Min Se Hee, Topaz Maxim, Lee Chiyoung, Schnall Rebecca
University of Pennsylvania School of Nursing, Philadelphia, PA, USA.
Columbia University School of Nursing, New York, NY, USA.
Clin Nurs Res. 2025 Jun 19:10547738251344980. doi: 10.1177/10547738251344980.
With aging, female older adults experience biochemical changes such as drop in their sex hormones and biomarkers and often encounter stress, which can be manifested in psychological symptoms. Previous literature has confirmed that racial/ethnic differences exist in the interactive relationship between sex hormones, biomarkers, and psychological symptoms. Yet, the racial/ethnic differences in their interactive relationship have not yet been examined. This is a secondary data analysis using the cross-sectional data of Wave II (2010-2011) from the National Social Life, Health, and Aging Project (NSHAP), and included 1,228 female older adults without moderate to severe cognitive impairment. Moderated network analysis was conducted with race as a moderator to examine the interactive relationship among sex hormones, biomarkers, and psychological symptoms and to compare the differences between the White and non-White group. The White group had a more positive relationship between total hemoglobin and cognition (edge weight = 0.18; moderated edge weight = 0.22). The non-White group had a positive relationship between progesterone and anxiety (edge weight = 0.05; moderated edge weight = 0.04) and between estradiol and cognition (edge weight = 0.03; moderated edge weight = 0.03), both of which were not present in the White group. We found a small moderated effect of race, and the strength of relationship among sex hormones, biomarkers, and psychological symptoms was different between the White and non-White group. Our study offers important preliminary findings to understand the potential racial/ethnic disparities that exist among sex hormones, biomarkers, and psychological symptoms in female older adults and the need to take an interactive approach.
随着年龄增长，老年女性会经历生化变化，如性激素和生物标志物水平下降，且常面临压力，这可能表现为心理症状。以往文献证实，性激素、生物标志物和心理症状之间的相互关系存在种族/民族差异。然而，它们相互关系中的种族/民族差异尚未得到研究。这是一项利用国家社会生活、健康与老龄化项目（NSHAP）第二波（2010 - 2011年）横断面数据进行的二次数据分析，纳入了1228名无中度至重度认知障碍的老年女性。以种族作为调节变量进行调节网络分析，以检验性激素、生物标志物和心理症状之间的相互关系，并比较白人群体和非白人群体之间的差异。白人群体中，总血红蛋白与认知之间的关系更为积极（边权重 = 0.18；调节边权重 = 0.22）。非白人群体中，孕酮与焦虑之间（边权重 = 0.05；调节边权重 = 0.04）以及雌二醇与认知之间（边权重 = 0.03；调节边权重 = 0.03）存在正相关关系，而白人群体中不存在这些关系。我们发现种族的调节作用较小，白人群体和非白人群体中性激素、生物标志物和心理症状之间的关系强度不同。我们的研究提供了重要的初步发现，有助于理解老年女性性激素、生物标志物和心理症状之间潜在的种族/民族差异，以及采取交互作用方法的必要性。
