Suchergebnisse

<p class="Pa7"><strong>Background: </strong>Few studies have addressed retention of minorities, particularly African Americans, in longitudinal research. Our aim was to determine whether there was differ­ential retention between African Americans and Whites in the ARIC cohort and identify cardiovascular disease (CVD) risk factors and indicators of socioeconomic status (SES) as­sociated with these retention differences.</p><p class="Pa7"><strong>Methods: </strong>15,688 participants, 27% African American and 73% White, were included from baseline, 1987-1989, and classified as having died, lost or withdrew from study contact, or remained active in study calls through 2013. Life tables were created illustrating retention patterns stratified by race, from baseline through visit 5, 2011- 2013. Prevalence tables stratified by race, participation status, and center were cre­ated to examine CVD risk factors and SES at baseline and visit 5.</p><p class="Pa7"><strong>Results: </strong>54% of African Americans com­pared with 62% of Whites were still in follow-up by 2013. This difference was due to an 8% higher cumulative incidence of death among African Americans. Those who remained in follow-up had the lowest baseline CVD risk factors and better SES, followed by those who were lost/withdrew<em>, </em>then those who died. Whites had lower lev­els of most CVD risk factors and higher SES than African Americans overall at baseline and visit 5; though, the magnitude of visit 5 differences was less.</p><p class="Pa7"><strong>Conclusions: </strong>In the ARIC cohort, reten­tion differed among African Americans and Whites, but related more to mortality dif­ferences than dropping-out. Additional re­search is needed to better characterize the factors contributing to minority participants' recruitment and retention in longitudinal research.</p><p class="Pa7"><em>Ethn Dis. </em>2017;27(1):31-38; doi:10.18865/ed.27.1.31.</p>

Geographic differences in cardiovascular disease (CVD) mortality among African Americans (AAs) are well-established, but not well-characterized. Using the Minnesota Heart Survey (MHS) and Atherosclerosis Risk in Communities (ARIC) Study, we aimed to assess whether CVD risk factors drive geographic disparities in CVD mortal­ity among AAs.ARIC risk factors were measured be­tween1987-1989 from a population-based sample of AAs, aged 45 to 64 years, living in Jackson, MS and Forsyth County, NC. Simi­lar measures were made at MHS baseline, 1985, in AAs from Minneapolis-St. Paul, MN. CVD mortality was identified using ICD codes for underlying cause of death. We compared MHS and ARIC on CVD death rates using Poisson regression, risk factor prevalences, and hazard ratios using Cox regression.After CVD risk factor adjustment, AA men in MHS had 3.4 (95% CI: 2.1, 4.7) CVD deaths per 1000 person-years vs 9.9 (95% CI: 8.7, 11.1) in ARIC. AA women in MHS had 2.7 (95% CI: 1.8, 3.6) CVD deaths per 1000 person-years vs 6.7 (95% CI: 6.0, 7.4) in ARIC. A 2-fold higher CVD mortality rate remained in ARIC vs MHS after additional adjustment for education and income. ARIC had higher total cholesterol, hypertension, diabetes, and BMI, as well as less education and income than MHS. Risk factor hazard ratios of CVD death did not differ.The CVD death rate was lower in AAs in Minnesota (MHS) than AAs in the South­east (ARIC). While our findings support maintaining low risk for CVD preven­tion, differences in CVD mortality reflect unidentified geographic variation.Ethn Dis. 2019;29(1):47-52; doi:10.18865/ ed.29.1.47

Background: We assessed cross-sectional differences in sleep quality and risk factors among Asian, Black, Latino, and White participants in the Kaiser Healthy Aging and Diverse Life Experiences (KHANDLE) Study.Methods: KHANDLE enrolled community-dwelling adults aged ≥65 years living in northern California. Participants completed a modified Pittsburgh Sleep Quality Index to measure six sleep components and a global sleep score (scored 0-24). Covari­ates included age, sex, central adiposity, education, income, alcohol consumption, ever smoking, physical activity, and depres­sion. Ordinal logistic regression was used to model sleep component scores across race/ ethnic groups. Linear regression was used to assess racial/ethnic differences in global sleep score and the association between risk factors and global sleep score.Results: 1,664 participants with a mean age of 76 (SD=7) and mean global sleep score of 6 (SD=4) were analyzed. Using Latinos as reference (highest average sleep score), Blacks had an average .96 (.37, 1.54) unit higher global sleep score (worse sleep) while Asians [β: .04 (-.56, .63)] and Whites [β: .28 (-.29, .84)] did not significantly differ. Compared with Latinos, Blacks and Asians had greater odds of a worse score on the sleep duration component; Blacks and Whites had greater odds of a worse score on the sleep disturbances component; and, Whites had greater odds of a worse score on the medication component. Risk factors for poor sleep did not differ by race/ethnic­ity except alcohol consumption (interaction P=.04), which was associated with poor sleep in Blacks only.Conclusion: In this cohort, racial/ethnic differences in sleep quality were com­mon. Ethn Dis. 2020;30(3):469-478; doi:10.18865/ed.30.3.469