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

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.

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

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.

scholarly journals Documentation of Dementia as a Cause of Death Among Mexican-American Decedents With Dementia

2021 ◽  
Vol 5 (Supplement_1) ◽  
pp. 59-60
Author(s):  
Brian Downer ◽  
Lin-Na Chou ◽  
Soham Al Snih ◽  
Cheyanne Barba ◽  
Yong-Fang Kuo ◽  
...  
Keyword(s):  
Cause Of Death ◽  
Mexican Americans ◽  
Mexican American ◽  
Hospice Care ◽  
Healthcare Resource ◽  
Epidemiologic Study ◽  
The Elderly ◽  
Medical Specialist ◽  
Physician Visits ◽  
Lower Odds

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.

Spirituality, health and well-being in the elderly

2018 ◽  
Vol 30 (12) ◽  
pp. 1741-1742 ◽  
Author(s):  
Orestes V. Forlenza ◽  
Homero Vallada
Keyword(s):  
Social Support ◽  
Older Adults ◽  
Well Being ◽  
The Elderly ◽  
Theories Of Aging ◽  
Goal Adjustment ◽  
Flexible Goal Adjustment ◽  
Health And Well Being ◽  
Daily Spiritual Experience Scale

Bailly et al. (2018) examined the trajectory of spirituality in a cohort of 567 non-institutionalized older adults living in Tours, France, during a period of five years. The measurements for spirituality (Daily Spiritual Experience Scale, DES), social support (Satisfaction with Social Support subscale of the Duke Social Support Index), and accommodative tendencies (Flexible Goal Adjustment) were longitudinally collected at three time points (2007, 2009, and 2012). The results of the study confirmed some expected observations, such as higher levels of spirituality among religious older adults when compared with the ones without religion, and older women reporting higher levels of spirituality than older men. But the most interesting finding was the observation that the measured levels of spirituality among older adults remained stable during this five-year period. Based on a growing number of studies and theories of aging suggesting that the levels of spirituality increases during a person's lifetime, one would expect an increase in the levels of spirituality along the study follow-up. The authors, however, interpreted the stable level of spirituality informed by the participants as having already reached a relatively high mean rating score of spirituality at baseline. From the beginning of the trail, many participants expressed self-contentment and reported having found meaning in their lives. Moreover, the responders had, in general, more years of education than expected for people in their age group, lived at home independently with a good self-health evaluation, had relatively fewer diseases, and a good perception of financial satisfaction; these characteristics perhaps make this group not representative of the French general population in the same age bracket.

scholarly journals A 20-YEAR COHORT STUDY OF LIVING ARRANGEMENTS AND COGNITIVE DECLINE IN THE MEXICAN AMERICAN POPULATION

2019 ◽  
Vol 3 (Supplement_1) ◽  
pp. S712-S712
Author(s):  
Phillip A Cantu
Keyword(s):  
Social Support ◽  
Cognitive Decline ◽  
Living Arrangements ◽  
Mexican Americans ◽  
Independent Living ◽  
Mexican American ◽  
Living Arrangement ◽  
Growth Mixture Modeling ◽  
The Elderly ◽  
Community Based Interventions

Abstract Backgrounds/Objectives: The prevalence of dementia in the elderly Latino population is expected to significantly increase from around 200,000 cases in 2000 to as many as 1.3 million cases in 2050. This demographic trend has important consequences for options in care and living arrangements. Very little is known about how of cognitive impairment trajectories co-vary with support available to Mexican Americans. We examine the relationship between living arrangements and the social support of individuals with dementia. Methods: Using data from nine waves from the 23 years of the Hispanic EPESE (n=3,952), we examine trajectories of cognitive functioning and family and social support. We first describe the change in Mini Mental Status Examination (MMSE) scores for survivors from Wave 1 (1993/1994) to Wave 9 (2015/2016), n=255. Growth Mixture Modeling (GMM) is then used to assess how changes in MMSE scores are distributed among living arrangements for individuals living independently compared to household extension (living with others) using the full sample. Results: Analyses reveal different trajectories in MMSE score. 12% (n=27) of the sample had no decrease, while the remaining (88%) were split between moderate decline (60% n=136, 1-10 point decline in MMSE) and severe decline (28% n=62 >10 point decline In MMSE). Changes in living arrangement over the same period show that 89% of individuals who move from independent living into extended household experienced cognitive decline. Conclusions: This study provides new information on how cognitive trajectories are associated with living arrangements. We discuss implications for improving community-based interventions for Latino family caregivers.

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

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.

scholarly journals Sport, physical activity and social health in older adults. Caring with technology in the COVID-19 pandemic

2021 ◽  
pp. 101269022110456
Author(s):  
Ivana Matteucci
Keyword(s):  
Physical Activity ◽  
Social Support ◽  
Older Adults ◽  
Social Networks ◽  
The Elderly ◽  
Social Health ◽  
Short Version ◽  
The Social ◽  
Communications Technologies ◽  
The Impact

The aim of this paper was to photograph this precise moment in history, focusing on the situation of older adults during the COVID-19 health emergency in Northern Italy. In particular, we analysed the relationship between social networks and social support, sport and recreational activity, and the use of communications technologies in December 2020. We investigated and discussed such use of technologies, wondering if and how it helped to compensate for the diminishment in social health, usually gained trough social interactions and the practice of sport and physical activity. We examined how reduction of mobility, social distancing and isolation measures imposed by the government to reduce the spread of COVID-19, affected the living conditions of the older adults, in particular their social health, and the level of sport and physical activity they were engaged in. We collected data through interviews with the subjects, assessing their social networks, the perceived social support provided by their family members, friends and caregivers, and the level of sport and physical activity they were engaged in. Moreover, we analysed the impact of technological communications devices, which were employed to help older adults to maintain their relationships with the outside world and to preserve their active life. The interview questions were formulated based on the Lubben Social Network Scale-Revised (LSNS-R), the short version of the Social Support List (SSL12-I) for the elderly and the Physical Activity Scale for the Elderly (PASE). A relationship was found between the social health related to physical activity of the older adults subjects during the COVID-19 emergency and the use of communications technologies, which played a role in mitigating the impact of the crisis on their social health by helping them to keep physically and socially active.

Age Trajectories of Physical Health Among Older Adults of Mexican Descent: Implications of Immigrant Status, Age at Immigration, and Gender

2017 ◽  
Vol 31 (1) ◽  
pp. 3-36 ◽  
Author(s):  
Maria A. Monserud
Keyword(s):  
Older Adults ◽  
Physical Health ◽  
Chronic Conditions ◽  
Epidemiologic Study ◽  
The Elderly ◽  
Descent Method ◽  
Mexican Descent ◽  
Immigrant Status ◽  
Growth Curve Models ◽  
And Gender

Objective: This study examines consequences of immigrant status, age at immigration, and gender on age trajectories of activities of daily living (ADL) limitations and chronic conditions among older adults of Mexican descent. Method: This research draws on 7 waves of the Hispanic Established Populations for the Epidemiologic Study of the Elderly and employs growth curve models. Results: All men had similar age trajectories of ADL limitations, regardless of immigrant status and age at immigration. All women experienced steeper increases in ADL limitations, although U.S.-born women and those who immigrated by age 19 had lower initial levels. Men who immigrated between ages 20 and 49 had steeper increases in chronic conditions, despite lower initial levels. U.S.-born women and those women who immigrated by age 50 had more chronic conditions at age 65. Discussion: This study highlights the multidimensional nature of physical health by demonstrating that immigrant status-gender disparities can vary by the health outcome examined.

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