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Doyle C, Andel R, Saenz J, Crowe M. Correlates of SuperAging in Two Population-Based Samples of Hispanic Older Adults. J Gerontol B Psychol Sci Soc Sci 2024; 79:gbae058. [PMID: 38581241 PMCID: PMC11075730 DOI: 10.1093/geronb/gbae058] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/15/2023] [Indexed: 04/08/2024] Open
Abstract
OBJECTIVES "SuperAgers" are generally defined as people 80+ years old with episodic memory performance comparable to those 20 years younger. Limited knowledge exists to describe characteristics of SuperAgers, with even less known about Hispanic SuperAgers. METHODS We examined indicators of cognitive, physical, and psychological resilience in relation to the likelihood of being a SuperAger using data from 2 population-based studies of Hispanic older adults (Puerto Rican Elderly: Health Conditions [PREHCO] Study; Health and Retirement Study [HRS]). SuperAgers were defined as (1) ≥80 years old, (2) recall scores ≥ the median for Hispanic respondents aged 55-64, and (3) no cognitive impairment during the observation period. Overall, 640 PREHCO participants and 180 HRS participants were eligible, of whom 45 (7%) and 31 (17%) met SuperAging criteria. RESULTS Logistic regressions controlling for age and sex demonstrated that higher education (PREHCO: odds ratio [OR] = 1.20, p < .001; HRS: OR = 1.14, p = .044) and fewer instrumental activities of daily living limitations (PREHCO: OR = 0.79, p = .019; HRS: OR = 0.58, p = .077; cognitive resilience), fewer activities of daily living limitations (PREHCO: OR = 0.72, p = .031; HRS: OR = 0.67, p = .068; physical resilience), and fewer depressive symptoms (PREHCO: OR = 0.84, p = .015; HRS: OR = 0.69, p = .007; psychological resilience) were associated with SuperAging, although not all results reached threshold for statistical significance, presumably due to low statistical power. Additionally, known indicators of physical health (e.g., chronic conditions and self-rated health) did not relate to SuperAging. DISCUSSION Increasing access to education and recognizing/treating depressive symptoms represent potential pathways to preserve episodic memory among older Hispanic adults.
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Affiliation(s)
- Cassidy Doyle
- School of Aging Studies, University of South Florida, Tampa, Florida, USA
| | - Ross Andel
- Edson College of Nursing and Health Innovation, Arizona State University, Phoenix, Arizona, USA
- Memory Clinic, Department of Neurology, Second Faculty of Medicine, Charles University and Motol University Hospital, Prague, Czech Republic
| | - Joseph Saenz
- Edson College of Nursing and Health Innovation, Arizona State University, Phoenix, Arizona, USA
| | - Michael Crowe
- Department of Psychology, University of Alabama at Birmingham, Birmingham, Alabama, USA
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Zhang Y, Yu G, Bai W, Wu S, Geng X, Zhang W, Liu Y, Meng Y, Gao J, Li W, Kou C. Association of depression and sleep quality with frailty: a cross-sectional study in China. Front Public Health 2024; 12:1361745. [PMID: 38645453 PMCID: PMC11026860 DOI: 10.3389/fpubh.2024.1361745] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/26/2023] [Accepted: 03/21/2024] [Indexed: 04/23/2024] Open
Abstract
Background With the rapid growth of global aging, frailty has become a serious public health burden, affecting the life quality of older adults. Depressive symptoms (depression hereafter) and sleep quality are associated with frailty, but the pathways in which sleep quality and depression affect frailty remain unclear. Method This cross-sectional study included 1866 community-dwelling older adults. Demographic characteristics and health-related data of them was collected, and we also assessed frailty, depression, and sleep quality. Descriptive statistics were carried out and ordinal logistic regression analysis was used to identify the factors correlated with frailty. Spearman correlation analysis and mediation analysis were employed to assess associations between sleep quality, depression and frailty. Two-sided p < 0.05 was considered as significant. Results The results showed that 4.1% older adults were frail and 31.0% were pre-frail. Ordinal logistic regression showed that age, consumptions of vegetables, exercise, sleep quality, depression, number of chronic diseases, chronic pain, and self-rated health were correlated with frailty. Spearman correlation analysis revealed that frailty was associated with depression and sleep quality. There was a mediation effect that sleep quality was a significant and positive predictor of frailty (total effect = 0.0545, 95% boot CI = 0.0449-0.0641), and depression was a mediator between sleep quality and frailty (mediation effect = 60.4%). Conclusion Depression and poor sleep quality may be early indicators of frailty in older adults. Improving the sleep quality and psychological state of older adults can improve frailty, which is beneficial for healthy aging.
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Affiliation(s)
- Yue Zhang
- Department of Epidemiology and Biostatistics, School of Public Health, Jilin University, Changchun, Jilin, China
| | - Ge Yu
- Department of Epidemiology and Biostatistics, School of Public Health, Jilin University, Changchun, Jilin, China
| | - Wei Bai
- Department of Epidemiology and Biostatistics, School of Public Health, Jilin University, Changchun, Jilin, China
| | - Songyu Wu
- Department of Epidemiology and Biostatistics, School of Public Health, Jilin University, Changchun, Jilin, China
| | - Xiaohan Geng
- Department of Epidemiology and Biostatistics, School of Public Health, Jilin University, Changchun, Jilin, China
| | - Wangyi Zhang
- Department of Epidemiology and Biostatistics, School of Public Health, Jilin University, Changchun, Jilin, China
| | - Yihang Liu
- Department of Epidemiology and Biostatistics, School of Public Health, Jilin University, Changchun, Jilin, China
| | - Yujiao Meng
- Department of Epidemiology and Biostatistics, School of Public Health, Jilin University, Changchun, Jilin, China
| | - Junling Gao
- School of Public Health, Fudan University, Shanghai, China
| | - Wenjun Li
- Department of Social Medicine and Health Management, School of Public Health, Jilin University, Changchun, Jilin, China
| | - Changgui Kou
- Department of Epidemiology and Biostatistics, School of Public Health, Jilin University, Changchun, Jilin, China
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Angel JL, Angel RJ, Aguila E. Privatizing Responsibility for Old Age Security. THE PUBLIC POLICY AND AGING REPORT 2024; 34:27-30. [PMID: 38371943 PMCID: PMC10874180 DOI: 10.1093/ppar/prad033] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/12/2023] [Indexed: 02/20/2024]
Affiliation(s)
- Jacqueline L Angel
- LBJ School of Public Affairs, The University of Texas at Austin, Austin, Texas, USA
| | - Ronald J Angel
- Department of Sociology, The University of Texas at Austin, Austin, Texas, USA
| | - Emma Aguila
- Sol Price School of Public Policy, University of Southern California, Los Angeles, California, USA
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Ambriz E, De Pierola C, Calderon NM, Calderon L, Kogut K, Deardorff J, Torres JM. Definitions of successful aging among middle-aged Latinas residing in a rural agricultural community. PLoS One 2023; 18:e0294887. [PMID: 38032988 PMCID: PMC10688629 DOI: 10.1371/journal.pone.0294887] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/15/2022] [Accepted: 11/11/2023] [Indexed: 12/02/2023] Open
Abstract
INTRODUCTION Latinos are the fastest growing aging population in the U.S. However, there has been limited attention to conceptualizing successful aging among Latinos, especially those residing in rural communities. Latinos are the largest racial or ethnic group residing in rural underserved communities and rural Latinos experience significant structural barriers to access the conditions they need to age well. The goal of this study is to make unique contributions to the successful aging literature by describing what successful aging means for middle-aged Latinas residing in a rural community. METHODS This qualitative paper used inductive thematic content analysis to examine definitions of successful aging among Latina women (n = 40) residing in an underserved agricultural community and entering mid-life (mean = 49 years old; age range 40-64). RESULTS With regards to definitions of successful aging, four themes emerged: 1) Having good health; 2) maintaining an active lifestyle; 3) the wellbeing of one's children; and 4) being independent. DISCUSSION Participants' definitions of successful aging aligned to some extent with existing frameworks, specifically related to health and independence. However, middle-aged Latina participants' unique definitions of successful aging also diverged from existing frameworks, especially around the wellbeing of their children and the importance of work as a way of maintaining an active lifestyle. More research is needed to understand the unique social context and circumstances of middle-aged Latinos residing in rural communities and how they influence their aging journeys. This can provide important information for the development of culturally sensitive services, interventions, and policies to help Latinos age well.
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Affiliation(s)
- Elizabeth Ambriz
- Department of Epidemiology & Biostatistics, University of California San Francisco, San Francisco, California, United States of America
| | - Camila De Pierola
- School of Public Health, University of California Berkeley, Berkeley, California, United States of America
| | - Norma M. Calderon
- Center for Environmental Research and Community Health (CERCH), University of California Berkeley, Berkeley, California, United States of America
| | - Lucia Calderon
- Department of Epidemiology & Biostatistics, University of California San Francisco, San Francisco, California, United States of America
| | - Katherine Kogut
- School of Public Health, University of California Berkeley, Berkeley, California, United States of America
| | - Julianna Deardorff
- School of Public Health, University of California Berkeley, Berkeley, California, United States of America
| | - Jacqueline M. Torres
- Department of Epidemiology & Biostatistics, University of California San Francisco, San Francisco, California, United States of America
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Stroope S, Kroeger RA. Age Changes in Religious Service Attendance in Mexican American Older Adults: A Growth Curve Analysis. J Aging Health 2023:8982643231219034. [PMID: 38008951 DOI: 10.1177/08982643231219034] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2023]
Abstract
OBJECTIVES This study examines age patterns in religious attendance in older Mexican Americans. Previous research has focused on majority-white samples, limiting generalizability to other groups. Research in ethnic minority populations is needed. METHODS We descriptively analyze Hispanic Established Population for the Epidemiological Study of the Elderly (Hispanic EPESE) data and estimate a mixed effects linear growth curve model to assess the relationship between age and religious attendance. Results: Descriptive results reveal an inverse U-shaped pattern of religious attendance. Results from the growth curve model indicate rising religious attendance after age 65 and a decline after the mid-70s, an earlier decline compared to majority-white studies. Discussion: These findings have implications for individual well-being, the functioning of religious congregations, and for understanding the patterning of a salient form of social participation among older adults. Further research is needed to explore the underlying mechanisms and to examine religious attendance patterns in understudied populations.
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Affiliation(s)
- Samuel Stroope
- Department of Sociology, Louisiana State University, Baton Rouge, LA, USA
| | - Rhiannon A Kroeger
- Department of Sociology, Louisiana State University, Baton Rouge, LA, USA
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Quiñones AR, McAvay G, Vander Wyk B, Han L, Nagel C, Allore HG. A Joint Model for Disability, Self-Rated Health, and Mortality Among Medicare Beneficiaries-Differences by Chronic Disease and Race/Ethnicity. J Aging Health 2023:8982643231210027. [PMID: 37879084 DOI: 10.1177/08982643231210027] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2023]
Abstract
OBJECTIVES Quantifying interdependence in multiple patient-centered outcomes is important for understanding health declines among older adults. METHODS Medicare-linked National Health and Aging Trends Study data (2011-2015) were used to estimate a joint longitudinal logistic regression model of disability in activities of daily living (ADL), fair/poor self-rated health (SRH), and mortality. We calculated personalized concurrent risk (PCR) and typical concurrent risk (TCR) using regression coefficients. RESULTS For fair/poor SRH, highest odds were associated with COPD. For mortality, highest odds were associated with dementia, hip fracture, and kidney disease. Dementia and hip fracture were associated with highest odds of ADL disability. Hispanic respondents had highest odds of ADL disability. Hispanic and NH Black respondents had higher odds of fair/poor SRH, ADL disability, and mortality. PCRs/TCRs demonstrated wide variability for respondents with similar sociodemographic-multimorbidity profiles. DISCUSSION These findings highlight the variability of personalized risk in examining interdependent outcomes among older adults.
