Vision Impairment and Frailty among Older Mexican Americans: Findings from the Hispanic Established Population Epidemiologic Study of the Elderly

Abstract There is lack of data on the frequency and correlates of dementia being documented as a cause of death in Hispanic populations. We investigated characteristics associated with dementia as a cause of death among Mexican-American decedents diagnosed with dementia. Data came from the Hispanic Established Populations for the Epidemiologic Study of the Elderly, Medicare claims files, and the National Death Index. Of the 744 decedents diagnosed with dementia before death, 26.9% had dementia documented as a cause of death. More health comorbidities (OR=0.38, 95% CI=0.25-0.57), older age at death (OR=1.05, 95% CI=1.01-1.08), and longer dementia duration (OR=1.09, 95% CI=1.03-1.16) were associated with dementia as a cause of death. In the last year of life, any ER admission with (OR=0.56, 95% CI=0.32-0.98) or without (OR=0.31, 95% CI=0.14-0.70) a hospitalization, more physician visits (OR=0.95, 95% CI=0.92-0.98) and seeing a medical specialist (OR=0.41, 95% CI=0.24-0.70) were associated with lower odds for dementia as a cause of death. In the last 30-days of life, any hospitalization with an ICU stay (OR=0.57, 95% CI=0.37-0.88) and ER admission with (OR=0.58, 95% CI=0.40-0.84) or without (OR=0.48, 95% CI=0.25-0.94) a hospitalization were associated with lower odds for dementia as a cause of death. Receiving hospice care in the last 30-days of life was associated with 2.09 (95% CI=1.38-3.16) higher odds for dementia as a cause of death. The possible under-documentation of dementia as a cause of death on death certificates may result in underestimation of healthcare resource need of dementia care for Mexican-Americans.

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ROLE OF SOCIAL DETERMINANTS IN ENROLLMENT AND DISENROLLMENT IN MEDICARE INSURANCE PLANS IN OLDER MEXICAN AMERICANS

Innovation in Aging ◽

10.1093/geroni/igz038.2081 ◽

2019 ◽

Vol 3 (Supplement_1) ◽

pp. S563-S563

Author(s):

Amit Kumar ◽

Maricruz Rivera-Hernandez ◽

Lin-Na Chou ◽

Amol Karmarkar ◽

Yong-Fang Kuo ◽

...

Keyword(s):

Social Support ◽

Older Adults ◽

Mexican Americans ◽

Epidemiologic Study ◽

The Elderly ◽

Fee For Service ◽

Clinical Factor ◽

Medical Risk ◽

Medicare Data ◽

Dual Eligible

Abstract Objective: The objective of this study is to examine the association between social-medical risk factor with disenrollment from Medicare Fee-for-Service (FFS) and enrollment in a Medicare Advantage (MA) plan in Older Mexican Americans. Methods: The sample included older adults participating in the Hispanic Established Populations for the Epidemiologic Study of the Elderly linked with Medicare data. We used logistic regression to estimate odds ratios (OR) for the association of each sociodemographic and clinical factor with insurance plan switching. Results: FFS enrollees were more likely to speak Spanish, less educated, lower income, disability, and be dual eligible compared to MA enrollees. At 2-year follow up, older adults with social support had higher odds of switching from FFS to MA after controlling for all covariates (OR; 1.73, 95% CI: 1.11-2.69). Conclusion: Having social support from family and the community was strongly associated with disenrollment from FFS and transition to an MA plan.

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Self-Reported Sleep Characteristics and Mortality in Older Adults of Mexican Origin: Results from the Hispanic Established Population for the Epidemiologic Study of the Elderly

Journal of the American Geriatrics Society ◽

10.1111/j.1532-5415.2012.04144.x ◽

2012 ◽

Vol 60 (10) ◽

pp. 1906-1911 ◽

Cited By ~ 6

Author(s):

Bret T. Howrey ◽

M. Kristen Peek ◽

Mukaila A. Raji ◽

Laura A. Ray ◽

Kenneth J. Ottenbacher

Keyword(s):

Older Adults ◽

Epidemiologic Study ◽

The Elderly ◽

Mexican Origin ◽

Established Population

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Documentation of Dementia as a Cause of Death Among Mexican-American Decedents Diagnosed with Dementia

Journal of Alzheimer s Disease ◽

10.3233/jad-210361 ◽

2021 ◽

pp. 1-10

Author(s):

Brian Downer ◽

Lin-Na Chou ◽

Soham Al Snih ◽

Cheyanne Barba ◽

Yong-Fang Kuo ◽

...

