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Pan C, Cao N. Dual trajectories of depression and social participation among Chinese older adults. Geriatr Nurs 2023; 53:153-161. [PMID: 37540910 DOI: 10.1016/j.gerinurse.2023.07.013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2023] [Revised: 07/15/2023] [Accepted: 07/18/2023] [Indexed: 08/06/2023]
Abstract
OBJECTIVES This study aimed to investigate the dual trajectories of social participation (SP) and depression among older adults, and explore common factors that may influence both trajectories. METHODS The study utilized data from four waves of the China Health and Retirement Longitudinal Study (CHARLS, 2011 to 2018). The dual-trajectory model was employed to estimate the dual trajectories of SP and depression. RESULTS This study identified two SP and three depression trajectories. The results revealed that the reciprocal relationship between SP and depression trajectories is confirmed in all sub-groups of the dual trajectories. Our study identified six distinct sub-groups of individuals based on their SP and depression trajectories and some commen risk factors of SP and depression trajectories. CONCLUSIONS Related intervention policies should consider the dual trajectories of SP and depression and focus on subgroups with high vulnerability, such as high depression but low SP. Additionally, attention should be given to addressing the common risk factors that underlie these trajectories.
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Affiliation(s)
- Chaoping Pan
- School of Public Health and Management, Wenzhou Medical University, Wenzhou City, Zhejiang Province, China
| | - Na Cao
- School of Public Health and Management, Wenzhou Medical University, Wenzhou City, Zhejiang Province, China; School of Public Health, Wuhan University, Wuhan City, Hubei Province, China.
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Wang K, Ortiz DV, Colón L, Sun F, Falcón L. The moderating role of everyday discrimination on the association between post-traumatic stress and loneliness among older Puerto Ricans. Aging Ment Health 2023; 27:1388-1395. [PMID: 36444946 PMCID: PMC10225478 DOI: 10.1080/13607863.2022.2149695] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/16/2022] [Accepted: 11/14/2022] [Indexed: 12/03/2022]
Abstract
OBJECTIVES This study examines the relationship between post-traumatic stress and loneliness and whether this relationship varies by perceived everyday discrimination among older Puerto Ricans. METHODS A total of 304 Puerto Ricans aged 60 and above from Wave 3 of the Boston Puerto Rican Health Study were included. Ordinary least squares regression examined the association between post-traumatic stress, perceived everyday discrimination, and loneliness. RESULTS Post-traumatic stress was significantly associated with a higher level of loneliness (β = 0.282; p < 0.001; 95% CI: 0.142, 0.423). The interaction effect between post-traumatic stress and perceived everyday discrimination on loneliness was statistically significant (β = 0.083; p < 0.05; 95% CI: 0.062, 0.230). More specifically, the positive association between post-traumatic stress and loneliness becomes more robust with the increase in perceived everyday discrimination. CONCLUSION Given an increase in population size on the U.S. mainland and migration from Puerto Rico due to natural disasters and declining economic conditions, it is essential to better understand the effect of perceived discrimination against older Puerto Ricans on the mainland United States as well as those who immigrated and stayed through older age. Outreach strategies and interventions that address perceived discrimination can help mitigate loneliness among older Puerto Ricans who experienced trauma.