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Affiliation(s)
- Ana R Quiñones
- Department of Family Medicine, Oregon Health & Science University, Portland, OR, USA
- OHSU-PSU School of Public Health, Portland, OR, USA
| | - Gail McAvay
- Section of Geriatrics, Department of Internal Medicine, Yale School of Medicine, New Haven, CT, USA
| | - Brent Vander Wyk
- Section of Geriatrics, Department of Internal Medicine, Yale School of Medicine, New Haven, CT, USA
| | - Ling Han
- Section of Geriatrics, Department of Internal Medicine, Yale School of Medicine, New Haven, CT, USA
| | - Corey Nagel
- College of Nursing, University of Arkansas for Medical Sciences, Little Rock, AR, USA
| | - Heather G Allore
- Section of Geriatrics, Department of Internal Medicine, Yale School of Medicine, New Haven, CT, USA
- Department of Biostatistics, Yale University, New Haven, CT, USA
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Harrison TC, Taylor JL, Johnson A, Ortega LC, Lowe J, Blozis S. The Life-Course Perspectives of Mexican American Men With Mobility Limitation. QUALITATIVE HEALTH RESEARCH 2023; 33:897-910. [PMID: 37420336 PMCID: PMC10564382 DOI: 10.1177/10497323231170157] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 07/09/2023]
Abstract
The life-history narratives of 10 Mexican American men with mobility limitations, age 55-77 years (mean = 63.8, SD = 5.8), were explored using a qualitatively driven, life-history mixed-methods study to understand perceptions of mobility limitations over the life course. Within that methodological and paradigmatic framework, conceptualizations of alterity and masculinity guided interpretation of data. Through an iterative, thematic analysis, we detail the way the men's lives were influenced by growing familial responsibility with age. Quantitative data were integrated into themes of narrative inheritance, family, and masculinity. It was posited that masculinity with mobility limitations shaped and was shaped by ethnic identity and responsibility. This has implications for understanding the experience of Mexican American men over the life course.
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Garcia MA, Diminich ED, Lu P, Arévalo SP, Sayed L, Abdelrahim R, Ajrouch KJ. Caregiving for Foreign-Born Older Adults With Dementia. J Gerontol B Psychol Sci Soc Sci 2023; 78:S4-S14. [PMID: 36409465 PMCID: PMC10010468 DOI: 10.1093/geronb/gbac153] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/11/2022] [Indexed: 11/22/2022] Open
Abstract
OBJECTIVES This study examines how nativity, dementia classification, and age of migration (AOM) of older foreign-born (FB) adults are associated with caregiver psychological well-being and care burden. METHODS We used linked data from Round 1 and Round 5 of the National Health and Aging Trends Study and Round 5 of the National Study of Caregiving for a sample of nondementia caregivers (n = 941), dementia caregivers (n = 533), and matched care recipients. Ordinary least squares regression models were estimated, adjusting for caregiver characteristics. RESULTS Relative to nondementia caregivers, dementia caregivers were more likely to provide care for an older FB adult (8.69% vs. 26.70%), reported more assistance with caregiving activities, worse quality of relationship with care recipients, and higher care burden than nondementia caregivers. In adjusted models, interactions of nativity status × dementia and AOM × dementia revealed that overall, caregivers of older FB adults with dementia who migrated in late life (50+) reported lower psychological well-being than those caring for older FB older adults who migrated at (20-49 years) and (0-19 years). Moderating effects of AOM on the link between dementia caregiving and care burden were not observed. DISCUSSION Age of migration of older FB adults with probable dementia may have unique effects on the caregiver's psychological well-being. Our results underscore the importance of considering sociocultural factors of FB adults beyond nativity and the need for research to develop culturally appropriate interventions to enhance psychological well-being and reduce the care burden among dementia caregivers.
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Affiliation(s)
- Marc A Garcia
- Lerner Center for Public Health Promotion, Maxwell School of Citizenship and Public Affairs, Syracuse University, Syracuse, New York, USA
- Aging Studies Institute, Maxwell School of Citizenship and Public Affairs, Syracuse University, Syracuse, New York, USA
- Department of Sociology, Maxwell School of Citizenship and Public Affairs, Syracuse University, Syracuse, New York, USA
| | - Erica D Diminich
- Department of Family, Population and Preventive Medicine, Program in Public Health, Stony Brook University, Stony Brook, New York, USA
| | - Peiyi Lu
- Department of Epidemiology, Mailman School of Public Health, Columbia University, New York, New York, USA
| | - Sandra P Arévalo
- Human Development Department, California State University Long Beach, Long Beach, California, USA
| | - Linda Sayed
- Department of Comparative Cultures and Politics, James Madison College, Michigan State University, East Lansing, Michigan, USA
| | - Randa Abdelrahim
- Department of Disability Studies, School of Applied Health Sciences, University of Illinois–Chicago, Chicago, Illinois, USA
| | - Kristine J Ajrouch
- Department of Sociology, Anthropology and Criminology, Eastern Michigan University, Ypsilanti, Michigan, USA
- Life Course Development Program, Institute for Social Research, University of Michigan, Ann Arbor, Michigan, USA
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Garcia MA, Tarraf W, Reyes AM, Chiu CT. Gender, Age of Migration, and Cognitive Life Expectancies Among Older Latinos: Evidence From the Health and Retirement Study. J Gerontol B Psychol Sci Soc Sci 2022; 77:e226-e233. [PMID: 36107795 PMCID: PMC9799185 DOI: 10.1093/geronb/gbac133] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2022] [Indexed: 02/06/2023] Open
Abstract
OBJECTIVES Migration and gender are important factors that differentiate the Latino immigrant experience in the United States. We investigate the association between nativity status, age of migration, and cognitive life expectancies among a nationally representative sample of Latino adults aged 50 and older to explore whether age of migration and gender influence cognitive aging across the life course. METHODS This study used data from the Health and Retirement Study (1998-2016) to estimate Sullivan-based life tables of cognitive life expectancies by nativity, age of migration, and gender for older Latino adults. Cognitive status was based on the Langa-Weir algorithm. We test for both within-group (i.e., nativity and age of migration) and gender differences to explore the overall burden of disease among this rapidly growing population. RESULTS Foreign-born Latinos, regardless of age of migration or gender, spend a greater number of years after age 50 with cognitive impairment/no dementia than U.S.-born Latinos. However, the number of years spent with dementia varied by subgroup with midlife immigrant men and late-life immigrant men and women exhibiting a significant disadvantage relative to the U.S.-born. Furthermore, we document a gender disadvantage for all Latino women, regardless of immigrant status. DISCUSSION The robust relationship between nativity, age of migration, and cognitive aging suggests that older foreign-born Latinos experiencing cognitive decline may place serious burdens on families. Future research should target the needs of different subgroups of older Latinos who are entering their last decades of life to develop culturally appropriate long-term care programs.
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Affiliation(s)
- Marc A Garcia
- Lerner Center for Public Health Promotion, Aging Studies Institute, Department of Sociology, and Maxwell School of Citizenship & Public Affairs, Syracuse University, Syracuse, New York, USA
| | - Wassim Tarraf
- Wayne State University, Institute of Gerontology & Department of Healthcare Sciences, Detroit, Michigan, USA
| | - Adriana M Reyes
- Brooks School of Public Policy, Cornell University, Ithaca, New York, USA
| | - Chi-Tsun Chiu
- Institute of European and American Studies, Academia Sinica, Taipei, Taiwan
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Luck J, Govier D, Ðoàn LN, Mahakalanda S, Zhang W, Mendez-Luck C. Functional Limitations and Physical Health in Community-Dwelling Medicare Advantage Beneficiaries: Variation by Race and Hispanic Subgroup. J Aging Health 2022; 34:1269-1280. [PMID: 36175065 DOI: 10.1177/08982643221113133] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Objectives: The objective is to examine racial and ethnic heterogeneity in older adults' functional limitations and physical health. Methods: Data were from 2011 to 2015 Health Outcomes Survey of Medicare Advantage beneficiaries 65 and older (N = 828,946). Outcomes were Physical Component Summary (PCS) scores and need for assistance with activities of daily living (ADLs). Six non-Hispanic racial groups and five Hispanic subgroups were analyzed. Regression models adjusted for sociodemographic and health characteristics. Results: White and Asian respondents had the lowest unadjusted ADL difficulty rates and highest PCS scores. In adjusted analyses, Cuban respondents had the highest PCS scores and lowest rates of any ADL difficulty; White respondents had the lowest rates of specific ADL difficulties. Native Hawaiian or other Pacific Islander and multiple Hispanic respondents had the highest ADL difficulty rates. Discussion: Both the healthiest and highest need subgroups of Medicare Advantage beneficiaries were Hispanic. Understanding racial and ethnic subgroup differences may help target interventions to prevent or aid with functional limitations.
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Affiliation(s)
- Jeff Luck
- College of Public Health and Human Sciences, 51174Oregon State University, Corvallis, OR, USA
| | - Diana Govier
- College of Public Health and Human Sciences, 51174Oregon State University, Corvallis, OR, USA
| | - Lan N Ðoàn
- Department of Population Health, Section for Health Equity, 2694NYU Grossman School of Medicine, New York, NY, USA
| | - Shyama Mahakalanda
- College of Public Health and Human Sciences, 51174Oregon State University, Corvallis, OR, USA
| | - Wei Zhang
- College of Public Health and Human Sciences, 51174Oregon State University, Corvallis, OR, USA
| | - Carolyn Mendez-Luck
- College of Public Health and Human Sciences, 51174Oregon State University, Corvallis, OR, USA
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Angel JL, Rote S, Vega WA, Kim J, Chiu CT, Aranda M, Wang J. Duration of Dementia and Social Service Use in the U.S.-Born and Foreign-Born Mexican-American Population. J Aging Health 2022; 34:1291-1301. [DOI: 10.1177/08982643221125845] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Objective The study estimates the number of years after age 65 that Mexican Americans live with likely dementia and the impact of dementia on community-based services (CBS) use by nativity. Methods Using the Hispanic Established Populations for the Epidemiologic Studies of the Elderly Sullivan methods are employed to predict duration of dementia and logistic regressions identify the predictors of service utilization. Results Foreign-born women spend more years than other groups with dementia. The foreign-born are more likely to use out-of-home services, whereas U.S.-born are more likely to use in-home services. The foreign-born with dementia of relatively recent onset had the highest probability of service use. Discussion Given the high cost of institutional care and availability of family caregivers, community-based services are a potentially useful alternative for the growing Mexican-American population living with dementia. Expanded Medicaid and CBS programs could be an equitable and cost-effective alternative that should be investigated.
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Affiliation(s)
- Jacqueline L. Angel
- Lyndon B. Johnson School of Public Affairs, Center on Aging and Population Sciences, The University of Texas at Austin, Austin, TX, USA
| | - Sunshine Rote
- Kent School of Social Work, University of Louisville, Louisville, KY, USA
| | | | - Jiwon Kim
- Lyndon B. Johnson School of Public Affairs, Center on Aging and Population Sciences, The University of Texas at Austin, Austin, TX, USA
| | - Chi-Tsun Chiu
- Institute of European and American Studies, Academia Sinica, Taipei, Taiwan
| | - Maria Aranda
- USC Suzanne Dworak-Peck School of Social Work, USC Edward R. Roybal Institute on Aging, Los Angeles, CA, USA
| | - Juwen Wang
- Institute of European and American Studies, Academia Sinica, Taipei, Taiwan
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12
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Newsom JT, Denning EC, Elman MR, Botoseneanu A, Allore HG, Nagel CL, Dorr DA, Quiñones AR. Physical Activity as a Mediator Between Race/Ethnicity and Changes in Multimorbidity. J Gerontol B Psychol Sci Soc Sci 2022; 77:1529-1538. [PMID: 34374757 PMCID: PMC9371457 DOI: 10.1093/geronb/gbab148] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2020] [Indexed: 11/15/2022] Open
Abstract
OBJECTIVES Studies report racial/ethnic disparities in multimorbidity (≥2 chronic conditions) and their rate of accumulation over time as well as differences in physical activity. Our study aimed to investigate whether racial/ethnic differences in the accumulation of multimorbidity were mediated by physical activity among middle-aged and older adults. METHOD We assessed racial/ethnic differences in the accumulation of multimorbidity (of 9 conditions) over 12 years (2004-2016) in the Health and Retirement Study (N = 18,264, mean age = 64.4 years). Structural equation modeling was used to estimate latent growth curve models of changes in multimorbidity and investigate whether the relationship of race/ethnicity (non-Hispanic Black, Hispanic, non-Hispanic White participants) to changes in the number of chronic conditions was mediated by physical activity after controlling for age, sex, education, marital status, household wealth, insurance coverage, smoking, alcohol, and body weight. RESULTS There was a significant increase in multimorbidity over time. Initial levels and changes in multimorbidity over time varied significantly across individuals. Indirect effects of the relationship between race/ethnicity and changes in multimorbidity as mediated by physical activity were significant, consistent with the mediational hypothesis. Black respondents engaged in significantly lower levels of physical activity than White respondents after controlling for covariates, but there were no differences between Hispanic and White respondents once education was included. Discussion: These results provide important new information for understanding how modifiable lifestyle factors may help explain disparities in multimorbidity in mid-to-late life, suggesting greater need to intervene to reduce sedentary behavior and increase physical activity.
