Exploring the Moderation Effects of Race on the Relationship Among Sex Hormones, Biomarkers, and Psychological Symptoms in Female Older Adults

With aging, female older adults experience biochemical changes such as drop in their sex hormones and biomarkers and often encounter stress, which can be manifested in psychological symptoms. Previous literature has confirmed that racial/ethnic differences exist in the interactive relationship between sex hormones, biomarkers, and psychological symptoms. Yet, the racial/ethnic differences in their interactive relationship have not yet been examined. This is a secondary data analysis using the cross-sectional data of Wave II (2010-2011) from the National Social Life, Health, and Aging Project (NSHAP), and included 1,228 female older adults without moderate to severe cognitive impairment. Moderated network analysis was conducted with race as a moderator to examine the interactive relationship among sex hormones, biomarkers, and psychological symptoms and to compare the differences between the White and non-White group. The White group had a more positive relationship between total hemoglobin and cognition (edge weight = 0.18; moderated edge weight = 0.22). The non-White group had a positive relationship between progesterone and anxiety (edge weight = 0.05; moderated edge weight = 0.04) and between estradiol and cognition (edge weight = 0.03; moderated edge weight = 0.03), both of which were not present in the White group. We found a small moderated effect of race, and the strength of relationship among sex hormones, biomarkers, and psychological symptoms was different between the White and non-White group. Our study offers important preliminary findings to understand the potential racial/ethnic disparities that exist among sex hormones, biomarkers, and psychological symptoms in female older adults and the need to take an interactive approach.