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Affiliation(s)
- Kaipeng Wang
- Graduate School of Social Work, University of Denver, Denver, Colorado, USA
| | - Daniel Vélez Ortiz
- School of Social Work, Michigan State University, East Lansing, Michigan, USA
| | - Lisa Colón
- Department of Human Development, Washington State University
| | - Fei Sun
- School of Social Work, Michigan State University, East Lansing, Michigan, USA
| | - Luis Falcón
- College of Fine Arts, Humanities and Social Sciences, University of Massachusetts Lowell, Lowell, Massachusetts, USA
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Mogic L, Rutter EC, Tyas SL, Maxwell CJ, O'Connell ME, Oremus M. Functional social support and cognitive function in middle- and older-aged adults: a systematic review of cross-sectional and cohort studies. Syst Rev 2023; 12:86. [PMID: 37211612 DOI: 10.1186/s13643-023-02251-z] [Citation(s) in RCA: 8] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/17/2023] [Accepted: 05/07/2023] [Indexed: 05/23/2023] Open
Abstract
BACKGROUND Intact cognitive function is crucial for healthy aging. Functional social support is thought to protect against cognitive decline. We conducted a systematic review to investigate the association between functional social support and cognitive function in middle- and older-aged adults. METHODS Articles were obtained from PubMed, PsycINFO, Sociological Abstracts, CINAHL, and Scopus. Eligible articles considered any form of functional social support and cognitive outcome. We narratively synthesized extracted data by following the Synthesis Without Meta-Analysis (SWiM) guidelines and assessed risk of bias using the Newcastle-Ottawa Scale (NOS). RESULTS Eighty-five articles with mostly low risk-of-bias were included in the review. In general, functional social support-particularly overall and emotional support-was associated with higher cognitive function in middle- and older-aged adults. However, these associations were not all statistically significant. Substantial heterogeneity existed in the types of exposures and outcomes evaluated in the articles, as well as in the specific tools used to measure exposures and outcomes. CONCLUSIONS Our review highlights the role of functional social support in the preservation of healthy cognition in aging populations. This finding underscores the importance of maintaining substantive social connections in middle and later life. SYSTEMATIC REVIEW REGISTRATION Rutter EC, Tyas SL, Maxwell CJ, Law J, O'Connell ME, Konnert CA, Oremus M. Association between functional social support and cognitive function in middle-aged and older adults: a protocol for a systematic review. BMJ Open;10(4):e037301. https://doi.org/10.1136/bmjopen-2020-037301.
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Affiliation(s)
- Lana Mogic
- School of Public Health Sciences, Faculty of Health, University of Waterloo, 200 University Ave. W, Waterloo, ON, N2L 3G1, Canada
| | - Emily C Rutter
- School of Public Health Sciences, Faculty of Health, University of Waterloo, 200 University Ave. W, Waterloo, ON, N2L 3G1, Canada
| | - Suzanne L Tyas
- School of Public Health Sciences, Faculty of Health, University of Waterloo, 200 University Ave. W, Waterloo, ON, N2L 3G1, Canada
| | - Colleen J Maxwell
- School of Public Health Sciences, Faculty of Health, University of Waterloo, 200 University Ave. W, Waterloo, ON, N2L 3G1, Canada
| | - Megan E O'Connell
- Department of Psychology, University of Saskatchewan, 9 Campus Drive, 154 Arts, Saskatoon, SK, S7N 5A5, Canada
| | - Mark Oremus
- School of Public Health Sciences, Faculty of Health, University of Waterloo, 200 University Ave. W, Waterloo, ON, N2L 3G1, Canada.