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Affiliation(s)
- Jason T Newsom
- Address correspondence to: Jason T. Newsom, PhD, Department of Psychology, Portland State University, P.O. Box 751, Portland, OR 97207, USA. E-mail:
| | - Emily C Denning
- Department of Psychology, Portland State University, Oregon, USA
| | - Miriam R Elman
- School of Public Health, Oregon Health & Science University/Portland State University, USA
| | - Anda Botoseneanu
- Department of Health and Human Services and Institute of Gerontology, University of Michigan, Ann Arbor, USA
- Department of Health and Human Services, University of Michigan, Dearborn, USA
| | - Heather G Allore
- Internal Medicine and Department of Biostatistics, Yale University, New Haven, Connecticut, USA
| | - Corey L Nagel
- College of Nursing, University of Arkansas for Medical Sciences, Little Rock, USA
| | - David A Dorr
- Department of Medical Informatics and Clinical Epidemiology, School of Medicine, Oregon Health and Science University, Portland, USA
| | - Ana R Quiñones
- Department of Family Medicine, Oregon Health and Science University, Portland, USA
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13
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Piedra LM, Howe MJK, Ridings J, Gutwein M. Do Latino Older Adults and Service Providers Agree on Positive Aging? Using Concept Mapping to Compare Perspectives. THE GERONTOLOGIST 2022; 63:169-181. [PMID: 35639984 PMCID: PMC9872760 DOI: 10.1093/geront/gnac074] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2022] [Indexed: 02/02/2023] Open
Abstract
BACKGROUND AND OBJECTIVES In the United States, Latino adults are a growing segment of the aging population who will need research-informed interventions to help them age successfully. Arguably, how Latino older adults and service providers understand "positive aging" serves as an important precursor for the cultivation of such interventions. This investigation explored whether Latino older adults' conceptualizations of positive aging aligned with those of service providers. RESEARCH DESIGN AND METHODS We compared how Latino older adults (n = 93) and service providers (n = 45) rated 85 positive aging statements produced by Latino older adults. These 85 items were used to generate a concept map, which displays those items thematically by clusters and overarching regions of meaning. RESULTS We found divergences at each level of the map-statements, clusters, and regions-which illuminate differences between how service providers and Latino older adults think about Latino positive aging. For example, whereas Latino older adults prioritized the cluster containing items related to internal well-being, service providers rated it seventh of 11 clusters. The region comprising clusters related to relationships garnered the highest agreement between groups, but also a notable departure; compared to Latino older adults, service providers rated community and social involvement as less important. DISCUSSION AND IMPLICATIONS Understanding such differences can help providers tailor services consistent with the interests of Latino older adults. Future studies should examine the extent to which stakeholders believe various aspects of positive aging are modifiable.
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Affiliation(s)
- Lissette M Piedra
- Address correspondence to: Lissette M. Piedra, PhD, MSW, School of Social Work, University of Illinois at Urbana-Champaign, 1010 West Nevada St., Urbana, IL 61801, USA. E-mail:
| | | | - John Ridings
- Institute for Clinical Social Work, Chicago, Illinois, USA
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Aguiñaga S, Kaushal N, Balbim GM, Wilson RS, Wilbur JE, Hughes S, Buchner DM, Berbaum M, McAuley E, Vásquez PM, Marques IG, Wang T, Marquez DX. Latin Dance and Working Memory: The Mediating Effects of Physical Activity Among Middle-Aged and Older Latinos. Front Aging Neurosci 2022; 14:755154. [PMID: 35493932 PMCID: PMC9051326 DOI: 10.3389/fnagi.2022.755154] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/08/2021] [Accepted: 03/14/2022] [Indexed: 11/13/2022] Open
Abstract
BackgroundPhysical activity (PA) is a promising method to improve cognition among middle-aged and older adults. Latinos are at high risk for cognitive decline and engaging in low levels of PA. Culturally relevant PA interventions for middle-aged and older Latinos are critically needed to reduce risk of cognitive decline. We examined changes in cognitive performance among middle-aged and older Latinos participating in the BAILAMOS™ dance program or a health education group and compared the mediating effects of PA between group assignment and change in cognitive domains.MethodsOur 8-month randomized controlled trial tested BAILAMOS™, a 4-month Latin dance program followed by a 4-month maintenance phase. A total of 333 older Latinos aged 55+ were randomized to either BAILAMOS™, or to a health education control group. Neuropsychological tests were administered, scores were converted to z-scores, and specific domains (i.e., executive function, episodic memory, and working memory) were derived. Self-reported PA was assessed, and we reported categories of total PA, total leisure PA, and moderate-to-vigorous PA as minutes/week. A series of ANCOVAs tested changes in cognitive domains at 4 and 8 months. A mediation analysis tested the mediating effects of each PA category between group assignment and a significant change in cognition score.ResultsThe ANCOVAs found significant improvement in working memory scores among participants in the dance group at month 8 [F(1,328) = 5.79, p = 0.017, d = 0.20], but not in executive functioning [F(2,328) = 0.229, p = 0.80, Cohen’s d = 0.07] or episodic memory [F(2,328) = 0.241, p = 0.78, Cohen’s d = 0.05]. Follow-up mediation models found that total PA mediated the relationship between group assignment and working memory, in favor of the dance group (β = 0.027, 95% CI [0.0000, 0.0705]). Similarly, total leisure PA was found to mediate this relationship [β = 0.035, 95% CI (0.0041, 0.0807)].ConclusionA 4-month Latin dance program followed by a 4-month maintenance phase improved working memory among middle-aged and older Latinos. Improvements in working memory were mediated by participation in leisure PA. Our results support the current literature that leisure time PA influences cognition and highlight the importance of culturally relevant PA modalities for Latinos.Clinical Trial Registration[www.ClinicalTrials.gov], identifier [NCT01988233].
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Affiliation(s)
- Susan Aguiñaga
- Department of Kinesiology and Community Health, University of Illinois at Urbana-Champaign, Urbana, IL, United States
- *Correspondence: Susan Aguiñaga,
| | - Navin Kaushal
- Department of Health Sciences, Indiana University, Indianapolis, IN, United States
| | - Guilherme M. Balbim
- Department of Physical Therapy, University of British Columbia, Vancouver, BC, Canada
| | - Robert S. Wilson
- Department of Neurological Sciences and Psychiatry and Behavioral Sciences, Rush Alzheimer’s Disease Center, Rush University Medical Center, Chicago, IL, United States
| | | | - Susan Hughes
- Center for Research on Health and Aging, University of Illinois at Chicago, Chicago, IL, United States
| | - David M. Buchner
- Department of Kinesiology and Community Health, University of Illinois at Urbana-Champaign, Urbana, IL, United States
| | - Michael Berbaum
- Center for Research on Health and Aging, University of Illinois at Chicago, Chicago, IL, United States
| | - Edward McAuley
- Department of Kinesiology and Community Health, University of Illinois at Urbana-Champaign, Urbana, IL, United States
| | - Priscilla M. Vásquez
- Department of Urban Public Health, College of Science and Health, Charles R. Drew University of Medicine and Science, Los Angeles, CA, United States
| | | | - Tianxiu Wang
- Center for Research on Health and Aging, University of Illinois at Chicago, Chicago, IL, United States
| | - David X. Marquez
- Center for Research on Health and Aging, University of Illinois at Chicago, Chicago, IL, United States
- Department of Kinesiology and Nutrition, University of Illinois at Chicago, Chicago, IL, United States
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Cantu PA, Aranda MP. Neuropsychiatric symptoms and caregiver relationship quality for older Mexican Americans. Aging Ment Health 2022; 27:896-903. [PMID: 35266850 PMCID: PMC9463394 DOI: 10.1080/13607863.2022.2048358] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/01/2022]
Abstract
OBJECTIVES Caregivers play a key role in supporting older Mexican Americans, who are less likely to enter nursing facilities than other racial/ethnic groups in the US. However, there is little research on how Neuropsychiatric symptoms (NPS) affect relationship quality between caregivers and care recipients. METHOD Using data from the 2015 wave of the Hispanic Established Populations for Epidemiologic Studies of the Elderly (H-EPESE) (n = 416) study of older (age 85+) Mexican Americans, we examined relationship quality and NPS with ordered logistic regression. Relationship quality was measured using positive (enjoyment, appreciation) and negative (nerves, argue) assessments. NPS were categorized into hyperactivity, affective, and psychosis symptoms. RESULTS Hyperactivity symptoms were associated with appreciation, arguing, and nerves. Psychosis symptoms were associated with arguing and nerves. Spousal caregivers were more likely to report arguing and nerves and less likely to report feeling appreciated. Enjoyment assessments were not associated with NPS. CONCLUSION Relationship quality is related to behavioral changes in late life. Mexican American caregivers negatively evaluate their relationships, not in response to care tasks per se, but when the older person exhibits behavioral problems. The relationship between NPS and negative relationship assessments may be due to unanticipated behavior changes in late life and stigma around psychiatric symptomatology.
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Affiliation(s)
- Phillip A. Cantu
- Sealy Center on Aging, University of Texas Medical Branch, Galveston, TX, USA
| | - María P. Aranda
- Suzanne Dworak-Peck School of Social Work, Edward R. Roybal Institute on Aging, University of Southern California, Los Angeles, CA, USA
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Piedra LM, Howe MJK, Ridings J, Montoya Y, Conrad KJ. Convivir (to Coexist) and Other Insights: Results From the Positive Aging for Latinos Study. J Appl Gerontol 2022; 41:1421-1434. [PMID: 35100883 DOI: 10.1177/07334648211069269] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022] Open
Abstract
Many Latinos in the United States do not have access to culturally sensitive services to help them age well. We combined community-based participatory research with concept mapping methods to understand how a sample of community-dwelling Latino older adults view positive aging. Nine focus groups (N = 101) generated 85 non-repeating statements, which were used to produce a final map with 11 clusters, organized into four overarching regions: Convivir (To Coexist), Self-Sufficiency, Perspectives on Life, and Healthy Behaviors. Further analyses revealed three themes: (1) the importance of varied social connections, as conveyed by the region labeled Convivir; (2) a multifaceted understanding of "stability" that includes finances, relationships, and spirituality; and (3) the need for a mature mindset reflected in the thematic cluster Tomalo Suave (Take It Easy). Findings can inform the development of interventions for Latino older adults and the cultural adaptation of programs initially designed for non-Latinos.
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Affiliation(s)
| | | | - John Ridings
- 32351Institute for Clinical Social Work, At St Augustine College, Chicago, IL, USA
| | - Yadira Montoya
- 50478NORC at the University of Chicago, Chicago, IL, USA
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Wu B, Toseef MU, Stickel AM, González HM, Tarraf W. Associations Between Midlife Functional Limitations and Self-Reported Health and Cognitive Status: Results from the 1998-2016 Health and Retirement Study. J Alzheimers Dis 2022; 85:1621-1637. [PMID: 34958028 PMCID: PMC9116387 DOI: 10.3233/jad-215192] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
Abstract
BACKGROUND Life-course approaches to identify and help improve modifiable risk factors, particularly in midlife, may mitigate cognitive aging. OBJECTIVE We examined how midlife self-rated physical functioning and health may predict cognitive health in older age. METHODS We used data from the Health and Retirement Study (1998-2016; unweighted-N = 4,685). We used survey multinomial logistic regression and latent growth curve models to examine how midlife (age 50-64 years) activities of daily living (ADL), physical function, and self-reported health affect cognitive trajectories and cognitive impairment not dementia (CIND) and dementia status 18 years later. Then, we tested for sex and racial/ethnic modifications. RESULTS After covariates-adjustment, worse instrumental ADL (IADL) functioning, mobility, and self-reported health were associated with both CIND and dementia. Hispanics were more likely to meet criteria for dementia than non-Hispanic Whites given increasing IADL impairment. CONCLUSION Midlife health, activities limitations, and difficulties with mobility are predictive of dementia in later life. Hispanics may be more susceptible to dementia in the presence of midlife IADLs. Assessing midlife physical function and general health with brief questionnaires may be useful for predicting cognitive impairment and dementia in later life.
