Perceived discrimination and blood pressure in individuals aging with traumatic brain injury.

Rachel A. Bernier, Umesh M. Venkatesan, José A. Soto, Amanda R. Rabinowitz, Justin S. Hong, Frank G. Hillary

Research output: Contribution to journalArticlepeer-review

Abstract

Purpose/Objective: Older adults with a history of traumatic brain injury (TBI) remain an understudied population, resulting in a paucity of geriatric-specific guidelines. Given an increased vascular risk among older adults with TBI, we aimed to examine distal predictors of vascular health in this population. Specifically, we sought to compare levels of perceived discrimination in Black and White older adults with a history of complicated mild, moderate, or severe TBI, and to examine the relationship between levels of discrimination and pulse pressure, a measure of vascular health. Research Method/Design: Self-report measures of everyday discrimination (ED) and major experiences of discrimination (MED) were completed by 106 individuals aging with TBI (27 identified as Black, 79 identified as White). Resting blood pressure was collected during the assessment. Results: MED, but not ED, was significantly higher among Black individuals versus White individuals aging with TBI. Greater MED was significantly associated with higher pulse pressure independent of race and antihypertensive medication status. There was a marginally significant race by MED interaction, where the association between MED and pulse pressure was observed in Black individuals but not White individuals. Injury severity was not associated with pulse pressure, nor were there significant severity by discrimination interactions on pulse pressure. Conclusions/Implications: Discrimination, which may arise from multiple sources of bias (e.g., related to race, disability), is associated with vascular burden. These findings suggest that patients’ experiences of discrimination should be addressed as a factor that contributes to health and well-being in brain injury rehabilitation. (PsycInfo Database Record (c) 2021 APA, all rights reserved) Impact and Implications—We aimed to examine perceived major and everyday experiences of discrimination in a sample of Black and White individuals aging with traumatic brain injury (TBI) and its potential link with vascular health. We found that Black individuals aging with TBI reported higher levels of major experiences of discrimination compared to White individuals, and that level of major experiences of discrimination was associated with pulse pressure, a measure of vascular health, independent of race and antihypertensive medication use. These findings highlight the importance of considering the experience of discrimination of individuals aging with TBI as a factor that may impact patient cardiovascular health. (PsycInfo Database Record (c) 2021 APA, all rights reserved)

Original languageEnglish (US)
JournalRehabilitation Psychology
DOIs
StateAccepted/In press - 2021

All Science Journal Classification (ASJC) codes

  • Physical Therapy, Sports Therapy and Rehabilitation
  • Rehabilitation
  • Clinical Psychology
  • Psychiatry and Mental health

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