Lincoln Karen D, Nguyen Ann W
Suzanne Dworak-Peck School of Social Work, University of Southern California, Los Angeles, USA.
Case Western Reserve University, Cleveland, Ohio, USA.
J Gerontol A Biol Sci Med Sci. 2022 Feb 3;77(2):e82-e88. doi: 10.1093/gerona/glab003.
Compared to Whites, African Americans have elevated risk for earlier onset fatal and nonfatal chronic conditions and accelerated aging. Despite these persistent race disparities, the causes remain poorly understood. The purpose of this study was to define a biopsychosocial risk typology that might explain accelerated aging in African Americans.
Analyses were based on the African American and White subsample of the Health and Retirement Study (N = 8269). Latent class analysis was used to identify risk types. Chronic health conditions, salivary telomere length (STL), emotional support from family, negative interaction with family, early life adversities, and discrimination were used as class indicators. Latent class multinomial logistic regression was used to identify racial and demographic differences in risk type membership.
Three distinct risk types were identified: high risk, health risk, and psychosocial risk. African Americans were more likely than Whites to be assigned to the high-risk type characterized by chronic health conditions, shorter STL, strained social relationships and high psychosocial stress. African Americans were less likely than Whites to be assigned to the health risk type characterized by chronic health conditions, shorter STL, optimal social relationships, and low psychosocial stress.
The biopsychosocial risk typology accounted for population heterogeneity, identified high-risk profiles, and modifiable factors within risk types that can inform current clinical interventions. The risk types also revealed different patterns of risk and resilience factors and shed light on the interplay between telomere length, stress exposure, chronic disease, and accelerated aging in African Americans.
与白人相比，非裔美国人患早发性致命和非致命慢性病以及加速衰老的风险更高。尽管这些种族差异一直存在，但其原因仍知之甚少。本研究的目的是定义一种生物心理社会风险类型，以解释非裔美国人的加速衰老现象。
分析基于健康与退休研究中的非裔美国人和白人子样本（N = 8269）。采用潜在类别分析来识别风险类型。慢性健康状况、唾液端粒长度（STL）、来自家庭的情感支持、与家人的负面互动、早年逆境和歧视被用作类别指标。潜在类别多项逻辑回归用于识别风险类型成员中的种族和人口统计学差异。
确定了三种不同的风险类型：高风险、健康风险和心理社会风险。与白人相比，非裔美国人更有可能被归为高风险类型，其特征为慢性健康状况、较短的STL、紧张的社会关系和高心理社会压力。与白人相比，非裔美国人被归为健康风险类型的可能性较小，该类型的特征为慢性健康状况、较短的STL、最佳的社会关系和低心理社会压力。
生物心理社会风险类型解释了人群异质性，识别了高风险概况以及风险类型中可改变的因素，可为当前的临床干预提供参考。这些风险类型还揭示了不同的风险和复原力因素模式，并阐明了非裔美国人中端粒长度、压力暴露、慢性病和加速衰老之间的相互作用。