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Affiliation(s)
- Benson Wu
- Department of Neurosciences and Shiley-Marcos Alzheimer’s Disease Research Center, University of California San Diego School of Medicine, San Diego, CA
| | - Mohammad Usama Toseef
- Department of Healthcare Sciences and Institute of Gerontology, Wayne State University, Detroit, MI
| | - Ariana M. Stickel
- Department of Neurosciences and Shiley-Marcos Alzheimer’s Disease Research Center, University of California San Diego School of Medicine, San Diego, CA
| | - Hector M. González
- Department of Neurosciences and Shiley-Marcos Alzheimer’s Disease Research Center, University of California San Diego School of Medicine, San Diego, CA
| | - Wassim Tarraf
- Department of Healthcare Sciences and Institute of Gerontology, Wayne State University, Detroit, MI
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Williams TB, Garza M, Lipchitz R, Powell T, Baghal A, Swindle T, Sexton KW. Cultivating informatics capacity for multimorbidity: A learning health systems use case. JOURNAL OF MULTIMORBIDITY AND COMORBIDITY 2022; 12:26335565221122017. [PMID: 35990170 PMCID: PMC9389034 DOI: 10.1177/26335565221122017] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/23/2022] [Accepted: 07/29/2022] [Indexed: 11/16/2022]
Abstract
Background The aim of this study was to characterize patterns of multimorbidity across patients and identify opportunities to strengthen the informatics capacity of learning health systems that are used to characterize multimorbidity across patients. Methods Electronic health record (EHR) data on 225,710 multimorbidity patients were extracted from the Arkansas Clinical Data Repository as a use case. Hierarchical cluster analysis identified the most frequently occurring combinations of chronic conditions within the learning health system’s captured data. Results Results revealed multimorbidity was highest among patients ages 60 to 74, Caucasians, females, and Medicare payors. The largest numbers of chronic conditions occurred in the smallest numbers of patients (i.e., 70,262 (31%) patients with two conditions, two (<1%) patients with 22 chronic conditions). The results revealed urgent needs to improve EHR systems and processes that collect and manage multimorbidity data (e.g., creating new, multimorbidity-centric data elements in EHR systems, detailed longitudinal tracking of compounding disease diagnoses). Conclusions Without additional capacity to collect and aggregate large-scale data, multimorbidity patients cannot benefit from the recent advancements in informatics (i.e., clinical data registries, emerging data standards) that are abundantly working to improve the outcomes of patients with single chronic conditions. Additionally, robust socio-technical system studies of clinical workflows are needed to assess the feasibility of integrating the collection of risk factor data elements (i.e., psycho-social, cultural, ethnic, and socioeconomic attributes of populations) into primary care encounters. These approaches to advancing learning health systems for multimorbidity could substantially reduce the constraints of current technologies, data, and data-capturing processes.
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Affiliation(s)
- Tremaine B Williams
- Department of Biomedical Informatics, University of Arkansas for Medical Sciences, Little Rock, AR, USA
| | - Maryam Garza
- Department of Biomedical Informatics, University of Arkansas for Medical Sciences, Little Rock, AR, USA
| | - Riley Lipchitz
- Department of Internal Medicine, University of Arkansas for Medical Sciences, Little Rock, AR, USA
| | - Thomas Powell
- Department of Biomedical Informatics, University of Arkansas for Medical Sciences, Little Rock, AR, USA
| | - Ahmad Baghal
- Department of Biomedical Informatics, University of Arkansas for Medical Sciences, Little Rock, AR, USA
| | - Taren Swindle
- Department of Family and Preventive Medicine, University of Arkansas for Medical Sciences, Little Rock, AR, USA
| | - Kevin Wayne Sexton
- Department of Biomedical Informatics, University of Arkansas for Medical Sciences, Little Rock, AR, USA
- Department of Surgery, University of Arkansas for Medical Sciences, Little Rock, AR, USA
- Department of Health Policy and Management, University of Arkansas for Medical Sciences, Little Rock, AR, USA
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Levchenko Y. Aging into disadvantage: Disability crossover among Mexican immigrants in America. Soc Sci Med 2021; 285:114290. [PMID: 34352506 PMCID: PMC8416786 DOI: 10.1016/j.socscimed.2021.114290] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/07/2021] [Revised: 07/08/2021] [Accepted: 07/30/2021] [Indexed: 10/20/2022]
Abstract
The "Hispanic paradox" refers to the accepted finding that Mexican immigrants have lower mortality compared to the US-born population, despite having lower levels of income, educational attainment, and health insurance coverage. However, Mexican immigrants' mortality advantage is not matched by lower disability rates, particularly later in the life course. Past studies have identified a crossover in disability rates for Mexican immigrants using age-specific disability rates but confound the effects of aging and duration of residence. By using the synthetic cohort method, I extend prior work on the disability crossover by tracing immigrant cohorts across the life course and disentangling newly arrived immigrants from those already established in the U.S. I use American Community Survey (ACS) 2015-2019 data to test whether the acculturation or cumulative disadvantage hypotheses account for the disability crossover. I find that, contrary to the expected finding of a socioeconomic health gradient in disability rates, Mexican immigrants' high disability rates converge regardless of education level or immigrant cohort. In addition, Mexican female immigrants are doubly disadvantaged, living in a protracted period of disability compared to males of the same education level. My findings support the negative health acculturation hypothesis as the dominant pathway for Mexican immigrants' later-life disability trajectories and consequently the explanation behind the disability crossover.
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Affiliation(s)
- Yuliana Levchenko
- Department of Sociology and Criminology, Pennsylvania State University, 412 Oswald Tower, University Park, 16802, Pennsylvania, United States.
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20
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Kim J, Angel JL, Rote SM. A Longitudinal Study of Cognitive and Instrumental Activities of Daily Living Disablement Among the Oldest Mexican Americans. J Aging Health 2021; 34:196-205. [PMID: 34388944 DOI: 10.1177/08982643211037512] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
ObjectivesMexican Americans live longer on average than other ethnic groups, but often with protracted cognitive and physical disability. Little is known, however, about the role of cognitive decline for transitions in instrumental activities of daily living (IADL) disability and tertiary outcomes of the IADL disablement for the oldest old (after 80 years old). Methods We employ the Hispanic Established Populations for the Epidemiologic Study of the Elderly (2010-2011, 2012-2013, and 2016, N = 1,078) to investigate the longitudinal patterns of IADL decline using latent transition analysis. Results Three IADL groups were identified: independent (developing mobility limitations), emerging dependence (limited mobility and community activities), and dependent (limited mobility and household and community activities). Declines in cognitive function were a consistent predictor of greater IADL disablement, and loneliness was a particularly salient distal outcome for emerging dependence. Discussion These results highlight the social consequences of cognitive decline and dependency as well as underscore important areas of intervention at each stage of the disablement process.
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Affiliation(s)
- Jiwon Kim
- The University of Texas at Austin, Austin, TX, USA
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21
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Vásquez E, Zhang W, Dreby J, Lee S, Botoseneanu A. Nativity, Family, Disability: Results from the Hispanic Established Populations for the Epidemiologic Study of the Elderly. Ethn Dis 2021; 31:253-262. [PMID: 33883866 DOI: 10.18865/ed.31.2.253] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
Abstract
Objectives ativity and family support may influence attitudes and behaviors that delay or accelerate the disability process in older adults. The objectives of this study were twofold: 1) to evaluate nativity and migration cohort differences in trajectories of disability (assessed by activities of daily living [ADL]) among older Mexican Americans; and 2) to determine the role of objectively measured family support in the association between nativity, migration cohort, and disability changes over time. Methods This is a longitudinal study with up to 18 years follow-up (1993-2011) using data from the Hispanic Established Populations for the Epidemiologic Study of the Elderly (N=2,785, mean age =72.4 years). Disability was assessed using self-reported limitations in activities of daily living (ADL). Nativity and migration cohort were self-reported. Family support was assessed by marital status and the number of their children participants saw each month. Linear growth curve models evaluated the trajectory of ADL disability over 18 years and assessed variations by nativity status, migration cohort and family support. Results Foreign-born respondents who migrated before age 20 had more starting ADL limitations (β= .36, P<.001) and accumulated disability faster (β=.04, P<.01) compared with their US-born counterparts. In contrast, foreign-born respondents who migrated at later ages showed disability trajectories similar to US-born respondents. Married respondents had a lower level of disability (β= -.14, P<.01) and a lower rate of accumulation over time (β= -.02, P=.001) compared with participants who were not married. Discussion Mexican Americans who migrate at younger ages may experience greater disability over time; however, family support may help mitigate the accumulation of disability among older Mexican Americans.
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Affiliation(s)
- Elizabeth Vásquez
- University at Albany School of Public Health (SUNY), Department of Epidemiology, Albany, NY
| | - Weihui Zhang
- University at Albany School of Public Health (SUNY), Department of Sociology/Biostastics/Epidemiology, Albany, NY
| | - Joanna Dreby
- University at Albany School of Public Health (SUNY), Department of Sociology, Albany, NY
| | - Sunghee Lee
- University of Michigan, Institute for Social Research, Ann Arbor, MI
| | - Anda Botoseneanu
- University of Michigan, Department of Health & Human Services and Institute of Gerontology, Ann Arbor, MI
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Flores Morales J. Aging and undocumented: The sociology of aging meets immigration status. SOCIOLOGY COMPASS 2021; 15:e12859. [PMID: 33868455 PMCID: PMC8047879 DOI: 10.1111/soc4.12859] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/01/2020] [Revised: 01/10/2021] [Accepted: 01/14/2021] [Indexed: 05/22/2023]
Abstract
Being undocumented is strongly correlated with low wages, employment in high risk occupations, and poor healthcare access. We know surprisingly little about the social lives of older undocumented adults despite the vast literature about youth and young undocumented migrants. Literature about the immigrant health paradox casts doubts on the argument that unequal social conditions translate to poorer self-reported health and mortality, but few of these studies consider immigration status as the dynamic variable that it is. Reviewing research about older migrants and minorities, I point to the emergence of undocumented older persons as a demographic group that merits attention from researchers and policymakers. This nexus offers important lessons for understanding stratification and inequality. This review offers new research directions that take into account multilevel consequences of growing old undocumented. Rather than arguing that older-aged undocumented migrants are aging into exclusion, I argue that we need careful empirical research to examine how the continuity of exclusion via policies can magnify inequalities on the basis of immigration status and racialization in older age.
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Affiliation(s)
- Josefina Flores Morales
- California Center for Population ResearchUniversity of California Los Angeles‐SociologyLos AngelesCaliforniaUSA
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Rote SM, Angel JL. Gender-Based Pathways to Cognitive Aging in the Mexican-Origin Population in the United States: The Significance of Work and Family. J Gerontol B Psychol Sci Soc Sci 2021; 76:e165-e175. [PMID: 33141216 DOI: 10.1093/geronb/gbaa189] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2020] [Indexed: 11/13/2022] Open
Abstract
OBJECTIVES This study uses the life course perspective to explore the role of key midlife factors (occupation and number of children) for gender- and nativity-based pathways to cognitive aging for older Mexican Americans. METHOD Using the Hispanic Established Populations for the Epidemiologic Study of the Elderly (H-EPESE, 1993/1994-2016, n = 2,779), this study presents (a) cognitive impairment trajectories over 20 years of data and (b) multinomial logistic regression analyses of trajectory group membership by lifetime occupation and number of children, controlling for educational attainment. RESULTS For older Mexican American men, lifetime employment in agricultural occupations is associated with elevated risk for late-life cognitive impairment. Delayed risk for impairment is observed for U.S.-born men who were employed in factory work (e.g., production and repair) and in Mexican-born men who were employed in occupations with skilled or supervisory requirements. For all women, labor force participation, especially in skilled occupations, is related to a delayed risk of cognitive impairment. Number of children is unrelated to impairment for men; however, women with five or more children (compared to women with two to four children) are at risk for consistent and rapid cognitive impairment in late life. DISCUSSION Late-life cognitive health disparities that disproportionately impact the Mexican American population can be addressed by improving access to educational and occupational opportunities in early and midlife. This study points to key areas of intervention within work and the home for the Mexican-origin population.
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Affiliation(s)
- Sunshine M Rote
- Kent School of Social Work, University of Louisville, Kentucky
| | - Jacqueline L Angel
- School of Public Affairs and Department of Sociology, The University of Texas at Austin
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Mejia‐Arango S, Aguila E, López‐Ortega M, Gutiérrez‐Robledo LM, Vega WA, Andrade FCD, Rote SM, Grasso SM, Markides KS, Angel JL. Health and social correlates of dementia in oldest-old Mexican-origin populations. ALZHEIMER'S & DEMENTIA (NEW YORK, N. Y.) 2020; 6:e12105. [PMID: 33344751 PMCID: PMC7744026 DOI: 10.1002/trc2.12105] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/01/2020] [Revised: 09/15/2020] [Accepted: 09/30/2020] [Indexed: 11/27/2022]
Abstract
INTRODUCTION Substantial gaps in research remain across oldest-old ethnic populations while the burden of dementia increases exponentially with age among Mexican and Mexican American older adults. METHODS Prevalence and correlates of dementia among individuals ≥82 years of age were examined using two population-based cohort studies: The Mexican Health and Aging Study (MHAS, n = 1078, 2012) and the Hispanic Established Populations for the Epidemiologic Study of the Elderly (HEPESE, n = 735, 2012-2013). The analytic MHAS and HEPESE samples had an average age of 86.4 and 88.0 years, 1.2 and 1.8 women to men, and 2.7 and 5.1 average years of education, respectively. RESULTS We identified 316 (29.2%) and 267 (36.3%) cases of likely dementia in the MHAS and HEPESE cohorts, respectively. For Mexicans but not Mexican Americans, age-adjusted prevalence rates of likely dementia were higher in women than men. For both populations prevalence rates increased with age and decreased with education for Mexican Americans but not for Mexicans. In both populations, odds of likely dementia increased with age. Health insurance for the low-income was significantly associated with higher odds of likely dementia for Mexican American men and women and Mexican women but not men. Living in extended households increased the odds of likely dementia in women, but not in men for both studies. Multiple cardiovascular conditions increased the odds of likely dementia for Mexicans but not for Mexican Americans. DISCUSSION Our study provides evidence of the high burden of dementia among oldest-old Mexicans and Mexican Americans and its association with health and social vulnerabilities.