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Huang AA, Huang SY. Hospitalized COVID-19 patients with diabetes have an increased risk for pneumonia, intensive care unit requirement, intubation, and death: A cross-sectional cohort study in Mexico in 2020. Health Sci Rep 2023; 6:e1222. [PMID: 37081996 PMCID: PMC10112272 DOI: 10.1002/hsr2.1222] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2023] [Revised: 04/06/2023] [Accepted: 04/07/2023] [Indexed: 04/22/2023] Open
Abstract
Background Diabetes mellitus is a chronic health condition that has been linked with an increased risk of severe illness and mortality from COVID-19. In Mexico, the impact of diabetes on COVID-19 outcomes in hospitalized patients has not been fully quantified. Understanding the increased risk posed by diabetes in this patient population can help healthcare providers better allocate resources and improve patient outcomes. Objective The objective of this study was to quantify the extent outcomes (pneumonia, intensive care unit [ICU] stay, intubation, and death) are worsened in diabetic patients with COVID-19. Methods Between April 14, 2020 and December 20, 2020 (last accessed), data from the open-source COVID-19 database maintained by the Mexican Federal Government were examined. Utilizing hospitalized COVID-19 patients with complete outcome data, a retrospective cohort study (N = 402,388) was carried out. In relation to COVID-19, both univariate and multivariate logistic regression were used to investigate the effect of diabetes on specific outcomes. Results The analysis included 402,388 adults (age >18) with confirmed hospitalized COVID-19 cases with mean age 46.16 (standard deviation = 15.55), 214,161 (53%) male. The outcomes delineated included pneumonia (N = 88,064; 22%), ICU requirement (N = 23,670; 6%), intubation (N = 23,670; 6%), and death (N = 55,356; 14%). After controlling for confounding variables diabetes continued to be an independent risk factor for both pneumonia (odds ratio [OR]: 1.8, confidence interval [CI]: 1.76-1.84, p < 0.01), ICU requirement (OR: 1.09, CI: 1.04-1.14, p < 0.01), intubation (OR: 1.07, CI: 1.04-1.11, p < 0.01), and death (OR: 1.88, CI: 1.84-1.93, p < 0.01) in COVID-19 patients. Conclusions According to the study, all outcomes (pneumonia, ICU requirement, intubation, and death) were greater among hospitalized individuals with diabetes and COVID-19. Additional study is required to acquire a better understanding of how diabetes affects COVID-19 outcomes and to develop practical mitigation techniques for the risk of severe sickness and complications in this particular patient population.
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Affiliation(s)
- Alexander A. Huang
- Department of Statistics and Data ScienceCornell UniversityIthacaNew YorkUSA
- Northwestern University Feinberg School of MedicineChicagoIllinoisUSA
| | - Samuel Y. Huang
- Department of Statistics and Data ScienceCornell UniversityIthacaNew YorkUSA
- Virginia Commonwealth University School of MedicineRichmondUSA
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Chen S, Zhang H, Underwood BR, Wang D, Chen X, Cardinal RN. Trends in Gender and Racial/Ethnic Disparities in Physical Disability and Social Support Among U.S. Older Adults With Cognitive Impairment Living Alone, 2000-2018. Innov Aging 2023; 7:igad028. [PMID: 37223006 PMCID: PMC10202553 DOI: 10.1093/geroni/igad028] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2022] [Indexed: 05/25/2023] Open
Abstract
Background and Objectives Informal care is the primary source of support for older adults with cognitive impairment, yet is less available to those who live alone. We examined trends in the prevalence of physical disability and social support among older adults with cognitive impairment living alone in the United States. Research Design and Methods We analyzed 10 waves of data from the U.S. Health and Retirement Survey spanning 2000-2018. Eligible people were those aged ≥65, having cognitive impairment, and living alone. Physical disability and social support were measured via basic and instrumental activities of daily living (BADLs, IADLs). We estimated linear temporal trends for binary/integer outcomes via logistic/Poisson regression, respectively. Results A total of 20 070 participants were included. Among those reporting BADL/IADL disability, the proportion unsupported for BADLs decreased significantly over time (odds ratio [OR] 0.98, 95% confidence interval [CI] 0.97-0.99), and the proportion unsupported for IADLs increased (OR = 1.02, CI 1.01-1.04). Among those receiving IADL support, the number of unmet IADL support needs increased significantly over time (relative risk [RR] 1.04, CI 1.03-1.05). No gender disparities were found for these trends. Over time, Black respondents had a relatively increasing trend of being BADL-unsupported (OR = 1.03, CI 1.0-1.05) and Hispanic and Black respondents had a relatively increasing trend in the number of unmet BADL needs (RR = 1.02, CI 1.00-1.03; RR = 1.01, CI 1.00-1.02, respectively), compared to the corresponding trends in White respondents. Discussion and Implications Among lone-dwelling U.S. older adults with cognitive impairment, fewer people received IADL support over time, and the extent of unmet IADL support needs increased. Racial/ethnic disparities were seen both in the prevalence of reported BADL/IADL disability and unmet BADL/IADL support needs; some but not all were compatible with a reduction in disparity over time. This evidence could prompt interventions to reduce disparities and unmet support needs.
