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. 2023 Aug 18;79(1):gbad121. doi: 10.1093/geronb/gbad121

Table 3.

Moderated Mediation Analysis Examining Whether Indirect Effects via Biologic Aging of Perceived Neighborhood Problems on Incident Heart Failure Are Moderated by Psychosocial Risk and Resilience: ARIC–JHS Cohort 2000–2017 (N = 1,448)

Moderator: Negative affect Moderator: Optimism
Unadjusted Adjusted Unadjusted Adjusted
Path A β (95% CI) β (95% CI)
PNP (standardized) −0.08 (−0.31, −0.02) 0.30 (−0.11, 0.61) −0.02 (−0.17, 0.10) 0.36 (−0.03, 0.70)
Moderator (standardized) 0.70 (0.01, 1.35) 0.69 (0.16, 1.16) −0.72 (−1.42, 0.23) −0.11 (−0.56, 0.42)
PNP × Moderator 0.85 (0.34, 1.88) 0.77 (0.37, 1.26) 0.04 (−0.55, 1.11) −0.08 (−0.48, 0.59)
Path B HR (95% CI) HR (95% CI)
Biological aging (GrimAge) 1.07 (1.04, 1.10) 1.06 (1.02, 1.10) 1.06 (1.03, 1.09) 1.06 (1.01, 1.10)
Path C HR (95% CI) HR (95% CI)
PNP (standardized) 1.18 (1.01, 1.38) 1.16 (0.99, 1.34) 1.18 (1.00, 1.37) 1.16 (0.99, 1.34)
Moderated mediation HR (95% CI) HR (95% CI)
Direct effect 1.18 (1.01, 1.38) 1.16 (0.99, 1.34) 1.18 (1.00, 1.37) 1.16 (0.99, 1.34)
Indirect effect 1.00 (0.98, 1.00) 1.02 (1.00, 1.04) 1.00 (0.99, 1.01) 1.02 (1.00, 1.05)
Index of moderated mediation 1.06 (1.02, 1.11) 1.05 (1.01, 1.09) 1.00 (0.97, 1.07) 1.00 (0.98, 1.04)
Path A β (95% CI) β (95% CI)
PNP (Q2 vs Q1) 0.02 (−0.53, 0.34) 0.58 (−0.37, 2.27) −0.07 (−1.09, 0.20) 0.59 (−0.44, 2.28)
PNP (Q3 vs Q1) −0.17 (−0.72, 0.04) 0.77 (−0.06, 1.56) −0.12 (−0.64, 0.27) 0.87 (0.00, 1.66)
PNP (Q4 vs Q1) −0.03 (−1.06, 0.38) 1.00 (−0.18, 2.09) 0.08 (−0.59, 0.52) 1.11 (0.10, 2.39)
Moderator (standardized) −0.66 (−2.53, −0.16) −0.38 (−1.29, 0.10) −0.91 (−2.33, −0.39) 0.11 (−1.06, 0.61)
PNP (Q2 vs Q1) × Moderator 1.21 (−0.59, 4.28) 0.92 (−1.05, 2.09) −0.47 (−3.69, 1.83) −0.58 (−1.77, 1.14)
PNP (Q3 vs Q1) × Moderator 0.94 (-0.44, 2.64) 0.76 (-0.30, 1.98) 1.44 (-0.50, 3.31) 0.25 (-0.43, 1.40)
PNP (Q4 vs Q1) × Moderator 3.58 (2.08, 5.90) 2.71 (1.54, 3.93) -0.72 (-2.69, 1.29) -0.73 (-2.23, 0.83)
Path B HR (95% CI) HR (95% CI)
Biological aging (GrimAge) 1.07 (1.04, 1.10) 1.06 (1.02, 1.10) 1.06 (1.03, 1.09) 1.06 (1.01, 1.11)
Path C HR (95% CI) HR (95% CI)
PNP (Q2 vs Q1) 0.91 (0.53, 1.36) 0.89 (0.52, 1.40) 0.91 (0.53, 1.37) 0.90 (0.53, 1.42)
PNP (Q3 vs Q1) 1.12 (0.64, 1.67) 1.09 (0.62, 1.63) 1.11 (0.64, 1.64) 1.08 (0.63, 1.63)
PNP (Q4 vs Q1) 1.40 (0.76, 2.45) 1.35 (0.76, 2.22) 1.40 (0.77, 2.50) 1.34 (0.77, 2.22)
Moderated mediation HR (95% CI) HR (95% CI)
Direct effect (Q2 vs Q1) 0.91 (0.53, 1.36) 0.89 (0.52, 1.40) 0.91 (0.53, 1.37) 0.90 (0.53, 1.42)
Direct effect (Q3 vs Q1) 1.12 (0.64, 1.67) 1.09 (0.62, 1.63) 1.11 (0.64, 1.64) 1.08 (0.63, 1.63)
Direct effect (Q4 vs Q1) 1.40 (0.76, 2.45) 1.35 (0.76, 2.22) 1.40 (0.77, 2.50) 1.34 (0.77, 2.22)
Indirect effect (Q2 vs Q1) 1.00 (0.98, 1.02) 1.04 (0.99, 1.20) 1.00 (0.92, 1.01) 1.04 (0.98, 1.21)
Indirect effect (Q3 vs Q1) 0.99 (0.95, 1.00) 1.05 (1.00, 1.13) 0.99 (0.96, 1.02) 1.05 (1.00, 1.15)
Indirect effect (Q4 vs Q1) 1.00 (0.93, 1.02) 1.06 (0.99, 1.17) 1.01 (0.96, 1.03) 1.07 (1.00, 1.19)
Index of moderated mediation (Q2 vs Q1) 1.08 (0.96, 1.28) 1.06 (0.94, 1.19) 0.97 (0.77, 1.10) 0.97 (0.86, 1.05)
Index of moderated mediation (Q3 vs Q1) 1.06 (0.98, 1.21) 1.05 (0.99, 1.17) 1.09 (0.97, 1.26) 1.01 (0.97, 1.13)
Index of moderated mediation (Q4 vs Q1) 1.26 (1.14, 1.50) 1.18 (1.05, 1.36) 0.96 (0.85, 1.10) 0.96 (0.87, 1.04)

Notes: β = linear regression coefficient; ARIC = Atherosclerosis Risk in Communities; CI = confidence intervals; HR = hazard ratio; JHS = Jackson Heart Study; PNP = perceived neighborhood problems. The continuous exposure perceived neighborhood problems was calculated from a standardized multilevel categorical confirmatory factor analysis model with quartiles in the analytic sample ranging from −2.04 to 1.46 (Q1 = −2.04 to −0.56, Q2 = −0.55–0.00, Q3 = 0.01–0.55, Q4 = 0.56–1.4). The mediator GrimAge was computed from an epigenetic clock composite of DNAm-based markers for seven plasma proteins and self-reported smoking pack years. The moderator negative affect ranged from −1.71 to 4.83 and was calculated from a standardized single-level continuous confirmatory factor analysis model. The moderator optimism ranged from 6 to 24. One standard deviation is equal to 3.3. The outcome of adjudicated incident heart failure was determined from medical records. Parameter estimates generated by fitting a causal moderated mediation structural equation model. Coefficients (β) from Path A represent estimates from linear regression. Hazard ratios from all other paths represent estimates from cause-specific, Cox proportional hazards regression. Full-information maximum likelihood was employed to account for missing values. Adjusted model included sex and chronologic age at baseline.