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Affiliation(s)
- Silvia Mejia‐Arango
- Department of Population StudiesEl Colegio de la Frontera NorteTijuanaBaja CaliforniaMéxico
| | - Emma Aguila
- Health Policy and Management Department, Sol Price School of Public PolicyUniversity of Southern CaliforniaLos AngelesCaliforniaUSA
| | - Mariana López‐Ortega
- National Institute of GeriatricsNational Institutes of HealthCiudad de MéxicoMéxico
| | | | - William A. Vega
- Office of Research and Educational DevelopmentFlorida International UniversityMiamiFloridaUSA
| | | | - Sunshine M. Rote
- Kent School of Social WorkUniversity of LouisvilleLouisvilleKentuckyUSA
| | - Stephanie M. Grasso
- Speech, Language and Hearing SciencesThe University of Texas at AustinAustinTexasUSA
| | - Kyriakos S. Markides
- Department of Preventive Medicine and Community HealthUniversity of Texas Medical BranchGalvestonTexasUSA
| | - Jacqueline L. Angel
- LBJ School of Public Affairs and Department of SociologyThe University of Texas at AustinAustinTexasUSA
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Lorenti A, Dudel C, Hale JM, Myrskylä M. Working and disability expectancies at older ages: The role of childhood circumstances and education. SOCIAL SCIENCE RESEARCH 2020; 91:102447. [PMID: 32933645 DOI: 10.1016/j.ssresearch.2020.102447] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/20/2020] [Revised: 05/22/2020] [Accepted: 07/13/2020] [Indexed: 06/11/2023]
Abstract
The ability to work at older ages depends on health and education. Both accumulate starting very early in life. We assess how childhood disadvantages combine with education to affect working and health trajectories. Applying multistate period life tables to data from the Health and Retirement Study (HRS) for the period 2008-2014, we estimate how the residual life expectancy at age 50 is distributed in number of years of work and disability, by number of childhood disadvantages, gender, and race/ethnicity. Our findings indicate that number of childhood disadvantages is negatively associated with work and positively with disability, irrespective of gender and race/ethnicity. Childhood disadvantages intersect with low education resulting in shorter lives, and redistributing life years from work to disability. Among the highly educated, health and work differences between groups of childhood disadvantage are small. Combining multistate models and inverse probability weighting, we show that the return of high education is greater among the most disadvantaged.
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Affiliation(s)
| | | | - Jo Mhairi Hale
- Max Planck Institute for Demographic Research, Germany; University of St Andrews, Scotland, UK
| | - Mikko Myrskylä
- Max Planck Institute for Demographic Research, Germany; London School of Economics and Political Science, UK; University of Helsinki, Finland
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Burrows B, Andrade FCD, Piedra L, Xu S, Aguiñaga S, Steinberg N, Sarkisian C, Hernandez R. The Influence of Evidence-Based Exercise and Age Reattribution on Physical Function in Hispanic Older Adults: Results From the ¡Caminemos! Randomized Controlled Trial. J Appl Gerontol 2020; 40:278-288. [PMID: 32508211 DOI: 10.1177/0733464820927171] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022] Open
Abstract
Older Hispanics routinely exhibit unhealthy beliefs about "normal" aging trajectories, particularly related to exercise and physical function. We evaluated the prospective effects of age reattribution on physical function in older Hispanics. Participants (n = 565, ≥60 years) were randomly assigned into (a) treatment group-attribution-retraining, or (b) control group-health education. Each group separately engaged in four weekly 1-hr group discussions and 1-hr exercise classes, followed by monthly maintenance sessions. The Short Physical Performance Battery (SPPB) measured physical function throughout the 24-month intervention. No significant difference in physical function between intervention arms was evident over time. However, both groups experienced significant improvements in physical function at 24 months (β = 0.43, 95% confidence interval [CI] = [0.16, 0.70]). Participating in the exercise intervention was associated with improvements in physical function, although no additional gains were apparent for age attribution-retraining. Future research should consider strengthening or modifying intervention content for age reattribution or dosage received.
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Affiliation(s)
| | | | | | - Shuo Xu
- University of Illinois at Urbana-Champaign, USA
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Andrasfay T, Goldman N. Physical functioning and survival: Is the link weaker among Latino and black older adults? Soc Sci Med 2020; 255:112983. [PMID: 32353650 PMCID: PMC7316127 DOI: 10.1016/j.socscimed.2020.112983] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2019] [Revised: 04/07/2020] [Accepted: 04/09/2020] [Indexed: 01/25/2023]
Abstract
Measures of physical functioning are among the strongest predictors of mortality, but no previous study has assessed whether the predictive value of such measures varies by race/ethnicity, as has been done for the simple self-rated health question. The current study tests whether the relationship between two measures of physical functioning (the number of self-reported functional limitations and measured walking speed) and mortality is weaker (has a lower hazard ratio) for Latinos and blacks than for whites. Data were drawn from the 1998-2014 waves of the Health and Retirement Study, with mortality follow-up through 2016. We used Cox hazard models with household random effects to test for interactions between race/ethnicity and these measures of physical functioning and verified earlier findings for self-rated health. The number of self-reported functional limitations is significantly related to mortality for all racial/ethnic groups, but has a substantially lower hazard ratio for blacks and Latinos than for whites, as hypothesized. This hazard ratio remains lower for blacks and Latinos after adjustment for sociodemographic characteristics and health conditions. These findings suggest that the higher rates of functional limitations observed among Latinos and blacks compared with whites may reflect a history of strenuous physical work, inadequately controlled pain, lower leisure-time physical activity, or untreated/under-treated mobility problems that can lead to reduced physical performance without necessarily having a substantial effect on mortality risk. On the other hand, we do not detect significant racial/ethnic differences in the association between measured walking speed and subsequent mortality. This may be the result of the smaller sample size for the walking speed tests, the more nuanced nature of the continuous walking speed measure, or the fact that the walking speed test captures only a subset of the limitations included in the self-reports.
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Affiliation(s)
| | - Noreen Goldman
- Office of Population Research, Woodrow Wilson School of Public and International Affairs, Princeton University, USA
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Employing Participatory Citizen Science Methods to Promote Age-Friendly Environments Worldwide. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:ijerph17051541. [PMID: 32121001 PMCID: PMC7084614 DOI: 10.3390/ijerph17051541] [Citation(s) in RCA: 44] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/19/2019] [Revised: 02/20/2020] [Accepted: 02/24/2020] [Indexed: 01/21/2023]
Abstract
The trajectory of aging is profoundly impacted by the physical and social environmental contexts in which we live. While “top–down” policy activities can have potentially wide impacts on such contexts, they often take time, resources, and political will, and therefore can be less accessible to underserved communities. This article describes a “bottom–up”, resident-engaged method to advance local environmental and policy change, called Our Voice, that can complement policy-level strategies for improving the health, function, and well-being of older adults. Using the World Health Organization’s age-friendly cities global strategy, we describe the Our Voice citizen science program of research that has specifically targeted older adults as environmental change agents to improve their own health and well-being as well as that of their communities. Results from 14 Our Voice studies that have occurred across five continents demonstrate that older adults can learn to use mobile technology to systematically capture and collectively analyze their own data. They can then successfully build consensus around high-priority issues that can be realistically changed and work effectively with local stakeholders to enact meaningful environmental and policy changes that can help to promote healthy aging. The article ends with recommended next steps for growing the resident-engaged citizen science field to advance the health and welfare of all older adults.
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Wadsworth PA, Chen NW, Raji M, Markides KS, Downer B. Mobility but Not Balance Limitations Are Associated With Cognitive Decline among Older Hispanics. Gerontol Geriatr Med 2020; 6:2333721420947952. [PMID: 32851118 PMCID: PMC7427021 DOI: 10.1177/2333721420947952] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2020] [Revised: 07/10/2020] [Accepted: 07/16/2020] [Indexed: 11/29/2022] Open
Abstract
Aging is associated with changes in lower-body functioning. The extent to which lower-body function is associated with cognitive changes over time is unclear, especially among older Hispanics, a high-risk population for declines in physical and cognitive functioning. We sought to determine if the association between lower-body functioning and cognitive decline over 9-years differentially varied with respect to balance, gait speed, lower-body strength (chair stands), or a summary score of the three measures. This retrospective cohort study used clinical performance data from the Hispanic Established Populations for the Epidemiologic Study of the Elderly (H-EPESE). Cognitive function was measured using the Mini-Mental Status Exam. Linear mixed modeling was used to investigate the association between lower-body function and cognitive decline, controlling for patients' demographic and health characteristics. We found that gait speed and timed chair stands but not balance were associated with accelerated cognitive decline in Mexican-Americans age 75 years and older. These parameters of lower-body function can be feasibly measured in any clinic. As limitations in lower-body functioning may be an early marker of cognitive decline, this suggests an opportunity for the development of interventions to slow cognitive and physical disablement and promote successful aging among persons older than 75 years.
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Affiliation(s)
| | - Nai-Wei Chen
- The University of Texas Medical Branch, Galveston, TX, USA
| | - Mukaila Raji
- The University of Texas Medical Branch, Galveston, TX, USA
| | | | - Brian Downer
- The University of Texas Medical Branch, Galveston, TX, USA
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Angel JL, Angel RJ, Cantu P. Medicaid Use among Older Low-Income Medicare Enrollees in California and Texas: A Tale of Two States. JOURNAL OF HEALTH POLITICS, POLICY AND LAW 2019; 44:885-910. [PMID: 31408881 PMCID: PMC10409604 DOI: 10.1215/03616878-7785799] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/10/2023]
Abstract
CONTEXT States face increasing Medicaid expenditures largely as a result of growing dual-eligible populations. In this article we examine self-reported community-based Medicaid participation among Medicare recipients 65 and older in California and Texas, with a particular focus on the older Mexican-origin population. METHODS We use six waves of the Hispanic Established Populations for the Epidemiologic Study of the Elderly (H-EPESE) covering the period from 1993-94 to 2010-11. FINDINGS The data reveal relatively high Medicaid participation rates by older individuals of Mexican origin, but significant differences between the two states. At baseline, 30% of older Mexican-origin Medicare beneficiaries in California reported receiving Medicaid compared to 41% in Texas. CONCLUSIONS Despite California's more liberal eligibility criteria, community-dwelling Texans were more likely than Californians to report coverage at some point during the 17-year follow-up. Our data, as well as administrative data, reveal that California classifies nearly all of its community-dwelling Medicaid recipients as "full duals," meaning that they receive full benefits, whereas Texas is more likely to classify similarly poor and disabled individuals as "partial duals," meaning that they receive less coverage, thereby lowering overall program expenditures. Cost containment strategies that restrict access may be especially consequential for vulnerable Hispanic populations.