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Affiliation(s)
- Shanquan Chen
- Department of Psychiatry, University of Cambridge, Cambridge, UK
- International Centre for Evidence in Disability, London School of Hygiene & Tropical Medicine, London WC1E 7HT, UK
| | - Huanyu Zhang
- Shenzhen Research Institute, The Chinese University of Hong Kong, Shenzhen, China
| | - Benjamin R Underwood
- Department of Psychiatry, University of Cambridge, Cambridge, UK
- Cambridgeshire & Peterborough NHS Foundation Trust, Fulbourn, Cambridge, UK
| | - Dan Wang
- Faculty of Health Sciences, Ontario Tech University, Oshawa, Ontario, Canada
- Centre for Disability Prevention and Rehabilitation, Ontario Tech University, Oshawa, Ontario, Canada
| | - Xi Chen
- School of Public Health, Yale University, New Haven, Connecticut, USA
| | - Rudolf N Cardinal
- Department of Psychiatry, University of Cambridge, Cambridge, UK
- Cambridgeshire & Peterborough NHS Foundation Trust, Fulbourn, Cambridge, UK
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Tseng MY, Liang J, Yang CT, Wang JS, Wu CC, Cheng HS, Chen CY, Lin YE, Shyu YIL. Trajectories of social support are associated with health outcomes and depressive symptoms among older Taiwanese adults with diabetes following hip-fracture surgery. Int J Geriatr Psychiatry 2022; 37. [PMID: 36371613 DOI: 10.1002/gps.5842] [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] [Received: 01/10/2022] [Accepted: 10/29/2022] [Indexed: 11/09/2022]
Abstract
OBJECTIVE This study examined trajectories of social support and their relationships with health outcomes over 2 years post hip-fracture surgery for older adults with diabetes mellitus (DM). METHODS This was a secondary analysis of data derived from a clinical trial, which included 158 hip fractured older adults with DM who had completed the Medical Outcomes Study Social Support Survey at 1-, 12-, 18-, and 24-months following hospital discharge. Health outcomes for self-care, physical and nutritional status, mental health, and depression were assessed at 3-month intervals up to 24-months after hospital discharge. Trajectories of social support were derived with latent class analysis while hierarchical linear models were employed to assess the associations of social-support trajectory with health outcomes. RESULTS Four social-support trajectories were derived for persons with DM following hip-fracture surgery: poor and declining (n = 18, 11.4%), moderate and stable (n = 29, 18.4%), high but declining (n = 34, 21.5%), and high and stable (n = 77, 48.7%). Relative to those in the poor and declining group, participants in the high and stable trajectory group performed better in Activities of Daily Living and quadriceps muscle power, had better mental Health-Related Quality of Life and nutritional status, and had fewer depressive symptoms. These differences persisted over the 2 years following hospital discharge. CONCLUSIONS These results suggest social support for persons with DM should be continually assessed following hip-fracture surgery.
