The health status of racial and ethnic minority groups in the U.S. has improved steadily over the last century. Despite such progress, disturbing disparities in health persist between majority and minority populations. Demographic projections predict a substantial change in the racial and ethnic makeup of the older population, heightening the need to examine and reduce differences in health and life expectancy.
Assessing Cognitive Differences. Census data indicate that in the United States, Latinos have become the largest ethnic minority group, and it is important to understand their health needs. However, it may be difficult to assess the incidence of age-related conditions, particularly cognitive impairment, in this population, as many relevant neuropsychological instruments are inappropriate for studies of older Latinos. Last year investigators found that one test, the Spanish English Verbal Learning Test, is a valid and sensitive measure of cognitive functioning. More recently, the researchers determined that there may be a similar pattern of cognitive declines for verbal memory and expressive language and findings on brain imaging that predict declines in everyday functioning in both Hispanic and Caucasian older adults.
Racial Differences in Family Caregiving. Resources for Enhancing Alzheimer's Caregiver Health (REACH) is a unique, two phase, multisite research program sponsored by the NIA and the National Institute on Nursing Research to carry out social and behavioral research on interventions designed to enhance family caregiving for AD and related disorders. Recently, REACH investigators published two companion papers addressing the issue of racial differences in family caregiving. In one analysis, African-American caregivers reported lower anxiety, better well-being, less use of psychotropic medications, more benign appraisals of stress and perceived benefits of caregiving, and greater religious coping and participation than white caregivers. In the other study, Latina caregivers reported lower appraisals of stress, greater perceived benefits of caregiving, and greater use of religious coping than white caregivers. In addition, several differences emerged between less and more acculturated Latinas, emphasizing the need to examine heterogeneity among Latino caregivers.
The NIA is initiating a new project, “Promoting Research Participation Among Black and Hispanic Seniors.” Through data analyses, interviews of informed community members, and focus group discussions, this year-long project at the Yale-Older Americans Independence Center will identify characteristics of Black and Hispanic study participants and nonparticipants and develop recommended practices to improve and promote the recruitment and retention of Black and Hispanic older adults in aging-related research and studies of geriatric health conditions.
Innovations in Communications
NIHSeniorHealth.gov. Last year, the NIH launched NIHSeniorHealth.gov, a unique web site geared toward the health needs of older adults. Developed by the NIA and the National Library of Medicine, the content of this web site is easy for older persons to read, understand, remember, and navigate, using large print and short, easy-to-read segments of information repeated in a variety of formats—such as open-captioned videos and short quizzes—to increase the likelihood that it will be remembered. The site also has a Atalking@ function, allowing users the option of having the text read to them. The content focuses on health topics of particular interest to older people—AD and AD caregiving, arthritis, hearing loss, and several common types of cancer—and will be regularly expanded and updated.
In its first year, NIHSeniorHealth.gov was extremely successful, attracting some 380,000 unique visitors and garnering over three million page views. It was also one of six programs, and the only web site, to receive an “Industry Innovators Award” from the International Council on Active Aging. Recent innovations include a “printer-friendly” version of the online text, as well as more text sizing options. A “Share a Senior Exercise Story” feature, in which older adults will be invited to send in their stories and photos to serve as an inspiration to others, is planned, and a Spanish-language version of the site is also under development.
Meals on Wheels Initiative. During a 2002 Congressional hearing, it was recommended that NIA and the Administration on Aging (AoA) work together to disseminate research-based consumer education materials to the thousands of seniors who participate in the Meals-on-Wheels (MOW) program across the Nation. In participation with AoA, NIA conducted focus groups with the MOW Association of America to identify the types of information of greatest interest to MOW's clients and the best ways to deliver such information. Now, a new booklet entitled “Take Your Medicines the Right Way – Everyday!”, as well as a plastic cup with the same message, are being made available to MOW providers for their clients free of charge. The booklet is in easy-to-read language and covers important steps to help ensure safe and effective medication use.