Keyword(s):

Older Adults ◽

Cause Of Death ◽

Mexican Americans ◽

Mexican American ◽

Hospice Care ◽

Epidemiologic Study ◽

The Elderly ◽

High Risk Population ◽

Physician Visits ◽

Lower Odds

Background: Hispanic older adults are a high-risk population for Alzheimer’s disease and related dementias (ADRD) but are less likely than non-Hispanic White older adults to have ADRD documented as a cause of death on a death certificate. Objective: To investigate characteristics associated with ADRD as a cause of death among Mexican-American decedents diagnosed with ADRD. Methods: Data came from the Hispanic Established Populations for the Epidemiologic Study of the Elderly, Medicare claims, and National Death Index. Results: The final sample included 853 decedents diagnosed with ADRD of which 242 had ADRD documented as a cause of death. More health comorbidities (OR = 0.40, 95% CI = 0.28–0.58), older age at death (OR = 1.18, 95% CI = 1.03–1.36), and longer ADRD duration (OR = 1.08, 95% CI = 1.03–1.14) were associated with ADRD as a cause of death. In the last year of life, any ER admission without a hospitalization (OR = 0.45, 95% CI = 0.22–0.92), more physician visits (OR = 0.96, 95% CI = 0.93–0.98), and seeing a medical specialist (OR = 0.46, 95% CI = 0.29–0.75) were associated with lower odds for ADRD as a cause of death. In the last 30 days of life, any hospitalization with an ICU stay (OR = 0.55, 95% CI = 0.36–0.82) and ER admission with a hospitalization (OR = 0.67, 95% CI = 0.48–0.94) were associated with lower odds for ADRD as a cause of death. Receiving hospice care in the last 30 days of life was associated with 1.98 (95% CI = 1.37–2.87) higher odds for ADRD as a cause of death. Conclusion: Under-documentation of ADRD as a cause of death may reflect an underestimation of resource needs for Mexican-Americans with ADRD.

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Understanding Transitions in IADL and Their Consequences for Cognitive Impairment Among Older Mexican Americans

Innovation in Aging ◽

10.1093/geroni/igaa057.1070 ◽

2020 ◽

Vol 4 (Supplement_1) ◽

pp. 333-334

Author(s):

Jiwon Kim ◽

Jacqueline Angel ◽

Sunshine Rote

Keyword(s):

Cognitive Impairment ◽

Mexican Americans ◽

Oldest Old ◽

Epidemiologic Study ◽

The Elderly ◽

Cognitive Frailty ◽

Transition Analysis ◽

Socioeconomic Resources ◽

Iadl Disability ◽

Over Time

Abstract Mexican Americans tend to live longer lives than other ethnic groups, but it remains unclear how this trend influences the trajectory of disability and its consequences for cognitive frailty. Building on previous research, we assess transitions in IADL among the oldest old. We use data from three waves of the Hispanic Established Population of the Epidemiologic Study of the Elderly (H-EPESE) to investigate trajectories of IADL disability as individuals’ age into their 80s and 90s, a period of the life course with much higher rates of morbidity and decreasing socioeconomic resources. The H-EPESE is a benchmark longitudinal cohort study based on an original sample of 3,050 Mexican-Americans aged 65 and older in the Southwestern United States. Our modeling approach estimates transitions in patterns of IADL employing the Latent Transition Analysis (LTA). Results revealed three heterogeneous latent classes: high IADLs, difficulty in transportation and mobility, and low IADLs. Those with high IADLs tended to remain in the same class over time. Individuals having difficulty in transportation and mobility tended to stay in the same class or transfer to high IADLs, whereas those with overall low IADLs transferred to either the same class or to difficulty in transportation and mobility. Additional analysis revealed that cognitive impairment was a significant predictor of instrumental disability over time. Furthermore, females were more likely than males to belong to difficulty in transportation or mobility class than to the low IADL class. Our results highlight the long term consequences of cognitive decline on IADL limitations.

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