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Affiliation(s)
- Ming-Yueh Tseng
- Post-Baccalaureate Program in Nursing, College of Nursing, Asia University, Taichung, Taiwan
| | - Jersey Liang
- Department of Health Management and Policy, School of Public Health, University of Michigan, Ann Arbor, Michigan, USA.,Healthy Aging Research Center, Chang Gung University, Taoyuan, Taiwan
| | - Ching-Tzu Yang
- School of Nursing, College of Medicine, Chang Gung University, Taoyuan, Taiwan
| | - Jong-Shyan Wang
- Healthy Aging Research Center, Chang Gung University, Taoyuan, Taiwan.,Graduate Institute of Rehabilitation Science, College of Medicine, Chang Gung University, Taoyuan, Taiwan
| | - Chi-Chuan Wu
- Department of Orthopedic Surgery, Linkou Chang Gung Memorial Hospital, Taoyuan, Taiwan
| | - Huey-Shinn Cheng
- Department of Internal Medicine, Linkou Chang Gung Memorial Hospital, Taoyuan, Taiwan
| | - Ching-Yen Chen
- Department of Psychiatry, Keelung Chang Gung Memorial Hospital, Keelung, Taiwan
| | - Yueh-E Lin
- Department of Nursing, Linkou Chang Gung Memorial Hospital, Taoyuan, Taiwan
| | - Yea-Ing L Shyu
- Healthy Aging Research Center, Chang Gung University, Taoyuan, Taiwan.,School of Nursing, College of Medicine, Chang Gung University, Taoyuan, Taiwan.,Department of Nursing, Kaohsiung Chang Gung Memorial Hospital, Kaohsiung, Taiwan.,Department of Gerontology and Health Care Management, Chang Gung University of Science and Technology, Taoyuan, Taiwan.,Dementia Center, Department of Neurology, Linkou Chang Gung Memorial Hospital, Taoyuan, Taiwan
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Abstract
This article describes the public health impact of Alzheimer's disease (AD), including incidence and prevalence, mortality and morbidity, use and costs of care, and the overall impact on family caregivers, the dementia workforce and society. The Special Report discusses consumers' and primary care physicians' perspectives on awareness, diagnosis and treatment of mild cognitive impairment (MCI), including MCI due to Alzheimer's disease. An estimated 6.5 million Americans age 65 and older are living with Alzheimer's dementia today. This number could grow to 13.8 million by 2060 barring the development of medical breakthroughs to prevent, slow or cure AD. Official death certificates recorded 121,499 deaths from AD in 2019, the latest year for which data are available. Alzheimer's disease was officially listed as the sixth-leading cause of death in the United States in 2019 and the seventh-leading cause of death in 2020 and 2021, when COVID-19 entered the ranks of the top ten causes of death. Alzheimer's remains the fifth-leading cause of death among Americans age 65 and older. Between 2000 and 2019, deaths from stroke, heart disease and HIV decreased, whereas reported deaths from AD increased more than 145%. More than 11 million family members and other unpaid caregivers provided an estimated 16 billion hours of care to people with Alzheimer's or other dementias in 2021. These figures reflect a decline in the number of caregivers compared with a decade earlier, as well as an increase in the amount of care provided by each remaining caregiver. Unpaid dementia caregiving was valued at $271.6 billion in 2021. Its costs, however, extend to family caregivers' increased risk for emotional distress and negative mental and physical health outcomes - costs that have been aggravated by COVID-19. Members of the dementia care workforce have also been affected by COVID-19. As essential care workers, some have opted to change jobs to protect their own health and the health of their families. However, this occurs at a time when more members of the dementia care workforce are needed. Average per-person Medicare payments for services to beneficiaries age 65 and older with AD or other dementias are almost three times as great as payments for beneficiaries without these conditions, and Medicaid payments are more than 22 times as great. Total payments in 2022 for health care, long-term care and hospice services for people age 65 and older with dementia are estimated to be $321 billion. A recent survey commissioned by the Alzheimer's Association revealed several barriers to consumers' understanding of MCI. The survey showed low awareness of MCI among Americans, a reluctance among Americans to see their doctor after noticing MCI symptoms, and persistent challenges for primary care physicians in diagnosing MCI. Survey results indicate the need to improve MCI awareness and diagnosis, especially in underserved communities, and to encourage greater participation in MCI-related clinical trials.
