Race/Ethnicity, Vascular Aging, and Mortality Risk: Evidence from the Health and Retirement Study

Abstract Vascular aging, which is associated with cardiovascular disease risk and mortality, is characterized by increasing arterial stiffness. The gold standard method for the assessment of arterial stiffness is carotid-femoral Pulse Wave Velocity (cfPWV). An emerging body of research suggests that cfPWV can be reasonably estimated from two commonly measured clinical variables—age and blood pressure. Thus, estimated Pulse Wave Velocity (ePWV) holds promise as a novel and easily obtained measure of arterial stiffness that can be used to study vascular aging, particularly with nationally representative datasets that collect biomarker data on sufficiently large sample sizes to examine race/ethnic differences. This analysis uses data from the 2006-2016 Health and Retirement Study to examine race/ethnic variation in the relationship between ePWV and mortality risk. We estimate logistic regression models predicting mortality over an eight-year period for four racial/ethnic groups: White, Black, Other, and Hispanic. Controls are included for sociodemographic characteristics, health status and behaviors, and blood biomarkers such as C-reactive protein, cystatin-C, hemoglobin A1c, total cholesterol and high-density lipoprotein (HDL) cholesterol. The results indicate ePWV increases the risk of mortality in the total sample and among each race/ethnic group, net the effect of age, systolic blood pressure, and diastolic blood pressure. Mechanisms that mediate this relationship are explored. The findings provide insight into vascular aging processes that influence mortality risk among race/ethnic groups.

Despite changes in the demography of older Black women who are living longer, there is limited research on how older Black women conceptualize and understand successful and healthy aging.The objective of this presentation is to interrogate the meaning and cultural aspects of aging among older Black women, gaining insight into how gender and race operate and intersect to shape experiences and perceptions of aging.Using an intersectionality framework, this qualitative study was conducted with three older Black women.The women ranged in age from 58-65 years old, each residing in an US urban city (Detroit, St. Louis, Atlanta).Data were collected between October and November 2020, using a semi-structured, open-ended interview protocol to encourage participants to provide in-depth descriptions of how they conceptualized aging.Interviews were between 2 -2.5 hours, conducted via videoconferencing, and audio-recorded for transcription.Participants discussed: the life experiences that have shaped their ability to age well; what it means to age well, and factors that might hinder someone from aging well.Transcripts were coded using a constructivist grounded theory approach.Results revealed six themes Black women in later life identify: aging well, aging as a mindset, independence and freedom, authenticity, personal control and preparation, and aging role models.This extends the knowledge base on how older Black women view aging and factors that enhance or diminish their ability to age well.Results from this study can be used to enhance the development of public health and social work interventions with older Black women.

RACE/ETHNICITY, VASCULAR AGING, AND MORTALITY RISK: EVIDENCE FROM THE HEALTH AND RETIREMENT STUDY
Kevin Heffernan, Janet Wilmoth, and Andrew London, Syracuse University, Syracuse, New York, United States Vascular aging, which is associated with cardiovascular disease risk and mortality, is characterized by increasing arterial stiffness.The gold standard method for the assessment of arterial stiffness is carotid-femoral Pulse Wave Velocity (cfPWV).An emerging body of research suggests that cfPWV can be reasonably estimated from two commonly measured clinical variablesage and blood pressure.Thus, estimated Pulse Wave Velocity (ePWV) holds promise as a novel and easily obtained measure of arterial stiffness that can be used to study vascular aging, particularly with nationally representative datasets that collect biomarker data on sufficiently large sample sizes to examine race/ ethnic differences.This analysis uses data from the 2006-2016 Health and Retirement Study to examine race/ethnic variation in the relationship between ePWV and mortality risk.We estimate logistic regression models predicting mortality over an eight-year period for four racial/ethnic groups: White, Black, Other, and Hispanic.Controls are included for sociodemographic characteristics, health status and behaviors, and blood biomarkers such as C-reactive protein, cystatin-C, hemoglobin A1c, total cholesterol and high-density lipoprotein (HDL) cholesterol.The results indicate ePWV increases the risk of mortality in the total sample and among each race/ethnic group, net the effect of age, systolic blood pressure, and diastolic blood pressure.Mechanisms that mediate this relationship are explored.The findings provide insight into vascular aging processes that influence mortality risk among race/ethnic groups.

RACIAL/ETHNIC DIFFERENCES IN THE LONGITUDINAL EFFECTS OF FEAR OF FALLING ON FALLS
Tuo Yu Chen, 1 and Giyeon Kim, 2 1. Taipei Medical University, Taipei, Taipei, Taiwan (Republic of China), 2.

Chung-Ang University, Seoul, Seoul-t'ukpyolsi, Republic of Korea
Research suggests that the effects of fear of falling on falls may differ by race/ethnicity.We investigated whether race/ ethnicity (White, Black, and Hispanic) moderated the longitudinal effects of fear of falling on the incidence of falling and having a repeated fall among community-dwelling older adults.We used data from 2011-2018 of the National Health and Aging Trends Study (NHATS).These included a total of 19,516 person-intervals from 5,113 respondents.Selfreported any fall in the past year was the outcome variable with baseline fear of falling as the predictor and race/ethnicity as the moderator.Known risk factors for falls were included as covariates.Results showed that among respondents without the experience of falling at baseline, baseline fear of falling significantly increased the odds of a newonset of fall at 1-year follow-up among Blacks, compared to Whites.Among respondents who already fell at baseline, baseline fear of falling significantly increased the odds of having a repeated fall later on among Hispanics, compared to Whites.Clear evidence of racial/ethnic differences was found in the relationship between fear of falling and falls among community-dwelling older adults in the U.S. Special attention should be paid to Black older adults with a fear of falling but have not fallen down recently and Hispanics with fear of falling and have fallen in the past year.Readily available educational programs should be actively advertised to older adults to reduce the fear of falling and culturally tailored educational programs should be developed for older adults from racial/ethnic minority backgrounds.

RELATIONSHIP BETWEEN MEANINGFUL ACTIVITY ENGAGEMENT AND WELL-BEING MODERATED BY RACE
Dugan O 'Connor, and Jennifer Smith, Mather, Evanston, Illinois, United States Engaging in meaningful activities has benefits for health and well-being in older adults; however, racial differences in meaning from activities have been observed.The current study examined how the relationship between engagement in a variety of meaningful activities and well-being differs for Black and White older adults.Participants (130 White and 101 Black older adults), ages 53 to 90 (M=69), completed an online survey that measured the extent to which engaging in various activities provided meaning or fulfillment as well as measures of purpose in life, positive affect, negative affect, and loneliness.Overall, the most meaningful activities included "spending time with family," "reading," and "being outdoors/experiencing nature."The least meaningful activities included "job/career," "caring for pets/animals," and "supporting a social or political cause."Black older adults reported greater meaning from "religious faith," "spiritual practices/meditation," "spending time with family," and "listening to music," and less meaning from "caring for pets/animals," compared to White older adults.A series of multiple regression analyses (with age, gender, education, and income