Financial Hardship and Age-Related Decrements in Kidney Function Among Black and White Adults in the Midlife in the United States Study.

IF 2.9 3区医学 Q2 PSYCHIATRY Psychosomatic Medicine Pub Date : 2024-06-01 Epub Date: 2023-11-10 DOI:10.1097/PSY.0000000000001263

Agus Surachman, Meera Harhay, Alexis R Santos, Jonathan Daw, Lacy M Alexander, David M Almeida, Christopher L Coe

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Abstract

Objective: This analysis examined if financial hardship was associated with age-related decrements in kidney function using a material-psychosocial-behavioral framework. We also tested if this association was mediated by comorbidity of cardiometabolic risk factors (obesity, elevated blood pressure, and insulin resistance).

Methods: Data from 1361 non-Hispanic Black and White adults (ages 26-94 years; non-Hispanic Black = 258) were obtained from the Wave 3 and Refresher phases of the Midlife in the United States project. Kidney function was based on serum creatinine-based estimated glomerular filtration rate (eGFR; Chronic Kidney Disease Epidemiology Collaboration formula without race adjustment). Financial hardship was evaluated in three domains: material (income to poverty line ratio, health insurance coverage, and public/government financial assistance), psychological (perceived financial status, control over financial status, and perceived financial strains), and behavioral responses (financial adjustment/coping such as sold possessions and cutting back on spending).

Results: More severe financial hardship (overall score and in each domain) was associated with age-related decrements in eGFR, even after adjusting for sociodemographic, education, and health-related covariates. The association between financial hardship and age-related decrements in eGFR was conditional on sex but not race. Finally, cardiometabolic risk factors mediated the association between financial hardship and age-related decrements in eGFR.

Conclusions: These findings affirm the negative effects of financial hardship on age-related decrements in renal clearance. In addition to incorporating traditionally used indicators of SES, such as education and income, future research on social hallmarks of aging should also consider the role of financial hardship on the aging process and age-related diseases.

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美国黑人和白人中年成年人的经济困难和年龄相关的肾功能下降(MIDUS)研究。

目的:本分析使用物质-心理-社会-行为框架检查经济困难是否与年龄相关的肾功能下降有关。我们还测试了这种关联是否由心血管代谢危险因素(肥胖、血压升高和胰岛素抵抗)的共病介导。方法:1361名非西班牙裔(NH)黑人和白人成年人(26-94岁;NH Black = 258)均来自美国MIDUS项目的Wave 3和Refresher阶段。肾功能以血清肌酐为基础估计肾小球滤过率(CKD-EPI公式，无种族调整)。经济困难在三个方面进行了评估:物质(收入与贫困线之比、健康保险覆盖率和公共/政府财政援助)、心理(感知的财务状况、对财务状况的控制和感知的财务压力)和行为反应(财务调整/应对，如变卖财产和削减支出)。结果:更严重的经济困难(总分和每个领域)与年龄相关的eGFR下降相关，即使在调整了社会人口统计学、教育和健康相关协变量后也是如此。经济困难与年龄相关的eGFR下降之间的联系与性别有关，而与种族无关。最后，心脏代谢危险因素介导了经济困难与年龄相关的eGFR下降之间的关联。结论:这些发现证实了经济困难对年龄相关性肾清除率下降的负面影响。除了纳入教育和收入等传统上使用的社会经济地位指标外，未来关于老龄化的社会特征的研究还应考虑经济困难对老龄化进程和与年龄有关的疾病的作用。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Psychosomatic Medicine 医学-精神病学

CiteScore

5.10

自引率

0.00%

发文量

258

审稿时长

4-8 weeks

期刊介绍： Psychosomatic Medicine is the official peer-reviewed journal of the American Psychosomatic Society. The journal publishes experimental, clinical, and epidemiological studies on the role of psychological and social factors in the biological and behavioral processes relevant to health and disease. Psychosomatic Medicine is an interdisciplinary peer-reviewed journal devoted to high-quality science on biobehavioral mechanisms, brain-behavior interactions relevant to physical and mental disorders, as well as interventions in clinical and public health settings. Psychosomatic Medicine was founded in 1939 and publishes interdisciplinary research articles relevant to medicine, psychiatry, psychology, and other health-related disciplines. The print journal is published nine times a year; most articles are published online ahead of print. Supplementary issues may contain reports of conferences at which original research was presented in areas relevant to the psychosomatic and behavioral medicine.