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Mutambudzi M, Chen NW, Howrey B, Garcia MA, Markides KS. Physical Performance Trajectories and Mortality Among Older Mexican Americans. J Gerontol A Biol Sci Med Sci 2019; 74:233-239. [PMID: 29438556 DOI: 10.1093/gerona/gly013] [Citation(s) in RCA: 21] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2017] [Accepted: 01/30/2018] [Indexed: 01/06/2023] Open
Abstract
Background We sought to identify distinct trajectory classes of physical performance in Mexican Americans aged 75 years and older and to examine whether these trajectories predict mortality. Methods We used four waves of Hispanic Established Populations for Epidemiologic Studies of the Elderly (H-EPESE) data for adults 75 years and older from 2004-2005 to 2013. Latent growth curve analysis was used to identify distinct trajectory classes. Multinomial logistic regression analysis was used to examine the association between baseline characteristics and the newly constructed trajectories. Cox proportional hazards regression models examined the hazard of mortality as a function of Short Physical Performance Battery (SPPB) trajectories. Results The study follow-up period was approximately 9.5 years. One thousand four hundred and eleven adults were successfully classified into three (low-declining, high-declining, and high-stable) physical performance trajectory classes. Depressive symptoms (relative risk ratio = 1.94, 95% confidence interval [CI] = 1.17-3.22), diabetes (relative risk ratio = 2.44, 95% CI = 1.63-3.65), number of other comorbid health conditions (relative risk ratio = 1.40, 95% CI = 1.16-1.68), and obesity (relative risk ratio = 2.83, 95% CI = 1.67-4.80), increased the relative risk of classification into the low, relative to high-stable trajectory class. Male gender and foreign-born status significantly reduced risk of classification in the low-declining and high-declining trajectory classes. We observed a statistically significant association between low-declining (hazard ratio = 3.01, 95% CI = 2.34-3. 87) and high-declining (hazard ratio = 1.64, 95% CI = 1.32-2.03) trajectories and increased risk of mortality. Conclusions Differences in mortality across physical performance trajectory classes suggest that these physical performance classes represent differences in underlying disease progression, and thus differences in mortality risk among older Mexican Americans, which warrants additional research to better understand differential physical performance trajectories and their effects on morbidity and mortality in heterogeneous aging populations.
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Affiliation(s)
- Miriam Mutambudzi
- Global Health Institute, Department of Epidemiology and Social Medicine, Faculty of Medicine and Health Sciences, University of Antwerp, Belgium.,Department of Preventive Medicine and Community Health, Galveston
| | - Nai-Wei Chen
- Department of Preventive Medicine and Community Health, Galveston
| | | | - Marc A Garcia
- Sealy Center on Aging, University of Texas Medical Branch, Galveston
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García C, Garcia MA, Chiu CT, Rivera FI, Raji M. Life Expectancies With Depression by Age of Migration and Gender Among Older Mexican Americans. THE GERONTOLOGIST 2019; 59:877-885. [PMID: 30203062 PMCID: PMC6857755 DOI: 10.1093/geront/gny107] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/17/2018] [Indexed: 01/05/2023] Open
Abstract
BACKGROUND AND OBJECTIVES Prior studies examining depression among older Mexican Americans suggest both women and immigrants are at higher risk of depressive symptomatology than males and U.S.-born Mexican Americans. We use data from the Hispanic Established Populations for the Epidemiologic Study of the Elderly to examine whether life expectancy with depression and without depression varies by nativity, age of migration, and gender. RESEARCH DESIGN AND METHODS Sullivan-based life tables were used to estimate depression life expectancies among Mexican Americans aged 65 years and older residing in the Southwestern United States. Depression is based on the 20-item Center for Epidemiological Studies Depression scale (CES-D). The CES-D is a continuous scale (0-60) with higher values indicating worse mental health. We dichotomize depression as a score of 16 or greater. RESULTS Immigrant women, particularly those who migrated in late-life (after age 50) are at a significant disadvantage in the number of years after age 65 lived with depression and the ratio of years spent without depression relative to U.S.-born women. Among men, only late-life immigrants were disadvantaged in the number of years spent with depression. Early- and mid-life immigrant males did not differ from U.S.-born males. DISCUSSION AND IMPLICATIONS Our results highlight the heterogeneity among older Mexican Americans in life expectancies with depression. These findings illustrate the importance of considering age of migration as a high-risk factor for depression among Mexican-origin immigrants. Including this risk factor as a part of depression screening is a key step for timely interventions in preventing disability and comorbidities associated with untreated depression.
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Affiliation(s)
- Catherine García
- Leonard Davis School of Gerontology, University of Southern California, Los Angeles
| | - Marc A Garcia
- Department of Sociology & Institute for Ethnic Studies, University of Nebraska-Lincoln
| | - Chi-Tsun Chiu
- Institute of European and American Studies, Academia Sinica, Taipei, Taiwan
| | | | - Mukaila Raji
- Division of Geriatrics, Department of Internal Medicine, University of Texas Medical Branch, Galveston
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Abstract
Data from the Mexican Census reveal that between 2005 and 2015, nearly two million migrants returned voluntarily to Mexico from the United States. Currently, high rates of voluntary-return migration to Mexico continue at the same time that migration flows to the U.S. steadily decline. This return migration trend presents serious challenges for Mexico, a country that has long struggled to satisfy the health care demands of its population. However, little is known about return migrants' health care needs. In this study, we examine the health risk profiles and healthcare utilization for Mexican return migrants and the non-migrant population. We examine how these outcomes are affected by both the migration and return migration experience of the returnee population, while paying close attention to age-group differences. We employ inverse probability weighting regression adjustment (IPWRA) and logistic regression analysis of a sample of 348,450 respondents from the 2014 National Survey of Demographic Dynamics (ENADID) to test for differences in health conditions between those Mexican return migrants and non-migrants. We then turn to the Survey of Migration at Mexico's Northern Border (EMIF Norte, for its Spanish acronym) for the 2014-2017 period to further assess whether certain characteristics linked to aging and the migration experience influence the prevalence of chronic health conditions, and health insurance coverage among 17,258 returned migrants. Findings reveal that compared to non-migrants, returnees are more likely to be physically impaired. These poor health outcomes are influenced by the migration and return migration experience and vary by age group and duration of residence, the time that has elapsed since returning to Mexico. We do not find an association between return migration and mental or emotional distress. Policy implications are discussed in light of immigration reform and restrictions on eligibility for health insurance coverage for older adults in Mexico.
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Sadarangani T, Missaelides L, Eilertsen E, Jaganathan H, Wu B. A Mixed-Methods Evaluation of a Nurse-Led Community-Based Health Home for Ethnically Diverse Older Adults With Multimorbidity in the Adult Day Health Setting. Policy Polit Nurs Pract 2019; 20:131-144. [PMID: 31373878 PMCID: PMC6827350 DOI: 10.1177/1527154419864301] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Multimorbidity affects 75% of older adults (aged 65 years and older) in the United States and increases risk of poor medical outcomes, especially among the poor and underserved. The creation of a Medicaid option allowing states to establish health homes under the Affordable Care Act was intended to enhance coordinated care for Medicaid beneficiaries with multimorbidity. The Community-Based Health Home (CBHH) model uses the infrastructure of the Adult Day Health Center (ADHC) to serve as a health home to improve outcomes for medically complex vulnerable adults. Between 2017 and 2018, we used a sequential explanatory mixed-methods approach to (a) quantitatively examine changes in depression, fall risk, loneliness, cognitive function, nutritional risk, pain classification, and health care utilization over the course of 12 months in the program and (b) qualitatively explore the perspectives of key stakeholders (registered nurse navigators, participants, ADHC administrators, and caregivers) to identify the most effective components of CBHH. Using data integration techniques, we identified components of CBHH that were most likely driving outcomes. After 12 months in CBHH, our racially diverse sample (N = 126), experienced statistically significant (p < .05) reductions in loneliness, depression, nutritional risk, poorly controlled pain, and emergency department utilization. Stakeholders who were interviewed (n = 40) attributed positive changes to early clinical intervention by the registered nurse navigators, communication with providers across settings, and a focus on social determinants of health, in conjunction with social stimulation and engagement provided by the ADHC. CBHH positions the ADHC as the locus of an effective health home site and is associated with favorable results. CBHH also demonstrates the unique capacity and skill of registered nurses in integrating health and social services across community settings. Continued exploration of CBHH among diverse populations with multimorbidity is warranted.
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Affiliation(s)
| | | | | | | | - Bei Wu
- New York University Rory Meyers College of Nursing, NY, USA
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Quiñones AR, Botoseneanu A, Markwardt S, Nagel CL, Newsom JT, Dorr DA, Allore HG. Racial/ethnic differences in multimorbidity development and chronic disease accumulation for middle-aged adults. PLoS One 2019; 14:e0218462. [PMID: 31206556 PMCID: PMC6576751 DOI: 10.1371/journal.pone.0218462] [Citation(s) in RCA: 170] [Impact Index Per Article: 34.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2019] [Accepted: 06/03/2019] [Indexed: 11/21/2022] Open
Abstract
Background Multimorbidity–having two or more coexisting chronic conditions–is highly prevalent, costly, and disabling to older adults. Questions remain regarding chronic diseases accumulation over time and whether this differs by racial and ethnic background. Answering this knowledge gap, this study identifies differences in rates of chronic disease accumulation and multimorbidity development among non-Hispanic white, non-Hispanic black, and Hispanic study participants starting in middle-age and followed up to 16 years. Methods and findings We analyzed data from the Health and Retirement Study (HRS), a biennial, ongoing, publicly-available, longitudinal nationally-representative study of middle-aged and older adults in the United States. We assessed the change in chronic disease burden among 8,872 non-Hispanic black, non-Hispanic white, and Hispanic participants who were 51–55 years of age at their first interview any time during the study period (1998–2014) and all subsequent follow-up observations until 2014. Multimorbidity was defined as having two or more of seven somatic chronic diseases: arthritis, cancer, heart disease (myocardial infarction, coronary heart disease, angina, congestive heart failure, or other heart problems), diabetes, hypertension, lung disease, and stroke. We used negative binomial generalized estimating equation models to assess the trajectories of multimorbidity burden over time for non-Hispanic black, non-Hispanic white, and Hispanic participants. In covariate-adjusted models non-Hispanic black respondents had initial chronic disease counts that were 28% higher than non-Hispanic white respondents (IRR 1.279, 95% CI 1.201, 1.361), while Hispanic respondents had initial chronic disease counts that were 15% lower than non-Hispanic white respondents (IRR 0.852, 95% CI 0.775, 0.938). Non-Hispanic black respondents had rates of chronic disease accumulation that were 1.1% slower than non-Hispanic whites (IRR 0.989, 95% CI 0.981, 0.998) and Hispanic respondents had rates of chronic disease accumulation that were 1.5% faster than non-Hispanic white respondents (IRR 1.015, 95% CI 1.002, 1.028). Using marginal effects commands, this translates to predicted values of chronic disease for white respondents who begin the study period with 0.98 chronic diseases and end with 2.8 chronic diseases; black respondents who begin the study period with 1.3 chronic diseases and end with 3.3 chronic diseases; and Hispanic respondents who begin the study period with 0.84 chronic diseases and end with 2.7 chronic diseases. Conclusions Middle-aged non-Hispanic black adults start at a higher level of chronic disease burden and develop multimorbidity at an earlier age, on average, than their non-Hispanic white counterparts. Hispanics, on the other hand, accumulate chronic disease at a faster rate relative to non-Hispanic white adults. Our findings have important implications for improving primary and secondary chronic disease prevention efforts among non-Hispanic black and Hispanic Americans to stave off greater multimorbidity-related health impacts.
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Affiliation(s)
- Ana R. Quiñones
- Department of Family Medicine, Oregon Health & Science University, Portland, Oregon, United States of America
- School of Public Health, Oregon Health & Science University, Portland, Oregon, United States of America
- * E-mail:
| | - Anda Botoseneanu
- Department of Health & Human Services, University of Michigan, Dearborn, Michigan, United States of America
- Institute of Gerontology, University of Michigan, Ann Arbor, Michigan, United States of America
| | - Sheila Markwardt
- School of Public Health, Oregon Health & Science University, Portland, Oregon, United States of America
| | - Corey L. Nagel
- College of Nursing, University of Arkansas for Medical Sciences, Little Rock, Arkansas, United States of America
| | - Jason T. Newsom
- Department of Psychology, Portland State University, Portland, Oregon, United States of America
| | - David A. Dorr
- Department of Medical Informatics and Clinical Epidemiology, Oregon Health & Science University, Portland, Oregon, United States of America
| | - Heather G. Allore
- Department of Internal Medicine, School of Medicine, Yale University, New Haven, Connecticut, United States of America
- Department of Biostatistics School of Public Health, Yale University, New Haven, Connecticut, United States of America
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Rote SM, Angel JL, Moon H, Markides K. Caregiving Across Diverse Populations: New Evidence From the National Study of Caregiving and Hispanic EPESE. Innov Aging 2019; 3:igz033. [PMID: 31517066 PMCID: PMC6733633 DOI: 10.1093/geroni/igz033] [Citation(s) in RCA: 37] [Impact Index Per Article: 7.4] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2018] [Indexed: 11/14/2022] Open
Abstract
BACKGROUND AND OBJECTIVES The current study employs population-based data to determine the extent to which stress and coping factors are related to self-rated health and distress for informal caregivers (CGs) from the 3 largest racial/ethnic groups in the United States (non-Latino White, African American, and Mexican American). RESEARCH DESIGN AND METHODS Data on primary, informal CGs are obtained from the 2015 National Study of Caregiving (NSOC) (n = 667) and the 2016 Hispanic Established Populations for the Epidemiologic Studies of the Elderly (H-EPESE) CG supplement (n = 287). Logistic regression models of health are presented for all CGs and specifically for dementia CGs. RESULTS Caregiving intensity is related to health for non-Latino White CGs and African American dementia CGs. Support from family and friends is related to better self-rated health, but only for African American dementia CGs. While better relationship quality is related to better health for African American CGs and White dementia CGs, formal support utilization is related to worse CG health for Mexican American dementia CGs. DISCUSSION AND IMPLICATIONS Findings emphasize the importance of earlier detection and intervention with CGs at the beginning in the caregiving career, the interplay of formal and informal support, and appropriate ways to intervene with dementia CGs. Culturally tailored home- and community-based care options are needed to supplement the low levels of CG support, especially for the Mexican American population.
