Plasma neurofilament light (NfL) is a marker for neurodegenerative diseases. Few studies have examined the association of NfL with middle-aged changes in cognitive performance, and no studies have examined differential NfL effects by race. Using data from the Healthy Aging in Neighborhoods of Diversity across the Life Span (HANDLS) study (n = 625, Agev1: 30–66 y, 41.6% male, 56.3% African American, 27.8% below poverty), we investigated the associations of initial NfL levels and annualized change with cognitive performance over time in global mental status, verbal and visual memory, fluency, attention, and executive function. We used ordinary least squares and mixed-effects regressions stratified by race, while exploring differential associations by age group, sex, and poverty status. Over a mean follow-up of 4.3 years, we found initial NfL level was associated with a faster decline on normalized mental status scores in Whites only and in those >50 years old. Annualized increase in NfL was associated with a greater decline in verbal fluency in men. In other exploratory analyses, annualized increase in NfL was associated with a slower decline in verbal memory among individuals living above poverty; in the older group (>50 years), first-visit NfL was linked with better performance at baseline in global mental status and verbal memory. In summary, first-visit NfL was primarily associated with the global mental status decline among Whites, while exhibiting inconsistent relationships in some exploratory analyses. Plasma NfL levels can be detected and quantified in non-demented middle-aged adults and changes can be analyzed over time. More longitudinal studies are needed to address the clinical utility of this biomarker for early cognitive defects.

Carotenoids may strengthen the association of antioxidant vitamins A, C, and E with favorable cognitive outcomes over time, though a few prospective studies have examined this hypothesis. We evaluated the longitudinal data from 1251 participants in the Healthy Aging in Neighborhoods of Diversity across the Life Span (HANDLS) study (Age at visit 1 in 2004–2009 (v₁): 30–65 years). Vitamins A, C, and E dietary intakes and total and individual dietary carotenoids were computed using two 24-h recalls at v₁. Cognitive tests, covering global mental status and domains of memory/learning, attention, psychomotor speed, visuo-spatial, language/verbal, and executive function were conducted at v₁ and/or v₂ (2009–2013); mean ± SD follow-up: 4.66 ± 0.93 years. Mixed-effects linear regression models detected an interaction between vitamin E and total (and individual) carotenoids for three of 11 cognitive tests at v₁, with only one meeting the statistical significance upon multiple testing correction whereby vitamin E was linked with greater verbal memory performance in the uppermost total carotenoid tertile (γ_0a = +0.26 ± 0.08, p = 0.002), a synergism largely driven by carotenoid lycopene. Vitamins A and C showed no consistent interactions with carotenoids. In conclusion, we provide partial evidence for synergism between vitamin E and carotenoids in relation to better baseline cognitive performance, pending further studies with time-dependent exposures and randomized trials directly examining this synergism.

Complex processes appear to link sleep duration and quality with dietary patterns. Numerous studies show healthful benefits of the Dietary Approaches to Stop Hypertension (DASH) diet, but few have examined its association with sleep duration or quality. The current study tested cross-sectional associations of DASH diet quality score with sleep quality among adults. Analyses of participants were from the 2005–2008 wave of the National Health and Nutrition Examination Surveys (n = 3941 adults ≥30 years of age, complete data). We performed sex- and age group-stratified multiple OLS regression analyses with DASH total score and components as main predictors and sleep quality as main outcomes, adjusting sequentially for socio-demographic, behavioral and health-related factors. Sex and age differences in associations of DASH with sleep quality, adjusting for covariates, were also examined by incorporating two-way interaction terms between sex/age and the DASH score in each unstratified model. We found that the DASH diet score was inversely related to poor sleep-related daytime dysfunction adjusted by age, sex, demographic and socio-economic factors. Some sex-specific associations were detected between DASH diet component scores and sleep quality. Notably, the potassium DASH component was inversely associated with Factor 1 (“sleepiness and sleep disturbance”) among women. The fiber DASH component was associated with better sleep quality and inversely related to Factor 2 (“sleep-related daytime dysfunction”) in younger subjects. This study indicates health benefits of the DASH diet for sleep duration and quality. Future longitudinal studies and randomized placebo-controlled trials are required to ascertain protective effects.

This study had three goals: 1) to examine the association between racial discrimination and intimate partner violence (IPV) perpetration; 2) to determine whether this relationship is explained by mental health (MH) symptoms; and 3) to determine whether these associations vary by poverty status or gender. During the Wave 4 (2013-2017) visit of the Healthy Aging in Neighborhoods of Diversity Longitudinal Study (HANDLS), Black adults who were in a relationship (N = 433; mean age = 55.26, SD = 9.30; 51% men) provided self-report data on IPV perpetration; frequency of racial discrimination; and levels of anxiety, depression, and post-traumatic stress symptoms. Multi-group mediation models used these cross-sectional data to test whether racial discrimination was associated with MH symptoms, which in turn were associated with IPV perpetration, determining the significance of direct and indirect pathways and whether any pathways varied by poverty status or gender. Racial discrimination was associated with more MH symptoms, which in turn was associated with IPV perpetration. The negative effect of discrimination on MH was stronger for Black women than Black men and for Black adults with household incomes below 125% of the Federal poverty line than those with incomes above this cutoff. Efforts to prevent and treat IPV in the Black community should address the negative effects of racial discrimination experiences on mental health and partner aggression, especially among those with multiply marginalized identities. IPV prevention efforts may be enhanced through an overarching commitment to dismantle structural racism and intersectional forms of oppression.

• National survey of COVID-19 vaccine intent among U.S. racial and ethnic groups. • American Indian/Alaska Native and Black groups were less likely than White persons. • Spanish-speaking Latino and Asian groups were more likely than White persons. • Vaccine concerns focused on side-effects, safety and effectiveness. • COVID-19 vaccine efforts must address public concerns and equity of vaccine access.

Purpose: Intimate partner violence (IPV) is a serious public health problem that disproportionately affects racial/ethnic minorities in the U.S. This study examines risk factors for IPV perpetration that are salient for racial/ethnic minorities; specifically, we test if racial/ethnic discrimination among Latino men is associated with IPV perpetration, if poor mental health (MH) mediates this link, and whether relationships differ by immigrant status. Methods: Using National Epidemiologic Survey on Alcohol and Related Conditions (NESARC-II) Wave 2 (2004–2005) data, multigroup structural equation modeling compared immigrant (N = 1187) and U.S.-born (N = 1077) Latinos on a mediation model whereby discrimination increases IPV risk via poor MH (anxiety, depression, post-traumatic stress (PTSS); alcohol dependence (AD) and drug dependence (DD)). Results: For U.S.-born Latinos, discrimination increased anxiety (β = 0.24, p < 0.001), depression (β = 0.16, p < 0.001), PTSS (β = 0.09, p < 0.001), AD (β = 0.11, p < 0.001) and DD (β = 0.16, p < 0.001); anxiety (β = 0.16, p < 0.001), AD (β = 0.19, p < 0.001) and DD (β = 0.09, p < 0.01) increased IPV risk. Among Latino immigrants, discrimination increased anxiety (β = 0.07, p < 0.001), depression (β = 0.16, p < 0.001), PTSS (β = 0.08, p < 0.001) and DD (β = 0.03, p < 0.001); PTSS (β = 0.16, p < 0.001), AD (β = 0.21, p < 0.001) and DD (β = 0.05, p < 0.01) increased IPV risk. Conclusions: Among Latino men, discrimination is associated with poorer MH and contributes to IPV perpetration; MH risk factors vary by immigrant status.