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Wei K, Liu Y, Yang J, Gu N, Cao X, Zhao X, Jiang L, Li C. Living arrangement modifies the associations of loneliness with adverse health outcomes in older adults: evidence from the CLHLS. BMC Geriatr 2022; 22:59. [PMID: 35038986 PMCID: PMC8764854 DOI: 10.1186/s12877-021-02742-5] [Citation(s) in RCA: 23] [Impact Index Per Article: 11.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2021] [Accepted: 12/16/2021] [Indexed: 01/02/2023] Open
Abstract
Background Although it has been suggested that loneliness is a risk factor for adverse health outcomes, living arrangement may confound the association. This study aimed to investigate whether the associations of loneliness with adverse health outcomes differ in community-dwelling older adults according to different living arrangements. Methods In the 2008/2009 wave of Chinese Longitudinal Healthy Longevity Survey, 13,738 community-dwelling older adults (≥65 years) were included for analyses. Living arrangements and loneliness were assessed. Health outcomes including cognitive and physical functions were assessed using MMSE, ADL/IADL scales and Frailty Index in the 2008/2009 and 2011/2012 waves; mortality was assessed in the 3-year follow-up from 2008/2009 to 2011/2012. The effect modificaitons of loneliness on adverse health outcomes by living arrangements were estimated using logistic regression or Cox proportional hazards regression models. Results Living alone older adults were significantly more likely to be lonely at baseline (52% vs 29.5%, OR = 1.90, 95% CI = 1.67–2.16, P < 0.001), compared with those living with others. Loneliness in older adults was a significant risk factor for prevalent cognitive impairment and frailty, and 3-year mortality, especially among those who lived with others (OR = 1.32, 95% CI = 1.15–1.52, P < 0.001; OR = 1.39, 95% CI = 1.24–1.57, P < 0.001; HR = 1.14, 95% CI = 1.05–1.24, P = 0.002, respectively). In contrast, among the living alone older adults, loneliness was only significantly associated with higher prevalence of frailty (OR = 1.42, 95% CI = 1.07–1.90, P = 0.017). Living arrangement significantly modified the associations of loneliness with prevalent cognitive impairment and 3-year mortality (P values for interaction = 0.005 and 0.026, respectively). Conclusions Living arrangement modifies the associations of loneliness with adverse health outcomes in community-dwelling older adults, and those who lived with others but felt lonely had worse cognitive and physical functions as well as higher mortality. Special attention should be paid to this population and more social services should be developed to reduce adverse health outcomes, in order to improve their quality of life and promote successful aging. Supplementary Information The online version contains supplementary material available at 10.1186/s12877-021-02742-5.
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Affiliation(s)
- Kai Wei
- Shanghai Key Laboratory of Psychotic Disorders, Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, 600 South Wanping Road, Shanghai, 200030, People's Republic of China
| | - Yong Liu
- Shanghai Key Laboratory of Psychotic Disorders, Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, 600 South Wanping Road, Shanghai, 200030, People's Republic of China
| | - Junjie Yang
- Shanghai Key Laboratory of Psychotic Disorders, Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, 600 South Wanping Road, Shanghai, 200030, People's Republic of China
| | - Nannan Gu
- Shanghai Key Laboratory of Psychotic Disorders, Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, 600 South Wanping Road, Shanghai, 200030, People's Republic of China
| | - Xinyi Cao
- Shanghai Key Laboratory of Psychotic Disorders, Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, 600 South Wanping Road, Shanghai, 200030, People's Republic of China
| | - Xudong Zhao
- Shanghai Key Laboratory of Psychotic Disorders, Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, 600 South Wanping Road, Shanghai, 200030, People's Republic of China
| | - Lijuan Jiang
- Shanghai Key Laboratory of Psychotic Disorders, Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, 600 South Wanping Road, Shanghai, 200030, People's Republic of China
| | - Chunbo Li
- Shanghai Key Laboratory of Psychotic Disorders, Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, 600 South Wanping Road, Shanghai, 200030, People's Republic of China. .,Institute of Psychology and Behavioral Science, Shanghai Jiao Tong University, Shanghai, 200030, People's Republic of China. .,CAS Center for Excellence in Brain Science and Intelligence Technology (CEBSIT), Chinese Academy of Science, Shanghai, People's Republic of China. .,Brain Science and Technology Research Center, Shanghai Jiao Tong University, Shanghai, People's Republic of China.
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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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