RACE AND STRESS IN THE INCIDENCE OF HERPES-ZOSTER IN OLDER ADULTS

OBJECTIVES: To examine the effect of black race and acute (negative li fe events) and chronic (lack of social support) psychological stress o n the risk of herpes tester in late life. DESIGN: A population-based, prospective cohort study. SETTING: Central North Carolina PARTICIPANTS : Duke Established Populations for Epidemiological Studies of the Elde rly, a stratified probability sample of community-dwelling persons mor e than 65 years of age. MEASUREMENTS: Interviewers administered a comp rehensive health survey to the participants in 1986-1987 (P1, n = 4162 ), 1989-1990 (P2, n = 3336), and 1992-1994 (P3, n = 2568). Incident ca ses of tester between P1 and P2 and P2 and P3 served as the dependent variable. Hypothesis-testing variables included race, negative life ev ents, and five measures of social support. Control variables included age, sex, education, cancer, chronic diseases, basic ADLs, instrumenta l ADLs, depression, self-rated health, hospitalization, and cigarette smoking. Statistical analyses employed chi-square tests and proportion al hazards model. RESULTS: At baseline, the sample had a mean age of 7 3.6 years and was 55% black, 45% white, and 65% female. There were 65 cases of tester between P1 and P2 and 102 cases of tester between P2 a nd P3. From P1 to P2, 1.4% of blacks and 3.4% of whites developed test er (P < .001). From P2 to P3, 2.9% of blacks and 7.5% of whites develo ped tester (P < .001). After controlling for the above variables, blac ks were significantly less likely to develop tester (adjusted risk rat io = 0.35; 95% confidence interval (CI), 0.24-0.51; P < .001). Negativ e life events increased the risk of tester, but the result was borderl ine for statistical significance (adjusted RR = 1.38, 95% CI 0.96-1.97 ; P = .078). No measures of social support were significantly associat ed with tester. CONCLUSION: Black race decreased the risk of tester in late life significantly. Measures of stress were not significantly re lated to tester, but study limitations preclude definitive conclusions . Future research should focus on these factors in larger samples and different populations.