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Affiliation(s)
- Sunshine M Rote
- Kent School of Social Work, University of Louisville, Kentucky
| | - Jacqueline L Angel
- School of Public Affairs and Department of Sociology, The University of Texas at Austin, Galveston
| | - Heehyul Moon
- Kent School of Social Work, University of Louisville, Kentucky
| | - Kyriakos Markides
- Preventive Medicine & Community Health, University of Texas Medical Branch, Galveston
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Correlates and Predictors of Mobility Limitation in Community-Dwelling Hispanic Older Adults in the United States: A Systematic Review. J Immigr Minor Health 2019; 20:729-743. [PMID: 28424998 DOI: 10.1007/s10903-017-0587-3] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
This article presents a systematic review of the literature on correlates/predictors of mobility limitation among community-dwelling U.S. Hispanic older adults. A search of scientific databases (PubMed, CINAHL, and PsycINFO) was conducted. After abstract and full text review, 20 epidemiologic studies that met all eligibility criteria were included. The theoretical framework of mobility was used to categorize factors related to mobility limitation. The majority of the studies reviewed (n = 17) examined some aspect of physical factors in relation to mobility limitation. Several factors emerged as important influences on mobility outcomes: diabetes mellitus, stroke, obesity, arthritis, and depression. None examined the influence of built environment. This review suggests that multilevel factors can impact both mobility limitations and disability among U.S. Hispanic older adults. However, the study findings were inconsistent, with some studies showing significant relationships or effects and others demonstrating no associations or mixed findings.
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Vásquez E, Murillo R, Echeverria S. Neighborhood Social Cohesion and Walking Limitations in Ethnically Diverse Older Latinos in the United States. Ethn Dis 2019; 29:247-252. [PMID: 31057309 PMCID: PMC6478048 DOI: 10.18865/ed.29.2.247] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
Abstract
Walking is the most common form of physical activity and socially cohesive neighborhoods may provide the context for racially/ethnically diverse groups to maintain an active lifestyle, particularly at older ages. Among Latinos, the association between neighborhood cohesion and walking behaviors may additionally differ by Latino group. We examined the association between neighborhood social cohesion and walking limitations among Latinos overall and by specific Latino groups. We combined data from the 2013 to 2016 National Health Interview Survey (NHIS) and selected adults aged ≥60 years (n= 3,716). Walking limitations were assessed based on responses to the "experienced difficulty walking" survey question. Social cohesion was measured using four NHIS questions regarding neighborhood social cohesion. Logistic regression models were stratified by Latino subgroup. Mexican Americans represented the largest proportion of the sample (55%). Cubans had the highest proportion of individuals reporting high neighborhood social cohesion (51%), while Dominicans had the lowest proportion (29%). In the total sample, those with high and medium neighborhood social cohesion reported lower odds of walking limitations. Although tests for interaction were not statistically significant, stratified analyses showed that all Latino groups had lower odds of walking limitations if they lived in a high social cohesion neighborhood compared with low social cohesion neighborhoods. Our results suggest that neighborhood social cohesion is associated with walking limitations among diverse groups of older Latinos.
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Mueller CW, Bartlett BJ. U.S. Immigration Policy Regimes and Physical Disability Trajectories Among Mexico-U.S. Immigrants. J Gerontol B Psychol Sci Soc Sci 2019; 74:725-734. [PMID: 28369615 DOI: 10.1093/geronb/gbx026] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/26/2016] [Accepted: 03/02/2017] [Indexed: 11/14/2022] Open
Abstract
OBJECTIVES Although immigration policies have shifted dramatically over the course of U.S. history, few have examined their role as a source of health heterogeneity among immigrants. We address this gap by evaluating whether exposure to U.S. Immigration Policy Regimes (IPRs) corresponds with later-life disability disparities among Mexico-U.S. migrant women and men, and assess the degree to which observed differences may also be associated with immigration policies and occupational composition. METHOD We analyze 8 waves of data from the Hispanic Established Populations for the Epidemiologic Study of the Elderly (3,044 individuals and 14,474 observations from 1993/1994-2013). Using hierarchical linear models, we estimate trajectories of physical disability associated with gender, occupation, and IPR. RESULTS We find differences in disability trajectories by IPR. Associations are not different between men and women, and are not mediated by occupational composition. We also observe an additive effect for certain occupations among women, but not among men. DISCUSSION Findings demonstrate that exposure to different IPRs is associated with disparate disability trajectories among Mexico-U.S. migrants. Future research is needed to contextualize the role of IPRs amid other mechanisms of gendered racialization that powerfully contribute to cumulative health differences across the life course.
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Affiliation(s)
- Collin W Mueller
- Department of Sociology, Duke University, Durham, North Carolina
| | - Bryce J Bartlett
- Department of Sociology, Duke University, Durham, North Carolina
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Laditka JN, Laditka SB. Lifetime Disadvantages after Childhood Adversity: Health Problems Limiting Work and Shorter Life. THE ANNALS OF THE AMERICAN ACADEMY OF POLITICAL AND SOCIAL SCIENCE 2018; 680:259-277. [PMID: 31031404 PMCID: PMC6481962 DOI: 10.1177/0002716218795436] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/09/2023]
Abstract
We examine how childhood adversity relates to work disability and life expectancy, using 1999-2015 data from the Panel Study of Income Dynamics. We estimate the probabilities of work disability and death, adjusting for age, sex, race/ethnicity, and education in a nationally representative sample of African American, Hispanic, and white women and men. We find that people in all these groups who experienced high adversity childhoods (individuals with four or more of six adversity indicators) had significantly more work disability and shorter lives than those who experienced no adversity. These findings provide evidence that childhood adversity is associated with substantial disability, and a reduction in life expectancy of at least a decade. Childhood adversity was generally associated with more lost years of life for men than for women, and more disability for women than for men. The results are robust, even when controlling for diabetes, heart disease, depression, obesity, and sedentary behavior.
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Affiliation(s)
- James N Laditka
- Department of Public Health Sciences, University of North Carolina at Charlotte, 9201 University City Boulevard, Charlotte, NC 28223,
| | - Sarah B Laditka
- Department of Public Health Sciences, University of North Carolina at Charlotte, 9201 University City Boulevard, Charlotte, NC 28223,
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Garcia MA, Reyes AM. Physical Functioning and Disability Trajectories by Age of Migration Among Mexican Elders in the United States. J Gerontol B Psychol Sci Soc Sci 2018. [PMID: 28052929 DOI: 10.1093/geronb/gbw167.] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Objectives To address a gap in our understanding of the long-term consequences of nativity and age of migration for the health of the Mexican elderly population. Method We employ age graded latent growth curve models stratified by gender to examine the extent of physical functioning and disability, measured in terms of performance-oriented mobility assessments (POMAs) and activities of daily living (ADLs) after age 65 in a large longitudinal sample of Mexican-origin individuals. Results Self-care measured ADLs show no age of migration differences. However, physical capacity measured POMAs differ significantly for men and women by age of migration. Migrants who arrived in midlife have fewer functional limitations at age 65 but have steeper increase in POMAs with age. Discussion With a rapidly changing demographic profile that includes a large number of aging Mexican-origin immigrants, our society must implement social and health policies to ameliorate the negative health outcomes among immigrant and U.S.-born minority groups.
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Affiliation(s)
- Marc A Garcia
- Sealy Center on Aging, University of Texas Medical Branch, Galveston
| | - Adriana M Reyes
- Population Studies Center, University of Michigan, Ann Arbor
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Garcia MA, Reyes AM. Physical Functioning and Disability Trajectories by Age of Migration Among Mexican Elders in the United States. J Gerontol B Psychol Sci Soc Sci 2018; 73:1292-1302. [PMID: 28052929 PMCID: PMC6146757 DOI: 10.1093/geronb/gbw167] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/06/2016] [Accepted: 11/28/2016] [Indexed: 11/13/2022] Open
Abstract
Objectives To address a gap in our understanding of the long-term consequences of nativity and age of migration for the health of the Mexican elderly population. Method We employ age graded latent growth curve models stratified by gender to examine the extent of physical functioning and disability, measured in terms of performance-oriented mobility assessments (POMAs) and activities of daily living (ADLs) after age 65 in a large longitudinal sample of Mexican-origin individuals. Results Self-care measured ADLs show no age of migration differences. However, physical capacity measured POMAs differ significantly for men and women by age of migration. Migrants who arrived in midlife have fewer functional limitations at age 65 but have steeper increase in POMAs with age. Discussion With a rapidly changing demographic profile that includes a large number of aging Mexican-origin immigrants, our society must implement social and health policies to ameliorate the negative health outcomes among immigrant and U.S.-born minority groups.
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Affiliation(s)
- Marc A Garcia
- Sealy Center on Aging, University of Texas Medical Branch, Galveston
| | - Adriana M Reyes
- Population Studies Center, University of Michigan, Ann Arbor
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Garcia MA, Saenz JL, Downer B, Chiu CT, Rote S, Wong R. Age of Migration Differentials in Life Expectancy With Cognitive Impairment: 20-Year Findings From the Hispanic-EPESE. THE GERONTOLOGIST 2018; 58:894-903. [PMID: 28486598 PMCID: PMC6137351 DOI: 10.1093/geront/gnx062] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2016] [Indexed: 11/13/2022] Open
Abstract
Background and Objectives To examine differences in life expectancy with cognitive impairment among older Mexican adults according to nativity (U.S.-born/foreign-born) and among immigrants, age of migration to the United States. Research Design and Methods This study employs 20 years of data from the Hispanic Established Populations for the Epidemiologic Study of the Elderly to estimate the proportion of life spent cognitively healthy and cognitively impaired prior to death among older Mexican adults residing in the southwestern United States. We combine age-specific mortality rates with age-specific prevalence of cognitive impairment, defined as a Mini-Mental Status Exam score of less than 21 points to calculate Sullivan-based life table models with and without cognitive impairment in later life. Results Foreign-born Mexican immigrants have longer total life expectancy and comparable cognitive healthy life expectancy regardless of gender compared to U.S.-born Mexican-Americans. However, the foreign-born spend a greater number of years after age 65 with cognitive impairment relative to their U.S.-born counterparts. Furthermore, we document an advantage in life expectancy with cognitive impairment and proportion of years after age 65 cognitively healthy among mid-life immigrant men and women relative to early- and late-life migrants. Discussion and Implications The relationship between nativity, age of migration, and life expectancy with cognitive impairment means that the foreign-born are in more need of support and time-intensive care in late life. This issue merits special attention to develop appropriate and targeted screening efforts that reduce cognitive decline for diverse subgroups of older Mexican-origin adults as they age.
