Glycosylated Hemoglobin Level,Race/Ethnicity,and Cognition in Midlife and Early Old Age

Empirical evidence linking racial/ethnic differences in glycosylated hemoglobin levels (HbA1c) to cognitive function in midlife and early old age is limited. We use biomarker data from the Health and Retirement Study (HRS, 2006–2014), on adults 50–64 years at baseline (57–73 years by 2014), and fit multinomial logistic regression models to assess the association between baseline HbA1c, cognitive function (using Langa–Weir classifications) and mortality across 8 years. Additionally, we test for modification effects by race/ethnicity. In age- and sex-adjusted models high HbA1c level was associated with lower baseline cognition and higher relative risk ratios (RRR; vs. normal cognition) for cognitive impairment no dementia (CIND; RRR = 2.3; 95%CI = [1.38;3.84]; p < .01), and dementia (RRR = 4.00; 95%CI = [1.76;9.10]; p < .01). Adjusting for sociodemographic, behavioral risk factors, and other health conditions explained the higher RRR for CIND and attenuated the RRR for dementia by approximately 30%. HbA1c levels were not linked to the slope of cognitive decline, and we found no evidence of modification effects for HbA1c by race/ethnicity. Targeting interventions for glycemic control in the critical midlife period can protect baseline cognition and buffer against downstream development of cognitive impairment. This can yield important public health benefits and reductions in burdens associated with cognitive impairment, particularly among race/ethnic minorities who are at higher risk for metabolic diseases.     

Sexual Assault in Intimate Relationships: Introduction to Special Issue

ABSTRACT

The 13 articles in this special issue draw from the experience of women and men in Australia, Canada, Denmark, India, Micronesia, Sierra Leone, Tanzania, Vietnam, and the US to shed light on the complex problem of accounting for Intimate Partner Sexual Violence (IPSV) in a globalizing world. As a collection, the articles draw from qualitative methodologies in social science and humanities privileging local narratives drawn through interviews, focus groups, participant observation and historical surveys. This special issue presents articles from multiple disciplinary vantage points that seek to bring to the fore insight drawn from the close reading of sexual violence in varied global cultural contexts. The collection of articles challenges the idea that there is a universal way to understand and measure IPSV. Together the articles demonstrate key elements of the disconnect between local understandings and the assumed universality of concepts that undergird most sexual violence research. Congruent with our previous work, the challenge of the work in the cross-cultural perspective taken by this special issue lies in the acknowledgement that the ways we account for and define sexual violence in intimate (dating, cohabiting and marital) relationships is culturally-situated and must be contextualized as such. This cross-cultural perspective values the conceptual insight that can be drawn from cultural difference and pushes against a homogenization of notions of sexual violence in studies within global societies as well as those that work to compare them.