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.