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Affiliation(s)
- Marc A Garcia
- Sealy Center on Aging, University of Texas Medical Branch, Galveston
| | - Joseph L Saenz
- University of Southern California, Davis School of Gerontology, Los Angeles
| | - Brian Downer
- Division of Rehabilitation Sciences, University of Texas Medical Branch, Galveston
| | - Chi-Tsun Chiu
- Institute of European and American Studies, Academia Sinica, Taipei, Taiwan
| | - Sunshine Rote
- University of Louisville, Kent School of Social Work, Kentucky
| | - Rebeca Wong
- Department of Preventive Medicine and Community Health, Sealy Center of Aging, University of Texas Medical Branch, Galveston
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Piedra LM, Andrade FCD, Hernandez R, Trejo L, Prohaska TR, Sarkisian CA. Let's walk! Age reattribution and physical activity among older Hispanic/Latino adults: results from the ¡Caminemos! Randomized trial. BMC Public Health 2018; 18:964. [PMID: 30075709 PMCID: PMC6090751 DOI: 10.1186/s12889-018-5850-6] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/06/2017] [Accepted: 07/13/2018] [Indexed: 12/12/2022] Open
Abstract
Background Many older Hispanics/Latinos are physically inactive and suffer the harmful health consequences associated with prolonged periods of inactivity. Negative age attributions that equate getting older with “slowing down” reinforce this inactive behavior. We implemented a community-based exercise intervention among insufficiently active older Hispanics/Latinos with a randomized trial of an attribution-retraining program, ¡Caminemos! (Let’s Walk!), and measured the effect of the program on walking behavior. Methods Five hundred and seventy-two older Hispanics/Latinos (≥60 years) were enrolled in an exercise program that randomly assigned participants to the exercise class and one of two conditions: (a) treatment (attribution retraining to dispel the notion that physical activity inevitably ceases with age) or (b) control (generic health education). Data were collected at baseline and follow-up (1, 12, and 24 months). Physical activity was determined through pedometer data and the Yale Physical Activity Survey. We also measured the intervention effects on age-expectations, self-efficacy expectations, and outcome expectations for physical activity. Mixed-effects regression models were used to determine intervention effects on prospective measures of physical activity and intrapersonal expectations. Results The sample had a mean age of 73 years (SD = 6.8) and was 77% female, and 76% of the sample reported income <$20,000. At baseline, control and treatment groups walked about 3000 steps/day. By 24 months, participants in both arms of the intervention maintained greater than 10,000 mean steps/day, but the difference between the groups was not statistically significant. In analyses adjusted for age, sex, education, income, health status, and acculturation, participants in both trial arms increased their mean numbers of steps at 12 and 24 months, with the treatment group showing a greater number of mean steps compared to the controls at 12 months. Conclusions In this group of physically inactive older Hispanics/Latinos, attribution retraining in combination with an exercise class was superior to the exercise class alone with regard to increasing walking behavior. This success was sustained at 12 months (the pre-defined primary study outcome) but not at 24 months. For older Hispanics/Latinos, enrollment in an attribution-retraining exercise program can improve an inactive lifestyle. Trial registration clinicaltrials.gov identifier: NCT00183014.
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Affiliation(s)
- Lissette M Piedra
- School of Social Work, University of Illinois at Urbana-Champaign, 1010 West Nevada St, Urbana, IL, 61801, USA.
| | - Flavia C D Andrade
- Kinesiology & Community Health, College of Applied Health Sciences, University of Illinois at Urbana-Champaign, Champaign, IL, USA
| | - Rosalba Hernandez
- School of Social Work, University of Illinois at Urbana-Champaign, 1010 West Nevada St, Urbana, IL, 61801, USA
| | - Laura Trejo
- City of Los Angeles Department of Aging, Los Angeles, CA, USA
| | - Thomas R Prohaska
- College of Health and Human Services, George Mason University, Fairfax, VA, USA
| | - Catherine A Sarkisian
- David Geffen School of Medicine at UCLA, Los Angeles, CA, USA.,VA Greater Los Angeles Geriatric Research Education and Clinical Center, Los Angeles, CA, USA
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Disability crossover: Is there a Hispanic immigrant health advantage that reverses from working to old age? DEMOGRAPHIC RESEARCH 2018. [DOI: 10.4054/demres.2018.39.7] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
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Crist JD, Montgomery ML, Pasvogel A, Phillips LR, Ortiz-Dowling EM. The association among knowledge of and confidence in home health care services, acculturation, and family caregivers' relationships to older adults of Mexican descent. Geriatr Nurs 2018; 39:689-695. [PMID: 29880443 DOI: 10.1016/j.gerinurse.2018.05.005] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2018] [Accepted: 05/18/2018] [Indexed: 12/15/2022]
Abstract
The purposes of this study were to examine the relationships among knowledge of and confidence in health care services (HHCS), acculturation, characteristics of family caregivers of Mexican descent, and differences by caregivers' relationship (spouse or adult child). A sample of Mexican-descent older adults and their caregivers was recruited (n = 74 dyads) in Arizona. Each participant completed questionnaires on knowledge, confidence, and acculturation. There were moderate but significant associations among higher Anglo Orientation with Knowledge and with Confidence. Fear of HHCS was positively associated with higher Anglo Orientation and English Language Preference; and negatively associated with Mexican Orientation and Spanish Language Preference. For Spouse caregivers, Fear of HHCS was positively correlated with higher Anglo Orientation and English Language Preference; for Offspring caregivers, Fear of HHCS was negatively correlated with Mexican Orientation and Spanish Language Preference. Results support assessing caregiver cohort and socio-cultural context to decrease HHCS use disparities by Mexican-descent caregiving families.
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Affiliation(s)
- Janice D Crist
- College of Nursing, The University of Arizona, PO Box 210203, Tucson, AZ 85721-0203.
| | | | - Alice Pasvogel
- College of Nursing, The University of Arizona, PO Box 210203, Tucson, AZ 85721-0203
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Downer B, Garcia MA, Saenz J, Markides KS, Wong R. The Role of Education in the Relationship Between Age of Migration to the United States and Risk of Cognitive Impairment Among Older Mexican Americans. Res Aging 2018; 40:411-431. [PMID: 28367726 PMCID: PMC5503795 DOI: 10.1177/0164027517701447] [Citation(s) in RCA: 20] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Abstract
Prior research indicates age of migration is associated with cognitive health outcomes among older Mexican Americans; however, factors that explain this relationship are unclear. This study used eight waves from the Hispanic Established Populations for the Epidemiologic Study of the Elderly to examine the role of education in the risk for cognitive impairment (CI) by nativity, age of migration, and gender. Foreign-born women had a higher risk for CI than U.S.-born women, regardless of age of migration. After adjusting for education, this risk remained significant only for late-life migrant women (risk ratio [RR] = 1.28). Foreign-born men who migrated at >50 had significantly higher risk for CI compared to U.S.-born men (RR = 1.33) but not significant after adjusting for education. Findings from a decomposition analysis showed education significantly mediated the association between age of migration and CI. This study highlights the importance of education in explaining the association between age of migration and CI.
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Affiliation(s)
- Brian Downer
- University of Texas Medical Branch, Galveston, TX, USA
| | | | - Joseph Saenz
- University of Texas Medical Branch, Galveston, TX, USA
| | | | - Rebeca Wong
- University of Texas Medical Branch, Galveston, TX, USA
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Collins DM, Downer B, Kumar A, Krishnan S, Li CY, Markides KS, Karmarkar AM. Impact of Multiple Chronic Conditions on Activity Limitations Among Older Mexican-American Care Recipients. Prev Chronic Dis 2018; 15:E51. [PMID: 29729133 PMCID: PMC5951156 DOI: 10.5888/pcd15.170358] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Abstract
INTRODUCTION Older Mexican Americans are living longer with multiple chronic conditions (MCCs). This has placed greater demands on caregivers to assist with basic activities of daily living (ADL) or instrumental activities of daily living (IADL). To understand the needs of older Mexican-American care recipients, we examined the impact of MCC on ADL and IADL limitations. METHODS We analyzed data from 485 Mexican American care-receiving/caregiving dyads. Selected MCCs in the analysis were diabetes, hypertension, stroke, heart disease, arthritis, emphysema/chronic obstructive pulmonary disease, cognitive impairment, depression, and cancer. Care recipients were dichotomized as having 3 or more conditions or as having 2 or fewer conditions. Three comorbidity clusters were established on the basis of the most prevalent health conditions among participants with comorbid arthritis and hypertension. These clusters included arthritis and hypertension plus: diabetes (cluster 1), cognitive impairment (cluster 2), and heart disease (cluster 3). RESULTS Care recipients with 3 or more chronic conditions (n = 314) had higher odds of having mobility limitations (OR = 1.98; 95% CI, 1.34-2.94), self-care limitations (OR = 2.53; 95% CI, 1.70-3.81), >3 ADL limitations (OR = 2.00; 95% CI, 1.28-3.17), and >3 IADL limitations (OR = 1.88; 95% CI, 1.26-2.81). All clusters had increased odds of ADL and severe ADL limitations. Of care recipients in cluster 2, those with arthritis, hypertension, and cognitive impairment had significantly higher odds of mobility limitations (OR = 2.33; 95% CI, 1.05-5.24) than those with just arthritis and hypertension. CONCLUSION MCCs were associated with more ADL and IADL limitations among care recipients, especially for those with hypertension and arthritis plus diabetes, cognitive impairment, or heart disease. These findings can assist in developing programs to meet the needs of older Mexican-American care recipients.
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Affiliation(s)
- Diane M Collins
- University of Texas Medical Branch, Department of Occupational Therapy, 301 University Blvd, 3.916 School of Health Professions, Galveston, TX 77555-1142.
- Division of Rehabilitation Sciences, University of Texas Medical Branch, Galveston, Texas
| | - Brian Downer
- Division of Rehabilitation Sciences, University of Texas Medical Branch, Galveston, Texas
| | - Amit Kumar
- Department of Health Services, Policy, and Practice, Brown University, Providence, Rhode Island
| | - Shilpa Krishnan
- Division of Physical Therapy, Department of Rehabilitation Medicine, Emory University, Atlanta, Georgia
| | - Chih-Ying Li
- Department of Occupational Therapy, University of Texas Medical Branch, Galveston, Texas
| | - Kyriakos S Markides
- Department of Preventive Medicine and Community Health, University of Texas Medical Branch, Galveston, Texas
| | - Amol M Karmarkar
- Division of Rehabilitation Sciences, University of Texas Medical Branch, Galveston, Texas
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Angel JL, Berlinger N. The Trump Administration's assault on health and social programs: potential consequences for older Hispanics. J Aging Soc Policy 2018; 30:300-315. [PMID: 29634422 PMCID: PMC10371221 DOI: 10.1080/08959420.2018.1462678] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
Abstract
Health and social welfare policy proposals put forth by the Trump administration and Republican-controlled Congress could have huge impacts on low-income groups. This paper focuses on older Hispanics, with an emphasis on the Mexican-origin population who form the largest Hispanic subgroup. A demographic portrait is presented that indicates that Mexican-origin individuals have less wealth and lower incomes than do non-Hispanic Whites. Given rising health care costs, lower use of nursing homes, and greater propensity to live with grown children, prevailing economic disadvantage has serious consequences for this population. More restrictive immigration policies aimed at limiting family reunification could have intergenerational caregiving consequences. In addition, because of labor-force disadvantages, low-income Mexican-origin adults are less likely to have private insurance compared to non-Hispanic Whites as they approach retirement. Consequently, Mexican-origin older adults tend to rely on Medicaid when eligible; in contrast, late-life migrants-who do not qualify for federally funded benefits for at least five years-and unauthorized migrants-who are excluded from federally funded benefits-have extremely limited access to safety net provisions. The potential effects of proposed cutbacks in health care financing on older Hispanics are discussed.
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Affiliation(s)
- Jacqueline L Angel
- a Department of Sociology and LBJ School of Public Affairs, The University of Texas , Austin , Texas , USA
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Laditka JN, Laditka SB. Work disability in the United States, 1968-2015: Prevalence, duration, recovery, and trends. SSM Popul Health 2018; 4:126-134. [PMID: 29349281 PMCID: PMC5769114 DOI: 10.1016/j.ssmph.2017.12.006] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/07/2017] [Revised: 12/03/2017] [Accepted: 12/23/2017] [Indexed: 01/12/2023] Open
Abstract
The United States workforce is aging. At the same time more people have chronic conditions, for longer periods. Given these trends the importance of work disability, physical or nervous problems that limit a person's type or amount of work, is increasing. No research has examined transitions among multiple levels of work disability, recovery from work disability, or trends. Limited research has focused on work disability among African Americans and Hispanics, or separately for women and men. We examined these areas using data from 30,563 adults in the 1968-2015 Panel Study of Income Dynamics. We estimated annual probabilities of work disability, recovery, and death with multinomial logistic Markov models. Microsimulations accounting for age and education estimated outcomes for African American, Hispanic, and non-Hispanic white women and men. Results from these nationally representative data suggested that the majority of Americans experience work disability during working life. Most spells ended with recovery or reduced severity. Among women, African Americans and Hispanics had less moderate and severe work disability than whites. Among men, African Americans became severely work disabled more often than whites, recovered from severe spells more often and had shorter severe spells, yet had more severe work disability at age 65. Hispanic men were more likely to report at least one spell of severe work disability than whites; they also had substantially more recovery from severe work disability, and a lower percentage of working years with work disability. Among African Americans and Hispanics, men were considerably more likely than women to have severe work disability at age 65. Work disability declined significantly across the study period for all groups. Although work disability has declined over several decades, it remains common. Results suggest that the majority of work disability spells end with recovery, underscoring the importance of rehabilitation and workplace accommodation.
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Affiliation(s)
| | - Sarah B. Laditka
- Department of Public Health Sciences, University of North Carolina at Charlotte, 9201 University City Boulevard, Charlotte, NC 28223, United States
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