.brum.beds.ac.uk/10.3390/ijerph18031358
Received: 29 November 2020 / Revised: 28 January 2021 / Accepted: 29 January 2021 / Published: 2 February 2021
(This article belongs to the Special Issue Social and Built Environments and Healthy Brain Aging)
Background: Race/ethnicity, toxic stress (TS), resilience-promoting factors (RPFs), and their interactions were investigated in relationship to neurocognitive impairment (NI) in a nationally representative sample of adult Americans ≥50 years enrolled in the Health and Retirement Study (HRS) between 2012 and 2014. Methods: NI was defined as physician diagnosis of Alzheimer’s disease/dementia or HRS total cognition score ≤ 10. Race/ethnicity (i.e., African American, White, or Other), TS (i.e., everyday discrimination and chronic stressors), and mastery (as indicator of RPF) were self-reported. Multivariable logistic regression models estimated race-, TS-, RPF-associated odds ratios (ORs), and 95% confidence intervals (CI) for NI adjusting for socio-demographic confounders. Results: 6317 respondents interviewed between the years 2012 and 2014, age range 55–104 years old, 83% White, 13% Black and 4% Other race were included in the study. Chronic stress (OR = 1.88, 95% CI: 1.42–2.48), discrimination (OR = 3.31, 95% CI: 2.12–5.19) and low mastery (OR = 1.85, 95% CI: 1.38–2.48) were each associated with higher NI risk while low mastery was associated with higher NI risk in discrimination and race/ethnicity dependent manner. Specifically, low mastery-associated risk for NI was evident among adults that denied experiencing discrimination (OR = 2.01, 95% CI: 1.51–2.68), but absent among those that experienced discrimination (OR = 0.72, 95% CI: 0.32–1.62). Further, AA race was associated with NI risk but only among adults with high mastery (OR = 2.00, 95% CI: 1.20–3.35). Conclusions: Discrimination, chronic stress, and low mastery were associated with worse cognition. Persisting cognitive disadvantage for AA vs. White/Other race only among high mastery adults suggests that adverse social experiences may counteract mastery-associated cognitive benefits among AA population. TS reduction through policies that promote equal treatment by race/ethnicity in social life, health, justice, and economic systems may promote successful cognitive aging. View Full-Text
Keywords: toxic stress; resilience promoting factors; everyday discrimination; neurocognitive impairment; minority race; older Americans toxic stress; resilience promoting factors; everyday discrimination; neurocognitive impairment; minority race; older Americans
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MDPI and ACS Style

Nkwata, A.K.; Zhang, M.; Song, X.; Giordani, B.; Ezeamama, A.E. The Relationship of Race, Psychosocial Stress and Resiliency Indicators to Neurocognitive Impairment among Older Americans Enrolled in the Health and Retirement Survey: A Cross-Sectional Study. Int. J. Environ. Res. Public Health 2021, 18, 1358. https://0-doi-org.brum.beds.ac.uk/10.3390/ijerph18031358

AMA Style

Nkwata AK, Zhang M, Song X, Giordani B, Ezeamama AE. The Relationship of Race, Psychosocial Stress and Resiliency Indicators to Neurocognitive Impairment among Older Americans Enrolled in the Health and Retirement Survey: A Cross-Sectional Study. International Journal of Environmental Research and Public Health. 2021; 18(3):1358. https://0-doi-org.brum.beds.ac.uk/10.3390/ijerph18031358

Chicago/Turabian Style

Nkwata, Allan K., Ming Zhang, Xiao Song, Bruno Giordani, and Amara E. Ezeamama. 2021. "The Relationship of Race, Psychosocial Stress and Resiliency Indicators to Neurocognitive Impairment among Older Americans Enrolled in the Health and Retirement Survey: A Cross-Sectional Study" International Journal of Environmental Research and Public Health 18, no. 3: 1358. https://0-doi-org.brum.beds.ac.uk/10.3390/ijerph18031358

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